Ep #234: The Anatomy of Anxiety with Ellen Vora, MD

This is Feminist Wellness, and I’m your host, Nurse Practitioner, Functional Medicine expert and life coach, Victoria Albina. I’ll show you how to get unstuck, drop the anxiety, perfectionism, and codependency so you can live from your beautiful heart. Welcome, my love; let’s get started.

Victoria Albina: Hello, hello my love. I hope you're doing so well. I cannot stop giggling because I am in the presence of the outstanding and amazing Dr. Ellen Vora. Hi, Ellen.

Dr. Ellen Vora: I talk now? First time using a computer, and I was expecting dinner and candles. Okay. Yeah, this is like amateur hour here. Okay, so like a pro, here we go. Hi, I'm Dr. Ellen Vora. I'm a holistic psychiatrist, which is not exactly a household term, but your listeners are not exactly at the household level with these things.

When I approach mental health, I think about the full portrait of my patients lives. How are they sleeping? How are they eating? Are they incredibly inflamed? Do they have community or ritual or pleasure or a sense of meaning and purpose in their lives?

It feels like a little bit of a no-brainer when it comes to mental health. These are all actually evidence-based determinants around mental health. But here we are, and we need a special word to qualify psychiatrists to say that we care about all these other dimensions of our wellbeing.

Victoria: I wish we didn't need a special word for it. I'm glad that you are the holder of that special word because you’re a most special animal, and I'm really glad to be here with you.

Yeah, one thing we were talking about before we hit record, is how we are both very sciency, evidence-based nerdettes. We like to nerd pretty hard. I'd say mild to moderate nerding. Sometimes moderate to severe, in the nerding. And we're both witchy women.

Ellen: Yeah, it's a really fun bridge to be standing on.

Victoria: It really is, isn't it? Science on the left, witchy on the right.

Ellen: It's a yin-yang, and it's been a delightful ride for me too for so long to perform the nerdiness, to get admission into the boys’ clubs, and to be considered rational and reasonable and objective. Then, it's been a delightful journey to reclaim witchiness in full force, and to realize there's a time in place for the nerding out but I don't need to be silencing the witchiness. That is an equal part of my dynamic equilibrium of what makes me, me.

Victoria: I think, what makes you a really efficient clinician, right? That makes you a really beautiful caregiver to folks.

Ellen: Really useful to have both compasses.

Victoria: Yeah. Would that be compi? Compassies? We started talking about this because neither one of us slept well last night. We're recording this on Tuesday, August 1st, full moon, Venus is retrograde in Leo. Those are the big things, right?

Ellen: Yeah. We're both feeling it really deeply. I'm here for that. But it's interesting, I think that this might go down in history as my most unhinged podcast episode; no asleep, I'm in grief, and I am just here for the truth. Or without any of the regular executive function layers that make me filter that through, here's how I think people are ready to hear it.

Victoria: To which I'll say both, Amen and hallelujah. Because if you're going to just let it all fly, I think Feminist Wellness is a good space for that.

Ellen: Yeah, gratitude to that.

Victoria: Do you remember, like over a decade ago, when in between patients, we were both working at a primary care office? We'll just leave it right there. In New York City, and between patients, we would gather in your office or mine and shake it off.

Ellen: Yeah. Or sometimes take a walk in the nearby park.

Victoria: Yeah, get a little nature.

Ellen: I mean, there's a download in that for everyone listening. Which is that when this river of life sends you in a bend of the river, one of your people, just to have appreciation for that. And also realize that we're worthy of the incredible special souls that come our way and just allow yourself to receive.

Victoria: But it can feel so challenging sometimes to really allow it in, right?

Ellen: It stirs up all of our attachment funkiness. But in a way, this life is short and we risk missing out. There is no future point when, then I am worthy of the friendships. Then I will receive the relationships. It's right now. And those people in your life, if you're listening, ‘who I really feel my best around that person, I really admire that person. They get me. We laugh in a special kind of way.’

Just drink it up and know that it is for you. You don't have to be anything other than who you exactly are right now to be worthy of that.

Victoria: It's a match. You don't have to perform your livability. You talked about performing your smartness and your rationality. I get that, from the practice of Western medicine. I see so many of us attempting to perform being lovable, being worthy, being good enough, right? It becomes this mask we wear, this façade, between us and really experiencing life.

Ellen: I am someone who… overarching umbrella view right now… is this saying, “Trust in Allah, but tie your camel.” I know it's like, trust this, surrender to this. There's love and guidance in there for you. And take responsibility for your part and tie the camel while it’s around.

I think that, in terms of performing lovability, I feel like I've always gotten that tension wrong. Which was, perform the lovability but don't necessarily do the work on being a better friend. I'm really trying to see that differently right now. There doesn't need to be any performance of lovability, and forever tie your camel.

