The Crippling World Of Men’s Anxiety - Tim Clare

Tim Clare is an author, poet and creative writing coach. Anxiety rates have skyrocketed over the last decade. After spending hours every weekend wracked by crippling panic attacks, Tim decided to contact every anxiety expert he could to hear their suggestions for potential strategies to reduce it, and then he did all of them. Expect to learn why people are turning up to A&E believing they're having a heart attack, how the gut-brain connection plays a role in mediating our mood, why exercise is as effective as an anti-anxiety drug, how early childhood can influence our anxiety levels, the most effective tactics Tim has implemented to improve his mental health and much more... Sponsors: Join the Modern Wisdom Community to connect with me & other listeners - https://modernwisdom.locals.com/ Get 20% discount & free shipping on your Lawnmower 4.0 at https://www.manscaped.com/ (use code MODERNWISDOM) Protect yourself from identity theft online with Aura. Try 14 days for free at http://aura.com/modern (discount automatically applied) Get 10% discount on your first month from BetterHelp at https://betterhelp.com/modernwisdom (discount automatically applied) Extra Stuff: Buy Coward - https://amzn.to/3FHA31R Follow Tim on Twitter - https://twitter.com/TimClarePoet Get my free Reading List of 100 books to read before you die → https://chriswillx.com/books/ To support me on Patreon (thank you): https://www.patreon.com/modernwisdom #anxiety #mentalhealth #masculinity - 00:00 Intro 00:25 Tim’s Anxiety Journey 07:19 What Does a Panic Attack Feel Like? 12:23 Why Panic Attacks Exist 23:30 How Exercise Soothes Panic 32:13 Diet’s Impact on Anxiety 43:18 Long-Term Effects of Child Adversity 57:08 Being Defined by Panic Disorder 1:02:40 Importance of Leaning into Discomfort 1:17:04 Lessons from Tim’s Research Experiences 1:24:02 Where to Find Tim - Join the Modern Wisdom Community on Locals - https://modernwisdom.locals.com/ Listen to all episodes on audio: Apple Podcasts: https://apple.co/2MNqIgw Spotify: https://spoti.fi/2LSimPn - Get in touch in the comments below or head to... Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx Email: https://chriswillx.com/contact/

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  But when you are on the floor, having shoved a towel in your mouth to try and cover the sound of you screaming, so your baby daughter doesn't hear, because you don't want her to be afraid in sort of two rooms away, while your wife looks after her, I think it's impossible for anyone, no matter what their relationship to masculinity, to feel diminished by that.

• 0:22Chris Williamson?

  What is your expertise? What gives you licence to write a book about anxiety?

• 0:29Speaker 00

  So, the awful truth is, is that I was sitting down, having written sort of a couple of novels, and thinking, what can I write about? And I'd written non-fiction before, and I was like, what am I an expert? Because like you say, like when you're pitching something, whether it's like an article or a book, one of, one of the four pitch lines, you know, it's like, this is a story about this, or I wanted to look into this, the reason why I'm the person to do this, and you shouldn't get a better known celebrity to do it instead, is because this is my area of expertise. And I was like, what am I an expert on? And it was like, well, I'm mentally ill, like, I guess, like, I'm really anxious, like, I was like, at the time, like, I had a two-year-old daughter, um, she's still, she's just older

• 1:14Speaker 00

  now, I still have a daughter, she's just older, but, um, and I, I was really struggling with, like, severe anxiety and panicked, that was like, I was having panic attacks every week, sometimes I was having multiple ones a day, that would like, put me on the floor, and I'd have several a day over like a three-day period. And I was like, this is taking, this is just like, this is unlivable.

• 1:44Speaker 00

  And also, you know, in my work I do, doing like a creative writing podcast, I'd started to have like neuroscientists on, I'd started having psychologists on, I studied like, four years of psychology back in school, but I'm not like qualified, my background is in, in writing, but I, I'd spoken to these guys, and had some really interesting beginning talks about the brain, and, you know, the differences when they put like writers in an MRI scan, FMRI scanner and stuff like that. And so I was like, think, and then we signed my daughter up to a developmental study, where they started studying her brain and the development of kids at different ages, and...

• 2:24Speaker 00

  I got to take her in and see they put this thing called an F N I S on her, which is it's like a portable scanner in a kind of skull cap. It looks like a Medusa fright wig. They stick it on her head. She looked like, uh, like, uh, well, she looked like a cross between Medusa. And this is like a very deep cut nerd reference, but like, uh, when Patrick Stewart plays like Lucius out of the Borg, she looked like one of the Borg. She had like one red eyepiece on that, um, tracks her vision. And I was seeing on a computer, different parts of her brain lighting up, uh, because of something called the bold response. The blood oxygen level dependent response, showing different parts of her brain, uh, as different levels of demand wanted more or less oxygen.

• 3:09Speaker 00

  And I was like, I'm watching my daughter think. We are at a level now where psychology and neuroscience. We can like look inside people's heads and I'm like, there's got to like, I only get access to this because we've signed up to this study. But I'm like, there's got, I now know I, there's researchers out there are willing to speak to me, uh, for some reason. And I guess the reason, the thing was I just wanted to get well. And I was like, well, if I say I'm writing a book. These people are going to open their doors to me.

• 3:43Chris Williamson?

  They have to talk to me.

• 3:44Speaker 00

  Exactly. I'm going to be able to grandfather myself in to speak to all these people. And then I'm going to go like, and at the same time I'd like. Or, uh, you know, like if you've got hay fever, everyone in your family will like send you emails going, hey, I just read this article with this like their homespun remedy. On how to beat hay fever and, and you.

• 4:03Chris Williamson?

  Manuka honey. Yeah. You need to spread the manuka honey over your nasal, nasal cavity or something. Yeah.

• 4:08Speaker 00

  Exactly. And you'll, you'll never be short of suggestions. Well, obviously people knowing that I was really scared. I, I was never short of people making suggestions, sending me articles and you see all these articles saying we, that this new treatment has been found. So I was like, I keep reading that we're like five years away from this treatment that's going to blow it open. Whether it was a new drug, uh, a new, uh, sort of, uh, a new strategy that people were doing, you know, like, uh, I think it's you social prescribing people going for walks. Forest bathing, dice baths, things like that. And I was like.

• 4:46Speaker 00

  What if I just go and speak to the people? There are people who are spending their lives studying this in all different disciplines. What if I go and speak to them and then I try and do everything? Because the other thing was, I'd also read all the studies on the effect of mental illness, a parent's mental illness on children, and how that stuff starts early and it gets passed down, and how across a whole range of profiles, it makes kids' outcomes worse. And like, stuff you'd expect, like their chance of mental illness being worse, but also crazy stuff, like their chance of having asthma. And I was like, it's, this, I want my daughter to have the best chance in life she can. And like, some of us can be like, really down on ourselves and go like, I can't do this, I'm not worth it. But like,

• 5:31Speaker 00

  the bottom line was, do I think it's worth having a go at this for my daughter's sake? You know, if I don't care about myself, do I care about her? And the answer was like, yeah.

• 5:39Chris Williamson?

  That's one hell of a motivator, yeah.

• 5:42Speaker 00

  I know, yeah. And so that's, that's how, so, you know, the short answer to your question was when I started out doing this, in terms of my qualification, I was quite smug. I was like, I've been, I've been, I've been really anxious for ages. I have the worst panic attacks out of anyone I've ever encountered. I've read a lot of articles. My nan has sent me a lot of clippings. I was like, I'll go and speak to a couple of, I'll speak to a couple of scientists, right? And they'll kind of sprinkle like a little bit of legitimacy pixie dust on the top of it. They'll just quote stuff that I kind of already know. I'll go, yeah, yeah. I thought I'd sit in there, I'd get into their labs, I'd chat with them, and they'd tell me stuff and I'd go, because of course it's this, isn't it? I'd go, it's

• 6:27Speaker 00

  the amygdala, right? And they'd go, oh, you know about that? Oh, you're a colleague. And we'd kind of like nod and they'd see that I was an expert. And then, and then I, and then I'd go and write my book. And it's only when I went out and started speaking to people, and they're going, no, Timmy, it doesn't work like that at all. And I was like, oh, I'm in deep trouble. I'm in really deep trouble. And then I just went down this rabbit hole, read over a thousand peer reviewed studies end to end. Spoke to dozens of people, including like every expert that I could find in all sorts of disciplines. And by the end of it, like at least what I can say is I know

• 7:09Speaker 00

  how little I know, if that makes sense. Like I know how dumb I am, and I know what the edges of my knowledge in any given discipline are.

• 7:19Chris Williamson?

  Well, the difference is that you've got that in the trenches experience, you know, like even if it even if it wasn't

• 7:26Chris Williamson?

  medical understanding originally, you were able to appreciate it from an experiential standpoint, right? So what, for the people that haven't had one, how do you describe what a panic attack feels like?

