Can You Become a "Practical" Optimist?

There are many benefits to being an optimist - particularly when things go wrong in our lives. But we aren't all naturally optimistic, so can we learn to adopt the best and most positive behaviours of born optimists? Through treating New Yorkers caught up in the 9/11 attacks, psychiatrist Dr Sue Varma developed a concept she calls "practical optimism". She shares her tips on how we can all be more optimistic in the face of life's challenges. Read more in Sue's book Practical Optimism: The Art, Science, and Practice of Exceptional Well-Being https://www.doctorsuevarma.com/book/ Dr Laurie spoke to Sue Varma MD at the 2025 World Happiness Summit https://wohasu.com/. Get ad-free episodes to The Happiness Lab by subscribing to Pushkin+ on Apple Podcasts or Pushkin.fm https://www.pushkin.fm/join-pushkin. Pushkin+ subscribers can access ad-free episodes, full audiobooks, exclusive binges, and bonus content for all Pushkin shows. Subscribe on Apple: apple.co/pushkin http://apple.co/pushkin Subscribe on Pushkin: pushkin.fm/plus https://www.pushkin.fm/join-pushkin See omnystudio.com/listener https://omnystudio.com/listener for privacy information.

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

• 0:00Speaker 00

  This is an iHeart Podcast. Guaranteed Human.

• 0:04Speaker 01

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• 0:32Laurie Santos?

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• 1:16Laurie Santos?

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• 1:47Speaker 00

  Pushkin.

• 1:55Laurie Santos?

  There's no way around it. Sometimes, life is tough. Awful even. Bad things happen all the time. Whether it's an unanticipated health problem, a new relationship woe, or dire news on the job. Sometimes these nasty circumstances result from our own behaviors and choices, and sometimes they have nothing to do with us whatsoever. Every day, people become the victims of random accidents, natural disasters, or even unprovoked attacks. In the aftermath of awful events like these, it's easy to feel upset and broken. And when things are really bad, you can even start wondering whether you'll be able to pick up the pieces of your life again.

• 2:30Speaker 03

  It is so fabulous to be back in Miami, in this beautiful city, in this beautiful weather. With your beautiful people.

• 2:36Laurie Santos?

  This spring, I was invited to host a discussion at the World Happiness Summit in Miami. And that gave me the chance to interview someone who's dedicated her career to helping people whose lives have been impacted in awful ways.

• 2:48Speaker 03

  Thank you so much. Meet this amazing audience. I'm so excited to see you.

• 2:53Speaker 04

  I am so excited to be here.

• 2:55Laurie Santos?

  This is psychiatrist Dr. Sue Varma. Sue was the first medical director at the World Trade Center Mental Health Program at NYU, where she treated people caught up in the attacks of 9/11. Sue has now gathered her insights from decades of this kind of work into a new book called Practical Optimism: The Art, Science, and Practice of Exceptional Well-Being. In the book, Sue explores strategies we can use to deal with the difficult chapters in life. And her biggest recommendation is to adopt a particular form of optimism, what she calls "practical optimism."

• 3:26Speaker 04

  To me, optimism has head-to-toe benefits, but at the end of the day, what optimism is, is a mindset.

• 3:34Laurie Santos?

  The World Happiness Summit, or WASHU as we call it, is an amazing event. If you like this podcast, you would have an absolute blast at WASHU. But with so many speakers scheduled, I only had time to chat with Sue about a tiny part of her work. So I asked her to record a fuller interview just for you.

• 3:50Speaker 03

  Nice to see you. My pleasure. Looking forward to it.

• 3:53Laurie Santos?

  So I got her back to join me on Zoom.

• 3:55Speaker 03

  Yeah, I'm fine with whatever works for you. I don't mind doing a full episode. Yeah.

• 3:59Laurie Santos?

  And began at the beginning with her story of the morning of September 11, 2001.

• 4:05Speaker 04

  So, you know, on 9/11, I was a medical student and I was working in a New York City hospital. And I remember getting the call to say, you know, discharge as many healthy-ish people as you can because we need to make beds for people who are going to be coming in who are injured. And we did that. And we waited and waited and waited. And we just simply didn't see the kind of numbers that we were thinking because the death toll was so high.

• 4:29Laurie Santos?

  Do you remember where you were when you first like heard about the towers? Like, were you already like at work and saw it on TV or something?

• 4:37Speaker 04

  Yes. I remember like we would come in at 5:00 AM. So I'd already been there for like three plus hours when we were hearing the news and seeing it live as the towers were coming down and as a plane crash. So, you know, it was freakish. And I remember like, you know, my sister-in-law was working downtown in 9/11. So many friends and family members were somehow down and around there. And we couldn't get through to anybody. Like, nobody was answering the phone. And we did lose loved ones, friends. I mean, there were so many stories of people getting caught in the dust cloud, seeing people jump out of the buildings, getting trampled on. And in the days after, myself and my colleagues, we volunteered in a variety of ways with first responders, with cleanup, rescue, recovery at the morgue, getting trauma training. You know, being a New Yorker my whole life, like

• 5:20Speaker 04

  this is a place I identified with. But I think no matter where you were in the country or in the world, I think a lot of people felt somehow connected and traumatized, rightfully so. It was devastating. You know, when I think of trauma, like you're never left the same. There's a you before it, and then there's a you after it. When I think of mass disasters and terrorism, it's really intended to chip away at your morale and your sense of self and your sense of confidence and trust in the world. And so what I saw in, you know, this whole concept of, you know, New York Strong, it really, to me, came from this idea that great tragedy, not always, but sometimes can bring out a sense of grit and toughness and community. And it wouldn't be until years later, after I'd finished my residency training

• 6:03Speaker 04

  at NYU in psychiatry, to be recruited for this role that I really didn't feel prepared for, but felt so honored to be considered and thought of for it. And, you know, it was a massive effort. It was a new program. And so when I- I came on, you know, I remember the early days, they're like, there's several hundred patients who are on our list. You're going to be treating first responders and civilians. And I was like, great, how many psychiatrists do we have, like six, seven? They're like, no, it's just you. I joked, I'm like, these are big shoes to fill. And they're like, no, no, no, you're breaking your own shoes because there are no shoes. Like, this is the first program of its kind. So incredibly daunting, challenging, but eventually extremely meaningful and rewarding.

