Why Anxiety Is Not Your Enemy With Dr. Nicole Cain

 

Anxiety will always be a part of the roller coaster of life. However, suppressing it will only lead to frequent panic attacks and a more emotionally unstable you. Joining Tim Westbrook, MS is Dr. Nicole Cain, ND, MA, a licensed naturopathic physician in Arizona and a leading expert in trauma-informed and integrative mental health. Together, they discuss how to turn anxiety into intelligent signals from the body that lead to healing. Dr. Nicole also breaks down the four steps of reprogramming, the nine different types of anxiety, and how to listen to your symptoms. Find out how to treat anxiety not as an enemy but as a messenger you should closely listen to.

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Why Anxiety Is Not Your Enemy With Dr. Nicole Cain

Our guest is Dr. Nicole Cain, ND, MA, a leading expert in trauma-informed and integrative mental health. She is a licensed naturopathic physician here in Arizona, has a background in clinical psychotherapy, is trained in EMDR, and takes a truly multidisciplinary approach to emotional wellness, medical, psychological, and holistic.

Dr. Cain is the author of the acclaimed book Panic Proof, where she reframes anxiety and panic not as something to suppress, but as intelligent signals from the body pointing us toward healing. This conversation goes deep into trauma, the nervous system, gut health, neuroplasticity, spirituality, and what real panic freedom actually looks like. Dr. Cain, welcome to the show. I’m glad to have you here.

I’m happy to be here.

How Dr. Nicole Got Into Anxiety And Trauma Healing

Before we get into the conversation, what originally pulled you into anxiety and trauma healing?

For many of us, we are the wounded healers. I grew up in a very stressful environment. My dad is a Marine. My mom was the daughter of very taciturn Dutch people. For people who do not come from Dutch culture, it is very much like, “Suppress, do not talk about it.” If it does come out, it is usually anger and avoidance.

You push it down and push it down until there is an explosion?

Yes. As a little person, I felt like my job was to help my parents not to feel so stressed, not to feel so angry. I became a master at paying attention to little nuances in their behavior, like, “When dad does this, it means he is getting annoyed,” or “When mom does this, it means she is feeling overwhelmed.”

I would try to jump in and manage that. Of course, learning those patterns and taking that responsibility is a lot for a little person. I myself started to become more anxious and more stressed, but I did not have the language for what that was. I thought that there was something wrong with me. Ultimately, it got to the point where I was having all these physical symptoms.

My parents finally took me to the doctor, and the doctor said, “You have anxiety, here is a pill.” By the time I went to college, I was on six different prescriptions, and I was no healthier. I did not have the language for what was going on. My symptoms were problems to be solved. “Your anxiety is bad. It is a problem. We need it to stop. Your nasal congestion is bad. It is a problem. We need to stop it. Your asthma is bad. It is a problem. We probably need to stop it.”

Ultimately, I decided to try to fix it myself and became a therapist. That was not working. I went to medical school, and it got to the point where, I do not know if anybody here also resonates with that, we end up at this rock bottom place where we have to make the decision of, I continue on this road, which is not working, or I have to do something different.

It was the metaphor of the phoenix burning to ashes and rising again. That started a whole new road, which ultimately resulted in this book where I write about everything I learned by looking at traditional medicine, trauma-informed medicine, and how the mind and body can actually heal and be here with you today.

It sounds like you had to be in control, like you had to pay attention. It is like, “When dad does this, I need to do this. When mom does this, I need to do this.” When did you notice you were doing that?

No one has asked me this question. There is a moment, and we lived in North Carolina. We had to drive all the way to where my dad was stationed in Iowa. My little brother and my mom were in one car, and it had fuzzy seats, and it was nice. I knew my mom better because my dad had been deployed, been away in Japan, so I did not know him very well. He had his old Chevette with the fake leather, an uncomfortable, cold material.

I remember we were sitting at a gas station passing sandwiches through the window. I remember thinking, “I wish I could be in the car with mommy, but I do not want daddy to be sad.” That was the moment when I had this meta-awareness that I was not acting in my own agency, that, in a sense, I was putting myself in the back seat to please and care for somebody else.

Now, were drugs or alcohol ever part of your story?

Not personally, but I did try to help a lot of my friends whose stories involved that. I was so afraid of my dad, and he was very authoritarian. If I were to be caught, the consequences for my dad terrified me. I was like the little cheerleader on the side. A bit by proxy.

Walking on eggshells. I learned in recovery that God is in control. Tim does not have to be in control. Call it God, call it your higher power, call it the universe, call it something bigger than me. When I realized that I do not have to be in control, then life is so much easier.

That is hard. There is still that part of me that, as I hear that, I am very logically aware. My adult Dr. Nicole self is logically aware, yes. There is still this other part of me that is like, “How can I control the not being in control?” Noticing the difficulty in the fear and the chaos of not being in control. I wonder if others feel this way, but when we are younger, we are ultimately not in control. Our caretakers tell us what to eat and when to eat. They help us go to the bathroom.