• 7:40Speaker 00

  So I went to the, I mean, you can get a technical answer, right? Which is you go to the DSM five and there's a list of symptoms, right? And you have to have like X number from a list of symptoms. And then then it's officially diagnosed. A psychiatrist could say, yeah, you've had a panic attack, right? And I think it's just just like a hair under eight thousand possible like acceptable combinations of symptoms you can have for a panic attack. So they're incredibly diverse. But reading the explanation of what a panic attack is,

• 8:19Speaker 00

  it's kind of like licking a photograph of an ice cream, right? Like describing a panic attack, I could, I can tell you that it it's it feels like it can feel like you're going mad. Like you, a lot of people, especially men,

• 8:34Speaker 00

  don't know they've got panic disorder until they present at A and E saying they're having a heart attack. They think that they're having a heart attack, that they're having cardiac arrest. They go to A and E and the doctor's like, no, you're you're having a panic attack because so many of the symptoms are the same breathlessness, what they call like air hunger. Um. But also a feeling of like derealization, which is really difficult to describe until you've been through it, but you can feel like nothing's quite real. Like this sudden feeling that you're in a dream, which is also why a lot of people who are having a panic attack think they're going mad or insane. Um. Your your airways closing up, um, dizziness, uh, racing heart, sweating, uh.

• 9:20Speaker 00

  You trembling, um, you might start getting pins and needles in your extremities, your extremities might start. Um. They call that pins and needles and your the your extremities might, your fingers might start going into claws, which they call tetany. Um, uh, which is to do with like calcium deficiency, uh, as you breathe so hard. Um. You might, obviously like feelings of dread and fear, often terror. I mean, my panic attacks, but all of this is like, if I described like, you know, they call it, they, you know, they'll call it in the literature. They'll say a panic attack is like this feeling of sudden dread and fear accompanied by extreme physiological symptoms, which is a bit like calling like being kicked in the balls.

• 10:05Speaker 00

  Like a sudden extreme pressure to the testicles, right? Like it's a very, very different thing to go through it. Um. And you're like, hey, hang on. And and even after I'd had one, I'd look back and go, yeah, but that's not so bad. And then you're going through it and you you you feel like you're dying. And it's ridic, in a sense, it is ridiculous because you're not, but there's various ways and and various elements that I would later learn speaking to like. Pulmonary biologists and psychiatrists, uh, about the physiology that makes it actually very difficult to think straight while you're having one. It's not just a failure of character. Um. So that's what it is. But I would say like, they can present very differently.

• 10:47Speaker 00

  Some people have talked to me having, we talk about the fight, flight or freeze response, right? Those kind of three things and and panic attacks, I would say you can come split them into those three categories. Some people. You wouldn't necessarily know that they're having a panic attack. They just go completely frozen up. I've had a friend I talked to who said he had a panic attack on stage while doing a stand-up gig, right? And he's at the mic and he starts having a panic attack. Now, people, all that people saw was him going completely silent, completely still, and staring out like warlike over this. It looked like stage fright, right? From his perspective, he's having a panic attack. He can't breathe. There are other people like me that, like, honestly, it looks like a toddler having a tantrum. Like, I'm like,

• 11:31Speaker 00

  on the floor. I might be screaming, I might be saying I can't breathe. I'm like sweating. I might be like convulsing. You might think I'm having a heart attack. It was like, it was super embarrassing. It was, it was like the most, it was like the least dignified thing. You could, the only way I could have been worse if I was like, doing kind of like honking farts while I was doing it.

• 11:53Chris Williamson?

  I was literally true about, so the only thing you could have done was shit yourself at the same time, and that would have somehow made it worse.

• 11:58Speaker 00

  Yeah, it was like you were emotionally shitting yourself. It's that like, complete, like, incontinence of like emotion and terror, which would, you know, when, when we see them in kind of, the panic attack is preserved amazingly well over like millions of years of evolution. You can get very similar reactions from, you know, like voles and stoops.

• 12:23Chris Williamson?

  Why is it, why does it exist? How is it adaptive to have a panic attack?

• 12:27Speaker 00

  Okay, so that's a great, that's a fantastic question. And there's loads of, like, people have jumped on this, like going, why? And a, there was a psychiatrist called Donald Klein, who in 2003 wrote a paper where his theory was, he sees it as a kind of, he called it like a suffocation false alarm. So he's going back to, like, we know that panic attacks can be reliably triggered by something called the CO2 challenge, right? Where you give someone a mask and they breathe in a mix of air that's got 25% CO2 in it, carbon dioxide, right? That reliably gives people like smashes of a panic attack. Like, it's the grimmest thing.

• 13:12Speaker 00

  It's quite, and I've spoken to a psychiatrist who, you know, did it himself before he used it in his experiments. But we know that people who are vulnerable to panic attacks are much more likely to have. Bigger and worse panic attacks when they do that challenge. And it's one breath, by the way. Like you put this mask on, you take one.

• 13:31Chris Williamson?

  No way.

• 13:32Speaker 00

  It's I, I, I, people who've done it have like said, you can't. I, I, I should say like, there's a, there's a famous patient called Patient SM who had her, her amygdala, both her amygdalas removed, the amygdala, they're, they're these parts of the brain that have often been thought by kind of like, when they talk about them in magazine articles, they call it the brain's fear center. Now, it's not, but it's definitely implicated in our threat circuit. She'd had this rare genetic condition that meant she lost both of her amygdala were eaten away by calcium deposits. She couldn't feel fear. She had like a gun held to her head and someone threatened to kill her. She didn't even realise that they were threatening her.

• 14:14Speaker 00

  They've done all these tests on her. They have her held, they had her held snakes. They took her to like a fun house and there was a guy dressed up as like Pinhead out of the Hellraiser movies. And apparently she made him jump because she went up and grabbed one of the nails coming out of his mask to just to find out what was going on. She's been beaten up. She's been assaulted. At no point has she felt fear.

• 14:38Chris Williamson?

  Not all of these were in a, not all of these were in an experiment, I'm going to.

• 14:41Speaker 00

  No, no, no, no, they're, they're super, they're actually the experimenters, all of them that talked about her were really sort of protective and tender about her. She wasn't like some weird like caged.

• 14:52Chris Williamson?

  Well, the, the problem that you have with, with someone that doesn't have any fear is that they're pretty bad at looking after themselves. If you're not able to do threat response or threat detection very well, you're unbelievably vulnerable.

• 15:05Speaker 00

  Yeah, she's, I mean, and that's been a, there's case studies from her life where, you know, a stra, a really sketchy guy just like rolled up in his car and said, do you want to get in and come with me? And she was like, oh yeah, hi. Yeah. And he took her to a, a abandoned barn and assaulted her. Like she's had that throughout her life, trusting people.

• 15:26Chris Williamson?

  But then she does the, she does the mask thing.

• 15:29Speaker 00

  Yeah, yeah. And then, but thi- this is the thing is like, she's just not able to, she, so she does this, um, she did this CO2 challenge, this 25%, and she had the worst panic attack they'd ever seen with that. So even somebody who cannot feel fear in their life had a panic attack, a terrifying one, when she had it. Now, the difference with her is afterwards, they said, do you want to do it again? She was like, yeah, all right. She, she wasn't able to learn from the experience, but during it, she was screaming, I can't breathe. She was grabbing for the, so, so the theory is that these chemoreceptors in the brain are there, developed from when we were kind of like burrowing animals. You, you, you go to sleep in a burrow, it collapses.

• 16:15Speaker 00

  CO2 levels will start going up because you're going to suffocate. You want something that will just flood the body during sleep with adrenaline, cortisol, get the heart hammering and go just move, scrabble, thrash around, try and get out. That's the, that's Donald Klein's theory, that it's preserved because there was a time when it was adaptive to wake up suddenly because you, and it kind of still is, right? Like, um, we know that children who have seizures during the night can, if, if, if the seizure reaches the amygdala, they are capable of, um, of just stopping breathing. In fact, they've had problem, you know,

• 16:56Speaker 00

  this has been one of the problems with COVID. Um, there've been COVID patients who stop breathing, have incredibly low oxygen levels and just aren't aware. They call them happy hypoxics, right? Like the infection, this kind of neuro might reach the amygdala and, and these chemoreceptors are somehow affected in the same way that people report sort of problems with taste and smell. And they don't know that they're not breathing. And that little alarm that says, shit, like you're suffocating, you've got to breathe now and sort of jolts you awake, doesn't go off and people can just sit there and pass out. Um, so that's the, that's one of the theories. Another theory is that like a panic attack is like.

