Ep. 337 Transform Your Life with Practical Optimism with Dr. Sue Varma

Today, I have the pleasure of connecting with Dr. Sue Varma.

Dr. Varma is a privately-practicing board-certified psychiatrist and a Clinical Assistant Professor of Psychiatry at New York University. She is a nationally acclaimed keynote speaker, medical contributor, media consultant, and advisor to leading television networks and programs.

In our discussion today, we examine the impact of shared life experiences like 9/11 and the pandemic, exploring the role of PTSD and the effects of practical optimism, self-care, and self-reliance. We discuss optimism, its inheritability, and the significance of milestones for women, including transitioning from high school to college, navigating midlife, and addressing feelings of loneliness. We also look into purpose and compassion, the complexities of processing emotions, the challenges of the perfectionism façade, the role of trauma, ACE scores, autoimmunity, and the benefits of mindfulness and meditation. 

Stay tuned for more!

“People don’t realize that unprocessed emotion wreaks more havoc in your mind and body than simply letting it out.”

– Dr. Sue Varma

IN THIS EPISODE YOU WILL LEARN:

• Dr. Varma discusses the collective sense of grief, fear, connection, and empathy after 9/11 and the pandemic
• The importance of optimism and resilience when dealing with tragedy
• How Dr. Varma helps her patients identify their blind spots and other areas for improvement in their lives
• How perimenopause can bring about a sexual awakening and increased desire for intimacy but also loneliness and dissatisfaction in relationships
• Why friendships are essential for our well-being
• Why do we need to invest in different types of connections and relationships?
• The critical importance of finding purpose in life 
• How unprocessed emotions affect our mental and physical well-being
• How trauma impacts mental health
• Some practical tips for incorporating mindfulness into daily life 
• The benefits of meditation

Bio: 

Dr. Sue Varma is a board-certified psychiatrist in private practice and a Clinical Assistant Professor of Psychiatry at New York University (NYU) Langone Health. She is a Distinguished Fellow of the American Psychiatric Association. Dr. Varma was the first medical director and attending psychiatrist at the World Trade Center Mental Health Program at NYU Langone Health, treating civilians and first responders in the aftermath of 9/11. Dr. Varma is a nationally acclaimed keynote speaker, medical contributor, media advisor, and consultant to major networks and shows. She regularly appears on the Today Show, Nightly News, CBS Mornings, and Good Morning America and is frequently interviewed by Time, Washington Post, NPR, and beyond. Dr. Varma is the recipient of numerous prestigious awards for her ground-breaking efforts in mental health education and advocacy, including a Sharecare Emmy. Her forthcoming book, “Practical Optimism,” is eagerly anticipated worldwide, with translations in several languages.

Connect with Cynthia Thurlow

• Twitter
• Instagram
• LinkedIn
• Check out Cynthia’s website
• Submit your questions to support@cynthiathurlow.com

Connect with Dr. Sue Varna

• On her website
• Instagram
• Facebook
• Twitter
• LinkedIn

Transcript

Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness podcast. I’m your host, Nurse Practitioner, Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

[00:00:28] Today, I had the honor of connecting with Dr. Sue Varma. She’s a board-certified psychiatrist in private practice and a Clinical Assistant Professor of Psychiatry at NYU. She’s a nationally acclaimed keynote speaker, medical contributor, media advisor, and consultant to the major networks and TV shows. 

[00:00:47] Today, we spoke at length about the impact of both 9/11 and the pandemic as a shared life experience, the role of PTSD, the impact of practical optimism, self-care and self-reliance, the role of optimism and how there is a degree of inheritability to it, major milestones for women, including transitioning from high school to college, midlife, loneliness, and more, the role of purpose and compassion, processing emotions and the perfectionism facade, the role of trauma, ACE scores and autoimmunity, mindfulness and meditation, and so much more. I know you will love this conversation as much as I did recording it.

[00:01:32] Dr. Varma, such a pleasure to connect with you. I really enjoyed reading your book, and I’m really grateful that you’re here today to share your experiences and your knowledge with my community. 

Dr. Sue Varma: [00:01:41] Thank you so much for having me. Thank you. And thank you for taking the time to read it, so I can’t wait to dive into it with you. 

Cynthia Thurlow: [00:01:46] Yeah. And we’re speaking before we started recording that you were a new physician. I was a new nurse practitioner when 9/11 happened, and I can’t even imagine how transformative that must have been for you to be really in the thick of it. As you said, all of us were impacted by 9/11, but you were part of this directorship and attending for the World Trade Center Mental Health Program, walk us through how that impacted you as a clinician and as a human being, because I would imagine it would have been incredibly, every emotion that we can think of, overwhelming, sad, inspiring by those that you were working with. 

Dr. Sue Varma: [00:02:25] Absolutely. And it was all of the above, scary in the sense that there are very few tragedies or traumas that you as a clinician will live through side by side with your patients. Because all of us come in with our own unique life experiences, but never do you have this collective sense of grief or dread or fear as we did. I would say in my lifetime, twice as it was with the 9/11, and then fast forward 20 years with the pandemic where you answer the phone and because that’s what we were doing during the pandemic, is phones or Zoom calls with patients. And almost that there’s this shared connection of, I see you, I know exactly or not maybe exactly, because again, variations of experiences, but I know what you’re going through and I can feel it. And so very little needs to be said.

[00:03:16] And 9/11 was one of them, because I think the saddest thing for me working in a New York City Hospital at that time was, we were expecting so many more people to come in and to need to be treated. And we had discharged so many patients thinking we’re going to be flooded and really the opposite happened where there were so many deaths and a lot less people that we wanted to treat. But I want to say, as a clinician, not being prepared for the level of magnitude and tragedy, because when a patient comes to you, often it’ll be with one crisis, either they’ve lost a loved one or they’ve had a job loss or something, one loss. It’s never that you’re meeting someone who’s like, I lost everything. I lost my team members.

