Transcription:

Melanie Cole: Welcome to Back to Health, your source for the latest in health, wellness, and medical care, keeping you informed. So you can make informed healthcare choices for yourself and your whole family. Back to Health features conversations about trending health topics and medical breakthroughs from our team of world-renowned physicians at Weill Cornell Medicine. I'm Melanie Cole and today we're discussing navigating personal interpersonal emotions and stress during the black lives matter movement. Joining me is Dr. Gurmeet Kanwal. He's a Clinical Associate Professor of Psychiatry at Weill Cornell Medicine and an Associate Attending Psychiatrist at New York Presbyterian Hospital. Dr. Kanwal, it's such a pleasure to have you, what a great topic, there's so much to discuss for this. So let's jump right in. We're living at this time of so much stress for so many reasons. How do all of these feelings of stress that we're feeling and the fear that we're feeling as well, impact us as individuals and how can we remain compassionate in the middle of all of this when we feel like we're just trying to get through each day?

Dr. Kanwal: It's true. We certainly are living through extraordinary times. We're still very much in the middle of a pandemic. Something none of us has ever experienced before. And we're also facing great economic stress with more than 40 million people having lost jobs. And then we're witnessing a time of great reckoning with the history of racism in this country. So the social unrest is really coming at a time when our country and the entire world is already on edge. Now we can think of the effect of these current events as going in one of two directions. And these two directions are not always mutually exclusive. First on the trauma side, there are those who might already have experienced trauma earlier in life, and it doesn't have to be about the exact same situation. Those people are finding that their earlier traumatic reactions are being reactivated by current events.

And then they're also experiencing new and ongoing trauma and stress. So some psychologists refer to this combination of ongoing and earlier trauma as complex post traumatic stress disorder or complex PTSD. And there's one psychologist, [inaudible02:43] working in Palestine who uses a good term, continuous traumatic stress disorder or PTSD instead of PTSD to emphasize the ongoing nature of the stress. But often there can be symptoms of stress without the person's functioning being deeply affected. So not all traumatic stress becomes a traumatic disorder. Now the second direction, which people tend not to talk about as much is that social unrest and even stress, and movements like black lives matter, can also have some positive effect on people.

So for example, some people can feel inspired for the first time or they can feel they belong to a certain group or they can feel vindicated, or they can feel their life has a purpose that allows them to rise above their daily problems and have a larger perspective. On the other hand, relationships can also become tense and even break under the pressure of different political and social views. Coming to the second part of your question, how can we remain compassionate at a time like this? That Melanie, I think is a very important question. First of all, though, let's understand what one means by compassion. Compassion is not just a feeling. It's an attitude and a perspective. It is a way of recognizing and accepting the great complexity of everything.

The more complexity you can accept, the more you can be capable of compassion, which means recognizing that there are many truths, many different experiences, and many different kinds of suffering in any situation. So we know this both from psychology and the biology of the brain that the more stressed, fearful, or anxious a person is, the less capable they become of accepting complexity. Therefore, as stress increases, the ability to be compassionate decreases. So what can we do to access our compassion? Well, I'll mention three things that all of us can try to do no matter what our place in society. First, we can try to learn strategies to relax because we know that being relaxed makes it more likely that we can experience and access our compassion. Second, we should remember that empathy is not a starting point, it's a destination.

And the way to get to empathy is by asking questions. So in order to be compassionate, one should try to ask questions. Instead of assuming that one already understands something. The third point I would make is that the greatest gift of the pandemic to us as a human family has been that Pandemic has made it clear that whatever happens to one of us happens to all of us. We're all deeply connected in the chain of cause and effect, whether we like it or not. So those are my three suggestions to cultivate compassion during these times, try to relax. Don't be afraid to ask questions and just remember that we're all in this together.

Host: What great advice Dr. Kanwal, and as you're giving us this advice about how we can remain compassionate and empathetic, we have our own traumas, as you said, and emotions that are triggered at this time, whether, you know, you're somebody older, that's been through the Civil Rights or who knows people have their own traumas. How can we manage those when we're feeling that it's traumatic all over the place right now, but we have our own inner traumas going on?

