Critical Thinking: Is It Becoming Extinct? w/ Guest Jon Abramowitz

Welcome to the Anxiety Society Podcast.

We're your hosts, Dr.

Elizabeth Mackinbell and.

Cali Werner, both therapists and individuals that have navigated our own anxiety journeys.

Have you ever wondered how we became a society that is so defined by anxiety?

Tune in as we discuss, learn and dive into what anxiety is, how we perpetuate it, and how we can stop it.

This podcast will be real, raw and unfiltered, just like the anxiety that plagues so many of us.

We are here to push boundaries, challenge the status quo, and deep dive into topics that are sure to make you uncomfortable.

If you're ready to step outside of your comfort zone and explore the unfiltered truth that will help you change your entire relationship with anxiety and get back to living your life, you're in the right place.

This is the Anxiety Society podcast.

We live it, we contribute to it, and together we can change it.

And there's one thing that I need from you.

Can you come through?

This episode is brought to you by the OCD Institute of Texas.

Listen up, parents.

From June 9th to the 13th, we will have an adolescent OCD camp for adolescents in the teenage years, hoping to gain some insights and traction with their ocd.

We'll be using evidence based practice or one on one clinician support and peer to peer support, gaining tools with exposure with response prevention to help gain freedom from ocd.

If this is something that's interesting to you or your adolescent, please give me a call at 832-900-1282.

Kali Werner here to help.

Also, you can email me@callieustonocd.org welcome back.

To Anxiety Society Podcast.

Today's episode, you guys, is going to hit home.

I can promise that no matter who you are or where you're joining, what stage of life you're in, this is going to resonate and I'm just so excited.

We have an incredible researcher, clinician, and also someone I like to call a friend and an amazing colleague, Dr.

John Abramowicz.

So, John, thank you so much for joining.

I'm so, so excited about today's show.

Thanks for having me.

Oh, we are so excited.

And I was going to say, I kind of was thinking like, oh, well, Liz could do this episode with John herself, but I'm such a fan girl that I had to be here too.

So I am excited static to be here.

John, this is the first time I'm actually talking to you.

No pressure.

Oh, well, okay.

No pressure.

It's nice to meet you.

No pressure for me, pretty much.

So.

Okay.

Anxious moment we always start every episode.

So this is kind of what made us anxious this past week.

Yeah, whoever.

Yeah, I'll go first.

I'm happy to, but I have felt a bit anxious about life.

Shocking, I know, but kids, I don't know if I've talked about this, but I feel like so many people in my circle right now have kids that are about to go to kindergarten.

And so everybody's talking about, what school are you going to send your kids to?

And I have no clue what school my kids are going to go to.

I don't know where they might get in.

We also are, like, not in a public school we'll probably go to.

So then you feel like there's all this pressure of, like, oh, my gosh, do I have to move?

What decisions do I have to make?

And I just find myself constantly reminding myself that it doesn't actually matter what school they end up at, and healthy kids can come from any school and that this pressure is kind of ridiculous.

But for me, I have to accept that.

But also, I have found I kind of have to limit the amount of time I spend talking and thinking about it, you know?

And so Matt will say things like, liz, I don't want to talk about school anymore.

Like, it doesn't matter right now.

We're not applying to schools anyways, yet, you know?

And so you'll have to kind.

I have to remind myself that, am I doing things that are making this stress or anxiety, which I really can't control that much, Just that much worse by my actions.

Yeah.

Like trying to solve something that's unsolvable.

Yeah, trying to solve it.

Or like, talking to everyone about it, asking them what they're doing, getting all these opinions when, like, what does that matter?

Like, what they're doing may not impact what I do at all.

Yeah.

Yeah, that's hard.

I.

I don't have kids, and I could imagine that being really challenging because there's just such a comparison, too.

My kid does this because they go to this amazing school.

Oh, should I be looking at that amazing school, too?

My anxious moment.

It's just been, like, an anxious week.

I feel like I've been saying the same thing every week, but there's just like, 10 things happening at our house at once.

The new house that we've moved into, and we can't settle really yet.

And then our old house that we're trying to sell is starting to jump with all these problems, and so I just feel like I can't really catch a break.

Our dog is jumping over the fence.

So we had to build a new fence.

Our garage door broke at our new house.

And so we're going to spend this whole day building a fence that instead we spent the whole day working on a garage door.

And so I wake up sleep deprived and I go to bed sleep deprived right now.

And so just like, my rational thinking isn't the best because that's one of the first things that goes for me when I'm anxious and stressed.

And so, yeah, that's just where I'm at in life.

And I could add to the list, but I feel like that's not necessary.

Well, you talked about it earlier.

I feel like the way you described it earlier was really good as you were just like, liz, I feel like I have no capacity for right now.

People make little things into big things, and that just is like, I don't have time for this.

Why are you doing this?

And I feel like you were saying, it's a good indicator for me that I'm overwhelmed.

But I was also like, actually, it's kind of a good thing too.

Right.

If we're at this place where we're like, you're being ridiculous.

Like, I'm not going to feed into this or make this another problem because I don't have capacity for it right now.

Yeah, yeah.

Like someone that feels like a problem is so big, and I'm sure it is in their world for them, but I'm like, that's not something that I can have stress about right now, so.

All right, John, your turn.

You're up.

Yeah.