[00:03:59] Maybe my spouse was also working in one of the towers. And I don’t have a job. I live downtown, and my place is covered with dust and debris, and I’ve had medical injury. So, the number of things that and we know that the risk for posttraumatic stress disorder goes up, the more losses you have if you were not physically impacted. And a lot of patients were from cough and asthma and sinus. And what was really, I think, valuable about this experience was to see, oh, my God, first of all, I always know tragedy teaches you, especially these manmade swords, the depths of depravity, but also the heights of humanity, of how kind people were. Like, when they say New York strong, like, you know what that means? Because you’re like, I would give the shirt off my back to my fellow New Yorker, which is what happened that day. 

[00:04:49] People lost shoes and clothes and covered with blood and dust and debris and saw, like, people were jumping out of buildings, things that you should never have to see and that you should never have to experience. And at the same time, I learned we all had to depend on each other as colleagues because none of us had experienced this. Yes, I was young, and yes, I was green, but there’s definitely imposter syndrome. But I was selected for this program amongst competitive pool of candidates. So, I had to remind myself, “Okay, then maybe there’s something about me that they’re seeing that I can do the job.” And then you’ve learned so much along the way. And I became interested in optimism through resilience. 

[00:05:24] Optimism is not something that you learn about in medical school. It’s not something you learn about in psychiatry training. It’s not something anyone talked about then, and really, no one is talking about now. And not just sunny skies positivity, but using optimism as a medical intervention and tool and a resource and a skill set that can be taught, that can be learned, that can be practiced, and that can lead to so many positive benefits. So that’s my story in a nutshell.

Cynthia Thurlow: [00:05:50] No and it’s interesting as I was reading your book, I was writing down quotes and pearls and things that really stood out to me as a clinician myself. And I loved your story about your father. And I’m sure we will talk about this. But how refreshing, as a licensed healthcare provider myself, to hear another clinician saying, “Using optimism as a tool is, it’s like, wow.” I mean, I think sometimes we overcomplicate things. Clearly, there’s a place for pharmacotherapy, there’s a place for invasive diagnostic testing. But I think on a very basic level, we forget how important that positive reframe is. One of the things in the book that stood out to me was “Flourishing is more than bouncing back from adversity, but thriving in the face of it.” And so, again, that reframe about optimism. 

[00:06:37] And so let’s talk about the influence of your father, because you weave this into the book, and both your parents are incredibly accomplished, as are you. And it sounds like you really were exposed to this practical optimism as a child and young adult and how it has so heavily influenced your evolution as a young woman, but also as a clinician as well. 

Dr. Sue Varma: [00:06:58] Totally, no. Thank you so much for saying that. And I was born to immigrant parents, so it was a very unique experience in that. My parents left India in the 1960s and had this vision of what their culture was and philosophy and held on to it for better, for worse. And I think a lot of times when immigrants come to a new country, they hold on to their values because that’s the only world that they know. But it’s so interesting how it worked. I think, in some places and ways, to my benefit and some maybe to my determent. My parents were highly educated. They were the top of their classes. They ended up being superstars in their communities. Started this pioneering program in India that was way ahead of its time. 

[00:07:38] My father was the first child psychiatrist in northern India. He came to the United States in the 60s, did his training, was starting a practice here, and then had heard about this pioneering work my mom was doing. She had graduated high school at 13, had four Bachelor’s by 18, then went on to get a bunch of Masters and a PhD, never ending and really ahead of her time, started a school first in her living room, and then it caught the attention two of the first three prime ministers of India. And they’re like, this woman is doing things ahead of the game where she’s including medical treatment, psychiatry, social work, into the fold of schools and bringing children with disabilities who are normally shunned into mainstream classrooms and saying that everyone has talent, everyone has something to share. Let’s really highlight the positive strains and get the kids help.

[00:08:28] And this was unheard of. It’s a very high achieving society in many families and education. And if you have attention problems, no one had recognition. They were just like, “You’re lazy, you’re stupid, you’re an idiot.” These kids would get called such bad things and not given resources. So, my dad flew back to India and then first volunteered, then later was selected to be the medical director of the school. And together they fell in love and did amazing work. But my dad always had, in the back of his mind, I want to give my kids this amazing opportunity for education and benefit, so maybe he can go back, bring my mom, and start a family, and then continue their pioneering work there in the United States. 

[00:09:06] So, they did do a lot for psychiatry, for mental health with child psychiatry, both for immigrant populations in the United States, but also for local populations. And my father was just honored a few years ago as a 50-year Distinguished Life Fellow, American Psychiatric Association. And I got Distinguished Fellow, and we both walked down the aisle and got our medal. So, it was really sweet. I never thought, “Okay, yes, your dad gives you away at your wedding day, but not in this professional capacity.” So, it was really fulfilling and full circle to see that. We had amazing conversations at the dinner table.

[00:09:37] Like, I grew up in New York, and our living room was always filled with people who were asking my parents for help because whether they were in the South Asian community or really just neighbors of our down the street, like Bill and Bob and Ted and Harry, who were like, we don’t know who to talk to because no matter what community you were from, unfortunately, there was so much stigma, there still is about mental health. And my parents were always just very kind people who were like, “Let’s try to help you. Let’s try to get you help. Let’s try to put our brains together what resources can we–“

[00:10:03] So, I always saw them as just being pillars in the community, but then that was also, in some ways, to my detriment, because I grew up thinking, you have to be strong for other people. And there was never this idea that, “Hey, wait, you also might need to take time and prioritize yourself and self-care.” And that was definitely not a part of our culture. It’s not part of medicine, it’s not part of South Asian culture, this concept of self-care. So, that’s something I had to learn on my own and was also one of the reasons that I decided to write this book, because I had my own blind spots, and I was always in this position of leadership and of giving. And there’s sometimes when you do need to take time and get your own help. I learned so much from 9/11, but also from being on both sides of the couch. And I think it’s made me a better therapist having lived through and gone through therapy myself.

Cynthia Thurlow: [00:10:51] I jokingly tell people that I will be doing some form of self-development therapy for the rest of my life. Because anytime I get triggered or something happens, I’m like, “Oh, that’s something I need to work on.” Being aware, being self-aware and certainly, I think I 1000% agree with you. I grew up in a family of people in medicine, people in education, being of a service to others. And so, when I had my own little health care hiccup in my early 40s, it was not really looked upon with a great deal of support from my family because they’re like, “You should just continue to suck it up. It doesn’t matter that you’re tired. Keep moving forward, you have a good job, you should keep doing this.”

