A BEGINNER'S GUIDE TO MENTAL HEALTH

By: DR. ARIANNA BRANDOLINI & MIGHTY PURSUIT

Dr. Arianna Brandolini is a Harvard-trained psychologist who specializes in treating anxiety, depression, OCD, trauma and other trauma-related disorders. This episode of the Mighty Pursuit Podcast serves as a tell-all for mental health, as we cover everything from negative thinking, cognitive distortions and mental disorders to therapy, emotional intelligence and relationships. Dr. Arianna Brandolini: Hi. Mighty Pursuit:Nice to see you. And thank you for coming in today. Dr. Arianna Brandolini: Yeah, thanks for having me. Mighty Pursuit:So, yeah, we were talking about your education. So you originally got your education at Harvard. And obviously, a lot of people know that Harvard has the lowest acceptance rate in the world. Obviously produced a lot of brilliant minds. And so, what was the experience like going there? Dr. Arianna Brandolini: It was awesome. Yeah, it was awesome. I mean, you have these incredible professors and incredible minds that are very famous. Which is very cool. But I think what made what makes Harvard really special is the students. I remember it was like my first week there as a freshman and I was doing laundry in the laundry room, and there was this girl and she was practicing the violin as she was waiting for her laundry. And I was like, wow, she's really good. And then I learned later that she tours internationally with this orchestra. And so you just don't know, the student that's sitting next to you is extraordinary in many ways. So that was really cool. Mighty Pursuit:Was there like a sense of competition at all at Harvard or not really? Dr. Arianna Brandolini: There can be, if you want to engage with that. But, I think there's sort of a large percentage of the population of the students that are very studious and probably pretty competitive. But then there's like maybe the 20% that parties and is not necessarily as competitive. And so I think you can kind of choose where you want to sit in that. Mighty Pursuit:So what led you then to become a psychologist after school? Dr. Arianna Brandolini: When I graduated I was in an identity crisis for about six months. Traveled to India. I was like, oh my gosh, what am I going to do with my life? It was extremely stressful. And so then I'd tried all these different things like TV and advertising, and I didn't like it. And so then my academic advisor from Harvard called me, and she's like, listen, why don't you come back? You can work in my lab as a research assistant. It was under Richard McNally, who's, you know, a big trauma guy. Well known name. So she's like, why don't you work part-time in my lab? And then part-time, I can get you a gig at McLean hospital. And so, at their OCD Institute. So McLean Hospital is a very well-known hospital in Boston. They had an entire residential program for people who suffered from obsessive compulsive disorder. Mighty Pursuit:It's like one of the top mental health hospitals in the country, right? Dr. Arianna Brandolini:It is. Girl, Interrupted is based there. The movie. Mighty Pursuit:Is that with Angelina Jolie? Dr. Arianna Brandolini: The OCD eye at McLean was one of the few places where you could have interactions with patients with just an undergraduate degree. So you kind of ran the unit as a community counselor. So you ran groups and people lived there. So you would make food with them. You would implement the kind of the behavior plans that their therapist and psychologist would come up with. So it was really great training. I got kind of a lot of OCD expertise, which is a very specific type of treatment that not a lot of people know about or are trained in. And so, you know, my academic advisor was like, why don't you just see if this is something that you would like to do as a psychologist? Like you're good at this stuff. You like it. Why not? So I was like, okay. So I went and I did that for about a year and a half and then decided to go to graduate school. Mighty Pursuit:So how many years have you had your own private practice now? Dr. Arianna Brandolini: Seven years. Mighty Pursuit:Seven years? Dr. Arianna Brandolini: Over seven years now. Mighty Pursuit:What is your opinion on mental health? After all these years of doing it and just the field and working with people? Dr. Arianna Brandolini: I love it, I absolutely love it. And I never thought I wanted to do private practice. I actually thought I wanted to do other stuff. I worked at my residency. I worked at the Manhattan VA and different hospital settings and community settings, and I loved that. But I kind of got pushed into private practice and I wasn't sure I would like it, and I actually really love it. And so it's awesome. It's like an honor. I think I struggled with a lot of different professions because I think for me, what's really important is feeling like my work is meaningful. And because this has always just been my personality, my bent in terms of helping people. My mom tells a story. I was like, around five years old. And she walks into the kitchen. I was giving my babysitter relationship advice, so I was just destined to do this stuff. Mighty Pursuit:Your babysitter? Dr. Arianna Brandolini:I think you have a sense of responsibility, you're in a position to really impact someone's life, right? And so I think that there is a sense of responsibility to be like, okay, like this person's trusting me in a moment, maybe of intense pain, of intense confusion, and they're coming to me to actually help walk with them through this, to find a path forward. And so it's like a huge honor. And so I'm really humbled a lot of the time, you know.

