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Anxiety Disorders and Strategies to Enhance Emotional Resilience w/ Burkhart Hahn
18 Plays2 months ago
In this episode I talk to Burkhart Hahn PhD candidate from Oklahoma State University where is specializes in research focusing on anxiety disorders. Here we talk about his own mental health and how that has made him a better therapist. Tools to better understand and cope with anxiety disorders. The anxiety disorders as a whole and the mechanism behind their function. Along with how exercise can help improve anxiety symptoms.
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Transcript
Introduction to Burkhardt Hahn and His Research
00:00:00
Tony Montgomery
All right, today we have on Burkhardt Hahn, a friend of mine, fellow colleague at Oklahoma State. You are part of the psych department with um Dr. Damon Grant working under him and in his lab. um So we've come to know each other over the last year, working together in the lab. So I thought um based on our conversations that we had over coffee, that it would be fun to have you on and talk about some of the research you're doing, um the way that you see the research going in terms of ah mood disorders and and and how we can kind of bring all that together to form a fundamental idea of how maybe we we can overcome some of this stuff and just a better way to to think about it. So thanks for coming on the show, man.
00:00:42
Burke Hahn
Yeah, absolutely. Thank you very much for having me on. I'm very excited to to talk with you and to discuss some of this stuff. So yeah, thank you for having me on.
00:00:51
Tony Montgomery
Yeah, of course, of course. So let's give everyone just a kind of a quick little background on um your research, what you're looking at, what you're focusing on, and then maybe some ideas of like what brought you to this course of action, because I always feel like the backstory of like why people get into psychology is, is always fascinating. and It usually comes from like, I came from a messed up home, I went to therapy, I had a really good interaction with my therapist, so I want to help people as well, or you know, something tragic, traumatic happened to them and they see the power in um psychology. ah For me, I got into psychology because I really wanted to understand why we interesting creatures do the things that we do. Being involved with the Special Forces group in the Marine Corps, I thought it was always interesting that like all these guys are in supreme shape
00:01:43
Tony Montgomery
Um, but yet there's 80 to 85% attrition rate. Like why, why are they quitting? Like psychologically what's going on in their mind? So that kind of brought me to that. And then obviously dealing with friends and PTSD and going to war, like all those things brought me into the realm of like psychology and and how can I help it? So it'd be interesting to get your backstory and kind of a synopsis of what your research is.
00:02:06
Burke Hahn
Yeah, of course. um And ah definitely that that complexity piece that you mentioned that there's just so many different psychological factors going on for lots of different people and different reasons for, um you know, kind of where they came from and how they sort of developed some of the concerns they're having and everything like that was definitely a big reason why I got into psychology. But um I'll start with my current research interests and my kind of goals for the future and where like I'm hoping to like take my research career and in my clinical career and then I'll kind of like um build up that that background like you mentioned.
Exploring Exercise and Anxiety
00:02:40
Burke Hahn
um so Currently, I am conducting a study on exercise and social anxiety, particularly looking at the the internal physiological mechanisms of what contributes to social anxiety disorder and anxiety disorders broadly.
00:02:58
Burke Hahn
um so What that means is you know we have ah you know cognitive symptoms of anxiety, so you know worrying about lots of different things, having your brain feel like it's flooded with adrenaline, you're not able to concentrate, stuff like that. And then in conjunction with that, we have these physiological and emotional symptoms. um And so my interest overall is integrating those two things, looking at how physiological mechanisms influence cognitive mechanisms and vice versa.
00:03:26
Burke Hahn
um And so when social anxiety, we have um a lot of internal focus. And so what I mean by that is let's say you go to a party or a social gathering around public or whatever it might be, and you're getting anxious or so stressed or whatever it might be.
00:03:42
Burke Hahn
um and you're starting to notice your heart rate beating faster, and you started to notice yourself sweating or blushing, and suddenly your attention is directed more toward those things than it is toward a conversation. um And so what that can do is it will limit the cognitive resources that you have available to be able to you know like concentrate on the conversation topic, to say what you want to say, to listen to other people, to be kind of aware of your surroundings.
00:04:08
Burke Hahn
um and just kind of be in like a calm, relaxed state and just enjoy yourself. um And so what I'm interested in is that attentional focus and then um how exercise can influence those things. Because I am ah really interested in the ah fact that exercise you know kind of activates a lot of the same or very similar physiological mechanisms as anxiety. you know Anxiety, we have a lot of that.
00:04:37
Burke Hahn
um you know, that sympathetic nervous system activation, we have a lot of that stress, that fight or flight response. And then with exercise, we're activating a lot of those similar things, um but we see that exercise actually helps reduce anxiety. And so the question is, well, why? What what is it about exercise that reduces anxiety, that helps people to have more control over the anxiety or just kind of like let it flow and not kind of get stuck with some of those worry thoughts?
00:05:05
Burke Hahn
So bringing it back to kind of the project I'm working on now, I'm looking at a psychophysiological indicator of um of ah internal attention or what's called interoception. um And I'm sure we'll get to this later, but it's called the heartbeat evoke potential, which basically um in brief is looking at your cognitive effort dedicated to the heart.
00:05:27
Burke Hahn
And so I'm looking at how, um, not only how to standardize our measurements of that technique, cause it's very new, but also how exercise, how worry and how just being at rest impacts the, um, the kind of the, uh, the, how much attention is directed to the heart by examining those, um, kind of those, uh, physiological mechanisms and those, um, that brain weight, those brainwaves, that cognitive effort.
00:05:53
Burke Hahn
um So that's what I'm looking at now. um And then kind of taking a step back, um I got into psychology, um starting out as early as high school. Excuse me. and um Uh, part of the reason for that is I had mental health struggles on my own.
Personal and Genetic Influences on Mental Health
00:06:09
Burke Hahn
Um, I struggled with, um, uh, as I'm getting older, uh, pretty severe depression, starting to realize it was more severe than I thought at the time. Uh, and also, um, social anxiety, um, and just generalized anxiety as well. Uh, and so through some pretty intense challenges, um, and with some, um, you know, uh, some bouts of
00:06:34
Burke Hahn
you know like self-harm and like things like that, that my parents were, although they did not have a ton of like experience with therapy mental health, they were able to talk with me to me about it and get me a therapist. And so when I started with that therapy, the therapist that I had was life-changing for me. um i It was a really strong relationship I got developed i got to develop with him um to help but develop skills to process some of the stuff I was going through to challenge some of those negative core beliefs that I have about myself and about other people. um And it was really, really powerful. And I found myself just falling in love with being able to um connect that on such an emotional level with somebody and to be able to assist them through um some things that maybe they weren't even aware of themselves.
00:07:27
Burke Hahn
um And so at a kind of a core metaphysical level, that was my true passion, which which would has kind of set me off to learn more about psychology. And then I took AP Psychology in high school and that was the first class that I was like, man, I like reading the textbook here.
00:07:42
Tony Montgomery
Yeah, yeah.
00:07:43
Burke Hahn
so um And which was like a really neat experience.
00:07:43
Tony Montgomery
yeah
00:07:46
Burke Hahn
And so um I got to kind of like pursue that. And then I started college at the University of Tulsa and my first semester there. Um, I, you know, I got some advice from, uh, some faculty that was teaching a course.
00:07:59
Burke Hahn
And also, uh, my mom was pushing me to, uh, very thankfully pushing me to go, uh, you know, get more involved. And so, um, in, in research.
00:08:09
Tony Montgomery
Hmm.
00:08:10
Burke Hahn
So I joined a research lab. um where we studied chronic pain, particularly in Native American populations, um looking at why ah Native American populations have like a higher prevalence of chronic pain than non-Hispanic whites or other racial and ethnic groups. um And there's a lot of complexity to that, um ah but it was I was there for four years.
00:08:34
Burke Hahn
And it was a wonderful time being able to get involved with research, to learn more about psychology, um but then also be able to find my passion of connecting physical and mental health. um Chronic pain is such an interesting phenomena where, um yes, there are fit obviously physical sensations, like you get noxious stimuli, ah you know, like a finger prick or like a pinch that hurts, but you also have um different modulatory systems in the body. So your spinal cord actually modulates how much pain signals are sent to the brain. Your brain modulates how you interpret those pain signals. So this cognitive appraisal of this pain. And I was fascinated by this because, um you know, there's like pain, ah like in exercise, for example, they can be very pleasurable. Like you could go to the gym, you can, ah you know, lift some weights or you can run for a really long time and you can feel that like, man,
00:09:27
Burke Hahn
This hurts, but i it hurts so good. You know what I mean? And so there was just like a lot of variety of um
00:09:31
Tony Montgomery
Yeah.
00:09:35
Burke Hahn
of like pain mechanisms and things like that. And i was like and that was I was noticing that there was also very little connection between the exercise, kinesiology, exercise science, and psychology. Even though that you know we were all talking about very similar mechanisms and it's they're all part of the body, i was there was like almost no connection with that. And so then moving into graduate school, and um I you know applied for Dr. Grant's, Damod Grant's lab um because he did ah research on exercise but examining those physiological mechanisms and met with him, talked to them about my some of my study ideas of looking at exercise and anxiety and um he seemed to really take to it and um kind of the rest is history. you know I got an offer from OSU and now being here for five years um has been
00:10:27
Burke Hahn
I just have been so confident that this is like exactly where I need it to be, um and it's just very, very interesting interesting stuff. Anyway, that's ah just a brief synopsis, I guess, of of kind of how I got into psychology. but um Yeah, yeah it's been it's been a really wonderful journey and psychology is just um ah just overall,
00:10:50
Burke Hahn
um you just learn so many skills and so many things about like yourself and about other people and about humanity in general, um which I love.
00:10:53
Tony Montgomery
Yeah.
00:10:58
Tony Montgomery
Yeah, no, for sure. I mean, I share a lot of those same sentiments. um Going back to something you said, just to kind of linger on it for a little bit. um when When suffering with depression and anxiety, we know that there's a big um hereditary true like carry on with that but it sounded like your parents never kind of went through that or maybe they did go through that and the family history is something that you saw but back then maybe therapy was stigmatized so they didn't go to therapy um so now that you're in the practice looking at it can you see a family history of this kind of being pushed down or would you think that this is mostly an an environmental factor that kind of took over and is there something
00:11:43
Tony Montgomery
um and If you want to go into specifics, you can, but is there something that triggered this um depression, anxiety kind of phenomena that you went through?
00:11:53
Burke Hahn
Yeah, of course. um So I would say it's definitely a mix of both environmental and um kind of genetic family history effects. So I'll start with the um like the family history stuff. So um I first of all, I love my family so much. They're like wonderful people, incredibly supportive. um And obviously, you know, just like everyone else, we like have our struggles as family, but um As I become an adult, getting to know my parents, um and i they would agree with me on this, so I feel confident saying it, is that they have kind of discovered their own mental health challenges as ah my sister and I have gone through, like what we have gone through, because my sister also struggles with some mental health challenges as well.
00:12:28
Tony Montgomery
Anyway.
00:12:37
Burke Hahn
And so my dad, for example, um, you know, he grew up, uh, in, um, like semi rural Oklahoma, never really had a lot of mental health, um, um, like facilitation when he was growing up, you know, very much pull yourself up by your bootstraps. And you can see that with my grandpa as well. Um, like he does not like to talk about his feelings stuff. And that's, um, you know, either here nor there, but when for my dad,
00:13:03
Burke Hahn
Um, you know, he's gone through, he was in the air force for 25 years, you know, activity reserves. He's seen a lot of things throughout his life that, um, like causes a lot of ah challenges for him. And, um, he is like struggled with trauma response and, um, so like PTSD symptoms. And so he's gone to therapy. Um, my, my mom, although that she hasn't gone to therapy directly, um, has her own ways of kind of managing her mental health concerns.
00:13:30
Burke Hahn
So, um, I guess to, to kind of answer your question more directly, like I would say there's certainly a genetic component. Um, but that is, uh, I would say at the time when I was in high school, that was um kind of emphasized or maybe catalyzed by the fact that my parents also weren't really aware of their mental health challenges at the time.
00:13:48
Tony Montgomery
Yeah.