[00:11:31] And so, I think for a lot of individuals that are listening, that have grown up in those kinds of environments, it’s really hard to be your own best self-advocate. And that investment in yourself with therapy is so important. I’m curious, we had 9/11, and then 20 years later, essentially, we had the pandemic. How had you grown as a clinician? Did it make it a little easier because what you had gone through during 9/11 to be able to support people during that time period, because New York again was really this epicenter of the pandemic in 2020.

Dr. Sue Varma: [00:12:01] I want to say there’s no way, obviously, you would never want to compare two very dark, dismal situations, but a lot of lives were lost on a daily basis during the pandemic. And it felt, I think, scary because you knew it was coming, but you didn’t know how it was going to hit you. And then people were like, “Oh, two weeks.” And I remember thinking in the back of my mind, there’s no way what’s going to change in two weeks. It’s not until things change on a broader scale. And a lot of things personally have happened to me in the last 20 years. I finished medical school, I finished psychiatry, I became a mother, I lost a mother. 

[00:12:36] So, all of these things and then just having years of practice and then of working with patients, you also just become a little bit wiser, life experience wise. But I don’t think, again, anything can prepare you for what we were going to go into. Because I started reading about the literature on quarantine and how that really affected people’s mental health. They were studies that looked at somebody in, I don’t know, Australia or Singapore, Hong Kong, wherever. And it was like, just for a few days, like, if there was like, H1N1 flu virus, they were like eight-day quarantine. And they were like, the longer the quarantine, the longer the mental health effects. And then here we are, six months, one year, two. So, it was a different set of challenges. 

[00:13:17] But what I also saw is how quickly we as a society could pivot with technology. Because I remember being, one of the hats that I wear is, I’m a morning show contributor, and I did NBC interviews in a day, and it was just one station. And it was more than sometimes you would do an entire month or an entire year, because mental health wasn’t seen as important of a topic as other medical topics or other topics in general. And I remember the day, it was Friday the 13th, March 13th, and everything was coming to a halt. And I kept getting called back. Come back in, come back in. And I was like, “I have patients, my friends. I can’t keep– nightly news, all of that.”

[00:13:54] And a couple of things I realized is very quickly, within a few days, whereas all of the TV segments had to be done in person, all of a sudden, we switched to Zoom, and I was like, wow, we had this technology all along, or with patients to be able to pivot very, almost seamlessly. And I think in the beginning, people thought that the quality of these remote or virtual things were second class, but now it’s taken over in some ways become the default. So, I’ve learned a lot and I’ve also seen how, again, resilient we are and how quickly that we can pivot and also what I think the pandemic did is fast forward the mental health conversations like two decades. 

[00:14:29] Because again, the shows, and I use the shows just as an example because it shows you what’s on people’s mind, because obviously the shows want to cater to what people are thinking. And all of a sudden, producers are like, “Hey, everyone is talking about anxiety because we’re all stuck at home.” We’re navigating relationships with our spouses, or lack thereof, or with our children, or we’re worried about our child’s mental health. So suddenly, I recognize that on a national level, mental health was front and center in a way that it hadn’t been, and it was within not even a day of shutdown being announced. So very quickly, people are like, what are we going to do? How are we going to manage this? 

[00:15:04] So, again, pros and cons of tragedy, but being able to find meaning, being able to find a silver lining, assuming there is one. Sometimes there isn’t, and that’s totally fine. And this idea of posttraumatic growth, which is something really horrific happened and is there anything positive we can take from it? And I always say, don’t feel pressured to find that in the moment. Sometimes you can only have that with time and distance and perspective to be able to find something positive about something so dark or negative. 

Cynthia Thurlow: [00:15:33] I think that’s so incredibly insightful. And the reframe that we found. My children are teenagers, but we had an entire year of just the four of us and two dogs. And as wild as that year was, I don’t think I can really articulate another word to describe what that wild ride was. But so very grateful, because how many parents, especially with teenagers, have a whole year where it’s just the four of you and you’re doing puzzles and Legos. And my teenagers, many years ago, had put those things aside, and we were playing games together every night and eating all these meals. And so, I love that you talked about how important mental health became because we were faced with having to have these discussions. And I agree with you wholeheartedly that even as a clinician myself, there still is this outward. 

[00:16:21] In many instances, people still feel uncomfortable. They feel a sense of shame if they’re advocating for their own mental health, but it’s okay if they go in and say they have knee pain or they’re having pain in their ear, but if they come to their clinician and say, “I’m really struggling, I’m quite depressed, or I’m feeling really anxious, and I can’t work through these challenges.” So, let’s talk more about practical optimism, because there is, as you mentioned in the book, you talk about how some of this can be inherited, how there is a neural basis to optimism, which my husband and I were discussing, which I found really interesting, as well as this association with specific types of genes that can make it more likely for us to be optimistic. 

Dr. Sue Varma: [00:16:58] Yeah. So, something I found out years after 9/11, which they didn’t discover until about 2011, was that there is a genetic association to optimism. And I think a lot of people would be like, “Yeah, that makes sense,” but there’s more to it. So, there’s a gene, the oxytocin receptor gene, and there’s been since that discovery, maybe some further research that’s like, “Is it 100% this gene? Could it be other genes?” I mean, look, there’s always things we’re still developing and always understanding. But the fact that anyone was able to even make any connection to a specific gene, to me, is fascinating because we don’t have too much genetic basis of anything of any behavior or outlook. 

[00:17:39] So, the oxytocin receptor gene, they say that if you’re born with a certain variant, you’re more likely to be optimistic, and if not, you’re more likely to skew to pessimism and even depression. But to me, the most interesting thing was that, number one, only 25% of optimism is genetic. The rest is something within your control. And then the question is, what are those things within your control? And this study found that it could be things like coping mechanisms and psychological resources. And I was like, “I’m already doing this in my practice as a cognitive behavioral therapist.” How can I help people? And typically, in therapy, you’re helping people are coming in for a diagnosis, depression, and anxiety. And cognitive behavioral therapy is not meant for you to live your best life. 

