How Anxiety Can Help

How Anxiety Can Help

Never before, in recent history, at least, has it been so important to address issues of mental health, particularly anxiety, within synagogue settings. Because let’s face it, we’re all reeling and we’re searching for answers. I’m not going to give you those answers today. I’m not going to make you less anxious. I don’t know what the flyer said, but I will not give you any coping skills. I don’t have any tools to reduce your intense feelings of panic. No tools, tricks, tips, nothing.

I have a different approach to dealing with anxiety. It’s one that I think is going to be better than any anti-anxiety strategy or recommendation or even meds that you might have. It will probably run counter to many of the things that you’ve heard about anxiety, and many of the things you strive for with your own anxiety.

So, allow me to explain. At the start of the pandemic, I completely panicked, because I’m a clinical psychologist, and I have my role at McLean Hospital. In addition to that, though, I have an organization called the Center for Anxiety, centerforanxiety.org. We have four offices in New York, two offices in Massachusetts, and one in Princeton, New Jersey. And at that time, we had 500 patients. Now we have over a thousand. And we had to move every single one of those patients to telehealth within just two weeks – good luck!

So, of course, I was worried for myself, because I don’t know what’s going to happen. I also have an autoimmune condition, so I was trying to protect myself from this virus that everyone’s freaking out about. I was worried about my family and my kids.

But most of all, I was terrified for my patients, because there are these early reports coming out about anxiety and depression and suicidality and self-injury going through the roof. And here I have 500 patients. I’m moving every one of them to telehealth, and I’m not going to be able to see them with my staff. This is a huge liability, and a huge risk to these wonderful people who we’re trying to service.

 I was shocked at what ended up happening. The patients in our program who had already been in treatment before March 2020, as a group, did not experience an uptick in anxiety at any point during the pandemic at all. If you compare those people to individuals who were not in treatment, in fact, they did better than the general population. If you were in my clinic prior to March 2020 – January, February, March – and went through it all, you would not have had – apparently, statistically – an increase in anxiety. These findings were so shocking.

We published a paper on studying these effects on 764 patients. There were four stages: one was before January 2020; from January to March 2020; from April through December 2020; and then the last was after January 1, 2021. We were assessing for anxiety at every single session that we met people, so there were thousands of measurements with all of these groups. We used multi-level modeling to do this; it wasn’t just a pre/post comparison. The stats were solid. It didn’t matter when you started treatment; all four groups had significant anxiety at the beginning, which tapered down a little bit and then went down towards the end. None of them had an increase during the pandemic.

The American Culture Around Anxiety

So, I learned a really important lesson, and it’s changed my relationship with anxiety forever. And it’s the message of my book, and it’s the message I want to share with you today, which is that we need to stop trying to get rid of anxiety. We need to learn to embrace it and to use it constructively. We need to learn to thrive with our anxiety, to use it in a positive way, and to stop trying to get rid of it.

So, let’s step back a little bit. Over the past several decades, we have seen a substantial increase in emotional, mental, behavioral problems, issues, in our society. It is getting really bad. We are beyond just anxious – American society is emotionally, behaviorally dysfunctional, frankly.

During the 2010s, there was a 50% to 70% increase in mental distress, especially among young adults and teens. By 2019, 19.1% of the population, 50 million people on an annual basis, had a certifiable anxiety disorder warranting medical attention, and significant distress or impairment because of anxiety. And nearly 40% of the population had an anxiety disorder at any point. And all that is before COVID happened.

This trend did not just start in the last couple of years. The rates have shot up by 25% among adults, and 50% among kids and teens. That means that when you walk out of this room today, out of the next 20 people that you bump into, 10 of them have significant anxiety. And if it’s a group of teenagers, it’s 15. Well, 14 out of 20. My offices are busy, to say the least.

And no, we’re not just diagnosing more – yes, we are, but it’s not just about diagnosis. There are objective measures that something is very wrong, like the suicide rate, which is the second leading cause of death for all individuals under age 34 in this country, including 10-year-old children. Ten-year-old kids – that’s the second leading cause of death.