00:13:48
Burke Hahn
Um, and so, um, you know, uh, we had that genetic component and then we also had these environmental factors. You know, my, um, I was becoming a teenager. And I was very volatile. um My dad and I had a very volatile relationship. um And there were just some times where you know I got um like some of these really intense emotions that led to these really intense crashes. And um a couple of times, you know it led to some like suicide attempts. um And the for ah my my parents, you know when I was able to talk to them about that, or um at some points they like would even notice,
00:14:24
Burke Hahn
um That's when they sort of were very thankfully, um were like, okay, yeah, like we can definitely talk about like getting you like help and and sending you to a therapist. you know like There wasn't ever a time where I talked with them about mental health stuff and they were dismissive of that in such a way that they were like, we're not going to support you in getting the help that you need.
00:14:46
Burke Hahn
um So all that to say is there's definitely both um experiences, genetic and environmental for me. um And it's really nice to see now, especially I think that I've gotten so far into psychology that um I think it's rubbed off on my parents a little bit and they but like get some help themselves.
00:15:04
Tony Montgomery
Yeah. Yeah, yeah, no, that's awesome. I mean, that's the whole point of of why we do the things that we do.
00:15:09
Burke Hahn
Mm hmm.
00:15:11
Tony Montgomery
One of the things that that came to mind as you as you were talking is this idea of like, when we hear about things like um suicide ideation and depression and anxiety, we always um put our thoughts to like something very, very traumatic must have happened to this person in order for them to get to that point. And then we we kind of almost minimize like some of the other things. we like We don't truly understand the individual differences of how they receive traumatic experiences. um Talking to a bunch of people through research and and
00:15:47
Tony Montgomery
um just friends and and getting into these conversations. you know some Some people will talk about the trauma that they went through as ah as a child. and to me, it was like, Oh, that's just like, that's just like a Sunday night at the house. Right. But, but you can't minimize what they went through. Cause it's a, it's one of those things where we don't really truly know how they perceive it and interpret it. And I think that's the biggest thing, right? Is like the perception of what's going on.
00:16:19
Tony Montgomery
your ability to think that you can control it and the interpretation of all those things is what creates this like chemical may you of like. this is this is what's creating the trauma. So it doesn't have to be something that's like overly traumatic, like you're you know you were sexually abused or um your parent died in a tragic, right? It could be something very minor, but it's really just their ability to emotionally regulate. And I guess if you've never had those experiences with your families and and stuff like that,
00:16:50
Tony Montgomery
Um, which is very common from people that grew up in the world war two era and then just kind of pass it down. Like we were always taught like AR emotions. We, so we keep them inside. We don't really share them with people because we don't want to put that burden on other people. So having that inability to regulate those emotions is something that, um, we have to understand like each individual may have very strong tools depending on like their temperament, depending on, um,
00:17:18
Tony Montgomery
you know, maybe, maybe the friendships outside, like wherever they feel safe, or there's so many different things that can create a traumatic experience. So I just wanted to touch on that because it sounds like there was no one particular dramatic event that ignited you into this depression, anxiety kind of You know, it had to start somewhere, right? Obviously it started in the genetic component, but, but yeah, I just wanted to to touch on that because it didn't sound like there was anything super triggering that like made it be like, Oh, this was the event that I'm going to know for the rest of my life that started me on this road of mental health.
00:17:57
Burke Hahn
Yeah, man, that's so many things to to talk about there. But no, absolutely. um One thing I wanted to ah to talk about first and then kind of lead into one other thing is, um one of the things that you you mentioned is this, ah there's these generational factors, right? Where you have folks that are born like in the World War II generation or even before.
00:18:18
Burke Hahn
ah that are, you know, taught to um act a certain way, you know, keep their emotions inside or, you know, like whatever it might be. um And then ah that is passed down, not only like, like physically, genetically, like there are genetic um ah expression can change based on your environment. So that genetic expression can be passed down through generations, but then also we have these environmental factors that, you know, how you raise your kids, um how your parents raised you, um what environment that you live in, all of those things can go into um like these generational impacts of mental health.
00:18:55
Burke Hahn
um and, ah you know, ah mental health disorders and things like that, that's um very commonly researched in like the ah generational trauma um literature and things like that, like concepts of of how those things occur. um And also kind of leading into um this other thing that I've mentioned um that like,
00:19:15
Burke Hahn
Yeah, I mean, for me, there was I mean, there have certainly been some things in my life that I would consider to be like, um like traumatic experiences that I've had. um And ah but certainly, like, um you know, with when I started out, um being like having this like depression and anxiety.
00:19:24
Tony Montgomery
Hmm.
00:19:36
Burke Hahn
um Like there was it was more of like a lot of like smaller things that that had kind of come to to um I guess facilitator kind of like maybe put me at risk for developing, um, you know, a mood disorder and anxiety disorder.
00:19:51
Burke Hahn
Um, one of those things is, you know, we, um, uh, we had a, you know, my, my dad was in the military. We had a pretty, uh, like consistent life in where, you know, in, in Oklahoma where we lived, but we moved to Canada for three years and all my friends, like I lost all of those friends, all those relationships, never felt like I really fit in.
00:20:05
Tony Montgomery
Right.
00:20:10
Burke Hahn
Um, had a very volatile early romantic relationship during that time, which always is, uh, can be, can be harmful. Um, and then like, as time went on, you know, that kind of, there were some things that compounded on, on that as well. Um, that just kind of like triggered that for me. Um, and one of the things I think you mentioned too, that's really important to, to consider is that, um, you know,
00:20:35
Burke Hahn
Everyone that experiences a traumatic event, um it's not just the event and then the person. There's all of these different types of factors that go into it to you know developing um like PTSD or post-traumatic resilience for for um the event. and Even like somebody that maybe has you know a lot of ah trauma experiences and has come out of those with um like a lot of resilience, maybe later down the line, they start to develop um like PTSD. like Later on, PTSD, I'm sure with your experience in the military, like
00:21:16
Burke Hahn
You have seen that with some of your like friends and some of the folks you worked with that were like doing totally fine in that military environment, like left, and then like all of a sudden they start to develop these things because their environment has changed so drastically.
00:21:29
Tony Montgomery
The room.
00:21:29
Burke Hahn
um So anyway, yeah, there's just like tons of of different factors that go into it, and um it doesn't always have to be yeah like like one specific traumatic event that can trigger those things for sure.
00:21:40
Tony Montgomery
Yeah, especially when you look at like the literature on stress, right these this little continuous things that can cause stress, those are some of the biggest drivers of mental health disorders. right it's not It can definitely be one big stress bolus, right but it's that idea of like continuous stress starts to down-regulate all these abilities that we have, all these mechanisms that we have to fight the to be able to emotionally regulate, right? So whenever we continue to have these stressful things, that starts to down regulate, you know, the HPA access, it starts to um release glucocorticoids in our body, which starts to have a lot of downhill effects on our ability to have um good cognition, like all this stuff. And then the epigenetic phenomenon too is is always fascinating. They found that if people that have the five-HTT gene expression are more susceptible to depression,
00:22:35
Tony Montgomery
um But it also depends on the environment if you're going to switch that on or not. And then the the change in environment, too, like we've seen with the research, like the guys that went over to Vietnam that were addicted to opiates when they came back home, pretty much a high percentage of them um were able to not have that same addiction. So all those things play a huge factor, which also can make it very um overwhelming for people to think like, you know, holy crap, like all this stuff plays such a huge role. How can I begin to even
00:23:06
Tony Montgomery
control it and and hopefully that's some of the stuff um we'll go into. And one of the things you touched on, which is very interesting, because I know that Tulsa does a lot of research on the Native American population, and that was your first four years of undergrad kind of helping out with that
Cultural Perspectives and Community Resilience
00:23:21
Tony Montgomery
research. What what were some of the key things that you found in terms of different differences in those ethnic minorities compared to the Native Americans? I'd be fascinated to to learn about that.
00:23:32
Burke Hahn
Yeah, absolutely. um So, ah i just a caveat to, says you know, I've been out of that that research for quite some time, so I'll i'll do my best to to to speak on this on my screen.
00:23:42
Tony Montgomery
and you were an undergrad and and you didn't know what you you didn't know what you were doing, you didn't know what you were looking at, but yeah, just kind of do the best you can with that type of stuff.
00:23:44
Burke Hahn
i was right
00:23:51
Burke Hahn
Yeah, no, of course. though I appreciate that. um But I will say from from what I remember, um you know we did studies, we had a huge ah you know um like nationally funded R01 study ah um called OK Snap, um Oklahoma study of Native American pain risk. And what we were looking at is We were basically, it was through a spaghetti at a wall study where we took tons and tons and tons of different measures, um, and, uh, and tried to see how, if those, any of those, uh, kind of, uh, in the statistical analysis fit a pathway of predicting chronic pain. So it was a longitudinal study. We brought folks in for two sessions, uh, for each participant. They were like, I dunno.
00:24:36
Burke Hahn
four hours each, three to four hours each, so two sessions of that, which shows tons and tons of data. And then we also had ongoing longitudinal data where we would call participants and ask them um if they've developed any chronic pain. And the goal of the study was to look at, okay, can we say that there are certain factors that form a significant pathway to predicting who will develop chronic pain in non-Hispanic whites and Native American folks.
00:25:04
Burke Hahn
um so kind of ah With all that in mind, you know we looked at socio-demographic variables um in terms of socioeconomic status, um race, ethnicity, um gender identity, ah you know like trauma experiences, tons of stuff like that. We looked at ah how people culturally view pain. So one thing that was really interesting to me is we did an interview, which is a qualit or ah yeah qualitative interview asking them, okay, how did your parents treat you whenever you got hurt?
00:25:37
Burke Hahn
um
00:25:37
Tony Montgomery
Mm.
00:25:38
Burke Hahn
What kind of language do you use to describe pain? um From the culture that you grew up in, the environment you grew up in, how is pain treated? Lots of really cool stuff like that. But then we also did physical mechanisms of pain where we...
00:25:51
Burke Hahn
we and it Man, it must have been so tough for people to come in and do this study, but at least you know they got they got... compensated well enough, um but we would like put ah like electrodes on our ankle and and shock them at very like safe levels.
00:26:06
Burke Hahn
um Still painful, but safe levels to like measure um like ah measured ah you know muscle responses and spinal cord stimulation and pain ratings.
00:26:07
Tony Montgomery
and
00:26:13
Tony Montgomery
Yeah.
00:26:16
Burke Hahn
um We do things like they would put their hand in cold water and see how long they could hold it in there. We would do heat pain, and um ischemic pain, which we took a blood pressure cuff and put it around their arm and and kind of sweep that just to see like if there were different mechanisms of pain that led to this. So all that being said,
00:26:34
Burke Hahn
um One of the ah the the big things that was discovered, ah at least in the first study, ah is that there is a lot of, um of us I believe there's a significant significant pathway with um discrimination, like racial discrimination and discrimination experiences and and racial trauma, in addition to historical trauma. So um we looked at, it was looking at you know people that have had experiences with discrimination um in their environment,
00:27:04
Burke Hahn
um and and then looked at like if who developed chronic pain, and there was kind of a significant pathway where that discrimination predicted development of chronic pain.
00:27:13
Tony Montgomery
Thank you.
00:27:14
Burke Hahn
um And then ah there's one other thing that I wanted to mention. Oh, um i ah i I don't know if this is exactly with our lab, but I know that with um another lab in Tulsa, the Laurier Institute for Brain Research, they did research on ah cultural resilience.
00:27:29
Burke Hahn
And it was really cool because they found that ah cultural resilience is actually um ah meet a medium factor to limit that risk of chronic pain development if they have identity with their culture and they have a lot of community and things like that.
00:27:41
Tony Montgomery
Hmm. Hmm.
00:27:43
Burke Hahn
So that was really interesting. um And then one other thing that they they started that the lab I was in an undergrad started to do when I left was ah basically ah doing a similar study, but looking at um like diabetes and looking at um ah like blood glucose and ah neuropathy as well to try to see um if if that has any effect. I wasn't there for the results on that, but um that was also a really interesting, really interesting data that we got to collect about, you know, looking to see if um like development of like diabetes and like
00:28:19
Burke Hahn
you know, nutrition health and stuff like that and physical health can impact development of chronic pain as well. um So yeah, hopefully that that answered your question. um ah But yeah, it was it was a fascinating um study and very, very, very important.
00:28:29
Tony Montgomery
yeah
00:28:35
Burke Hahn
Like there was um Uh, whenever it began, like there was very little research on, um, chronic pain risk in native American populations, despite the fact that there is, there was a reported like much higher prevalence than pretty much any other racial or ethnic group.
00:28:51
Burke Hahn
Um, so, um, yeah.