We come into this world largely out of control for the longest amount of time of any mammal. Puppies. I have a four-month-old puppy, and she is pretty in control. She is a lunatic. Humans, we are out of control for much of our lives. I feel like often we do not want to go back to that. I want to be in control, but it is like this pendulum swing of powerlessness and control and chaos and control. How do we recreate a new identity with acknowledgment, acceptance, allowance, and not having to be in control all the time? That is hard.

It is like in the Four Agreements. We are domesticated. We are domesticated, and we learn how to operate. Becoming reprogrammed is part of the process. Awareness is 90% of transformation. First, you are aware, and then once you are aware, you can actually take steps to change.

I love the language of reprogramming that you are using because we are all programmed. I do not know if anybody has heard of the story of the story of little Albert, the little kid? They did this study on how humans can be programmed. They took this little baby, and they plopped him in front of a bunny rabbit. The bunny rabbit is cute. We love bunnies. Bunnies are fluffy. They bring us eggs. They do not, really.

He’s like, “The bunny is so cute.” He’s happy. They’re like, “Little baby Albert likes the bunny.” They changed this. They do not do this with humans anymore because it is not very nice. What they did next was they plopped Albert down, they showed him the bunny, and then they blasted a loud sound and startled the baby.

They repeated this until they could put the bunny in front of him, and there was no sound, and he was afraid of the bunny. He was programmed to associate the bunny with danger. Here is the most interesting part of the study. They found that the involuntary response, mind, body, and nervous system, was generalized to other fuzzy creatures. Teddy bears, kitty cats. He had learned that if it is cute and fuzzy, it is scary.

I love the language that you are learning about programming. It is looking at our symptoms, whether it is anger or panic, or maybe even dissociation, where we shut down and zone out. Where might that be an adaptation in my life? Where might that have been useful? Where did that programming come from? The conversation then is so much more interesting. It is not, “Do not be anxious,” it is, “What is this anxiousness trying to tell me needs healing, and how do I get to the roots or the origins of that and realize that that bunny is safe, that some rude scientists are hitting a bell in the background?”

Do you think it is important for a person to dig in and figure out the why?

Yes and no. I think that oftentimes the body keeps the score, and we can get amazing results in healing when the brain is not rationalizing it. An example of this is when we do polyvagal work. Has anyone here heard of polyvagal? Polyvagal theory is the idea that our nervous system holds on to stress. As the nervous system releases that stress, our brain likes to attach meaning to it. Is attaching meaning adding value, or is it getting lost in the analysis paralysis?

The body can get amazing results in healing when the brain is not rationalizing it. Share on X

What polyvagal theory teaches is that if we can teach Albert the baby to regulate his body when he is in the presence of the bunny, even without thinking about the person hitting the bell, if he can learn to regulate his body in the presence of the bunny, he can get better. I like to look at the why. We have 400 pages of why here. That is my jam. Also, I want to encourage people that sometimes it is, and sometimes we do not have to understand it. We just have to allow it and reprogram it.

Understanding And Differentiating Fear, Panic, And Anxiety

What is the difference between anxiety and panic, and why does panic feel so sudden?

Let us talk about the definitions because this changes everything. I am going to add a third to this. We have anxiety, panic, and fear. Fear is a natural biological response. Thank goodness you have it. Your ancestors were eating berries in the woods, and the tiger came. If they could not be afraid of that tiger, they would probably become the tiger’s lunch. A natural fear response allowed them to say, “There is a tiger, I need to get to safety.” They survived, and they had descendants, and we are all here today. That is fear, a natural biological response that helps us survive. We can fight, flight, freeze, flop, fawn, and fracture. We can come back to that. That is fear.

Deep Dive Into The Stoplight Strategy

Ken Richardson, the founder of CoDA, talks about fear being on a spectrum. I do not know if you have heard this before. The very lowest level of fear is concern. He says that the only healthy level of fear is concern. You have concern, worry, anxiety, panic, and terror. Something along those lines. I do not know if you have an opinion on that.

You are so good at volleying me into my next statement. It’s like, “Perfect. You’re reading my mind.” That is anxiety. Anxiety is on a spectrum. Think of it as the green light, the yellow light, and then the red light. A green light is when you are calm. I am feeling right now I am calm, I am connected, my body feels relaxed. Some of us do not know what it feels like to be in the green.

 

It has been so long, we are so stressed, we are so irritated, overwhelmed, depressed, and we are in pain. If we can imagine what it is like to be green, that is calm. We then go up the spectrum into yellow. There is this moment before the light changes. The green light is going, you see the hand counting down, and you are like, “The light is going to change.” That is the concern. That is the pay attention zone.

That is the moment that our bodies start saying, “Are we getting a little activated? Are we getting a little stressed? Are we going to get anxious?” That is the pay attention zone. That is the concern. If whatever causes that remains, we will go into yellow. My heart is beating a little harder, my thoughts may be future tripping, and I may be feeling a little bit rushed.

I may get a headache. If that continues to increase, we may go into the red zone. That is panic. Panic is when we have that same fight, flight, freeze response, but it is in the absence of actual danger. You are driving down the road, and you have a panic attack. You are like, “There is no tiger, I am safe, I know how to drive.” This is fear in the absence of actual danger. It can feel like it comes out of nowhere, but oftentimes the body will whisper before it shouts in panic.

