[Applause]
imagine this it's summer of 2018 I'm in
Mumbai India it's 120 degrees outside
and the sweat is dripping down my face
my patient Mina and I are stuck in an
old little taxi it's now our second day
driving around and today we've been at
it for 45 minutes if you have never been
to Mumbai that's exactly what he feels
like and Mina was brave enough to be
fighting her fear of a small enclosed
place by driving around in a cab with me
in Mumbai I look at Mina who is really
gasping for air at this point and
dripping sweat and I say to her Mina I
need you to get inside of the trunk of
this car and eventually you're gonna get
a trunk of a car here we go and I look
at her and I say I needed to get inside
of the trunk of this car
Minik panics she's looking at me
terrified why would I ask me in a
something so simile outrageous because
this is one of the most fundamental and
effective techniques in exposure therapy
and because Mina has been held hostage
by her anxiety for the past 18 years
every time should enter a small enclosed
place her heart would pound she'd feel
dizzy she felt as the world is closing
in Mina a very strong successful
this woman could not overcome her fears
she not only feared being in a plane and
had to take medication to fly she also
started to avoid small enclosed places
exactly like the taxi where an avoided
public transportation and even feared
been home alone yeah at age 65 Nina
wanted a different relationship with her
anxiety so here we are back in the taxi
Mumbai Mina it's still staring at me I
can almost hear her thoughts
why don't I hire a behavioral therapist
she's losing her mind
I should have taken my anxiety
medication this morning as Nina finds
her breath she says something in Hindi
to the taxi driver and the next thing I
know we're back at my hotel you wanna
get your passport my passport yes I
rather fly than to get inside of the
trunk of this car an hour later we are
boarding a flight in Mumbai Meena is
flying for the first time in her life in
the past 18 years without an anxiety
medication Meena is not alone in her
experience of anxiety nearly 275 million
people suffering from anxiety disorder
in the world making it the most
prevalent mental health disorder
according to the excit and depression
Association of America nearly 40 million
people in the US suffer for an anxiety
disorder costing the u.s. nearly 42
billion dollars in health care costs
a year yeah I'm here today to tell you
that you do not have
be paralyzed by your anxiety I'm here to
tell you that you can actually make your
anxiety your best friend so how do we
start a new relationship with anxiety to
answer this question I invite you in a
journey to the first moments where I
learned the techniques that I now teach
patients all over the world including
Mina my journey begins in Govan I don't
have a lot batteries a small town in
Ontario Brazil I'm now 10 years old and
my father has officially left us my
mother is faced with the reality of
having to feed my sister and I I still
remember a day when we had one potato
for the three of us don't get me wrong
we didn't starve but my mother being the
survivor that she is had to find a way
to keep reinventing herself she sold
brooms and when brooms were not selling
she sold hangers when hangers did not
pay the bills
she made clothes under work Jemma's
uniforms watching my mom thrive despite
of all odds it's the first time in my
life that I understood what it takes to
go through your anxiety to accept its
presence to make your best friend
instead of being paralyzed by it by age
15 I move to Belarus on chi which is the
third largest city in Brazil I'm sent to
live with my grandmother to get a better
education Butler's origin is super
exciting but also a little scary I
quickly learned that making friends in a
large city is not easy I'm going inward
I'm becoming shy I didn't catch this
but my grandmother dead on a beautiful
Saturday afternoon
my grandmother invites me to go for
lunch at a local shopping mall as we
walk towards lunch
my grandmother proceeds to tell me
that's just notice I hadn't made many
friends that I was thinking home a lot
and then she was concerned about this
that's what my grandmother called my
bubble my personal space she believed
that at that point in my life my bubble
was so large that I was keeping
everybody a bay and there was a primary
reason why I had no friends to be honest
with you I didn't care much about this
idea of a bubble and 15 what I cared
about was having Chinese food for the
first time in my life I can still smell
the sweet and sour chicken was delicious
as are you getting ready to sit with my
delicious food my grandmother looks at
me and says let's go sit with that woman
it looks like she does not want any
company
what right is it going crazy sitting
with a stranger at a shopping mall
eating with a stranger
I don't even friend have friends yet my
stomach was hurting my heart pound I
want to go home I'm begging my
grandmother let's go home yes she pushes
through next thing I know we're sitting
and eating and talking to a stranger let
me be honest my grandmother was talking
I was avoiding the whole thing I don't
remember how many times my grandmother
took me to the mall to talk to strangers