[00:18:20] I mean, it’s meant to help someone in the midst of a crisis, a depression and anxiety. But I was like, “Wait a minute.” Not only can many of these tools and skills that are helping you at your darkest moments help you go from, let’s say, dysfunctional to functional, but could these same tools and resources be applied to go from functional to optimal? And no one had looked at that. And that functional to optimal gap is where optimism comes in, is like, “Yeah, you’re okay, you’re getting by. Maybe you’re feeling a little bit empty or stagnant, bored. Don’t know, not feeling inspired, not feeling motivated.” But it’s not enough to warrant therapy or to go in. And even people who have mental health disorders, unfortunately don’t go in for therapy. 

[00:19:04] It’s almost maybe, like maybe 30% to 40% actually do end up seeking help. The vast majority don’t. And so, if people who need help are not getting it, certainly the people who are like, “Okay, but not ideal,” they’re not going in. So that’s who this book is written for. It’s for everyone on that spectrum. If you’re really down and out, and hopefully you’ll get therapy and use the book in conjunction. Or if you’re like, I’m on the fence, and I don’t know because I’ve never met a normal psychiatrist. I think the joke was, there’s got to be something wrong with you yourself. That’s why you would go into psychiatry. So, you’d read the book, and you’d be like, “Hey, she’s like me. She’s relatable. I like this lady. I can relate to her.”

[00:19:44] And maybe that would turn you on to wanting to get help. Or you’re like, “I’m okay, and I could better.” Or you think you’re an optimist, and then something hit, and you’re like, “You know what? Not every part of my life is going as well as it could be. What are the areas where I could.” Because a lot of times, people, we all have blind spot, some people are hyper functioning and successful in their career, and as a result of that, they’ve put friendships on the back burner. Or sometimes people have invested so much into their friend groups that they’re like, “All right, I need to take a step back and look at where I am career wise or personal health.” So, it gives you a 360. And that is what I do in my practice. 

[00:20:18] When I see patients, I’m like, “Okay, I understand that this is the crisis that brings you in,” but inevitably, what led to that crisis? Let’s look at that. Because a lot of times people say, “Oh, I just want to go back to my baseline.” And I’m like, what if your baseline was what got you here in this mess in the first place? So, clearly, that foundation that you thought was so solid wasn’t solid. Let’s look at your sleep. Let’s look at your nutrition. Let’s look at your friendships. Let’s look at it all. Personal health, fitness goals, all of that. 

Cynthia Thurlow: [00:20:44] No, it’s also important. And I’m curious, when you’re working with your patients, what are some of the big milestones for individuals. Let’s just talk about women that’s most of who listens to this podcast, big milestones probably when they get married, maybe when they become a parent, maybe when their children go off to college or leave the nest, if you will, or the sandwich generation, we have aging parents and like where I am right now, teenagers. Where are some of the blind spots? Where are some of the more vulnerable time periods in a woman’s life when you’re working with them that they might trigger them to come talk to you or to come start working with you? 

Dr. Sue Varma: [00:21:18] Yeah, I mean, I see it all because I work with people throughout the life cycle. So, I would say in my practice, I’ll see someone as young as, let’s say 17 and as old as like 75 or 80. And I would say that at every heap milestone in life, like entering, let’s say, into college. So high school into college is like one spot when young girls, let’s say there’s a parent listening right now, like body image, friendships, bullying, not feeling like they have friends that understand them. I think loneliness is huge in the extremes of the generations and the teens for any number of reasons.

[00:21:54] I’m not surprised that there’s a mental health crisis in younger people, the pressures on them to succeed, navigating the digital world and navigating their reputation and their identity and their popularity and connectedness and relatedness in real world, but also digitally. And then that technology for some people takes up. So, it could take up so much time where then it’s impacting and cutting into face-to-face friendships, into exercise and into sleep. So, there’s a lot happening in that high school to college. I often find for a lot of people, college is a time where they feel like they’re thriving because they’re making friendships, they’re pushing themselves, they’re getting outside of their circle. And I feel like sports is a big thing. 

[00:22:31] If sports was always a part of their life, it gives them camaraderie and friendship and body positivity, all of that. And then navigating the first job in their 20s, navigating relationships. And then one big thing that I see that happens a lot, but it doesn’t always have to happen is this idea of midlife loneliness in women and the number of prescriptions being, I mean, we know, I mean, you know, so perimenopause, hormones, a lot of women are like, a lot of things are happening to them. 

[00:22:56] A, it can be a sexual awakening for a lot of people. They’re like, I finally feel comfortable with my body. I finally feel ready to ask for what I want, and I finally realize that I’m not having the sex I want. So, I feel like relationships is a big thing. And also, how young are your kids and how involved are you in their care and the loneliness that comes with that because you might have put friendships on the back burner. Especially, I think if you’re juggling a busy job, juggling the household, there are any number of reasons, but oftentimes parents of young children might lean into the schools and they might build a friendship circle based on the kids.

[00:23:28] But something very interesting I’m noticing, even for my personal life, is as those children, before the pandemic, I’ll give you an example. My kids were young, and we would get invited almost every weekend to the kid’s birthday parties, because at that age, pre-K, 3, 4, 5, 6, 7, the custom was to invite everyone in the class. It’s not just the kids, one or two best friends for a private play date. And so, you end up having these built in layers of socialization or then when the kids are playing sports, like now, going to their games is another thing. But you have to be very mindful that if these things now that when your kids are older and they’re organizing their own hangouts directly and you’re not a drop off, you’re not necessarily socializing with the other parents, and if you’re not actively involved in the community, in the PTO or equivalent, and you’re working, and it’s so easy to let friendships, I feel like female friendships, they feed and nourish our soul. God bless our partners, but it’s just not the same. If you’re in a heterosexual relationship, I think a lot of things I hear is like, “Oh, my husband, yes, he’s great, but he doesn’t listen. He tunes out. He’s tired, he’s looking on his phone.” I mean, we’re all guilty of that. 