NEGATIVE THINKING

Mighty Pursuit:I mean not all psychologists obviously can be all things to all people but what I love is what you've done with your education, and practice is kind of like how well, well-rounded you are in multiple different areas. And so I kind of want to kick it off by talking about cognitive distortions, because of how much of a negative impact they have on people. I think a lot of people haven't heard that term before. They may be vaguely familiar with it, but when they think, oh, I have a lot of negative thoughts. They don't realize that what they're actually talking about is cognitive distortions. And so I think it doesn't really matter who you are, whoever's listening right now, probably struggles with this to some extent. I don't know if this was recently that you posted, but, the data is all over the place, but it's estimated like we have 12,000 to 60,000 thoughts a day or something like that. And 80% of those are negative. Dr. Arianna Brandolini: Yep. Mighty Pursuit:And so a lot of the thoughts are cognitive distortions. Why do you think we have so many negative thoughts? Dr. Arianna Brandolini: There are different theories on it. If you kind of look at it from an evolutionary perspective. A lot of people believe that one of the main drives as a human being is survival. And so in a modern world, it's hard to conceptualize. But if you conceptualize it before, when there were a lot of physical dangers and food was scarce and so you had to really fight to survive, you have a negative valence because that's the most important stuff to pay attention to. And so I think that jives in a lot of ways. I think we also live in a fallen world with a lot of issues and a lot of difficulties. And so I think that kind of force pervades. Mighty Pursuit:Well, yeah. I mean, you have the evolutionary thing going on and then kind of what you're alluding to, do you feel like the presence of the state of the world and our circumstances obviously amplifies certain of them? Dr. Arianna Brandolini: Yeah absolutely. So, like, we all have filters through which we see the world. Right, all of us. I have filters, you have filters. Some of them are healthy and good, but plenty of them are also unhealthy and not helpful. And the way that we develop these filters are different ways. So there's genetics. So you know, maybe your family has a genetic bent towards depression or anxiety towards certain ways of thinking. There's your personality. You can be born in the same family and have a very different personality than your siblings. You could be more neurotic. You can be more laid back, but a lot of it is based on your experiences, right? With your caregivers, with parents, with teachers. Did you experience trauma? Did you experience lack? Did you experience love? You know, all these different things actually shape the way that you see the world. Our parents, the way that our parents responded to situations gave us truths. Quote unquote of who we are and how the world operates around us. And so we get to a point where, part of why I love what I do is because I think in order to live healthy and free, it's really important to examine a lot of this stuff and be like, wait a minute, I keep having problems in this area or I keep having reactions in this area.This area of my life is not what I want it to be. Why? Why is that? Dr. Arianna Brandolini:Are there belief systems that I'm operating out of? And so the good news is that our brains are really plastic, meaning that they're really malleable. And so, those filters and negative automatic thoughts and kind of distortions are part of that. They're kind of clues to the deeper core beliefs that we have about us or the world. And so being able to examine that stuff, you can actually change it by rehearsing something different. I do something called cognitive behavioral therapy. And you talk about it as reconstructing a thought. Right? So yeah. So that's why I think it's so important to be able to have that awareness of what those thoughts tend to be. And then how are they impacting your life and how do you actually change them? Mighty Pursuit:So just very simply, can you define what cognitive distortions are and what makes them problematic? Dr. Arianna Brandolini: Basically cognitive distortions are distortions in perspective of a certain lived experience. And so these distortions are unhelpful and problematic in terms of how you relate to the situation and in terms of how you behave as a result of it. And so, what was the second part of your question? Mighty Pursuit:What makes them problematic? Dr. Arianna Brandolini: Well, exactly that, right. We operate out of our belief system. Right? The way that we behave is rarely just because of nothing. Even our emotions come from somewhere, right? They usually come from a thought that is so automatic. That is so sometimes subconscious. All you do is feel a feeling and react out of that place. Right? And so actually slowing ourselves down to be able to examine what that thought is, is important because cognitive distortions influence how you behave in the world, and they're going to influence how successful you are in the world. Because you can either behave in a helpful way or you can behave in a really unhelpful way. Right? Mighty Pursuit:So there's around like 15 cognitive distortions. So I want to break some of them down. You recently did a post on All or Nothing thinking, so what is that? Or it's also known as black and white thinking as well. Dr. Arianna Brandolini: So as you said, we all do these things. We all have these tendencies. And what I think is helpful, having them labeled and in textbooks is that it actually shows you that you're not alone. And this is something that a lot of us do. And so one of the big ones is black and white thinking or all or nothing thinking, which basically means it's along the lines of something is perfect or it's terrible. There's no gray. There's no kind of like that was pretty good. Or like, that wasn't great. And so when you're stuck in that kind of either all one thing or it's all another, which is not really how the world works. Mighty Pursuit:Do you have an example of, like, I thought, some situation that people might find themselves in? Dr. Arianna Brandolini: I talk about it a lot with work. That if you don't do a presentation or something or even a school something perfectly, then it's terrible. And people get really disappointed. Oh, I got a B. And they're like, "oh, that was awful." And it's like, "no actually, can we look at the gray here?" Even in a presentation or a date. Either it has to be amazing or it was a failure. It was awful. It was devastating. So it can be seen in every single area of life, and it's usually kind of that perfectionism. It has to be perfect. Otherwise it's absolutely awful. As opposed to living in a state of most things just need to be good enough. Some things need to be really excellent. And so it's important to expend energy on the excellent. If you're doing brain surgery you must be excellent. If you have a big presentation for lots of clients. You must be excellent. But otherwise, good enough is actually where a lot of success lies. Mighty Pursuit:I think another one is like mind reading. And I feel like everyone struggles with this. It's just like, what is Arianna thinking right now? Dr. Arianna Brandolini: Yeah, absolutely. Mighty Pursuit:And then, like, you're basically crafting a story in your head about what the other person is thinking. And then the worst part of it is, you're living as if it's true. Dr. Arianna Brandolini: Yeah. Mighty Pursuit:And so there's a balance with that one of having to deal with uncertainty, because you don't know what someone's thinking truly. I mean, you can discern from their body language. And so can you talk about that one a little bit and like what you've seen with your patients with that one specifically? Dr. Arianna Brandolini: Ultimately how I like to describe it is that you're basically projecting your own mind onto somebody else. Right? So when they're like, "oh, this person hates me", I'm like, "no, you're thinking that maybe you hate you, or this person hates you and you're actually projecting it onto this person." You have absolutely no idea what they're thinking, right? So it's actually more about you than it is about the other person. And so I think it's a really good one to be able to examine ourselves. Because oftentimes what we project onto someone else is an assumption that we're making. And usually those assumptions are not positive. They're usually pretty negative. And so being able to actually slow ourselves down to be like I actually don't know what someone else is thinking, it helps you either let it go and be like, you know, as you said, you have to tolerate the discomfort of not knowing because you're never going to know fully. Or it actually forces you to practice communication, forces you to say, I actually need to ask someone to clarify assumptions. And especially in relationships, that's really important. And I often say don't assume anything. Always ask. There's no such thing as over-communication. Mighty Pursuit:I think where it gets difficult or you could see clear issues with what you're talking about. I think that it kind of blends in the area of reading someone's body language. And so I think that in a sense, it is helpful to navigating the world around us. I'm looking at you and your body language is completely uncomfortable or you look angry or sad. And I think, we're going to talk about dating later, but a lot of people, when they're going on a date with someone, they're trying to figure out how this person feels. And you might get into this awkward place if you don't wanna put yourself out there. You don't want to put yourself out there at work. You don't wanna put yourself out there in dating. There's the rejection type element of it. And so the only thing you really have to go by unless you're going to be upfront and have a communication is like the person's body language. And so how do you interface between kind of mind reading and then just navigating the world through people's body language? Dr. Arianna Brandolini: I think what you're saying is totally accurate. And when we talk about cognitive distortions, it's more about an unhelpful pattern of thinking. And so I think being able to read someone and have emotional intelligence in terms of figuring out, I can kind of intuit, maybe I said something that made someone uncomfortable. Maybe this person's having a bad day, right? But mind reading is often believing absolute truth. Oh, this is what they're thinking. And I believe that as opposed to holding a tension, Ooay, this might be happening. But I also don't know for sure. So I think it's sort of that tension, right? I think with mind reading, it's often like an absolute truth that you believe and that causes a lot of anxiety and stress. And that isn't helpful. Right? Whereas being able to read people's body language and being able to kind of discern things is a very helpful and good skill to have. And I think people who are good at it also know this isn't absolute truth, right? And I could also be getting it wrong. Someone might be having a stomach ache or they might be having a bad day. So I think that that's also healthy, right? Not holding things in absolute truths all the time. Mighty Pursuit:That's really good. Another one is emotional reasoning. I like to say, "if I feel it, it must be true." Dr. Arianna Brandolini: Yeah, absolutely. Mighty Pursuit:And so, I feel that it kind of paints a picture of our culture right now of anything that I feel like in a given moment must be true. And so how do you work through that with patients? Dr. Arianna Brandolini: A lot of it is also learning about your emotions, right? The role that they play in your life and how you can use them for information, but don't let them run the show in anything. So with emotional reasoning, people often are like, I feel lonely, therefore I'm alone, right? Or I feel sad. Therefore this is bad, right? As opposed to recognizing that our emotional states aren't always accurate to the situation at hand. They're more actually information about us and how we're doing and what's going on within us. And so I think a lot of that is learning about your emotions and what they look like and how to work with them well. How to process them well. Our emotions are a gift. They absolutely are. But, there's also a healthy balance in how much you operate out of them. Right? So emotional reasoning is a big one. It's like if I feel it, therefore it must be true, as you said. And that's not accurate. And you also don't live a good life if you operate that way. Mighty Pursuit:It's a really interesting conversation in terms of how you view your emotions? And we had a previous episode with Dr. Anna Lembke, she's an addiction medicine specialist at Stanford. We were kind of just talking about the kind of happiness narrative of our culture. I'm not so certain that our parents and grandparents generations put so much weight on the way that they feel in the sense that our generation does. And so kind of coming from a psychology background, why do you feel like people struggle so much with their emotions? Dr. Arianna Brandolini: I think that's a nuanced question for a lot of different reasons. Some things in terms of what I believe, especially in Western culture, I think we see this a lot where it's very individualized. And so it's more about we are the priority. I'm the priority versus the whole, versus like the family or the community. And so as a result, if you focus too much on yourself and too much on your emotions. They end up ruling the show and you believe that these are of the utmost importance. How I feel is of the utmost importance. You know, I think we also don't necessarily do a good job of, I think it's getting a little bit better, but sometimes we don't do a good job of actually teaching kids or teaching people how to manage their emotions. And in the age of social media and things that are also very self focused, it's about you, it's about you, it's about you, it's about me, it's about me, it's about me. I think that's a big part of it. Mighty Pursuit:That's good. So I mean then it causes you to outwardly act out of that place. If it's like everything is about my feelings and my emotions and how things are making me feel in terms of what's beneficial for like a family unit or a friend group, or like a group of people or, I don't know, people around you at large. Dr. Arianna Brandolini: I think that there's a different bent in terms of the focus. It's more on the individual and so yeah, I think that's a big part of it. Mighty Pursuit:And then some of the other ones, you know, are just kind of overtly negative in a sense, like fortune telling, like trying to predict the future or living as if they can predict the future and know exactly how a situation is going to go. Or catastrophizing. Mental filtering. So kind of like filtering out all the positive aspects of a situation and only fixating on the negative. So I feel like a lot of people can resonate with that. And yeah, I think cognitive distortions in general, the risk is that we could start living in just like unreality, and create a world that doesn't actually exist. And so I think the struggle for me in this conversation, just very personally, it's important to quote unquote, take these thoughts captive and kind of measure them against what's true. But it doesn't always feel intuitive or obvious to do that. Sometimes you find yourself in these kinds of negative, automatic thought loops for minutes or hours. Sometimes you don't even realize that it's like going on. And it's just kind of like you're in a trance almost. And then it's like an hour and you're like, whoa I was just like thinking about that for like an hour. And so why do you think it's so hard to be aware of your own thought content and then just kind of be present with it in the moment? Dr. Arianna Brandolini: You know, we weren't really designed to think about our thinking. We were kind of designed to just operate in the world. If we're constantly thinking about what we're thinking, we're never going to get anything done. And so our brain is like a supercomputer that shortcuts all over the place to be able to help us behave efficiently. And so, as I said, usually what you see is your emotions and your behavior. And so it is sort of like a skill to learn how to slow yourself down enough to be like, "whoa, what's going on? What's going through my brain?" And so that's why we've been talking about kind of individualism and that being a lot of Western culture, I think that's why it's so important to actually have people in your life. Right? It's actually important to not be alone with your thoughts. Because otherwise you're in this echo chamber and there's no voice of reason being like, "wait a minute. Whoa, what are you talking about?" Right? We kind of need checks and balances in our life to be able to help us determine what is real, but also what's helpful. So often I say to people, "is that thought true? Even if it's true, is it helpful?" And so actually being able to recognize that you have blind spots, recognize that you do have ways of operating that you might not even realize are unhealthy to you. It just feels like the truth, right? And so being open to having people and avenues in your life where you're able to have someone speak into that stuff, right? And to be able to help reality check for you. Whether it's faith. Whether it's friends, whether it's community, whether it's therapy. You know, there's many avenues to do that. And that's why, you know, we're not meant to be alone. Because, us with ourselves can be a disaster. Mighty Pursuit:Also made me think about body image a little bit about how you could look at yourself in the mirror and be like, "oh my God, I'm just so ugly or something like that." And how the perspective of another person to come into that situation. It's almost like you have just a completely different lens and reality of I think this thing about myself and then someone else is looking at me or looking at a person, they're like, "oh, wow, they look really good. They look really handsome, beautiful or something like that." And I think you sometimes need another person to come in and help you. Dr. Arianna Brandolini: And it doesn't mean you believe it right away, but it actually, at least it gives you a signal to be like, "whoa, I actually have this thing, and it's not good or helpful for me in my life. What am I going to do about it?"