• 17:39Speaker 00

  The last resort of the fight, flight or freeze, the like most primal response to being like attacked by a predator, like if everything else has failed, if you've frozen and they still find you, if you try to run away and you still get caught, if you try to fight, the last thing is just to flood the body with adrenaline. And so you thrash, you scream, you fight in the hope that like basically it drops you, that you know, or it like, so it's like this last ditch effort, which is why, which is, you know, one guy I spoke to, John Wemy, who's like a psychiatrist, and he does like pulmonary biology and things like that. And he performs this CO2 test. His

• 18:21Speaker 00

  position was like, he said, when the amygdala is removed, what the amygdala might do is help us decide which of the fight, flight or freeze options, you've got to choose, right? When you get this flood of adrenaline, it might help us decide it. And when that's removed, we might just always default to the, to the worst thing, which is like panic attacks, right? So the amygdala is almost like a kind of spigot that chooses how much water you want. And if you hack the spigot off, it's just going to jet water. So that's one theory of panic attacks. Um, why, why some of the elements of them might be adaptive, that it's, it's a chemo receptor in the brain. There's

• 19:03Speaker 00

  very, well, actually, there's various areas that might have chemo receptors. The amygdala might have them, but also periaqueductal gray, kind of like around the back, that you might have these over sensitive chemo receptors. And actually, when they've done ambulatory monitoring of people who have panic attacks, where they monitor their breathing as they walk around throughout their daily life, they find that a lot of people who have panic attacks have a tendency to over breathe, right? So they're breathing a lot, they're washing out carbon dioxide, they're taking in a lot of oxygen. And so as they do that, right, they're, they're slowly training this kind of like this canary in the mineshaft, right? This, these chemo receptors to be more and more acutely aware of the tiniest bit of CO2.

• 19:48Speaker 00

  And so all you need then is a period where, you know, people frequently with panic disorder will wake up in the night having a panic attack. So there's been no trigger. It's not like they're they're in a shopping centre and they feel claustrophobic. They're in bed and they wake up thinking they're having a heart attack, right? And and then so there may be some dis- it's it happens. Panic disorder correlates with like sleep apnoea and like respiratory problems, people who you have them. So there may be some dysregulation of breathing. And then, of course, what happens if you're having a panic attack, which we often think is part of it, but is almost a second stage, is then you over breathe, you hyperventilate, which, I mean, I don't know, like,

• 20:32Speaker 00

  if you hyperventilate, it has all these crazy effects on. I mean, and this is what I didn't realise, I didn't get was like, and and it also explains the very traditional method of stopping someone having a panic attack, right? Where you see them on the old movies where they breathe into a paper bag, right? And that's not really dealing with panic attacks so much as the effects of hyperventilation, which are like an overcorrection afterwards, right? Someone breathes and breathes and breathes, it washes out all the CO2. And then with all that lack of CO2 in the bloodstream, you get something called cerebral hypoxia, where the brain is flooded with with oxygen.

• 21:17Speaker 00

  And as a response, it you get a vasoconstriction in the brain. So the capillaries, after about a minute of hyperventilating, the capillaries are about 50% of their previous capacity, right? And then, and this is all really complicated, it took me ages to get my head around this. Because you're like, well, the bloodstream is full of more oxygen. Surely more is going to your brain? Well, the body is a homeostatic system and it's constantly trying to make sure different areas are getting what's needed. And if your body thinks it's in fight, flight or freeze and there's, your brain thinks it's getting too much oxygen, it'll go, right, we don't need this, right? We're going to restrict the blood vessels, so the rest of the body, presumably we're being chased or in a fight, right?

• 22:01Speaker 00

  So I'm going to save the rest of that oxygen to for the mitochondria in the cells in sort of my legs, so you can run away, right? So we're all right here. And and and that's a mistake that the brain makes. At the same time, you get this thing called a leftward shift on the Hemoglobin disassociate dissociation curve, which basically means that hemoglobin, the tran- the protein transports of oxygen round the bloodstream cling on to that oxygen more tightly when you get a carbon dioxide washout. So it doesn't, they don't deliver those oxygen molecules as readily. So not only does your brain get 50% of the blood flow, but all of the oxygen that is flowing through the bloodstream is not letting go

• 22:42Speaker 00

  of. So your brain, like, within a minute, your brain has been massively starved of oxygen. So you start feeling dizzy, you can't think straight, you start getting that derealisation, you start thinking you're going mad, you can't take logical steps, um, because your brain is shutting down. And this is why people will regularly, you know, like I say, they will present thinking they're having a heart attack, they'll present thinking that they've gone in, that they've lost their mind. Um, and it's all to do with respiratory function, which is like, which is mad for me, right? That it's something so simple as like that dysregulation and then over breathing can lead to people gut thinking,

• 23:24Speaker 00

  I'm going insane and I'm dying. And it's just a breathing rhythm thing.

• 23:30Chris Williamson?

  Looking at the techniques that you went through in an effort to try and discover what can help anxiety disorders, what did you find out about exercise?

• 23:40Speaker 00

  So exercise is a really interesting one. I thought exercise was the first thing I tried, right? Cause I was like, well, this is a slam dunk. I mean, I was really, really unfit, like incredibly unfit. My job is three metres from my bed. My favourite activities are like video games and sleeping. Like I was not, it's no exaggeration to say I was, I'm like, I was a dad with a two-year-old, right? So like my sleep patterns were all out of whack. I was comfort eating because of the anxiety and because of, you know, I'd often get my daughter to bed at a crazy time and then I'd just like get a takeaway because the idea of then cooking for myself was, seemed like the least appealing thing. And I thought I fancy, you know, I deserved a treat.

• 24:25Speaker 00

  So, but I thought exercise, I was like, everyone's always telling me to do exercise, it'll be a shoo-in. And I went and started looking at the literature. I went to see a trainer called Dave Thomas, who owns a gym in London, who's got like twenty thousand hours of like one-to-one sessions under his belt to talk to him about like sports science and stuff like that. And I started digging into the literature. And what I was surprised to find is the relationship between exercise and reducing anxiety is by no means clear. There's a really interesting paper by a psychologist from Liverpool University called Peter Salmon, who looked at a load of studies on anxiety and exercise. And what he found is that most of the studies that you will read like in the

• 25:06Speaker 00

  paper in magazines that say, you know, fifteen minutes of HIIT a day will reduce exercise, will reduce anxiety and whatever. The people they get to do though, the sample that they use for those are generally, and they should be obvious for us, but like, people who sign up to those studies are not generally people who hate exercise. They need volunteers, right? And the people who tend to sign up to exercise studies tend to be people who quite like exercise. So for a start, there's a skewed sample in that the people who are doing them are people who generally don't hate exercise.

• 25:44Speaker 00

  Secondly, the samples that are used, and this is another weird one that surprised me, are often not people who are clinically anxious. They will get people who are just, you know, everyday people and they will study them. And then they'll give them a survey at the beginning and a survey at the end. And they'll go, do you feel less anxious now than you did before? And often people do, but they weren't clinically anxious to begin with. They just feel more relaxed. Does that mean it works with someone with PTSD or panic disorder? That study doesn't have anything to say on that necessarily. Secondly, a lot of studies don't. Thirdly, I should say, a lot of studies don't really distinguish between what type of exercise. Like, there were a lot, you know, exercises are big. That's like just saying, you know, books.

• 26:29Speaker 00

  Is a reading a book good for you? Well, what kind of book? What kind of exercise is walking the same as, you know, sprints or, um, uh, you know, fart like or hit is, are we talking like marathon running? Are we talking about like swimming? Um, what, what duration is, are we talking relative intensity to someone's fitness level or absolute intensity? Uh, what, how many days a week for over what period? So all of these questions are ones that, um, are not often well addressed in the current literature. And, and of course, one of the things that I got from talking to Dave is like, you know, if you start an exercise regime, the first thing it's going to start doing is at least

• 27:13Speaker 00

  transiently raise your cortisol levels, your adrenaline levels, you know, your, your testosterone levels as well, which is like more ambiguous when it comes to how that affects anxiety. But your stress hormones are going to go up initially, right? So the, the, and it's going to be unpleasant. When I started running, doing this book, I fucking hated it. It was grim. I did not like start running down the street, whistling to myself going, I feel so alive. I, oh my God, I hated life so much. I could taste blood in my mouth. I was limping. I'd like, I was aching next day, couldn't get up and down the stairs. I was so angry and I was like, why am I doing this? I hate doing this.

• 27:57Speaker 00

  But, and there is, there is a but coming here, right? Like, despite all that, so those are all the caveats, right? Despite all that, if you then look at the body of literature, there are some great results. Like one thing I'd say, like, let's imagine that you did a bunch of exercise, right? And it did nothing for your anxiety, but you started an exercise regime. Well, like, we already know you're going to live longer. You're going to have, you, you're gonna, um, you're gonna have more energy during the day. You're gonna be, your profile, risk profile across a range of diseases is going to drop dramatically. Um, so, so, so, so the worst case scenario is that you.

• 28:41Speaker 00

  Live longer.

• 28:42Chris Williamson?

  You're a healthier, better, leaner, sexier version of the person you were yesterday. You just still have anxiety.

• 28:47Speaker 00

  Yeah, exactly. So like, it's not like, you know, we're asking someone to put their hand in like a meat grinder. Like, it's something that's already good for you. I think is sort of unambiguous across the range of literature. But can it help anxiety? Well, there are some suggestions that there are ways it can do. Like, when we look at athletes and some studies of people who exercise regularly and do intense exercise, and they've done some of this with bodybuilders as well, actually, in response to a threat, and in the, you know, this, in the lab, this tends to be something like a, they call it like a shock protocol. So they literally wire someone up and give them unpredictable electric shocks.