• 6:39Laurie Santos?

  But you had, if I understand, I kind of someone to look up to who who'd kind of dealt with difficult situations with optimism. I'm thinking about someone in your family that you talked about in your book. Tell me the story of the inspiration that your dad was giving you.

• 6:51Speaker 04

  So, you know, my dad still is an inspiration, like he's going to be close to 90 soon. And he literally looks and acts and thinks 20 years younger, if not more. And one of the kindest, sharpest and healthiest people that I know. There's such resilience, you know, he came from very little in India and, you know, he was born in late 1930s and has seen so many decades of trauma and tragedy. And the things that I take away from him, you know, he would always say, simple living and high thinking. And this was a big saying in my family. And I always make fun of him. I was like, but dad, why are you always laughing? Why are you always smiling? Like, what is there to be like, especially now, like, what is there to be so grateful for? He's like, I mean, you can laugh or you can cry. I mean, you make the choice.

• 7:32Speaker 04

  He's always sometimes like laughing at his own jokes in his own head, telling himself stories, not in a delusional way, just like laughing. And I was like, but dad, you didn't have electricity, you didn't have running water. He's like, what are you talking about? We had like dance parties and slumber parties on the rooftop and camel rides and, you know, hurricane lamps. I'm like, that's because you had no electricity, dad. He's like, life was great. Life is great. He's like, how do you want to look at it? But like, how do you want to tell your story? And so, you know, I just saw him this morning and he's like standing there and he's like cutting fruit. That's how like immigrant dads show love in the house. He's like, what do you want to eat? Like, you know, cantaloupe, I'm cutting this, I'm cutting that. And I was like, wow, you spend three hours cutting fruits for the whole. Like, he's retired now. He's like, you know, we've got to spend our time some way. So I was just thinking about him and I'm like, you know, that saying like, you don't want to just add years to your life. You want to add life to your years.

• 8:16Speaker 04

  And he is like the perfect example of that, of just always enjoying himself, no matter where he is. No matter, he's always reading new books, always coming back and listening to podcasts and interviews and sharing things. So keeps himself intellectually stimulated.

• 8:28Laurie Santos?

  So it seems like part of his story is that even though he came from circumstances that might feel kind of negative or feel sort of harsh to other folks when they're listening to it, he seems like he's really happy and optimistic and resilient. And this sort of seems to fit with the question that you faced when you saw your patients. I mean, talk about the puzzle you sort of experienced as you saw different patients' reactions to the trauma of 9/11.

• 8:51Speaker 04

  Yes. So, you know, first thing I want to say is I never want anyone to feel less than if they do end up experiencing mental health disorders, whether it's related to an event or an incident or not. Most people, 20, 30, 40% of folks in their life will experience a mental health disorder, and 70 to 80% of people will experience a life-threatening event at some point or another, right? Well, what's interesting that when it comes to post-traumatic stress disorder, that while 80% of people will experience a life-threatening event, only about 8 to 10% of people will actually meet criteria for post-traumatic stress disorder. So what that says to me is, wow, right? Like, at least 90% of people will have really bad things happen to them in their life, big, bad, life-changing things,

• 9:34Speaker 04

  and yet they will move on. We had a lot of patients who were in the medical monitoring program but never met criteria for anxiety, depression, PTSD. So our brain has a great ability to bounce back, right? But to me, bouncing back from adversity, that's only part of the equation. It's an important part, but it's only one part. I wanted to help people thrive in the face of adversity, because which one of us will escape this world, you know, without anything bad ever happened to us? None of us. That is where practical optimism came to me, is because I would see these folks who, a lot of these patients who never became anxious or depressed, they would still come to our program and helping other folks. They'd bring them to their appointments. In the aftermath of 9/11, a

• 10:17Speaker 04

  lot of patients would have agoraphobia, or like avoidance of people, places, things, reminders is a feature of PTSD. So was hypervigilance, insomnia, nightmares, irritability. So they don't want to leave their house. And we would have these other patients who were like, I'm fine, I'll bring you, I'll take the subway with you, because they were so afraid of there being another attack in the days After or just having triggers and reminders. So these folks who never made it into my program, I would see them in the hallways and I literally would be like, what is your secret? And I started to see common threads of specific things that they did. But resilience in my mind was always something you either had or you didn't. And one feature of it was optimism, but there were other features like altruism,

• 11:01Speaker 04

  social support, moral compass, cognitive flexibility. But optimism was again, one of these things that you had or you didn't, and so was resilience. But what about the rest of us? And it wouldn't be until years later that there was a paper done with researchers from UCLA and they said, you know, there is a genetic link to optimism. So that was my first question, is it genetic? Is it something you're born with? And I love it when I find science to back up things that I'm already thinking. And it said, yes, there is, and it's this oxytocin receptor gene. And if there's some variation in it, you know, you may not be as optimistic. And what did that mean? Well, if you're pessimistic or have pessimistic tendencies, then you're more likely to get depressed. And then they looked at this gene and they said, well, what is it actually code for, right?