Forever do the work of how can you strike the right balance of being prosocial, attuned, other oriented, and showing up and doing the right thing, being in integrity, right relationship to everybody in your life, everything in your life. And yet also, I think, especially for anyone socialized in this journey, with all the conditioning we get, I think that it's also so important to constantly be balancing that with, where do we suppress our own needs in service of others?

Because that was the message we got. This is what protects your attachment to caregivers. I think that’s a double balance that is central to how do we receive those people on our path?

Victoria: Right. Which brings to mind intentionality, for me. Just being very intentional with your reaching out, with your bids for connection, and with a gentle, graceful self-love asking, why? I will say, are you in people pleasing, people approving? Are you chasing people? Are you chasing people so that will validate you? So that you can tell a story about the connection?

Or are you actually looking to connect? Where are you staying in things that may not actually be filling you up and filling your cup? That may not be interdependent, right? That may not have mutuality and reciprocity at the base of them? Again, towards some sort of story that just feeds your ego and not your actual experience of life.

Ellen: Something else I've noticed myself do, and I don't know how many people within this will resonate, but I will sometimes stay in the relationship that's safe and comfortable, though not feeling my pep, not bringing out the best in me. But I stay very shy around the relationship that's the one that actually lights me up. I don't invest in that because the stakes feel higher. You feel more vulnerable there. And so, we stay shy, we miss out.

Victoria: Yeah, I'm going to guess that that's a really common experience. Probably one many of us haven't stepped into inquiry around. But it's an interesting one, right? Where are we giving a quarter of ourselves versus actually showing up in our wholeness? I get that.

Like, “Oh, I think she's so cool. She's so amazing. And she could probably never be my friend. I'm probably not good enough, so I'll just show up in this little portion of me. In this tiny little part of me that maybe she likes. If I show her my whole self and she rejects it, that's like this mortal blow to my ego, to my sense of self.” Which may be tenuous at best, to start with, right?

Ellen: There is, of course, an Ani DiFranco lyric to back this concept. Where she says, “I like you so much, I talk to everyone but you.”

Victoria: You know what? Ooh. Oh, Ani. Side note, I must say, one of my favorite memories of you and your husband is being at a holiday party at the primary care office where we worked.

Ellen: I'm right there with you.

Victoria: You’re right there. This is, again, a decade ago. Our Indigo Girls sing-along at the actual top of our volume…

Ellen: Top of our lungs?

Victoria: Lungs, thank you.

Ellen: Good to sing from the top of your lungs. Just a shallow little tight breath.

Victoria: My god, that was so amazing to sing “Closer to Fine” that loud with you and Zamal.

Ellen: Yeah. I have a real cosmic buddy in that way.

Victoria: Yeah, you do. He's pretty special.

Ellen: He’s pretty special.

Victoria: Yeah. It's interesting to think about, healing is both available in partnership, and for so many of us, the healing we get to do, in order to be ready to receive our cosmic buddy, our true loving partner, right?

Ellen: That's right. I think for me, I had a lot of re-parenting that happened in an earlier relationship. Whether I was re-parented by the partner or re-parenting myself in that safe container, with a little bit of column A and a little bit of column B, I think that readied me to receive.

But then also, realizing where I was unsatisfied in an earlier partnership helped me not exit when I found myself unsatisfied in the current partnership. It helped me see that that's my pattern. It had nothing to do with the other person's failings.

Victoria: Oh, projection’s a bitch, ain’t it?

Ellen: That should be the bumper sticker.

Victoria: So, I'm actually having them printed as we speak. But it is. If you're listening, and you're wanting a relationship that feels loving and healing and whole and good, one of these first steps is awareness of your own patterns, right?

The things that trigger you, the things that activate you… When I say triggered, I always mean in the clinical sense, right? Like, what's actually freaking out your nervous system. Not, did they get your salad wrong at Sweetgreen’s?

Ellen: You're saying those are mutually exclusive?

Victoria: I'm saying that being #triggered because you're annoyed is not actually what we're talking about. This is different between discomfort and triggered, right? That's a whole other show, though. Let's have that conversation, because that's a good one.

Ellen: The way that fast-cash and the errors that happen, is emblematic of how we've gotten to a really dark place with late-stage capitalism and how people's souls are rebelling. It inconveniences hungry people, and how that's its own indication of how we're so troubled these days. So, I think that there is actually some depth to the #triggered, and that we can get into it, sweet cream.

Victoria: I think that's really interesting. Will you say more about that?

Ellen: About what?

Victoria: Okay, I didn't know, if you're thinking of the concept of tools of the week, and being, we can problematize that term, but being late to the factory job when it's the only way you can show your displeasure. Are you saying, putting chickpeas instead of apples is a moment of that?