[00:24:30] But I feel like if you were to ask me, and they’ve done so many studies of looking at not just for women, but for men too, taking a snapshot midlife and looking at their friendships and that friendships are predictive of health, your quality of your life depends on the quality of these friendships and these relationships. So, I think at a time where it’s so easy to lose and put in the back burner, we really need to lean in and invest and say, “You know what? I’ve been putting off this get together for too long, or let me just call her. Let me just pick up the phone and call and let me make an effort.” So, you have to really be and I have a whole chapter dedicated to people. It’s one of the eight pillars of practical optimism, and I think it was my favorite pillar of all– I love people and I very much recognize the importance of it. 

Cynthia Thurlow: [00:25:11] Yeah. And it’s interesting because my kids are now teens. One is driving independently, he is supposed to be driving during the day with his parents. But you’re absolutely correct that when they were younger, there was so much socialization because weren’t driving, we had to take them everywhere. We had to stay when they had the parties. And then as they start getting older, some of those friendships change. So maybe there was a parent that you were friends with, but then your kids aren’t hanging out as much, and so it starts to shift quite a bit. And I know I’m just as guilty of this as probably anyone else. Sometimes, I can just get wrapped up in work and I’m like, “Oh, I don’t want to go to that event. I’ll just do that next time.”

[00:25:44] So, I think that’s such a good reminder of how important it is to have that social connection. And I would imagine that if we’re looking at the research, it’s more about quality than quantity of friendship. So, making sure that you have real close friendship or you have a couple of friends that you can really lean into if you have something that’s of concern that comes up, as opposed to those superficial friendships, which many times they serve a purpose. But that wouldn’t perhaps be the person that you’re calling in the middle of the night if you’re having a crisis. 

Dr. Sue Varma: [00:26:11] Yes. And I think it’s good to have a mix of both. It’s like when you go to a restaurant, sometimes you do want the appetizer, but then you need the main meal. Or sometimes you’re like, “You know what? I’m watching, what I’m eating. I’m just going to do the appetizers and not the main meal. I feel like we need a nice combination. And don’t forget dessert.” [Cynthia laughs] We need a nice combination of a little of each of those, like the micro connections or I call them social snacking is like, that is the superficial like you said hello to another parent at a game and you had talk for 15, 20 minutes. I mean, that has value, even if they’re not going to be the person you call it to in the morning. 

[00:26:39] Because maybe you are what we call informational buddies, where you’re like, “Oh, what camp are you guys doing this summer? And your kid plays that sport. I heard about this camp. Whatever or exchanging information, or I’m looking for a job, please keep me in mind or I’m moving, or I’m looking for an apartment.” Having people that can check different boxes and there’s some people that you’re just going to ask for information because they’re a great resource, but you’re not necessarily going to spend a Saturday night with them and vice versa. So, I feel like I never want to minimize the importance of the superficial connection, but at the same time, it can’t be all of it. You also do need to invest in one or two places, friendships and having a mix of both friendships and let’s say family relationships. 

[00:27:19] So, you might have a cousin or even though maybe your parents are not close, but it’s like a second cousin that you always resonated with. I feel like these ties can come from so many places, and there’s something called multiplex ties when you know the same person from like two or three different places. So, let’s say it is a parent in your child’s school, but then you decide to do a yoga class together. So, if you can develop different ways of getting different contacts for this context, for the same friendship, it’s more likely to be a little bit stronger, like a work buddy that you also then work out with. 

Cynthia Thurlow: [00:27:50] No, I love that. And it’s such a nice reminder to make sure that we’re making those investments, Now, one thing that I see a lot of women at this stage of life are figuring out their sense of purpose. And I think for so many of us, we tie this into what we do occupationally. You go to a party, people ask, “What do you do?” Depending on where I am, I sometimes just say nurse practitioner because I don’t want to have to unpack the entrepreneur piece. But helping people understand that purpose is more than just what gives you money or this exchange of money. It can also change over time. And this is something that I’m starting to see as we’re getting closer to my oldest going off to college, and certainly a lot of listeners can– This really resonates with our sense of purpose is starting to shift. And this can be a time, I would imagine, when individuals can be at risk for having greater awareness around uncomfortable feelings.

Dr. Sue Varma: [00:28:39] Absolutely. And I would say a few things about purpose. One is your purpose does not have to come from your paycheck. Your purpose 10 years ago does not have to be your purpose today. And if you can’t find your purpose, then it’s your job to create it and to put what’s called the cart before the horse and say, “You know what? I am maybe trying to figure that out.” What gives meaning every day. Your meaning could have been or still is from raising a family to say that I am the support system. Unfortunately, we don’t get enough credit for that hat. It’s like almost everyone takes that for granted. Of course, you take care of your family. Who else would, right? No one’s giving you a pat on the back. No one’s giving you a trophy. No one’s saying, like, good job. 

[00:29:15] They’re like, it’s your family of course you should be taking care of them. But nobody understands that some days it is very, very hard. Some days it is not necessarily a reward thing. And I feel like we need to take the shame out of that. Like, women need to be able to say to each other, “No, I don’t love being a parent 24 hours a day,” no. Yes, it changed the way my body is. It changed my mind. It changed my everything thing. So, giving people space and freedom to shame free, guilt free, talk about the lows of parenting, the hardships, the challenges. And, in fact, one of the things I talk about in this book is self-compassion. 

[00:29:46] And studies have found that whether you’re a student who failed an exam, like a math test, and you did a quick self-compassion exercise, which I talk about a little bit about the research, and how to do an exercise in that, you’ll do better on the test next time, or a parent who’s like, this is very stressful parent taking care of a child that might have special needs doing that self-compassion exercise says, “I’m not alone. Other people struggle in this. I’m aware of it, now what, what am I going to do?” So, there’s an acceptance of it, a common humanity piece, and then moving forward. But the purpose I would say sometimes maybe, Cynthia, just listening to your podcast would help them figure out, “Wow, this is really inspirational. I love health and wellness. All right, I’m going to take notes. What can I do? How can I build my brand? What do I need to do? What support do I need? And maybe I don’t want to do anything. Maybe I just want to take classes for myself.”

[00:30:32] I know women who are like, “Yeah, I did a whole yoga certification, Pilates training. It was tons of money and time, but in the end, I realized I just wanted to learn it.” That’s okay too. It doesn’t have to be the means to an end. It can be a means and the joy of doing it in and of itself. If you were to ask me the secret to having good purpose, it’s being curious, it’s learning, it’s challenging yourself, and it’s growing. And if you decide to put that growth of your own to somebody else’s benefit, I mean, that’s the icing on the cake. So, it’s like, great. You’re doing all of this and you do not have to do it for anybody else. But if your passion can be in service to someone and for someone, I feel like that, to me, is the greatest purpose of all. 

