Dr. Athena Robinson of Woebot Health: “Broadly speaking, building some structure into one’s day can help”

Broadly speaking, building some structure into one’s day can help. This allows people to plan adequate time for both work as well as other values-based activities. I also suggest that people block out time for activities that make their hearts sing — whether that’s something like painting, needle point, cooking or playing board games. Making sure to […]

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Broadly speaking, building some structure into one’s day can help. This allows people to plan adequate time for both work as well as other values-based activities. I also suggest that people block out time for activities that make their hearts sing — whether that’s something like painting, needle point, cooking or playing board games. Making sure to integrate recreational activities that bring joy and even connection with others is really important, especially as we are dealing with the pandemic and can’t do many of the things that we may have done previously.

Often when we refer to wellness, we assume that we are talking about physical wellbeing. But one can be physically very healthy but still be unwell, emotionally or mentally. What are the steps we can take to cultivate optimal wellness in all areas of our life; to develop Mental, Physical, Emotional, & Spiritual Wellbeing?

As a part of our series about “Things We Can Do To Cultivate Our Mental, Physical, Emotional, & Spiritual Wellbeing,” I had the pleasure of interviewingAthena Robinson, Ph.D., Chief Clinical Officer of Woebot Health.

Dr. Robinson is the chief clinical officer at Woebot Health and an adjunct clinical associate professor at Stanford’s School of Medicine. At Woebot Health, Athena oversees the company’s regulatory strategy and overall program of research, as well as its empirically supported psychotherapeutic product strategy.

Athena’s areas of expertise include evidence-based digital therapeutics, implementation science, and treatment-outcome behavioral health research. She is the recipient of a number of research awards and fellowships from industry groups, including the National Institutes of Drug Abuse (NIDA), the National Institutes of Mental Health (NIMH), the National Cancer Institute, the National Collegiate Athletic Association (NCAA) and Stanford University. Athena is also the author of dozens of original peer-reviewed research publications, articles and books on subjects ranging from digital mental health technology to eating disorders and is an ad hoc reviewer for several professional psychiatric and clinical psychology journals. Athena holds a PhD in clinical psychology with a specialty in behavioral medicine from the Joint Doctoral Program at the University of California, San Diego/San Diego State University, an MS in clinical psychology from San Diego State University and a BA in psychology and social welfare from the University of California, Berkeley. An expert in evidence-based interventions for a variety of psychiatric indications among both adults and adolescents, Athena is also a licensed clinical psychologist and continues her private practice in the state of California.

Thank you so much for joining us in this interview series! Before we dive into the main focus of our interview, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?

I’m Latina, the daughter of a first-generation Bolivian immigrant mother and Caucasian father. I grew up in Los Angeles. My parents divorced when I was young, and my very hard-working and driven mother raised my brother and me on her own. Her steadfast commitment to my education, coupled with my thirst for academics, resulted in my acceptance into the University of California at Berkeley, my beloved alma mater, where I began my psychology studies and further cultivated my passion for mental health.

What or who inspired you to pursue your career? We’d love to hear the story.

In eighth or ninth grade, I signed up for a peer counseling opportunity within my school. Throughout the program, we learned about ethics, confidentiality and how to deal with the various issues that peers may share. This program was very formative for me — I can still remember some of the students, the nature of our conversations, and how impactful our time together felt. It was through this program that I learned and experienced firsthand the deep value of empathy, rapport, trust and communication in emotionally supportive relationships.

From that moment forward, I knew I wanted to be a psychologist. It’s rare for a 14- or 15-year-old to be certain of their ideal career, but I never faltered. I completed high school knowing that psychology would be my university major and it was — I complemented it with a double major in social welfare and a minor in ethnic studies.

None of us can achieve success without some help along the way. Was there a particular person who you feel gave you the most help or encouragement to be who you are today? Can you share a story about that?

Definitely my husband. We met 20 years ago before I started graduate school. When I struggled through what seemed like the never-ending workload across the 5-year training program, he supported me through it all. We can laugh together now remembering studying for my comprehensive exams and getting my thesis and dissertation finished. Together, we’ve moved across California multiple times in support of my career.

Can you share the funniest or most interesting mistake that occurred to you in the course of your career? What lesson or take away did you learn from that?

I was a very good student, but my freshman year of college I got a D- on my first psychology test. I was so embarrassed. But I had to pick myself up and carry on. I changed my study habits and met with my professor in order to improve my grade. Looking back now and seeing how hard I’ve worked to come far in my field, that D-grade sticks out in my mind as a reminder that although we get discouraged and make mistakes, we can always learn from them and persevere toward our goals.

Is there a particular book that made a significant impact on you? Can you share a story or explain why it resonated with you so much?