Among pre-teenagers, 10% are engaging in self-injury, harming themselves. We ‘re talking about  10, 11, 12-year-old kids – in a class of 30 kids, three or four are harming themselves, and that’s pretty significant. Anxiety and depression are the #1 cause of going on disability benefits in this country.

 But I think here’s the most shocking statistic, which is that healthy American kids today are more anxious than hospitalized psychiatry inpatients from the 1950’s. People who were institutionalized in McLean Hospital during the 1950s had less anxiety than your typical child today. In America, something has radically changed in the way that we feel.

A Peculiarly American Problem?

What’s really interesting is that if you look around the globe, among other countries, they’re not all the same. Middle-income countries have half as much anxiety as high-income countries. And low-income countries have half as much anxiety as middle-income countries.

 So that’s kind of crazy, because if you look at a place like Colombia or Peru, where 70% of the country does not have access to clean water, and you compare a typical schoolchild there to somebody living in the United States, where we’re driving on cantilevered surfaces and have unfettered access to electricity and water and so many other essentials.

I’m not saying we don’t have social problems. Don’t get me wrong – there are issues. I’m not sugar-coating our lives. But at the same time, a six-year-old girl living in Peru who has no access to clean water is four times less likely to have an anxiety disorder compared to her same-age peer in the United States.

Adversity and Resilience

I saw a paper in the Journal of Affective Disorders a couple years ago, and I was taken by the abstract: Individuals who are high-SES (socioeconomic status) had the greatest decrease in mental health during the pandemic. For individuals with low SES, there was barely a change in mental health.

 And yet, people of low socioeconomic status are much more impacted by adversity, materially speaking. Higher income and higher blessing in your life externally – greater access to greater privilege, frankly. There’s the expectation that everything is great, and the delta – the difference between the expectation of what you think you should have, what you are expecting, what you want, and the reality – is such a huge chasm.

Living in dire poverty, you might think, “Why would I expect to have a good day?” There’s no sense of anything being taken away by an adverse event like a pandemic. If you’re having a bad day, do you know what it’s called? Wednesday.

The more adversity we have, in some ways, it actually makes us more resilient and stronger, and we’re not bothered by the smaller things – which are significant, don’t get me wrong. But in the grand context of life, we don’t see that kind of resilience in our own society.

What about Israel? At the beginning of the war, people started asking me, “What’s going to happen with Israel?” I’ve been doing projects there for years. I thought about it, and I said, “You know what? I’m actually less concerned about Israelis than I am about American kids.” Because the most reliable data I’ve seen, which is really from 2007, is that 4% of Israeli society had an anxiety disorder each year. And even if you increase that by 50%, or 100%, you’re still going to end up with a number that’s between 25% and 50% of that which we have in the United States.

I flew out to Israel on the Monday before Passover on Monday night. As you may have seen, there was a huge firework show courtesy of the government of Iran, and 300 missiles, 300 devices, including 120 ballistic missiles, which, by the way, are fired into outer space and then descend down with a grand total travel time of about 12 minutes, between Iran and Israel, which is terrifying beyond belief.

And yet, one of the biggest complaints that people had in the country was that the schools weren’t open on Sunday. I kid you not. It actually made the papers. There were MKs, Members of Knesset, who stood up and said, “Why are our kids not going back to school? This is crazy. It’s almost Passover. We have preparations to make. Come on, let’s get back to business.” The biggest issue we had with travel was a three-hour delay coming out of JFK airport.

I was so blown away by the resilience of people who I met across all age groups. What would happen if a single ballistic missile were fired upon the United States by any country? The airways would be shut for a month across the country.

So, why? Why are we so anxious? More importantly, why are greater risk of malnutrition, less security, less financial stability, all associated with decreased risk for anxiety? Why are the most privileged people on planet Earth also the most anxious? That’s my question. In some ways., we have more to lose. But what are we really going to lose? What’s the actual tangible threat on a daily basis that we face?

 Anxiety: An Abnormality? An Illness?