I like to teach people to practice that mindful awareness of their thoughts, the mindful awareness of their body, so that they can start to become familiar with, “This is what it is like for me when I am calm.” “This is the pay attention zone. Something is getting goofy here.” If we can start to use our coping skills and start addressing things like “I need to change my environment,” or “maybe I need a friendectomy,” we might need to make some changes before it escalates and we are in crisis mode.

I love it. You say symptoms are like a check engine light. Why is that such a powerful reframe?

It’s because instead of trying to avoid them and suppress them, we get to use them as data. That is exciting. Here is an example, if I can share.

Yes, please.

I was on a Southwest flight. Does anyone here have a fear of flying? I used to have the worst fear of flying. I was on a Southwest flight. We hit some bumpy air, and everyone had been calm. We were coming into the airport. It is bumpy coming into Phoenix. This gentleman sitting next to me freaked out when we hit this pocket of air, and he threw his water bottle across. I was like little Albert with the alarm bell.

I immediately developed this horrible fear of flying, where my body would start to get hot, gesturing at my gut and my chest. It was turning. That is my yellow zone. It would get so bad that I felt like there was electricity shooting through my teeth. I was sure I was going to die, and I am chomping ice chips in the fetal position, clutching my Bible and praying that God does not take me out. It all started with that moment. Through the years and the work that I have done, I’m able to fly all the time because I live partially in Michigan.

I am able to fly now, and I am no longer afraid, but sometimes when we hit that bouncy air, I may get that little pay attention like, “I feel something a little goofy.” Now it can inform me instead of getting fear of fear. Now I could say, “Thank you, symptoms. I hear you. I am listening. You know what? We have got this.” I can start to utilize strategies that work for me to help me continue to reprogram that, to pet the fuzzy bunny, and to remember it is okay, we are safe, in a way that is actually correct. It is the gift of loving and honoring our symptoms.

Is there something that you do that stops you from getting to the red light?

It is all about the right match. A lot of people give me the feedback of, “I had a fear of flying,” and so they told me to do some breathing, or “I was nervous about my kids going back to kindergarten, so they gave me an Xanax.” They are like, “Now I am zonked out,” or “Do not tell me to breathe when I am having a panic attack.” It is a mismatch of symptoms. We want to create solutions that match our experience.

My favorite way of doing that is to identify what type of anxiety we have and what the intensity is. I did a whole bunch of research and looked at what the DSM said. Many of you have probably heard of the DSM. It is the big purple book they use to give a psychological diagnosis. The medical association loves this big purple book, but it is imprecise. If I were to go through each person here today and ask you what it is like when you are stressed, it would be a little different for everybody.

You would all get a pretty similar treatment. They give you an antidepressant, probably not a Benzo, because they are being much more careful about that now. It is kind of like going down the algorithm. If I were to ask somebody and they say, “When I get anxious, I feel pounding in my heart, and I feel like my heart is going to jump out of my chest.” If you go to a conventional doctor, they may give you a beta-blocker like Propranolol. The heart does not beat as hard. If you go to a naturopathic doctor, they may give you theanine, which can be helpful if you have overdosed on caffeine and you feel anxious.

If you go to a trauma-informed clinician, then we can do mind-body work and say, “Let us talk to the heart. Let us see what that heart is trying to tell you.” We start to build your treatment plan. This is a long answer. What I love to have people do concretely is get a little bag, a little purse, or a little fanny pack and make a panic pack. In that panic pack, you are going to put things that will help calm the body, depending on your level of stress.

Maybe you put an ice pack in there. You go to Amazon or whatever online retailer you use, and you can get those hiking freezer things. You shake them up, and they get cold. Put that in there. It is the size of your wallet. Put in there Warheads, those sour candies, because sour stimulates the vagus nerve in your tongue. The vagus nerve is like your light switch for calm. You might put in essential oil if you like the smell of oils, or you might put in earplugs because sometimes we get overstimulated and we need to block it out.

You might put in different rocks or crystals that you like because the grounding of rubbing and feeling something helps. You build your resource kit, and if you have a doctor who gives you medications, and that is part of your plan, you can use those. That is what I would use in emergencies. If you are not feeling anxious right now and you are like, “I do not want to feel anxious in the future,” we could totally talk about how to start reprogramming that.

Before we get into that, can you fight anxiety?

You can, but it will win.

Does it work? It often makes it worse.

What you deny will amplify. What you resist will persist. It is like in Michigan. We have Lake Michigan. It looks like the ocean, and it actually has a riptide. Did you guys know that? I am a desert girl. I had no idea. I look at the water from afar with respect. What I learned from taking swimming lessons is that if you get caught in a riptide and the riptide pulls you out and sends you down the beach, if you fight it, that is when people drown. If you allow the water and you float, it will suck you out and be scary, but you have got this.

It will suck you out, and then it will spit you back on the shore down the beach. That is like anxiety. If you can allow it to inform you, “This feels yucky. My heart is pounding. I feel like I am going to pee my pants. I feel like my head is going to explode. I feel like my throat is closing up.” I notice that I do not like it, but I am going to hold space for it. It will swell. Usually, emotions come in increments of 30 seconds to 90 seconds. Maybe you even count. “I know this is going to pass,” and then it will.