Ellen: I guess I always have more to say.

Victoria: You always have more to say, come on now.

Ellen: I don't mean to romanticize a vision of a different economy, a different culture, but let's say you're in a completely different world, where everyone's work is something that they take pride in. And something that exists in an energy exchange that's reasonable, tenable, and balanced for them.

And so, it's, “I'm a fisherman. I keep this shop, it’s my baby. I pour love and effort into this. I want to make a meaningful contribution. I want to enrich the world. And this industriousness that I do, keeps me intact.”

That is a tenable energy exchange between what we put into work and what we get back from work. I think that we're in a moment right now, where everything has gotten so, so, so many layers of abstract, it's intangible. It's not our own baby. It's very much someone else's baby. They're not even necessarily in their own alignment.

I've been thinking a lot about the concept of “freedom takers” and “freedom givers.” That some people are at the top of the food chain, and they've gotten there mainly because they're very cunning about how to take freedom from givers. Whereas other people realize that they are in a role where their blood, sweat and tears is providing somebody else freedom, not merely subsisting you.

I think that the problems that happen at Sweetgreen, are actually emblematic of how someone is working that job. And it's such an untenable and unsustainable situation that there's no pride in it. But there's a very healthy soul rebellion against doing that job with pride, sometimes.

I actually tend to think, grand scheme, like Sweetgreen kind of works, and it's kind of a good thing. But I think that that's where we're at so often. And it is triggering; it's everyone involved.

Victoria: As always, an excellent point.

Ellen: This is our food. We imbibe it, we incorporate it into our cells, and it is made with love versus made with somebody who's in a feeling of desperation, and energetically charges the food.

Victoria: Yeah, it’s an excellent point. This neo feudal state we're in, this neo feudal economy, is interesting to begin to think about it on that level of… I think a lot about food production and the farms from which I get my food. Which is an incredible privilege I have. I live in the Hudson Valley, it's a beautiful place, right? I bought a quarter cow. You know if I'm going to eat meat, as an Argentine, I'm grass fed organic. Meow, meow, meow.

Meow, meow, meow, Ellen. Come on, now.

Ellen: It's the Maria Victoria Albina equivalent of yada, yada, yada.

Victoria: With a touch of, nobody slept last night. But yeah, it is interesting to get down to the level of the human interaction with the food, which makes sense. I was reading something yesterday.

Okay, no, I was about to give a disclaimer of, don't laugh at me, but the frequency of fabric. Of course, you’ve thought about this, but I had not. And like, cotton and wool and linen have a frequency that is most resonant with the human body. Which makes logic, right?

Ellen: Meanwhile, I was the sort of champion of the athleisure movement. I wanted to feel like I looked appropriate for work, but I know secretly, I'm wearing pajamas. These easy, moisture wicking, quick drying, flattering, falling fabrics are plastic and PFOS and forever chemicals and endocrine disruptors. And we're absorbing it through our skin.

It's such an underappreciated dimension of health. We focus a fair amount on what we put in our mouths, but anything on our skin we're absorbing to some extent, whether that's makeup or sunscreen or perfume or leggings. So, yeah, I'm starting the slow and financially sustainable approach to transitioning what fabrics touch the skin in my household. From all of these plastics to something that came from animals and earthier.

Victoria: Yeah. You and I have been talking about the nervous system and polyvagal and autonomic… we've been talking this talk for over a decade together, well over a decade, with our little nervous system shake it out recess. I'm really glad that it's gaining some popularity and that it's #trending. People are talking about it, right?

One of the areas that I'm not seeing in conversation is toxicity trauma, right? The trauma, and the impact to the autonomic nervous system of having a chemical onslaught from the world. It is sympathetically activating.

Ellen: This is such a tricky both/and. Because here's the thing. We understand, somewhat, in these circles, increasingly, the role of trauma and how that's locking limbic systems into a state of hyper arousal. The foot is stuck on the gas pedal. I think that there's only one direction you want to go from there. You want to heal that. You want to work on the level of the body. You just want to metabolize that trauma and move forward.

When it comes to toxicants that we're exposed to, it's a delicate dance all the way forward, as well. Because we are a little bit stuck between a rock and a hard place. Considering that we don't live in the shadow of an active volcano, in a healthy agrarian community where the soil is good, and where the food is in integrity.

Here, in this soil, what we have to do to decrease exposures to toxicants, is live in a pretty high maintenance way. It's come to my attention, that in an effort to consume high vibration food, we can find ourselves in a lot of low vibration pitfalls around that; sharing food and feeling like the body is fragile.

You can be obsessive. Letting meal prep become a part time job. Declining social invitations to break bread with friends.

Victoria: We’re too poor to tolerate bread.