• 11:42Speaker 04

  It's a mindset, yes, but in addition to being a mindset, it's also the ability to regulate your emotions, to be able to ask for help. And I was thinking about so many of these things that in my therapy with patients, what is it that I'm helping them with? And can I teach people optimism? Can I teach them the things that optimists do? How do we codify this? What does this look like behaviorally in the world? And I found data in every field of medicine talking about it. People who are optimistic and do a brief optimistic intervention recover faster from colds or have less colds or infections. Or looking at exceptional longevity in this study in JAMA, that it was a meta-analysis of over 200,000 people and said that people who are optimistic live 10 to 15% longer. And not just longer lives, but healthier lives.

• 12:26Speaker 04

  So the concept of health span, because lifespan may be increasing, but we're spending the last decade of our lives, especially women with dementia, living in a nursing home or dependent on other people. So I was like, head to toe, optimists have less anxiety and depression. 30% less likelihood of getting strokes or dying from heart attacks or really all cause mortality. They're happier, they're 40% more likely to get Raise in the next year, they have more friendships, stronger and longer bonds from childhood, they are happier in their romantic relationships. I was like, why is no one talking about this? This to me is the jackpot. This is the well spraying of health.

• 13:00Laurie Santos?

  So I wanted to talk a little bit about how people tend to think about optimism. Cause I think when we hear the word optimism, we sometimes get it wrong. So what is optimism?

• 13:08Speaker 04

  Yeah, so I think a lot of people, I know I did think of it as like this woo woo thinking and just look on the bright side and everything will work out. And that is definitely not optimism. That is toxic positivity, asking someone to just get over something or look on the bright side. Optimism simply is the tendency to have a positive outlook in an uncertain situation to kind of expect best possible outcome. But to me, optimism by itself is only part of the equation because it's like I can have all the positive thinking in the world, but if I'm not doing anything actionable and proactive, I'm not going to be able to translate those positive outlooks into positive outcomes. And so in my mind, I needed something more. I needed a skill set and a tool set. And that is what practical optimism is. And that is how practical optimism differs from optimism.

• 13:53Speaker 04

  So if you're in that 25% bucket that is born naturally with a positive outlook, excellent. But the reality is that 75% of us are not skewed that way. You know, we might be sort of somewhere in the middle or maybe skew more pessimistic. So optimism is having a very favorable outlook, but by itself, it's not sufficient.

• 14:10Laurie Santos?

  So let's walk through this sort of updated version, practical optimism. How is that different?

• 14:14Speaker 04

  So practical optimism helps you translate positive outlooks into positive outcomes through action. And practical optimism is a practice, like having a yoga practice, learning a new language, learning how to ride a bike, learning a sport. Some days it's five minutes, some days it's longer, but it does require effort and work. And more importantly, it's a skill set. And what, why that was so freeing to me is like, we can all learn skills and we all should learn skills. And the practical optimism is a practice that requires you to take chances and to put yourself out there in the world and to course correct and to continually learn from mistakes.

• 14:49Laurie Santos?

  It's time for a quick break, but we'll dive deeper into Sue's idea of practical optimism when the happiness lab returns in a moment.

• 14:59Laurie Santos?

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• 15:42Laurie Santos?

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• 16:27Laurie Santos?

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• 17:11Laurie Santos?

  In her book Practical Optimism: The Art, Science, and Practice of Exceptional Well-Being, psychiatrist Dr. Sue Varma explains that a major pillar of becoming more optimistic is facing up to our emotions and processing them. So, why is that so important?

• 17:25Speaker 04

  When people look at optimists, they want to dismiss their happiness and say, "Well, they've never had anything bad happen to them. Of course, they're happy." And what people don't realize is that optimists and pessimists both experience the same number of life adversities. The difference is that optimists are better able to cope with them. And the reason is, is because they are in real time processing their emotions. It requires more effort and more energy to suppress your emotions. And when you suppress your emotions, they say that your body expresses what your mind cannot. And so, a lot of my patients will come to me and they'll say, "I don't know why I'm always sick," or "I have these headaches," or "I have these unexplained aches and pains," or "I ended up in the emergency

• 18:09Speaker 04

  room from panic attacks." So, processing your emotions is such a key pillar of optimism because it says, "Bad things are gonna happen to you. People are gonna piss you off. And what are you gonna do about it?" And a lot of times, people end up suppressing negative emotions, like when we talk about any kind of addiction or unhealthy behavior with substances, with anything. Hours of binge-watching, doom-scrolling, if it's meant as an avoidance, as a procrastination, you cannot escape negative emotions. They will come to haunt you. And that's why I say manage your emotions before they manage you, because in some form or another, I see so much suffering. You know, in my practice, a lot of these people look to the world as if they have it all together. And the reality is, I know differently because I get an interesting inside perspective of what is actually going on in their lives.

• 18:54Speaker 04

  And so, in one form or another, whether it's their relationship suffering, whether it's their work, something is going to suffer. So, we know that people who deal with their emotions are less likely to have all sorts of problems, heart disease. You know, there's something called type D personality. We've heard of type A and type B. And type D is this kind of like angry, holding on to emotions, not expressing them. It takes less energy to express it. I think so many people are afraid of their emotions. They're afraid to be alone. They're afraid to be alone with their thoughts. I know people who will put the music on always in the background because they don't want to be alone with their thoughts. And they're like, what would that mean for me? If I actually had to confront how I feel?

• 19:28Laurie Santos?