The Spirit Catches You and You Fall Down by Anne Fadiman is well-known curriculum in various psychiatry, psychology and medical training programs. I made the book required reading when I taught a consultation class for my graduate students. It’s a story about a Hmong family from Laos whose daughter, Lia, was diagnosed by Western medicine doctors with epilepsy, and how subsequent communication, as well as treatment recommendations and implementations, clash with Lia’s family because their cultural beliefs cited the tremors as a consequence of their daughter’s soul fleeing her body. The book illustrates multifaceted considerations in the cultural intersection between Lia’s family and her Western medical doctors, despite how much both sides yearned and strove for the child’s wellness. It’s a phenomenally powerful book and reminds me to be humble, open-minded, communicative and collaborative as a provider.

One of my areas of expertise is treating anorexia nervosa. In treatment, I speak with patients and their families about their cultural practices around food. Working together, we find ways to integrate the family’s cultural practices around food selection, preparation and serving styles, with the needs of their child who is medically starving and work collaboratively toward the child’s recovery.

Can you share your favorite “Life Lesson Quote”? Why does that resonate with you so much?

In Leonard Cohen’s song “Anthem,” he wrote, “Forget your perfect offering. There is a crack, a crack in everything. That’s how the light gets in.” It’s so beautiful.

This line reminds me of a practice in Japanese culture called Kintsugi. In Kintsugi, the Japanese repair broken pottery by adding seams of gold. This powerful and compelling art acknowledges that our mistakes and ‘broken pieces’ are actually the threads of gold that make us unique and whole. As humans, we’ve all made mistakes, which are actually gifts of lessons directly contributing to our learning and growth.

What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?

At Woebot Health we’re focused on providing evidence-based mental health care and destigmatizing mental illness. Our products use a therapeutic relational agent, called Woebot, to deliver elements of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) to people who face anxiety and mood concerns. I am so driven by the work I do and love the nature of it. For example, our work with women experiencing post-partum depression (PPD) is deeply meaningful for me. Whether we know it or not, we all are likely to have had a mother, sister and/or friend who suffered from PPD. Women with depression and anxiety concerns during the peripartum period are tragically often undetected and grossly underserved by our healthcare systems. This precious period, a mother with her new baby, is so delicate yet transformational in its demands, and it must be supported through mental health and emotional support which will allow new mothers to blossom and find their parenting niche in the healthiest way possible for them and their child.

OK, thank you for all of that. Let’s now shift to the core focus of our interview. In this interview series we’d like to discuss cultivating wellness habits in four areas of our lives: Mental wellness, Physical wellness, Emotional wellness, & Spiritual wellness. Let’s dive deeper into these together. Based on your research or experience, can you share with our readers three good habits that can lead to optimum mental wellness? Please share a story or example for each.

Broadly speaking, building some structure into one’s day can help. This allows people to plan adequate time for both work as well as other values-based activities. I also suggest that people block out time for activities that make their hearts sing — whether that’s something like painting, needlepoint, cooking or playing board games. Making sure to integrate recreational activities that bring joy and even connection with others is really important, especially as we are dealing with the pandemic and can’t do many of the things that we may have done previously.

Lastly, when doing what you love, make sure to fully immerse yourself and be mindful. If you’re dancing, turn the music up louder or if you’re on a video call with friends, tell them a vulnerable story about yourself or a recent experience. Being fully present in the moment allows us to drink in the full spectrum of benefits of that moment.

Do you have a specific type of meditation practice or Yoga practice that you have found helpful? We’d love to hear about it.

Personally, if I am feeling overwhelmed, I have found that being underneath a tree and looking up at its branches greatly calms me. If my mind is racing, I often lay on my couch and look out my window and up to the center of an oak tree in my yard. Through this exercise, I am able to relax my mind and practice mindfulness. It’s very soothing.

Thank you for that. Can you share three good habits that can lead to optimum physical wellness? Please share a story or example for each.

Definitively, the first one would be movement, and a close second is time outdoors. These are two needs that are so inherently fundamental to our design, physiology and biology as humans. You can ask someone, “did you regret going on that walk?”, or “did you have a bad time on that hike?” and it’s very rare that they’ll say “yes.” Beyond being purely enjoyable, movement is critical to blood and oxygen flow as well as getting Vitamin D from the sun.

So much of our world has been crafted around making us comfortable in our seats, yet exercise is one of the most well-supported mechanisms for improving a depressed or anxious mood. For example, I run for therapy. I pick different routes and enjoy the scenery — especially the feel of the fresh, crisp air after a rain. I can detect a mood or irritability difference when I haven’t exercised for a few days in my work and relationships.

Last but not least, sleep is imperative. It’s critical that we get enough quality rest so that we wake up feeling refreshed. Sleep is one of the core pillars of mental health and wellness. Like others, I have a very busy mind, so to facilitate my rest I use essential oils and aromatherapy.

Do you have any particular thoughts about healthy eating? We all know that it’s important to eat more vegetables, eat less sugar, etc. But while we know it intellectually, it’s often difficult to put it into practice and make it a part of our daily habits. In your opinion what are the main blockages that prevent us from taking the information that we all know, and integrating it into our lives?