Ellen: I think that this is the task at hand. It’s this delicate balance where we feed ourselves nourishing, high vibration food, with transparency, with integrity, with love in its cells, but we do it with maintaining an attitude of ease, a focus on pleasure, and it has to be affordable and convenient. It's a tall order.

And so, it's a journey out of toxic trauma. But I do think it's really hard on our nervous systems. That's the whole first half of my book, false anxiety. That is not our core essence, the way we're anxious so much of the time, it is unnecessary suffering related to these seemingly innocuous aspects of modern life that tip our physiology out of balance and generate a stress response.

We're anxious, but it's actually that our blood sugar's crashing, we’re sleep deprived, hungover, over caffeinated, and there's inflammatory molecules coursing through our veins.

Victoria: Well said, as always. First, I'll say again, Amen and hallelujah. What I hear you pointing to is intentionality once more. Presence, mindfulness, intentionality. Why are you skipping that meal out with the girls? Which again, because my bend, where's the codependency there, right?

Where's the people pleasing and perfectionism that tells you, if the girls are like, “Ooh, who's getting a drink?” that it would be problematic for you to say, “Oh, no, I'm just having water.” Right? Where will that people pleasing tick? Where you'll eat the pizza and you'll drink the booze and you'll stay out way too late, and you'll skip the things that truly serve what feels like your wellness.

Ellen: I'm going to follow up a couple half-baked thoughts, and we'll just see where this goes.

Victoria: I love your half-baked thoughts, they’re my favorite.

Ellen: One relates to, in childhood, if you have a pretty socially wired brain, you figure out quickly what behaviors protect your attachments, your primary caregivers. In amazingly rare and perfect circumstances, those behaviors are also your true and authentic self. So much of the time it's a suppression of your needs. It's a shift into inauthenticity. It's a ‘you were left-handed, and now you need to be right-handed.’

I think that what I've learned about myself, is that I was probably just enough on the spectrum that I wasn't wired to figure out what behaviors would protect attachment so I didn't do it. That came as a negative consequence. But it also gave me a lifetime of muscle memory of being like, “I'll have the water.”

Of course, there's a record scratch. Because all of the socially wired people in the room are like, “What? But we're bonding over wine. We’re wine homies, this is what we do.” But I also think that I really root for other people to find their dose of where can you record scratch the room in a self-loving reclamation of, “Well, this is my need. There's nothing inherently wrong with this, I'm not hurting anybody, and I'm going to drink water.

Victoria: So, what advice would you give folks?

Ellen: I think on the one hand, you have to find your people, so that you're not always alienated. You need to find the other people that are like, “Let's go out for water.”

Victoria: I feel like most of our dates, hanging out, this decade, have been walks.

Ellen: It's effectively an elaborate way of going out for water. So, you find your people so that you're not always in a state of alienation. But in those moments when you are out of sync, and you want to care for yourself but also go along with the people that you have legacy friendships with, even if they're bonding over wine, to just get comfortable with it. Most of the time, that fear around saying ‘I want water’ when everyone's getting a drink, the anticipation is the worst phase of that.

And then, when it's an awkward conversation with a waiter or when it's an awkward conversation with someone at the table, it turns out that you witnessing yourself, if without shame and without a lot of drama, are just being like, “This is what I'm doing right now. I choose this. It helps me feel good.” You get a real dose of self-efficacy from witnessing yourself having that exchange. I encourage people just start tiptoeing toward that; baby kitty, kitten…

Victoria: Yeah, kitten steps!

Ellen: Just try those conversations. Then you test, how do you feel before, during, and after? I think that even navigating the choices themselves gets tricky. Because then we could get very all or nothing and tied to an identity of ‘I’m a nondrinker. I'm a this or I'm a that.’

I learned this from a friend of mine. Her name is Kimberly Ann Johnson. She's written a few books. Call of the Wild, I believe, is her most recent book. She was about to go on a Wim Hof breathwork cold plunge trip, and she said to herself, “Why am I doing this? Why on earth are you doing that?” And her answer was, “Because I love myself.”

To me, that's the frame. So, why am I having the water? Because I love myself. Why am I choosing the wine tonight? Because I love myself. Why am I having the gelato? Because I love myself. Why am I not having the gelato? Because I love myself. There is no hard and fast rule of, ‘it's always the answer; is the water and the no gelato.’ The hard and fast rule is, what is the choice of radical self-love in that moment? And it will vary moment to moment.

Victoria: Absolutely. You’re right, the way to get there is kitten stepping. I talk a lot about soft bridges. We don't b.s. ourselves in this family. We learn what's true and what's authentic for us, and we set goals and move gently towards them. Because the nervous system has a bullshitometer, and when it smells garbage and lies, which is often what happens with a CDP kind of framework, right?