• 29:30Speaker 00

  That's how they find out someone's stress levels and they'll check their cortisol with a swab. When you look at these people, actually, their fight, flight or freeze response, their hormone cascade is generally more pronounced than people who don't exercise. However, it tends to normalise more quickly as well. So they have almost like more of an adrenaline boost in response to a stimulus. But then they return to baseline faster. And this is something actually we see a lot across a lot of anxiety, that it's not so much someone has a bigger, it's not like someone has a bigger startle reflex or that that can be part of it, but that they're worse at responding to safety cues and returning

• 30:15Speaker 00

  to baseline.

• 30:16Chris Williamson?

  Less equanimity on the other side of it.

• 30:18Speaker 00

  Exactly, yeah, like, like, you know, and it was true of me that like a can of beans could fall out of the cupboard and that would be me gone for the rest, that would be my nerves shattered for the morning. I'm just like, I've got to take to my bed now with a case of the vapors and fan myself saying, what shall become of us? Because like, that was it, like, I was just jittery.

• 30:39Chris Williamson?

  Yeah.

• 30:39Speaker 00

  So it's going to normalise that. The other thing is, and I'm sure, you know, you'll be thinking about this as well, but like your blood sugar levels, like when in response to a shock, you know, your body is going to release glucose, there's various hormones that release, you know, glucose into the bloodstream, anticipating a threat. So it's going to be available to the muscles so you can start running and whatever. So it releases these sugar stores. If you don't. Immediately use that up, then your body is is going to release insulin to reabsorb it. So you get these big crashes. So that's why often people with anxiety have this horrible

• 31:22Speaker 00

  up and down thing where you get the shock and then you drop into like the equivalent of a sugar crash afterwards, where you feel sluggish, you can't think. And then, of course, you it's tempting to like have a sugary sports drink or something which will sort of briefly bring you back up and normalise. But then, you know, you start this kind of like your day is this series of peaks and troughs. Exercise can help down regulate some of the kind of corticoid, like some of your receptors that that deal with things like cortisol to make them sort of slightly less responsive. And they can put you in a situation where those kind of like sugar spikes are less pronounced. They help with things like

• 32:06Speaker 00

  insulin resistance as well. And that's, of course, you were shading into diet now, but exercise is part of that as well.

• 32:12Chris Williamson?

  Well, yeah, what about that? Because I've always heard that there's more serotonin released in your gut than there is in your brain, and that there's a gut brain connection when it comes to anxiety and inflammation is something that you need to watch out for because you can eat some gluten and you'll have an anxiety attack. What did you what's the lessons to be learned there?

• 32:32Speaker 00

  Yeah, so like, that's really important. And it's what that serotonin receptors in that you've got you that idea of like having loads of serotonin receptors in your gut. Yeah, like serotonin, five hydroxytryptamine, most of it is, you know, is doing stuff around in different things all across your body. And it's also the reason why you can't just take a serotonin pill, right? Because it doesn't cross the blood brain barrier to get into your brain. It's not won't be available in your brain. You've got a blood brain barrier that stops like nasties getting into your brain. Obviously, your brain sort of like very, very, that's one of the reasons why you get kind of like cerebral vasoconstriction so quickly, why it has these crazy responses is because. It's really, really conservative. Finally tuned.

• 33:16Speaker 00

  Yeah, yeah, yeah, because it doesn't, you know, because getting a virus into your brain is is much, much worse than getting one into your stomach. Like, if it's in your stomach, you can just diarrhoea it out, which is one of the functions of serotonin in the gut is is what they call, it contributes to gut motility or peristalsis, which is why if someone takes like an SSRI, a selective serotonin reuptake inhibitor, to increase the availability of serotonin, one of the side effects is diarrhoea. It's also one of the reasons why, like, taking, like, a real strong serotonin agonist like psilocybin can give someone gut cramps and extreme cases like diarrhoea, because it is that you've

• 34:01Speaker 00

  got all these serotonin receptors in the gut, yeah, that are, but but they do something different, crucially, to what what they might do in the brain. Mostly, they're, you know, they're flushing out nasties. Yeah, peristalsis is like the motion a worm makes, and they make your gut do that to kind of force stuff through quicker. So what you eat, I'd say, like, like, one of the key areas for me, I spoke to a couple of people, I spoke to a microbiologist called Simon Carding at the, in Norwich, and he deals with, well, what he deals with, like, I'll be honest, the real reason I spoke to him, like, a little

• 34:43Speaker 00

  bit, is because they do these fecal microbiota transplants, right, these FMTs, where, and they've been using it to deal with people who've got C. difficile infections, right, really serious, life-threatening infections in their microbiome. And what they do is they take a cocktail, they take, basically, they take, they get a fecal transplant from someone else, they, someone donates their

• 35:11Speaker 00

  Pooh that who's got healthy microbiome, they kind of whisk it up and then they and then they sort of syringe it into the patient's either up their rear end or that you can swallow it in something that they call a Crapsul and it will like restore your microbiome. Yeah, I know, right. And there's all these beautiful stories that are like my dad's poo saved my life and stuff that you see in the papers. So that's like well evidence for C. D for seal, but they started to find these other things where there was sort of like brave mice where they took the microbiome from the quote unquote brave mice, these these this one strain are known to be more likely to explore a maze and they'll jump

• 35:54Speaker 00

  down from a raised platform quicker and they injected the microbiome from their from their gut into well, well, from a little pouch and so that mice have called the secom and they took that and they injected it into the timid mice, these ones that are a strain called Balb C that come from like a they're traced all the way back to like a 1913 pet shop dealer in like Ohio and they've and they've just been bred and bred and bred and they're known to be very sort of Wimpy mice. Mouse equivalent of nervous, right. And so they'll inject that microbiome into those mice and those mice become braver, they become quicker to jump down from a raised platform.

• 36:38Speaker 00

  So people are like, what the hell's going on here? You can give one microbiome to another type of mouse that is like genetically that is like known to be heret have a hereditary cowardice and it changes. They don't become as brave as the other mice, but they become more brave, right? What's going on here? So they've been looking at it in humans. Can we give people, can we change people's gut microbiome and make them braver? So, so the the disappointing answer is like,

• 37:08Speaker 00

  At the moment, probably not. Like, we've, we've looked at it for ages and it seems to work with mice, but mice have got like three inches of gut. We've got like three metres. Like, there's a reason, like, we are, it was funny speaking to Simon Carden because he was like, almost like pinching his nose, like, the number of times he'd had to tell journalists, mice and humans are different. And it's like, almost surreal to like, have that conversation over and over and go, a mouse is not a per, is not a little person. Like, they've got all sorts of differences in their guts. They, they can't, like, mice and rats can't be sick. They, they don't have a gag reflex. They've got massive differences in what they can and can't do. But

• 37:51Speaker 00

  in terms of, like, your diet, um, there's plenty of, like, epidemiological studies, so big, big, big studies, where they take huge numbers of people that suggest, like, there's a mild association with, like, a Mediterranean diet and lowered risk of anxiety and, uh, depression. It's, it's not like a huge, uh, one, it's like, uh, like, for one in every forty-five people who switch to a Mediterranean diet will avoid depression or anxiety that would have otherwise got. But there's like a small, but, oh, you, you do that over a population, right? And suddenly you are reducing, you're getting hundreds of thousands of fewer people hitting the mental health system with anxiety and depression.

• 38:35Speaker 00

  And hundreds of thousands, and that's only clinical level as well, but hundreds of thousands of people potentially who aren't having their life, like, ruined by this. So, so, you know, it gets to big numbers if you look across a population. Um, but I did speak to, you, you asked about inflammation. I spoke to a, uh, an immune, she called herself an immunosychiatrist, I say she called herself, that was her job title. She, she's, she's at, um, the University of Southampton, Dr. Riwa Hu, and she told me she looks exclusively at, um, at the links between inflammation and depression and also anxiety.

• 39:15Speaker 00

  And she said that there are, you know, what the, what we're, we're finding a bidirectional link between anxiety and chronic inflammation in the body. Now, it just so happens that, um, being sort of like chronically over

• 39:31Speaker 00

  Weight increases inflammation in the body. It just so happens that doing lots of exercise

• 39:38Speaker 00

  reduces inflammation in the body. So if there is a bidirectional link between those two things, we can kind of put the pieces together. And I'm kind of like speculating slightly, although she felt that this was reasonable, that eating, you know, a good diet and that'd be one, you know, a Mediterranean style diet, you know, full of like plant-based like polysaccharides, lots of fibre, things that are going to like increase that gut motility and stuff is going to reduce inflammation and reduce your risk. I think it's, I think it's fair to say reduce your risk profile of anxiety rather than immediately cure your anxiety. She also mentioned things that I, I thought she was

• 40:21Speaker 00

  taking the Mickey, to be honest, when she told me them because she said, oh, so what's some other things you can do? And she said, oh, like be religious. And I was like, that can't be right. And she was like, being religious is reduced with lowered inflammation, lowered this CRT, this marker of inflammation, people who are religious and part of religious communities have have lower levels of that. I was like, so I ended up looking into the research of that. And it is true, doesn't specify what religion. So, um, you know, if you want to kind of, you want to start your own cult, apparently that will reduce your chances of anxiety as well. But I suppose, you know, the takeaway from all of this is anxiety is not just one thing.