I want to add another little layer to this. Our culture views anxiety as a disease. When we feel anxious, we freak out because we think something’s wrong. And that is a misperception, as opposed to understanding that anxiety is a human emotion, and it is something that all human beings will, and do, experience.

 Here’s proof. How many people have you met who have never had anxiety before – ever? They’d be dead. We’d be dead. Maybe the goal is to become more comfortable feeling anxious – “managing” it, although that’s a tricky word today, because there’s a fine line between “manage” and “control” that I think has really kind of gone away.

 What does it mean to “manage” anxiety? Do we manage it by actually embracing it, by understanding that it’s a part of us? By being able to be okay feeling anxious, and allowing ourselves to experience that adversity – by leaning into it, by doing something constructive with it? Or by squelching it – by trying to control it? By trying to reduce it? By “managing” it? If “manage” is a medical word, today, it’s being used across the board.

 Last summer, there was a federally-funded panel of American physicians who came up with an idea to screen all Americans for anxiety at their primary care physicians’ offices. You would think I’d be jumping for joy on this. I mean, I literally have the URL “centerforanxiety.org.”

This is great for business, right? It is.

 On the other hand, they set the bar a little low. They used what’s called the GAD-2, the General Anxiety Disorders two-item measure, which is used by the American Psychiatric Association. There are two items on it. “How much worry have you had in the last two weeks? How much anxiety have you had in the last two weeks?”, rated on a 0-4 scale. Unfortunately, there is very little contextualization for this scale. If you’re dealing with stressful events in your life, it doesn’t ask, “Are you going through a stressful time? Are there difficulties in your relationships? Are there difficulties at work?” It’s not contextualized at all.

 Basically, they set the bar for anxiety at 0, which means that today, across the country, anybody who goes into a PCP’s office and says that they have had any anxiety or worry in the past two weeks is automatically flagged and medically diagnosed with having anxiety and warranting treatment.

This is the medicalization of normal human states. And when it comes to anxiety, this is what makes it worse – because if you expect to have zero anxiety, you will feel more anxious! The moment you start to feel anxious, you’re going to freak out, because you start to think, “I shouldn’t be feeling this way. Something’s not okay here.” What’s going to happen to your level of adrenaline? You’re literally signaling to your adrenal glands “There is a threat here,” and that will shoot this amazing chemical into your bloodstream, which will increase your heart rate, dilate your pupils, increase your breathing rate, increase your body temperature… and that whole cascade happens because you’ve been told that the feeling that you had initially, which was totally normal, is actually wrong.

 So, we’re creating a cultural cascade that the moment we start to feel anxious when we think things like “I am diseased,” or “Something is wrong with me.” Ironically, our pursuit of an anxiety-free life has created and increased the prevalence and severity of anxiety en masse. That’s the cycle.

I don’t know anyone who has no anxiety, except maybe the Dalai Lama. You know, one of my colleagues at McLean put it really well. They said, “If you’re living in Ukraine and you don’t have an anxiety disorder, you’re psychotic.” Like, you have a much bigger issue on your head. Either you’re drunk – either there’s an alcohol problem, right, or you’re drunk, or you’re dead, or something’s very, very wrong if your adrenal glands aren’t reacting to a normal situation.

 Rather than understanding the context around patients’ anxiety, we prescribe drugs like benzodiazepines. In a country of 350 million people, 100 million prescriptions are filled by US pharmacies on an annual basis.  Beyond medication, if you go online and say, “get rid of my anxiety,” or like, “anti-anxiety,” you will find tens of thousands of approaches – potions and mantras and home therapies.

On the one hand, I get it. We want to feel better; we want to feel less anxious. On the other hand, it’s not dangerous to feel anxiety. It’s not a medical problem to have anxiety.  In my 12 years since founding an anxiety clinic, I have never lost a single patient to anxiety alone, ever. No one I know has ever died from anxiety. This is not something that actually, in and of itself, takes lives. Yes, the population responds to anxiety in the suicide rate. That is true. But that’s our response to the anxiety, which is trying to get rid of it, because we think that something is wrong with us.