Like, “I'm amazing. I’m so incredible, and I love myself.” Your body's just like, “You know what? Va fan cul with that. I'm done with you. You thought you were depressed before. You thought you had a little false anxiety before. You want a little true anxiety? You want a little bit? There you go.”

Ellen: “Live out of integrity with your words, there you go. Now there’s true anxiety.” So, the framing I use for this is always the Marshall B. Rosenberg ‘true yes, true no.’ I've learned to take that sacred pause. If I'm faced with, should I meet up with this person for coffee? Should I take on this work assignment? I check in with my body. Does my body feel expansive and warm? My true full yes, in my body.

Versus, do I feel a sense of contraction, coldness, tightness, and overwhelm? That’s usually my true no. Every once in a while, you're at a phase of life, you're in a situation where you do have to hand out your false yes. We try not to, and I feel like the most of the work is in just catching ourselves when we're about to give a false yes. Realizing that story never ends well.

We can answer something and we flake at the last minute. We go through with it and we've compromised other priorities. Or we just go through it and we resent the other person. If you think about it from the other side, you wouldn't want somebody to say yes to you if it meant they were going to resent you.

In workplaces and different phases of our career there are times when you have to give a false yes. I think it's so important in that moment to have a wink to yourself.

And so, you're not in that betrayal of the fact that your body said, “Pretty sure we said no. How come you just said yes? But it's a wink, I hear you and I agree, this is a no. Here we are. And because I love myself in this moment, we're going to hear a yes. But noted, that this is out of alignment. And we're going to circle back on this later.”

Victoria: I love that, the wink to yourself, the little wink and a nod. That idea of being your own ally, your own advocate, your own coconspirator in life. And learning to have your own back. Slowly, slowly learning to have your own back.

Ellen: One time a patient said, “This feels like I'm in couples therapy with my body.” I love that. I think that it is interesting, the stories in the world that got us into a bad marriage with our own internal physical experience. Whether it feels like… I mean, in her case, it was, why is her digestion so bad? Why can she not lose weight? Why can I not stop binging?

I think that when we see it as like, “What's wrong with this partner? They're the reason for my troubles,” and externalize the blame to that, when in fact, it's, how do I more properly communicate with this partner? How can I [crosstalk] them? How can I understand their perspective and attune, and actually really celebrate and root for them?

Victoria: And take their concerns seriously. So, when the body says, “Belly ache,” “Okay, my love, I hear you with the belly ache and the heartburn and the joint pain, et cetera.”

The migrating motor complex has got a lot of opinions, having spent many years treating a lot of SIBO (Small intestinal bacterial overgrowth). It’s got a lot of opinions. And they're mostly, “If you're stressed and you're angry at me, I'm going to send you into sympathetic. I'm going to stop digesting.”

Ellen: The small intestine is so at that interface between nervous system, whether it's directly through trauma or through toxic and trauma, I think both are doing similar paralysis to our digestive tracts.

Victoria: Once again, self-love is the answer.

Ellen: Then I think you can pan out and see that as not purely self-love of this individual walking this earth, and everyone is free to have such a different variation on this worldview or a completely different worldview, but something along the lines of, ‘what if it isn’t to be in this meat sack and to be this experience of consciousness and this identity, and is it actually such the self the way we perceive it to be?

Victoria: I knew you were going nonduality, because have a non-duality look to your face.

Ellen: I've been treating anxiety for long enough now that I needed a salve for that truest of true anxieties. Which is the inherent fragility of walking this earth in a human body. The fact that we will one day die. The fact that we lose the people that we love. The fact that there is suffering, and what do we do with that?

And for me, when I'm faced with those moments, the salve has been to arrive at a stance where I believe that there is something vastly beyond our comprehension occurring here. That makes it comfortable for me to trust it, to surrender to it, and to learn from it. It's not the spiritual bypass of ‘everything happens for a reason.’

It's the resilient and enriching experience of, ‘well, this S just happened,’ and how do I make meaning of that? How do I move through that? How do I learn from that? And for me, I've kind of come out of the closet and just talk very gaudy about this stuff now, at this point.

But it's like, what, in my reaction to this, is not God? Where am I still in fear, and not in this dual assignment? Which I think on the one hand, is work. I think we're here perhaps shifting the fear, in this galaxy, to love. It's part of the work we're here to do.

It's almost like the galaxy has this body, and where it still has cancer, where it's still out of balance, is where we're still in fear. If we can chip away at that and shift that towards love, it's treating the SIBO of the galaxy. I think that that's one part of the assignment.

But the other part of the assignment, is maybe to be divine and to slow down into density just enough to have a physical experience; to taste food, to experience the sacred sexual pleasure, to dance, to enjoy music, and just to bask in this nature masterpiece. I think that that is another equal part of the assignment.

