How to Make Anxiety Your Best Friend | Luana Marques | TEDxEmory
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Reviewer: Leonardo Silva Imagine this: It’s summer of 2018. I’m in Mumbai, India. It’s 120 degrees outside, and the sweat is dripping down my face. My patient, Mina, and I
are stuck in an old little taxi. It’s now our second day driving around, and today we’ve been at it for 45 minutes. (Car honking/traffic sounds) If you have never been to Mumbai,
that’s exactly what it feels like, and Mina was brave enough to be fighting
her fear of a small, enclosed space by driving around in a cab
with me in Mumbai. I look at Mina, who is really
gasping for air at this point, and dripping sweat, and I say to her, “Mina, I need you to get inside
of the trunk of this car.” And eventually, you’re going to get
a trunk of a car… Here we go. And I look at her and say, “I need you to get inside
of the trunk of this car.” Mina panics. She’s looking at me, terrified. Why would I ask Mina something
so seemingly outrageous? Because this is one of the most
fundamental and effective techniques in exposure therapy, and because Mina has been
held hostage by her anxiety for the past 18 years. Every time she would enter
a small enclosed space, her heart would pound, she’d feel dizzy, she felt as if the world was closing in. Mina, a very strong,
successful businesswoman, could not overcome her fears. She not only feared being in a plane
and had to take medication to fly, she also started to avoid
small enclosed places, exactly like the taxi we were in, avoided public transportation and even feared being home alone. Yet, at age 65, Mina wanted a different
relationship with her anxiety. So here we are, back in the taxi in Mumbai. Mina is still staring at me. I can almost hear her thoughts, “Why did I hire a behavioral therapist? Is she losing her mind? I should have taken
my anxiety medication this morning.” As Mina finds her breath, she says something in Hindi
to the taxi driver, and the next thing I know, we are back at my hotel. “Luana, get your passport.” “My passport?” “Yes! I’d rather fly than to get inside
of the trunk of this car.” (Laughter) An hour later, we are boarding a flight in Mumbai. Mina is flying for the
first time in her life in the past 18 years, without an anxiety medication. Mina is not alone
in her experience of anxiety. Nearly 275 million people suffer
from an anxiety disorder in the world, making it the most prevalent
mental health disorder. According to the Anxiety and Depression
Association of America, nearly 40 million people in the U.S.
suffer from an anxiety disorder, costing the U.S. nearly $42 billion
in healthcare costs a year. Yet I’m here today to tell you that you do not have
to be paralyzed by your anxiety. I’m here to tell you that you can actually
make your anxiety your best friend. So, how do we start
a new relationship with anxiety? To answer this question, I invite you on a journey to the first moments
where I learned the techniques that I now teach patients
all over the world, including Mina. My journey begins in Governador Valadares, a small town in the interior of Brazil. I’m now 10 years old, and my father has officially left us. My mother is faced with the reality
of having to feed my sister and I. I still remember a day when we had one potato
for the three of us. Don’t get me wrong, we didn’t starve, but my mother, being the survivor that she is, had to find a way
to keep reinventing herself. She sold brooms, and when brooms were not selling,
she sold hangers. When hangers did not pay the bills, she made the clothes- underwear, pajamas, uniforms. Watching my mom thrive
despite of all odds, it’s the first time in my life
that I understood what it takes to go through your anxiety,
to accept its presence, to make it your best friend
instead of being paralyzed by it. By age 15, I moved to Belo Horizonte, which is the third largest city in Brazil. I’m sent to live with my grandmother
to get a better education. Belo Horizonte is super exciting, but also a little scary. I quickly learn that making friends
in a large city is not easy. I’m going inwards, I’m becoming shy. I didn’t catch this, but my grandmother did. On a beautiful Saturday afternoon, my grandmother invites me
to go for lunch at a local shopping mall. As we walk towards lunch, my grandmother proceeds to tell me that she’s noticed
I hadn’t made many friends, that I was staying at home a lot, and that she was concerned about this. That’s what my grandmother
called my bubble, my personal space. She believed that
at that point in my life, my bubble was so large
that I was keeping everybody at bay, and that was the primary reason
why I had no friends. To be honest with you, I didn’t care much
about this idea of a bubble at 15. What I cared about was having Chinese food
for the first time in my life. I can still smell
the sweet and sour chicken. It was delicious! As we’re getting ready to sit,
with my delicious food, my grandmother looks at me and says, “Let’s go sit with that woman. It looks like she does not
want any company.” “What?! (Laughter) Right? Is she going crazy? Sitting with a stranger
at a shopping mall? Eating with a stranger? I don’t even have friends yet.” My stomach was hurting, my heart pounds. I want to go home. I’m begging my grandmother,
“Let’s go home!” Yet, she pushes through. Next thing I know, we’re sitting and eating
and talking to a stranger. Let me be honest,
my grandmother was talking; I was avoiding the whole thing. (Laughter) I don’t remember how many times my grandmother took me to the mall
to talk to strangers. But I do remember
it repeated again and again, and I do remember
that it was very painful. But I also remember that after a while, I enjoyed our lunch dates, and I even enjoyed talking to strangers. By the time I was 18, I moved to Buffalo, New York,