You know, I would say that the whole hurricane.

Oh, my gosh.

Oh, boy.

You know, now I'm even.

I'm embarrassed.

I'm forgetting the name of the Helena storm.

Helena, yeah.

That just ravaged parts of our state.

And my daughter actually went to school.

She graduated last spring, but she went to school in Boone, North Carolina, which is one of those towns that, like, is barely hanging on now.

But we love spending time in Boone and Asheville.

And yeah, it's pretty anxiety provoking.

We went over the last weekend and met both of my daughters.

My older one now lives in Atlanta and the younger one is in Columbia, South Carolina.

So both were in the path of the storm.

We went to.

We were going to go visit them anyway.

It was my younger daughter's 24th, 21st birthday, but there was some anxiety with, you know, what was going to happen and now certainly the aftermath of all that.

So that's been terrible.

Oh, it's devastating.

You see it on the news and you're just like, man, this is.

It's so hard to watch.

And you can't imagine for those living there.

So do your girls have power?

They do.

One of them lost power for, like, parts of, I guess, last Thursday evening, but they really were not impacted very much at all.

The one who was driving from Atlanta to Columbia, it's like a four hour drive.

It took her, like, six hours because there were, you know, a lot of traffic and downed tree limbs and stuff like that.

But minor compared to what's going on in western North Carolina.

Like an aching anxiety.

Like an aching hurt kind of anxiety that you're feeling.

Yeah.

Like, yeah, you wish you could do something.

And there's actually.

My band played a gig on Sunday, and we donated all the tips to Western North Carolina, and people tipped way more for that than they would have otherwise to hear our band.

So that's.

Wait, you're in a band and slow down.

That's not on your bio.

I was literally about to say, I don't see that he's in a band on our bio.

I didn't know this.

Give me more details.

What instrument do you play?

I play guitar and I sing.

And we do.

We're a Grateful Dead cover band and we're called the Loose Loose.

So you can.

People can check us out on YouTube.

I thought you knew that.

I didn't know that.

No.

But now, like, karaoke night at the conferences feels so much different with you.

Yeah.

Do you get.

You, like, get booked for things?

Everybody loves the Grateful Dead.

Oh, yeah.

We do a lot of, like, you know, bars and sometimes, like, private parties and neighborhood.

We did a music festival, like, not a neighborhood, like a community music festival on Sunday night.

That is so cool.

Well, I love that.

And I love that y'all were able to give back, because I do.

I feel like part of what happens.

As someone who.

In Houston, we've been hit by storms recently.

You know, it is so hard for people who feel like, what can I do?

You know, because if you're not in the middle of it, you do you feel like, okay, I can donate money, but, like, I want to be doing more.

It's so hard.

So that's awesome.

Yeah.

Well, I think we should go ahead and introduce you.

And I will plug that.

John is in a band.

In addition to being a PhD professor and director of Clinical Training in the Department of Psychology and Neuroscience at the University of North Carolina at Chapel Hill, usa, His research and clinical work focuses on obsessive compulsive disorder and anxiety disorders, including Fears and phobias, health anxiety and panic attacks.

He has authored over 300 scientific publications and 20 books, which have been translated into several languages.

He served as president of the association for Behavioral and Cognitive Therapies and as editor of or associate editor of several academic journals.

Dr.

Abramowicz has received wide recognition for his scholarly work and contributions.

Wow.

So impressive.

Amazing.

Yeah.

And I just want to say, like, I think that you have obviously so many accolades.

We can call and know that you are a leading expert in the field, all things related to anxiety and ocd.

And what I love is that I feel like you have this incredible, incredible ability to take research that can be really heavy and can be deep and for many of us, boring, candidly, but make it translatable to patients and to families.

And that's such a.

Such an incredible skill that most people don't have.

Thanks.

I think that's important.

Why do we do research?

We do research to help folks to get the help that they need and inform them, you know, about problems like anxiety and ocd.

And so it's.

I think that's an important skill of any researcher to be able to take that, you know, information and translate it to, you know, language that most folks can understand, even if you're not a nerd about anxiety and OCD 100%.

And so that's actually my goal for today, which I got so excited about.

Callie's like, do we need to outline?

I was like, no, I don't want an outline today because we're talking to John.

She's like, okay, Liz, so what are we going to cover?

And I was like, we are going to cover what's happening in the world.

So I feel.

John, like, I.

So I've kind of.

I've talked about this on recent podcasts, but I've gone down this, like, kick of trying to get rid of processed foods in my house for my kids, because I'm like, this isn't good for them.

This isn't healthy.

And, man, it's like a rabbit hole, right?

You, like, start going down it.

And I'm trying to do it just for health.

And I think that it's good to get that out of my house for my kids.

But.

But also, you can start getting caught in this, like, oh, my gosh, what could this be causing?

What are the impacts this has?

What?

And then I have to sit back and say, okay, Liz, like, what are you doing?

Like, what's evidence based, what's not, but what I have found.

And this is actually why we started this podcast.

So one of the reasons I really started the podcast is that there was a couple, there's a lot of influencers, but there was one in particular who kept promoting CBD gummies for her anxiety and every way.

And she's this really well known influencer, has a ton of followers.

And it frustrated me because as an anxiety clinician, I was like, all the advice you're giving, first of all, you're not a clinician, you really shouldn't be giving clinical advice or feedback.