I do remember he repeated again and
again and I do remember that it was very
painful but I also remember that after a
while I enjoyed our lunch dates and I
even enjoy talking to strangers by the
time I was 18 I moved to Buffalo New
York as an exchange student eager so so
very eager to finally have a chance to
leave my America
dream as the months passed I met my old
fear again the fear of talking to
strangers what would they think of me
would they like me except me what me in
their circle this time it was much more
difficult because I barely spoke any
English so what did I do
I did the unthinkable I joined Ski Club
that's right
without every skiing before a Brazilian
in the slopes not a pretty fixture why
did I do it well I had to be stuck it
took an hour every week to and from the
ski resort being stuck with 40 people in
a bus meant I had to find a way to
shrink my bubble I had to find a way to
talk to strangers and by the end of my
exchange student ear I had made friends
for a lifetime and you'd be happy to
know I was skiing if you can call that
skiing in retrospect I can see now how
this experience shaped my decision to
become a behavioral therapist so to
learn more I started graduate school
pursuing a degree in clinical psychology
that's when I began to understand what
my mother and grandmother had been
showing me all along
I learned that ink is oily anxiety is
adaptive biologically sealing our body
something important it's telling us
about the injure if there was a lion
right now right here in front of all of
us our body our anxiety would protect us
by getting us ready to react how by
turning on our limbic system the
fight-or-flight center of our brain
once our limbic system is on our heart
starts to pound we breathe faster we
sweat our muscles contract we are ready
to run there's a significant difference
between what I was learning in graduate
school which is anxiety is biologically
adaptive and it's something that kept us
alive and yeah what I saw at the clinic
paralyzing my patients so should I do
what most of my patients ask me to do
take away all of their anxiety
absolutely not taking away our anxiety
it's like taking away our pain receptors
if we touch a hot stove without any pain
receptors or burn so don't pain is
unpleasant it protects us from further
injury
just like in keziah T which is protects
us from danger so if anxiety is adaptive
and necessary then what is the problem
avoiding is the problem of what are your
anxiety makes all of us you a little
better momentarily and yet in the long
run it can be really harmful think about
it this way avoiding anxiety is like
taking a tylenol for a fever due to a
bacterial infection although the tylenol
will bring our fever down you will not
fight the infection to fight the
infection you're gonna need something
designed to target the bacteria like an
anti biotic the good news is when it
comes to anxiety the antibiotic is
called exposure therapy it skills that
all of us can learn to help
limbic system the fight-or-flight part
of our brain to differentiate an
imaginary lion from the real lion there
is a crucial difference however between
being exposed to our fears versus
approaching our anxiety as a skill Nina
was exposed to flying again and again
and again for 18 years and could not get
on a plane without taking an anxiety
medication in Bella resort and in
Buffalo I was exposed to strangers all
the time and they did not mean that I
wasn't afraid to talk to them so what is
the key what is the difference in
exposure therapy the differences we need
to approach our specific fear and do it
over and over again in a specific
pattern an exposure therapy that's
called looping looping is the idea of
facing a particular fear staying with it
long enough for anxiety to come down by
at least half and then repeating it
again and again and again on their first
day in Mumbai Meena and I drove in a
high taxi for hours and hours and hours
once Meena got on that first flight we
proceeded to take eight more flights in
five days that's right and then
ultimately Meena was able to overcome
her fear of small enclosed places by
getting side of the trunk of her car
again and again and again Meena was
brave and overcame her claustrophobia at
age 65 he was approaching my own fears
that got me to pursue a life in this
country to learn English
sooo my dream of becoming a behavioral
therapist and to soar high enough to get
a position at Harvard my dream for each
of you all of you today is that you
choose to engage with your anxiety at a
much earlier age than you know my dream
for each one of you today is that you
learn how to make your anxiety your best
friend just like that friend that you
have that you love but keeps nudging you
out of your comfort zone and the magic
is if you learn to make anxiety your
best friend before it becomes a
paralyzing light by paralyzing force in
your life you won't need a PhD to
overcome it both my mother and
grandmother without a college degree
taught me the skills that later I learn
to be scientifically sound based in
biology and that I now teach patients
including Nina so come dream with me
today teach somebody how to overcome
their fears one step at a time
I promise you you change their lives and
yours forever
thank you
[Applause]