 Teachers have been seeing students adopt a vocabulary around being “triggered” – if they see a certain image, or hear a certain song, it triggers an unwanted emotional response. The proper response to this isn’t just “deal with it.” I think that’s invalidating. Yes, these stimuli are triggering, and that’s why we need to move forward and continue to learn to metabolize them, because life is triggering. But it’s not invalidating, it’s not like, “Get on with it. What’s wrong with you?” It’s – “Yes, this is a normal response. You feel triggered? Great, you’re human. Now, do you want to learn how to live an emotionally robust and resilient life? Well, then we have to face it more.”

Exposure and Triggers

The same thing occurs with our emotional systems. Our emotions work the exact same way. When we face adversity, and we move into it intentionally with knowledge, up front, that it’s going to be hard – when we intentionally approach that “trigger” – that builds resilience, that builds our capacity to withstand adversity elsewhere.

And that’s what happened with my patients back in 2020, because that’s what they had learned in therapy. What we teach our patients is not to squelch their anxiety. We teach our patients to metabolize, to learn to face adversity, to learn to muster up the courage, to learn to move forward from where they are. 

And I do think the education system does need to change on this, to be able to teach this, and maybe the corporate world too. By the time people come to me, I’m not going to say “it’s too late,” but it’s already a mess.

I would like to see this happening much more en masse, where we encourage people and reward people for facing emotional adversity, for building their resilience, for having difficult emotions and learning how to move forward. We don’t do that. We try to control our emotions. We try to put them in a box, try to squelch them, try to reduce them. We medicalize these symptoms to say that there’s something wrong with us, and the whole approach is just creating havoc on our mental systems.

More often than not, they’re external triggers, like going to speak to somebody who you don’t know, as you mentioned before, thinking about that which you’re afraid of, spelling it out – whether it’s financial or health-related, or whether it’s about climate change or the end of the world – there are so many things. But it helps to actually go there and think about it, or think about our reaction when we’re reading material that makes us anxious.

And I don’t mean doing this all the time. You don’t work out in the gym all the time, but you do, hopefully, two, three times a week, four times a week. You can spend even just a couple of minutes a day facing adversity intentionally, with the purpose of building that muscle.  

When people face their anxiety along the way, they’re a lot less likely to get to that point of feeling anxious all the time for no reason. That’s sort of – the train is already way found way far down on the station, so I would like to catch it earlier and see it throughout our systems.

I think saying all this in a nice way is probably the message – but, obviously, without invalidating. We all still need to be validated: “this is a real struggle, and it means you’re human. This is great. Here’s your opportunity to grow.” Adversity strengthens us. It nurtures us, and actually gives us life, in many ways.  

Pharmacology

Let me talk about pharmacology a little bit more. I don’t want people to think I’m against pharmacology. I’m not. More than 50% of my patients are on pharmacology, and I support it. I think it’s actually very important. But how it’s used is very critical. When people come in and their anxiety is at 9 on a scale of 0 to 10, it’s hard to live life that way. We usually need to get them to a 4, 5, or 6 for them to be able to function and process things day-to-day. And using a pharmacological intervention to get them from that 7, 8 or 9 to a 4, 5 or 6 is reasonable, because they’re still going to have some degree of adversity, they’re going to learn how to do it over time, and eventually the scale can shift and you can actually taper off the medication. And those are the successful cases that I’ve dealt with.

The responsible pharmacologists that I deal with, especially when dealing with anxiety, will prescribe temporarily to reduce, not eliminate, the patient’s level of anxiety, and then over time, decrease and taper down, the medication, increasing the patient’s ability to have the emotions over time until hopefully, eventually, they’re off it or at a low-enough dose.

 The problem I have is when people come in, “you have a disorder or a disease, we have to get rid of this right away,” and the goal is to get from a 7, 8 or 9 to a 0, 1 or 2. If that’s your expectation, you will fail, because even if you’re on high doses of benzos, you’re going to have breakthrough anxiety. Everyone has a rough day, a rough week, a rough month. Stuff happens. And when patients expect to stay at a 0, 1, or 2, and then all of a sudden something brings them back up to a 5, they go back to their doctor and say, “Something’s wrong with me.” And then they layer on another med, and throw in a mood stabilizer, or even an antipsychotic.