Dr. Kanwal: First of all, as I said before, we've got to remember that not all the emotions that are triggered during such a time are negative or destructive, because I think it's important to be able to notice the more positive ones as well, the more constructive emotions which can even include outrage at injustice. And then we have to learn to distinguish those from the more negative emotions such as excessive worrying or depression or helplessness or despair or indiscriminate anger. I don't know who actually said this originally, but I find it to be useful. The opposite of depression is not happiness, it's expression. So talking to those who can be helpful, processing what one is feeling or finding ways to express one's feelings in some creative and artistic form can be very useful during times like this. Taking appropriate social action, joining organizations who might be taking action.

These can also be ways of achieving expression for me recording this podcast is a form of expression. Lastly, there are many strategies that can be used to diminish the effects of traumatizing experiences on our autonomic nervous system. So the sympathetic part of our autonomic nervous system is that part of our nervous system, that's responsible for many of the felt symptoms of anxiety and stress. Meanwhile, there is a parasympathetic part of our autonomic nervous system, which helps to reduce the symptoms of stress, for example, by lowering our heart rate and blood pressure. So if we can learn to exercise a little control over our autonomic nervous system, which we can, it can help to modify our stress reactions, learning, to breathe properly, making sure we get enough sleep, having an exercise routine. These are actually all ways to optimize the activity of our autonomic nervous system.

Host: They're great ways as well. And one of the things that I think that so many people are running into right now, Dr. Kanwal, is engaging in dialogue around the black lives matter movement. And it's sensitive. And I mean, it's hard if you have family or friends that don't see it, they don't see it the way you see it. How can we engage in this dialogue? Because it's such an important question. I have that question myself, my friends and family have this question, tell us how we can engage in dialogue, or if we should, because do we even know if we're going to change anybody's minds?

Dr. Kanwal: That's a great question, Melanie. And yes, we definitely should try our best to engage in dialogue, but you know, emotional intensity is very high in the country right now. And then at the same time, there is great polarization of viewpoints more than ever before. So combine that with the fact that so many people are feeling that the stakes are extremely high for whatever it is that one believes in. And you do have a very difficult setting then for people to be able to have respectful and constructive dialogue. But the goal should be for two people to converse in such a way that both come away, having gathered some new information about a viewpoint that is different from ones own, see dialogue should not be about convincing someone else that you are right or about putting down the other person's viewpoint.

That's not what dialogue is. It should be about both people learning something from the conversation, keeping that in mind can help in having conversations about very difficult subjects. And there are many of those today. Sometimes it can even help to set ground rules between friends, partners, or family members. For example, only one person speaks at a time or each person gets to call a timeout. If things get too hot, respecting difference seems like a simple and cliché idea. But Melanie, in fact, it is one of the most difficult things to practice in life.

Host: I understand that Dr. Kanwal, but I want to jump back for one second. And you said to learn from each other and that is vital. It's so important and true. But how can we accept learning if we feel that those other person's views are antithesis to our own and actually in our own minds cruel and trigger those emotions? How can we try and learn why they feel that way when to understand why they feel that way just makes it all that much harder to understand?

Dr. Kanwal: Yeah. Well, so you see the thing that happens is that people mistake answers in a conversation for some already determined outcome. There is a difference between a conversation and an outcome. We have to try to hear people without feeling threatened by the answer without confusing the answer for something that is definitely going to happen or has already happened. Answers are a way of getting to someplace conversations. Dialogues are a journey. We can't take them as, Oh, if this person is saying this, therefore it is already set in stone. And so now I have to react because I'm feeling threatened or outraged because that's what the reality is, what, whatever this person is saying. Instead we have to think, okay, this is where we are starting, but if we can talk, then there is a possibility, may not always happen, but there is a possibility of getting to some different place. Otherwise, if we don't talk that possibilities are raised and then we're really stuck.

Melanie Cole: You're right. And that really does make perfect sense. You're so right about that. So now from a societal and social psychology perspective, why do movements like this become so impactful and powerful? We've seen it throughout time that when these movements become a force, the change can be affected. Tell us about that.