00:28:52
Tony Montgomery
Yeah. Yeah, fascinating. Was this funded by the CIA to come up with torture? ah
00:28:59
Burke Hahn
Uh, he,
00:29:00
Tony Montgomery
just um follow What are we doing over there? what Even better.
00:29:06
Burke Hahn
Yeah, well, it was even better because our lab was in the basement, so people wanted to go down to the basement, and so it was like a pain dungeon that we had down there.
00:29:12
Tony Montgomery
Oh, yeah.
00:29:16
Tony Montgomery
Oh, man. Yeah. No, one of the things that I'm sure well we'll hear this a lot echoed throughout this conversation. You touched on it with the military, you're touching on it now with the Native American population is this community aspect. Like once you leave that community, that's when we start to see a lot of the deleterious effects to the veteran population. um But the fact that they had the ones that had stronger community had better resilience makes it makes a ton of sense, which also makes me really think about where we are as a society being so individualistic and so hooked on the internet that we start to lose this community of social interaction, like face to face social interaction. And we now supplant it with online social interaction. And we know based on the research that that interaction is nowhere near as positive or as good.
00:30:10
Tony Montgomery
um So that that is interesting, and and I'm sure we'll we'll talk about that a lot, because I feel like that community not only gives you a sense of of purpose, but it also gives you a sense of like, I'm not in this alone.
00:30:24
Tony Montgomery
Right. And when you have that, you think like, Oh, now I can kind of do anything like this. This doesn't define me in the communities with me. Like I have chances to make it now. And I think that perception of, of that community outlook is something that is really powerful for people.
00:30:41
Tony Montgomery
um Sebastian Junger wrote a really good book called Tribe where he analyzes the whole idea of um community and the aspects of community. And, you know, he's a very successful author and he lives in a, um with his wife, they lived in a Dominican, like a poor Dominican community in New York. And they absolutely loved it because everyone was looking out for everyone um as opposed to the more individual, in individual communities that we have, society that we have in America now.
00:31:10
Tony Montgomery
No, that was really interesting. Thanks for thanks for pulling that out because I know trying to get an undergrad to like walk and talk while they're so busy with getting inundated with like this new thing.
00:31:15
Burke Hahn
you
00:31:23
Tony Montgomery
It's hard to remember this type of stuff. so um but move on to kind of something that is near and dear to
Exercise as a Mental Health Tool
00:31:30
Tony Montgomery
both of our hearts. What we're doing our research on now is um the the thoughts of using exercise as a therapeutic tool to help with um mental health disorders.
00:31:38
Burke Hahn
Mm hmm.
00:31:40
Tony Montgomery
Specifically, we'll we'll talk about anxiety, but I think the the role that it plays in anxiety also plays the same role in um all these other um mental health disorders as well. Actually, before we get into the exercise part, can we go over kind of the types of anxiety disorders and can you give like a just a quick little rundown ah of each type?
00:32:02
Burke Hahn
Yeah, of course. Let's see, this will um hopefully reflect that I still have my knowledge from taking my psychopathology class in grad school. But no, I'm just kidding. um Yeah, so ah there's a variety of different anxiety disorders, um at least what's the ones that are categorized in the DSM-5, the diagnostic manual. um So the the, I guess the, maybe the most common one or the most popular one, so to speak, is generalized anxiety disorder. um And that is, it's characterized by this this core ah this just like worry about a lot of different things. um worry about um you know the Worry about the future, about your health, about ah finances, about whatever it might be, and the fact that you have challenges controlling that worry. so
00:32:52
Burke Hahn
You're just kind of ruminate or ruminating or some of that repetitive negative thinking about a lot of different topics. So that's generalized and guided disorder. Social anxiety is characterized by, um, a core fear of evaluation. Um, now that I believe in the DSM, it says, uh, negative valuation, but there's been a lot of research that says even like positive evaluation can be anxiety evoking for folks with social anxiety.
00:33:15
Burke Hahn
which is really interesting. um So that's, yeah, absolutely.
00:33:17
Tony Montgomery
Yeah, fascinating.
00:33:20
Burke Hahn
um And I think from from what I've read, it just the kind of like this idea of being noticed of people noticing you and like looking at you and saying, I've noticed things about you that can be stressful for for some folks.
00:33:31
Burke Hahn
um But yeah, it is really interesting um kind of nuance there. And then we have specific phobia, which as you might guess is an anxiety disorder or ah I guess a specific fear about one particular thing. So a lot of the time it's you know dogs or spiders or needles. Lots and lots and lots of different different things can can occur with specific phobia. And then let's see. I know I'm going to miss one.
00:34:00
Tony Montgomery
yeah we got
00:34:00
Burke Hahn
um
00:34:01
Tony Montgomery
anneic disorder
00:34:02
Burke Hahn
Panic disorder. Yes, thank you. And panic disorder is really interesting.
00:34:04
Tony Montgomery
ye
00:34:06
Burke Hahn
because it's not necessarily you have panic attacks, right? That can, you can actually have generalized anxiety or social anxiety with panic attacks. ah Panic disorder is specifically about being anxious about having a panic attack in a public space.
00:34:19
Burke Hahn
So being anxious that you're going to like have a panic attack and then that you're going to die or that people, you're not going to be taken care of or just the fact that you're going to have a panic attack um is panic disorder.
00:34:25
Tony Montgomery
Yep, we got panic disorder.
00:34:30
Burke Hahn
And then we also have, um, I believe agoraphobia as well, which is basically kind of just like the fear of ah being outside of like a safe place and not being able to get help, um not be able to seek help.
00:34:46
Burke Hahn
um And it's most commonly I think seen in in kiddos, but we do see sometimes see it in adults as well. um
00:34:54
Tony Montgomery
Yeah, and then just to go over two more, because people don't think of PTSD as an anxiety disorder, but it is definitely labeled as one. But I think people see that as kind of like its own separate thing, but it is related to the anxiety disorder family, and then also hypochondria as well, the um idea that your creating these sicknesses inside of you that you have this health anxiety um that can manifest itself into going to the doctor and telling them you have X, Y, and Z, even though you don't have it. So all things that, as you can see, can like cripple your ability to interact with the world and in a positive way. um So then how can how can we use exercise
00:35:39
Tony Montgomery
Maybe what are some of the mechanisms that exercise has ah that plays that plays a role in helping with these disorders?
00:35:46
Burke Hahn
Yeah, absolutely. Well, I mean, first of all, you're absolutely right that like, um, you know, PTSD, um, and you know, hypochondria and stuff like that can also be like really related to anxiety.
00:35:56
Burke Hahn
Um, even obsessive compulsive disorder can sometimes be characterized as an anxiety disorder as well, because there's a lot of, um, what we call like trans diagnostic factors or factors that are kind of common across all of these different disorders, like not being able to control worry thoughts, um, uh, not being able to, or having these kind of, um,
00:35:59
Tony Montgomery
and
00:36:17
Burke Hahn
intrusive thoughts as well. So a lot and symptoms are very similar.
00:36:19
Tony Montgomery
Yeah.
00:36:20
Burke Hahn
So lots of different things absolutely can coincide there.
00:36:22
Tony Montgomery
Yeah. The OCD stuff is. why Like I listened to a podcast of a therapist who specializes in OCD and I was not aware of the the levels of it. And like you think of OCD, you think of like washing your hands and you think of like these nervous ticks. um But there's also this idea that a lot of people don't think about is like you have these intrusive thoughts that aren't necessarily reflective of who you are as a person but can also make this conflict of like the inner self and the the real self converge and and cause a lot of issues. And one of the things this lady was talking about was like a lot of people with OCD or one of the things that OCD can manifest is like these intrusive thoughts of like thinking children are attractive and
00:37:11
Tony Montgomery
you know then they're like, oh my God, am I am i a pedophile? What's going on here? right And I had no clue that that was part of that process. It was it blew my mind to think about like the intrusive thoughts that could come in, that you don't really have control over. like I do these stupid long endurance runs and everyone always says, like oh, you must get like so much introspection and self-awareness on these runs. And I tell them, like no, like I honestly, the stupidest shit comes into my mind you know like i'll think of a song that i haven't heard in 15 years and i don't even like the song and then i can't get it out of your head but so the idea that like these intrusive thoughts can be something that can almost define you as like a pedophile even though you're never going to act on those things
00:38:00
Tony Montgomery
And that would be something that if I didn't know that that was actually related to like an OCD disorder, I would think like, like holy crap, like I need to go lock myself up, like I'm going crazy. So that that actually blew my mind.
00:38:14
Burke Hahn
Yeah, it's incredibly fascinating. And you know this is kind of a theme we've been talking about of the ah you know the external world, like what you know we see and what we see other people do and what like you know you see like the world. But then we also have this internal world of what's going on. OCD is such a great example of that because ah you know all we see as people looking on the outside is the um like the the the compulsions like what you know like you said checking the the lock on the door or washing your hands a lot or you know rearranging things or whatever it might be but ah what we don't see is what's behind that and just like you said is those intrusive thoughts like there's even ones like the one you mentioned about um like oh i'm so worried i'm gonna be attracted to kids like i have to make sure to like you know i can't go outside right i can't ever go by a school or something even though they have no
00:39:04
Burke Hahn
ah like behavioral or even desire or intent to do anything like that. They have these intrusive thoughts coming in.
00:39:09
Tony Montgomery
Now.
00:39:11
Burke Hahn
Another one that's pretty common is like that um is in the research and and some of the ones I've heard um in kind of my clinical career is mothers after they have their child like worried that they're going to like hurt or or kill their child and again they have no desire or anything to do that but it causes them to be have these like
00:39:25
Tony Montgomery
Yeah.
00:39:31
Burke Hahn
compulsions to make sure everything is safe all the time. um And so yeah, it's it's incredibly fascinating.
00:39:38
Tony Montgomery
Yeah, yeah, yeah, definitely. Sorry about the the side tangent. Let's get into exercise now. what What are some of the mechanisms like maybe think about if aerobic exercise does X, resistance training may do Y, like what are some of the things that exercise does to help with these mental disorders?
00:39:57
Burke Hahn
Yeah, absolutely. So um I have you know like a whole list of them here. And it's really it's really neat to think about this because um you know whenever I talk with other people that aren't in psychology about my research, you know they're always like, oh, yeah. like Whenever I exercise, you know like i I always feel good afterward. like I know that like this has been helpful for me in the past, or this is helpful for me now. Or whenever I go out for a walk, I love that I can clear my head.
00:40:25
Burke Hahn
Um, and so, but they always ask like, well, why is that? Like what, what is it about? And you know, I think what we we've talked about before and kind of alluded to this, like those, the, uh, the endorphins, the endorphins coming up, that's a really common one. So, um, you know, endorphins, kind of what they do is they, uh, assist the body in like processing and enduring pain.
00:40:44
Burke Hahn
Um, especially during like periods of stress. Um, and so after exercise, there's like this release of endorphins. Um, and that's commonly known as like, you know, the runner's high and that's, and a lot of different workouts, like, you know, people that do strength training, they get, they get the pump and they feel like they're just so energized and and stuff like that. And that's like one aspect of the endorphin endorphins coming in. There's also um you know regulation of neurotransmitters like serotonin and dopamine. um You mentioned the h HPA axis earlier about helping to ah regulate the body and get the body used to the stress response. um There's a lot of immune response research out there. um
00:41:26
Burke Hahn
There's one really interesting, um that's not really well studied, and ah but it's about this thermogenetic effect that because the body increases temperature while exercising, that it actually kind of helps to ah alleviate some like tension in the body, because we have some of that like ah heat, ah similar to you know if you have a heating pad or something like that.
00:41:43
Tony Montgomery
but
00:41:47
Burke Hahn
um So anyway, there's a there's tons of stuff out there um that that why exercise can be can very helpful.
00:41:55
Tony Montgomery
Yeah, it's like if you're ever stressed, you get into a warm shower and it's just like everything disappears.
00:42:00
Burke Hahn
yeah
00:42:01
Tony Montgomery
and Same concept. Yeah, I think So some of the things that you touched on, right exercise as a whole helps with HPA access regulation. So if there's any type of dysregulation um due to cortisol or glucocorticoids or any of that stuff coming in, it can help with that. it also and this and that The funny thing about research is if you don't know what you're looking for, you're going to get some weird answers sometimes.
00:42:25
Burke Hahn
Mm hmm. Yeah.
00:42:27
Tony Montgomery
But you're seeing the research that if they if they do exercise, you'll see a ah spike in cortisol, which is you would expect that due to sympathetic response towards exercise.