 I can’t even tell you how many patients on our caseload at Center for Anxiety have three or more psychiatric medications. There have been zero medical trials in the history of psychiatry of three or more psychiatric medications – not a single randomized controlled trial. I think doctors who write these prescriptions are well-motivated and they are trying to help people. I don’t think it’s malfeasance or selfishness. I do think it comes from a good place, but the thinking is wrong. We are trying to get rid of people’s emotions as opposed to reducing them to a reasonable level in order to help them deal with adversity and build up their resilience over time.

 An analogy that I give is: Do you work out at a gym? You like it, but is it a comfortable experience while you’re doing it? No – because if it doesn’t challenge you, it doesn’t change you. And that’s how we build our physical strength, and that’s how we build our stamina. If you start running, it’s going to increase your cardiovascular fitness, your mitochondria are going to be able to function better – you’re going to have higher functioning, in general, in your physical life.

 In yoga, what you’re doing oftentimes is learning to accept the discomfort; holding a yoga pose is a lot harder than it looks. If you’re in the gym and your trainer says, “You can’t pull those 50-pound weights, but with a certain elastic band, we can get you to be able to do it.” You do it for a week, for two weeks, for a month, and then eventually, all of a sudden, you’re doing 50-pound weights. Why don’t we do that in mental health?

It’s gotten better, but I think psychopharmacology is often used clinically in ways that don’t map on to the science – at least not in ways that I can see. We still don’t even know how SSRIs like Prozac and Zoloft work. The serotonin hypothesis of depression was actually systematically disproven during the 1980s. I’m not saying to go off your Prozac just because we don’t understand how it works, but we need to acknowledge that it’s opaque.

Strategies for Dealing with Anxiety

I want to get practical. Again, I promised you I would not give you strategies to get rid of your anxiety, and I am not. I want to help you to use your anxiety. I want to help us – I’m in this, too – to use our anxiety appropriately.

And as the rabbi put it, we have a very rich liturgy and tradition around this. Judaism embraces this. By the way, that is not explicit in my book, but since I got prompted by a rabbi, and we’re in a synagogue, I’m going to go there.

There are the different mitzvot. There’s bein adam le-chavero – our relationship with each other, and then there’s bein adam la-Makom, our relationship with God, whether you believe in God or not. And there’s a relationship with our spirituality, some sort of latent force in the world. Both of those can be enhanced by our anxiety in a big way.

Humans are social creatures. And if you want to deepen the relationship you have with another person, try opening up to them about the fact that you feel anxious. If you think about the people who you’re closest to in your life, the people for whom your relationship really matters, it’s probably not your business partners or acquaintances. It’s the people whose shoulder you’ve cried on, the people who have come to you in emotional pain, speaking from the heart and baring their soul. They’ve embraced their challenge, the emotional challenge in front of you, and you’ve held them, or vice-versa. Those are the relationships that really matter.

Somehow, when we feel anxious, it’s actually part and parcel of developing close relationships with others – allowing ourselves to be vulnerable and to be held by the people who care about us, the people who we care about. That’s what creates that connection. “I really need you right now. I am having a hard time right now. Now I’m struggling.” Not, “I need you, and I’m going to be there for you.” It’s, “I’m having a hard time” – embracing the anxiety, embracing the difficulty.

Technology and Shabbat

With technology, the biggest mechanism isn’t just comparing yourself to others on social media, which does happen. It’s the fact that if you’re only connected with somebody through one of these electronic appendages, and you’re texting them and you’re having strong emotions, what do you do? Maybe you’ll use an emoji, but probably you’ll put the phone down and withdraw.

It’s very difficult to connect with someone in a real way over these devices, because the moment you have that negative emotion it’s just so easy to stop the conversation. In person, though, if you’re having an emotional response in the presence of another human, they pick up on it. They pick up on the facial movements, they pick up on the body language, they pick up on the voice, intonation, pace of speech – all those nonverbals are cues that enable them to actually say, “Hey, you’re having a hard time. Can I talk to you about that?” And then you open up. And that’s what creates the human connection.