But your following is actually like following advice that's making their anxiety worse.

Right.

All the things she was telling people was crutches and quick fixes and things that we know don't actually address anxiety symptoms.

But I feel like that has become the norm in society.

Right.

Is that we're looking on TikTok or Instagram or whatever, it might be some flashy news article to tell us what to do instead of following what research and science and evidence tells us is actually the best route.

Right.

It has the strongest chance of success.

And so I want to just pause for a second and ask you, like, how do you explain why research is important and why it should lead decisions that people make when it comes to interventions for anything they're dealing with?

So research, scientific research takes advantage of certain processes, paradigms to get around a lot of biases that we human beings all have.

An example of that would be a confirmation bias, which is this naturally occurring.

We all have this, we all do this when we think we're right.

We look for evidence to support what we think we're right about.

If I have anxiety, and it's not always bad that we do that, if I have anxiety and I take some sort of treatment and then I get better, and I think that that's what worked, then I'm going to look for things to kind of confirm that.

And often we make an error that's called after this.

Therefore, because of this, I felt anxious.

I.

Yeah, I've heard that term a lot of people call research me search because you're looking for the things that you feel are correct.

Yeah, exactly.

That's right.

And so a lot of people think, well, you know, I felt anxious, I did this, and I didn't feel anxious anymore.

And therefore this, this must have worked.

But that's not really.

It's more complicated than that.

Just because I did some sort of treatment doesn't mean that it was the treatment that worked.

It could have been other things going on in my life.

It could have been just random fluctuations in My, in my levels of anxiety.

What research does, what clinical, carefully controlled research does, is it gets around those sorts of biases by controlling for lots of other factors.

And so that's really the best way to get at knowledge.

I should say that science and research is imperfect.

It's not perfect.

But, but there's not really a plan B.

That really is the best thing that, that we have.

The question I have, just because I get this feedback a lot when I'm trying to explain it, is, yeah, but sometimes it's fast tracked or sometimes it feels like it was pushed way too fast, right.

To try to get something to the finish line.

And we think about that like, let's just be honest with COVID vaccine, right?

That's what we heard all the time, was like, oh yeah, but this was faster than most.

And I think one thing you've talked a lot about, we've heard this in the OCD world, right, where people are saying, hey, here's a new intervention.

It's worked for some people, there's some evidence.

So therefore it's an evidence based intervention and we should promote it as first line.

And those of us that are clinicians are saying, wait a second, it could be one day.

But to date, we don't have the appropriate research to truly say it's evidence based.

So how, like, how do we actually say something like what clarifies or makes something become an evidence based intervention?

And is there varying degrees of that?

Like, could, could something be evidence based?

That's a lot more sound than something else that's evidence based.

That's like a newer intervention.

Yeah, great question.

And not all scientific studies are equal.

There is a specific type of study called a randomized controlled trial or rct.

And that's where you take a treatment and a control, like a placebo, or you take two different treatments, you randomly assign participants to receive the different treatments.

Hopefully you have a large sample of people because that helps us to be able to generalize the results better.

And everyone has an equal chance of receiving either treatment.

And that controls for all sorts of differences that could happen above and beyond the treatments that are being offered.

And then you give both treatments to both, you know, to.

You give one treatment to each group and then you can compare the differences between groups.

And that is the most rigorous way to tell if a treatment is better from another treatment or if a treatment is better than a placebo.

And we did not just one of those studies, but we need multiple studies that are like that coming from different groups of researchers.

If I Invent a treatment and I do a couple of randomized controlled trials.

I have biases and I might inadvertently.

My therapy might work out best in my lab because I want that to happen and so I might inadvertently.

Right.

So we need more.

Or you're a better clinician.

Right.

Like maybe you have a better therapeutic rapport.

A million reasons why it could change.

Right?

That's right.

Or.

Yeah, exactly.

Or I'm rooting for that therapy.

So I work harder to deliver that therapy than the, than the control therapy.

And we know that that has an effect.

When you root for a therapy, the therapy works.

That's in research and also in clinical work as well.

And so we need people in different settings who don't have a stake in the outcome to reproduce the same outcomes, the same studies.

Yeah.

So I was going to ask because I know when I am trying to find my own information or just talking to others.

We did an episode on political anxiety recently and I sometimes will even try to research just general basic information about our politics, but I find it so hard to I guess even start the search because I'm already typing my question with a bias.

Right.

Like in my search.

So if you have any advice on how to even get to that first step to make sure that when we're looking something up we are actually going to find the evidence based response, that would be super helpful.

Yeah, I mean, I, I think so.

First of all, just to kind of lean into those biases.

We all have those and science has, is, has a bias too.

And so just read the, the more that we consume and making sure that we're.

When I say consume, I mean, you know, read we're.

The more that we read that comes from credible sources that have been replicated.

In other words, different researchers have found the same results.

That's kind of how you can have a better sense that you're getting at the truth.

So how do you differentiate a credible versus non credible resource?

I think about this all the time and I hate to use Covid, but it's just a good example for the general public where it was like, I might say, oh, this source is credible and someone else is like, I don't think that source is credible at all.

Right.

So I guess the question is what from a true science research background would make you say this is what established something as being a credible source.

Experts are people who have a certain degree of knowledge, the most formidable type of knowledge.

They've done lots of training in their field.