THE IMPORTANCE OF SELF-AWARENESS

Mighty Pursuit:That's good. So kind of the reason why I wanted to talk about cognitive solutions first is because I feel like you need to have a baseline understanding of that to become more self-aware. And you called self-awareness the cornerstone of emotional intelligence. So why is self-awareness so important? Dr. Arianna Brandolini: Self-awareness is foundational to be able to operate optimally in the world. Meaning to have good relationships, to be successful at your job, to be healthy. Right? Because if you're not aware of how you behave and how your behavior affects others and impacts the world, then you're never able to actually modulate, change it, modify it for the better. And so being able to examine all that stuff helps you be better able to, not only have better self-worth, better self-esteem, but also it impacts how you operate and change the people around you and every single area of your life. Mighty Pursuit:Obviously the challenge is kind of what you said before, it doesn't intuitively come natural to us. Dr. Arianna Brandolini: No. Some people are better at it than others, naturally. But, you know, it's work. It's work. Mighty Pursuit:So then what is emotional intelligence and how would you define that? Dr. Arianna Brandolini: I mean, I would define it as basically, how aware are you of your emotional state? How well are you able to manage your emotional state and how aware of you about other people's emotional states? And how are you able to relate to them in that? So it's kind of being able to recognize and manage your emotional state to be able to operate in a healthy and productive way. Mighty Pursuit:I think for me personally, it's like I can recognize what you would call a surface emotion. So it could be anger but there's like deep roots probably to anger or anxiety. And do you see that like with a lot of your patients that they're in some way self-aware of "I feel anxious right now" but then not really understanding what the root cause is of that. Dr. Arianna Brandolini: Yeah, absolutely. And I think for all of us when we have a strong emotion, as I always tell people. People often judge a lot of their emotions as bad or good. And I'm like, emotions just are. They're not good or bad. They're information about something that's going on. And so being able to approach this with curiosity and be like, I'm feeling really angry. What does that mean? And certain emotions will mean certain things. You know, sadness might mean loss or grief, or feeling trapped. Anger might feel like there's an injustice that's been had or that you feel diminished in some way. Anxiety can mean all sorts of things. It's often a numbing agent, right? Sometimes anxiety can be used, and anger too, can be used to mask deeper ickier emotions like shame. So again, I think that there's people who are naturally pretty good at it and there's some people who just need coaching. They need to think in terms of how to examine your emotions and how do you actually use them in a healthy way? How do you manage them if they're overwhelming? There's lots of stuff to it. Mighty Pursuit:So what do you feel like the starting point to self-awareness is then? For just the average person listening, that may or may not be going to a therapist? Dr. Arianna Brandolini: I think the start is recognizing that there are areas in your life that you have blind spots. It's recognizing, oh, I probably have areas where I operate in unhealthy ways and unhealthy belief systems. And so I think that starting off with curiosity is extremely important to be able to be curious about that stuff. And along with that, to actually start doing it. I talk a lot about the importance of slowing yourself down to be able to actually start to evaluate what's happening, right? We talk a lot about things like mindfulness. And even on my website and stuff like that, I have all these resources that people can access to start to slow yourself down, to ask yourself questions. I often say, I don't want you to react out of anxiety, out of fear, out of emotion. I want to help you learn how to respond out of your values despite feeling an emotion, and so I often say that emotions are like children. You don't want them driving your car because they will crash i. You don't want to shove them in the trunk because they might die. You want them in the back seat where they can be seen and heard and attended to, but they're not in control of anything. And so what is your emotion? If your emotions are screaming in the back, what is it telling you? What do I need right now? Mighty Pursuit:Obviously the kind of flip-side to that is the harm of you could put so much weight in your emotions, or you could completely suppress your emotions and just push them down. Dr. Arianna Brandolini: As I said, emotions are a gift. They're part of what makes us human. They're really important because they're clues as to what's going on. If you're feeling something, maybe there's something you really need and you need to attend to that to be healthy. And we talk about processing emotions and people are like, I don't even know what that means. And to me, processing emotions is literally just allowing yourself to feel them. And if you look at research, emotions don't last very long. Emotions are like waves. If you let them happen they will move through you. And that's kind of what processing looks like. It's allowing the emotion to happen without suppressing it, without trying to change it, without trying to ignore it. And maybe without trying to indulge it too much. It's allowing it to be there. So emotions are awesome, but having a healthy relationship with them is important. Mighty Pursuit:Is that true universally? I mean we're going to talk about diagnoses in a minute, but is the idea of an emotion just kind of being temporary or moving through it, is that true for OCD? Is that true for clinical depression? Is it true for just the average person? Or is that just for some people? Because it feels like for some it would last longer. Dr. Arianna Brandolini: It's been a while since I saw that study, but no if you have any kind of clinical diagnoses, the reason why someone has something we call a disorder, it just means that it's disordered. It means that it's not functioning as it optimally should be. And so I think that even with emotions, there's reasons why, whether it's biological, whether it's because of something that you're dealing with, whether it's also because you've developed very unhealthy habits. Things get stuck. And so there was a study that showed that emotions only lasted a certain amount of time. But then there's stuff that we do that can maintain it and that can keep it going. Mighty Pursuit:One of the things that I learned through therapy is that just even the presence of that negative thought or the emotion, to your point, if we're looking at it like I'm on an airplane and the flight's going to end in an hour and then I'm going to be like on the ground. If you look at your emotion the same way that it has a time limit to it, it makes it a lot easier to withstand the pain of that emotion in the moment that is like I'm not always going to feel this way. But I think the tendency or struggle at times is to not believe that and then be like this is just going to last. And then you just like really get in the hole because it's like, I don't want to feel this way right now. It's painful. And then you kind of just start medicating or like distracting yourself. Emotional eating I don't know. Whole range of things. Dr. Arianna Brandolini: Yeah. I had a supervisor a long time ago who said to me, he actually believes that most mental health issues happen because of the avoidance of pain. And I think I found that a lot in terms of working with people that if you look at the whole spectrum of human emotion, half of them are negative. Half of them are not fun. And I think there's a fear often of feeling these negative emotions and it's like, I can't handle it. I have to get rid of it. I can't do this. And that actually ends up perpetuating it and we develop unhealthy habits. It's not good, right? So it's actually learning how to radically accept the fact that you are going to have some emotions that really suck. I often talk about making anxiety your friend. And being like okay, he's here for the day. Come along. Try not to get too close, but here you are, right? And actually when you're able to not avoid it, you also figure out I can actually handle this. And then you come to recognize that this doesn't last forever. I'm not going to feel this way forever. So I love that analogy. Mighty Pursuit:I feel like that's the key to almost resilience or greatness. Of developing a character and stuff. I mean, it's especially relevant to dating as well. Because, let's just say you like someone and they don't necessarily reciprocate that feeling. And it's just like, oh, God, I just feel terrible. And now I just feel so terrible about myself. And the last thing you want to do is -- you're accepting that okay, they don't like you. They just rejected you. And then on top of that, you're like, oh let's sit with this feeling now. And it's just really, really hard. Dr. Arianna Brandolini: Yeah, it's really hard. You know, and so again, that's why I don't think we need to do this stuff alone. I think having people to encourage you to be like, yeah, you can do it. All of that management isn't just yourself. It's also meant to be in community. When you find it hard to do it for yourself, you need encouragement, for people to be like, you're amazing. Stop it. It will be okay.

WHAT'S THE POINT OF THERAPY?