Kids today don’t have that, because if you’re connecting through these devices, there’s no real emotional attachment that can be forged. It can enhance an existing attached relationship with somebody else, when you’re, for instance, using the electronic appendage to remain connected to them when they’re in a different country, when you’re apart. That can help enhance the connection but it can’t create it. It’s not a continuum to create real relationships. 

By the way, this is a really great reason why I think for a Sabbath, frankly – and I’m a Sabbath observer – we do not have electronic devices in my home. My kids love it, because we’re actually connecting with each other. We have a day to actually talk about what comes up during the week and process it and schmooze about it. We’ll just be sitting there doing nothing at the dinner table for three hours. It’s like, the best thing in the world. My colleagues think I’m nuts – “How do you get anything done?” I respond, “How do you live your life?” For me, I don’t understand what I would do without a Sabbath.

And even if it’s not 24 hours, even if it’s just a Friday night or a Thursday night, even if it’s just a two-hour period during the week, have a sabbath of sorts. Ariana Huffington had this practice years ago where she took a period of time: “No devices. I’m just going to connect with you.” That’s the concept of a Sabbath, which might or might not have a religious connotation today, but has real psychological value, I think. 

Some people, I think, don’t have those connections. Sometimes it’s a function of circumstance, but more often than not, I think it’s a function of that also being a train that’s gone too far. Learning to open up to people about what’s going on creates those connections along the way. We have to feel anxious and we have to feel vulnerable. We have to learn to cry on other people’s shoulders in order to create those, to take away that loneliness.

Practical Advice

So to get really practical on this, a couple of real recommendations. I do think we have to have one-on-one time with other people on a regular basis that does not involve the distractions of electronics. But opening up to people emotionally is even more important. When we are feeling emotionally charged, we need to speak to someone. That is our bodies’ way of calling out and saying, “You need to connect with someone else.” Not to bury it, not to distract yourself with work, not to distract yourself with, you know, drugs or drinking or just, you know, being a social butterfly – like, actually having a one-on-one conversation with whoever’s closest to you about what’s really on your mind and on your heart.

I gave you one set of strategies, which is the bein adam le-chaveroour relationships, and how critical they are. 

I think it’s also worth talking about our relationship with spirituality, though, because I was nudged along this path – so I’ll take the bait. According to psychological science, one of the main reasons why people feel anxious is because we can’t tolerate uncertainty. It fits into the whole theme that we talked about. When you can’t tolerate not knowing what’s going to happen next, you’re going to worry about the future. That’s why we have predictions for everything, like sports outcomes, epidemics, political elections… you know how robust the market is for predictions. Guess how much Americans spend “psychic services” on an annual basis? It’s a billion dollars. It’s a billion dollars in tarot card readings in the United States of America.

 I don’t mean to single out tarot cards – I’m not passing spiritual judgment. I’m saying, emotionally, the more we try to control and predict the future, the worse off we’re going to be. Like, let’s face it, we don’t know what’s going to happen next. We have no clue. We don’t know what’s happening even today, let alone tomorrow, and let alone later this year. It’s actually a good thing.

 In many ways, the events of the last several years have been poking through this veil of certainty in our lives. Like, we’re all trying to feel certain about the future – and then you have climate change, you have COVID, you have crazy politics all over the world, and now look what’s happening in the Jewish world and beyond.

 I would wonder whether there’s a greater message here, that the world is becoming more chaotic to remind us that it was never planned, and it was never something that we could plan for in the first place. Uncertainty is a part of our lives, and it always will be. And the more we run against that and try to resist that, the harder it’s going to be.

There’s Rabbi Naftali Brawer, who lives here in Boston, and is a very wonderful, heartfelt man, who really understands people. He shared a beautiful quotation at the beginning of this whole war, which came from the Vilna Gaon, the great sage of Vilna, in the 18th century: “Just as a field must be plowed before seeds can be planted, you have to plow the field.” If you throw seeds onto a field that’s not plowed, then the water or the wind will come to wash it or blow it away. You have to plow the field. You have to break up the ground. It has to be a process.