And I think what's really important is that they are recognized by others in their field, other experts, right.

As, as being credible sources.

So we're talking about people who are journal editors because a journal editor, if you've been, you know, chosen as a journal editor, your peers have decided that you get to, you know, evaluate research that is done and choose if it gets published and disseminated into the, you know, into the world.

Awards that, that organizations, credible organizations have, have given a person that, you know, helps you to tell if someone is, is an expert.

There are lots of self proclaimed experts.

I did all of these, you know, workshops or you know, and that's not an expert.

An expert is someone who has the recognition of their peers and that's really who you should trust.

And you know, I just add just in this day and age where you can publish anything on the web and on social media, there are lots of people out there saying, you know, I'm, I'm an expert.

And they list all the things that they have an expertise in.

But it's just self proclaimed.

And I think so much of it is based on like marketing and influence.

Right.

You know, nowadays, like there's.

I've talked about this before, but I had so many friends reading this book that became this New York Times bestseller and was about like.

And I didn't read the whole book, I have to tell y'all, but it was about parenting and everybody was like, this is the most credible book.

You have to read this.

And John, I opened it up and in the first, I can't remember, it was in the foreword or the first chapter.

It's like, yeah, I like once was trained on evidence based treatment, but then I decided that just wasn't for me and I closed the book and I was like, I can't read this book.

But all my friends were living and breathing by this book because again, it was relatable, it was New York Times bestseller.

It was something that.

And so, and again, maybe the book was great, maybe she brought back evidence based research within it.

But I was like, I can't get past that because to me now you're influencing individuals by an opinion versus by research and decades of experience.

Experience and backing.

Absolutely.

So you said a few things I just want to kind of point out, right.

For listeners.

One, the last thing you said there about opinion, right.

People can have opinions, but that is different than scientific evidence.

If you've got an opinion and you can back it up with science, then that says something.

But the other thing that you alluded to with the book is that especially in this day and Age, anyone can publish stuff, anyone can write a book, you can publish a book by yourself.

Publishers are only too happy.

They will make money off of you if you have something to say.

But just because you published books, and frankly, unfortunately, just because you've published research articles does not make you an expert because in this day and age, all of that has become watered down with how easy it is to publish stuff.

And so you're right, people are using the web, they're using journals, scientific journals, they're using publishers as their own kind of PR campaign.

Yeah.

And unfortunately, the part that kind of makes me sad is that it seems like based off what you gave as a response for how to get to the true evidence based work, you've got to do your own work and research yourself.

And I just think that most of the world isn't really willing to do that.

Right.

Or they don't know how.

Yeah, well, that.

But then even just, just knowing like, okay, I've got to look up four or five articles to make sure that it says the same thing in order to ensure that it's evidence based.

So I'm just going to go to TikTok and see what this person says instead.

And I find myself doing that.

Right.

If I want to build a desk, I'm not going to go look up how to build a desk.

I'm going to ask Siri to tell me how to build a desk.

Fair.

Yeah.

No, and I think that that's a really important piece is like some of my friends will say to me, like, like they'll say, hey Liz, I was told I need to go to this doctor.

Here's a couple doctors.

Who do you think I should go to?

And I get it.

Like they want me to look at their background, right?

Because I'm looking at academic training, I'm looking at their education history, but I'm also looking at like, where did they do their training and what.

Right.

And they don't know how to do that.

And so I would love for us to talk about just how does the everyday consumer become appropriately educated to where they would feel confident doing some of their own research?

Because even like you just said, Callie, looking up three to five research articles, most people don't know how to do that or they don't have a subscription to an academic library where they could even do that.

Right?

But like most people, they look up a PubMed journal article and they can read it, but they don't know what it means.

They don't know what a P value is and what statistic you know, whatever stats levels mean, you know, for them.

And so how does the average consumer become their own advocate, but to where they're advocating for themselves in the right way instead of in a way where they.

Because I think I have found that today's world, nobody wants to become reliant on an expert solely because they feel like there's.

I don't know, I think people feel like there's bias, but I think they, like, I get a lot of like, well, you just trust everything your doctor says.

And I'm like, yes, because I know my doctor's background, I know my doctor's training.

And if I'm asking her a specific question, I do trust what she says because she is an expert in that arena.

Right.

Like, I know my doctor's an expert, but a lot of people don't know if their doctor's an expert.

They don't know if they should trust this person telling them these things.

So how, as a consumer do you make decisions that would allow you to feel comfortable, you know, taking advice and feedback that's for yourself to use?

Wow.

I mean, such a great question.

And unfortunately, you know, it is very difficult.

You have to train your brain to think critically and to not just kind of accept everything that you read or that you see on TikTok or that you hear from other people.

I teach a class.

I teach a first year freshman seminar at UNC Chapel Hill that's called How To.

The nickname of it is kind of how to Use youe Brain.

And it's all about what we're talking about, how to think critically.

And just because you see it published somewhere doesn't mean that that's the truth and how to evaluate claims.

And, you know, we spend a whole semester learning how to do that.

And those are people who are in college and hopefully at the very beginning of learning.

But it is a journey to be able to move from this place where you're just kind of not thinking critically and, oh, this has sexy, some sort of sexy picture in it.

So therefore it must be true.

Going from there to being able to see through that and say, wait a minute, the fact that it has a sexy picture with brains lighting up and all that probably means that it's not true.