Four Practical Steps To Reprogram Your Brain

This too shall pass. How does one reprogram?

This is my favorite. Four steps for reprogramming. This is fun because we have known this in therapy for years, and neuroscience is catching up. They are proving that this works. It is four steps. Step number one is we want to get back in the body because anytime we get activated or triggered, the logical brain shuts down.

Anytime we get activated or triggered, the logical brain shuts down. Share on X

If I were to pull up a brain scan and project it on the wall, I would show you a picture of the brain, and I would show you how the logical brain, which is the prefrontal cortex that lives behind your forehead. When we get activated, we do not want to analyze the tiger in the woods. We do not want to think about, “What kind of tiger is it? What is it hungry for? What is it doing? Where did it come from? What are his ancestors? Does it have pink toe beans or black toe beans?”

We do not want to worry about the tiger. We want to have a fear response and get away. Biologically, when we get anxious or when we get rageful, or we get panicky, or we get depressed or get activated, our logical brain is not on board. That is why if someone tells you, “Just calm down,” you want to freak out on them because your logical brain cannot do that yet.

The first step is to leverage the body. That is when you pull out your panic pack, and you put the cold around your eyes for 30 seconds. I would count and say, “Dr. Cain said there is going to be 30 to 90 seconds.” Put the cold pack there. You do your panic things. You breathe. I love the exhales. You do the body things. I know I need to breathe. We are breathing. A great way to breathe is to imagine drawing the square. How do you like to do your breath?

I do box breathing a lot. I was thinking about a guy that I started seeing in 2016. His name is Larry. I went to see him because I wanted to learn how to run. I want to do an Ironman. I could not run more than 5 or 6 miles. I went in to see Larry, and he said, “Run from here to there.” I ran, and he is like, “Stop. You are not breathing.” I was like, “What do you mean? I am breathing.”

Does everybody know how to breathe? You think you know how to breathe, right? What I noticed after working with Larry is that most people walk around with very short, shallow breaths, which leads to anxiety. Larry said, “Stop running,” and he made me go and do Pilates. He said, “Go do Pilates.” I went and did Pilates for a month. With Pilates, there are lots of things where you are supposed to connect to the breath. Really, with Pilates, every move is an inhale or an exhale. I learned how to breathe from Larry.

Go Larry.

Now I notice it. I walk around, and most people walk around with very short, shallow breaths.

That is so true. The body is like: “We are in danger. I can make a dangerous response. Got you guys.” My favorite way to breathe is actually when I feel a little bit stressed, I exhale as long and as hard as I can. Push it all out, and then you can take a nice breath in, and you count one Mississippi, two Mississippi, three Mississippi, four, and then you hold the breath at the top for one Mississippi, two Mississippi, three Mississippi, four.

The longest sigh that you can, and then hold it at the exhale for four counts, and then repeat that. That has been studied to be the most effective thing we can do. It is free. Your breath is everywhere with you. There are no contraindications to breathing. It is good. That is step one. Step one, we got ourselves back into our bodies. Now the brain is like: “I can light up logical brain because now we are not in that acute state.”

Now your logical brain is back on. Now we get to practice onboarding it. There is a technique called Havening. Has anyone here heard about this? We will practice it. It works so well. The idea of this step is that we want to create a bridge in the brain from emotion to the logical brain. Otherwise, our emotions are programmed to save us from the tiger. They run away from us. It is hard to be logical when we are emotionally activated, especially in certain activating situations.

 

We can literally reprogram the brain to say, “When I get on this plane, and I feel a little activated, I know how to control that by reprogramming my brain to feel safe on the plane, and now we fly.” When I am on the plane, my coping skill when I notice getting a little feeling a little activated and a little goofy is I will start doing a Sudoku puzzle. It has to be easy because it is hard to wake up the logical brain when it is fighting with the emotional brain.

You could do mental math, or you could say your ABCs, or you could do basic addition, or you could imagine going into Costco or your favorite retailer and picking ten things that you want to buy. Anything that requires thought. That is what you are going to do in step two. Get my thinking back on board. Step three is now we are going to practice connecting the dots between the brain and the body. We got into our brains, we woke up logical, so now we can think critically, and now we are connecting the brain and the body.

The body is giving you all sorts of stuff. Your stomach is churning, your heart is pounding, and you cannot feel your fingers. Now we are going to connect the brain and the body. I feel like psychology for so long has been very here up. We started with Alfred Adler and the talk therapists. Now we are getting to the somatic treatment, where we get to regulate the body. Now we can start to notice, “When I get in that pay attention zone, interestingly, the bottom of my left foot always gets hot. I am going to notice the bottom of my left foot.”

“I notice when I am getting a little activated, and it gets worse, that I cannot hold still. I get restless.” We are practicing awareness of the body, and we could breathe into that awareness or use a Warhead candy into that awareness. Start to pair the brain with the body in whatever way we do. Pilates is a good example of that. That is step three. Now step four. I think this is my favorite one. Step four is where we practice panicking. I did an interview once with a lady. She was an anxiety expert, and she said, “Dr. Cain, I do not ever get anxious.”