  Which I think is so sad, right? Because our emotions are this really useful signal about what's going on in reality and what we need to do differently. I feel like ignoring them, we do that really at our peril, right?

• 19:38Speaker 04

  Totally. And you know what is interesting, Laurie, is that I think a lot of times people are afraid to confront emotions because it means that they will have to make, in their mind, what they perceive as massive changes in their life. And they're not ready to do that. Because like, if somebody confronted the fact, wow, I really can't stand my partner, and I've been resentful for so many years. And if they were to confront it, it would require something to change. And maybe they're afraid that it would mean that this would be the end of this relationship, and then who would I be without it? So I get it, I understand. But I would also say that Rome wasn't built in a day. Like, we don't have to deconstruct our lives as a result of figuring out what it means. Like, I had a patient the other day who was sharing with me like, a lot of things that she was not

• 20:20Speaker 04

  happy about with her partner. And I was like, what do you think would be most helpful for me to say right now? And she was like, well, I know what I don't want you to say. I know I don't want you to tell me to break up with him. She knows on some level that the way things are not working, but isn't ready to end the relationship. So that's just one example. There's so many where somebody's like, I know what I need to do in terms of changing my life, or changing a job. Like, they know that if they were to allow themselves to be enveloped by the emotion, either that they would be debilitated by it. And I always say to patients, think of it as like dresser drawers. I'm not saying let's open all of them and take everything out and create an entire mess and pile in the middle of your room. I'm saying like, let's just look at one drawer at a time. And I'll help you pack it a little bit neater, right? But we're not saying everything, take out everything.

• 21:05Speaker 04

  Because I think there's a fear of being overwhelmed.

• 21:08Laurie Santos?

  And I think that fear of being overwhelmed can also involve not just being overwhelmed by the circumstances you need to change, but this worry that you might be literally overwhelmed by the emotion itself. And that's one of the reasons I love your book. You share this sort of handy rhyming catchphrase, which I love for how we can begin processing our emotions. What is this catchphrase?

• 21:25Speaker 04

  So it's name it, blame it, tame it, and reframe it. And the naming part is just name the antecedent or the trigger, just being aware of it. And there's so much evidence that having emotional granularity, just like understanding, putting words to what you're feeling and what caused the trigger. You know, when we look at people who have suicidal thinking, as weird as this may sound, we feel that patients who have understanding of what the trigger was probably have a lot higher chance of recovery and prognosis because they can tie it back to a specific event. And if you can do that, then you're more likely to be able to address the underlying causes and prevent them from happening again. So naming your trigger and antecedents and knowing what they are is really important.

• 22:05Laurie Santos?

  And so next up is claim it. What does it mean to claim our emotions?

• 22:08Speaker 04

  So when I say claim your emotions, where in your body do you feel them? A lot of times people will say that I have insomnia, or I have frequent urination, or frequent bowel movements, or I have headaches, or I have a lot of tension in my neck and my shoulders. So I say that the body expresses what the mind cannot, and a lot of times our painful or forbidden emotions shows up as physical symptoms.

• 22:29Laurie Santos?

  Another reason you talk about the importance of claiming emotions is it allows us to think about what we might call our forbidden emotions. What are forbidden emotions?

• 22:37Speaker 04

  So I think for some people, women especially, anger might be really forbidden. I have so many patients that I work with that end up crying when they're angry. It's scary because either I think that they're afraid of pushing the other person away, or that it means confronting or challenging the person. And then what? I think we've all created stories in our head about if I were to say something to someone, they're not going to like it, they're going to leave me, they're going to be mad at me, and then what? And I think it's helpful to be like, okay, yeah, and then what? There's a statistic that says that 85% of the time, the things that we worry about never actually happen. And the 15% of the time that they do, we're better equipped to handle it than we think. So I think that's really important to just keep in mind.

• 23:20Laurie Santos?

  So that's claiming our emotions, but next up is that we have to tame our emotions. And one way that you suggest doing this is to really try to tame our ruminative loops. What do you mean by ruminative loops? I think I know what you mean. I think I've experienced this myself first.

• 23:33Speaker 04

  Yes, I definitely have experienced ruminative loops. And it's just like you're going in circles with the same thought and what That does is end up creating powerlessness and it strips us away of our agency because you're repeating the same emotion. What if, or you're catastrophizing, assuming the worst case scenario, or you're projecting. But taming your emotions is like short circuiting and creating a break in that and saying, all right, I am feeling angry, anxious, helpless. What am I going to do to self soothe? And so taming is really about soothing. And what I say is pick an activity that's not going to create a negative habit on its own. So somebody may say a glass of wine helps me soothe, right? Then what happens when you need two or three or four to have the same effect, right? So we don't want the soothing activity to take on a life of its own.

• 24:17Speaker 04

  So I would say pick something that seems relatively healthy-ish. Can you make a five-minute phone call to a friend? Can you text someone that you know is going to be supportive and helpful? Could you do a one-minute meditation in place, wherever you are, just closing your eyes and taking a deep breath? For me, walking is one of the most soothing activities. And I was fascinated by the science of walking, that there's something about when you're walking, your eyes have to track what's out there in the world, like, so you don't want to get hit by a car. And all of that forces you, those eye movements, to get out of your own head. So going for a walk or any kind of exercise just gets you out of your own head and gets you out of routine. So whatever you're capable of doing, it could be a five-minute stretch. So we just want to keep it simple and lower the bar, but what's soothing for you? That's the big take-home point.

• 24:59Laurie Santos?

  You also mentioned this other strategy that I'm totally going to adopt myself, which is this idea of emptying your emotional spam folder. What is this?