• 41:01Speaker 00

  It's not, it's a bit more like a headache, right? It's a symptom that could have many causes. And it may be that there is a subgroup for whom their chronic anxiety is arising from chronic inflammation, from a kind of feedback loop, from poor diet, lacquer moving around, and sort of lowered hormone profiles across a range of things. There's other things that exercise boosts like this neuro peptide. Why is this one particular peptide that's associated with lower anxiety in people who have it, lower rates of PTSD in people who have like high levels of neuro peptide? Why? That is produced by doing lots of exercise. So.

• 41:47Speaker 00

  There is a good chance that there is a subgroup of anxiety sufferers who may be, you know, they, when, when we've looked at the depression profiles of with, uh, with inflammation, we can see that there are some people who respond really well to just taking anti-inflammatories for their, for their depression. There is like a subgroup who seem, that seems to like,

• 42:09Chris Williamson?

  That's the crux of their depression. That's one of the reasons that their depression manifests.

• 42:14Speaker 00

  Yeah, but I would never want to get into this. You, you can get sucked into these sort of arguments where people are going, so are you saying that anxiety exists in the brain? Or are you saying it's just about inflammation? Or are you, you know, surely if someone's like having a stressful life, that's going to contribute. And, uh, and then there'll be other people who say it's only their environment and you can't ever say anything about neuroscience. Even though like clearly all the thoughts we're having, all the experiences we're having are, you know, in some way instantiated in the brain. Like there was a brain is one of the pieces in this puzzle, right? And, and sometimes when I get sucked into those, I feel a bit like I'm watching two people

• 42:55Speaker 00

  have a brutal fistfight over whether Kermit is a muppet or a frog, you know, like it's, it's just like, these things can all, um, be contributors. And for me, like, inflammation is definitely sort of a reasonable culprit, but it may not be everybody's sort of primary boogeyman kind of behind what, what's giving them anxiety.

• 43:17Chris Williamson?

  What about childhood trauma and bullying and stuff like that? How does that contribute?

• 43:23Speaker 00

  Well, I spoke to, yeah, so I spoke to a, oh, I spoke to a brilliant neuroscientist called Nim, Nim Tottenham, who has done lots of studying of like childhood adversity and particularly how it affects brain development and how, um, when people have had very traumatic childhoods, either because of like a single traumatic incident or because of like lots of different things that have happened. Um, it affects.

• 43:52Speaker 00

  There's suggestions that it affects brain development in a way that's not always immediately apparent at the age of the trauma, but happens later abnormal development of, I've mentioned the amygdala before, but also the hippocampus, which is associated and implicated in parts of memory. We're trying to get away from this idea that one part of the brain is kind of like one department for doing one thing, but certainly hippocampus is important in forming memories and specifically for anxiety, it seems to be to do with associating certain environments with safety or threat, which is why there seems to be a lot of dysregulation

• 44:33Speaker 00

  in the hippocampus in soldiers with PTSD, people coming home who can't-

• 44:40Chris Williamson?

  Become hypersensitive to it somehow.

• 44:43Speaker 00

  Yeah, you know, that kind of like the kind of classic thing is like a car backfiring and they think they're kind of under gunfire, but like the brain's inability to differentiate between a theatre of war and a safe zone, you know, the hippocampus is almost certainly implicated in some level in that. But Nim Tottenham looked at how the brain, often those, she did this great paper that showed that like often our studies suggest that the brain starts to change in adolescence, but as the result of things that happen much, much, much younger and we might get a sort of upregulation of, if you're looking at, I guess what they

• 45:26Speaker 00

  call like neuroanatomy, you might get much bigger or much smaller areas. Like the one thing I'd say at the moment is the literature is really ambiguous over whether an area like the amygdala, whether having a big amygdala is worse because you're going to be more anxious, or whether having a smaller one is worse because you have less regulation over anxiety. It's not entirely clear what the relationship is between sort of size and function.

• 45:54Chris Williamson?

  Did they say what sort of age this could begin from? Are we talking about before stuff that we could potentially even remember, sort of toddler age, that there could have been things that have impacted on our brains from then?

• 46:06Speaker 00

  Absolutely. I mean, some of the, I was looking at one study that was suggesting that we can't start forming- coherent autobiographical memories that we're able to retell to people until about two and a half. So, you know, they could be things that you don't remember, but certainly like from the moment you're born, you you're you are learning, your threat circuits are active, right? But babies are not great at um certain types of threat perception, but you you you you come out the womb with sort of like flinch responses to say like being dropped or pain or things like that. Um babies for a while, they've done these great studies where they get babies to crawl out over a perspex floor that suddenly underneath

• 46:50Speaker 00

  dip like goes is a cliff like drops away. And, you know, a crawling age, they will just crawl happily out over the edge. Um on this perspex thing, they don't know that they're on a see-through kind of like ledge. Um and then there'll be a certain developmental point where they'll go, I'm not, I'm afraid of heights now. Um. So we know that some fears are are are required. Some are developmental steps, like it's good when a child starts to get a little bit of stranger fear. There'll be a moment where a child gets a bit more clingy. Well, they're starting to differentiate between faces. That's quite good. You know, obviously, like, it can be pathological, but it's part, it's a, it's a neuroanatomical

• 47:34Speaker 00

  and neuro um developmental milestone that's actually pretty great, right? Like they're they're they're learning to go, this face is safe. This is a stranger. But yeah, from really early on, they, Nim Tottenham did a great study in mice, um where they played them music when they were born, like they play a particular song. And then they found mice don't normally like to nest around any noise at all, like they're naturally timid. Um, but then, uh, if this song was played when they were adult mice, um, they would want to go, they'd prefer to go and make their nest when this music was playing. So they tried it with.

• 48:16Speaker 00

  Adults, they got butt people in and they played them songs. They did this very stressful test where it's this like notorious test called the trias where basically you're made to do a maths test that is rigged that you're always going to fail. It's going to be too hard and the answers come too quickly. There's like a loud horn sounds every time you get one wrong. You can see a bar that supposedly how other people who've done the test before did and you're always doing much worse than that bar, right? People report doing this trias as like the most stressful thing, more stressful than like noxious thermal stimuli

• 48:58Speaker 00

  where their hand is burnt, more stressful than seeing like graphic photos of like corpses. The trias is what people find the most stressful and don't want to go back and do again. And she did this test where they would be made stressed by that and then they'd either be played some random music or one group were played music from this what they call the critical period, which is like around five and six. And if you're played, if she found that when people played the music from five and six, I mean reliably reduced their stress levels more than the control music.

• 49:33Chris Williamson?

  You mean that they went back to the time when these people would have been five and six, looked at the typical songs that were playing on the radio, Phil Collins or whatever the fuck?

• 49:43Speaker 00

  Yeah. So everyone will have like a critical period. So she think, and so she, her theory is this is a critical developmental period when we are learning safety because people who had had a trauma around that age, their critical developmental period was shifted earlier to about three or four. So as if the brain just goes, shit, we're not going to have time to fully develop. We need to like get things going, right? So they tended to respond better to music that was.

• 50:18Chris Williamson?

  What was the response? The threat response was downregulated? What happened?

• 50:23Speaker 00

  Yeah. So it's the, it's lowering of cortisol levels. So they'll do like cortisol swabs. It's also things like they'll do galvanic skin resistance. So they'll check the sweatiness of skin and things like heart rate as well. They'll also just get people to. Because we can, I got quite like obsessed with all these kind of like objective measures of like anxiety, but they'll also just ask people, what is your subjective, how stressed are you feeling right now? Which is always like a useful thing to do because sometimes you can get a lot of studies they've done on neuroscience and stuff, they'll get parts of the brain that are supposedly associated with threat flashing up and they'll go, oh, this person must be scared. But then when you ask someone in the scanner, are you feeling scared? They'll go, no.

• 51:06Speaker 00

  And actually, some of those studies, I spoke to one neuroscientist, Alexander Shackman, who was like, you know, actually, one of the problems we have is the tests are kind of boring and people fall asleep in the scanner. So clearly we can't be studying anxiety if like someone's like fallen asleep because they're so bored. And you're going, these people are scared of these things. So yeah, like the response was people were having, they were like moving into that kind of parasympathetic rest and digest state of kind of going, it's like almost like those songs are safety cues for them.

• 51:38Chris Williamson?

  Okay, so is the lesson, what's the lesson to take from that when it comes to childhood trauma and adult anxiety?