00:42:38
Tony Montgomery
um But then if you notice, like with high intensity interval training, right You'll get this huge spike of cortisol release, um but then you'll notice compared to like continuous exercise, 30, 60 minutes later, it actually plateaus and goes back down to so baseline and sometimes even lower. So if you're not measuring it where you're supposed to, it could look like, oh man, exercise is actually a negative. It's gonna bring along more cortisol as opposed to getting rid of it. But over time within that 24 hour window, exercise has this opportunity to help you
00:43:12
Tony Montgomery
um release cortisol. Another thing that you touched on is the neurotransmitters that go on and I don't study anxiety as much as I do depression, but I know that they link serotonin a lot to depressive states even though that's getting a lot of pushback right now if that's the actual thing that's causing this neurochemistry dysregulation, um looking at things like glutamate.
00:43:38
Tony Montgomery
is one that isn't really studied too much, ah but starts it's starting to get studied due to like some of the ketamine research. Ketamine research is showing that it binds to the ah glutamate receptors, or it actually know it they give them It doesn't bind to the glutamate. It restricts the receptors from accepting the glutamate, so therefore you have more glutamate going. And it almost gives them like this manic state. So if you have someone that is suffering from depression and they do ketamine, it gives them more of a a manic state, which is why if you do ketamine two days in a row, you get that manic, you go into a manic state.
00:44:14
Tony Montgomery
So they're using almost this like excitatory glutamate transmitter to bring up the depression and they're finding really good benefits of that. So then maybe people are like, Oh, maybe serotonin isn't the only one. And then you look at like the.
00:44:30
Tony Montgomery
repetitive TMS research out there where they're doing that with people with depression and they're seeing 85, 90% remittance and that has nothing to do with serotonin
Types of Exercise and Their Benefits
00:44:41
Tony Montgomery
at all, right? So this idea that the neurotransmitters play a huge role and in depression is a little ambivalent at the moment. They do play a role, um but what are you seeing specifically as far as the, like what neurotransmitters are the ones, are they the same as depression?
00:44:58
Tony Montgomery
um Because I know anxiety and depression have a lot of commonalities and sometimes anxiety can manifest itself into depression um and maybe vice versa as well. So they they're very much linked together. Are there some neurotransmitters that are sticking out in the research that are like prominent ones that we want to um look at?
00:45:18
Burke Hahn
That's a great question. um Besides kind of serotonin and and dopamine, I don't have ones off the top of my head that I think are are different at the very least. um But I do know that serotonin and and dopamine can be very prevalent and related to anxiety disorders and how um you know that can end I don't want to say this. So yeah, so like you said, there's these trans diagnostic factors. um And with anxiety, you know, that serotonin dopamine, there's certainly like other ones um that I can't think of right now that are kind of related, but
00:45:59
Burke Hahn
I think those are the main ones in the research that I've seen, especially how exercise can impact them, right? Those are kind of the main ones that exercise um really influences those specific neurotransmitters, whether that be through a development of self-efficacy or even just like a direct physical effect of, um you know, um ah having some more like serotonin release um after exercise and things like that.
00:46:29
Burke Hahn
um So anyway, yeah, I'm not sure exactly if there are other ones besides serotonin and dopamine, but i'm I'm sure there are um and just be interesting to to look into more.
00:46:35
Tony Montgomery
Yeah,
00:46:38
Tony Montgomery
yeah yeah, because you would have to imagine GABA would probably be one because that is inhibitory one. And then when we exercise, you get releases of epinephrine, norepinephrine, and I'm sure they play a role within the endorphin kind of MEU. And yeah,
00:46:56
Tony Montgomery
The thing with SSRIs and all that stuff is it does um inhibit the receptors from uptake in serotonin, and it gives you more serotonin floating around, it gives you more dopamine floating around. So exercise does the same thing without actually having to take the the medication for it. um So you won't get a lot of those negative side effects that come with the medication, not to say that the medication is bad,
00:47:18
Tony Montgomery
um because we know that research shows that it definitely has efficacy and and in what it does. um But the research shows that if you combine that with exercise, it actually helps attenuate the the process even more. um And a lot of research is coming out now showing that like The first week or two of taking these pharmacological medications can cause a dip to make depression and anxiety rise. So if you supplement that with exercise in the very beginning, those endorphins, all those positive responses can help um create that, like bring that dip up to baseline so you never really have that dip.
00:47:55
Tony Montgomery
So that's one of the that's one of the things that exercise can do. um Endorphins, that's an interesting one because it is it is very like ephemeral. like you You get the endorphin release, it lasts like 30 to 60 minutes. um So maybe it's like, what can we do within that time period to start to shift the mind towards more positive at least that's the way i think of it is like do we have this almost like an anabolic window for gains we have this for like a positive mindset and a positive ah valence towards certain things maybe we can start to use some cbt type strategies after exercise while they're in a positive state to create this idea of like
00:48:35
Tony Montgomery
now my mind's in a pot so I can start to, you know, because with depression, all you see is negativity. So then if you can start to do certain things, certain some of the stuff with I'm doing within the lab that I'm in, we're looking at this type of stuff. We have a research study going on right now. Once we finish it, I'll be able to talk about it more. But we're we're looking at this aspect of like, how can we maximize this window because you have endorphins,
00:48:57
Tony Montgomery
um You also have neuroplasticity and BDNF release, so you can really start to change the neurogenesis and the brain makeup. And I think if we can harness those two things post-workout, maybe we'll see some some positive results. but I think that's one of the big ones that the research kind of touches on is like the exercise has this way of transforming your brain um both psychologically of like self-efficacy, self-mastery, self-esteem, but it also changes the connections, the synaptic plasticity, it changes um the
00:49:34
Tony Montgomery
white matter track starts to strengthen them, you have better connectivity and things like that. So it is is one of those things that the mechanism-wise can start to explain some of the the benefits. Have you noticed, and you can touch on whatever you want with that, but also have you noticed the difference between um resistance training versus like aerobic training in the literature and like which one could be better for certain types of things and maybe why?
00:50:00
Burke Hahn
Yeah, um absolutely. um So ah the first thing, ah I want to say, man, i so many things to talk about with with what you just said. So this this is great. Um, but to kind of answer your question directly now, I'll probably ramble on into talking about some of the other things. Um, so, uh, the funny thing about resistance training, at least from, um, like a kind of a mental health standpoint is that compared to aerobic exercise, there's very little, um, about resistance training in, in the literature. And so actually it was actually part of some of my motivation to get into exercise research is to look at some of this resistance training. Um,
00:50:38
Burke Hahn
Now, ah there is some um interesting um ideas about, like like you mentioned, where they can be most effective. And we have with like aerobic exercise, we have that you know that oxygen release, the body is getting to that, like specifically into that aerobic state where you're using oxygen in a very specific way to help you kind of maintain that activity.
00:51:02
Burke Hahn
um And part of the reason why it's so prevalently studied in the in the literature um is because ah there's a lot of standardization as to, okay, after this amount of time, doing this amount of, ah you know, kind of aerobic exercise, they will get what's called the aerobic effect, and which is um kind of describing this ah beneficial effect that exercise can have.
00:51:28
Burke Hahn
ah Which is not to say you can't have it before this that that kind of period of time but um you will start to get literally like you mentioned those physiological changes in the body that can start to have these things like um endorsement release we have ah even some things.
00:51:43
Burke Hahn
um like ah different, um you know, hormones and stuff like that, that can be released ah for um for, for after that kind of aerobic exercises is activated. And so a lot of the literature does that um because we have that very strict kind of cutoff, because it's a lot easier to measure, right? You can go into a lab, you have a bike, you just do that, no problem. Like we're an anxiety lab. I have just like an under desk bicycle, very kind of rudimentary exercise, but it works. But what we can't do is bring in like a weight bench, right? For people to like do like bench press for like, you know, two hours or I mean, obviously not bench press for two hours straight, but you know, having just different types of resistance training. And so
00:52:28
Burke Hahn
feasibility is definitely an issue. um The other thing that I wanted to mention as well, so we have this like change in how the body is like using oxygen with aerobic activity.
00:52:40
Burke Hahn
But with, um, with resistance training, we have some like other benefits as well in the sense that you, um, can, and I'm, I'm not necessarily like the most into like, uh, running as much as you are, Tony. So you can maybe talk about this. Um, but you have a lot of, um, this like self-efficacy development and being able to like, ah you know, you're pushing this weight up, uh, you know, communicating to your body that you have the strength to do this.
00:53:09
Burke Hahn
um And i I know that that can be a lot of development of self-advocacy. One other thing that's kind of like in in the weeds ah thing a little bit, but there's also this ah the research on ah mitochondrial function. um And mitochondrial function is really related to neuroplasticity, which um you know you don't want, ah like especially as an adult, you don't want your brain to be completely plastic because that means you haven't learned anything. But but what you do want is to have some adaptability within your brain ah to be able to like adapt to new circumstances, to continue lifelong learning, to maintain brain health. And there's actually been some research that muscle loss um can decrease neuro neuroplasticity. And so um exercise, especially like resistance training, not only does it help with like muscle growth and bone health and bone and strength and things like that, but it can also actually increase mitochondrial content um within the brain to help ah maintain that neuroplasticity, which I
00:54:08
Burke Hahn
find to be like incredibly fascinating.
00:54:11
Tony Montgomery
Yeah, yeah, I mean, Dr. Mike Roberts from Auburn, um he's done some research showing that there is mitochondrial biogenesis through resistance training, which people used to think you can only get that through aerobic training. um So that is some of the the fascinating stuff too, I think too with like,
00:54:29
Tony Montgomery
With strength training, you you get those beginner gains, so you can start to see progress, which can really boost self-esteem, self-mastery, and learning the technique too, like feeling like you um know what you're doing, like you can do it and you feel comfortable doing the technique. Those are all psychological aspects of resistance training.
00:54:51
Tony Montgomery
um You don't necessarily get the same ah brain benefits from resistance training, but what it what it does do is we know that a lot of resistance training and releases myokines and those myokines help certain things pass through the blood-brain barrier that normally wouldn't pass through the blood-brain barrier. So it does open it up, which is why we see that when you combine resistance training with aerobic training, you get significantly better results than one by themselves. And I think it's because of that at addition of like, hey, I can see progress from the very beginning. Like I can go in on day one and do X workout. And I can go in the very next day if I'm new to training and do the same workout and probably add 10 pounds, right? As opposed to if you've never worked out and you go in there and you do, you get on the treadmill for 20 minutes,
00:55:41
Tony Montgomery
you hate life for 20 minutes. And then the next day you're like, I don't want to do this again. So resistance training may be a better first approach to get people in to like buy into the the physical activity, which I don't think a lot of people think about is like, how can we create better buying? How can we create a better positive valence towards exercise and starting somebody off with like treadmill running?
00:56:02
Tony Montgomery
that may that may make them run out the door and like never see you again because everyone knows it takes about two to four weeks of consistent running for it to actually start to feel good. So when you have somebody who's already suffering from all these mental disorders,
00:56:17
Tony Montgomery
um emotional regulation issues, putting them in a state of negative valence in the very beginning is something that's going to make them not not adhere to exercise. So I think that's one of the things that I think of resistance training as being this like masterful thing to incorporate because you see progress like that.
00:56:36
Burke Hahn
Yeah, ah you're you're so right about that. And one of the things, um I'm sure we'll get into this um like more as well, ah you mentioned like buy-in and you mentioned like people that are coming in and you know, maybe they are like they have depression, they're experiencing some anxiety,
00:56:53
Burke Hahn
ah maybe even experiencing anxiety about being in the gym space in general. and They're coming in that are new um and wanting to them to have a pleasurable experience working out for the first time or working out to like build that habit. um And one of the things that I love um that I haven't seen necessarily like Research on although it could kind of extrapolate from other areas of of research with um you know like their psychological therapy interventions but um I've seen out um you know like watching you know like. um
00:57:25
Burke Hahn
and like fitness YouTube and things like that about ah making sure that people when they start training are doing something that they enjoy, doing something that's fun for them.
00:57:29
Tony Montgomery
Oh yeah.
00:57:34
Burke Hahn
Um, and that's something I'm like very passionate about because if, you know, you go into somebody to say like, Hey, like you want to get a personal trainer, say, Hey, like I really want to start like to get in shape.