I find that being curious and seeking around these themes of what is actually happening here, and is this something that I can lean into and accept and trust and surrender to, helps quite a lot when there's loss and when there's the big existential fear; loss is not quite so absolute in that framing.

Victoria: Right. In nonduality there isn't a loss. That's impossible.

Ellen: I wish I could say I'm there. I'm not there, yet. That's where my Indigo Girls partner is way ahead of me.

Victoria: Say more about Zamal please.

Ellen: She's steeped in the nonduality right now.

Victoria: Oh, yeah. Yeah, yeah. What does that look like?

Ellen: Just if your blood sugar crashes.

Victoria: [Inaudible].

Ellen: Then he is, too.

Victoria: Oh, I thing that's a whole other podcast.

Ellen: It's like, I've been treating his false anxieties all this time. But it turns out meditation was the thing.

Victoria: It's really shocking how often the answer is a snack and some meditation. Like, a five-minute sit in the Target parking lot, in your car. Eat a snack, close your eyes, get still. Be with self, which is to be with the universe. I think New York City agrees. I don't know if folks listening to the podcast could hear the siren, but New York City was like, “Amen. We got you. We’re with you.”

Ellen: In the police siren way, it knows how to communicate, right?

Victoria: It's the only way. New York's got a lot of ways to communicate. Let's be clear. Let's be very clear. If your N or your R has ever turned into a queue in the middle of the night, like trying to get home after a show, you're like, “Why? Why? Why am I where I am?” Oh, New York.

Ellen: I appreciate this about it.

Victoria: Yeah, I miss a lot about it. But my nervous system is so much more chill up here in the country.

Ellen: Yeah, I feel that instantly when I get out of the city.

Victoria: That's pretty wild, how it impacts legit everything.

Ellen: Then, we acclimate in a way that's almost more unsettling. Because when you've acclimated to New York, I don't think it means that your nervous system has downshifted. It’s the sense fatigue, you don't smell it anymore.

Victoria: Well, it's like functional freeze, you're just inured to it instead of actually being in any kind of real piece. I think we have like 400 podcasts that we should do, based on the things we've touched on in this time together. Maybe we should have our own podcast.

Ellen: That would be interesting.

Victoria: That would be really fun. I will work on that, because we don't have anything else going, right?

Ellen: The global ascension...

Victoria: Right. That's cool. I want to make sure that we talk about your incredible book. If you have not read The Anatomy of Anxiety, I've talked about it on the show before, it's amazing. It's incredible. Ellen, it’s so friggin’ good.

Ellen: Thank you. I really appreciate your support of it. It's fun to write a book. It's quite a birthing experience. It took me a lot of Beyoncé videos to really get through the artistic process. I needed that level of inspiration. The way she channels Source energy, I think she's in constant communication with Source.

I think she's complicated. There's a lot of different competing themes coming through these days. I think she's a light worker, and that she knows how to channel Source energy and make art on this earth plane.

And so, I had to watch a lot of Beyoncé videos to get myself back in my chair, typing on the laptop, to actually tie that camel. Because that was a lot of work. But it's such a beautiful birthing process, because humans inherently want to enrich life, we want to make a contribution.

I feel like this is such an important message for us all to receive, is that we just all have some unique combination of perspective, and the things that light us up, and the things that come a little more naturally to us and to other people. My moon is in Gemini, and I'm here to communicate it and to be a bridge between the nerdiness and the witchiness, and to somehow be able to translate that.

Yeah, it's my life's work in 250 pages, and I feel good about it. Also, there's so many things I now disagree, with myself, three years later. So, that's why people write second books.

Victoria: Yep. You can always do a reprint, a new edition. But I think this is a beautiful baby, and I think you've done a brilliant job really elucidating this thing that folks aren't talking about, this difference between false and true anxiety. And I want to make sure that folks hear about that. Because we talked about false anxiety without really defining it. It’s really life changing.

Ellen: So, here's the central thesis of the book. False anxiety, which I realize now, a year and a half into a book tour, is an incredibly hashtag triggering term. And so, importantly, it's not to invalidate the very real experience of this type of anxiety. This is life altering suffering. The pain as real.

But false anxiety is avoidable anxiety. It doesn't need to be happening. It doesn't serve some greater purpose. It's based in the physical body, and it occurs when something has tipped our nervous system out of balance. It's usually some seemingly innocuous aspect of modern life. You're in a blood sugar crash, you had an extra cold brew coffee, you're hungover, you're sleep deprived, you were up doing scrolling till 1am, it was the full moon; you’re feeling that; which I wouldn't say is totally false.

And then inflammation is a really big common factor there, as well. I think we would do well to address it at the level of the physical body. Identify that root cause of false anxiety, address it, eliminate and avoid unnecessary suffering. That's just a whole fun project to do with patients.