Dr. Kanwal: You know, what social psychology tells us is that the drive to belong, to belong to a group of family, a country, a culture that is a very powerful influence on how we feel, think, and behave. And I see that all the time in working with people. So when there's great social unrest, when some of society's long established norms are being shaken, it automatically shakes up people's ideas of who belongs where, and who is with or against whom, think of it this way. If you have a can of beans, that's been lying still for a while, and every bean is sitting comfortably in its own place. All of a sudden someone comes and starts shaking this can, now every bean has to find a new place to settle. So the social can of this country is being shaken vigorously right now. And for good reason, it will take some time before everyone figures out where they belong, ideologically or emotionally.

The other reason why social movements can impact many of us so powerfully has to do with our histories of having been traumatized in the past. As I mentioned earlier, past experiences of trauma can become reawakened for many of us. Some of us may not even realize that we've gone through that trauma, but it's there. And so in witnessing or participating in the black lives matter movement, those old feelings can become reactivated. So then we have to manage those experiences that we are reminded of from the past, even as we are trying to deal with the present. And that's why large social movements can have a huge impact on our psychic life.

Host: Well, I love the bean analogy, Dr. Kanwal, that's perfect and really paints a picture for us. Now, when it comes to racism, we all want to figure out a way to be involved. And for those of us that may not be directly impacted, but want to be allies. How can we channel what we're feeling into taking helpful action versus feeling helpless and overwhelmed? I mean, with COVID, some of us might be afraid to go out and join those protests. Or if we're trying to tell our children or our friends about these things, and we've never been marginalized or actually felt it, how can we find the words, how can we put into action these feelings of helplessness? Help us along those lines. This is a great psychology class we're getting today, Dr. Kanwal.

Dr. Kanwal: So, you know, you're raising the issue of being an ally. And what I want to emphasize is that being an ally is actually a hard thing. It's not just about believing something or agreeing with something. A lot of people can do that, but really being an ally is about doing something, it's about taking action on behalf of those, you want to be an ally to. The action though, can take many different forms from becoming better informed about social realities, about history, current events, or to being out in the streets, marching for justice, everyone in some way has to figure out what they are capable of and what works best for them. There's no one best way. So a poet might write poetry. A painter might paint something. A writer might write a book, but someone else might feel comfortable marching. I'll recommend at least two sources for people who want to get into this more. One is a Brian Candy's book on how to be an antiracist.

And then the second one is Robin D’Angelo’s work on White Fragility. I find both of those to be very good sources, to get some ideas on how to think about all of this. But, you know, your question, Melanie actually points to a very important thing about being an ally. And this is crucial to the whole idea of helplessness and being overwhelmed. When you take an active part against racism, you are not only helping those who are oppressed. You are actually also preventing yourself from feeling helpless and depressed because you are taking action. So what we really need to keep in mind is that being an ally is a win, win

Host: That is beautifully put. And I know that it's true because I felt exactly what you just said now, as different generations experiencing this movement differently, due to their life experiences. And we've talked in other podcasts for Weill Cornell Medicine about teaching our children about racism and black lives matter and pride and younger generations, what should they know about older generations and vice versa? Dr. Kanwal, my dad is 96 and he talks to my teenage children about serving in Germany during World War II and what that was like and seeing the Cold War and the Civil Rights Movement, and all of it, tell us how to interact with these generations and why it's so important that we learn from history and try to understand each other.

Dr. Kanwal: It certainly is important. And it's a complicated question. You know, because there are different generations in terms of age, but those in one generation are also not a homogenous group. The older generation of one community might experience the current events very differently from the older generation of another community. And the same is true of younger generations. But if one is talking about the difference, let's say between those of the younger generation black, Brown, or white, who are taking an active and leading role in the protests against social injustice and those of the older generations who have a history of being involved in previous civil rights movements for example. Then I think there are at least two kinds of differences between the experience of these two generations. Firstly, I think the younger generation is a much more vocal and naturally non-accepting of authoritarianism. Now I'm purposely saying non-accepting of authoritarianism rather than anti-authoritarian because that phrase has inaccurate and negative connotation.