If they have to get my attention that way.

If the data can't speak for itself and just kind of turning our normal reasoning on its head and there are all sorts of idioms like if it sounds too good to be true, it probably is.

And most people don't, don't understand that they don't know to question, that there are certain.

There are certain.

There are certain strategies that people will use to try to get your money, get whatever from you.

And it's a learning process for how to see those as red flags.

It's unfortunate, but that's where we are 100%.

And so I want to get a little political because it's the climate and it's.

We're in.

I don't even know what month, but October today, right.

So we're not talking.

Political season's coming up.

Hard to believe.

This is such a perfect example where I find so many individuals, myself included, right.

That depending on where the information's coming from.

So if, you know, if it's coming from my political party that I identify with, it must be right, and I believe it.

And if a different political party opposite to my belief says something, I automatically am finding ways to refute it and to tell people.

And this we see across the board.

Everyone's doing it right now, right.

That, like, if your party or someone you like or someone that you want to win or that you think is respectful.

Right.

Whatever.

What they say holds all the weight, even though often you're not thinking critically, you're just trusting what they say at face value, which you honestly, half the time should never do by the time, by the way, with politicians, it's another story, you know, and.

Or vice versa.

So I just.

I want to go back to, you said, teaching people how to think critically.

How do you do that when it also is, like, fueled or backed with, like, heated political thoughts or just in general these, like, biases or this, like, these beliefs that you have that are ingrained, these emotional decisions.

Right.

Or these emotional feelings that are really strong.

How do you separate the two?

It's really difficult.

And, you know, I know people that seem like they're really intelligent people, but they're.

They are.

They have very strong political views one way or the other.

And even something that is clearly biased, smart people have trouble seeing beyond that.

Oh, the other side must be lying about that.

And, yeah, that is really difficult.

When you were talking earlier, it made me think of Dr.

Fauci, right?

He's a great example of someone.

He was the head of the nih, you know, disease center.

You know, I forget which.

Which institute he was, but clearly someone who was nominated by his peers, clearly an expert, and because he started saying some things that folks on the right, in this example, disagreed with, a whole group of people, without really looking at his credentials, just all decided that he, Whatever he says is wrong, and we're going to do the opposite.

And I'm sure the same thing happens on the left as well with.

With other, you know, folks.

But, you know, it's one of the things that I lose sleep over.

Like, how are we ever going to get past this?

Do we get past this?

You know, our society seems to become more and more polarized.

How do we know?

You turn on one channel and you hear this information, you turn on a different channel, you hear the exact opposite.

Which one is right or is the truth somewhere in the middle?

I have no idea.

I go back to what I said before.

You have no idea.

What's learning?

Critical thinking.

We are screwed.

I mean, I have.

But I'm saying I have felt that.

Way for a long time.

Figure it out.

I can't, you know?

Well, I think too, just like, knowing that our emotions are such a driving factor in every aspect of life is such a huge thing.

Right.

Just even thinking about the book, the Psychology of Money, talks about how our emotions are one of our biggest indicators of how we spend, and our emotions are one of the biggest indicators of how we decide or respond to things.

It's not actually the facts.

And so we have to work really hard to stop, not respond immediately, and get to the facts so that we can actually make the choices.

Yeah.

And I find, you know, that I think, for me, I am somebody that I love to consume information.

Right?

So, like, I want to hear both sides, and I want to get kind of political.

We were at dinner this weekend with a friend who has totally different political beliefs than us.

And my.

My husband kept asking her questions, and she was like, do we have to talk politics at dinner, Matt?

And he was like, sorry, like, if this is upset.

I really want to learn.

Like, I want to hear both sides, because we are not somebody that, like, we're right, you're wrong, and we're going to push it down your throat or vice versa.

It's like, I want to learn, like, where are you coming from?

Like, tell me more about this.

And I want to, because that's how I can become more informed, you know, And I'm somebody that when someone says something to me that I like, strongly disag, I will think about it for three weeks being like, why do I feel so strong?

And do I feel strong because it's just an immediate reaction, or is that really how I feel?

And if it's really how I feel, why?

Right.

I'm big in the.

Like, I want to know the why.

And everybody should want to know that, right?

You should really want.

I talk about this all the time.

But when you have a baby now, you know, when they send your baby home from the hospital, they tell you back is best, put your baby to sleep on their back.

And if you don't ask why, you would might be kind of annoyed by that.

Like, oh, babies sleep better on their stomach.

Like, why would I want my baby to sleep on their back?

I'm not going to get as good sleep.

But when you know that it has reduced the risk of SIDS significantly and that it increases, you know, the chance of your child not dying, there's not a question if I'm going to put them on their back or not, right?

It's like, well, of course, duh, I'm going to put them on the back because I know why you're telling me to do that.

But I think so much, so many times nowadays we're not explaining the why.

Right?

We're telling people what to do.

We're giving people directives, but no one is really saying why.

And so I want everyone to think about that of like, when you're doing anything in your life or saying anything that you feel strongly about, do you know the why or have you just been influenced based on a marketing campaign or a sexy article or whatever it might be?

Yeah, good point.

And I think that also goes for treatments for problems related to anxiety and OCD and stuff like that.

How do they work?

Why are they working?

Is, in my mind, is as important as does it work?

