Session 224: ICYMI, Slaying Your Anxiety

Session 224: ICYMI, Slaying Your Anxiety

Dr. Joy: Hey, y'all! Thanks so much for joining me for Session 224 of the Therapy for Black Girls podcast. We'll jump right into the episode after a word from our sponsors.

[SPONSORS’ MESSAGES]

Dr. Joy: Over the first 58 days of the COVID-19 pandemic, there were an estimated 3.4 million Google searches related to anxiety in the United States. The past 17 months have indeed given us lots to be anxious about. In case you missed it, I thought it would be great to re-share my conversation with Dr. Alicia Hodge all about anxiety.

Dr. Hodge is a licensed psychologist in Maryland and a registered psychology associate in the State of Virginia. She received a master's in Counseling Psychology from Bowie State University, as well as a master's and doctorate degree in Clinical Psychology from the University of Hartford. Dr. Hodge has extensive experience in providing cognitive behavioral therapy across various treatment settings with adolescents and adults.

We chatted about what anxiety looks like, where it comes from, and helpful tips and strategies to help manage anxiety. If something resonates with you while enjoying our conversation, please share it with us on social media using the hashtag #TBGinSession. Here's our conversation.

Dr. Joy: Thank you so much for joining me today, Alicia. I'm very happy to have you with us.

Dr. Hodge: Thank you.

Dr. Joy: I definitely wanted an expert to come on and talk with us all about anxiety. I think a lot of us probably struggle with some anxiety symptoms and may not even know what it is, so can you start by telling us what anxiety is?

Dr. Hodge: For sure. And yes, you are correct. Anxiety is a very natural experience that all humans have so, more than likely, if you're alive, you have experienced anxiety and it can be a number of things that make us anxious. It could be getting up to talk in front of a large group of people, it can be maybe introducing yourself to someone new. But in some ways, anxiety is actually useful because it helps prepare us and motivate us to do well.

But there are times when anxiety takes control of us in a way that we have intense fear or distress and that's when things get overwhelming and we actually want to maybe back away or shy away from that thing, and those are the times when we find anxiety does get in the way. And it's very common, actually. About 18% of adults in America have anxiety, which probably shakes out to be about 40 million adults so that's a large number of people. It's actually one of the most common mental health concerns and disorders in the United States.

Dr. Joy: Yeah, that definitely is a lot of people.

Dr. Hodge: Mm hmm, for sure. A lot of the times, anxiety (I guess in a nutshell, the way that I like to describe it to people) it's a natural response that we have to a dangerous situation. For example, if you and I were in a room and we opened the door and we saw that there was a bear, we will both of course be immediately afraid. Our muscles would become tense, we would freeze very fast and we'd be ready to go, and sort of that fight or flight type of state. But what happens, more so in anxiety disorder, is that the panic and then the distress is there but there's no bear. So oftentimes the person can be feeling anxious and realize, wow, I actually don't know what it is that I'm worried about. I don't have a reason but I can't shake this feeling. Because essentially, anxiety sort of causes us to overestimate how bad the situation will be and also underestimate our ability to handle it.

Dr. Joy: And where does that come from?

Dr. Hodge: The anxiety, the feelings, you mean?

Dr. Joy: Yeah. Like if there is no bear, like why do we sometimes develop that kind of a response?

Dr. Hodge: Essentially, what happens is that our brain is operating on a fear-based reaction which sometimes there maybe is something fearful. And that's usually in the form of a thought, so we may think about something like, “Ooh, I have that test tomorrow.” And most of us would be a little bit anxious and maybe start to prepare and say “Well, that means I need to go study,” where someone who's quite anxious doesn't really move to the problem-solving stage. They're kind of stuck in that fear-based response and they're reacting to a concern and they can't move forward to the problem-solving phase.

Which, if you think of our brain, if you look at your head, you're sort of responding to fear in the back of it, whereas problem solving is more towards the front of our brain. Although it's a short distance if you're looking at your own head, it's quite far in terms of neurons. So what happens is that when we respond in a fearful way, we kind of get cut off from the problem solving portion of our brain.

Dr. Joy: That's a great way to put it. I don't know that I've heard it described that way. But it's a very like simplistic... Like you can kind of see how it happens that way.