• 25:07Speaker 04

  For me, I do that in journaling and I think that there's so much value and there's so much science behind two 10-minute journaling sessions. And there's no one right way to journal. What works for you? Like, sometimes it's literally for me, reiterating what happened in the day. And it's getting it out of your head and putting it on paper and you're like, all right, that's it, I'm done. You know, when I was a patient and going for my own therapy, I learned a technique called worry journaling. And somebody may say, well, that seems counterintuitive. Why would you keep a journal of your worries? And what I learned is that when you write the same thing over and over again, you start to see that there's a trend in your worries, there's a common theme. You're worried about the same types of things and that the things that you're worried about are not actually happening. And if you're willing to write down how you handled it, that creates a sense of mastery as well.

• 25:52Speaker 04

  So putting it on paper is one way to unload your worry spam folder.

• 25:56Laurie Santos?

  And so that's a nice transition to the last of our four tips for kind of processing our emotions. We need to reframe them. What is reframing our emotions? Why can it be so important?

• 26:07Speaker 04

  So reframing is one of the best techniques to try to put a different spin on a negative situation that happened. And I just want to say that there are some negative things that happen to you, that there will be no positive spin. There will be no silver lining, and I hundred percent get that. But other than the sort of big tragedies, ask yourself, and sometimes it may not be until you've created some distance between you and this bad thing that happened, but reframing allows us to take back some control and says, you know what? I'm not going to allow myself to be debilitated by this. And one way might say, is there another way for me to look at the situation? Could I look at it from another person's point of view? Could I understand it in the context of the larger plan for my life? So sometimes it might be a rejection. And there's this catchy thing, rejection is really just redirection.

• 26:51Speaker 04

  There were so many things that I wanted to do at certain times in my life, and I am glad in retrospect that they didn't happen at that time. Because for any number of reasons, I might have thought I was ready, or maybe I gained more experience later on, or I was better equipped to handle the challenge. And you could say, well, that's just you trying to be an optimist. And I'd say, sure. But the point is, I couldn't control it. I couldn't change it. So why not reframe it in a way that puts me at ease? So reframing really just is taking back control. And it's saying, I don't have to choose to allow myself to be a victim of this situation. Reframing is one of the most powerful techniques used in trauma processing therapy. But I recognize, you know, I had 9/11 survivor patients and friends, and they would say, you know, when we would talk about reframing, and they're like, you know, I don't see, there's no silver lining.

• 27:36Speaker 04

  And I'd say, absolutely. And it would be later on that I would recognize that there are some things that there'll be no positive way to put a spin on it. And then I realized from my eastern upbringing, something my parents would say to me is that, is this a problem to be solved or a truth to be accepted? And sometimes you cannot reframe something, and then it just becomes about acceptance. And I think, you know, my western upbringing would have me believe that acceptance was resignation, surrender, passive, meek and weak. Eastern upbringing says, no, acceptance is a very strong place to be when you don't have a choice.

• 28:08Laurie Santos?

  We need to take another quick break. But when we return, Sue will explain how she's been inspired by the Japanese art form of kintsugi, taking broken pottery pieces and reconstructing them to be even more beautiful than an undamaged vase. The Happiness Lab will be right back.

• 28:26Laurie Santos?

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• 29:10Laurie Santos?

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• 29:19Speaker 01

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• 30:01Laurie Santos?

  Treating people caught up in the destruction of the World Trade Center had a huge impact on Dr. Sue Varma's career. Of course, doctor-patient confidentiality prevents Sue from talking in detail about the specific cases she treated, but she wrote about one inspiring person who escaped the collapsing towers, a woman that Sue calls Shelley.

• 30:19Speaker 04

  So, you know, Shelley was one of the first patients I worked with and I had imposter syndrome. I was like, this is like a big job and like, how am I qualified to be here? And I was scared and I was like, how am I going to help Shelley? Because Shelley, in some ways, represented a lot of the themes that I was seeing, which was these amazing people, many of them high achievers, many of them leaders in their community. You know, Shelley's a mom and just like a very honest, hardworking, strong human being. And, you know, she was someone who considered herself an optimist, go-getter. She's like, I'm the one always doing the 5K races and throwing the company get-togethers. And so I never saw that something could break my spirit. And that was literally what she said. She was like, you know, on 9/11, here I am, I'm getting trampled, I'm getting caught in the dust clouds.

• 31:03Speaker 04

  I'm wearing heels that day, I love to look cute when I come to work. And the heel broke and then I'm walking barefoot and I'm asking for help. The next thing you know, like the dust cloud, like just, I, like, I, there's no ways to even put words on what happened that day. You go to work thinking this is just a regular day and then you're seeing people die in front of you everywhere. And she was like, I couldn't get home that day and my husband couldn't reach me. Like, she wasn't able to go back to work in that office. And eventually, when she did, she never took a day off and never asked for help. And it was really like only through the program that a lot of people were told that they're going there for physical reasons, for checking up like asthma, GI problems, and then they got mental health screenings. She wasn't even thinking that like, I need to get help.

• 31:47Speaker 04

  And in her story, as she's unfolding it, she just starts crying and she's like, I don't cry in front of people and I don't think I've ever cried about this in front of anyone before. And, you know, at the end, she said, I feel broken. You know, that was one of the hardest things to hear because I was like, what role do I possibly even play in helping you? Because everything you're saying to me is 1,000% legitimate. There's no silver lining. How do I get you to reframe? There's no positive spin. So the theme was the brokenness that Shelley was sharing. And it made me think of this art of broken ceramics, kintsugi in Japanese culture, which is preparing something to beyond its original form.