Because not enough to know that something works, because there could be lots of reasons why something works.

So I want to know what is it about that that's, that's helping a person so that we can dig into that and maybe even improve it and have some sort of understanding of what to do more of and what not to do.

Well, and I think we also have to get better at being okay with people asking why.

Right?

Because, like, sometimes I want to ask why in certain situations, but I know that I'm going to get a lot of pushback or shut down or shut down for.

And I'll give an example and maybe we'll decide to cut this out later.

But like, why has autism increased in ocd?

You know, just the amount of people that we see with autism and OCD now is significantly more than when I worked here in 2017.

And that doesn't automatically mean that I am someone that is blaming vaccines that I just want to talk about why without getting, I don't know, politicized and.

You'Re probably curious, like, is there being research done?

Are other people noticing this?

Is this backed by stats, or is that just something we're seeing?

Maybe.

We are known to treat autism and ocd, which, by the way, we are one of the few clinics that's known.

I've.

I've gotten a couple calls recently where it's like, the other RES programs say they don't treat comorbid autism.

And I'm like, what?

I'm so confused by that.

But, you know, so who knows?

There could be a lot of reasons, but it's like, we want to ask why so that we can understand.

Like, is there a trend?

What does that mean?

Are.

Is research being done?

Can we help with that instead of tiptoeing around it?

Right.

Okay.

So I want to talk about something that I think we all experience, and I'll.

I'll share some of my own examples, but I've talked to you about this before, too, Dr.

Bermotz.

But, you know, as somebody who I've talked openly, of course, about my lived experience with OCD and somebody who has been really a patient, and then I went to advocacy, and then I got my appropriate education and training and now would consider myself a, you know, professional in the field.

It's been such an interesting journey for me because I.

I think that there was this influence when I was young of my own treatment and my own struggle, that that's how I saw OCD or anxiety.

Right.

Was through my own lens, because it's what I knew, it's what I experienced.

And I'm.

I'm now so far from that.

Like, it doesn't mean I still don't, of course, remember that.

But I do not see ocd, anxiety, or treatment through what I experienced.

I see it through research.

What works, what we see in practice, the way we've changed.

I mean.

Right.

The way I was treated.

While, yes, it worked, it was so different.

We didn't know what inhibitory learning was or was it Right.

There's so many amazing advances, but I find that so many times, individuals, consistently especially, it feels like in the mental health space, and I feel like social media made this a lot more visible and, you know, change the landscape a lot.

But it's almost this belief that, like, if I have lived experience, I'm just as much of an expert or have just as much of an ability to tell you how to treat your OCD or to be giving you advice and education than somebody like yourself or others of us that are in the field that have been doing this for decades and have the clinical training, the education, the research history in the background.

And I'm just curious, like, what your thoughts are on that.

Like how as a researcher and clinician, have you.

What have you seen evolve?

Because there's this piece where it's amazing people are talking about ocd.

When I was first an advocate, as you know, no one else was advocating, like, no.

So it's awesome that people are talking about it and there's.

The stigma is decreasing.

Yet I also see this translation, and I've seen it especially in the OCD world, where people are pushing new interventions or different interventions and saying things like, well, ERP didn't work for me and this did, therefore this is a treatment we should be promoting.

And it's like, wait a second, that can be really dangerous.

Yeah.

This is a trend, I think, in certainly in OCD and I think in other areas of mental health and in discussing it with researchers and doctors in other areas of medicine and healthcare.

I think this is a trend that we're seeing across the healthcare sphere.

And I think that there are different.

One's lived experience is a different type of knowledge than is scientific research.

Your personal knowledge is helpful when it comes to understanding your feelings about your thoughts and your feelings about having a certain disorder, your thoughts and your feelings about different treatments and how it was for you.

At the same time, everyone is different and everyone is affected by different circumstances.

We're all built differently on the inside.

We all have different experiences with the environment on the outside.

And so it's hard for us to be able to generalize what works for us to what would work for you or a group of people.

And that's where the research comes in.

So certainly I think it's important for scientists to hear from people who have lived experience and gather information from them and to be able to consider that information.

At the same time.

One's personal, or what we call anecdotal experience is not, you know, you can't say, I had this experience and then speak for everyone else with autism or ocd.

That is where scientific research comes in.

Again, because one of the nice things that research does, that these randomized controlled studies do, and that all research does, is that it brings in large groups of people and that controls for those individual differences, because everyone is different, especially in mental health, but also in other areas of health too.

And so we can take kind of averages and we can get summations of large groups of people and infer better than we can just inferring from one individual.

Yeah.

I think the marketing piece going back to that is what makes this so challenging.

Like it's just so easily accessible to engage in any marketing strategies.

And I'll give a personal example.

Example.

I was super embarrassed about this when I, whenever I did it like three years ago, a lot of distance runners take iron because prone to being iron deficient and a female especially.

And I remembered trying this iron supplement before I was training for a marathon and I loved the taste of it and I like just posted it on my social media and I have tons of dietitian friends who like one of them, I'm so grateful she did reached out to me and said, Callie, that's actually not a great supplement because it doesn't hold enough iron milligrams, whatever it is.

And I was like, oh my gosh, I was totally out of my wheelhouse there.

And I took it down.

Right.

Like, because I, I realized that's not something that I specialize in and I don't want to be sending the wrong message there.