Dr. Hodge: Yeah, absolutely. And a lot of times, I find that that is helpful to people to sort of understand that this is something that's happening on multiple levels. It's not only maybe some of your thoughts but it's your emotions, it’s the actual physiological process in your body. So for the most part, when I'm working with individuals, I try to intervene on all those levels to kind of give them some sort of relief.

Dr. Joy: You kind of mentioned like the fast breathing and increased heart rate. Can you talk about maybe some of the other symptoms that sisters may be experiencing that they may not even recognize as anxiety?

Dr. Hodge: Absolutely. Oftentimes, you hear people sort of throw out the term anxiety like “I'm anxious.” And a lot of times we tend to think of the more extreme presentation, which is maybe intense crying or being really paralyzed with fear. But a lot of times, I come across people who tell me things like, “I've been experiencing some chronic headaches. I've been feeling pretty dizzy,” which is usually from like a lack of oxygen from the hyperventilating. But interestingly, another area is like gastrointestinal problems, and so things like stomachaches and cramping.

A lot of times, people will just say, “I don't know, you think about I had a presentation and I've been having to get up and go to the bathroom a lot.” Things like frequently having to urinate or even having more extreme ones as diarrhea, but another thing that women in particular experience is irritability, and that's something that I think is very much overlooked as an aspect of anxiety. Because there's a tension there, that maybe not wanting to be bothered or even the smallest thing is setting you off, it could be that some anxiety is actually going on.

Dr. Joy: Ooh, that's a good one Alicia. How would you be able to kind of distinguish between kind of just being irritable in general and it being an actual anxiety kind of symptom?

Dr. Hodge: It's actually pretty tricky, I have to admit. And at times, I will get people to start looking at what are you thinking about? Because we tend to go through life and get set off by very small things and that does happen, and it doesn't necessarily mean you have a disorder. However, if you can kind of look at what else is going on for me, what is it that I'm worried about? Am I sort of maybe not present in my own life? It really requires you to pull apart your thoughts a little bit and see, what am I irritable about?

So if there's a situation where maybe you find I’ve blown up at someone, maybe if you can, stop yourself in that moment and say, “What was really the issue there?” And that may help you walk backwards to see, oh, was that person just getting on my nerves or could I potentially be worried about something else?

Dr. Joy: Okay, that's a good way to look at it. And what are some of the most common anxiety disorders?

Dr. Hodge: Some of the more common ones are things like generalized anxiety. Which the way that I like to describe that to individuals is, you're usually worried about maybe two or more different types of things in different areas of your life–whether that be finances, family, friends, performing well at work. And the sense that most people have (who experience general anxiety) is: You know what? Life is going okay right now but I always seem to feel on edge as if I'm waiting for that other shoe to drop. And that is usually an indicator of being really preoccupied about the *[inaudible 0:10:42] of life and the process of life, really. And you're kind of thinking, yeah, I can say out loud definitively that things are okay right now, but I'm pretty on edge thinking that tomorrow they won't be.

And another common thing is social anxiety or social phobia as it’s called sometimes. Which is essentially being very nervous and uncomfortable and really kind of overthinking those social interactions. Kind of asking yourself why did I say it that way? What if I offended someone? Will I offend someone? Will they like me? Being very preoccupied to the point where you're almost unable to engage in social interactions or find yourself avoiding them frequently.

Dr. Joy: Do you think that social media or the increased use of social media has impacted social anxiety in any way?

Dr. Hodge: You know, I do find that sometimes it can exacerbate situations. Because as we all know, you can put a tone to anything on a text message or a status and you can sort of make inferences and say “that's probably about me” or “I think that person's mad.” And because social interactions are so complex, when someone is already nervous about them, I do believe that interactions on social media and online can sort of spin way out of control a lot quicker than in person. Because you don't have those facial cues to read, you don't have tone, or even the ability to sort of just immediately get that feedback, like “what did you mean by that?”

Dr. Joy: When people suggest things like not having difficult or tough conversations on social media or by text, that's kind of what we're getting at, right? Like that you can't interpret so much through text, that it's better to have like the face to face conversation.

Dr. Hodge: Yes. I am a strong proponent of encouraging people to speak in person as much as possible or at least by phone. A, because I just think it is nice human connection, but I also believe that it gives you an opportunity to really evaluate what's going on and not put your own bias or emotional state into it.