• 32:28Speaker 04

  Restoring it, but bringing upon a level of beauty that is like the two point O version. In Kintsugi, like you're putting these broken ceramic pieces together with a golden glue, a golden lacquer, and it ends up being even more majestic and expensive and valuable. And so when she said that, it reminded me, because I remember when I was in therapy and I would, I saw this art form in my therapist's office, it's a thing that my dad had from one of his trips many years ago in Japan. I thought to myself, is this an opportunity? Could tragedy ever be an opportunity for us to come back stronger? And so then became the journey, I think it was a parallel journey of me becoming a therapist, I think, learning so much from my patients and just going home and saying, you know what, like, I'm on this ride with them for better or for worse, and we're gonna, we're gonna get through this together.

• 33:12Speaker 04

  I don't have all the answers and I don't have them right now. But we're gonna co-create and co-construct a new reality that hopefully will be just as good. It's never gonna be the same. I get it. That Shelley who wore the heels is the Shelley that now wears sneakers. Or if she wears kitten heels and she brings like a bookbag, duffel bag and had a change of clothes, always anticipating in a way, like, what if this were to ever happen again? So in some ways, she was right. She was never gonna be that person. But after the treatment ended, you know, I sat with her and her husband. And he's like, I used to be the warrior in the relationship. And like, I finally have my wife back and she's able to function and she was able to ask for help. But it's returning back to a person, that sense of self that they lost of like that ability of, I can do this.

• 33:55Laurie Santos?

  It seems like going through trauma, so many people that you've worked with went through this idea of the sense of inner brokenness. And you talked about this as the effect that trauma has had on people's self-efficacy. What is self-efficacy and why is it so important for mental health?

• 34:08Speaker 04

  Self-efficacy is your confidence in your own abilities. And I think it's so interesting because it's not really saying anything about your actual abilities. And you know that saying like fake it till you make it? I think there is some truth to it, but not. The reality is nobody is saying completely fake it. Like you need to do the work, whatever that work is. If it's training to become a musician, like you need to train. But you also have to have faith and confidence in your ability to achieve the thing that you're working towards. So there's two aspects of it. One is continuing to push yourself to develop that ability, but then eventually. Actually believing that it is going to come to fruition. And we see there's so much work, like Albert Bandura had done a lot of study on self-efficacy. And he says that this sense of confidence comes from your own personal experience,

• 34:52Speaker 04

  from vicarious learning, looking at role models, getting feedback from trusted people. And then also just a sense of how does it make you feel, your own physiological feedback.

• 35:02Laurie Santos?

  It also seems like self-efficacy involves some specific expectations, both expectations about ourselves and outside ourselves. Explain what the research shows about that.

• 35:11Speaker 04

  Yes, there's two features to it. One is just the belief that you yourself have the capacity to achieve this. And then the fact that this outcome is achievable, period. So I'm just going to use weight loss as an example. Somebody may say, I'm doing all the things I know, like I know what I need to do. And that could be anything, like if somebody says, I'm trying to put on more muscle. I need to eat more protein. I know what I need to do. If I need to wake up like better sleep hygiene. So intellectually knowing what the steps are, that's a part of it. Number two, you carrying it out. But number three, will my work in the end be impactful? Will I see results? Because there'll be people who say, I'm still not seeing the result. Sometimes the results are not in your hand. You may say, I'm working really hard at work for promotion.

• 35:53Speaker 04

  I know what I need to do, but I'm dealing in a very stressful work environment that feels unfair, that feels biased, that feels like I'm walking an uphill battle. So I think that there are two parts that you need to feel efficacious because your environment lends itself to making you feel that way. And the environment needs to be supportive because you can do all you want. But if the system feels rigged against you, and again, it could be a matter of perception or it could be reality. So we have to entertain both. And I always try to ask my patients, I say, listen, I just want to get a better sense of your work. Tell me a little bit about your boss's personality. Give me a sense of the interactions. How do you feel? How do your colleagues feel about this? So I never want to deny that reality. If somebody says, I'm trying, I am doing my best and things are still not working for me.

• 36:36Laurie Santos?

  But both of those expectations seem to contribute to the benefits of experiencing self-efficacy. What happens when it feels like we're not able to do what we really want to do? What happens when we're not feeling so effective?

• 36:47Speaker 04

  So I think we end Feeling demoralized, disenchanted, disenfranchised, and we give up. And it's natural to think that you're going to fail. But what you really need to be reminded of is that you can rise up again. And so to me, proficiency is about reminding people at their very core of their capability. And like they did experiments with athletes and they're told, you're not going to win against this person. They're so much better than you. What they didn't know was they were actually matched with an athlete who was at the same level as them. But when you're told in advance, you're not going to be able to do this, they can't. And when they were told the opposite, oh, this person sucks compared to you. You're so much better. You're going to win. So a lot of times our expectation really predicts outcomes. And like there, there's an experiment where they tell students going into a classroom,

• 37:31Speaker 04

  the people there are very friendly or they're not. And the success of this student going to the classroom, being able to make friends, really had to do with what their expectations of what was to come. So I do believe in this concept of self fulfilling prophecy. And I don't think that optimism is at all magical thinking.

• 37:45Laurie Santos?

  So how can we fight some of these barriers that lead to a lack of self efficacy? What can we do to become more proficient? One of the barriers you talked about a lot is sort of fighting helplessness. How can we fight our inner sense of helplessness?

