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Dr. Susan Rich: “Here is How To Develop Mindfulness And Serenity During Stressful Or Uncertain Times”

Stay Socially Connected. During this unprecedented era of isolation due to COVID-19, encourage anxious people that “social distancing” should be termed “physical distancing.” We can remain socially connected even though we may be working remotely. As a part of my series about “How To Develop Mindfulness And Serenity During Stressful Or Uncertain Times”, I had […]

Stay Socially Connected. During this unprecedented era of isolation due to COVID-19, encourage anxious people that “social distancing” should be termed “physical distancing.” We can remain socially connected even though we may be working remotely.


As a part of my series about “How To Develop Mindfulness And Serenity During Stressful Or Uncertain Times”, I had the pleasure of interviewing Dr. Susan Rich.

Dr. Rich is a child/adolescent & adult psychiatrist and distinguished fellow with the American Psychiatric Association who has taught and practiced mindfulness with veterans, people with substance abuse issues, children, teens, parents, families, and communities for the past 20 years. She holds a Master of Public Health in Health Policy and Doctorate of Medicine from the University of North Carolina, completed residency training in psychiatry at Georgetown and a 2 year child psychiatry fellowship at Children’s National Medical Center. Dr. Rich has been in private practice since 2006; speaks internationally on issues related to mindfulness, agrotherapy, neurodevelopmental conditions; consults on forensic and death penalty cases of individuals affected by prenatal alcohol exposure; and operates a nonprofit inclusive biodynamic wellness farm in Maryland.


Thank you so much for doing this with us! Our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?

After public health school, I wrote grants and developed programs in a rural, socially disenfranchised county of North Carolina, including developing a 24 unit transitional housing community for women in recovery to be reunited with their dependent children from foster care. Many of these children had a condition known as Fetal Alcohol Spectrum Disorder (FASD). When a pediatrician told me that they often call children with full Fetal Alcohol Syndrome (FAS) “Funny Looking Kid” because of their facial features, I felt compelled to attend medical school to make a more significant difference at a national and international level to prevent and treat this condition.

Can you share the most interesting story that happened to you since you started your career?

In 2015, I presented about my work on death row with patients with FAS at the International Congress on the Law and Mental Health in Vienna, Austria and was able to visit the home of Dr. Sigmund Freud. There I learned that he had a dog, a chow named Lün-Yu, who laid on the couch during his therapy sessions. Since my Golden Doodle named Copper was a “co-therapist” in my practice, I felt I had something in common with Dr. Freud besides both of us being psychiatrists!

What advice would you give to other leaders about how to create a fantastic work culture?

I would encourage assessing potential employees for their strengths and interests and creating positions uniquely for them rather than creating a generic position then finding people to fit that specific role. This will improve the likelihood that their staff will find meaning and purpose in their jobs. Psychologist Abraham Maslow’s hierarchy of needs says that in order to become self-actualized and enlightened, it is not just food, clothing and shelter as well as safety and community that we need. We also need to have love, belonging and sense of community, as well as meaning and purpose to feel self-actualized. The workplace can be more than a “job,” but a place where people can contribute to the greater good of society using their skillset and interests. Additionally, flexibility of workspaces with fluid seating, plant scapes, water features, and natural outdoor settings for relaxation provide a more tranquil approach to improve mindfulness and reduce stressors. Providing private spaces to work and a small calming meditation room with theta wave music, aromatherapy, and dim lighting for meditation during break times, yoga workshops and vegetarian options at mealtimes also will improve well-being.

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?

In April 1992, I read a book called The Broken Cord by Dr. Michael Dorris about raising an adoptive son with Fetal Alcohol Syndrome (FAS). The book inspired me to seek out a researcher at UNC who showed in 1981 that FAS occurs with as little as 4–5 servings as early as the late 3rd week post conception — well before most women know they are pregnant. I was concerned that women were exposing their babies to alcohol without realizing they were pregnant or without understanding the consequences of their use. I decided to leave a career in pharmaceutical research to attend public health school then medical school in order to help children and families affected by prenatal alcohol exposure. I later wrote The Silent Epidemic A Child Psychiatrist’s Journey beyond Death Row (www.prenatalalcoholexposure.com) to help raise awareness about this leading, preventable cause of intellectual disability and neurodevelopmental disorders.

Ok, thank you for all that. Now let’s move to the main focus of our interview. From your experience or research, how would you define and describe the state of being mindful?