Cynthia Thurlow: [00:31:16] Absolutely. And I want touch one thing that you said is that sometimes women are uncomfortable talking about how challenging it is to be a parent. And I recently was around a young woman who had a baby, and she didn’t have any family close by, and she was talking about, “I went back to work. It’s really hard. I’m not getting enough sleep.” And I said, “I want you to understand that every woman goes through this. We don’t talk about it enough.” I think we need to do a better job. I’m a middle-aged woman, and I think I need to do a better job when I’m around younger women, if they’re open to talking about it, letting them know, validating for them. 

[00:31:47] I remember what it was like when I went back to work with two under the age of 2 and how little sleep I got. And it really was challenging. And there were women that were older than me that would validate for me, they would mirror what I was experiencing. They would validate it. And for me, I always felt very much this camaraderie. And I think it’s so important for women to support other women. And that was just something that brought up for me was how important I think that is, because this young woman that I was talking to was like, “I cannot tell you how much that meant to know that someone saw me and acknowledged what I’m going through, because my husband doesn’t understand.” And I’m not suggesting husbands don’t understand, but there’re certainly circumstances where women get it. They understand what it’s like to have little people at home and be exhausted and have days where you feel like you’re spinning your wheels. Now, something we talk about a lot on the podcast is working through uncomfortable feelings, processing emotions. I know this is something that you do work around with your own patient population. And so, how do unprocessed emotions hinder us from growth or from other opportunities?

Dr. Sue Varma: [00:32:46] Yes. So, people don’t realize that unprocessed emotion actually wreaks more havoc in your mind and body than simply just letting it out. And what I mean by letting it out is trying to, in a safe space, with permission, vent to a friend and to ask and to say, “Is it okay? I have a lot going on. I really just need to talk to someone.” And what I see happening so often is I feel like people, we all put up walls, right? Like we need to maintain an image of perfection. I’ve got it all under control. Of course, everything is going right in my life. And people will spend so much effort and energy to maintain, unfortunately, a facade, only to have this, let’s say, anger or sadness or grief, then take over in the form of autoimmune disorders, headaches, tension headaches, everything from head to toe, cardiac problems.

[00:33:36] We know that there’s a type D personality that keeps a lot of anger in and hostility, and they’re much more likely to get heart attacks. So, there’s simple things that you can do, whether it is keeping a journal of your emotions, just the mere fact that you are connecting your emotions to a trigger to say this happened today, this could be the reason I feel so low. This could be why I’m feeling so sad. So, number one, acknowledging feelings, that is not going to make you weak. A lot of people are like, “I don’t have time for feelings. They’re very inconvenient.” [Cynthia laughs] Who the hell has time to sit there and cry, “Oh, my God, if I talked about my childhood, I would just break down. I wouldn’t be able to function.” 

[00:34:12] And I totally understand our body and our mind sometimes needs to put up walls as a defensive mechanism, as a protective mechanism. Our skin is a barrier, and it protects us from getting burned and all sorts of things, but at the same time, we have to take care of it. And I think there’s a concept of emotional immune system, and just the way you take zinc and vitamin C and you want to boost that up. Practical optimism gives you infinite techniques of how to boost your emotional immune system. And it says, get sleep, get help, consult with a board of trustees, run it by somebody, and don’t be afraid to seek therapy. Even one session of therapy can be so valuable. But I would say a short course of 8 to 10 sessions. 

[00:34:54] If you’re lucky enough to have health insurance, turn over the back of the card, call the behavioral health provider line, look @psychologytoday.com. There’s so many websites, zocdoc.com and it’ll show you providers in your area that are affordable and available. So, I feel like there’s so many things that we can do, and processing emotions can, if you notice, will really reduce physical symptoms of illness, decrease the frequency of coughs and colds. Insomnia is often related to unprocessed emotions, fatigue, so really kind of head to toe. 

[00:35:22] It’s not like the minute you start talking about your emotions, everything is going to suddenly fix, but being able to talk about them and then do something with them, and that’s where cognitive behavioral therapy, and I’ve really pulled from that because it made such a huge difference in my life and I talk about it in the book. What are the cognitive distortions that you’re doing? Do you have a tendency to ___, fill in the blank, catastrophize, mind read, fortune telling, black and white thinking? So, I got to give a list of this and then how to challenge those distorted thoughts. What would you tell a friend? How would you think about this five years from now? 

[00:35:52] So, this is something that, for me with practice, because I have done it on myself, I do it with patients that, it’s not that a negative thought is never going to come into your mind. That is not at all the goal. That’s why it’s called practical optimism. It’s not like, “Go walk around with this airy-fairy Pollyanna thinking,” like, everything is going to be fine. That’s toxic positivity. That’s not what we’re talking about. We’re talking about, “I’ve been in the trenches with people, and I have seen what helps people get out of the trenches in the darkest of times.” So, it’s like, if there is one selling point, it’s like I’m not here talking from an ivory tower. I’ve been down and dirty with my sleeves rolled up and I’ve seen it all. I’ve seen people with multiple tragedies on top of tragedies. 

[00:36:35] Survivors of some of– the people that I was working in 9/11, many of them had experienced multiple prior traumas, whether they were first responders, whether they came from South America, they were involved in rescue and recovery, and they had political kidnapping, beating, assault, like political prisoners, like just anything and everything you can imagine, someone who’s been raped in the past. So, trauma is very complex, and there’s no one single way out but talking about it is a start. 

Cynthia Thurlow: [00:37:00] Yeah, absolutely. And it’s interesting. I interviewed Gabor Maté in 2022 when his book came out. And I think trauma is something that I learned very little about as a clinician and have learned a great deal over the last 10 years. And one thing that I hadn’t made the association with, but it makes a great deal of sense if anyone’s listening and they had, you can go and do these evaluations, these adverse childhood events, and you get a score. The higher the score, the more likely you are to develop autoimmune conditions. As someone who had quite a bit of trauma in my childhood, never occurred to me that was why, by the age of 40, I think I had three diagnosed autoimmune conditions.