I was like, “That is not good. You need to feel fear. Fear is a part of the human experience.” What that means is she is either dissociating or suppressing, or she is living within her window of tolerance. Have you guys talked about the window of tolerance? It is our comfort zone. It is where we feel safe. It is where we can reliably perform. We know the expectations. For many of us, especially if we also struggle with obsessive-compulsive symptoms, OCD, it can be difficult to go out of that window of tolerance.

You need to feel fear. It is part of the human experience. Share on X

What can happen is that our world could get smaller and smaller. Step four is practicing panicking, doing safe things that take you out of your window of tolerance. Pilates is an example of this, too, because in Pilates, your heart starts beating fast, which can be activating for some of us. You go into autonomic arousal, your breathing is faster, your body temperature rises, your heart beats faster, and then you regulate yourself.

You bring it back down, you do the exhale, you cool your body. Another example is if you are a hot-constitutioned person, cold plunges would be awesome. This sounds like hell on earth to me, because I am cold all the time. Pitta people need the cold plunge. When you get into a cold plunge, sitting in an ice bucket, that is inherently activating.

The body goes in, and it is like, “What are you doing?” Instead of fearing the discomfort, you breathe, you hold it, you learn to love it, and then you rescue yourself every time. High ropes courses. We have some of these in the valley. You clip in, it is safe, but holy moly, that is high. I feel the fear, I allow the fear, and then I rescue myself.

If you practice every step, all four steps, and do something every single day, get into the body, practice logical brain, practice interoceptive awareness, noticing what our body is saying to us, and then practicing going outside of our comfort zones, that when panic and fear strike, you will say, “I have done this a thousand times. I know how to panic. I can do this. I am going to be okay.”

Has anybody here done a cold plunge? You guys are awesome. Who here is in the PHP house? Have you guys done the cold plunge there? Not yet? Maybe today. It is cold right now. It is hard. In the summer, it is much easier. I love the cold plunge.

I love that you have that.

We have one at our RTC, and we have one because the cold plunge has been a huge, like one of the things I love, and I never heard that before. I never thought about it that way. That is something that makes you panic, and it is like, “You are going to be okay. Focus on your breath, and you can get in there, and you can do it for 30 seconds.” If I have not done it for a while, sometimes I am like, “I am going to do it for 30 seconds. I am in for 30 seconds. I am going to do 30 seconds longer.” I typically get to around three minutes.

That is a huge victory. I would turn into an icicle. That is why I am here in Arizona half the year. In Michigan, it is like a constant cold plunge.

Why Deep Breathing Sometimes Fails During A Panic Attack

The stoplight strategy and anxiety types. We already talked about green, yellow, and red. Why do tools like deep breathing sometimes fail during a panic attack?

Mismatch. When we are at 10 out of 10, and we are in crisis mode, and someone tells you, “Just do some breathing, it is not enough,” We need more crisis-appropriate resources. If you have time today, get out a piece of paper and write down what your green light is. What does it feel like when you are calm and grounded in your body? What helps you stay calm and grounded? For me, it is absolutely time outside, putting my feet on the ground, petting my dog. Write down what it is like when you are yellow. “I notice that every time I go into Costco, I get in the yellow. It is like overstimulating me. People run me over with their carts.

Walmart is worse.

Touche. Walmart is worse. Breathing would be helpful for that moment. When we go into the red and we go into crisis, we need our own crisis toolkit. For me, in my crisis toolkit, I have a therapy dog, I have Kava Kava tincture that I take, and I have exercises that I figured out that work for me. I would work with your therapist or with your doctor and figure out what might be helpful in each of those moments, so that someone does not tell you, “Just breathe,” and then you feel like nothing works, you feel hopeless because it is a mismatch.

Breaking Down The Nine Different Types Of Anxiety

Different types of anxiety, did we talk about that?

I introduced it, but we did not go through them. I would love to share that.

Let’s talk about the different types of anxiety.

There are nine types of anxiety. Knowing what type you have will help you zero in on treatments that will work better. I had a patient who was flying from California to the Carolinas for work, and she had a fear of flying. Her doctor kept giving her Gabapentin, and then they gave her Ativan, and they were giving her all these prescriptions, but she would get there, and she could not perform. She had to sleep. This is the example I shared earlier. They finally gave her a beta blocker, because she had chest anxiety, and it did not knock her out, and she did not have any anxiety flying because her heart was not bursting out of its chest.

That is the first one, that is chest anxiety. Breathing gets faster, or maybe we hyperventilate, or we feel like we cannot get oxygen, or our heart beats faster, or it skips a beat. It is anxiety here. We have thought about anxiety. This is worrying, catastrophizing, future tripping, or ADHD. Sometimes that is rooted in anxiety. Maybe, like someone asks you a question, have you ever had this happen? I have it at the most inopportune moments, where you are like a brain blank. I cannot think. Words are hard. That is thought anxiety.