Dr. Joy: Gotcha. You've mentioned some symptoms that we may not have been aware of, so the irritability, kind of some of the gastrointestinal stuff. And I think another thing that sometimes presents as anxiety is overthinking, and I think a lot of us get trapped in that. Can you talk about the overthinking piece that sometimes is a symptom of anxiety?

Dr. Hodge: Absolutely. Overthinking is really present in anxiety and the anxious brain is one that is very hyper vigilant. What I mean by that is it’s always on the lookout and is looking for danger or is looking for what could happen. Oftentimes, when someone is anxious, I like to call it the what if game. They can play “what if” eternally. They can say, what if this happened and then what if that happened? What if, what if, what if. And it can tend to make them make a mountain out of a molehill, really. You may overthink and obsess about what you said, what you shouldn't say, about if you're measuring up in the world. Am I kind of where I'd like to be? You might play the what if game and kind of make scenarios in your mind about things that could go wrong or things that could happen to our family members.

Another area is sort of that fear of what if–what if I have a panic attack? What if these things happen and I can't control it? What if, pretty essentially, what if anything? You know, that big looming question mark over your head that causes you to think through so many scenarios that more than likely actually won't happen.

Dr. Joy: How do you get out of that loop? Like you’ve mentioned, you could play what if forever, right? So how do you kind of break through that loop to kind of get yourself out of that game?

Dr. Hodge: The main thing that I encourage people to start having is more self-awareness and sometimes that sounds a little bit paradoxical to people. They're like, well, I am aware: I know my thoughts, I know I worry all day long, and here are the things that I'm worried about. And I say that's great, that's a start, and I'd like you to take a step back and ask yourself: are there any other options? Because when you sort of play that what if game, you get really into it and you actually experience those emotions of like, what if I got a flat tire, and then this would happen and then this would happen?

But I say, is it a possibility that you won't get a flat tire? What if you don't get a flat tire, then what? And then people sort of open up to realizing there are so many other options or alternatives. And essentially, that's the first step I like to encourage in saying you're taking the short route. You’re jumping to the “what if” each time–I want you to challenge yourself and ask yourself, are there any other possible outcomes? Because that actually, in some ways, even trains their mind not to go to the first scary thought only but to consider what if it's not scary?

Dr. Joy: Yeah, that sounds very simple when you talk about it.

Dr. Hodge: Of course! Yes, that's a really good point and I actually do get that response. People are like, well, if it was that easy, then I wouldn't be talking to you. And I sort of present it in a simple manner simply to say that worry tricks your mind into believing that you cannot handle these things. Or worry sort of has this way of catching your mind’s attention. And the way that our minds are created, if something is not interesting, we tune it out. And I'm sure that we all have experienced that. You know, you're watching the show–half watching it, half pay attention to a conversation.

So what worry is, is sort of like this little red flag that says, “Hey, hey! Pay attention to me, there's something important about this.” But as you start to consider alternatives, in the beginning, it is difficult. And I sort of describe it like exercise. In the beginning it’s clumsy and hard and you're sore. But after a while, if you continue to practice, your brain actually becomes a little bit bored with some of these worries. Because they realize, oh, we can think of some other things. Or, oh, that's probably not going to happen so I'm actually not as interested in that anymore.

Dr. Joy: Yeah, so it is very much kind of like an exercise for your brain muscles.

Dr. Hodge: Yes, it is.

Dr. Joy: Yeah, yeah, okay. More from my conversation with Dr. Hodge after the break.

[BREAK]

Dr. Joy: You’ve mentioned already, we kind of throw around a lot of these terms just in everyday language like, “Oh, I'm anxious. Oh, I'm this. Oh, I’m that.” A couple of the other ones, I think, that people throw around without giving very much thought to are terms like OCD and PTSD. Like, oh, I got PTSD kind of thing. It sounds like that’s probably a big pet peeve for you.

Dr. Hodge: It is a challenge. That is something that really hits me and the reason why is that I'm happy that people are sharing, you know, that I'm anxious or that something happened to me and I'm upset. But I do think that we need to be careful of the terminology we use because there's a big difference between symptoms or traits of the disorder and actually experiencing a disorder.