[00:37:38] And it’s interesting is that as I have done the internal work, as I have done therapy, as I have done all the things to quiet my autonomic nervous system, everything’s in remission. And so, helping people understand that you can go through quite a bit and you can get to a point where you are healing both emotionally and physically. Are there prognostic indicators? Are there things that, when you’re working with patients, that give you a sense of whether or not they are more likely to work beyond a single trauma or multiple traumas and get to a point where they’re in a healthier state of mind and being. 

Dr. Sue Varma: [00:38:11] Yes, no, thank you for sharing that about the adverse childhood events. Because what’s so interesting is that people don’t realize that when you start listing them, the likelihood that most people have had at least one, like parents’ divorce is considered one of them. And I think because it’s so common, nobody even thinks of it as a trauma. Like, they’re just like, “Oh, but whose parents weren’t” like the 70s and 80s when you started seeing more of that? So that is a big thing. And for a lot of people, just being able to say, I have a reason and this makes sense now I understand why I could be this way. 

[00:38:42] But definitely when I start to see, when you asked about prognostic indicators, when I know this is how I know when someone is getting on the other side of things, is when they start helping people, when they start being able to get out of their own psyche and the ruminations that keep them so mired in their negativity. Because when they first come to see me, the thought of helping somebody else is the last thing on anybody’s mind, and rightfully so. They’re like, I’m just trying to survive. I’m trying to get my head above water. And they’re depending on what’s happened, frazzled, they’re panicking, they’re agitated, their heart’s racing, they’re not sleeping, they don’t feel calm, safe or reassured in the world. And it’s understandable with all that’s happening in the world. And then add personal loss and injury and trauma, no matter what. 

[00:39:25] Even if it’s a job loss, it’s a shock to the system. It’s like I was on path A just minding my business, thinking that I have a way to pay my bills. And for example, I know a lot of people in the journalism world because a lot of the morning shows that I do, I meet a lot of people who are writers and producers, and they’ve been massive layoffs. And it’s really hard to hear and see. Every single day, somebody’s like, “I am the breadwinner. I needed my health insurance,” and this got cut off immediately. Like this institution went bankrupt. Now that is a trauma. And when we talk about just like life stressors and challenging events, even having a baby is up there, even if it’s something you chose, even if it’s something that you want. 

[00:40:01] So, when you are saying that and what we don’t realize is giving back actually helps, gives to us, replenishes us, and we always think of it as like a zero-sum game. If I gave to you, it’s my loss. And that’s not the case at all. And I talk about this under in the chapter and purpose, about all the benefits of volunteering. Even if it’s not something you can regularly commit to, but an act of kindness. It makes you feel as a human being that you have meaning, that you have a sense of purpose. And when I see people who are experiencing depression, their sense of purpose has become obscured. It’s not as if they don’t have it, that’s what happens in depression, it causes cloudiness of your perception. 

[00:40:40] So, you may have this amazing job and this amazing family, but for any number of reasons, you’re not able to see it or hear it or experiencing it. And it’s like if your rear-view mirror is fogged up, you want to clean it. And sometimes it’s not about finding a purpose, it’s just reconnecting with one and it’s very hard in the midst of a depression. So, I don’t want to say that you can just will your way out of a depression by positive thinking, but I can certainly tell you, practicing the tools are very much part of a treatment of depression. 

[00:41:09] I basically put all the tools and resources that I’ve had and learned from working with people who’ve experienced the big T of trauma, the big tragedy, the life-threatening losses, and have taken that and applied it to everyday stressors and challenges like the everyday, “Oh my God, I got rejected. Oh my God, I didn’t hear back from my boss. Oh my God, I didn’t get a promotion.” This is within the realm of every day. And the beauty is that the same things that help people with the big T are the same exact things that help people with the little t. It’s just a little bit of a different maybe magnitude or proportion or frequency or tweaking that you need, but they’re very similar skill sets.

Cynthia Thurlow: [00:41:45] Yeah. And it’s interesting because your book, obviously, I read a lot of books for the podcast, but your book has such a practical focus, which is one of the reasons why I so wanted to make sure that we connected and I was able to share your gifts with the community. One thing that you do emphasize in the book is talking about mindfulness. I think for every person that’s listening, this is something I have to work on every single day. I always say the things you try to avoid doing are oftentimes the things you need to be doing. And so, helping people understand how powerful meditation can be, how being fully present, it’s so easy to get distracted. Our phones do a great job of unless we put them in our pocket or leave them in our purse or leave them on a counter, so easy to be disconnected from dealing with reality because there’s so many distractions. 

Dr. Sue Varma: [00:42:29] And also because reality can be so painful. So, it’s like no wonder we are looking for escapes because it’s really hard to face things certain times. So, I would say the simplest definition of mindfulness for me is simply doing something one at a time. And if you’re having a conversation with somebody, put the phone away and be like, “I’m here.” And if you’re someone who’s nervous and you’re like, “I have a 60 million things to do,” then you know what? Put an alarm if that helps you. If you’re so afraid of getting caught up in the moment and getting swept away, first of all, I’d be like, please go get swept away. [Cynthia laughs] 

[00:42:58] But if you’re like, I don’t have the luxury of getting swept away, then be like, “You know what, I’m going to allow myself to get swept away in 15-minute increments and I’m going to have this conversation wholeheartedly.” My younger son is really into playing like UNO. And so, every day I’m just like, “Okay, we are going to do this again.” And after there are days when I’m like, “I have 75 emails I need to return. There’s so much that I need to do.” But doing circumscribed, it sounds funny because you’re like, “How is playing a game of UNO being mindful?” But all it really is just being present in the moment with who you’re with and what you’re doing. And that could be you doing dishes. Maybe they’ll listen to your podcast Cynthia.