• 51:45Speaker 00

  Well, like

• 51:47Speaker 00

  there's two and like one of them is like the obvious ones that like, we've got to like really protect children and make sure they grow up in the best environments possible. Because these things can have disproportionate effects on how they grow up. But I would also say, you know, as an adult, you can, if you've been through difficult things in your childhood, it can be the most depressing thing in the world for someone to go, oh yeah, I'm afraid you're screwed. And here's like 50 studies proving it. By all it like, we're seeing more and more like neuroplasticity is still a thing. So what I would say is there is clearly an effect from that critical period of music. And you might find that listening to songs from that period help you.

• 52:31Speaker 00

  But I'm not convinced that that, having like looked across the literature, that effect is necessarily bigger than just listening to music that you love, right? I'm not sure, it might be an effect, but whenever we find an effect in our research, we've got to ask, compared to what? And there, and I'd say probably those songs do work better than random songs. Do they work better than like your favorite songs? I don't know. But in terms of like what we can do about it, the takeaway is that yeah, you may have had experiences early on. That have predisposed your brain to go, not in a nasty way, it's not even pathological. It's gone, okay, the world is a dangerous place. I'm gonna, we are gonna be on the lookout for stuff.

• 53:11Speaker 00

  And we're gonna look around and make sure that we spot this early. So, so I, you know, I'm, you know, someone might have social anxiety, right? They might like constantly think, does this person hate me? They, you know, you might be on a train and there's a couple of people are drinking. And you start getting anxious and you're, and part of your brain is thinking, is it gonna kick off? Are these people gonna be a couple of drinks down the line and gonna start like getting Larry? And am I gonna be, gonna get in a fight? Well, all of that is actually quite compassionate and rational of your brain. If you grew up in an environment where like, don't piss off dad. If dad comes home and he's had a few, like just get out of the way, like spot the early warning signs

• 53:55Speaker 00

  that someone might be not safe to be around, like, and try and spot the moments where the, you know, the shift in the tone of voice. If you've grown up around that, there's something, there's like a little note of warning in someone's voice, and that is the time you're gonna get, you're gonna get hiding if you don't get out the way. Your brain's gonna go, cool, like, well, that's cool, we're gonna apply that.

• 54:17Chris Williamson?

  That's an adaptive lesson, yeah, that's a useful thing.

• 54:20Speaker 00

  Yeah, like if you have a soldier, like in a theatre of war, who's just prepared to like walk down, sort of walk through an urban environment where there are like installed snipers, sort of whistling and like twiddling, twiddling an umbrella around their finger, you wouldn't go, oh, that's great, that's like a healthy human being who has no anxiety disorder. These things are contextual, they're deeply contextual, right? That you would think, you would think that person has rightly, I think you would think that person has lost their mind, their behaviour would be maladaptive. To be non-anxious and to not have any threat perception in a dangerous environment is, is, is, is in some cases fatal. As we've sort of said before, when people, you know, are unable to tell if someone's trustworthy

• 55:04Speaker 00

  or not, the question is, and I think the question that anyone's gotta ask is like, is this, how's that working out for you, basically? Is this still serving me? If it's not, there is no indication that the brain is not.

• 55:21Speaker 00

  Plastic, the, the, the brain is changing all the time, which is why I got a lot of neuroscientists laughing at me when I was going, I read a study that said eight weeks of, of, of meditation can change the shape of the brain. And they're like, yeah, like taking a shit changes the shape of the brain. Like if you do that in the same loo every day, like, like every action we do changes the brain. Every action we do is making new connections, strengthening connections, wrapping these myelin sheets around neurons. What this is, you know, what they call Hebb's postulate, what fires together, wires together. You cannot do a thing in your life that isn't changing your brain. So I, I would, you know,

• 56:03Speaker 00

  I think it's a really important takeaway is to say like you, you know, of course, there are neurological conditions. You can get, you can take a brain injury that affects your brain. But in terms of a childhood experience, um, meaning that you were destined for all your life to, to, you can't get better, you can't improve. Um, I'd say there is, um, the, the, the, the, the research simply doesn't support that at all is the good, is the good news. Like it is the research doesn't support the idea that you can't change the brain. I'd say it's almost impossible not to be changing the brain with almost every action and decision you make, which is its own kind of existential crisis. You're like, what habits am I laying down?

• 56:47Chris Williamson?

  You don't get to not make a habit, man. You only get to choose which type of habit you want to make. That's what people need to remember. Like every action that you take moves you toward a tomorrow that is more likely for you to do that thing again. You know, you want to eat the cookie or not eat the cookie. It's not just a case of eating the cookie is not not eating the cookie. It's also ingraining the eat the cookie module. So one of the things, talking about, um, identity, our sense of self, growing up and being an adult and stuff like that. Something that I'm really, really interested in, given the fact that you're a man, you're a professional, you have an identity, you have people that follow you online. You've got this big course that lots of people have done about coaching them to write and stuff, father, husband, masculine purpose.

• 57:30Chris Williamson?

  In the modern world, all this sort of thing. Something that I'm really interested in is how you have dealt with the sense of self referential feelings around being someone that has panic attacks. Now, did you struggle with masculinity, with your identity, with what you feel your place in the world is, given the fact that you're doing something that traditionally is not seen as that protector provider stereotype?

• 58:01Speaker 00

  I mean, so yeah, absolutely. And I think that, of course, like you wanna, part of you's like, imagines that you're above all that and you kind of go, well, I don't really, you know, I don't, I'm confident enough in my own masculinity to not feel threatened by that. But when you are on the floor, like having shoved like a towel in your mouth to try and cover the sound of you screaming so your baby daughter doesn't hear because you don't want her to be afraid in sort of two rooms away while your wife looks after her. And you're, because you're scared of nothing. Also, also, you're just in your house, right? There's no threat.

• 58:46Speaker 00

  It's, I think it's impossible for anyone, no matter what their relationship to masculinity, to feel diminished by that. We know actually from really, some really interesting studies I read, that people who have more of a sense of sort of what we might think of as sort of traditional masculine values. And I want to be careful how I say that because that's, that's a bit loaded. But the idea that men shouldn't get anxious, that men should be sort of self sufficient.

• 59:18Speaker 00

  They consistently have worse, are more likely to get PTSD and have worse symptoms when, when they do.

• 59:24Chris Williamson?

  Why do you think that is?

• 59:25Speaker 00

  I think if you can't, well, we know that the ability to, it's gonna sound so like obscenely simple, but the ability to talk to someone about what you're feeling and have it validated and be heard. It's like, I think, fundamental to getting over anything, to be able to go like, partly because it means you've got to be able to articulate yourself. So it requires some self, level of self insight. And if you can't, if you can't.

• 59:56Speaker 00

  If it shatters your identity to go, at the moment, I'm really anxious, I'm not coping. So you can't let that in. You're going to constantly have an incongruence between your daily experience and the person you want to be. And you'll know that you're not living up to what you want to be, right? Like, you can say it all the time, but you know. And so you constantly feel like a failure, right? You continually do. Also, if you can't go to a doctor or, you know, or just a friend, right? And say, I'm having the shittest time. I'm getting like stressed, I like getting keyed up, I like, I can't sleep at the moment. I'm like, keep thinking there's someone in the back garden, gonna break in.

• 1:00:39Speaker 00

  I was up at two o'clock, like with a flashlight, like all of these things. If you can't speak to someone and they go, yeah. Like what I was talking about earlier, that sounded like a throwaway line about religiosity, reducing inflammation. Well, one of the reasons that might be is just people having supportive communities who they can go to where it's normalized to go, I'm having a shit time. I've just been bereaved, you know, like in a religious community. If you lose, if you lose someone in your life, they die. It's expected that you'll be able to talk to them about it. And that is in itself like has such a, it may even account for many of the instances of the placebo effect that sort of so bedevil psychological research in that just going to someone.

• 1:01:23Speaker 00

  In fact, when we look across all types of evidence-based therapy, it doesn't matter what the modality is, right? It doesn't matter, it doesn't matter what type of therapy it is, they all perform about the same. And a lot of that, I think, is just being in a room with someone who listens. We're a social gregarious species. We are, which is why I think like so many people found like lockdown. And I don't think you could have done anything worse for people's mental health than stop people being able to meet up with each other. It's such a terrifying thing, especially, and then people dying outside, right? Those two things in combination, terrible for people's mental health. And I, I, I think that, I think there's loads of great aspects to masculine values.

• 1:02:06Speaker 00

  You know, it's one of the things I talked about with Dave Thomas about exercise and stuff. Setting and meeting challenges is.

• 1:02:16Speaker 00

  Is is one of the things that, you know, helps my anxiety the most, like pushing myself, not going, I, oh, I need to sort of back away from this. The more you back away from challenges, I think it's understandable that we want to people and everyone around you will say we should, you should rest, you should, you know, give yourself a break. But actually, the stuff that's always helped me has been like, I'm going to train to run a marathon.

• 1:02:38Chris Williamson?