• 37:57Speaker 04

  So I think the first thing is just understanding and recognizing it as that and allowing yourself time to rest and to sometimes hit pause, maybe not stop. Validation is a key part of that is just to say, I had a really hard time. Like if you're lucky enough to have someone really like loving and caring and has your best interests at heart, to say, I get it. I see you. I see how hard you're working. And this was not your fault. Or could you learn something from this if you did have a role in it? And what can you do differently? So I think pausing, resting, recovering. Cause I think so many of us just go from one project to another, to another. And it's this like sort of destination addiction where you're like, I need to get to the next place. Without really thinking through, why do I continue to strive? You know, and to, and sometimes to look at the helplessness and say,

• 38:42Speaker 04

  is this an opportunity for me to change course? You know, am I meant really for this? Do I really want this? Or is there another way for me to achieve this?

• 38:49Laurie Santos?

  And that really nicely gets to a second barrier. You've talked about this idea of stuckness where it's like, I just, I'm never going to find a path forward. I'm just always going to be stuck. How do we fight this barrier? Proficiency.

• 38:59Speaker 04

  Fighting stuckness is about finding flexibility. And I talk about in the book about patients who are like, oh, I must go to, I don't know, fill in the blank, like business school or medical school or whatever it is. And it was actually a patient who, you know, she was like, I have to be a PhD in psychology. Like, this is the only thing she wanted since she was a kid. And her parents were like, no, that's, you're not really meant for that very long course. And we don't have the money for it. Like, and I remember talking to this patient, saying, is there anything else that you can think of? And one thing led to another. And next thing you know, she's the head of a wellness company. And years later, you know, she sent me a clipping of some award that she got. And it said, she had written, thank you. And this was something you shared with me in therapy. Write your purpose in pen, but your path in pencil. And that was so poignant to me because I was like, number one, I don't remember saying that, but thank you. I'll take it.

• 39:42Speaker 04

  And then number two, wow, you know, it was something that probably I needed to hear at that time. And, you know, just this idea that we don't have to be fixated on one specific path. Cause there's so many roads to feeling satisfied, to feeling needed, to feeling impactful. And often it's not the road that we thought that we would be. And that's totally fine. So flexibility is a big part of proficiency. Like you have to be nimble, you have to be quick, you have to say, I have tried. And it is okay. Giving up isn't always a sense of failure. I think a lot of times in this culture of go, go, go and work warrior, make it happen. Too much emphasis is on the final product, on the success, rather than the process, which is about making mistakes and learning and fun and creativity and getting lost. When my husband and I travel and sometimes we make plans and sometimes we don't, you know,

• 40:27Speaker 04

  we don't like to have fixed structured itineraries. We like to drive and go to small villages and meet people and see where things take us. You know, and I get that that's not always reality and it's not always productive or efficient, especially if you're traveling with young kids. But I think as much as possible, I love the idea of getting lost and just think about what feels safe and what parameters and guardrails. How do you want to intentionally and safely allow yourself to get lost?

• 40:51Laurie Santos?

  Such a nice way to sort of reframe your perceptions, which I think is like such an important part of flexibility. And so, so those are ways we can sort of fix stuckness. But the third barrier is also one that I relate to a lot. It's this kind of just fatigue, this idea that like, I'm too tired to be proficient. Like I just can't do. This.

• 41:09Speaker 04

  Yeah.

• 41:09Laurie Santos?

  What are some ways we can break through that barrier to proficiency?

• 41:12Speaker 04

  Well, I love that you share that because when I think of so many like really successful and high achieving people, I feel like we are at risk of burnout because we hold ourselves to really high standards. And I feel like in this culture, we're often taught that rest has to be earned or that rest is wasteful, unproductive, and it's frowned upon. And I just think that rest and leisure need to be incorporated as part of the work plan and scheduled with the same type of intention and urgency in a way. So when fatigue sets in, I think that whatever fills your cup, play, I think for me is always a way to do that. So give yourself grace and be gentle and recognize that, do you want to get to the peak or the summit of this mountain?

• 41:54Speaker 04

  Completely out of breath, weathered and worn down, demoralized, you got to the peak, but at what cost?

• 41:59Laurie Santos?

  It also sounds like it's just really recognizing our natural limitations, whether those are just kind of mental natural limitations, like we just need some rest, we need to take a break, but also physical natural limitations. I think this is sometimes why we feel so fatigued is that we're not taking care of our physical bodies too.

• 42:15Speaker 04

  Yes, yes. And I say like for me, like something I'm really working on right now, and it's something I've been thinking about for a long time is like sleep hygiene. You know, I think that I've always just taken my physical health for granted and sometimes there's there's consequences to that. And I've just assumed, oh, I'm a machine, it'll work itself out. And I remember a friend several years ahead of me telling me that, Sue, there's going to come a point in your life when you're going to make your schedule around sleep. And I was like, I don't believe you. Like, I make my schedule around everything else but that. That just fits itself in. She's like, no, I'm very careful about it. And now I'm thinking backwards where I'm like, if I want to protect this time, whatever it is, seven, eight, nine hours, then I'm going to work backwards. And the things that I'm saying yes to and no to are going to be centered around the sleep schedule.

• 42:57Speaker 04

  You know, it's about making deposits into this rest account. And so sleep is one way, 15 minute naps is another way, one minute meditations is another way, exercise is another way, anything that's going to refill your cup and replenish your energy.

• 43:12Laurie Santos?

  And so all these strategies that you're talking about for replenishing your energy, fighting helplessness, feeling less stuck, these were exactly the kind of things you talked about with Shelley. What was the outcome there? Was she able to use these strategies to kind of heal that inner sense of brokenness?