Balanced eating is a foundational component to maintaining overall wellbeing. Our bodies require nutrition to thrive and stay active. Eating a wide variety of foods as well as eating at regular intervals throughout the day are ideal practices.

Can you share three good habits that can lead to optimum emotional wellness? Please share a story or example for each.

I think one pillar here is communication. Being vulnerable, sharing your thoughts and getting support from loved ones as well as connecting with one another is critical. If we don’t talk about things, we can get left in the space that is our own minds, and if we’re struggling with mental illness, it can feel like a vortex of thoughts that is hard to navigate alone. It’s like being swept under by a wave when you don’t know which way is up or down but talking to someone during those times can be clarifying and dispel fears. If we aren’t talking about our mental health and being open, the more we are empowering negative stigma around mental illness.

Secondly, mindfulness enhances awareness of the emotions that you’re experiencing. Practicing mindfulness can also help you to identify when you may need to problem-solve or use a skill to help you manage the moment. If we’re not in the present, we’re often too caught up in thinking about the past or the future. In that same moment, we miss the opportunity to hear our intuition and wise mind, which is the intersection of our rational and emotional minds, about what’s happening and how to respond accordingly.

It is also helpful to look at daily lived experiences and to ask: am I engaged in activities that show my values? For some that means connecting with nature in their garden, contributing to their community through volunteer work, gifting to others by writing cards, or growing spiritually with their yoga practice or religion.

Do you have any particular thoughts about the power of smiling to improve emotional wellness? We’d love to hear it.

I love smiling, and there’s a wonderful skill in dialectical behavior therapy called half-smile. The idea of half-smile is founded in the logic that we can facilitate emotional change through behavioral change. For example, if someone is feeling depressed and wanting to sit in bed all day, through the action of getting out of bed, showering and getting dressed, they can begin to experience an emotional shift.

Half smile communicates to us and to others. A gentle half-smile actually can somewhat shift how you’re feeling inside, and then other people respond in kind. It’s a skill I’ve taught for 15 years and at first, people may giggle a little bit at the idea, but I encourage them to experiment with it. It’s hard to be as angry or upset with a half-smile on your lips and smiling can also be contagious. It’s not intended to be a panacea for persistent negative mood, of course, but it is a reminder of the small changes we can make to brighten our days.

Finally, can you share three good habits that can lead to optimum spiritual wellness? Please share a story or example for each.

Spirituality means that someone feels connected to something that is meaningful to them. People are connected to traditional notions of spirituality like god and church, but other folks are connected to other higher powers, the universe, mother nature or their spirit within, maybe even a moment in time. Realizing this significant connection and defining it can positively impact spiritual wellness.

Breathwork can help people be in the moment and reduce distractions that tug at their minds. I often compare our brains to popcorn machines. They’re always making something. Sometimes we have to take a minute to connect to our environment and the moment in order to slow down be present.

Do you have any particular thoughts about how being “in nature” can help us to cultivate spiritual wellness?

Getting outdoors is so important, regardless of location (as long as the surroundings are safe, of course). It’s about stepping back and taking in your surroundings, whether that is listening to leaves crunch beneath feet, cars passing by or a plane overhead. Taking a moment to engage the five senses and noticing the sensations around you can give you a sense of perspective and release.

Ok, we are nearly done. You are a person of great influence. If you could inspire a movement that would bring the most amount of good for the greatest number of people, what would that be? You never know what your idea can trigger.

One of the things I’ve always wanted to see implemented is emotion skill building and training in middle or high schools around the world. We do a great job of teaching our youth so many wonderful things, but sometimes I wish we could do more in helping them to understand their emotional experience and normalize it, as well as teaching methods of emotion responding and coping. Youth (like we adults!), on a broad scale, could greatly benefit from help in developing their emotional tool kits. After all, adolescence involves a critical period of neurological development that impacts how they process and respond to emotionally provocative stimuli. An example of this is that the subcortical limbic regions — the seat of emotional experience — becomes fully formed in adolescence, whereas the prefrontal cortex is one of the last brain systems to mature. Thus, adolescents can essentially experience intense emotional states without the fully formed, sophisticated executive functioning skills required to regulate them.

We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US, whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we both tag them 🙂

I would choose Amanda Gorman. She is the 22-year-old poet who performed at President Joe Biden’s inauguration. Her mastery of prose was fantastic; her ability to weave together recent current events with the honest, underlying messages of her piece, which also resonated with the spirit of the day, was extraordinary. I would love to talk with her about her process, not just the pen to paper part, but emotionally what the creative process was like for her and how she felt sharing her work on such a day.

How can our readers further follow your work online?

I invite everyone to download Woebot on the App Store or the Google Play Store to get a hands-on look at my work. Additionally, readers can visit woebothealth.com or follow us on Facebook, Twitter and LinkedIn.

Thank you for these really excellent insights, and we greatly appreciate the time you spent with this. We wish you continued success.

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