[00:43:30] But that’s mindfulness, being like, “Okay, I’m doing this and I’m paying attention, and that’s all I’m doing. I’m not also trying to do my laundry and running around.” So, doing something single mindedly, intentionally. And also, the mindfulness comes in of awareness of your own feelings. And there’s a beautiful idea, like, I talk about this a lot, the idea of, I was just coming back from a trip and I’m very big on this. Like, if you’re looking at an airport baggage carousel, you’re going to see the luggage go by, but you’re not taking anyone else’s luggage home. The same way be aware of these packages of thought, negative thoughts, whatever they might be, even positive thoughts. “I’m the best in the world”, that’s great.

[00:44:06] But at the same time, how is that serving you if you think you’re so amazing? Are you really– because there are people who are very skewed in that direction and they have no self-reflection and no sense of accountability and taking responsibility in self-awareness. So, you just kind of want to be aware. Like, “I think I’m the biggest whatever, great.” Just be aware. [Cynthia laughs] Look at it and let it go. Don’t necessarily attach yourself. And that’s very much like from the eastern wisdom is nonattachment or healthy loving detachment to both the good and the bad. And that’s something I learned, which is not really so much of western. Like, I was born and raised in the United States, and so much of the western is like, “Rah, Rah, you got this go, go, go, go.” Okay, but what if my body doesn’t want to go? What if my body’s like, “No, I’m good, I’m staying right here.” [Cynthia laughs] 

[00:44:46] Like, not everything will work at the time you want it to with the speed that you want it to, and that’s okay. I always say, rest, hit pause, don’t necessarily need to stop. If something you’re doing is not working, it’s okay to take a step back and reevaluate and get help and get input and get feedback. Because I think a lot of people also listening might be like, I’m trying so hard for this project, this business to take off, and I’m not succeeding, I don’t understand why. It’s totally okay to then say, is this how I want to be spending my time? Can I be creative? What other ways can I accomplish the same goal? Do I need to pivot and regroup and maybe do a plan B or a plan C or a plan D? And there’s no harm in acknowledging that and be like, “Okay, maybe this is not meant for me at this time.” No doesn’t mean forever. It just means not now. And that’s okay. Maybe the universe is like, “Take a break, just take a moment.”

Cynthia Thurlow: [00:45:39] Yeah, it’s interesting. I oftentimes say when things don’t work the way I want to in my business, it’s an opportunity to pause and reflect that I really want to do x, y, or z. And my team knows this. I mean, I have no problems pivoting, moving in different directions. I always say when we’re 100% in alignment, when we’re doing exactly what we love doing, more often than not that seems to work seemingly effortlessly. When something seems arduous and extra hard, it’s like do we really want to be doing this? And I think it’s important to understand we can course correct. 

[00:46:09] I want to just end our conversation talking about meditation, because I think that meditation, in many ways, my husband meditating, he’s an engineer, so trying to get him to meditate because it was something he couldn’t see, I was like, “Listen, there’s all this research. It’s so helpful.” I actually ended up buying him a Muse. And so now he wears this headband. And that has helped him as an engineer. He knows if he’s in the right frame of mind when he’s meditating. But I think meditation is one of these practices that people can do at any time in their lives, but is so powerful, but is greatly underutilized and discussed and talked about. What do you feel like for your patient population or for anyone that’s listening? What are the things about meditation that you think are so important for people to understand? 

Dr. Sue Varma: [00:46:50] Yeah. So first, that there’s no right way to meditate that the very act of meditation simply means showing up and practicing, and that’s it. And some days are going to be easier than others. Some days your mind is going to wander. I think a lot of times when people are in the midst of anxiety, like anxiety attack or acute untreated anxiety, they find it very hard to meditate and they resist against it, and it might not be the right time for them. And they may need to come back to it later on. And sometimes you need guidance and sometimes you need to do it with. You may want to start out by having a guided meditation. And there’s a million apps, and you talked about device, but there’s so many. And having the Calm app a lot of times, free stuff on YouTube. 

[00:47:32] So, what I see is a sense of calmness, agency control. It changes your brain, the gray matter, the volume increases your heart rate, your cortisol goes down. Parasympathetic nervous system is activated. So, there’s a million benefits, even like health benefits from immune system to wound healing. But just start small, start with a minute. Build it to three, build it to five if you can do it twice a day. But I would say keep the entry barrier to it really low. But there are numerous benefits from anxiety, depression, either in prevention of it or as part of a comprehensive treatment plan.

Cynthia Thurlow: [00:48:07] Yeah, it’s been interesting for me. The more I meditate, the better my heart rate variability is. And so that’s been one I’m actively working on. Probably haven’t shared it with my community, but that has been my piece of why I’ve been doing meditation, other than the fact that it’s very relaxing, is also I see huge benefits and gains in heart rate variability. And I track all of that on my Oura Ring. Well, I really loved your book, Practical Optimism. You have all these pillars, the eight p’s. So, there’s definitely this thematic element. Please let listeners know how to connect with you on social media, how to purchase your book, etc. 

Dr. Sue Varma: [00:48:39] Thank you so much. It was such a great conversation. So, yes, Practical Optimism: The Art, Science, and Practice of Exceptional Well-Being is available for preorder before February 20 and then on sale everywhere books are sold. And I would love for people to stay in touch with me. I’m most active on Instagram, but you can also find me on Facebook, Twitter, and LinkedIn. And my handle is the word doctor spelled out, @doctorsuevarma. And my website is doctor, the word doctor spelled out doctorsuevarma.com. So, I’d love for people to stay in touch and subscribe to the website. I hope to eventually sending newsletters, but please just stay in touch on Instagram and the book wherever books are sold. And I would love for people to share it with their communities and also to develop even an account like Practical Optimism Partner. 

[00:49:28] If there is a group, if you have a reading—already if you’re lucky enough to have a book club built in to continue the conversation and to share like this pillar resonated with me most. And there’s a quiz in the beginning of the book with 40 questions, five questions for each of the eight pillars that helps you take an assessment and a snapshot. So, I hope that people can share. People are telling me that this is like going to be a good dinnertime, cocktail party conversation. I know you said you and your husband were talking about it, so I’m so glad and thank you for this opportunity. It was very interesting learning about you and your journey. So, thank you for having me. 

Cynthia Thurlow: [00:50:01] Absolutely. It was a pleasure. 

Dr. Sue Varma: [00:50:02] Thank you. 

Cynthia Thurlow: [00:50:05] If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.