Mighty Pursuit:I was gonna talk about this later, but what role do you feel like therapy plays in this? Because I feel like there's a much more positive, cultural perception of therapy than there was 20 years ago. 30 years ago, especially 50 years ago. I mean, and even if you look at studies, it's like, I don't know, 4% of boomers went to therapy. And now it's like, I feel like generation Z is like teens, like early 20s are much more open to this stuff. But I think what's weird is when you look back on human history, it's like therapy or psychotherapy, I think got introduced maybe in the 1800s. So you have an entire like thousands of years where like we did not have therapy and we were still having to deal with all these things. And so, like, what role do you feel like therapy should play in people's lives? Dr. Arianna Brandolini:Well, I think part of it is that modern life has evolved to something that isn't recognizable from what it was. Right? We don't really live in the communities in the structures that we used to. And again, it was also safety in-numbers. It was safety and community. And so people might not have had a therapist, but maybe they had a mentor, maybe they had a rabbi, they had a priest, maybe they had an older brother or sister. I don't think therapy's suddenly the culmination of we figured out things that are now going to change and revolutionize the world. I think it's just another manifestation of something that's been around for millennia of having wise counsel. And so in a Western culture, especially where people aren't living in communities where people don't have elders in their life to help them. We have something called therapy, which is awesome, you know? So I don't think therapy is the only way to heal. And I don't think you're also supposed to be in therapy forever, necessarily. Sometimes people have been through terrible things. And therapy is a very helpful thing to have as a lifelong avenue to continue healing. But your therapy is supposed to also help you. I like to tell people I want to teach people how to be their own psychologist. I want you to be able to develop skills and self-awareness and all this stuff to then to be able to be self-reliant, that when bad things happen, you don't need me. I can be there for support, you know? But you also have the strength and resilience to be able to withstand it yourself. And so whether it's with therapy or whether there's other avenues too. Like, I don't think it's the only way. I think it's a very helpful way. And obviously I'm a big proponent of it. Mighty Pursuit:I mean, the world has changed. I mean, to your point about individualism. We're in New York City right now. And a lot of people come here with dreams. They come here with aspirations or whatever. And they don't have a tribe. They don't have people that they feel like they can trust, which is very different from living in like little communities and I think that what therapy at least has done for me is it's a space for radical vulnerability without judgment. The human paradox, if you will, is that we want to be fully known and fully loved. But that's actually like our deepest fear. And we don't want to risk being like, oh, I just shared this really terrible part of myself. And then I either get ripped for it or someone's like, looking at me weird or shaming me. And so I feel like therapy in today's modern, evolved world give you a space to work through that. Dr. Arianna Brandolini:Yeah. It does. I think there's also a very big cultural aspect to it too, right? My husband comes from a Persian Armenian culture where a lot of like arbitration and family, it's actually done within the family. And for them it's sort of like this is what works because this is my cousin. Of course, I trust him implicitly. And so I think there are also a lot of cultures in the world where they're able to do that. It's just different, you know? And so I think, again, in a westernized culture of the classic view of therapy, as you said, for us who might not be in tribes, it's a very important place, and especially, as you said also sometimes tribes are very involved and it's really unhelpful and they're unhealthy. And so having that space that's just yours, you know, which again I think things like rabbis and priests and stuff like that also play into that role. But one thing too, I think also in this model that we're in, I think therapy's also it can be very self-indulgent. Like a lot of people are like, yeah, my therapist because I want to work on me. Not everybody. But sometimes I think when we try to find balance in life and in society, we kind of swing towards the opposite direction. And so as we try to find the middle ground we'll kind of be swinging. Most people engage with therapy for absolutely beautiful and awesome reasons. And I think sometimes it can be a little self-indulgent. Which is fine. I think it all shows that there's a need that you need met. And that's actually a really good place to explore it in therapy. Mighty Pursuit:We do a lot of social listening. And you see that swing in the way that more influential people or commentators are talking about things. Like the Andrew Tates of the world or Candace Owens and I don't want to speak for what their full opinion on therapy is, but I feel like a part of our society thinks that therapy is, just this whiny little thing about your emotions. Like me, me, me, me, me. And so I think it becomes hard for people to wade through the truth of actually approaching the thing if it feels so polarizing on the subject. Dr. Arianna Brandolini: So it's messy. That's why I'm often always talking about kind of the middle ground, where there's truths in different areas. There's still a lot of taboo. There's still a lot of sections of society that do look down on therapy and it's very self-indulgent and all that kind of stuff. I think that's why coming back to how do I know what's best for me? And how do I engage with something that, regardless of what other people say or think, what's going to be the best for me to actually be able to heal, have accountability, to be able to transform, to be able to change? And if that is therapy, that is awesome. Part of living a healthy life is being able to take in information from wise counsel but also not allow other people to dictate how you're going to live your life. Mighty Pursuit:I think the other dynamic is some people want to go to therapy. And one thing I just don't feel like is talked about is there's these three levels of issues. And this mainly has to do with the government and insurance. But a) is like the accessibility of therapy. B) is the affordability of therapy and then c) the quality of therapy. And so in our society obviously psychotherapy is 200 years old. So naturally that means that there's a disconnect between the amount of people that actually need therapy versus the amount of therapists that are out there. And so some of the stats, even when it comes to counselors in like K through 12 schools, it's like one person to 1000 or 2000 therapists. So that could be overwhelming if there aren't enough therapists to meet the demand. Mighty Pursuit:And then the second thing is kind of like the affordability of therapy. And since in America, healthcare in general when it comes to physical issues is just so reactive. And it's like, oh okay, we'll treat you once you have cancer. But let's just no not care about the before that. And so I'd imagine as a psychologist having to deal with the government isn't covering all the costs. And so out-of-pocket costs for people could be so overwhelming. It could be like $65 an hour, which some people would think is a lot depending on how much income you're making, I don't know, the specialist for OCD could go all the way up to $450 an hour, which is like the rate of a lawyer. And if you do the math, there's 670 hours in a month. And if you sleep eight hours a day, that would be an additional 224 hours. So that leaves us with like 448 waking hours a month. And so let's just say you saw a therapist one hour every week. That's like .008 of waking time. And it feels like, is it actually worth the investment? And then obviously the quality of the therapy too. I made it sound like I'm being a devil's advocate for not doing therapy. But this is the reality. Dr. Arianna Brandolini: It is. It's the absolute reality. And it's a crappy situation. I think what's really good is that there have been a lot of people who are trying to disrupt the system. People love disruptors these days. Who are trying to solve that problem, to allow people to have easier access to therapy. But we're still ironing out the kinks in terms of quality control. All you mentioned are tough problems. And I don't really know what the solution is, but so often the people who need therapy the most are the ones who don't have access to it. That's a huge problem. And it's hard because for therapists, there's not a lot of incentives. And this is also like teachers, right? If you're working with the hardest of the population, it's a very thankless and emotionally heavy lift. And you're not getting paid to do it. It has to really be an altruistic call. Which is beautiful, and a lot of people have it, but a lot of people are like, I'm going to burnout. I can't do this. Mighty Pursuit:You need to be financially stable to sort of step into the altruistic lens as a therapist. Dr. Arianna Brandolini: And I think that that's how a lot of therapists are managing it in terms of "okay, like I also need to live", especially if New York City is the most expensive city in the world, right? So it's like, okay, I need to make a living. And so, you know, I'm going to have people who are full pay, but then I'm going to have a section of people who maybe have a sliding scale or low fee or volunteer in a certain way. But it's very individualistic, it's very much up to the person to decide how they do that. And so it would be great if there was like a governmental incentive where you were actually able to have a good salary and you're able to really serve an underserved population. Mighty Pursuit:It's crazy because even when you observe what's happening with the presidential elections, I feel like I never hear this talked about. It's just so not one of the main issues that's talked about, but it feels like it's playing plaguing everyone. Because the reality is like okay, I'm going to go see a $65 an hour therapist. They could be good. But the reality is you're getting what you pay for. And so the care might not be that great. But then do you feel like on the upper end, there's an ethical dilemma, if you're charging crazy amounts of money an hour. Do you feel like in that case, is a therapist actually really wanting to help someone? And in that instance, what do you feel like is going on there? Dr. Arianna Brandolini: I don't know if I can speak to it as a blanket statement. People are also doing therapy for different reasons. People become therapists for different reasons. They want to invest in certain populations for different reasons. And so ultimately, yes, you are doing a service for people, but it's a business. It is a business. Right. And so I would hope there are people, [who would say], "there are certain people who can pay that, and it's not a big burden and there's certain people who can't." And so how do I leave opportunities for them? But I think it's a good question. I haven't really thought deeply in terms of the ethical dilemma. But there's certain people that I know who are specialists and for one session, they are beyond that. They're in the $600 an hour range. And I'm like, wow, that's amazing. Mighty Pursuit:Like I have to make like $40,000 more a year or whatever just to cover seeing them for four hours a month. Dr. Arianna Brandolini: But they can determine the rate. And so yeah it's really hard because also as you said, it's individuals helping individuals. And so each person is making decisions for themselves. And they're making decisions for many different reasons. We don't know what those decisions are. And so I think it would be really helpful to be able to have something that's not on an individual scale and actually more of a group. That's why we have organizations, that's why we have hospitals, clinics, things that kind of take the burden off of the individual, on both ends to be able to, to make it healthier I think. Mighty Pursuit:This is just my opinion, but I think universally, one of the things that therapy is strongest for. And you said this earlier, which is like it doesn't have to be forever. And I think like when it comes to understanding how our brains work, I mentioned our conversation with Dr. Anna Lembke before, and she was talking about the presence of high dopamine stimuli everywhere and how that's influencing the mental health crisis and our ability to deal with emotions. But then the other part of the equation, you can't avoid it, is the presence of mental disorders. Trauma, other issues like that. And so I think you need a specialist, you need a therapist to be able to help you work through this is how your brain works. And I specialize in this issue, and it kind of helps you develop a game plan for how to move forward. Dr. Arianna Brandolini:I've had some patients, especially ones who are kind of older and they're like, why has no one told me this stuff before? It's like an area of knowledge and skill that you don't necessarily have access to in your day-to-day life. And so that's why I tell people, listen like I've been to tons of school for this. So let me help you and I'll teach you what I know so that then you can kind of implement it in your own life.