But even I think in those instances I had no idea that I was promoting something.

And your intention was good.

It wasn't like you were trying to promote a supplement.

You were just truly like, hey, this is actually one I can tolerate.

Right.

Right.

But I think that's just such an example.

It's so easy to put that information out there.

And yeah, of course people are confused about what to choose.

Yeah.

And I don't find, especially like mental health advocates, I don't find most people aren't bad intentioned.

Right.

Like their intentions are really good.

And I think about, I honestly probably would have done similar things if when I was a kid, social media, you know, when I first started doing advocacy work, social media had the same platform.

It didn't.

Which I'm grateful for, to be honest.

But you know, I, I think what I struggle with, and I see this all the time, John, is that there's so many advocates which their personal experience is so valid and it's so important, yet they are using it as a platform to heal, treat other people or try to heal.

And I get so anxious about this and you know, I have to get a little controversial with life coaches because it's a similar thing.

Right.

There has now become an entire profession where people are charging the same amount for a life coach that they're, they're, you know, obviously paying the same amount then for a licensed clinician who is an expert in the field.

And that is just mind boggling to me.

But to a Consumer.

How do you know?

They're like, this life coach has a hundred thousand followers, Everybody loves them.

My gosh, this is the person of course I'd want to go to.

And I'm like, oh my gosh, please don't do that.

You know, but how do we handle that?

How as clinicians, do we, how do we help people understand that?

Sure, we get why this made sense, but this isn't where to start.

You know, I wish I had an answer for that.

Educating folks about how to consider different, you know, like we were talking about before, how to consider different types of expertise and you know, and I think there can be a place for so called paraprofessionals.

Right.

And these appeals to lived experience.

I think that there is a place for that.

But like you were saying, it's valid, but it also, we have to take it for what it's worth.

This is a certain type of information that's different from scientific information.

Yeah.

I also think we have to look at some of the red flags that humans are just prone to draw.

Draw to.

Right.

Like why are you drawn to that person?

Yeah, yeah.

So I think about, I've been thinking about this a lot lately, how you can be a captivating speaker and I can go into a presentation, I think, and really talk about something.

I have no idea of what I'm talking about, but because of the way I come across, get people to listen to me.

Oh yeah, think about cult leaders.

I know, my gosh, I really be on cloud nine.

But really, right.

You think about it, you're like, it is a lot of it is about like, what influence, what presence are you charismatic.

Right.

Do you have.

And that plays a big role.

Right.

And I get that.

Like, why would I want to have a session with a boring clinician who's like this smart researcher, then have with someone that's going to make me feel great and energized and excited.

Or like those scams that you get in the mail because we've been getting a lot of those in our new house now.

Like, oh, you have to fill out this warranty now and it's bright orange.

And so like, ooh, I've got to see what this is.

You know, just like Matt got a.

Good one the other day where they actually mailed us a full a $1 bill.

And he was like, but this is actually a really good idea.

And I was like, well that's fine, but we're not falling for it.

But we'll keep, we'll keep the dollar.

It was like, But I'm going to keep the dollar.

This is a brilliant campaign.

And I'm like, okay, whatever.

Right?

But it was so funny and so, so going back to the.

The consumer, because this is something that's really important to us, right, Is when people are living with anxiety.

And I think that the reality is everything we're talking about, like, what provider do you choose?

How do you know you can trust your doctor?

How can I trust certain information?

Right.

That causes people anxiety.

Right.

It makes people feel like this is overwhelming.

I don't know where to start.

Analysis paralysis.

Totally.

Right.

I'm just gonna avoid it altogether or I'm gonna let someone else make that decision for me.

And so my question is, is, like, how does someone sift through?

Like, what is your clinical advice?

How do you manage your anxiety but still move forward and make good decisions for yourself?

You know, I thought we were only doing easy questions today.

I guess not.

You've been grilled.

You know, it's.

I mean, boy, that's.

I.

My heart goes out to folks, especially folks that didn't grow up with, you know, feeling comfortable around social media and technology and stuff like that, because you're just bombarded with all sorts of information and the portal and for your doctor and all the social media and all the things that we see on TV and the hundreds of different channels and the different political perspectives on things.

I wish I had an answer, but I don't find someone who understands that stuff.

And I don't know my grandparents, who have all four gone to the great beyond by now, they were alive when the Internet kind of started, but they never had computers.

They didn't understand.

They cursed all that stuff.

And I just remember my mom telling me that my grandfather got scammed.

Somebody called him and found out all sorts of stuff about my cousin and told them that he needed to deposit all this money to get my cousin out of jail.

And he knew all these facts about my cousin because he could go online and find out all about him.

And the same kind of thing happens with healthcare, just in different ways.

Obviously, there are all sorts of scams.

It's really difficult to be able to separate the crap from the real deal.

And we're going to have to do better at educating folks how to think critically.

The problem with that is that there's a whole segment of our society that looks down on higher education and thinking critically.

Again, getting back, because they think that's totally biased politics.

They think it's.

They exactly.

They think it's totally biased.

Oh, look what the you know, the left wing, you know, elites are teaching people.

And yeah, it's.

We're not going in a good direction when it comes to critical thinking.

We're thinking less and less critically.

And I say that about both sides too.

Again, totally.

Yeah.

I was about to say that.