• 43:25Speaker 04

  Yes. And it's funny because she would joke, she's like, I didn't often know where you were going with certain things. Like when I'm telling you how I'm scared about another terrorist attack happening, or I feel like my sense of safety, or calmness, or hope has been changed or demoralized, you would say to me, talk to your boss about trying to get time off or sleep. She's like, I didn't understand where we were going necessarily, but you know, I figured I'm here, so I might as well show up and go with you. And so I think a lot of times when people come in to work with me, they'll come in with one specific problem in mind, and they're hoping to get an answer for that problem. And then I often say, let's back up and sort of take a 360 to approach your wellness, even though you're talking to me about, let's say, problems at work. You know, she wanted to get a raise, she wanted to get a promotion, but she was just so afraid. She thought that if I asked

• 44:10Speaker 04

  for days off, if I asked for rest, even if it was like blocking off an hour for therapy, that all of these things would get in the way of promotion because she would be seen as you're not really serious about this job. And what was interesting was by taking care of her mental health, by resting more, her boss was like, I had no idea that you were going through all of this. I am more than happy to give you PTO. No, I'm not going to doctor pay. Like, please consider it as part of the sick leave that you have, which you have tons of, you have never taken a sick day in your life. And she finally felt her mission to rest, her mission to take care of her mental health. And she ended up getting the promotion. I mean, her life changed. Like, a lot of it is because embracing the fact that your life is not the same. You know, and I think that's the hardest part, because so many people very quickly after trauma or any, any kind of setback,

• 44:52Speaker 04

  want to get back to who they were. I mean, it's not possible, because this, this event has transformed you and your understanding and framework of the world. But also, for a lot of people, going back to baseline also doesn't make sense, because your baseline might have gotten you to where you are right now, and why you're in my office to begin with. So really think about when someone says, I just want to be who I was. Is it realistic? Is it possible? And is it healthy?

• 45:18Laurie Santos?

  Because sometimes optimism really seems like it's about kind of accepting where we are and giving ourselves The grace to be in that spot.

• 45:24Speaker 04

  Yes, exactly. So it's interesting because when you think about optimism, it's just you think it only means one thing, which is to look on the bright side, not recognizing that it includes a practice of gratitude, of leisure, of rest, of self-compassion, of proactivity, of challenging the way that you're thinking. So there's so much more to it. And optimists do it naturally, not to mention having healthier habits and what's involved with that.

• 45:49Laurie Santos?

  Thanks to Dr. Sue Varma and the folks at the World Happiness Summit who introduced me to Sue's work. If you want to learn more about the summit or sign up for their 2026 event, you can visit worldhappinesssummit.com. That's worldhappinesssummit.com. But my discussion with Sue at Wausau was so insightful that I can't help but leave you with one more of the highlights. This was when Sue agreed to lead me and the audience in a name it, claim it, tame it, and refrain it exercise.

• 46:16Speaker 04

  Okay, so first of all, like just if you want to close your eyes, feel free, if you want to keep them open, you know, whatever worked best for you. Name the antecedent. Think of a problem, right? Think of anything that might have happened today or in the last week that could have triggered you to feeling upset, right? And the more granular you get, the more likely you are to be able to put your finger on it and change the problem. And we see this even as far and extreme as suicide, where somebody can put their finger on, these were the events that led to me feeling like my life didn't have value anymore. I didn't want to live anymore, right? So that is a dark scenario. But just think of an everyday problem. Name the antecedent, right? Then I want you to feel in your body, right? So maybe you want to close your eyes for this. Where in your body are you feeling the tension, right?

• 47:01Speaker 04

  Are you feeling it in your jaw? Are you feeling it in your shoulders? Are you feeling it in your legs? Where do you tend to hold the problem and the stress in your body, right? So now you've named the antecedent. You've claimed where it is in your body because often the body will express what the mind cannot, right? And it will take place in the form of medical problems, headaches, things like that. And then I want you, this is the taming part, and everybody has a different form of self-soothing. Some people may say that I want to take a one-minute meditation. I call these oasis moments, where you are shutting the world out and finding your grounded sense of peace internally. Right? It could be one-minute meditation. Or something that I've worked on

• 47:45Speaker 04

  that is based off of a best possible scenario. It's an optimism intervention. It's 10 minutes, but this is a one-minute version of it. So if you want to do this with me, let's go. I'd like to just close your eyes, settle in, let your shoulders drop, and I want to take you on a little journey with me. So now that I've asked you to envision a problem, right? So you've clearly defined the problem in your mind. I want you to imagine a road, a path, leading to the solution to that problem. And I want you to get very specific. What does that solution look like? And what does the road to the solution look like? Is that road straight?

• 48:30Speaker 04

  Does it wind? Does it twist or turn? And now I want to imagine that we are walking together towards that solution. We're getting closer. You're getting closer. And this solution is the best possible outcome that you could have envisioned. And you're starting to feel the anticipation of excitement, of delight, of success, of satisfaction, of personal gratification. You're getting closer. And now you have arrived at the best possible outcome of your solution.

• 49:18Speaker 04

  And I want you to feel all the feelings that come with success, with mastery, with resolution.

• 49:27Speaker 04

  Peace, happiness, and success are enveloping you right now. I want you to take a deep breath to the count of five,

• 49:39Speaker 04

  inhaling gently through your nose

• 49:44Speaker 04

  and exhaling slowly through your mouth.

• 49:48Speaker 04

  You're feeling relaxed, hopeful, successful.

• 49:56Speaker 04

  And just know that this feeling is always at your fingertips. Success is accessible within you through a positive mindset that you have chosen. And take a deep breath and open your eyes.

• 50:12Speaker 04

  Pretty good, right?

• 50:17Laurie Santos?

  That's pretty good. Thank you.

• 50:24Laurie Santos?

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• 51:28Speaker 05

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