  Yeah, lean into it, man. That's, this is one of the things, the kind of recursive self-loop that I see. And I've seen in myself. So throughout my twenties, I was struggling with low mood, depression. I don't know whether it would have been clinical. I went to a GP when I was 21, and this, they gave me a single printout and sort of ushered me on my way. So I'm hoping that it's that the NHS has improved a little bit since then. But throughout all of that time, when I was suffering with low mood and stuff like that, so much of what happens is you become increasingly less able to lean into discomfort. A difficult thing happens, or there's a challenge that's placed in front of you, and you get to the stage where getting out of bed seems like

• 1:03:21Chris Williamson?

  an insurmountable task. You think like, I, I, I simply can't go and have a shower. I simply can't go and make myself some food, or even be bothered to go and get myself a glass of water. And then you do it, and you come back and you go, oh, my God, like, that was, that's me for today. That's me done for the day. And then what you see when you're in a good place is that that reverses. You see that you're more able, you're more anti-fragile. You go into the gym, and you're putting more weight on. And there's this sort of, it is, it is a masculine value, right? You sort of grit your teeth and get through this very, very difficult thing that you're doing. And it's not out of some sense of fear. It's out of a sense that you know that you can, and that you're going to do more, and you're motivated. But both of these spiral either

• 1:04:04Chris Williamson?

  down or up the same way, you know?

• 1:04:07Speaker 00

  What's so fascinating about that is that I actually ended up having that confirmed. The bit where that part clicked for me was when I was speaking to AI scientists, right? There's this whole field of psychology now called computational psychology, where we started making like, self-piloting drones that would become neurotic, that would stop leaving the, that would stop leaving the factory, right? And we started having AIs that were acting a bit like people with anxiety disorders, right? They're self-driving cars. Really interesting speaking to a friend who like, Works, you know, as a researcher for self-driving cars and they had all these problems with the self-driving cars in um Milton Keynes where they were so

• 1:04:50Speaker 00

  they were really, they were, you know, that these cars are made to not crash into people, right? And the public realised that the cars were really conservative in how they drive, so they just start walking out in front of them. And it got so self-driving cars couldn't, would like be stopping and starting and just creeping along. Because they get more, because people adapt their behaviour around them. Well, what we see with AIs is we started to notice that some AIs would sort of, would, would, would, would travel less and less far in like route finding. And then eventually just wouldn't go anywhere. And what it was is they were learning about threats, taking evasive action. And then maybe that threat was only temporary. Maybe a seagull was flying through that area at that one time.

• 1:05:35Speaker 00

  But because they never try that route again, they stop updating their data on that. Because when we do anything, and this comes from like computer, from computational psychology and this kind of AI science, we're actually surreptitiously doing two things, right? We're doing the action, we're doing the behaviour, we're also collecting data on the results of that behaviour. Well, when you're depressed, if you stop leaving the house, you stop receiving data on what it's like to leave the house, right? And it, and, and, and, and your whole schematic of what is, what, what, what threats are in the world and what the world is even like is, gets more and more skewed. It gets more, you, you get, your data becomes more outdated and you get a data set

• 1:06:17Speaker 00

  from a tinier and tinier cluster of behaviours. Well, as soon as you start doing the opposite, I, I wouldn't even say to people, you have to get to the stage where you believe I can smash this, I can, I can get fit. I can go down the gym and I can bench my, my, past my personal best. All you have to do is be a good scientist and go, should we test this? Like, should we, should we do a test? Because like, you know, depression sitting on your shoulder, it's like, or anxiety or whatever, it's going like, okay, that is a good hypothesis. I can't do this. Let's try out. Let's see what happens, right? We can do this. Let's do four trials. Let's do this properly, right? Because if you're so convinced, you're not going to be scared for me trying this, right?

• 1:06:58Speaker 00

  Because you're going to be proven rapturously right. So let's try it out. And then, of course, what happens is you go, shit, oh, I did that. What was good? So if I was wrong about that, that one localized misbelief, what other things could I be wrong about? And then the whole

• 1:07:17Chris Williamson?

  Spiral again, that's that recursive spiral that I'm talking about. The problem and the point at which I've been at staring at the ceiling of a bedroom for more days than I can remember, trying to break the inertia between those two worlds, trying to break the inertia of I can't do this to let's try and do this. And that that is the point at which I got stuck an awful lot. And I think a lot of other people do. And now, you know, many years hence and a lot of self work and stuff like that, it's increasingly difficult for me to think about that. And it's increasingly easy for me to find equanimity when something bad happens and increasingly easy for me to lean into discomfort when I need to as well. And you know, I might

• 1:08:02Chris Williamson?

  relapse at some point in the future or whatever, but every single time that even anything difficult does happen, it seems to happen less. And that spiral makes me feel empathetic for the previous version of me that I used to be, because I know how far that person was from having that positive reinforcement, from overcoming something and knowing that we'll be okay and getting out the other side. And it's fine. It's just for now. It's not forever. And all of that stuff. That learning process is is very meaningful.

• 1:08:31Speaker 00

  Yeah, and it's also, I mean, that feedback as well, they, they, it's, it goes back to kind of like the old kind of like classical conditioning that Pavlov was doing with, with, with the dogs where um, that his, his, um, his lab where he was testing these dogs, you know, where he was ringing, he was sounding a buzzer or having the ticking of a metronome and showing them like a bowl of meat powder and they would salivate and he would measure that, that they would certainly learn to associate the buzzer or the ticking of the metronome um, with food and they'd salivate just at the noise, right? Well, he had a flood in his lab um, one, one night and um, all the dogs had to be rescued and it was very traumatic for them.

• 1:09:13Speaker 00

  Like the water was coming up to the, because it was in a basement area, right? And, and the dogs had like a pretty shit life under Pavlov anyway, but like this was particularly bad. But afterwards, um, they found that all the dogs they had in the lab were no longer, they couldn't do that classical conditioning after that. They, there's something had frozen in them and they couldn't learn new associations. And, and this has been like in the work of um,

• 1:09:42Speaker 00

  in, in, in the work on learned helplessness, where a dog gets sort of like, one area of the floor will be electrocuted and another won't and it will be, it will be shown a light and it has to move from one to the other. And eventually they make the task impossible for the dog. Eventually it will just lie down and let itself be electrocuted. And the only way that you can retrain a dog that has been through that is the, the, the, the experimenter has to like literally go in and drag the dog onto the safe area of floor to show that its assumptions about what is and isn't safe. Once that, because they'll, they'll, once they make the test possible to win again, the dog won't bother to learn that it, that it can win it because it's just learned that life is impossible.

• 1:10:22Chris Williamson?

  But the dog's inertia around its own worldview is so high that it on its own can't overcome it.

• 1:10:30Speaker 00

  And, and so, and an experimenter has to like come in and literally, I mean, it's hot, don't do that to dogs. Like I could have told you that a dog would be depressed if you electrocute it repeatedly. But nonetheless, the lesson from this is they, you know, that you drag the dog onto the safe area and you do that repeatedly and eventually it's like. Okay, my assumptions about the world are wrong, but it is not going to do that itself. And that's what we can end up like, basically, in this kind of metaphor is like, we just stay on that electrocuted part of the floor. And I saw this in other experiments, this guy Peter Loverbond did one where people would be get an electric shock just before a sort of blue square would be flashed up on the screen. And they'd be told, there's a button, right? And you can press it.

• 1:11:17Speaker 00

  And if you press it, like, within a second of the blue square coming up, the electric shock won't happen. And what they found is that they could, the button could be wired to nothing, right? And they just tell people that's what's going on. And they learn to press the button and they think they're stopping an electric shock, but there was actually never going to be one. And then, when they're shown a blue square, people who had that button to press will get a jolt of anxiety, you know, all those kind of like physiological signs of it, even though they've never been electrocuted by that blue square. And people who weren't given a button to press, who didn't think that there was any sort of the safety behaviour, who actually then had the moment of going, I'm going to be electrocuted.

• 1:12:01Speaker 00

  Oh, oh, no, there was no electric shock. Unlearn that association and don't find it scary anymore. And this is something they call safety behaviours, like our ability to, people thinking, I can't, I have a panic attack on the bus unless I sit, I have to sit like one of two seats by the driver. And this is the second bit I wanted to get on really quick, based on what you were saying about like facing up to stuff. As I spoke to this amazing researcher from Oxford University called Dr Andrea Reinika, who I heard about, someone told me about her and I thought that can't be true, where she was solving, curing people of their phobias and anxieties, like claustrophobics, by locking them in a cupboard, in a dark cupboard.

• 1:12:46Speaker 00

  While giving them this thing called, uh, decycloserine, which is like increases neuroplasticity and saying you won't be let out. Like, I'm gonna put you in there and I'm not telling you when I come back. Can't call for me, don't scream, don't do anything. And these are people with like chronic, like really bad, um, phobia, claustrophobia. Um, and you just have to trust I'll come back. And you also, you can't do any safe behaviours. No, taking, you know, a rescue remedy or a, a propranolol, you can't like do rosary beads, you can't pray, you can't tell yourself the nice lady will be back soon. You've just got to sit there and just like bathe in it. How the fuck is this ethical?