For people that might not understand, a disorder is sort of related to how much your life is actually impaired by this or how much does it get in the way. If you're saying I have OCD, the D is a disorder, so I have obsessive compulsive disorder. Where, as you may just be describing, like it goes for me personally, I love my kitchen counters to be perfectly neat and I need the flour jar and the sugar jar to be in a certain area. And it definitely makes me more comfortable and I feel like this is nice.

However, the disorder at a clinical level is much more like: “You know what, I'm going to organize my flour and sugar jar and I'm going to go to work. And then as I'm on my way out, I'm like, oh, wait, let me just go back and check. Is it organized right? I get into my car and I'm like, you know what, I'm gonna drive back home to make sure that flour and sugar jar are straight.” And that, as you can imagine is going to impair my life. You know, I'm going to be late to work, I may get written up, things will be much more difficult than me just saying “I'm a neat person and I like my flour and sugar jar to be neat.” So that's sort of an example, I think, between having those symptoms and traits or characteristics versus having an actual disorder.

Dr. Joy: And what about PTSD? You gave a great example that kind of helps to illustrate what OCD looks like, but what about like PTSD?

Dr. Hodge: Correct. PTSD is a pretty significant disorder that I also as well don't take lightly. Of course, people are usually referencing a traumatic event. It may be like, “Oh, yeah, I waited a long time at that store, I got PTSD.” I would say no, I don't agree. But I would say it's more accurate to say “I was a little traumatized.” Because we've all experienced some form of trauma in our lives and it isn't up to other people to say whether or not we thought it was traumatic.

But serious events like, you know, the typical thing is military combat or assault or surviving a natural disaster can have a really long-standing effect on our lives, and PTSD is related to our biological response. So if we're in an event in which we fear maybe that our life is in danger or someone else's life is in danger, it can cause us to really enter into a crisis. And we'll re-experience that later through things like intrusive memories (which are more commonly called flashbacks), avoiding a place or a person or objects that are reminders of that trauma. Feeling numb, guilty, out of your body, or just being very easily startled. And kind of the hyper vigilance I mentioned, like always on the lookout for what might happen. And that's much more severe and difficult than me just saying, “Well, I don't want to go to that Walmart because they have long lines.”

Dr. Joy: Alicia, what would you say.... I've talked about this on quite a few episodes, just kind of the impact that everything that's going on in the world, I feel like the black community has almost like a shared PTSD response to just kind of everything that’s happening. Like with people being killed by police and looking at the political climate. What would you say about that? I mean, that isn't necessarily like a trauma that you may have personally experienced but because we see so much on the news and on social media, it does kind of feel like that. Can you talk more about that?

Dr. Hodge: Oh, yeah. I agree with you. I definitely, even myself, have had to kind of step back from watching those videos and watching those things. Because I do believe that I was, at least at minimum, having like traumatic stress responses. Like I would be really upset, I'm up at night, I'm thinking about these things, I'm kind of seeing it after I've already viewed it. So in some ways, you are correct.

PTSD amongst the black community, we're actually more susceptible to PTSD or we experience it more and are diagnosed with it more because of things like our exposure to violence, our exposure to homelessness, so you are definitely hitting something on the head. I don't want to minimize that experience and I do think that we, as African Americans, do need to practice selfcare around those things because they speak to a part of us that we can't change. If I'm watching a video where someone was assaulted simply because of who they are and I am like that person, it definitely can inspire in me a fear and a reaction.

Dr. Joy: And are there strategies that you have maybe used with clients or that you could talk about that might help to kind of manage some of that?

Dr. Hodge: Yeah. What I would say is, the first thing that I've actually even personally done is sort of limit my exposure to those things and limit my viewing. And also sort of reminding myself that we're in a society of sensational things and that, unfortunately at times, that's all that I get to see. So I do try to look at things that are kind of mindless or meaningless. I also encourage people to talk with one another because a portion of PTSD is that narrative and that story and that avoidance. Sometimes we kind of enter into this zone of mental avoidance and we don't want to go back to those stressful things, we don't want to talk about them and that can actually exacerbate our symptoms.

So feeling comfortable and safe. Hopefully, you have someone safe that you can talk to and kind of share with your friends and share your feelings and kind of hear if they're feeling anything similar. But giving yourself that rest and that break and realizing that you don't need to click every link. If the title says, you know, “man beat up” or “attacked by dog,” like it's okay to just keep scrolling.