00:57:47
Burke Hahn
And then they put you on, you know, whether it be running or, um, you know, resistance training or whatever it is. And you're like, well, you know like I'm not really interested in doing that. That's not gonna be something that you're gonna wanna continue unless you have just like already that discipline built in. You say, I know this is what like I need to do, I have to do this. um But for for folks that like maybe like don't have that built up that like are untrained or maybe that they um you know they're starting something new or whatever it might be, like being able to be creative with what you enjoy with physical activity um can also have this um
00:58:24
Burke Hahn
ah kind of ah combination combination effect with exercise that you're doing something that's fun, which is like a direct psychological treatment for depression, like it incorporating fun activities into your life, while also having all of these other wonderful physical and psychological benefits of exercise. And um so for example, like Maybe you don't like running.
00:58:45
Burke Hahn
Maybe you don't like resistance training, but you love dancing or you love doing yoga or you love, you know, playing a sport, right?
00:58:48
Tony Montgomery
Yeah.
00:58:52
Burke Hahn
Find like an intramural club, like just, you can get so creative with these things. Um, and, uh, and that is something I think is very, very important, not only for like people to know, but more importantly, I think, because I'm sure most people already know this, but more importantly for, um, like, you know,
00:59:09
Burke Hahn
therapist or for personal trainers to but so recognize that this person is coming in with their own passions and I need to like help facilitate that and not kind of like push those down and shove my own desires for them and stuff like that. um And there's obviously like a balance with with that and everything, but um yeah, getting something that you enjoy, ah like you mentioned, with like the resistance training initially can help um like kind of have those initial gains, can really be um an early factor that can help build up these these these habits to help improve mental health and physical health.
00:59:44
Tony Montgomery
Yeah, no, I agree. The idea that like you're getting these people in that have, think of it as like a ah ah bucket, right? And the buckets full of all these negative intrusive thoughts, right? So you as the therapist or as the trainer want to put as many positive things into that bucket as possible. So the idea of like, yeah, what do you want to do? What do you enjoy doing? So we can start to build those positive things. A lot of people want to exercise without knowing that they're exercising.
01:00:11
Tony Montgomery
So yeah, recreational stuff, right? That can help out a lot. And even the research kind of hints towards this too. You have the the peak end role by Danny Kahneman with the idea of like,
01:00:22
Tony Montgomery
people remember the most like intense part of it and they remember the end of it. So what his research looked at in this frame was they put people in, they put their hand in cold water for 60 seconds and then took it out, gave a rate and gave a score. They put their left hand in cold water, same cold water for 60 seconds, but then they made it warm, like slightly warmer, like a couple degrees Celsius warmer for an additional 30 seconds. So they had their hand in for the same 60 seconds of cold, but that additional 30 seconds of slightly warmer water made them enjoy that experience more. And they also said that they would come back and do that one again. So then there's people that took that into the exercise realm and found very similar results. um And they also found too that, yeah, by allowing someone to pick the exercise first,
01:01:17
Tony Montgomery
not only gives them this idea of, like, I have control of the situation, but it does make it a more enjoyable experience. And then they interviewed those people afterwards and they said, yeah, I'd be more likely to exercise again if I could pick those exercises. And they had a more positive rate and scale after that. So all those things are are fundamental. And i know I don't think that the people that do exercise research in psychology think about that.
01:01:45
Tony Montgomery
um because they're focused so they don't really think about the resistance training part. They're thinking about like, how can we create a resistance or exercise stimulus without thinking about those? And then the people on the exercise science side think about like, how can we get the most adaptations? And they don't think about the psychological side, right? So how can we combine those two to to get the most out of it? And um one of the things I'd be interested to get your idea on, because I've i've been reading about this a little bit, is ah you the idea of like high intensity interval training.
01:02:14
Tony Montgomery
is a positive thing for people that suffer with anxiety because it is allowing them to put themselves in a situation that teaches their body to tolerate temporary discomfort, but because the they're putting themselves in that situation as opposed to not having control of it and just manifest itself, they think that that helps them regulate anxiety better because they're learning how to regulate it in a controlled environment that they chose. um Do you think that, I mean, to me, that makes sense
01:02:49
Tony Montgomery
But I don't know if the idea of like choosing something versus not choosing something, does that eventually work itself into having the same abilities to like work your way through it?
01:03:01
Burke Hahn
Yeah, man, Tony, that's that's such a ah such a great point. um And the um it actually touches pretty much exactly on a very popular theory as to at least one of the mechanisms by which ah exercise can directly help longitudinally with with ah with anxiety. um And part of that is, I'm going to touch on um first, is exposure therapy. And exposure therapy, you know it has um You know, people hear that and I think especially like kind of outside of the psychological realm, like it's very scary concept, right?
01:03:38
Burke Hahn
The idea of putting yourself in with your feared stimulus, right?
01:03:39
Tony Montgomery
yeah
01:03:42
Burke Hahn
If you you're afraid of spiders, you don't want to be near a spider. But the funny part is is that like um if done well, exposure therapy is the most effective treatment we have for anxiety.
01:03:54
Burke Hahn
It's the most ah ah effective and efficacious treatment we have for anxiety. And part of the reason is because we have um you know, avoidance, just like I mentioned, you know, you're afraid of spiders, you don't want to like be around them.
01:04:06
Burke Hahn
And so what does that do? Well, it tells your body, I only have one or two experiences with spiders, and they're all negative, right?
01:04:14
Tony Montgomery
Yeah.
01:04:15
Burke Hahn
And so um the idea is that through exposure therapy, if again, if done well, we don't want to like flood people by putting them in a room, a dark basement full of spiders and stuff like that, that'd be awful, but
01:04:25
Tony Montgomery
Eh.
01:04:28
Burke Hahn
very, very slowly building up their experience with that feared stimulus um and to be able to like, they can develop that skill. And also um what's most supported in the research is they are literally changing the fear learning that they have in their brain. So they are literally like changing the um the the mechanism, the association they have with this feared stimulus for it to be more realistic.
01:04:56
Burke Hahn
Not to say that it's like completely positive and you'll love spiders now, but it's more of like, oh, most spiders are, it's I could just be in a room and it's going to be fine, right? And I can go over and I can like slap one with my hand and kill it.
01:05:09
Burke Hahn
And I'm not really like that afraid of it or whatever. I can just like let it hang out. Cause they're spiders are good for the environment. You know what I mean? Whatever you want to do eventually, but yes,
01:05:15
Tony Montgomery
Yeah, yeah, no no spiders were harmed during the making of this podcast conversation just for everyone out there.
01:05:21
Burke Hahn
yes absolutely. Yeah. Um, but the same principle can be applied to, um, to exercise. And it's exactly like what you were talking about, Tony, with like the HIIT workouts and anxiety is that, um, if you think about how anxiety presents itself is it's a lot of that fight or flight mode. It's a lot of that, like your you starting to breathe faster, your heart rate's going, your mind's racing. um But when you get into like a HIIT workout where it's very high intensity, high energy, and you're kind of putting yourself into that really intense exercise stimulus, what you're doing is you are not only you're choosing to do that, you have this
01:05:59
Burke Hahn
um uh this autonomy to choose to do this which is giving you control over the situation you know i can stop whatever i want um i know i'm doing this for my own good having these positive and kind of combining with your research oni having these like cognitive appraisals of of your situation so you go and you realize oh if I start breathing heavily, that doesn't mean I'm going to have a panic attack. It doesn't mean like I am, you know, I'm going to die or whatever it might be, right? You go into that situation and you're literally relearning that, Hey, these stimuli, these internal stimuli that I'm experiencing are not all that dangerous. And so what that can do is it can teach your body that like, Hey, when we get anxious,
01:06:43
Burke Hahn
It's okay. like It's okay. where We all get anxious. It's no big deal. like It doesn't mean the world's going to end. um And so like over time, it can it can yeah help kind of train your brain to um be a little bit more okay with experiencing that anxiety.
01:06:59
Burke Hahn
Um, so yeah, absolutely. and And like I said, Tony, it really like also sounds like like your area of interest as well. So I'd love to hear your perspective on it too, of like cognitive appraisal of, um, of exercise and and how, you know, kind of going into a setting and having the autonomy, but then also having this like, you know, positive or realistic view of exercise, like how can, how that can impact what you think about exercise, but then also just think about like your own body in general.
01:07:25
Tony Montgomery
Yeah, I mean, definitely from what I've seen personally in the lab and then just reading the literature exercise, any motion regulation go handin hand in hand. It helps with the perception phase because it helps with the amygdala hippocampus connectivity, right? So it starts to blunt the amygdala response, that negative fear response that they get.
01:07:48
Tony Montgomery
And it helps the connectivity to the hippocampus. So the memories are starting to become formed of this is not as aversive as I thought it was. And aerobic exercise is something that plays a significant role in that. And then the perception phase as well, exercise helps with that.
01:08:04
Tony Montgomery
the ability to regulate through it. um And then what I've seen within my research is teaching people reappraisal strategies while they're exercising not only helps them perform better and exhaustive exercise, but it also helps them with their day to day lives of mood scores and depression scores and things like that because you're you're teaching them that hey whenever whenever negative stimulus does arise that you're able to refocus and recenter yourself and focus on the the positive outcomes on one of my favorite people that i listen to is jackal will make any of this idea of like
01:08:38
Tony Montgomery
good and that that's his that's his motto whenever something bad happens he says good like what can i learn from it what can i get from it like what are the lessons is gonna teach me and that's that reappraisal strategy so if you can if you can teach them that and it strengthens that through helping with um the prefrontal cortex because you get oxygen delivery, you get blood delivery to the prefrontal cortex, and it's been shown to increase in size through aerobic exercise. So you're better able to have these executive functions to choose and to to not choose what you're paying attention to. And then it also helps with the action phase as well um through ah inhibitory expression, right? You're able to control the way that you react to certain stimuli after the fact,
01:09:23
Tony Montgomery
So instead of being angry and wanting to punch something, it helps you regulate that and control that through the same kind of mechanisms of the amygdala and of the um responses in in the brain areas and that it helps with, the insula and in all those areas. So it does help with that strategy. And then if you can implement that in an aerobic setting and teach them how to how to manifest those things, I think it helps to begin solidify that they have control of all these situations and it teaches them how to have control of these situations. um And one of the big things is like the choice of it all as well. We've seen in the research that if you put a rat on a wheel and let it run as free as it wants to, it gets all the benefits of exercise. But then if you put a rat in a wheel and you cage it in and does exercise, it gets a lot of negative stimulus. It gets a lot of cortisol. It gets
01:10:16
Tony Montgomery
So that that choice of of action is is really important, which goes back to what we talked about of like picking your exercises, finding what's fun, doing those type of things. So they definitely play a ah role in and facilitating both those both those things. So um yeah, it is it is fascinating that something as simple as 10, 20 minutes of exercise can manifest itself into helping you regulate your emotions and control the situation a lot better. um But I do think a lot of that is because you choose to to do it as opposed to it's forced upon you. um I think when someone's forced upon you, you you can begin to compartmentalize, you can begin to avoid, and that could have its benefits, but it also can be very, very negative. So we want to make sure that um autonomy, self-autonomy is something that we think about when when trying to bring about these interventions and stuff like that.
01:11:07
Tony Montgomery
um But yeah, mechanisms are great, and this theoretical understanding of exercise and the role it plays is great, but how do how do we measure these
Understanding Brain Activity and Anxiety Mechanisms
01:11:16
Tony Montgomery
things? How do we measure these brain changes and stuff like that? um What you guys do in your lab, you do the EEG to collect data on brain, um and you guys look at event-related potentials, yeah ERPs, and then you guys also look at heartbeat evoked ah potentials, HEPs. Can you kind of to find those and then what they're telling us and and what you guys are looking at in your lab.
01:11:41
Burke Hahn
Yeah, of course. So, um first of all, ah both yeah ERPs and HEPs are subsumed under um EEG, which is electroencephalography, which is basically a big word saying like, what what we're doing is we're measuring um ah your brain's electrical activity at the scalp level.
01:12:00
Burke Hahn
Um, so, uh, you know, you are, you know, for kind of a fun way to put it, you're measuring brainwaves, right? You're measuring, uh, people thinking you're measuring people like, you know, moving their muscles, you're measuring, um, like everything that the brain is doing. Well, uh, most of what the brain is doing at kind of that scalp level. Um, and these are very like small.