MENTAL DISORDERS

Mighty Pursuit:It's a scary thing to go so many years of your life and not know how your brain works. So I was diagnosed with OCD when I was like 26. And I'm 34 now. But I have earliest memories of things that were symptoms of OCD when I was like eight. And so you have like an 18 year gap in my own life. And I just feel like my relationship with myself has completely changed, since I learned like, "oh, that's what's going on", because it was kind of this just hidden thing of like, why do I feel like I'm interacting with the world differently than other people? And so which ones do you treat the most and what do you see most in your practice of different mental disorders? Dr. Arianna Brandolini:Well, I specialize in treating anxiety disorders. So I see a lot of OCD in my practice. I see a lot of generalized anxiety, which is like a pervasive and chronic worry. I see a lot of panic disorder. I see phobias. So, you know, things that fall under the anxiety disorders umbrella. And so anxiety disorders basically mean different ways that anxiety will manifest depending on the individual. But the main driver is anxiety and it will manifest in different symptoms. Whether it's OCD, whether it's panic disorder and so I see a lot of that in my practice. And when we talk about disorders, mental health diagnoses, if you think about what they are, they're a bunch of people getting into a room and saying this is what it means to have anxiety. Mighty Pursuit:It's a cluster of symptoms. Dr. Arianna Brandolini:But people are determining that. And we're constantly evolving in that. And so I like to think of it as a continuum that we're all on continuum of these different things. And sometimes people will bump up into a clinical range, which means you have the diagnosis and sometimes people are in the subclinical range, meaning they'll have several of the symptoms, but not enough for a diagnosis. And so I see a lot of people also in that range where they might be type A high achieving, you know, high functioning, but they have intense anxiety. They have intense problems with relationships. They have depression. So I see a lot of sort of the seismic depression as well. And then just general stress, relationship issues, so there's also kind of like the general bucket. And then people, I've worked with trauma veterans for quite a while. And so my practice, there's some people who also have those trauma histories, but I think it's mostly just because of what I specialize in, it's anxiety. Mighty Pursuit:There's multiple different theories on this. But if you look at the kind of addiction to high-dopamine stimuli and you look at a chart, you'll see just what the age of social media is, it just goes way up. But then when it comes to things like OCD, bipolar, schizophrenia, are you of the mind that these things always existed, or that they are a result of something that's happening in our present moment or circumstances that have changed over the past 100, 200 years? Because it feels like there's been an explosion as well in just the presence of these disorders. Dr. Arianna Brandolini:I think that, yes, probably these things were around, but now we have a lot more information. We have a lot more access to information. We're a lot more open about talking about it. Right? And we've had huge advances in terms of being able to label some of these things, whereas before, they might have called people possessed. Right? They might have called people hysterical. There were different names for these things earlier on. So I think that there is a lot more understanding. I think there's a lot more accessibility and all of that good stuff. And then, yeah, I think we also deal with different things. So, I don't know, it's unfortunate that we don't have necessarily a lot of data to be able to say that. But, I think what's interesting is that depending on where you are in the world, people also have different symptomatology. And so there is also a cultural influence. So different cultures, maybe they have more physical symptoms that manifest that actually relate to mental health. They call things a different way. They describe things differently. So there is absolutely a cultural element to it as well. Mighty Pursuit:Yeah, that's really good. And you have somewhat of a background with neuroscience. So can you tell me specifically about OCD, because you could see it on a brain scan, like what's actually happening with OCD? Dr. Arianna Brandolini:So if you look at an OCD brain, what's basically happening is that there's certain patterns. Ways in your brain that kind of go between the emotional center and your frontal lobe, where you make all these decision making, evaluating. There are different pathways that are overactive and certain pathways that are under-active as opposed to a non-OCD brain. So it means that your brain is actually a little bit out of balance in terms of how it's firing. And so as a result, we have certain checks and balances in our brain that help us survive. So if I'm walking down a dark alley and I see a shadow move, I have an electrical impulse in my brain that then sparks an alarm bell saying, danger, danger. There's something wrong. You have to do something about this. So I have to run away, right? Or I have to protect myself. So with someone with OCD, that misfires a little bit. And so as a result, you get these alarm bell signals about things that aren't necessarily factually dangerous. So, a classic thing is sort of cleanliness. And so people who are really anxious when it comes to germs, they have that kind of similar reaction to a life or death situation, but it's happening with needing to wash their hands. Mighty Pursuit:It's like, it's actually happening. Dr. Arianna Brandolini:Yeah, exactly. And so you know, that's why OCD is one of the most debilitating diagnoses out there. Because it's also, along with that, your brain, I like to call it a sticky brain. So, not only is that happening, but with OCD, you also see a lot of intrusive thoughts. And so we all have intrusive thoughts. It's a normal part of being alive. If you see something on the news about someone killing someone and you have a thought of like I wonder what that would be like to shoot someone or, you know, it happens all the time. But with someone with OCD, they have a sticky brain, meaning that those kinds of thoughts stick around and they're hard to get rid of. And so as a result, because you have this intense emotional reaction as well as this intrusive thought, it makes you think, oh my gosh, this thought must be meaningful and it has to be dangerous. It must mean something really awful, right? And so as a result of these obsessions, which are intrusive, unwanted thoughts, images or impulses that create a huge emotional response, that is very real and it feels extremely real because you have it biologically going on. Then you do compulsions which are ritualistic actions or even in your brain. So behaviors to try to mitigate all of that. Because you're like, something's really wrong. I have to do something to fix it. So you might start avoiding certain things. You might start cleaning things more. You might start saying prayers, counting numbers. There's many different varieties of it. So that's why a lot of people with OCD, they believe they're having a psychotic break because they're like, this feels so real. But there's also a part of my brain that knows that this isn't quite happening. And so it's really distressing and that's why a lot of people who have OCD are higher intelligence and they're able to maneuver around a lot of this stuff. And so it usually takes around seven years on average for someone to get a diagnosis. And then from there, because the treatment is, I believe, one of the hardest treatments in the mental health world, it takes another seven years for someone to actually want to engage in treatment. Mighty Pursuit:Oh my gosh. I mean the OCD thing, it's kind of insidious because 3 to 4% of the population, something like that has been diagnosed with OCD. But I actually feel like it might be way higher than that. Of people that are just undiagnosed. Dr. Arianna Brandolini:Because as we said, there's a huge lag in diagnosis because it's also, people don't want to talk about it. And they don't know what's happening. Mighty Pursuit:And then there's these stereotypes in the culture of the hand-washing and all these kinds of crazy organizational things, but three practical examples of OCD, especially when it comes to your health, a normal person might have a headache and it's like, oh, is that brain cancer or something? But then the OCD person with, "oh, well, it's brain cancer. Wait, no it's brain cancer." And then you just start kind of going crazy about it. Or maybe relationships even, a lot of people with relationships, when they have OCD, it's like, "is this person the one for me or are they not the one? Or are they the one? Like, oh no, I don't like that about them. But do I like that?" And so it's like this deliberation. And so one of the biggest things with OCD that I see people rationalize it with, which could be difficult, “well, anybody would kind of do that with their relationship.” And so it's really hard to wade through all of that stuff. Dr. Arianna Brandolini:Yeah, absolutely. Because this is also what we're talking about in terms of self-awareness, where you're not entirely sure because you're living in your brain. To you it's normal. It's just the way you live your life. So being able to have someone be like, actually, you don't have to live life like that is really freeing. OCD is also known as the doubting disease. OCD takes a 0.0001% chance that something might happen. And it's always like, oh, but there's a chance, but there's a chance, but there's a chance, right? So a normal brain who doesn't have OCD will say, oh, it's probably not brain cancer. Mighty Pursuit:They live with as if there was certainty even though there's not really. Dr. Arianna Brandolini:There's no certainty in the world. But when you have a brain that has, when we talk about these overactive active pathways, you're able to feel a sense of certainty and move on because your brain is a machine. It calculates risk all the time. And so even getting into a car, there's a lot of risk getting into a car. You could get into an accident, but your brain is able to calculate this risk is worth it because I need to operate in the world. Whereas when you have OCD, that barometer is malfunctioning. So it feels like it's 50/50. And so it's that constant feeling of doubt and it's really emotional. People think it's sort of more of a brain thing or a physical thing. It's actually an emotional thing. And as I said, a lot of people operate around it. They're able to manage it. Often why I see people in my office is because the OCD has gotten bad enough that it's really impacting their life in a negative way. And they're like, I can't manage this anymore. Mighty Pursuit:Yeah, I mean, the important thing to just say on the OCD subject is that you could literally obsess about anything. And the weird thing about it is sometimes it almost feels like a superpower. It feels horrible sometimes. But then the flip side of OCD is people are able to see things that other people would never be able to see, and look at things and do things with such detail and that's where you see the intelligence thing. It's pretty high. Dr. Arianna Brandolini:So a lot of people who have OCD or OCD-like, so there's things like body dysmorphic disorder, things that are kind of in that bucket, they're often in very detail oriented jobs, graphic design, sometimes that there's patterns in that because there's certain details and certain things that they're very good at. But then it starts to become maladaptive in other areas of that. Mighty Pursuit:The other big thing in our culture is trauma. And so you treat some trauma related disorders. And again, I think, you know, advocating for therapy in this sense, obviously The Body Keeps The Score just took off in our culture. That book is just kind of like a phenomenon. It's been out like eight years, but it's still on the New York Times bestseller list. What's your opinion on that book? Did you read it? Dr. Arianna Brandolini:A while ago. And it's a big book. It's awesome because people have certain opinions on different things that they think that there's problems with. But, I just think in terms of educating people on the connection of the brain and the body. Something that now we're moving into an era where we're really paying attention to the body, which is extremely important. Before, with a lot of old school psychology, it's all about the brain, the brain, the brain, the brain, the brain. But your body works as a unit. It's a system. And so kind of being able to see things holistically and systemically and how your body and your nervous system impacts your brain and vice versa. It it opens up whole new avenues to healing. I think it resonated with so many people because it's so many people's experience just in terms of how emotions live in your body. If you look at old texts, even things like the Bible and or like the Old Testament, in the Jewish tradition, they always talk about the mind. But if you literally translated it, it's called the heart. Because they believe that a lot of wisdom, a lot of emotion, a lot of stuff came from there. And so talking about things like nervous systems, I think it's really helpful and it's just opened up a whole other avenue. That's very important. Mighty Pursuit:Touching on the neuroscience subject in reading that book and just looking at the brain scans of people that have had trauma. I was just like, there's so many evil things that have happened to people. And it's just like unspeakable evil, the fact that their brain literally just shuts down because they can't deal with it. Being raped by your father when you're like five years old or stuff like that. And so I think that there's spectrums and there's a spectrum of trauma. But I think understanding how your past is influencing your future, generational familial patterns, familiar wounds, all of that stuff has kind of made you into the person that you are today. And a lot of people are kind of like, well just leave the past in the past, like, let's not deal with it, but what would you say the danger is if you were to actually adopt that mentality and be like, oh, just leave the past in the past? Dr. Arianna Brandolini:One of the brilliant things that it's also done is that it's actually taking the burden of responsibility off of maybe victims. And actually been like, this stuff has physically, biologically impacted you. So the way that you're behaving, there's a reason for it. It's not just because you're quote unquote crazy or you're quote unquote disturbed. It's you actually dealt with stuff that has completely changed and transformed your brain, your body, your biology. It's not necessarily excusing bad behavior, but it's explaining why people do what they do. That's what I talk about is how do we approach things with curiosity and be like, there's a reason why you're behaving this way and so let's try to go to the root of what that looks like. And then again, the good news is that there are ways to transform that and to actually heal these things. With people who have that mentality of kind of like move on. It's in the past. It's just so invalidating, so dismissive and so wrong. Yes there are some people who maintain things by being attached or obsessive about certain things in the past. And actually the proper work is to be able to learn how to accept and let go. But for most people, it's rather than leaving things in the past, it's how do you actually transform it in the present so that it can look how you want it to look in the future?