as an exchange student. Eager, so so very eager, to finally have a chance
to live my American Dream. As the months passed, I met my old fear again – the fear of talking to strangers. “What will they think of me? Will they like me? Accept me? Want me in their circle?” This time, it was much more difficult because I barely spoke any English. So what did I do? I did the unthinkable – I joined ski club. (Laughter) That’s right! Without ever skiing before! A Brazilian in the slopes – not a pretty picture. Why did I do it? Well, I had to be stuck. It took an hour every week,
to and from the ski resort. Being stuck with 40 people in a bus meant I had to find a way to shrink my bubble, I had to find a way to talk to strangers. And by the end
of my exchange student year, I had made friends for a lifetime, and you’d be happy to know I was skiing – if you can call that skiing. (Laughter) In retrospect, I can see now how this
experience shaped my decision to become a behavioral therapist. So to learn more, I started graduate school, pursuing a degree in clinical psychology. That’s when I began to understand what my mother and grandmother
had been showing me all along. I learned that anxiety is adaptive. Biologically, it’s signaling our bodies
something important, it’s telling us about danger. If there was a lion right now, right here,
in front of all of us, our body, our anxiety would protect us
by getting us ready to react. How? By turning on our limbic system,
the fight or flight center of our brain. Once our limbic system is on, our heart starts to pound,
we breathe faster, we sweat, our muscles contract, we are ready to run. There’s a significant difference between what I was learning
in graduate school, which is anxiety is biologically adaptive and it’s something that kept us alive, and yet, what I saw at the clinic, paralyzing my patients. So should I do what
most of my patients ask me to do? Take away all of their anxiety? Absolutely not. Taking away our anxiety
is like taking away our pain receptors. If we touch a hot stove
without any pain receptors, we’ll burn. So although pain is unpleasant, it protects us from further injury, just like anxiety, which protects us from danger. So if anxiety is adaptive and necessary, then what is the problem? Avoiding is the problem. Avoiding our anxiety makes all of us
feel a little better momentarily. And yet, in the long run, it can be really harmful. Think about it this way: avoiding our anxiety
is like taking a Tylenol for a fever due to a bacterial infection. Although the Tylenol
will bring our fever down, it will not fight the infection. To fight the infection, you’re going to need something
designed to target the bacteria, like an antibiotic. The good news is,
when it comes to anxiety, the antibiotic is called exposure therapy, skills that all of us can learn
to help our limbic system, the fight-or-flight part of our brain, to differentiate an imaginary lion
from a real lion. There is a crucial difference, however, between being exposed to our fears versus approaching our anxiety as a skill. Mina was exposed to flying
again and again and again for 18 years and could not get on a plane
without taking an anxiety medication. In Belo Horizonte and in Buffalo, I was exposed to strangers all the time, and that did not mean
I was unafraid to talk to them. So, what is the key? What is the difference? In exposure therapy, the difference is we need
to approach our specific fear and do it over and over again
in a specific pattern. In exposure therapy,
that’s called looping. Looping is the idea
of facing a particular fear, staying with it long enough for anxiety
to come down by at least half, and then repeating it
again and again and again. On the first day in Mumbai, Mina and I drove in a hot taxi
for hours and hours and hours. Once Mina got on that first flight, we proceeded to take
eight more flights in five days. That’s right. And then, ultimately, Mina was able to overcome her fear
of small enclosed places by getting inside of the trunk of her car, again and again and again. Mina was brave and overcame her claustrophobia at age 65. It was approaching my own fears that got me to pursue a life
in this country, to learn English, to pursue my dream
of becoming a behavioral therapist, and to soar high enough
to get a position at Harvard. My dream for each one of you today is that you choose
to engage with your anxiety at a much earlier age than Mina. My dream for each one of you today is that you learn how to make
your anxiety your best friend, just like that friend
that you have that you love but keeps nudging you
out of your comfort zone. And the magic is, if you learn to make anxiety
your best friend before it becomes
a paralyzing force in your life, you won’t need a PhD to overcome it. (Chuckles) Both my mother and grandmother,
without a college degree, taught me the skills that later I learned
to be scientifically sound, based in biology, and that I now teach patients,
including Mina. So come dream with me. Today, teach somebody
how to overcome their fears one step at a time. I promise you, you’ll change their lives,
and yours, forever. Thank you. (Applause)

5 thoughts on “How to Make Anxiety Your Best Friend | Luana Marques | TEDxEmory

  1. Luana Marques, Ph.D. literally saved my life when it was falling apart and completely taken over and terrorized by severe OCD. She taught me to face my fears and now, several years later, I'm still using the same skills she taught me to manage and overcome my fears, instead of letting them manage me. Dr. Marques will forever, and ever, have a special place in my heart.

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