So, too, the heart’s shell has to be broken with intense emotions before spirituality can take root. And when we feel that heaviness, that brokenness, that we don’t know what’s going to happen next – there are seeds of spirituality that can sprout up within us that actually create more of a sense of spiritual connection than we might have ever had before. 

Prayer is a part of my life, and I will tell you, I’ve been definitely praying more intensely or connectedly, with more tears, this year than I have in many years, because I thought everything was predictable before October 7, and also some personal struggles I’ve been experiencing this year that just happened to be at same time. But I think when we acknowledge that we’re not in as much control as we think, how small we are in the universe, how infinitesimal we are. You go back to the Rosh Hashanah or Yom Kippur davening and the liturgy there – we can lean into that. And actually, in doing so, we can conceptualize a greater sphere. We can actually connect to something which is greater, and, I think, immeasurably enhance our lives.

So a practical suggestion there is to lean into that discomfort, and actually try to embrace the limits of our humanity, and however we conceptualize and connect with it, maybe speak to a being that is greater than us, to allow that to deepen our experience with that being. 

Dealing With Uncertainty

Anxiety can help us to grow, to bring out our potential, and to strengthen our relationships with ourselves, with others, and with our spirituality. That might not look like a flowering, beautiful bouquet. It might look like a difficult process of cells growing by grabbing onto one another, by moving forward. And it might be a painful process, but that therein lies the opportunity for us. Instead of trying to be flowers, trying to grow into something greater, that really, ultimately, is the key to thriving with our anxiety and to thriving in this challenging world.

I’m going to tell you a story. A couple years ago, I was invited to the Harvard campus, and it was a panel on mental health. It wasn’t on spirituality, but it was noted that I studied spirituality and mental health at McLean, which is true. And I took the opportunity to push the students a little bit, and I asked them the following questions. I said, “Who here chose when, whether or where to be born?” I said, “Who here chose which era of history that you would be born into and what would your life look like?” Had you been born in the 17th century, 18th century in Poland or in Lithuania, or if you were, you know, born in a poor country today, or if you were a foot taller or shorter, how would your life be different? There are so many of these different factors we have no control over.

There was dead silence in the room. It was one of the most uncomfortable moments in any talk that I had ever given, because these Harvard college students who couldn’t, for one second, wrap their heads around the fact that there are so many aspects of life that you can’t control. I felt so victorious that I had silenced a group of 50 Harvard students. But at the same time, it was so palpably uncomfortable for them to even go there for a moment.

I think this idea flies in the face of many things that we’re inculcating in students. And the more successful people are, the less they often want to embrace the uncertainty and the, as you put it, randomness of the world. But that’s not a healthy thing. I actually am very concerned for all of those students who attended that talk, based on their response. I don’t think it was a good indicator.

I’m going to bring this to a close with one more comment. I named my book Thriving With Anxiety, not Flourishing With Anxiety, and I did that for a reason. Flourishing is from the latin word florer, flower, which is when something is in full bloom, and it’s here and it’s doing great and wonderful. Thriving is not the same. Thriving is from the Nordic word thryphas, which simply means “to grow.” It doesn’t mean “to flower” or “to be in the expression of its fullness,” but it means that we are on the path towards becoming something greater than we are.

(This post is part of Sinai and Synapses’ project Scientists in Synagogues, a grass-roots program to offer Jews opportunities to explore the most interesting and pressing questions surrounding Judaism and science. Dr. David H. Rosmarin, PhD, ABPP is the director of the Spirituality and Mental Health Program at McLean Hospital and an associate professor of psychology in the Department of Psychiatry at Harvard Medical School, in addition to being the founder of the Center for Anxiety. This is a summary of a talk he gave at Congregation Mishkan Tefila on May 5, 2024.)

Illustration by Vicky Scott, used under a Creative Commons License

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