• 1:13:25Speaker 00

  Well, it had people's, um, they had their, it had their informed consent. There was a pretty reasonable dropout rate. A lot of people don't want to go through it, right? It's rough. Um, the trick, one of the tricks was, actually she came back in 15 minutes. People were, had like cleared the whole day. They thought they might be shut in there all day. She came back in 50 minutes. Her like cure rate is one of the highest I've seen out of any treatment. Um, we, we know that like phobias are probably one of the best, most amenable to treatment out of anything we can do. But these people would like have their amygdala response and their phobic response like normalized. I think it was something like

• 1:14:04Speaker 00

  at least two thirds, that was it. Like 15 minutes and their phobia was cured. And their claustrophobia was cured, which is nuts. Why? What's happening there? Is it the drug? So decycloserine is a controversial drug to use in this situation. Um, I read one paper that was called, right, so you will have already guessed what the problem with giving something that increases neuroplasticity is if you put them in a very traumatic situation. And the paper was called decycloserine, making, um, good exposures better and better exposures worse, right? If the person panics in there and starts doing safety behaviours, um, the, the neuroplasticity, um, bakes that trauma in harder,

• 1:14:47Speaker 00

  which is why, um, they're, you know, they're, they're looking at some other possibilities because it's a risky thing to use. Um. It's no good sitting down to someone and saying,

• 1:15:00Speaker 00

  "The spider isn't gonna bite you." Like, it's, how many times have you been bitten by a spider? None. How many people do you know have been killed by spiders in your friendship circle in the UK? None, right? Um, it's no good telling someone that. It's not getting to the parts of the brain that are making them feel like they're gonna die and they've got to get out of there. Your brain does not believe in hearsay. It doesn't care about that. It's got to experience it. And what going in that cupboard gives is like a cast iron experience. You have just gone up against everything you feared, and it had jack shit.

• 1:15:41Speaker 00

  Like, you turned around to the axe murderer who's chasing you in the dream, and you stood, and it turned out they were just a phantom, right? And there is something, I mean, of course, like on a conscious level, the idea of facing your fear, we can all kind of understand how invigorating that must feel. But just on a, on the kind of neurological level, and again, I'm talking about, I spoke to several neuroscientists who are like, their names are in. I got a copy of the manual Neuroscience out of the library, and I looked up the last living name in the history section on anxiety. And then I phoned him, I emailed him, and he was like, "Yeah, I'll speak to you."

• 1:16:25Speaker 00

  And I got to speak to this guy, Joe Ledoux, who's like the amazing neuroscientist who deals with anxiety, and like undoubtedly the most famous in the world. And he said that what you've got to do is let these parts of the brain, he talked about the amygdala and the hippocampus, just like learn that the threat is not a threat. But you can't do that consciously. It's got to happen non-consciously. It's got to go through it and go, "Yeah, oh, okay, stand down, everyone. Like, turns out we were worrying about nothing." You can't talk to that part of the brain.

• 1:17:04Speaker 00

  Theoretically.

• 1:17:05Chris Williamson?

  So having gone through all of these different strategies, tons of different techniques for trying to reduce anxiety, what is it that you've come to believe on the other side of it as someone who had a lot of firsthand experience, but also has now done a good bit of research with a thousand papers that you've read? What have you come to believe about what does and doesn't help anxiety? How's this changed the way that you deal with it in your daily life?

• 1:17:30Speaker 00

  Well, anxiety makes us crave certainty, right? I think anyone who's dealing with anxiety wants, like, I don't mind saying I wanted easy answers, right? I just wanted someone to say, this is what you need to do. Anxiety craves certainty. It submits to authority. We want people just to tell us what to do. And the way out, and it sucks, is uncertainty. It's exactly what you were talking about when you were saying that moment of doubt where you go, what if my beliefs about the world are wrong? There is something much more terrifying behind anxiety. And I think the key to it is in people who've been through childhood traumas and yet blame themselves somehow.

• 1:18:14Speaker 00

  And I spoke to one guy who did like psychotherap- psychedelic therapies and worked with people who've been through really, really grim shit, um, doing psychedelics and doing therapy while they were under the influence. And I said, why do people, why would someone think that was their fault? And the key thing is, if it's not your fault, then it wasn't under your control. If it wasn't under your control, there actually is no sequence of things you can totally do to stop bad things happening again. That is the horrible truth about being a human alive in the world that we are asking anxious people to embrace when we ask them to come out of the woods, right?

• 1:18:58Speaker 00

  And I think that's where we've got to start, right? That it's, there's a reason to hold on to the destructive beliefs of anxiety and panic. And it is that if I can just hate myself enough.

• 1:19:14Speaker 00

  I can, I can like, set the algorithm up, the fear algorithm, I can actually predict any threat, and I can actually make my life safe. You can't. You, you just can't. We can do sensible things. I'm not saying you should like drink a quart of whiskey and go dance on the motorway, but you cannot structure your life to avoid pain, threat, like it's just not possible. And that is a bitter pill to swallow in the midst of anxiety. But it's also where liberation lies. And that is, I mean, if you told me that at the beginning, I would have been so angry. I'd been like, you don't understand. And I'd say, no, I

• 1:19:57Speaker 00

  don't understand. So let's talk about it. Because the other thing is all of this stuff about, oh, this is how, you know, the cardiopulmonary system works. This is the hormone cascade is all for naught unless someone feels understood. This is what an anxiety therapist of 25 years, this guy, he's also an author, Mike Shell, told me. He said, he used to go in, he said, like, talking to people about the fight-flight response, and telling them all the literature, and just dumping it on them. And he said, he realized that you can't get anywhere until you feel like you've been understood, until someone has heard you. And you go, because

• 1:20:40Speaker 00

  that was the breakthrough moment for me. And you go, that's right. Oh, you get it. That's exactly how it is. And then the other, and it's almost like when you accept that, and when you've been heard, all this other stuff is like, actually, all this other shit is relatively easy. Because we know, like, oh, people are going, I know I should do exercise. I know I should eat better. I know I should challenge myself, but I can't. And that thing about the impossible task you were talking about, you can't like put your, people are going, we actually, we need to like, the world is very stressful, and we need to campaign for sort of a more just world. Well, I agree with that. But at the moment, I can't like bring myself to like have a wash. So can you understand why I'm

• 1:21:24Speaker 00

  not in a state to like upend the current system? Like, that's not helpful to me. Well, like, one of the things that unlocks that ability to start doing things that are in your best interest is in the moment where the message of anxiety Feels like it's delivered, like the little carrier pigeon of your anxiety has like delivered that message to someone and they've heard you and they've gone, that is shit. And you've explained it to them and you hear yourself say it as well. And you hear them say it back to you and you go, fuck. That's actually, now I say all that out loud, that's pretty bad, isn't it? I've been through a lot, I'm quite courageous.

• 1:22:03Speaker 00

  Then like a whole bunch of stuff melts and then a whole bunch of energy that you've been using to be anxious, you can start like redirecting that. That like adrenaline's fucking great. You can use that to like, I started doing like boxing, one to one lessons and it like beat the shit out of me. I went to the guy, I was like, can you, I just wanna learn how to get punched in the face. And he was like, yeah, let's do this. And it was great. And I'm like, it's, it is scary, it's not great. I don't enjoy particularly having like someone swing at me and punch me in the head, right? But it's, it also is funny, it's funny in a boxing contest, context to do all that stuff.

• 1:22:47Speaker 00

  And I'm like, oh, I've got all this adrenaline and energy. I can use this to like just rant it on like a step machine or a, or a bike or doing sprints or like getting the kind of like battle ropes and you're, and it's knackering you and you're like this, oh, like adrenaline feels good. So ultimately, I think like none of it, none of it, I think can start until you have felt understood. And if you can't find someone else to do that, then being able to write it down and at least for you to come to terms with it, you know? I, I think, I think, I think everything else comes out, out of that.

• 1:23:32Speaker 00

  And, and that's why some of this stuff about all the other stuff that we know we should do, but we can't bring ourselves to do, that falls into place.

• 1:23:41Speaker 00

  When that kind of like the core part of you inside, which is just like this kid that is freaking out, feels like someone's got the message. And then they're like, okay, stand down, alarm's off. Now, what were you saying about like, eating some vegetables? I can do that now because I've like delivered my message.

• 1:24:02Chris Williamson?

  Tim Clare, ladies and gentlemen. If people want to check out what you do online, where should they go?

• 1:24:07Speaker 00

  Um, you can follow me on Twitter at Tim Clare Poet, or you can just go to my website, timclarepoet.co.uk.

• 1:24:13Chris Williamson?

  And Coward as well. Your book will be linked in the show notes below. Tim, I appreciate you. Thank you.

• 1:24:19Speaker 00

  Thank you very much for having me.

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