We have nervous system anxiety. Anxiety can cause us to get shoulder tension and muscle tension. It can cause us to feel like we are losing finger feeling, or for some people, their face goes numb. You do not need to feel the details of things when we are running from a tiger. We need all that energy to our running muscles in our legs and in our heart. We may get numb. Headaches can be rooted in anxiety. That is nervous system anxiety. Of course, gut anxiety.

 

We could talk for days about the gut. Has anyone here heard about the gut-brain axis? We think we crave things. We think we have opinions about what we want to eat. Nope, those are your gut bugs. The gut bugs are if you have a bunch of Candida or an overgrowth of yeast, it is like, “Get the cookies.” You are like, “I think I have an idea. I want cookies.” The gut bugs are like, “You thought of that.” The gut matters. The gut talks to the vagus nerve. The vagus nerve we were talking about earlier is that light switch in the column.

If our gut is out of balance and we feel maybe indigestion, or we get gassy or bloated, or we get IBS, irritable bowel syndrome, and cramps, it could mean that the anxiety is rooted in our gut. All the therapy in the world is not going to work if we do not work on the gut. We have endocrine anxiety. What is happening with your hormones? Your thyroid, your testosterone, your progesterone, your estrogen, your adrenal hormones.

Sometimes you need a good doctor to do blood work and make sure that everything is healthy and in order, because thyroid issues can look like a panic attack. Sometimes doctors are rushed, and they do not give us the attention that we need. It could be a totally different treatment that helps our anxiety that has nothing to do with talking about it or coping with my four steps. I have to get my thyroid back on track. There is immune system anxiety, which is a big part of the post-COVID world conversation.

Many of us are inflamed, and we have spike proteins, and we have inflammation from the environment, inflammation from toxins, inflammation from mold, and inflammation from car exhaust. Does anyone here have allergies, like runny eyes or a stuffy nose? You have probably heard of antihistamines. Some people feel a little better on antihistamines. That is because histamine can be as stimulating to the nervous system as adrenaline. Your anxiety could be related to your immune system.

We have trauma anxiety, which arguably is using the umbrella of everything as an adaptation of what did or did not happen to you. It is trauma. I parsed this out separately because for some of us, like my fear of flying example, it was one event, and that changed everything. For little Albert, it was that loud horn that changed everything.

The therapy should target that root cause. Oftentimes, everything else will feel better. We have depressive anxiety, which is “I am sad plus anxious,” and then anger anxiety, which is the fight part. The fight, flight, freeze that is often ignored is, “Go to anger management, you’re angry,” but is it that, or is it fear? Is it a loss? Is it insecurity? Is it your histamine? We covered all nine.

That is a lot.

There is a free quiz in the book, and you could get this book from the library. The library is across the street over here. You do not have to buy it. Go get it from the library. There is also a free audiobook. If you do not like reading, you can get that for free at the library.

The Process Of Havening And How It Addresses Anxiety

You talked about Havening, and we talked about possibly doing it here with the group. Do you guys want to try out Havening?

That is so fun for me. Thanks for indulging me. I did not invent Havening. I am benefiting from learning Havening, and I am super excited to share it with you. It used to be called amygdala deamplification, but nobody can remember that, let alone pronounce it. They created the word Safe Haven. How to be your own safe haven. This is based on the idea that when our amygdala does anything, does anyone know what the amygdala is? This is advanced neuroscience.

It is your big feeling. I call her Amy. The amygdala has big feelings. “Amy is having big feelings and feeling anxious and feeling angry and feeling depressed.” That is Amy, the amygdala. Amy, the amygdala gets activated. Remember, the logical brain we were talking about earlier is offline. The body will ignore the logical brain. This treatment that you can do yourself in three minutes will actually help to calm Amy down and wake up the logical brain so that you feel calm and in control. This is two steps, and we will do them together.

The first step is we are going to think of something mild that is kind of yucky. For me, I will give you the example of my dog barking. I live in an apartment, and every time someone walks by, my dog needs to scream about it. I get anxious, and I am like, “My neighbors are going to hate me. They are going to give negative feedback.” My childhood stuff is like the worst thing ever. I am like, “I’m going to get in trouble.”

I get angry and anxious when my dog screams. I am going to pick something small like that. You think of something kind of mildly bothersome for today. Step two, to give you a preview of it, is that we are going to do a touch, and then we are going to do a mental math exercise. I will walk you through it. If you are going to do this at home, you might get your phone out if you have a smartphone as a stopwatch and set it for 30 seconds. Let us do this right now. I want you to notice something yucky, not big. We are going to start with baby steps here.

Something yucky, maybe a circumstance or an event. As you notice it, notice maybe where that yuckiness is in the body. We are going to notice that for about ten more seconds. Just honor it. You do not have to change it. We are noticing it for about three more seconds. Step two is you can look at me because I will show you, we are going to do one of three kinds of touch.

Touch grounds the body. We can dust off our hands if this is cozy. We do this the whole time in step two. If you want to give it a go, you can dust off your shoulders. dust off your shoulders. This is the most researched one is stroking down your face, forehead, down the cheeks, down the chin. Whatever you want to do, you are going to repeat this gesture for part two.