Dr. Joy: Got you. I think another thing that has come up, and probably this has been on the increase, like all of the different random shootings that we experience in the country. You know, so I feel like it's in the same vein as what we were just talking about. But it does, I think, strike a different type of fear in terms of like you just don't know what public event you might be at or where you might be in a shopping mall, like just really anywhere. You know, so I think that that is a very real fear, right? You kind of started this episode talking about like if we opened the door and there's a bear or if there’s no bear. This kind of feels like you don't know whether there will be a bear. Can you talk a little bit about that?

Dr. Hodge: Yeah. That fear of the unknown can be really difficult. And you're right, I think that it is important these days, unfortunately, to take some more safety precautions and kind of be more aware of your surroundings. And I think that having worries about that is kind of at a normal level. I would say, however, if someone was sort of saying like “there was a shooting at the movies and now I am not going to any movie theater ever again,” I would be a little concerned about that reaction. Although you are protecting yourself, and I think that self-preservation is key, that seems a little bit extreme.

So sort of looking at your own life to see, am I generalizing this fear to beyond what may be... And I hate to use the word normal, honestly, but maybe beyond what my usual life looks like. If I'm someone who used to go to the movies every week, okay, yes, maybe you will initially after a shooting cut back. But if you were then to say “I'm cutting movies out of my life,” I would say I think that you might want to reevaluate that perspective. But I would validate the fact that there's real danger and fear, unfortunately, based on these random shootings.

Dr. Joy: Right, right. More from my conversation with Dr. Hodge after the break.

[BREAK]

Dr. Joy: You have already given us like quite a few exercises and strategies, but I know people always really like stuff to hold on to. People who may be kind of struggling. Like I think one of the ones that is most common is like social anxiety, like not going to new situations. Or if you go to a new situation then you're playing on your phone until somebody gets there, that you know kind of thing. Can you give us some tips and strategies or things that you use with your clients to kind of help manage those everyday type anxiety things?

Dr. Hodge: Yeah. I usually try to balance two things. I try to balance someone's coping skills, which is what are the things that they're using to manage that anxiety and deal with it? And then also, there are other strategies I give that really can be uncomfortable at times. Because essentially, what I'm working on with people is how to face those fears and my advice is to lean into the fear versus pull away. And the way I tend to describe that is that when we get uncomfortable with people, we avoid. Sort of like you said–at this event, I don't really know anyone, instead of actually speaking to someone, I'm just gonna go check into the room until my girl gets here.

And at times, that's just a band aid. In the moment, it worked but it's only a band aid. It didn't give you the opportunity to actually tolerate the feeling, to actually see what it was like to actually meet a new person or introduce yourself. It doesn't give you any evidence that you can actually handle social situations. So on one end, when I'm talking about coping, I like to encourage people to do things like deep breathing, which is like the go to in therapy and sounds very cheesy. But I am aware that deep breathing really helps to reset us and our bodies.

Oftentimes, when we are anxious, we are sending messages between our body and our brain that says, “I'm uptight, something's wrong, I don't feel great.” When we start to breathe, we actually relax and the message goes to your brain to say “we're all good down here” and you tend to get much more calm. I suggest things like music, and that is according to someone's tastes. Are there any songs that sort of just make you feel a little more calm?

Yoga, again, which I feel like is in the generic therapist suggestion. But less of yoga in terms of like the actual posing and practice. I encourage yoga for relaxation–being more in tune with your body, realizing when your shoulders are tense. How does your stomach feel? How is your breathing? Those are some of the coping skills I would recommend. But for instance, in terms of techniques, a lot of it is literally jumping out there and kind of putting your toe in or jumping feet first to say, “You know what, I'm pretty nervous. What is the worst thing that could happen?” You evaluate what that is.

For example, we talked about being at a party so I say to myself, “Okay, I'm really nervous. My friends aren't here yet. The worst thing that could happen is that I introduce myself to someone and embarrass myself.” And that's not the greatest feeling, I'm sure, but then you ask yourself what else could happen. I could make a new friend, I could actually meet someone that is in my field and make a connection. I could find there's so many other great things that could happen. So I'm really telling people to challenge your thoughts. Ask yourself, is this is the only outcome? And then kind of really push yourself to say, “You know what, I can meet a new person. I'm just gonna go out there and say hi.”

