“This too shall pass.” This quote has been present in my mind more than ever lately as we’re dealing with the challenges of COVID-19. Even though we’re unsure of what the upcoming weeks and months will be like, I’m reminded that we have been through tough times as a planet before and have weathered those storms. We will get through this.
Asa part of my series about the things we can do to develop serenity and support each other during anxious times, I had the pleasure of interviewing Dr. Emily Guarnotta
Dr. Emily Guarnotta is a licensed clinical psychologist in New York. She has a strong passion for working with people dealing with anxiety, depression, and perinatal mood and anxiety disorders.
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?
Asa psychologist, this is one of the most common questions I get! When I started college, I was convinced that I wanted to get into education, but during my first semester, I took an introduction to psychology class and found it fascinating. The following year I joined my college’s crisis hotline as a peer counselor, which was my first experience providing counseling to people. I enjoyed the experience so much that I knew I wanted to work in the mental health field. I debated a few different career tracks but ultimately settled on studying clinical psychology because I felt that it would allow me to work in many different capacities. During my graduate school training, I was sure that I wanted to specialize in working with addiction. However, as my training progressed, I learned that I love working with many different areas of mental health. Over the past few years, I’ve become very passionate about working with perinatal mood and anxiety disorders, which is a fancy term for expecting and new mothers who may be dealing with difficulty adjusting to parenthood. In 2019 I founded The Mindful Mommy, which is an online resource for parents that provides information on everything from pregnancy to postpartum to parenting challenges.
Can you share the most interesting story that happened to you since you started your career?
I would have to say that one of the most notable experiences in my career is what is occurring right now. COVID-19 has completely shaken our country and the world and turned people’s lives upside down. I have seen rates of anxiety and depression increase significantly as people’s health, finances, and well-being are all at risk.
The current health crisis has also changed how I conduct psychotherapy as a clinical psychologist. Fortunately, new technology has allowed me to provide teletherapy, which is psychotherapy through virtual means. I am eager to see how, as a culture, we recover from the effects of isolation and reliance on technology for work, school, and socialization. My guess is that technology will play an even more important role in our lives and in the mental health field.
What advice would you suggest to your colleagues in your industry to thrive and avoid burnout?
This is a very important question since burnout is all too common in the mental health field. Between 20 and 60% of mental health providers experience burnout at some point in their careers. I have witnessed long hours, anxiety about helping clients and dealing with ethical issues, and the emotional impact of our work all contribute to burnout. In mental health, there is a concept called vicarious traumatization, which refers to how mental health providers can be affected by the traumatic experiences of their clients over time. As a psychologist, prioritizing my own mental health is an important and necessary part of my job.
Several practices have helped me in my journey as a psychologist to take care of my own mental health and prevent burnout. First, I have learned to set boundaries around my time and stick to them. There are significantly more people seeking psychotherapy than there are therapists or appointments available. In the past I’ve overbooked my time, working long days, evenings, and weekends. Since then I’ve learned how this practice is harmful because I end up feeling drained and overwhelmed, which negatively impacts my effectiveness as a therapist. Now I have set appointment times and I only work within those timeframes.
Another important practice that helps me thrive as a psychologist is prioritizing my own health by eating and sleeping well, exercising, and devoting a few minutes in the morning to my own mindfulness practice. I find that when I do all of these things, I feel much more calm, alert, and focused.
What advice would you give to other leaders about how to create a fantastic work culture?
I believe that taking an authoritative leadership style is the key to creating a positive and successful workplace culture. Authoritative leaders set mutual goals and encourage employees toward growth. They are not afraid to celebrate employees’ successes and show, rather than tell, their employees how to work hard.
One of my first experiences with leadership was in college while working at the peer crisis center that I mentioned earlier. While supervising a group of peers, one person shared that they felt I had found a way to effectively create structure and expectations while being kind and compassionate. I very much appreciated that compliment.
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?
There are many books that have had a powerful impact on me, but one that sticks out is “The Power of Now” by Eckhart Tolle. Tolle helps you understand the importance of being conscious of the present moment and to stop waiting to start living. I read two of his famous books, “The Power of Now” and “A New Earth,” immediately prior to starting graduate school. I anticipated that starting a rigorous graduate program was going to be filled with stress, anxiety, and little time for self-care. It felt like something that I needed to just finish, rather than an experience that would become a part of my own journey. Reading Tolle’s work helped me take a different approach to the experience of starting graduate school and other experiences in my life that my ego associates with stress.
Ok, thank you for all that. Now let’s move to the main focus of our interview. The past 5 years have been filled with upheaval and political uncertainty. Many people have become anxious just from the dramatic jolts of the news cycle. The upcoming fears of an impending coronavirus pandemic have only heightened a sense of uncertainty, fear, and loneliness. From your experience or research what are five steps that each of us can take to develop serenity during such uncertain times? Can you please share a story or example for each.
This is a very tough time in our history. The current coronavirus outbreak is forcing us to reevaluate how we approach all areas of our lives. My 5 top recommendations for coping with this very uncertain time are:
- Remember that change is inevitable. As much as we are uncertain of what the future will hold, we must remember that at some point, this will pass. Many of us remember the feeling immediately following 9/11. The level of anxiety and uncertainty remained for quite a while, but at some point, people slowly began to feel safe again. Sometimes this requires professional help and I strongly encourage you to seek more support if you continue to struggle when others seem to be returning to “normal.”
- Be patient and empathic with others. We are all in this together. When anxiety and stress are heightened, it is common to take our frustrations out on those closest to us. When we feel agitated, we must remember to pause and ask ourselves if our loved ones are really at fault, or our increased stress is contributing to our reaction.