I do not want to mess up my bangs, so I am going to do the hands. While you do this gesture, you are going to repeat this touch gesture, and what you would normally do is you would do this out loud, but you could do it in your head. Since we are all together, I want you to count backwards from 40 to 0 by 2s. You are going to start with 40, 38, 36, 34, 32, 30.

28, 26, 24, 22, 20, 18, 16, 14, 12, 10, 8, 6, 4, 2, 0.

That was so beautiful. We are going to continue to touch, and I would love to have you say your ABCs, please.

Out loud?

Let us do it. You are doing well. You are our spokesperson.

A, B, C, D, E, F, G, H, I, J, K, L, M, N, O, P, Q, R, S, T, U, V, W, X, Y, and Z.

That is so good. Normally, I would do one more, but for the sake of time, we are going to rest our hands in our laps, and we are going to go back to that first yuck that we were noticing for about 30 seconds. We are going to notice anything different from that. Did it change in intensity? Does the sensation feel any different? For about ten more seconds, we are going to notice it. Allow that to be present, talking to us. In about three more seconds, we are going to go back to the second step. Let us go back to whatever gesture you want to do. Tim, I am going to have you, if you can, name your top ten favorite food items.

Hamburger, French fry, ribeye steak, tacos, kebabs, salad, spaghetti squash, commuter sandwich from LGO. I think that was ten.

That is so good. Let us have you spell your first and last name, but backwards.

k-o-o-r-t-s-e-W-m-i-T.

That was so good. Normally, I would probably do one more, but for now, we will rest our hands in our laps. Maybe we will even take a breath in case we have been holding it. We will notice the thing that we were observing before and notice anything different about it. Maybe you might even notice a new thought that comes with that, or a new feeling that comes with that.

Sometimes it changes a little bit, and sometimes it gets even a little positive. Whatever it is, we notice it simply. We are going to finish by going back to the touch, back to the Havening part. I want you, Tim, to identify a mantra or a couple of words that feel like they would be nice, like “I’m okay,” or “It’s good,” or anything that you would want. Tell me if you feel comfy, what comes to mind?

“It’s going to be okay.”

That is wonderful. What we do in the last step when we get there is we repeat that to ourselves or out loud, and we notice how the body feels, and what we see is the more that we say that, “It’s going to be okay, I’m going to be okay, going to be okay, it’s going to be okay.” You may do that for four minutes, but what will happen is the body will start to rest into that. We will come back to the room, and we will come back to this moment. This exercise that we did is number one, the yuck. Number two is waking up the logical brain. Every time we go back to the yuck, it might change a little bit. Did anybody notice a change? What did you notice?.

I noticed it was less tense in my stomach muscles.

You might have had a little bit of gut stress. A little bit in a couple of seconds. A little bit less. Anything that changes is changeable. Did anyone else notice a change?

I noticed that there was like a tingling or a release towards the back of my brain and up through my scalp.

Your nervous system was talking. Your nervous system might be paying attention. You know that moment when we go from green to yellow, paying attention? Your nervous system is one of your guides. That is brilliant. I love that. Did anybody else notice anything? Did anyone notice any more yuck? Did the yuck get more intense for anyone?

The yuck for me got softer. Mine was my dog, who goes crazy whenever somebody comes to the door, and especially if I am on the phone, and it is like, “I want to yell at him.” It got softer, and then toward the end, he was sitting there smiling at me. “That’s my boy.”

That is amazing. You reprogrammed that. The way that you wire is the way that you will fire. If we practice this and we do this, even preventatively, like, “What’s something that was like a little yuck today?” You could do this with little yucks. You could do this with big yucks. If you are going to do it with a big yuck, I definitely recommend having your counselor or your helper, because sometimes big yucks are hard. We need people there until we have built those yuck muscles and we feel equipped to do it on our own. That is why you have this amazing team here, to help you see the yuck.

Answering Questions From The Audience

Was that helpful? Could you guys see yourself using that in the future? Now I want to open it up to questions. Any questions you would like to ask Dr. Cain?

We did it in the moment, but is the end result that when that yuck comes up, because mine was the exact same as yours. My dog goes crazy when someone comes over. Is the end result that when that happens again, you’re not as stressed as you originally felt it? Is that the intention?

You get to decide how you want to feel. That is the amazing part about it. When I fly, because it is a great recent example of the victory, I want to feel excited about where I’m going. I do not want to worry about flying. In my adult agency, I have chosen to buy that ticket and get on that plane, and I want to feel at least neutral about it.

What I love about that last mantra you selected is that it is the bullseye that you are creating. Sometimes we are lucky if we feel peace. Other times, you might want to celebrate and dance with your dog when they act like lunatics, or you are like, “They need to go to training, and I’m not going to be stressed. I’m going to do something.” That is so good.

Thank you.

What other questions? I love questions.

I am from Michigan, too, so I relate to that portion. I have a question for you. I suffer from PTSD and flashbacks. I relate to what you are going through. What you were talking about, I grew up in a very similar environment, but instead of watching the emotions, I do not embrace them. I live at the my window of tolerance, I am more of a hyper-arousal. I find that I can use it in high motivation settings, like for work, high goal setting, and stuff like that. Are there any examples that you have used of your hyper-arousal in those scenarios instead of trying to give a calm presence, which I feel like you’re doing right now?