01:12:20
Burke Hahn
small signals a lot of the time, so it's very hard to measure them. um But there's a lot of you know really um like wonderful researchers out there that have developed ways of like you know measuring this and cleaning the data and amplifying the signals and and stuff like that. But what our lab looks at um are event-related potentials. um And ah what I'm looking at is the heartbeat of a potential, which is kind of like another category of event-related potentials. and Just to break down yeah ERPs, so we have events um so we have an event, right the event part of event-related potential, something that occurs, and then we have a related potential. So we have your brain electrical activity, the but the brain potential, right the electrical potential of your brain after a certain event. um So it's a pretty easy way to think about it. like Let's say you
01:13:11
Burke Hahn
move your arm, we're going to measure your brain activity after you move your arm. um But what we're looking at is specifically with anxiety, we're primarily looking at attentional processes. um And so what that looks like is, let's say you Sit down on a chair, look at your computer, and you are flashed like a series of numbers, um and you're supposed to push your like this like push a button right right after you know you see certain numbers, but you're not supposed to push a button after you see like one specific number.
01:13:43
Burke Hahn
And so what we're what we want to look at is, okay, how does the brain process attention to the, this signal whenever you're supposed to not push a button, right? This inhibitory signal. Um, and so what we kind of found based on like some theoretical theoretical foundation and also our research is that through anxiety, anxiety actually directly impacts attentional focus. So you know I kind of mentioned ah way earlier in in the podcast that we have this
01:14:16
Burke Hahn
um We have this, ah you know, attentional challenge in directing to internal sensations. Well, we also have that to like external sensations, especially with generalized anxiety or even with social anxiety, right? You're looking at people's facial expression, at their responses to you, um instead of the content of what they're saying. um And so what that means is just like we kind of, again, talked about earlier,
01:14:41
Burke Hahn
We have this, um ah this you know ah what's called the Vigilance Avoidance Hypothesis, where you're constantly on the lookout for things that could be threatening, and then subsequently avoiding them. right youre You're looking for these things, right constantly on the lookout for somebody that like looks at you in a negative way, and then you're avoiding that. right You want to avoid those things um behaviorally. So kind of bringing it back to to what we talk about or study in our lab, ah is we look at how anxiety presents with its attentional focus in comparison to people without anxiety. And generally, the the theory is that while there is not a difference in um like effectiveness, like people with anxiety in general have the same level of effectiveness in terms of like how well they're able to like not push that button right whenever it comes up, um the number comes up. But there is an increase in attentional resource allocation.
01:15:38
Tony Montgomery
Mm.
01:15:39
Burke Hahn
And so what that means is that people with anxiety um are dedicating or having to dedicate more attentional resources to do one specific task because ah they, you know, their brain is already um kind of like trying to pull your attention in a lot of different ways and your resources are already being taken up. um And so, and there's a lot of nuances to that, but that's kind of the general aspect of what our lab looks at.
01:16:06
Burke Hahn
Um, and then my specific reaches looking at the heartbeat of a potential, which is kind of like a new, a new ish, um, ERP component. Um, we are looking at brain activity related to when your heartbeat goes off.
01:16:21
Burke Hahn
So when like, if you know of what a QRS complex is or that kind of like, if you look at an EKG, right? You see that like big spike up. Um, we're looking at your brain activity associated with that ARSP with that, um, that RP.
01:16:29
Tony Montgomery
Mm hmm.
01:16:35
Burke Hahn
um So, the idea, ah the theoretical foundation behind that is that it is a direct measure of how much attention you your brain is giving to your internal sensations.
01:16:45
Tony Montgomery
OK.
01:16:48
Burke Hahn
And there's been some research out there that shows in our lab and also other labs that shows that um folks with social anxiety have a higher amplitude of heartbeat of a potential, meaning they have more attentional focus to their heartbeat, especially when under social threat um or under threat of like you know um thinking that they're experiencing anxiety symptoms. um There's also been some interesting research on ah with like dissociative seizures that like um you know people that experience dissociative seizures, despite the fact that their heartbeat is increasing a lot more, they have a less heartbeat of book potential, meaning that they're not focused on that anymore. um theyre focused you know they have Their brain is kind of ah doing its own thing with like experiencing the seizure. You're not going to be focusing on your heartbeat a lot if you're experiencing a dissociative seizure.
01:17:38
Tony Montgomery
That's fair.
01:17:38
Burke Hahn
um Yeah, right. yeah ah So anyway, that's what I'm looking at right now. um and And that's kind of one of the really interesting ways we can actually physically measure these things right with you know neuroimaging, not necessarily through mr MRI, but through looking at electrical activity in the brain and how attentional focus is directed to um different external or internal stimuli.
01:18:03
Tony Montgomery
Yeah, no, great, great synopsis. One of the one of the drawbacks, because I don't want people to think that um you can do exercise while using EEG. So one of the drawbacks of EEG, any brain imaging really is you cannot be active while doing it. um So what what an intervention would look like to see if exercise has a positive effect is you would um do what you were talking about, you would you would sit people down, you put the EEG cap on them, you would take them through one of those tests and you would see whether or not that attention is getting pulled and if it manifests itself in different signals,
01:18:37
Tony Montgomery
um then you would put them through maybe say a four-week aerobic intervention. And then you'd come back after that intervention and you would test the same exact thing and you would see if that attentional response got dulled so they're able to focus better. And that's kind of the way that we use EEG in terms of like exercise interventions. um But you can also do like like you said, where you sit people down, you put them there and you'll see the brain um getting signaled and that can tell you like immediately. So it can help you build correlations of like, this can relate to that.
01:19:09
Tony Montgomery
um So those are kind of the two things that I think about when I think about EEG is it it does give you correlation immediately of what could be doing what? um But it can also show you changes in brain areas pre and post intervention as well. Is there anything else that I'm missing as far as what the EEG kind of can can give us what what some of the research is that they they look at in terms of those type of interventions? Those are the only two that come to mind.
01:19:37
Burke Hahn
Yeah, absolutely. So one, um a couple things I have in mind. One is you can actually look at, it's called a time frequency analysis. I'm not as like familiar on how to do it, but the idea is that you can look at um you know, like you said, changes in brain activity, but you can also look at that over time.
01:19:56
Burke Hahn
So instead of looking at a specific event, you can look at how the, the brain, uh, electro-collectivity changes over the course of like 10 minutes, right? So you can see like from minute one to minute 10, how have things changed?
01:20:05
Tony Montgomery
Right.
01:20:09
Burke Hahn
Um, which is a real, it's, it's kind of like a new type of analysis that EEG is, is, um, kind of undergoing right now. A lot of, uh, some literature is publishing that. Um, one other thing that's important to note with EEG,
01:20:21
Burke Hahn
is that um it's ah it's almost like you can can think about it as um you know the ah the the opposite of an um MRI. So whereas an um MRI, you are it's very like slow, you're in there for a long time, and you get like one kind of like brain picture, a couple of pictures of your brain right as it kind of like builds those um ah builds those images.
01:20:47
Burke Hahn
With EEG, you don't see anything necessarily, but you are getting kind of the like activity going on. And it's very like, um, there's a lot of temporal resolution or you can get like very nitty gritty with the time of like when it happens. So like to the millisecond level.
01:21:03
Burke Hahn
ah But you can't see necessarily brain structure. So while you can you say, oh, well, this ah effect is occurring at you know like kind of like the frontal part of of the brain, we have no idea if that's occurring like in ah the prefrontal cortex, if it's in the anterior cingulate cortex, whatever it might be. like We don't know the exact structure, but with um MRI you can. And so those are kind of like the differences there in terms of strength and weaknesses of EEG and what it can measure.
01:21:31
Tony Montgomery
Yeah, and I think, correct me if I'm wrong, but I think the MEG has better spatial and temporal, um not necessarily combined, but that's like one that can give you both of those um ideas. But yeah, so with EEG, g you're thinking about like time course, like how fast are they responding? how um the magnitude of that response as well. And you have all these different electrodes on the brain, and depending on where that response is, will signal that certain electrode. So if you look at the EEG g literature, you'll see things like P2, N1, right? And you're like,
01:22:06
Tony Montgomery
what that What the hell is that? i don't I don't know what these things are. So it can get a little difficult to read that literature if you're not familiar with it. um But once you get an understanding of the letters and the numbers are correlated to where they are on the scalp, um it starts to manifest itself ah a little bit better. But it it can be a little bit um difficult to to read. Do you have any like troubleshoot ideas that you can give out there to help it ah be a little bit more digestible?
01:22:35
Burke Hahn
Yeah, hopefully. um So it is it is it is challenging because you'll like a lot of the time, because even for me with MRI read i research, I'll look in that and I'll, ah you know, I have some familiarity with it now, but I'm like, some of this jargon, you know, while it's common for this literature, I have no idea what the hell they're talking about.
01:22:54
Burke Hahn
So hopefully this will be helpful for EEG stuff.
01:22:54
Tony Montgomery
Go ahead.
01:22:56
Burke Hahn
So first, like Tony mentioned, we have different um like electrodes all over the all over the ah what we call like a cap, an EEG cap. So tons of electrodes all over the all over the skull. um And the idea is that we're measuring um like all the electrical activity at those specific points. So some caps have nine electrodes, some have 32, some have 64. Obviously they get more expensive as you get more and more electrodes. And sometimes it gets gratuitous to you know you have caps with like way too many electrodes. But
01:23:29
Burke Hahn
Anyway, so generally, you know, like nine electro 32 electrode caps and so you have Your there's like I'm trying to remember how to how to say this exactly but you have like You'll see things like the electrode site CZ or the electro site P1 or the electro site Fp1 so what those correlate to is are specific areas of the brain, like literally physical locations on the brain. So CZ is central. So it's, you think of it as kind of, if you go kind of from front to back, central is like right in the middle, but then Z means it's in the middle from left to right. So it's kind of right down that midline. So CZ is right smack dab in the middle of your head. But you also have like F1 or P1,
01:24:27
Burke Hahn
Um, and so F1 would be like in like the frontal part of your brain. And one would go over, ah but I'm pretty sure it's, um, like odds are on one side, evens are on the other or something like that. And so you can kind of like, when you see like, okay, at, uh, this particular, uh, brain activity was, um, spiking the most at the CZ electrode. That's how you know, okay. It's right kind of in the middle of the head. So.
01:24:53
Burke Hahn
Um, and oftentimes, um, hopefully if, if the article is good, they'll give you like a scalp map. So like a map of the activity and it'll show like, okay, well, uh, you know, CZ is right here.
01:25:00
Tony Montgomery
Yeah.
01:25:04
Burke Hahn
You know, P one is back down here. So you can kind of look at that as well. But then also Tony mentioned, um, you have, uh, different ah types of components. So you have like the N one, the P 300, the N 200.
01:25:17
Burke Hahn
Um, and those are. ah specific ERP components. um So if you think about, if you look at an actual like yeah ERP, um what you'll see is, you know, an X and Y axis, and then you'll see like the actual waveform, right? You'll literally see a line kind of going up and down. um Well, what the components are, there are ah particular um instances at certain points in time where you have a like positive or negative deflection of electro ah electrical activity. So let's take the P3, for example, a very commonly studied one. That is the third
01:25:59
Burke Hahn
Um, positive peak, uh, there's the third peak in the positive direction. So, you know, you have like, uh, you know, if you say that the end one, for example, that is the first negative going peak. And then you have the end to the second negative going peak. So the idea is that we are categorizing them based on the number of peaks that there are. Um, and the, if it's going in the positive polarity or negative polarity for electrical activity.
01:26:26
Burke Hahn
um And that kind of gets into the weeds a little bit, but hopefully that will make it a little less scary to like read an article and be like, what the hell are they talking about? What's a P3? All that is is denoting this is the like time frame that this activity takes place in. And also, just like Tony said earlier, the correlation of what the P3 means. So the P3 is often associated with um like ah updating behavior and like what we call oddball stimuli. So ah stimuli that are unexpected, um we kind of see a ah ah really height heightened P300 wave. And so it's the idea that the brain is kind of doing some extra work there to adjust for something. um And that's a very loose interpretation of that. But so you can kind of see like, that's just the name of the specific component. And then what that's correlated with is the important part.
01:27:19
Tony Montgomery
Would positive be excitatory and negative be inhibitory?
01:27:22
Burke Hahn
Um question.
01:27:23
Tony Montgomery
Or would that be too easy and they would want to convoluted even more?
01:27:28
Burke Hahn
um I'm pretty sure, I don't think that's unfortunately what they mean. It's literally just because like the um the the type of electrical signal that the brain is giving off at that particular time is measured by our electrodes as like a negative or positive polarity.
01:27:45
Tony Montgomery
Okay.
01:27:45
Burke Hahn
So it's not necessarily like inhibitory or excitatory unfortunately because that would be like it would be make it a lot easier.