Dr. Joy: What does this look like with you in practice, Alicia? I know for a lot of people who like specialize in anxiety like you do, it may involve a lot of out-of-office kinds of things, right? So might you go with them to a social place or like a public place and work through some of that?

Dr. Hodge: For sure. I have done this actually quite often. If someone is experiencing social anxiety, we will do things like “you know what, okay, today, we're going to walk down to the end of this street and I would like you to say hi to five people.” So just starting off a little bit small with just acknowledgement. We do sort of go to the range of something called overcorrection, which is let’s sort of do some of these worst-case scenarios and see, is it that bad?

So if you're really embarrassed just to say hi, after a time, with some coping skills in place and you feel safe with me, I would say let's walk down the street and do some really weird things. Let's walk backwards, let's skip, let's ask people what time it is while we're holding our phones. Because obviously we know what time it is but we're just doing something embarrassing. Or even I've had someone pick up a pair of adult diapers and go to the front and ask what they were for.

Because we know that these types of things will invoke anxiety but essentially the purpose of treatment is to show you that you can handle it and perhaps it was not as bad as you imagined. And it also gives your body an opportunity to experience those anxious feelings and interpret them as less dangerous as they were being interpreted before.

Dr. Joy: Okay. A lot of what you're talking about, it sounds like, is really kind of trying to rewire your brain to like calm down and like “I'm not in danger. I'm actually okay.”

Dr. Hodge: Mm hmm. We're just trying to recalibrate your system a little bit and change your perspective on how you view these situations.

Dr. Joy: Okay. At what point might you suggest medication for somebody who's struggling with anxiety? Maybe you've done some of these exercises and you're seeing that there may be isn't a lot of movement, at what point might you suggest somebody consider medication for anxiety?

Dr. Hodge: As you mentioned, I engage in talk therapy but I am not against the use of medication adjunctive to therapy. If an individual is sort of explaining that they're having very frequent panic attacks–which might I put in there, that's another thing that I find that people say like, “oh, I had a panic attack,” and more than likely, they were just maybe overwhelmed or overcome by anxiety. But a panic attack is somewhat different and it has similar symptoms: racing heartbeat, inability to breathe, and kind of sometimes people will say I felt as if I was gonna pass out or have a heart attack. The difference is the intensity.

Panic attacks typically reach their intensity within 10 minutes or less and then they go down, and they usually are out of the blue. Unexpected. If you're having that type of experience and it's happening pretty often, medication can kind of help get your body to a more calm physical state so that you can actually do your work. Because, as I mentioned, a lot of the work that I do is putting you in somewhat of an uncomfortable situation and we need you to be able to have the resources and ability to kind of endure that to some degree. Also, if you find that you're spending a great portion of your day worrying or sometimes people describe it as like a hiccup in their brain–that they can't get off the thoughts and they can't deviate or distract themselves–then we might need some medical intervention there.

Dr. Joy: You have already mentioned like yoga and meditation. Do you have some favorite resources for your clients or other people, that you love to suggest that help to manage anxiety?

Dr. Hodge: I do. I am a huge fan of a book called The Worry Trick which is by Dr. David Carbonell, I believe is how you pronounce his last name. And what he discusses in that book is very similar to what you and I have talked about but he shares it in such a nice, simple format and he discusses how to manage chronic worry. He kind of tells you about your brain, about the physiological process, and he gives you some techniques that are really helpful to navigate, whether you're in therapy or not. I really like it because it explains chronic worry and how to kind of overcome it.

Let's see what else. I also like... YouTube has a lot of guided meditation scripts. Sometimes people who have a hard time relaxing or they notice they get distracted if they don't have anything to listen to, in YouTube, you can go on and I think if you just type in like meditation or guided meditation or even relaxation scripts, there's a lot of videos with calm music and someone with a really pleasant voice that guides you just through some relaxation. And teaches you how to relax your muscles or kind of to envision a happy place, so to speak.

And then in terms of technology, there are a few apps that I like. There's one that I actually haven't used (so user beware) but it's called Headspace. And that's a paid app that a lot of people have come to therapy and let me know like they've used it in the past. I'm not very clear on why they don't currently use it so that's why I said I can't really vouch for it, but they mention that it can be helpful. But also, if you like the Free.99 like I do, you can look up an app, it's called Relaxed Melodies.