I use an inventory. We’ll go through, why do you think you might be anxious right now? It's important, sometimes, to validate because of our brain. The brain is always going to brain, and part of its role is to make meaning of physical sensory input.

And so, we'll be in a moment of peak anxiety and our brain will say, “I know I'm anxious right now. It's this thing happening at work. It's this interpersonal dynamic from the seventh grade that still irks me.” Our brain is a constant meaning-maker.

But that actually is a retrofitted justification of what is, first and foremost, a physical sensation. The brain is attempting to tell us a story to make sense of what's going on in the physical body. There's always a kernel of truth to what it tells us.

So, in that moment, as you go through the false mood inventory, the false anxiety inventory, you might say to yourself, “Yeah, I'm feeling stressed right now. I'm overwhelmed. I'm anxious, I give myself permission to feel that way. It's understandable, this thing is going on at work. Maybe I need a snack right now. Maybe I'm getting my period tomorrow. Maybe I'm due for my dose of medication, I'm in a state of interdose withdrawal.”

And so, just to identify it, sometimes there's an actual solution. It's, “Let me have a snack. Let me go outside, move my body in the fresh air and sunshine.” Sometimes it just takes the charge out of the situation.

To know, “I'm getting my period tomorrow. And so, I'm probably feeling a little more raw, a little more tender right now. I'm due for my dose of medication. It's not that things are as doom and gloom and overwhelming as they feel. I'm seeing things through a biochemical lens of withdrawal.” It's powerful to have that grounding. That's the false anxiety.

True anxiety, on the other hand, is purposeful anxiety. It's not something that we get to decaf coffee or gluten free our way out of. It’s not even what's wrong with us. True anxiety is what's right with us when we're able to viscerally connect to what's wrong in the world.

That can be on a very personal level. It can be the ways that we're out of alignment in our lives. Whether that's career, relationship, where we live, how we live. It can have to do with our communities. It can have to do with the world at large. That wherever we have a unique role in course-correcting something that's out of alignment.

Our true anxiety is not something to suppress. It's not something to pathologize, it's something to listen to and honor and heed.

Victoria: Great teacher, eh?

Ellen: I mean, it’s a little bit of a body whisperer. Sometimes a body shouter, if we ignore it long enough. I really feel it, in my own life, like a little electric fence that leads me back on course.

Victoria: Yeah, yeah. In hindsight, what would you call false anxiety now?

Ellen: That's the trouble. I'm too married to the symmetry of that, that I think I'm actually just going to keep going with the ‘it's not a perfect term, and yet.’ Let's put that caveat in there, and move forward with the imperfect term. I think avoidable anxiety is less triggering, for sure. But I think that, I don't know, if you'll help me wordsmith what's the true…

Victoria: I think, exogenous. But I can see from… like publishing a book for regular people, having it be exogenous and endogenous anxiety, it doesn't really… I can see your publisher being like, “Absolutely not. Zero percent available for that.” But that's what you're talking about, right?

Ellen: I think that's a really good thought. Yeah. So, I think exogenous and endogenous works, but I think it doesn't even capture the full…

Victoria: Right, because, I guess, what I'm calling endogenous is really your reaction to imbalance.

Ellen: Well, I think there you mean, true anxiety is endogenous. I think it can be but it's not always. Ego-dystonic.

Victoria: It's a pickle.

Ellen. … Or dystonic. It’s a pickle. Here we are.

Victoria: Here we are. I like your disclaimer. I don't know, I am profoundly biased, but you just resonate such authentic, true kindness, that I could see somebody getting grumped by the book, but then seeing two seconds of a video of you and know you are a genuinely kind, wonderful person who takes the sting out. At least, it would for me. But I am biased.

Ellen: That's fair. I remember reading, or coming across this recently, this idea that some people are counselors, that's their natural gift. And some people are consolers and that's their natural gift. I think that there are a lot of different ways that my book rubs people the wrong way. And I think a big part of that is that I am by nature, not a consoler, I'm a counselor.

I think we need to know what we need. If you're feeling unwitnessed, unheard, and invalidated, let's start with consoling, because we have some distance to make up for, first. I come out of the gates counseling, and it's giving diet culture sometimes.

Counseling is a real tricky business. And I so desperately want to give someone tools to help them move the needle and genuinely feel better. I don’t feel like I can achieve that just through consolation. But I think that the delicate art of, how do you counsel in a way that reminds somebody they are their own guru? That reminds them that they are whole already? That they're not broken? They're not fundamentally wrong, but that we're living in a world that makes it pretty tricky to feel well?