ATTACHMENT THEORY

Mighty Pursuit: Getting into kind of how this kind of affects your dating relationships, whatnot, one of the things with the past that zero human beings can get away from is what's been revealed through attachment theory. So a lot of people don't understand that the care that they got as a kid from usually a parent, father, mother, that type of care now is being, assimilated or projected now into your adult relationships, and you don't even know that that's happening. And so can you tell us a little bit about what attachment theory is? Dr. Arianna Brandolini: Attachment theory was coined by John Bowlby and one of his colleagues. I can't remember what her name is right now, but it was basically a framework in order to be able to explain why certain people behave the way they behave in relationships. And the idea is that the relationships with your caregivers directly impacts the way that you relate to other people as an adult. And so he put things into four categories. Secure attachment, anxious attachment, avoidant attachment and disorganized attachment. And so secure attachment is if you had healthy families, healthy parents or caregivers who met your needs, gave you love and reassurance, all of that manifests in you being able to have healthy relationships where you're okay by yourself and you're also doing good in relationships. It's not like you need someone to fill you or to complete you. You're able to manage your emotions well. You're good at communication. You're able to think optimistically about your relationship and have basic trust, and believe that your relationship is going to succeed. And so that's kind of the secure piece. Dr. Arianna Brandolini: Anxious attachment that a lot of people relate to is when you need a lot of reassurance in your relationship, you're basically very afraid of rupture. You're very afraid of abandonment, and you're afraid of being alone. And so as a result, you need a lot of reassurance. You can be a little bit clingy. You can be codependent. That can often happen. And you're constantly attuned to disconnection in your relationships. So if your partner is having a bad day and doesn't respond well, your alarm bells are going off as I did something wrong. I did something wrong. And, you know, John Bowlby thought that that was as a result of having caregivers who were kind of disorganized or unpredictable in how they related to you. So sometimes they were really present, but sometimes they weren't because maybe they had their own mental health issues. Maybe they made you responsible for their own emotional well-being. And that's why a lot of people feel like they're responsible for their relationship. For your partner. Right. Dr. Arianna Brandolini: Avoidant attachment is when emotional intimacy makes you very uncomfortable. You feel very independent. Having someone too close feels really smothering. And you feel really trapped. You have relationships, but they kind of only go so far. You don't let someone in, you know? So people kind of feel that they don't quite know the depths of you. And so that's from caregivers who were just sort of emotionally checked out, kind of didn't fulfill your needs or very delayed in fulfilling what you needed or were very dismissive of your emotions. And it doesn't necessarily have to be abusive. It's just like, you know, if you had working parents who are emotionally checked out and you basically had to take care of yourself, right? You're teaching your kid. You can't trust people. People are not going to fulfill your needs. And so you have to fulfill your own needs. Dr. Arianna Brandolini: And so then disorganized is kind of a mix between anxious and avoidant. Basically you're desperate for love and intimacy, but you're also deathly afraid of it. So you push people away. It tends to be much more disorganized. Meaning like a lot of people who have trauma backgrounds, who have severe mental health issues, they kind of oscillate between the two. And so when we talk about attachment theory, some people think it's a bit reductive. That's not only what people deal with, but it can be a helpful framework to also help you think about how your relationship with your caregivers affects you now. And one thing that they talk about is how it's not like any of these is wrong quote unquote. It's not like there's something wrong with you for relating in this way. It's information. Mighty Pursuit: It's what happened to you. Dr. Arianna Brandolini: It's what happened to you. Right. And so this is now information. And so rather than feeling, you know, quote unquote crazy or incapable or defective, you can actually work towards how do I, especially because you do it with your partner, if you're aware of how you guys operate in that way, you're able to then communicate effectively and have ways to create a healthier relationship. Mighty Pursuit: Attachment theory in general, speaks to this idea of this innate desire that we all come out of the womb, that we need love, we need care. And none of us can get away from that. I've studied attachment theory over the past few years and it's like even with the avoidant attachment, it's not like you don't want it, like on a biological level. It's not like you don't want it. It's just terrifying to you. And so the thing with attachment theory is like it's not a philosophical idea. It's not even like science that's very hard to understand. It's like a very lived experiential thing. Like people who are on dating apps right now could immediately identify, "oh, okay. I'm dealing with, if you understand the concept, I'm dealing with an avoidant person right now, or I'm dealing with an anxious or clingy person right now." And so I think the topic and just awareness of it needs to be talked about so much more. Dr. Arianna Brandolini: Yeah, absolutely. It's really helpful. Mighty Pursuit: And then also what's interesting is like when attachment theory intersects with neuroscience. So Regina Sullivan, a neuroscientist at NYU, wrote in a 2012 report that, "even with proper nutrition and perfunctory care, if an infant does not receive affectionate social interaction, her physical development will be stunted and her brain development compromised." And so you had mentioned earlier that we actually have no control over what's happening. Like our brain development actually might be stunted in some ways, especially like relationships socially because this has happened. And then we talk about the mind, body and spirit a lot. And so when Jesus walked the earth 2000 years ago, he had a theory or a sense of what love is, which is like a self-sacrificial type of love. And so, Tim Keller is an author. He wrote, "your new child is the neediest human being you have ever met. She needs your care every second of the day, 24 hours a day, seven days a week. You make enormous sacrifices in your life. And yet the child for a very long time gives you nothing in return. And while later, the child can give you love and respect, never does she give you anything like what you have given her." And so I think what's interesting about attachment theory, about what Jesus claimed about love is like, if we as parents don't embody self-sacrificial love, it actually literally negatively impacts your brain development. And then you're kind of spreading a world of anxious and avoidant attachers. And to society, which cripples our relationship dynamics. Dr. Arianna Brandolini: That's why I'm such a proponent of people getting healthy. And listen, we're never fully arrived. You're never perfect. You're always going to make mistakes. That's okay. You don't have to be perfect. But it's true. Like, how do you know? This is why a lot of these days, people are talking about cycle breaking which is basically talking about how do I not perpetuate stuff so that I can raise functional, vaguely healthy kids who can have good relationships? And so we were talking at the beginning just in terms of negative thoughts. And I love how you brought some of this stuff in there about how we live in a fallen world. We live in a world where a lot of bad things happen. And so it's unavoidable. But how do I navigate it in a way that I can do the best I can within that space? Mighty Pursuit: Because, yeah, perfection is not possible. And I think that's completely unrealistic. But it does set a precedent of the type of love that we both need to give and receive. And I think kind of transitioning a little bit into dating is I think we could feel a lot of shame about the way that we are. And I thought you had this really powerful analogy that you had on social media recently about drinking a glass of water. And so I think a lot of people have shame that like, oh my God, I'm so needy in relationships. But it's really just like something that had happened to them. So can you explain to us the analogy with drinking water. Dr. Arianna Brandolini: I thought it was so powerful too, which is why I wanted to share it with people, because people often feel so much shame, as you said, about feeling really needy or feeling really anxious. And so it was talking about how, if someone has been walking through the desert for three days without any water, if you were to give them a glass of water and they were to gulp it down hungrily, and then ask for another one and ask for another one, you would have compassion and be like, I understand why this person is so needy of this water, because they have been starved of it. And so it's the same idea when this quote-unquote idea of neediness, it's not coming from a place of malice or purposefulness. It's actually because there's a deep need and a starvation that we've had. And so, rather than, again, bringing shame and judgment, how do you actually look on it with compassion and say, okay, let's figure out how to get this need met so it doesn't feel so desperate for you anymore? Mighty Pursuit: That's so good. And it speaks to the idea of helping fill in a gap for your partner if that is what their background is and that's what they struggle with. And being aware of that is critical. So yeah, when it comes to dating and relationships, obviously doing the individual work on yourself, is important. So what would you say the danger is of not being self-aware and not doing the work and then seeking a relationship, which is very common. Dr. Arianna Brandolini: It's very common, you know, and and so I talk so much about, you know, people are focused on this goal of getting a relationship and getting a boyfriend, getting a girlfriend, getting married. And you're not actually thinking holistically about your life. You can get married. Half of marriages end in divorce. And that is even more painful than being alone. It absolutely is. And so people are so focused on the here and now, they're not actually thinking about “how do I build something, good foundations where I can have a successful relationship?” Not just a relationship. And so that's why people have garbage relationships. It's not the only reason why. But I think a big reason why is because in order to be able to have successful long term relationships and also be able to have healthy choices, right, to choose people who are good for you versus not good for you. It kind of impacts absolutely every single part of your single journey, your dating journey, your relationship and marriage journey. And so we are meant to be, I believe as human beings, we're meant to be in relationships, whether they’re romantic or not. Building self-awareness and working on ourselves helps us have life giving, beautiful relationships that then creates a beautiful life.