Mindfulness is the state of awareness without conscious thought that comes after shutting down the sympathetic (fight or flight) part of the nervous system and allowing “flow” to happen with the parasympathetic nervous system doing its job. Our fight or flight system is active when we are stressed or aroused — frustrated, annoyed, irritated, overwhelmed. The Buddhists and Hindus believe that a person should constantly be in meditation, constantly be seeking new knowledge and constantly be in selfless service. In many ways, mindfulness provides that state of mind to allow such a trifecta.

This might be intuitive to you, but it will be instructive to spell this out. Can you share with our readers a few of the physical, mental, and emotional benefits of becoming mindful?

Mindfulness dampens down the “fight or flight” (sympathetic) signals in the body to allow activation of the parasympathetic system, which regulates blood pressure, improves thinking and concentration, increases immune function, regulates digestion and metabolism, and promotes sleep. Practicing mindfulness can improve emotional regulation, enjoyment of activities by staying “in the moment,” and attunement with others by focusing on the relationship rather than being distracted by extraneous stimuli.

Ok. Here is the main question of our discussion. The past 5 years have been filled with upheaval and political uncertainty. Many people have become anxious from the dramatic jolts of the news cycle. The fears related to the coronavirus pandemic have only heightened a sense of uncertainty, anxiety, fear, and loneliness. From your experience or research what are five steps that each of us can take to develop mindfulness and serenity during such uncertain times? Can you please share a story or example for each.

  1. Experience mindfulness as a continuous daily practice. Remember “ABC” — Always Breathe Calmly. When something is projecting to you as a threat (e.g., a person yelling, a boss berating you, a co-worker making belittling comments, a family member making demoralizing comments), this activates your “sympathetic” system. Try breathing and turning off your sympathetic nervous system with the breath. Use environmental filters to limit your exposure to media that will trigger “fight or flight” (arousal) mechanisms in your brain and body. Limit watching the news and news feeds on social media. Turn off notifications on your phone or computer. Instead, connect with friends and family and send positive affirmations to those you love and care about. Surround yourself with positive “vibes” and restrict the negative from your homelife.
  2. Consciously create “mindful moments” in your daily schedule. Take a few moments every day to sit in nature or touch an animal or look at a plant while letting go of thought, worry or anxiety. Nature has been shown to improve physical, mental and emotional health. Take a deep breath in through the nose and out through the mouth, collecting all the thoughts/anxiety as though in a balloon of air in your head and belly. Focus on the breath at all times, filling your head with air like a balloon and letting go of thought/worry/tension/pain/discomfort. This can be done during exercise, such as walking, running, or yoga. It can also be done before falling asleep, when waking in the morning, while making breakfast/meals, gardening, driving in traffic, sitting in front of a computer, and/or other times that are stressful or overstimulating.
  3. Use Yoga, Tai Chi, Running, or other exercise as moments for practicing mindfulness. For example, while walking or running, pay attention to your breath, let go of your thoughts, notice the feeling of air going in and out, feel your muscles, feet against the ground, and the movements of your joints, pay attention to the trees, flowers, grass and your surroundings.
  4. Find a passion project. We all need a “higher calling” — a purpose greater than yourself to become involved with, whether a volunteering with a community group or working for a nonprofit organization; alternatively, you might find ways to improve the environment in your area (i.e., picking up trash in your local neighborhood, taking a group of family friends or your own family into the forest for a group walk and collect trash along the way, creating a community garden, planting a tree, assisting an elderly neighbor). Studies have shown that when we have a higher purpose, we are able to overcome depression, anxiety, other mental health conditions, substance use disorders, and even catastrophic illness or imprisonment. Dr. Victor Frankl discussed this point in “Man’s Search for Meaning,” which is how he survived the Nazi death camp at Auschwitz.
  5. Be “mindful” of the gut microbiome. What we eat is broken down by the 10,000 species of microbes living in our gut and metabolized into the micronutrients, calories, and building blocks for our physical and mental health. Over 90% of the serotonin and 50% of our dopamine (feeling good chemicals) used by our brains and bodies is regulated by our gut microbes. The diversity of our microbes depends on the foods we eat. Processed foods contain chemicals that kill our gut bacteria. Sugar causes an overgrowth of yeast, which ferments into alcohol making us feel sluggish, lethargic, constipated, and mentally foggy. Eat healthy foods, such as raw fruits and vegetables, fresh cooked meals, and cut out processed foods whenever possible.

From your experience or research what are five steps that each of us can take to effectively offer support to those around us who are feeling anxious? Can you explain?