01:27:55
Burke Hahn
but um and I could be wrong about that, but from what I've what i've seen, it's more of just like how the electrodes are measuring it measuring that electro like like electrical activity.
01:27:56
Tony Montgomery
Yeah, yeah, and one of the things I've noticed with
01:28:05
Tony Montgomery
yeah yeah and one of the things i've noticed with the more The more technology you use in your research, the bigger the nomenclature you get
Challenges in Scientific Communication
01:28:16
Tony Montgomery
to use.
01:28:16
Tony Montgomery
And a lot of researchers like to write for other researchers, which is not the point. That's not why tax dollars are getting spent. You're supposed to write for the mass people to consume it.
01:28:27
Tony Montgomery
But they'll write as if you should already know what you're reading. And that really just pisses me off because it's like you're not doing your job and you're just being super pretentious.
01:28:33
Burke Hahn
Yeah.
01:28:39
Tony Montgomery
but you know that's it that's a whole nother rant that we could go on and and how to write and who you're writing for and who's actually paying your salary to do it.
01:28:40
Burke Hahn
Yeah. No, you. you and
Interoception and Anxiety Disorders
01:28:48
Burke Hahn
Yeah. So true.
01:28:49
Tony Montgomery
um Yeah, one of the things we touched on with this idea of heartbeat evoke potential is this introception, right? this And in what role does that play in anxiety?
01:28:59
Tony Montgomery
So can you define introception? um Maybe is there a specific, brain area or connectivity that is perpetuated through intraception? And then what role does that play in anxiety, both positive and negative?
01:29:17
Burke Hahn
Yeah, absolutely. So, um inter interoception is just the general idea of ah feeling like internal ah internal things happening. right you can it's it's It's kind of challenging to do, but if you really focus, um' you know you can actually feel your heart beating without even taking your pulse.
01:29:36
Burke Hahn
Um, and some people might be better at that than others or might have more, you know, like a stronger heartbeat or whatever it might be, but it's the idea that you can feel internal things happening. So another example would be your stomach growling, right? That's an easy one. You can feel like kind of food moving through your intestines and stuff like that. And so that is an example of interoception, having these like internal, um, the ability to perceive internal sensations. Uh, and part of the reason why that's so important with anxiety and anxiety disorders is because, as you might imagine, anxiety disorders activate a lot of these internal states. um And specifically, let's talk about panic disorder. So let's say somebody is afraid of having a panic attack. Well, a lot of the time they can be afraid of experiencing these internal sensations that they don't like. So, um you know, the idea is that they they start breathing a lot faster and then they start to get like more and more kind of anxious because like, oh no, I'm going to have a panic attack. And that kind of
01:30:35
Burke Hahn
so spirals down into them having like having a panic attack right and so some of the treatment for panic disorder is um what what we call um I think it's interoceptive exposure, I'm pretty sure, or something along those lines. But you have them like literally breathe through a straw. And so it's like getting that shortness of breath, ah sensation, but you're in a therapy room, you're in a safe space, so you can kind of process that. So um interoception is very, very important and implicated in a lot of anxiety disorders because of that fact, because it really plays on your ability and your appraisal of internal sensations.
01:31:13
Burke Hahn
um And then I think there was another another question that you asked that I that i ah didn't answer with that, but um but yeah, that's what interoception is.
01:31:22
Tony Montgomery
Yeah, I wonder if the introception with the straw that produced anxiety, I wonder if that research took a hit when they started doing the paper straws. Because I have to imagine like starting to lose some of that rigidity in that straw after a while.
01:31:37
Burke Hahn
Yeah. Yeah. I think so. Like, right. It starts to like, you know, kind of dip down and, and, you know, you know, it doesn't really, where it starts to break off and it's like, Oh, well.
01:31:42
Tony Montgomery
Yeah. yeah home what ah One of the things you don't think about until it happens
01:31:45
Burke Hahn
look
01:31:50
Tony Montgomery
um but so Are you familiar with um the the brain areas that are responsible for interoception? I believe, correct me if I'm wrong, but I believe it it's mostly focused in the insula, um but then it goes out to different other areas. Always always remember that the idea that um if it If the majority of it manifests and in one area, don't think that that's like a singular thing. We know that every brain area connects to everywhere, but I think the insula is what they coin as like the most responsible for that interoception feeling.
01:32:26
Burke Hahn
Yes, you're absolutely right. The insula is the main one. there's There's a, I think like the anterior cingulate cortex is another area that's implicated in there, but the insula is kind of the biggest one. um One other really interesting um ah piece of research that I haven't, I've looked into a little bit, but I'm more just kind of um um and familiar with from a tertiary perspective and talking with other people is the default mode network.
01:32:50
Burke Hahn
um And the default mode network is the idea that when you're at rest, um your brain ah kind of gets into this particular state, where you are thinking about yourself in different contexts, right?
01:33:04
Burke Hahn
So you're thinking about, um you know, yourself, you know, in like with memories that you have, or
01:33:10
Tony Montgomery
Mm hmm.
01:33:10
Burke Hahn
If you're thinking about the future, thinking of yourself in like what to do in the future, like, oh, well, you know, when I get home, I have to cook dinner. And then you're kind of like imagining yourself. you know, like, okay, what am I going to cook? And so you think about what's in the fridge and all this stuff, and you're thinking about yourself in this in this instance, it's completely like a natural thing to do. And so um that's also from that kind of related to some of this interoceptive experience, because like, that's always very influenced by some of these physical sensations. um And kind of to that point,
01:33:44
Burke Hahn
There's also just in general, uh, with like brain activity, a top down and a bottom up system. So, um, first you have your kind of top down system of like you, you know, you have a goal that you want. And so you, your brain is kind of like telling your body what to do. Um, but then with, um, you know, your bottom up, you have all these internal pieces, like everything that's going on within your organs, whether you're aware of it or not, like your blood pressure.
01:34:13
Burke Hahn
your blood sugar levels, um ah the oxygen levels that you have in your body, that if you're hungry or not, all this stuff, this pain um is constantly being sent up to the brain and it's being interpreted by the brain as well. And so I think both of those things that when you mentioned that like there's lots of different brain areas that kind of relate to this.
01:34:33
Burke Hahn
um that's also related to that, that there are so many different brain areas that kind of come together and um kind of formulate in, um you know, kind of pull, like the insula maybe like pulls from a lot of different places and is able to like interpret the situation and body sensations um based on what's going on. So yeah.
Therapeutic Strategies for Anxiety
01:34:53
Tony Montgomery
Yeah, and they've shown through like meditation and things like that, you're able to quiet the defo default mode network. um Exercise helps with the insula and that interception um dynamic. um but But they also show that, obviously, if you suffer from rumination and worry and and that type of stuff, intrusive thoughts, that meditation might not be as beneficial because you're kind of perpetuating the stimulus that causes the issue. And they found that um mindfulness is is a much better practice than meditation in those experiments because you're taking them out of their head and into their body. It's like focus on your breath, focus on the sensation in your feet, your body, that type of stuff, as opposed to getting out of the head. But
01:35:42
Tony Montgomery
Maybe once you are able to control that a little bit better, then going into meditation will allow you to quiet that default mode network. What are what are some ways um Obviously we can understand like the downfalls of interoception when suffering from anxiety disorders, because the last thing you want to do is be in your head when you have all this intrusive thoughts, these negative valence thoughts going on. um What are some therapeutic ways that we can help that you've seen in the literature incorporated to improve, ah to create a more positive valence and a positive introceptive state? Like how can we how can we overcome this rumination, this worry and all that stuff?
01:36:22
Burke Hahn
Yeah, absolutely. That's a great question. So um some of the stuff that you we just talked about, one, mindfulness is a big one. um And on top of that, um so I guess ah really quick, mindfulness, just like you described, being present, and attention to the present moment. So not look ah you know kind of having that rumination going backward or that worry going forward. You want to stay right here in the present moment, um which as I'm sure to you all, it sounds very familiar. there's a lot of kind of like spiritual practices that have done this for centuries, ah millennia. um And so this is just kind of like the Westernized research method of of describing that a little bit. But um yeah, we have so this like just attention to the present moment can really help um practice and flex that attentional control muscle in your brain.
01:37:16
Burke Hahn
Um, we also do things, I'm going to just kind of talk about some like specific evidence-based therapy strategies we have. Um, progressive muscle relaxation is really, really good. Um, and what that means is you start kind of like at, um, at the feet and you will flex like every muscle group, um, one by one and then relax them. So you'll flex your feet for like five seconds and then let it release. And a lot of tension will kind of go out there and what you're doing.
01:37:43
Burke Hahn
is you're kind of resetting the body almost, right? Where you're like, there could be a lot of tension built up. um Like right now me, for example, being kind of like, you know, anxious about, you know, being on a podcast to make sure I'm saying everything correctly, right? I can notice my shoulders now are a little bit tense. So I can like flex them and then let them rest. And now they feel more relaxed, right? So being able to do that and kind of sink down into ah the present moment is a very common strategy for anxiety.
01:38:10
Burke Hahn
um One ah other type of ah strategy that is is commonly used is through, um it's called dialectical behavioral therapy or DBT, and it's the idea that ah dialectical, meaning that like two things can exist at once, right? That we can have both be ah like, you know, angry, but then also not to kind of take it out on other people. We can manage that in a very successful way for us. Not like holding it in either. We want to be able to really like manage that in a healthy way and one ah very specific skill that can be used is it's very physical is called the tip skill or temperature intense exercise and then we have that like paced breathing um so we have ah temperature um holding ice cubes is a very common one for anxiety because your body is like so activated
01:38:59
Burke Hahn
Um, and so if you hold ice like with your hands or you go outside or, you know, put your face in the snow, if if you're, ah you're in winter and you live in a place where there's snow on the ground, um, or something like that, um, can really help literally cool your body down and reset it and get that really cold sensation to help focus on this in particular. And then intense exercise, which, um, you know, kind of to like bring everything together. is literally integrated into this skill of being able to like run up the stairs up and down the stairs a whole bunch right to kind of get that energy out but then also to um like kind of like Tony had mentioned earlier get that kind of that like a couple of you know like 30 maybe 60 minutes after you kind of feel a little bit better it resets the body again resets that sympathetic nervous system to activate more of the rest and digest system
01:39:50
Burke Hahn
Um, and then, uh, I mentioned exposure therapy is another, uh, really common, um, way to help with, uh, help with anxiety, kind of, uh, more logitudinally, like relearning things.
01:40:01
Burke Hahn
And then one other method, uh, that's very commonly used in like, especially like CBT therapies is, um, cognitive, um, uh, like a thought challenging, I should say.
01:40:12
Tony Montgomery
Mm.
01:40:12
Burke Hahn
So. people a lot of the times have beliefs about certain things, about themselves, about the world, um you know, and these can be like core beliefs or they can be like automatic thoughts that just come up. And so the idea is that you challenge those thoughts and the idea is not necessarily for them to be like always more positive or always, you know, more negative or whatever, but to be realistic. um And so let's say you're having the thought of like, you know,
01:40:41
Burke Hahn
you're a student and you have a test coming up and you're like, man, I am so worried about this. I'm going to fail. Right. And then if if I fail, like I'm going to drop out of college and whatever. And so the idea is that you ask yourself or the therapist will ask you questions like, okay, well, um, what is kind of the, um, like what has been your experience with this before?
01:41:03
Burke Hahn
And let's say that this student has like failed a test before. It's like, well, did you did you like have to drop out of college then? And then they'll say, like well, no. And say, OK, well, what's the worst thing that can happen? And so they kind of say that. And it's like, OK, well, what's the most realistic thing that can happen? You come up with all of these different ideas of like all of the different possibilities to reduce the impact of um reduce the impact of that worst case scenario because there's tons of different um experiences that as ah you as a person have had with failure that have gone like completely fine right that you can deal with. ah Or ah you know maybe you just reduce the impact of that worst case scenario to help kind of reduce that anxiety um and stuff like that. So those are the like the really common ways um that to help with with anxiety that I have been able to use, thankfully, in my like therapeutic practice and then also um just as our evidence-based practices for for anxiety treatment.