Hyper-arousal. The body is producing a bunch of energy, and you are describing that you are able to use that energy to help you be productive, and so that is good. The energy you alchemize it. I want to make sure that I give you the most helpful answer. I’m going to clarify the question. Are you asking about what we do with that hyper-arousal? Are you expressing like when it is coming out at inopportune moments?

It sounds like you have hit that in different portions of your life. Have there been times when you used that as motivation to go through school or to speak?

Yes. Our symptoms are trying to help us. Arousal is important. It is a matter of whether it is for me, or am I the one who is directing it, or is it backseat driving and trying to control me? There is a double-edged sword to it, which I think you are wisely pointing out, is I used that hyper-arousal, that hyper-vigilance, to get through medical school. I burned out. It is such a common thing. High performers, I have worked with high performers. I have worked with Brendan Burchard. I have worked with Tamron Hall.

I have worked with a lot of high performers. What you are wisely asking is a very common thing. I would encourage the coin flip. The yin and the yang, the shadow and the light. There are moments for the hyper-arousal to help fuel your goals, but then we have to flip the coin and allow the body to go into parasympathetic. That’s the sine wave. I go into arousal, but then I come out. I get into the cold plunge. I get arousal, but then you get out of the cold plunge. Does that kind of fit?

What you’re speaking about references a lot like what Kristin Neff talks about. I think she did that out of compassion for herself. It is what I am working on right now, but what you are explaining about that is all I know. I did what is in that workbook and stuff like that. I appreciate it. Thank you very much.

Thank you. I love her work, and I love the honoring of these assets that you have, that fire in your belly, I call it. That has helped you do a lot, and it is motivating you and honoring the ability to be like the waves of the sea, and allow that to swell and then allow that to go out. The two sides of the coin. Michigander, too.

What part of Michigan are you from?

Grand Rapids. What about you?

I am from Flint. Thank you.

Why You Should Advocate For Your Health

There has been a show that was filmed in Flint. We are coming to the end. Is there anything that you wanted to talk about that we did not talk about?

Let us recap what we talked about. We talked about the nine types of anxiety. We talked about how to strategize for healing our anxiety. We talked about the tiger and the fluffy bunny. We talked about making a panic pack. We talked about how your symptoms are here to help you. Something that might be poignant for us, too, is medical advocacy and making sure that we are feeling seen and heard by our medical team.

I was at a conference, I was speaking at the Integrative Medicine for Mental Health Conference, and one of the biggest things that came up was that healthcare is so siloed. If you have headaches, you go to a neurologist. If you have digestive pain, you go to a gastroenterologist. If you have anxiety or anger, you go to a psychiatrist. Oftentimes, these doctors are not able to collaborate or communicate.

Start advocating for yourself medically. Share on X

I want to encourage you to start becoming more of an empowered advocate of your own health. What that could look like concretely is to make a binder. When you go to your psychiatrist, ask them to print out your treatment sheet. When you go to your neurologist, your pain management specialist, or your therapist, ask them to make you a treatment sheet.

Make sure that when you go to your visits, other doctors are seeing other doctors’ treatment sheets. I cannot tell you how many times I have had a patient see their PCP, and they get Zoloft. They go to their gastro, and their gastro gives them Lexapro. Now they have serotonin syndrome, and the psychiatrist does not know that it is serotonin syndrome, so they give them Xanax. Now you have polypharmacy happening.

You are not broken. The system is broken, and unfortunately, that means you have to be advocates for your own health. A concrete solution for that is to have your medical records. You have a right to your medical records, and to make sure that you go to the front desk, “I saw a psychiatrist. Can you scan this into my chart? I need a printout of today’s summary.” Start advocating for yourself medically, because our symptoms are not from here up or here down. It is a whole thing.

Get In Touch With Dr. Nicole

There is a lot to it. How can people connect with you? How can they learn more about your work? Anything you want to promote?

Get the book from the library. It is so great. If you have nothing better to spend your money on, you can buy it online. Words of encouragement are awesome, so leave a good review. I am on Instagram, so if you guys like to go down the rabbit hole that is social media, I post positive goodies. It is Dr. Nicole Cain. Come hang with me.

Dr. Cain, thank you so much. I appreciate you, and I am grateful that you were able to spend some time with me.

It was fun. Thanks for hanging. Let us give it up for Dr. Cain.

 

Important Links

• Dr. Nicole Cain
• Dr. Nicole Cain on Instagram
• Dr. Nicole Cain on Facebook
• Panic Proof
• Four Agreements

 

About Dr. Nicole Cain

Nicole Cain, ND, MA, author of acclaimed book Panic Proof, is a leading expert in trauma-informed, and integrative approaches for mental and emotional wellness. With a degree in clinical psychotherapy, training in EMDR, and a license as a Naturopathic Physician in the state of Arizona, her approach to mental health is multidisciplinary: medical, psychological, and holistic.