  1. Always Breathe Calmly (ABC). When we stay calm, others are more likely to remain calm. When others around us are anxious, we should breathe gently in through the nose and out through the mouth (be mindful). Studies has shown that when one person meditates (practices mindfulness), the person across from them has a correspondingly lower heart rate and blood pressure. Studies have shown that those who are meditating and practicing mindfulness reduce the stress levels of those around them.
  2. Practice Positivity. Share positive news and inspiring/uplifting messages through social media or by posting in the workplace. Speak in optimistic terms about your day and promote a positive attitude to others. When someone brings their anxiety into the workplace, attempt to help them see something positive in themselves, see the brighter side of the situation, or that the thing they may be worried about may not be as bad as their mind is making them think. Often we “catastrophize” when we are in “fight or flight” mode, seeing everything as the worst case scenario.
  3. Recommend a Break from News. Encourage the person to not watch negative news. Much of the news projects negativity into the environment and onto the listener. When a person is anxious already, hearing about catastrophic events beyond one’s control further exacerbates the anxiety and makes the situation much worse.
  4. Model and Teach Mindfulness. Show others (coworkers, family members) how to breathe (in gently through the nose, collect all your thoughts and feelings, then breathe out through the mouth). As a psychiatrist, I teach parents to model mindfulness within the home and to notice when their children are anxious. Within the workplace, we can assess when co-workers are stressed or anxious and provide role modeling for how to let go of their negative thoughts, feelings, and worries while focusing on the breath.
  5. Stay Socially Connected. During this unprecedented era of isolation due to COVID-19, encourage anxious people that “social distancing” should be termed “physical distancing.” We can remain socially connected even though we may be working remotely. Suggest that anyone expressing anxiety try developing healthy coping skills through similar techniques that you use (yoga, mindfulness, passion projects). Having physical touch, hugs, laughter, and enjoyable activities during stressful times can reduce anxiety, improve immune function, and promote overall well-being. Physical isolation in times of stress leads people to feel despondent, despair, and disenfranchised.

What are the best resources you would suggest for someone to learn how to be more mindful and serene in their everyday life?

Years ago in my mid 20s, I read The Bhagavad Gita which helped me understand the basis behind the practice of mindfulness and meditation. The Calm App, listening to mindfulness music on Pandora, YouTube, or Amazon Prime, or other apps, Gaia TV (www.gaia.com) and The Daily Om (www.dailyom.com) are also really great ways to incorporate the practice of mindfulness.

Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?

“Never stop learning because life never stops teaching” is my favorite quote by Amitabh Saxena. Although I have 28 years of education (and I didn’t attend preschool or kindergarten because they didn’t have it in my hometown), I have continued to learn all my life. Most recently, at the age of 50, I purchased a 6.5 acre property to develop a biodynamic farm, operated by my nonprofit 501c3, and have hand raised 12 goats, several chickens, four cats, three dogs, and a rescued pig named Noah. I have learned so much about child psychiatry and neurology through working with the animals, who are bonded to me and serve as co-therapists in my agrotherapy practice. Building the farm has required learning to use power tools, like chainsaws, electric screwdrivers, automatic nail guns, and other mechanical devices. We are in process of receiving funding from the State of Maryland and Montgomery County to replace all the pasture fencing in order to get 3 rescue horses and 4 alpacas and to remodel all the outbuildings and sheds, creating a registration booth and ADA compliant bathroom with a compostable toilet for special needs schools to visit the farm. This will require additional learning and growing as I navigate the additional capital improvements and program development aspects. Every day becomes fertile ground for discovery and learning.

You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

One in 20 US children are affected by prenatal alcohol exposure — largely because 50% of pregnancies are unplanned and 13.5% of childbearing age women binge drink. In addition to people not knowing that alcohol is a problem, even in early stages of pregnancy, most Americans (and the international community) doesn’t realize the global impact of this epidemic. My book, The Silent Epidemic: A Child Psychiatrist’s Journey beyond Death Row aims to spawn a movement to bring understanding of preconception health and contraception for alcohol users. My biodynamic farm, Dream Catcher Meadows, opens the possibility of inclusive social, recreational and vocational experiences for neurodiverse children affected by anxiety, prenatal alcohol exposure and other neurodevelopmental conditions. The idea of inclusive workspaces with sensory softening cubicles (The Suess Cube) where individuals with neurodiversity can work without being overstimulated and distracted by the multiple inputs in the workplace would be part of this movement to ensure that individuals with FASD/ND-PAE have the chance for meaningful, purposeful lives.

What is the best way our readers can follow you online?

Twitter: @SusanDRichMD; www.Facebook.com/TheDreamCatcherFarmwww.BetterSafethanSorryProject.comwww.susandrich.com; Book: www.prenatalalcohlexposure.comhttps://www.facebook.com/SusanDRichMD/

Thank you for these fantastic insights. We wish you only continued success in your great work!

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