I was like, as a researcher myself and a clinician, like, I think at first I thought, oh, it's like more what?

And now I'm like, oh, no.

Lately it's like I it on every side all the way.

Like, there's we.

Everyone does it.

Living in North Carolina, you know, we're in a college town, very left wing.

You know, Chapel Hill is a pretty left wing, you know, kind of liberal area, but right outside of us is very right wing, you know, kind of rural North Carolina.

And the biases happen, I can tell you, on both sides.

For every person on the right who, you know, lives in rural North Carolina, who can't stand to consider something, you know, from the other side, there are people, professors, folks like that.

It's true what you hear about universities, academia right now is in a very left wing place.

Going further to the left, which is kind of what we see.

Also the right wing going further to the right.

Neither of which is good.

We need to come back to the center.

Yeah.

Yeah.

Amen.

I could not agree more.

And so I want to end with a question for you that I think will help our consumers.

If you were sick or someone you loved and you needed to find a doctor that you could trust, what would you do?

What would be your own kind of homework or work that you would do?

Maybe that doesn't include calling a couple friends you trust.

Right.

But if you had to go on the Internet and figure this out, what might be some simple steps you would take to say, okay, this is where I would feel more comfortable.

I sound like a real country girl today.

More confident, comfortable with their expertise.

Yeah, great question.

I would probably look for their background.

I would see where they.

I would look for where they went to school.

And that doesn't mean they have to go to like, Harvard or Yale or Baylor, but they need to.

Not that it's bad.

Not that it's bad.

No, those are great places.

But where they went to school says something about their credentials.

Right.

A.

A faculty and admissions committee from Harvard is going to be really selective about who they're not.

That doesn't mean that everyone who goes to Harvard is awesome.

There are plenty of slouches who went to Harvard for medical school or whatever, PhD, but that's going to give you a good idea.

At the very least, you want them to have the highest degree out there.

Right.

As far as the training that they can do, that they did the most amount of training, that they're board certified.

Which again means that a board of examiners has looked at this person, interviewed them, made sure that they cut the mustard for whatever the standards are in the field.

That's what I'm going to do.

But I would call some friends too, because what we talked about before, anecdotal experience does have its place.

So, you know, once I kind of narrow things down like who's the best eye doctor or whatever, then I.

Because, because I want to know about how does the person treat people.

Right.

Do they have good bedside manner?

I'm also going to look at years of experience.

So I'd rather see someone who's been out, you know, 20, 30 years from school rather than someone who's their first, you know, gig.

Those are some of the things that, that I would consider how, you know, if I'm looking for someone who treats OCD anxiety, I'm going to, you know, want to know how many folks they've worked with kind of thing.

Yeah.

And for anxiety, I would also.

Just to help with your own anxiety, drown out some of the extra noise outside of that.

Right.

Just like the.

For me right now I'm getting all.

Because I've listened to a lot of nutrition type talks, all of these social media posts about don't use aluminum cans, make sure you avoid the Ziplocs.

And I'm like, well, what do I hold?

My anxiety.

Yes.

And so it's for me just like have to.

Absolutely.

And training.

Don't eat.

Train.

Yeah, that's important.

I saw one the other day.

Don't eat blueberries.

I love blueberries.

Blueberries are healthy.

We know they're healthy.

Yeah, I'm screwed.

I mean those are like, I eat like fists full of blueberries all the time.

But then there's this some doctor who says, you know, here's what blueberries are doing to you.

Oh, and I had another.

Oh, don't read reviews on Amazon.

Or like they're these like MD rate MDs, like online or like.

Yeah, that's never read those things because the people who are really upset, those are the, or the ones that are really happy.

But mainly the people who are really upset, those are the only ones that are going on and rating doctors and products and stuff like that.

Stay away from that.

Yeah.

Also Amazon pays people to go write a positive review.

Like they get Paid to put five stars on something.

So that's another whole ball game.

And I know, yeah, we talk about that a lot in our field.

Yeah.

Oh, yeah.

Well, I know that doctors and psychologists, psychiatry, mental health professionals, they.

I don't know if they pay, but there are incentives for their patients to go online and say good things about them online.

Again, social media marketing, I mean, it's just.

It gets back to.

Social media has done a lot of.

There are a lot of good things about it, but it's done a lot of not so good things.

And this is one of those.

It's made people be able to just kind of promote themselves in ways that.

Can be unsavory, 100% and candidly, that are dangerous, you know, and unethical.

And I talk a lot about that.

And so I hope that we can start to see through that and think through it.

But this was awesome.

And I feel like it was just such.

I hope you'll consider coming back because we could keep going in so many different arenas.

But it's such a good, deep dive into thinking.

Are you thinking critically or are you thinking with your own bias?

And that's something for every single person listening, including myself, to really digest and take home today and to be thoughtful about.

How do our own biases get in the way?

And sometimes, you guys, this is detrimental to your own outcomes, right?

If you have your own biases that are impacting treatment and stopping you from being able to get the treatment that those of us that are specialists in that area really know would work, it's really hurting you more than helping you.

So be thoughtful about that.

Thank you, John.

This has been amazing.

Your background in education and, of course, clinical expertise is something that we are so, so grateful for, you sharing your time with us.

Thanks, you guys.

It's been a pleasure talking with you this afternoon.

Thanks for having me.

Absolutely.

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