RELATIONSHIP ANXIETIES

Mighty Pursuit: One of the biggest forms of baggage that people bring into relationships is just poor communication skills. And so why do you think our generation especially struggles with communicating so much? Dr. Arianna Brandolini: Communication takes a lot of courage and it takes the self-awareness that we've been talking about. A lot of people don't have language to describe what's going on with them or how they're feeling. And so a lot of what I do and work on with people is actually how do you put language to your experience so you can communicate effectively? To actually be able to show someone what's going on. And that takes courage because you have to examine yourself. And you also have to express something that's very vulnerable and ugly to somebody. And so people can blame, you can kind of not take responsibility. But that's not going to help your relationship. It's not going to help you. And so it's not easy because again it takes courage. It takes building self-confidence. It takes building self-worth. And then it also takes understanding yourself enough where you can have the language to do it. So the good news is that it's a skill that you can learn. But a lot of us haven't necessarily learned it because we don't have parents who did a good job of teaching us about it. And then if we weren't in environments where that was cultivated, we need to have someone teach us the stuff. Some people have it intuitively, but most of us need coaching. And so even for relationships, I'm such a big proponent of pre-marital counseling and couples counseling because people expect to get into a relationship and just kind of, "I like you and so it's supposed to work out." It's friggin' hard. Mighty Pursuit: Without thinking it through. Dr. Arianna Brandolini:And it's like if you want to be successful at your job, you have to work at it. If you want to have a successful relationship, you have to work at it. It's inevitable. Unfortunately. Mighty Pursuit: So in terms of the progression of like a relationship, okay, let's just say someone feels like they're ready to date, or has made sense to some of the things with self-awareness or attachment or whatever. Obviously the starting point for finding a partner today has completely changed. It's like dating apps. And so that can make dating in the digital world kind of quite brutal because people are just kind of commodities, you're seeing like 95 different people a day, just swiping through profiles and stuff. It's almost like the more options you get, it's like sifting through junk to find a meaningful connection. And so what's your opinion on and take on dating apps in general? Dr. Arianna Brandolini: As with anything, there's positives and negatives. And I think that there's a way to engage with dating apps that can be healthy and effective and a great way to meet people. It's opened up a whole way of meeting people you might never meet before. And a lot of people meet on apps, and so that's wonderful. But I talk a lot about intentionality in living your life, living intentionally, meaning thinking about how you're engaging with whatever's in front of you. So even when it comes to dating apps, thinking about how you're going to engage with this thing is really important rather than doing it reactively. And so, as you mentioned, being able to bring awareness that there's human beings on the other side of this thing. That you do not know a whole entirety of a person based on a profile. Know also that people who ghost, people who are incessantly chatting on the apps, being able to have certain standards and rules for yourself, where, "okay, I'm going to tolerate certain behavior and not tolerate others." So there's an element of, if you're able to be as healthy as you can be in it, it helps you be successful at it. It doesn't mean it's easy, because it also can promote a lot of bad behavior. I don't want to say bad, but disrespectful behavior where you feel like, oh my gosh, I'm just like, I'm not a human being. I'm not treated as a human being. Mighty Pursuit: There's all this like new terminology that's been introduced like ghosting. Breadcrumbing is like another one. Like orbiting, like all this type of behavior that -- Dr. Arianna Brandolini: I can't keep up. So my patients teach me these things. I'm like, what's that? Mighty Pursuit:And so you’ve said some things about ghosting in particular. You want to talk about one of the most recent posts that you did on that, of why we feel compelled to reach out to someone when they've ghosted us? Dr. Arianna Brandolini: Ghosting obviously is very prevalent these days because apps and kind of on online medium makes it very easy for someone to not have to have a hard conversation and just to kind of not respond to somebody. And so when someone ghosts you, it hits on some fundamental needs. It hits on a need to be certain, of certainty and safety. It hits on a need of self-worth and value. And so because you're talking about dopamine earlier, right? And so because someone who goes hits on these areas of insecurity, basically what you want to do is you want to do everything you possibly can to get that security back and get certainty back and get worth and value back. And so the temptation to text someone or to reach out to someone, or get an explanation from someone is to try to alleviate the discomfort that you're feeling. Recognizing that that's where a lot of those urges come from. A lot of people say they get ghosted and then they're obsessing about it. They're thinking about it. They want it to reach out to this person. They wonder why they're in that state because they're trying to alleviate that feeling of uncertainty and that feeling of low self-worth. And so rather than finding it in this person who obviously, you know, most of us have ghosted, it's not a judgment call, but it's kind of like, okay, this person obviously wasn't for you. How do you actually get those needs met in other ways? And to recognize that your desire to reach out or to connect isn't because you actually like this person very much. You're literally coming from that urge to alleviate a negative feeling that you're feeling. And so you're able to tolerate that, to not personalize it, to find self-worth and value and be reminded of that somewhere else, to let go of this idea of certainty and actually be able to come to a sense of certainty for yourself that you're never going to know. And that's okay. You're able to then not engage so much emotional energy in trying to re-engage someone or figure out why. Mighty Pursuit: Why do you think it's counterproductive to engage with that and to pursue them, if someone's ghosted you? Dr. Arianna Brandolini: Well because you're probably not going to get what you want, right? You're looking for something and you're looking for certainty. And even if someone explains to you why they ghosted, it rarely puts the situation to rest. Because you don't believe them or it's not enough, because it's not like this is something that's going to satisfy your need. You're always going to have that uncertainty. And then having someone reengage and you're like, oh, that means that I'm worthy and valuable. None of this stuff actually works in giving you worth and value and giving you that certainty. And plus, this person probably isn't for you if they behaved this way. A lot of people expend so much energy in trying to make something work, because of their feelings of insecurity. And it's like it's one of the bravest acts of self-love to actually let go of somebody who you might really like and say, this person actually isn't for me. And I'm sad about that, but I'm not going to put myself through the ringer to try to win something back because of trying to fulfill a need that another person can't fulfill. Mighty Pursuit: So how does one handle rejection? Dr. Arianna Brandolini:Well, I did a post about that too. So you can go watch that. But, you know, rejection sensitivity can really stump us in life. And rejection sucks. It's terrible. Everyone hates being rejected. Of course you do. But people who can actually change their relationship to rejection to have it not sting so much are going to be so much more successful in life. And you can see that actually in people who are successful, they have more resilience when it comes to rejection because we're all going to get rejected. And so if you're able to turn your perspective and change your perspective, that rejection isn't about you. It's actually for you, right? It's merely information about the compatibility between you and whatever you were rejected from. And so if you can look at it as this is actually for me because this wasn't good for me, you're able to bounce back a lot quicker and not personalize it so much because there's so much we don't know. We were talking about mind reading. We were talking about all these cognitive distortions. You know, people always project all of your own insecurities and stuff onto why someone might have rejected you. But there's a thousand reasons why, right? They might have gotten back together with her ex. They might have moved countries. They might have had a terrible accident. They might be really creepy, dangerous people that you actually don't want to be with. Mighty Pursuit:They might be avoidant. Dr. Arianna Brandolini:They might be avoidant. There's thousands of explanations that could also be true. Mighty Pursuit:I think one of the phenomenons in our culture when it comes to rejection is to use that as fuel. And I really want to get like a psychological opinion on this, to use it as fuel of like you hear the term like "revenge bod" or like something like that, where it's just like kind of like, "okay, you rejected me and now I'm going to spend my entire life making you regret that decision." I mean it could apply to someone who's ghosting or you were just talking for a little while. I think it could especially apply after a breakup or something like that. But, I'm going to make myself so good and so important that you're just going to regret this for the rest of your life. And so, what do you think of that attitude? And just like handling rejection that way? Dr. Arianna Brandolini: Listen, I think it's a very human reaction. And I think that after a big break up or something like that, it's okay. It's okay to feel like that. It's okay to be like I want to show you because you're processing something that's really hard. And if it's helping you create healthy behaviors. Okay, great. If that's happening a year later, five years later. If it's actually the motivation for a lot of what you're doing for a long period of time, that's not necessarily healthy, right? You're actually giving all your power away to somebody else saying, I'm doing this because of you. Even if it's healthy behavior, you're still giving away all your agency and power to somebody else and what they did to you. It's very powerless. And so I think with a lot of things I tell a lot of people, I'm like, that's yeah, it's normal. I don't blame you for hating their guts, being angry and wanting to do all these things. That's okay. I think sometimes the length of time, if this starts to become more in your life, and usually people do that and then they kind of get over it. Mighty Pursuit: It's just like this motivation kind of takes over and you're like, oh, I just lost 30 pounds now and did all this stuff because -- Dr. Arianna Brandolini: Which can be really healthy. So as I said, if it helps you create healthy behaviors. And again very human. Then we want you to maintain that healthy behavior because it's actually good for you. And you want to do it for yourself because you love yourself as opposed to because someone else is a jerk, you know? Mighty Pursuit: You also had a post about how do you keep yourself from spiraling after a breakup? Dr. Arianna Brandolini: All this talk speaks to resilience and kind of managing your mind and managing yourself in the midst of really hard emotions, right? And so there is going to be an element of spiraling because it sucks. It's so painful. You're dealing with a painful thing. And so you're going to be ruminating. You're going to be thinking about it a lot. And so again that's very normal. That's okay. But we also want it to be in a healthy range. Not where it's you're indulging it so much that it's really impacting things in a very negative way. And so I like to give people perspective and how to think about it in a different way, because when you're in an emotional state, that's all you see, right? And so if you actually think about it, I talk about it being like a love drug, right? When you're with somebody, you get a lot of dopamine hits. You get dopamine hits when you talk to them, when you spend time with them, when you hug them, when you see pictures of them, even social media posts, all of them are dopamine hits to your brain. Mighty Pursuit: It's like, "oh, my God. That person." Dr. Arianna Brandolini: Exactly. Exactly. We love that. We love dopamine. When you break up with somebody or when that person is out of your life, you suddenly have a dopamine deficit. You have a big trough where you're not getting those dopamine hits anymore. Mighty Pursuit: It's like a withdrawal. Dr. Arianna Brandolini: Exactly. So you're in love withdrawal and you're jonesing for some hits, right? You're like an addict. And so whether it's looking and checking on social media. It's looking for texts. All of those are dopamine hits to your brain. And so the key when you're going through withdrawal of a substance is to go cold turkey and to wait and give yourself time for the dopamine to rebalance in your brain so that those hits don't actually become as appealing anymore, because you have dopamine back in your brain at a normal level. And so even when you're thinking about that person and ruminating about that person, you're still receiving dopamine hits. And so if you can look at it from that model and be like, okay, I'm going to be in withdrawal for a while, it's going to be really hard. I'm going to be Jonesin' for all the hits. But how do I structure my life in a way where I can throw myself into exercising and seeing my friends and doing fun things, and maybe it's about muting them on social media so you're not looking at their posts for a while. Mighty Pursuit: So it's like replacing that activity with something else? Dr. Arianna Brandolini: Yeah, exactly. And also knowing that it's going to be hard. Knowing that you're going to be an addict for a while. And so having mechanisms in place to help you manage that. And again you're not going to be perfect. You're going to think about your ex. It's going to happen. But there's also ways of not indulging it to the point where it's maintaining itself for a long time. Mighty Pursuit: That's so interesting when you're talking about just love as kind of a drug, because we had talked about that in the episode with Dr. Lembke about just how it functions with the drug and then how the whole the withdrawal process works, which I think you did talk about in your post, it is literally like you were using cocaine and now you're not using cocaine. Dr. Arianna Brandolini: Yeah it's biological, that's why it's so powerful. Mighty Pursuit: One thing about dating that I had questions about. So you are adamant about focusing on the process and not the outcome when dating. And so one question I had is there's an ancient proverb that says, "where there's no vision, the people perish." And I feel like some people, especially people that might be avoiding attachment or just have a strong fear of commitment, might never think about, oh, like getting married to this person or whatever. And so is there a tension there and what do you mean when you say like focus on the process, not the outcome when dating? Dr. Arianna Brandolini: When it comes to any of the stuff, it doesn't universally apply. People are very different. There's different experiences. And this is also the danger of online social media stuff is that you can't speak to every person's experience. You are speaking to maybe a subset of people, specific people. It's sound bites. It doesn't incorporate the whole gamut of the human experience and complexity. We're reducing things to really simple terms. So I think that as you said, it's a balance. I think because I deal with a lot of anxious people in my practice, I think more often than not I see a lot of anxiety around dating where people are so focused on, I have to get a relationship. I have to get this person to like me. I want to get into a relationship. I want to get married. That they are not present to the actual process of dating, which is actually how you're going to be successful. And so, I think that you're right. You need to have a vision of what you want. Otherwise you're going to accept whatever comes your way, which is also not healthy. So I think being able to have vision, if you also have an avoidant person or someone who doesn't ever want to get married, that's a vision for your life and that's okay. And so it's important to be able to date accordingly, to not lead people on and to be like, "hey, this is actually the vision for my life. Are you okay with this vision or are you not?" Mighty Pursuit: It's expectations. Dr. Arianna Brandolini: Yeah, exactly. Mighty Pursuit: And you might not be aligned. Dr. Arianna Brandolini: And you might not be aligned, which means that you're not compatible. And that's okay. I think it's great that you mention that because I think even people who are so focused on the outcome, they're focused on the wrong outcome, they're focused on getting somebody they're not actually focused on what is going to be the right person for me that is going to help me have a healthy, long term relationship. You know, people might do that, but then they're so desperate to have something because they're afraid of being alone that they'll compromise a lot of their vision. And so I think that there's an element of having vision, but then holding yourself accountable to that vision. So I think that the vision is a really healthy thing to have. But what people are often focusing on isn't that vision. It's a really anemic version of that vision. Mighty Pursuit: I mean, you mentioned the word compromise. I mean, there is a component of fear of being alone, but do you feel like that's a main component of why people are so quick to compromise? Dr. Arianna Brandolini: Again, it's not universally applicable. I think for a lot of people it might be fear of being alone. It might be, also finding your self-worth and your confidence in external places, meaning how people view you. If someone wants to be with you, it makes you feel good about yourself. And so people will compromise it because the person that they're engaged with right now, even if they might not be the right person, that feeling of rejection or not being enough, if this person rejects me is too large to bear. So I will settle to be chosen by this person because it makes me feel good about myself, right? It can come from kind of those unhealthy places that can look very different depending on the human being. So yeah, I think it depends. Mighty Pursuit: So I mean you don't have to share this but, I mean you recently got married. Dr. Arianna Brandolini: Yes I did. About a year and a half ago almost. Almost two years, but between a year and a half, two years. Mighty Pursuit: And so that happened in your 30s, right? Dr. Arianna Brandolini: Yeah, in my late 30s. I got married when I was 37. Mighty Pursuit:Okay. So I guess to an extent you lived this, no? Dr. Arianna Brandolini: Absolutely. And so I've lived it. So I talk from experience as well as a psychologist. Mighty Pursuit: From a personal standpoint, what have you learned about this through the whole process? And now being married on the other side? Dr. Arianna Brandolini: I am so glad that I personally put in my own personal work to be able to be where I am today. Because my husband is amazing. He is so many answers to my prayers. He is so wonderful. And I would have missed out on this many times over, if I hadn't done a lot of hard work and inner healing on myself and been like I'm actually not going to compromise. Let me finish my thought and then I'll caveat it. So I was kind of like, okay, I have a vision. This is the vision that I want. I also come from a broken family. I come from a divorced family. I've seen a lot of broken relationships around me, and I've seen the profound loneliness of an unhealthy marriage and relationship. And I was like, I refuse to be that. I don't want that. So if I have to be single for the rest of my life, how do I actually build a life that I love, that I'll be really jazzed about, even if I don't have a partner? And a partner will be a cherry on top. That's of course, a desire of my heart. But I'm going to invest in my friendships, in my relationships. I'm not going to wait on taking that trip and doing that thing. Dr. Arianna Brandolini:I feel like a lot of people wait and think their life is going to start when they're partnered or married and your life is passing you by. You are just as worthy and valuable as you are right now, whether you're partnered or not. So I think that was a large part of my journey and about investing and building in my own sense of self and self-worth so that I wasn't afraid to necessarily take risks. I wasn't fazed if I was rejected. Of course it hurts, but it doesn't crumble me, right? I don't crumble at the thought of it. On top of that when I said kind of like I have a vision that I'm not going to compromise on, I think through that own personal work, I was also able to put that vision in the right place. I think a lot of people are also very stringent with their rules when it comes to dating. I hear these girls, they're like, "well, if he's under six foot, I'm not going to date him." And I'm like -- Mighty Pursuit: That's a big thing. Dr. Arianna Brandolini: And I'm like, I'm sorry, then you deserve to be single. I'm sorry, but you are passing over an amazing man who has integrity, who's going to treat you well because he's five eight? Like, who do you think you are? Sorry. It gets me really angry. And for guys who are like, oh, she's not young or hot enough. And it's like, it's okay to want these things, but they can't be your number ones, right? Like what is actually the foundation? And so I think that doing personal work can also help you tap into, I actually want someone who's kind. I want someone who's generous. I want someone who is still a good version of himself when bad things happen. How does he talk to me when he's mad at me? All these different things. And so I was also in a position where I was more open than I'd ever been in terms of what my husband was going to look like. And my husband is objectively a very handsome man, but he wasn't what I quote unquote typically went for. So when I met him, actually many years ago, I was like, nah. And then a friend of ours suggested us going out, and I was at a point where I was like, I actually care more about the character of a person than so many other things that I used to care about a lot more. And I think that that had a lot to do with inner healing and inner work. And as a result, I've actually been able to receive a gift that is exactly what is right for me. You know, that I wouldn't have recognized otherwise. Mighty Pursuit: I think you're speaking a lot of truth. I think people might be listening. There's what we know to be true and there's reality, and then there's the circumstances in the world that we're living in and having to deal with that. And what I mean by that is like, did you feel the social ramifications and the biological clock ramping up because people are like, "oh, I'm 35 now, okay. 40 is in five years. 45?" And I think that, unfortunately, this is a harder thing for women than men, because men I think, could in some senses get away with, oh I'm 45 now. I want to get married. Dr. Arianna Brandolini: They have a longer timeline. They do. Mighty Pursuit: But there's anxiety and nervousness. So were you prepared to be like, "okay, I'm not going to settle and accept that future". Potentially 40 might come, 45 might come. Obviously it didn't happen to you. But like -- Dr. Arianna Brandolini: Absolutely it's not easy. But I think that my faith was a huge part of that. So I think having faith is something that's such a gift. And it's so important because if I didn't believe in a God who was good, in a God who had good gifts for me and a God who had the best for me, whatever that looked like, then it would have been a lot. It was still stressful and it was still anxiety provoking because I'm human, but I think I would have operated out of that place of fear and anxiety, as opposed to a place of faith and trust. And hope. That even if I don't meet someone til' I'm 45 and 50 and maybe I don't have a biological child, you know, all these different things that you think about. Maybe I'm not as desirable because I'm older, all of that stuff was in the background. But because I have faith in a God who's got my back and who wants good things for me, I was able to not operate out of that fear place. Mighty Pursuit: Yeah. I mean, you're talking about acceptance. There's things that we don't want to accept, but we have to. We have to accept that this is like the case. And you can't force your control on something. Dr. Arianna Brandolini: Exactly.