How do we counsel someone to know, here's what I can nudge, kitty steps to do slightly differently to feel better? Without all the messaging of, “I'm broken. I'm wrong. I need to change.” Or the anxiety provoking feeling of, “Oh, God, I have so much to do to get it perfect.” I think that it's a gentle grace giving approach to, “Here's some strategies. Here's a buffet, I lay it all out. What resonates? What feels approachable? What feels accessible? Start there, and only there.

Victoria: My brain just went to how much of a consoler I am. We shared so many patients. So many people would see a you-me sandwich, right? I think that is really interesting. I need to sit with that and think about that.

Ellen: When we hopped on this Zoom, and I'm in a moment of grief right now, I felt the enormous hug of your consolation gift. It's such an important offering. You actually have quite a lot of talent with counseling, as well. So, you got the yin and the yang.

Victoria: Thank you, kitten. Dr. Ellen Vora MD, I adore you.

Ellen: It's mutual.

Victoria: Is there anything you want the good people to know? I think this interview has been about 16 hours at this point. We should probably let them go to bed.

Ellen: Choose, “What's alive in me, right now?” I could say something about community. I think that if you prioritize nothing else other than sleep, it's community. That's actually what we're here to do. I think that's part of this assignment, is relationship and learning loves. I think part of the reason we are suffering so much is that this modern world has disconnected us in so many important ways, in so many potential ways.

But I also just want to comment on grief for a moment, because that's very alive in me. You know this, I think a lot of your listeners know this, but we're really stunted culturally in terms of our relationship to grief. We have a lot of unmetabolized grief.

That can be from losing a loved one. It can be from transitions in your life that you never had the time or the space or the permission to fully mourn. I just want people to give themselves permission to cry enormously. To have the full spectrum of complex, nuanced, ambivalent thoughts about whatever is lost. Give yourself the grace to have shadow thoughts and all of it. It's okay, it doesn't make you bad.

We integrate it, and we realize that we contain these multitudes. With crying, what I've learned through two different big griefs in my life, is that we cry at like a three. Something worth working at is to get better at crying, and to cry at an 11. That is really medicine and energy, and there's so much connection to the sacred in grief.

Victoria: Thank you. Thank you. Thank you for holding all this wisdom. Thank you for sharing it with us, in your classically Ellen eloquence. Something I've always loved about how you can turn a phrase, and as a counselor, share things that are complex in such an accessible way, without ever talking down to us. All of that.

Ellen: I'm in this right alongside everyone. But thank you for all of these offerings that you've made to the world; so much good teaching and insulation. I'm honored to get to be on your path.

Victoria: Folks, please go buy Ellen's book, it's amazing. The Anatomy of Anxiety. Also, the cover’s just beautiful. Where can good folks follow you, keep up with you, learn more about you, work with you?

Ellen: I'm a chatty Cathy over at Instagram. I'm @ellenvoramd, and then my website EllenVora.com. This fall, if I get another pep talk from my friend Victoria Albina, I'm going to start an online group. That's coming.

Victoria: We've been talking about this for a really long time. We need to go and get it. Also, do you remember, this was pre-pandemic 2018, we had this conversation where you're like, “What is Instagram?” We were both just kind of like, “I don't know, but I think we should maybe make pictures there.” But neither one of us knew. And now, you have a bajillion very engaged followers learning so much from your brilliance.

Ellen: I'll be the first to say, I think social media is such a destructive force. But man, is there a useful conversation happening in that town square.

Victoria: I learn a lot. I’ve got to say it, I’ve learned so much.

Ellen: I learn a lot, and I think I keep my thyroid healthy expressing my truth there.

Victoria: Well, I love that. Let that throat chakra sing. I learned a great new way to clean the grout in the shower yesterday. I’ve got to tell you, reels are great. Like everything else, with boundaries and time limits, and not letting it be that first dopamine hit of the morning, nor the blue screen at night… But somewhere around 1pm, a little 20 minutes with a timer, it's magic. Yeah, I learn a lot, and it's a good time. You’re a good time. Thanks for being here, Ellen. I really, really appreciate you.

Ellen: Thank you for having me.

My love, I hope you enjoyed that conversation with Dr. Vora just as much as I did. I hope you got some sleep with last week’s full moon. And if not, just know that there's a whole community of tuned-in humans who were lying awake all night alongside you.

Alright, my beauties. Let's do what we do. Gentle hand on your heart should you feel so moved. Remember, you are safe. You are held. You are loved. And when one of us heals, we help heal the world. Be well, my darling. I’ll talk to you soon.

Thank you for listening to this episode of Feminist Wellness. If you want to learn more, all about somatics, what the heck that word means, and why it matters for your life, head on over to VictoriaAlbina.com/somaticswebinar for a free webinar all about it. Have a beautiful day, my darling, and I'll see you next week. Ciaos.