But the young generation has benefited from the work of previous generations and they can more easily envision a more equal and just society. There are very few examples of movements against social injustice catching on around the world so rapidly and in such magnitude. And again, it's the lesson of the pandemic spilling over into the movement for social injustice, that we are all one world. Secondly, the older generation is a generation of both wisdom and wounds, that the younger generation not always be familiar with, but they can benefit greatly from it. The older generation may experience a sense of satisfaction in seeing their earlier labors bearing fruit, but at the same time, sometimes they can also experience despair at how much still needs to change. But overall, I think the availability of so many different channels of communication in this digital world is actually enabling an unprecedented exchange between all the generations and different experiences of social injustice around the world. I think this is ultimately a time of great hope, a time of the coming together of generations and geographies.

Host: I couldn't agree more and it certainly has. And it's been, as you say, quite helpful to see that interaction and people coming together for this black lives matter movement, and all of the race issues that we're seeing today. As we wrap up Dr. Kanwal and what great information you're giving us today, how can people stay informed without feeling burnt out? I mean, the news comes at us through every form of social media. We're getting it all the time. Our kids are telling us what they're seeing. We're seeing things all the time. How can we not feel burned out and yet stay informed? Please wrap it up for us with your best advice about being involved, being engaged, and understanding compassion during the black lives matter movement.

Dr. Kanwal: Thanks Melanie. I think that that's a, also another important question. And I think that what we don't realize enough is that our daily informational diet is just as important for our mental health as our nutritional diet is for our physical health. Now, imagine if someone gave you the same food to eat every couple of hours all day long, I think you would say no pretty quickly, but we somehow let ourselves get sucked into watching the same news, the same videos over and over again, many, many times, even though we're not learning anything new about it after the first or second time. So I think we need to become much more conscious about what we consume in terms of information in this digital repetitive overstimulating, informational culture, besides contributing to burnout. This kind of repetitive exposure to stressful news is also a kind of repetition of the traumatic experiences we're having.

So you wouldn't want to keep scratching at a physical wound and pulling off the scab all day long. Would you? I don't think so. That will not help healing, but it's the same thing with the mind, turn off the TV. Don't allow every news channel to send you notifications on every device, listen to the news one or two times a day, not all day long, don't have your Facebook feed on the screen while you're working. Burnout basically is your brain's way of protesting the injustice and brutality of too much information, too much stress, and too much repetition. So in closing, what I would say is that to avoid burnout, keep in mind that diversity of experiences is good for us.

Host: So important. Thank you so much. And what a great final thought, Dr. Kanwal what a great segment and so needed at this time. You've really given us all hope and encouragement and great advice on how to deal with all of this. So thank you again for joining us. That concludes today's episode of Back to Health. We'd like to thank our listeners and invite our audience to download subscribe, rate, and review Back to Health on Apple Podcasts, Spotify, Google Play Music for more health tips, please go to weillcornell.org and search podcasts. And parents don't forget to check out Kid's Health Cast. I'm Melanie Cole,

Conclusion: If you or a loved one is undergoing cancer treatment, rehabilitation medicine can help with recovery and ease painful side effects. If you'd like to learn more about cancer care, we have a podcast dedicated to oncology. Cancer Cast hosted by Dr. John Leonard, a leading hematology oncologist. All information contained in this podcast is intended for informational and educational purposes. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition. We urge you to always seek the advice of your physician or medical professional with respect to your medical condition or questions. Weill Cornell Medicine makes no warranty guarantee or representation as to the accuracy or sufficiency of the information featured in this podcast. And any reliance on such information is done at your own risk. Participants may have consulting, equity, board membership, or other relationships with pharmaceutical biotech or device companies unrelated to their role in this podcast. No payments have been made by any company to endorse any treatments, devices, or procedures and Weill Cornell Medicine does not endorse, approve, or recommend any product service or entity mentioned in this podcast. Opinions expressed in this podcast are those of the speaker and do not represent the perspectives of Weill Cornell Medicine as an institution.