I think there's also another app called Nature Sound, and the nice thing about this app is it just has nice relaxing nature sounds and you can combine them on top of each other. So sometimes I'll do like rain mixed with the beach or the fireplace noise mixed with the wind. And it has a timer on it so you can even set it at night if nighttime is a time where you feel more tense. You can set it for about 20 minutes and kind of lay down, do your deep breathing and listen to the sounds and hopefully you get to sleep and it'll just shut off on its own. So that's really convenient.

Dr. Joy: Alicia, are there some like directions around meditation? Because I think I've always heard like you have to train yourself to kind of get into this meditative state. Like you can't necessarily try to put on a YouTube video in the middle of a panic attack and think it's going to work.

Dr. Hodge: That is a good point. Yes, and I'm glad you said that. Because actually the meditation, that guided thing, would be something that I encourage people to maintain their state of relaxation. It wouldn't be something helpful to us in a crisis at all; it would be something that you can use... I just try to say incorporate this into your practice of how you kind of wind down. But if you were actually more acute in terms of like I'm really anxious and I need something, one of the things that I encourage people to do is something called grounding. This works with people who have experienced trauma but also dealing with anxiety, and the purpose of it is try to get yourself into the here and now and be focused.

I tell people look at your hands and then think about the five senses, but you're really probably using four. And that is: What do you see in the room right now? Can you kind of look around and see anything? What are you hearing right now? Do you hear the clock ticking on your wall? Is there the wind going by? Is there any noise? What do you smell? (Which may be nothing but it still keeps you here in the moment, in your body.) And what do you feel? So usually I encourage people to just kind of tap the chair or rub your fingers together and focus on those sensations to keep you in the moment and maybe not flying off into a panic attack or kind of getting consumed by your thoughts.

Dr. Joy: That sounds great. Can you tell us more about your practice, Alicia, and where we can find you on the internet?

Dr. Hodge: For sure. Right now, I am located in Virginia. I have actually two locations, two offices: one in Falls Church, Virginia, and one in Alexandria, the old town area. And I'm actually located at The Center for Cognitive Therapy and Assessment. And if you would like to look that up online, the website is ktpsych.com and you can find me there and schedule an appointment if you would like to.

And also, I just really like to use my online platform for social media to really promote mental health awareness, which is something that’s very important to me. I think that we all can use a little bit more education and my intention is to also reduce the stigma and encourage good language around mental health. And encourage people to have health-seeking behaviors that’s not something that you can't handle. If for some reason you feel like you really can't handle things, there are people out here willing to help you. My Instagram name is @HelpMeHodge.

And lastly, I just recently completed an eBook about selfcare, kind of encouraging some of the things that I've talked about, which is being relaxed and kind of stepping outside of your head a little bit and not to get caught in the worry trap. And I recently have a website and the website address is www.HelpMeHodge.com, which is similar to my Instagram name.

Dr. Joy: Gotcha. And all of this information, of course, will be included in the show notes so if you're driving, you don't have to worry about trying to remember all of this.

Dr. Hodge: Yes, stay focused on the road, please.

Dr. Joy: Right, this is definitely when we want you to stay present! Thank you so much for joining us today, Alicia. I really appreciate it.

Dr. Hodge: Thank you. I appreciate you having me and I really hope that this is helpful to anyone and encourages people to realize that if any of these things are going on for you, there are trusted professionals out here that are more than happy to help you.

Dr. Joy: Thank you. I'm so grateful for Dr. Hodge and her expertise. To learn more about her work and to check out all the resources she shared, be sure to visit the show notes at TherapyForBlackGirls.com/Session224. And don't forget to share this episode with two other sisters in your life who just might appreciate the conversation.

If you're looking for a therapist in your area, be sure to check out our therapist directory at TherapyForBlackGirls.com/directory.

And if you want to continue digging into this topic or just be in community with other sisters, come on over and join us in the Sister Circle. It's our cozy corner of the internet designed just for black women. You can join us at Community.TherapyForBlackGirls.com. Thank y’all so much for joining me again this week. I look forward to continuing this conversation with you all real soon. Take good care.