- Practice radical acceptance. This is a concept that is taught in dialectical behavior therapy (DBT), a type of therapy developed by Marsha Linehan for people who struggle with depression, suicide, and borderline personality disorder. Radical acceptance involves acknowledging rather than resisting reality. We can put this into practice by identifying what is outside of our control and trying to accept it. We can say to ourselves, “The current outbreak is impacting me in many ways. I can follow the CDC’s recommendations to lower my risk, but beyond that I must accept the changes that are outside of my control.” The serenity prayer used in Alcoholics Anonymous can also be a helpful affirmation during a time like this.
- Practice mindfulness at least once a day. Mindfulness is present moment awareness. It can be done in a variety of different ways, such as by sitting, lying down, or walking. During this practice, you make an effort to draw your attention to your breathing. Beginners can start by counting their “in” breaths as “1” and their “out” breaths as “2.” If your mind wanders, nonjudgmentally bring your attention back to your breathing. It is very normal for your mind to go off in different directions, so make an effort to accept this when it happens.
- Do something that helps you feel “normal.” Many of us are struggling right now with being outside of our usual routines. As humans, we thrive on structure and stability. If your routine has changed recently, find at least one thing to add to your day that helps you feel like yourself. For some people, this might mean taking a walk outside, a relaxing bath, reading, or making music. Whatever it is, prioritize the practice in your day.
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?
Family and friends can play an important role in helping support loved ones dealing with anxiety. Some of the tips I offer my clients include:
- Don’t assume that you know what they’re feeling. Even if you’ve dealt with anxiety or worry before, don’t make the mistake of thinking that your loved one’s experience is the same as yours. Remember that we all have our own worries and fears and that anxiety manifests differently for each of us.
- Be careful to not dismiss or deny the person’s feelings. When we hear that a loved one is dealing with anxiety, it often makes us anxious. As a way to alleviate our own anxiety, we may resort to urging the person to not feel that way. Though this is well-intentioned, it only serves to make the person feel misunderstood.
- Provide empathy while encouraging the person to see the situation rationally. Empathy is the ability to consider what the other person may be feeling. Simply acknowledging a person’s feelings can do wonders for helping them feel understood. For example, when it comes to a worldwide health crisis, you might express an understanding of why the person would feel worried, while also highlighting that they are taking steps within their control to prevent illness. This balances providing empathy with encouraging rational thinking.
- Don’t underestimate the power of just listening. Many of my clients come in complaining that their loved ones tried to offer them solutions or advice when they brought up a problem. Why does this make them feel so bad? Because oftentimes the person already knows the right solution and just wants an opportunity to feel understood. Remember that listening is DOING something.
- Ask how you can help. When a loved one is anxious, there’s a tendency to try to offer solutions before asking what the person might need. I have found in my clinical practice that this is especially true for new mothers dealing with postpartum depression and anxiety. Many people underestimate how simply cooking a meal, holding the baby while the mother showers or goes on a walk, or cleaning the house can reduce a significant amount of stress.
What are the best resources you would suggest to a person who is feeling anxious?
There are two primary strategies that I think are most effective in coping with anxiety. The first one is getting to the core of your anxious thoughts, challenging them, and constructing more healthy and adaptive thoughts. This is the goal of Cognitive Behavioral Therapy, also known as CBT, which is a type of therapy that is effective for treating anxiety. You can practice some of the skills from CBT on your own by identifying your anxious thoughts and then asking yourself, “What is the evidence for my thoughts?.” If you can recognize that you’re thinking irrationally, then you can come up with new ways of thinking about a situation. If you’re struggling to do this on your own, I would recommend purchasing a CBT workbook that you can do at home or seeing a therapist. Sometimes having an outsider’s perspective can be helpful.
Distraction and relying on healthy coping skills are equally important when you’re feeling anxious. Staying connected to your support system can help distract from your anxious thoughts. I also highly recommend the leaves on a stream exercise from Acceptance and Commitment Therapy, also called ACT. During this exercise, you imagine yourself sitting on the bank of a stream and picture your thoughts on leaves. Next, imagine the leaves flowing down the stream, out of your head and away. When I teach this practice to my clients, I always remind them that it is completely normal if the thoughts come back up. Instead of feeling frustrated, just continue the practice. By doing this, you are strengthening your ability to turn your attention away from anxious thoughts and improving your control over your mind. This is a very powerful tool.
Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?
One of the life lessons that I use to guide my own life experiences is “this too shall pass.” During challenging times this reminds me that things will not always be this way. During good times, this reminds me of the same and helps me appreciate the moment.
This quote has been present in my mind more than ever lately as we’re dealing with the challenges of COVID-19. Even though we’re unsure of what the upcoming weeks and months will be like, I’m reminded that we have been through tough times as a planet before and have weathered those storms. We will get through this.
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. 🙂
I would like to see a movement toward even greater understanding and acceptance of mental health treatment and less stigmatization. I think we have come very far, but there is still much judgement and misunderstanding around mental illness. Since I work with postpartum mood and anxiety disorders, I would also like to see greater understanding of these conditions. I want for people to understand that you can feel love for a new baby while struggling with worry, sadness, and pain. You can have a great job, family, and money in the bank and still struggle with mental health issues. Life is not black-and-white or either-or. Two different feelings can exist together. Once we begin to understand this as a society, we will be able to show greater empathy for one another.
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Thank you for these fantastic insights. We wish you only continued success in your great work!