THE IMPORTANCE OF MEANING

Mighty Pursuit: Like there's an illusion of control that we have. And the only thing that could really force is compromising that in that sense. And I think that's kind of where it segways to where I want to land. Because in having your practice for all these years, what role, because you mentioned God, which is more of an existential big belief of like, do I believe in God and I don't believe in God? Like, who is God or whatever? And so what role do you think how we see the world and how sense of reality has on our mental health? Dr. Arianna Brandolini: I'm a big proponent of my patients finding faith, whatever that looks like. As you said, radical acceptance or being able to accept a circumstance and actually hold on to hope despite it is hugely important to be able to navigate the world, your life in a way where you're operating out of your values as opposed to reacting out of anxiety. If you have an ultimate belief that the universe God is for me, that whatever happens is actually going to be for my good in the long run, and that I have a source of strength that is going to help me get through this. It's going to help you with your resilience, it's going to help you face hard things. It's also a place where you can find truth and find reality, because ultimately we've been talking about what's truth, right? Ultimately, what truth is, is what you choose it to be. That's just it, you know? And so do you choose to believe what God says about the world? You choose to believe that or do you choose to believe you know something else? And so being able to have faith in something at least gives you a framework where you're able to have a beautiful, healthy view of reality and operate out of that place. And also, in terms of faith, it also provides things that we've talked about in terms of things like community, things like presence and mindfulness when it comes to rituals and prayers and all that kind of stuff. It's actually structured to give you so many healthy things that you need to live a healthy life. Mighty Pursuit: Well, I think when it comes to our culture, I think we're in a moment where it's just like people sometimes default to I don't know on the God question. And you know, he either is or isn't. We could say like, well I don't know. And that could be like what you feel in the moment, but at the end of the day, there is a god or there isn't. It's like a yes or no question. And so it's a faith in that and what that looks like. And I think what's fascinating about the God conversation, studies have shown that a sense of meaning is more important for our well-being than happiness. And that's really important, because how we make sense of the things that happen to us and our reality determines our well-being. And if we feel like there's a complete purposelessness to I'm 40 and single or I'm 45 and single or whatever, it makes it harder to deal with. Dr. Arianna Brandolini: And that's why often the question that I ask when people are like, oh am I deluding myself? And I'm like, well is this helpful or is this not helpful? The proof is in the pie. And so I think that's also a very important aspect when it's like when you can't get out of that, is it true? Is it not true? It's like “okay, but what's actually going to help you live a healthy, joyful, purposeful, productive life?” Mighty Pursuit: Do you see a lot of people that are working through more existential questions in therapy? Dr. Arianna Brandolini: Yeah, sure. Mighty Pursuit: Is that like a common one? How does that interact with a lot of people's issues? Dr. Arianna Brandolini: I don't know if it's very common. I mean, I think recently because we've had a shake up, I think in the Western church, for many reasons and people are experiencing a lot of church hurt. And questioning not only faith, but also kind of the structures of faith that we've operated in for so long. I think I see a lot more of that. And so there's been an uptick in that. But I think it takes a particular kind of person to really engage with the existential questions. What I see more is people avoiding it because it's something that's really hard to confront because if it's like, okay, if I actually do believe there's something out there, am I doing anything about it? If I'm not, there is a tension and a dissonance there that is too uncomfortable for me. And so I think a lot of people avoid it because most of the population I see is younger, so they're not actually confronted with the fact that you are going to die someday. And I think it's not an easy question. So I think it takes a particular type of personality to really wrestle with that. And so a lot of people avoid it. Mighty Pursuit: If you want to look at a top-down approach like that big question, then kind of knowingly or unknowingly influences a lot of your day-to-day decisions. Or if you want to look at it from the bottom-up, like in terms of a foundation, it's like, if that's not there, then your life is going to look completely different. And obviously, people are all on their own journey of making sense of those things, but obviously that is a big thing to work through when it comes to making sense of your mental health and meaning and stuff. Another kind of mental health hack, if you will, is also understanding what you said before about the mind-body connection. And so are there any recommendations that you give to people in terms of exercise, eating like all of that stuff when it comes to that being an influencer on mental health? Dr. Arianna Brandolini: Oh, yeah, I talk about it all the time. It's very unsexy because people want a cool guru revelation to make all my problems go away. And I'm like, you eat garbage and you sleep four hours a night. No wonder you're depressed. And so the foundations of physical health will impact your mental health. It just goes without saying. And so if you are not sleeping enough, if you are not moving your body in any way, if you are eating garbage all the time, you know people roll their eyes because they're like, this is like annoying basic stuff, but it's actually the basics that really help, you know? And so I have a lot of patients where we kind of talk about the importance of sleep and sleep hygiene and what that looks like and how many hours you need, and the quality of sleep. And it really radically impacts. They're like, wow, I actually feel a lot better. We talk about people who smoke weed, quitting weed, quitting over drinking, you know, and how both of those actually really impact your anxiety levels in a significant way. And so people don't want to give these things up. Even with the sleep thing, we happen to be in New York City where there's a lot of young professionals. It's the city that never sleeps. You work hard, you play hard. You also work so much that you know, I'm sure you've heard the term revenge, bedtime procrastination, where people get home after a long day. Mighty Pursuit: Oh, I don't want to go to bed now. Dr. Arianna Brandolini: Because they're like, my day was not my own. I had no time to myself. I want to do what I want to do. And so then you're watching shows or playing video games until one in the morning, and then you're getting three hours of sleep and you have to get up and go to work the next day. So those are the kind of things I start with honestly with a lot of my patients checking in on those foundational things about your sleeping. Exercise, it's just a fact that it is a natural antidepressant. It's just a fact that people who record exercise on a regular basis, it really does help and improve. And this is, you know, the average person. There's some people who have very intense mental health issues and so I'm not negating that. But for the average person, if you were to actually regularly exercise, you will see an improvement in your mood. And even the kind of foods that you eat. What's awesome is that in the age of online and social media, that you have so many resources out there to actually help you make healthier decisions. And so taking care of your body is going to be completely impactful on your mind and vice versa. Mighty Pursuit: And I think what I love about like just kind of closing the loop on mental health in general is we can't really approach it with this reductionist attitude. There are a lot of different things that we talked about today, the mental disorders and diagnoses and attachment. We talked about loneliness and having community earlier and meaning and different things like that. And so I think, like just circling back on the idea of self-awareness and understanding yourself, it's like what are you dealing with? What are you personally dealing with? And understanding those variables at play, I think could offer a lot of help to just anybody in terms of like where they're at right now. And there's a pathway to improving your mental health and improving your relationships and the way that you see the world. Dr. Arianna Brandolini: There's always hope.

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