01:42:03
Tony Montgomery
yeah Yeah, definitely. One of the things that exercise can do for anxiety is to kind of distract you, right? It can get you out of your head. If you're doing something hard, you're not really thinking about your intrusive thoughts. You're not really able to ruminate. So it does it does allow you to do that. the The idea of talking through it, that makes that makes a ton of sense, right? Because you're you're it's almost like a pros and cons list. It's like,
01:42:26
Tony Montgomery
What's the worst thing that can happen? Is that really that bad? But what's the best thing that can happen? How great is that if you just focus on that type of deal? And that can start to shift your perspective. It can also shift your focus of attention of like,
01:42:40
Tony Montgomery
Oh, well, this really good thing sounds pretty awesome. So now I'm going to focus on studying, you know, and I'm going to be as prepared as possible because I want this good feeling. And then if I don't do as good as I thought I was going to do, well, the worst case scenario doesn't really feel that bad.
01:42:56
Tony Montgomery
And I think from like a a general perspective, non-anxiety, I think people, if you if you think about that stuff, it'll help you feel less trapped in a situation that you feel like you can't get out of. So say you have a ah bad job and you're just like, man, this job is is killing me, but I just can't quit because I have... bills, I have this, I have that. If you work through that scenario, like, well, what's the worst thing that can happen if I quit? Well, maybe I can't find a job right away. What does that look like? Well, maybe, maybe we're going to be a little bit tighter on money. but but but You know, you go down that list and then it's like, well, what happens if I find the job of my dreams? Oh, well, then my marriage gets better. The interactions with my kids get better. I make more money, right?
01:43:38
Tony Montgomery
I think having that idea of like pros and cons, worst case, best case scenario is a great way to start to work through really anything in life, but it can definitely I can see the benefits of that being um something in anxiety. one of the One of the interesting things about you and about a lot of people, in the and at least in in our lab, is um You guys are really into like the fantasy dynamic of
Role of Fantasy Activities in Mental Health
01:44:02
Tony Montgomery
things. you You read a lot of fantasy books. You play Dungeons and Dragons. And it'd be interesting to know if that escape from reality
01:44:13
Tony Montgomery
could manifest itself in very similar situations that we were just talking about, to get out of your own head, to be more mindful, to have that social component, to do something that you love to do. um i I doubt there's research on D and&D and anxiety disorders, but is that something that Is that why that appeals to you? Is that something that gives you just an escape for a couple hours? like what What is that draw that I see a lot of people that do suffer with mental health disorders kind of gravitate towards a ah positive escape from um the the the rumination and the and the worry and stuff like that?
01:44:53
Burke Hahn
Yeah, absolutely. And you're right there. I mean, there is some, some, some research out there, very little unlike D and&D and and in therapy. And there's like some people that like practice using or facilitating therapy through D and&D, which is interesting, but it's very experimental.
01:45:10
Burke Hahn
um So I'll be speaking now more from, like you mentioned, I'm i'm more than happy to do this, to talk for a long time about this stuff, but from like a personal perspective. um So I have played, um like and ah broadly, like tabletop role-playing games since, um really, truly since high school, like about a year or two after like I started having mental health um like challenges and in my depression and anxiety and things like that.
01:45:38
Burke Hahn
um And there's a couple of points you mentioned that I super agree with. One, it absolutely helped me find a community. You know, we talked about having ah that culture, are having that community, having these people that you love and that love you and um are there to support you. um And having this like game that, um you know, really activates this like ancient um like primal human desire to like tell stories with each other. um It's such a powerful like connector with other people, um but it's also a way that you can explore yourself and who you are with other people around in an environment that feels a little bit safer. So I'll give an example.
01:46:26
Burke Hahn
um i um you know with With all of the you know mental health challenges I have and and searching through identity and and things like that, there was um ah there's multiple characters that I've got to play in longer term campaigns with um different parts of who I am. um I've played characters that are maybe a little bit ah more brash and and and confident that um you know I have a lot of like Midwest nice, so I'm not able to do that a lot. And so it was fun to be able to like practice those things in a safe environment, but also do it in a way that was fun and wasn't going to harm anybody. ah But then also even getting to play like, and this is kind of getting into um like more like kind of personal identity things, but like getting to play characters of like Different genders so let's say somebody has ah like gender dysphoria if they I like I identify as like non-binary or even transgender they're able to like um like explore a care being what ah what it would be like to be a character of like Somebody that they don't feel like as a person they are right now, but could be you know what I mean
01:47:32
Burke Hahn
um And it can be very, very therapeutic in that way. um And then also um some other things that can be helpful um is just being able to like have that um that distraction piece and kind of get your mind out of the world for a little bit is incredibly powerful. um I know for one, like being able to read lots of different books, um like fantasy novels, and kind of like identify with characters, and but then also play you know D and&D and and other role-playing games um and just like imagine myself and my character you know casting spells and swinging swords and stuff like that um with like you know very little kind of like scary real world consequences um can be ah ah just a place to ah to play right to like not lose that childlike wonder that ah you know it's very common to lose as you become an adult and
01:48:28
Burke Hahn
um just like kind of help maintain that like ability to just like have fun you know that's a huge aspect of it um so yeah i would say to like kind of summarize all that you have this like community piece where you develop a ah community with friends you have this um this like fantasy piece where you can imagine yourself in different scenarios uh you have this like fun piece and this piece of play and then you also have um you know, feeling like you're kind of connected with like all of humanity, both like present and past in like the storytelling aspect of it um can just be like a really, really powerful thing. Yes, it's very nerdy, um but it's it's it's a blast, you know what I mean? So, yeah.
01:49:12
Tony Montgomery
Yeah, I think a lot. of, or not maybe not a lot, but I've heard evolutionary psychologists talk about the idea that society started to form under the guise of of storytelling, that as soon as fires came about, that people didn't have to look for shelter or work through the night, that type of stuff. So they were able to sit by the fire and and tell these stories. And we see that manifested through things like um the Iliad and the Odyssey that were first
01:49:43
Tony Montgomery
used as a story through poetry, through singing, and then that manifested itself into a story. And then that's something that we all resonate with. um So that idea of of storytelling and and allowing yourself to connect with people makes a lot of sense, but I could also see um the downfall of that as well. Like if you're in a world where you just don't like to be there um thinking about like virtual reality and things like that, and then you find this escape um how have you found like What have you found to be the way that you've not necessarily fallen into the trap of trying to find that escape for the rest of your life? like why Why face reality when this escape is just so much better?
01:50:31
Burke Hahn
Man
01:50:31
Tony Montgomery
Is it because your friends have jobs and they can't play D&D 24-7?
01:50:38
Burke Hahn
ah Yeah, I mean that's that's definitely a part of it. I mean I you know I i also have stuff to do like I can't do it 24-7 either ah but man ah i'm I'm gonna kind of like think about this one a little bit um I Would say for one um It's something that has crossed my mind quite a bit.
01:51:08
Burke Hahn
And what I mean by that is, um you know, especially in high school when I was just like, you know, I just didn't, I hadn't built up kind of the life that I have now that I'm really very like privileged and happy with um and like very blessed to like have the life that I'm living now, even though it's, it's like certainly a lot of work.
01:51:09
Tony Montgomery
Thank you.
01:51:28
Burke Hahn
um But like in high school, when I didn't have a lot of that stuff, um what I found is, that losing myself in um like like fantasy novels and D and&D and stuff, but even things like social media, like watching YouTube all the time or you know when Vine or TikTok came out, like just watching that stuff all the time.
01:51:51
Burke Hahn
um And i there have been moments in my life where I have fallen into that, where I have like fallen into um you know just spending my time just like watching YouTube videos or Twitch streams or whatever it is um and and just not kind of not wanting to engage with the real world because there are certain times where it sucks. um But really what it came down to it for me um is, and this kind of goes back to one of the things that we had talked about, um, like very early on in this episode, uh, that, that true, like, uh, um, I don't want to say like physical, I guess, but like having that in-person human connection and having like a real life to have meaning for yourself, um, is,
01:52:48
Burke Hahn
while certainly more challenging, so much more rewarding than losing yourself in in fantasy and stuff like that. um and For example, part of my journey to get into like the fitness realm, um but not only did it look like I grew up doing you know sports and wrestling and stuff like that, but um I found myself like whenever I got out of sports, like I put on whatever I got my first job and I wasn't really doing any physical activity. ah You know, I put on like 50 pounds like in in like two years of high school because I wasn't doing anything.
01:53:27
Tony Montgomery
Yeah.
01:53:28
Burke Hahn
And then like, as I got into college, you know, I sort of realized that there was something missing from my life. And a part of it is that, you know, through therapy and through a lot of introspection, that I was just very passionate about, you know, wanting to um Like be a healthy human being to feel good to like have my brain, you know like function at like peak capacity as much as possible then also like people that I Admired, you know and that I as a kid, you know, I you know read fantasy novels and I'm like man I want to be like this really like super big strong character that like wields a great sword, you know and the only way that I can do that is by putting in that effort and so
01:54:12
Burke Hahn
um kind of trying to like tie it all together. I mean really what it was for me is like understanding how meaningful having being able to build those things in real life is.
01:54:28
Burke Hahn
um to um Like how meaningful that is to me um not necessarily just like imagining it but you know being able to like go work out and like now, you know, I I have like a couple of like um like medieval like I have like a a big Dane axe like in my room and so to be able to like take that out and just like kind of play with it and swinging around and stuff like that and knowing that I'm like strong and I can do that, I mean that is you know, I think that's really what it's about for me is having that real human connection with other people outside of like fantasy novels, not having just like, you know, parasocial relationships through social media, but then also being able to like build myself who I am in my physical, spiritual, mental, emotional body to become like, i you know, I want to be, I guess.
01:55:02
Tony Montgomery
No.
01:55:22
Tony Montgomery
Yeah, yeah, no, I mean the greater the challenge, the the greater reward. um It also sounds like based on what you've been saying that you're you and your parents didn't let the mental health disorders define you and they didn't coddle you. I think if they if you if you could have done that, you could have easily seen that you know you could have fell into a trap of like, oh, the world's scary. My parents Are gonna allow me to do whatever I want and I don't want to go face the world So now i'm going to be put in this situation where I can just escape I can play video games in my parents basements because they're allowing me to for the rest of my life but it seems like they had the foresight and you had the foresight of like
01:56:03
Tony Montgomery
getting out there and challenging yourself and, you know, not allowing the disorders to define who you are, but the ability to to overcome them. And um now, whether you whether you like it or not, um because I don't know if you signed up for yet, now you're going to do your first tire lifting competition.
01:56:21
Tony Montgomery
um So now that it's out in the ether, you have to do it.
01:56:24
Burke Hahn
I have to do it now. Yeah, no, absolutely.
01:56:25
Tony Montgomery
yeah Yeah. But yeah, I think is that something that you've always had as a defining characteristic of you is like the challenge because obviously you you're getting your PhD.
01:56:36
Tony Montgomery
That's no um small, small feat. Although it's not as, it's not as magnified as people make it out to. It's not the hardest thing in the world. I can attest to that.
01:56:44
Burke Hahn
Yeah.
01:56:45
Tony Montgomery
Trust me. Maybe because it's an exercise science, but maybe, maybe if you're being a brain surgeon, maybe it's going to be a little bit more difficult, right? not the hardest thing in the world, but it is a challenge, right? It is something that you have to spend eight years doing. um Is that something that you've always had? Is that something you developed through therapy? Like, how did you come to this idea that like, if I can face the challenges of the world, then I can really face face anything.
01:57:10
Burke Hahn
Yeah, um certainly therapy helped out a lot. Like, um yeah, absolutely. Therapy was one of the the biggest things. um Really being able to like explore myself and my own values, that was huge as well.
01:57:24
Tony Montgomery
yeah
01:57:25
Burke Hahn
Like values work, being able to like talk with other people in a very safe space about what you find to be valuable allows you to, um ah how do I wanna say this?
01:57:38
Burke Hahn
It's very difficult to lie to yourself whenever you are very confident in your own values.
01:57:42
Tony Montgomery
Yeah. Mm hmm.
01:57:44
Burke Hahn
um And I have found that for me, um like introspection and values work um has allowed me to like not only define my values, but also adapt them as I kind of grow.
01:57:58
Burke Hahn
um And it's it's very difficult for me to lie to myself about who I am and what I want to do now granted like there's obviously time says it's life gets hard and I'm not able to do as much as I want but ah Having that like having those values and then not lying to yourself um is like huge and then also Like you said with my parents, man, I love them very much. And and there was there was a lot of challenges kind of growing up, um for sure, and my with my relationship with them and and things like that. And even now, like things that yeah just like every child has with their parents, like things that they're still processing through, like you know as a parent makes a mistake, or like you as a kid make a mistake, and then like something happens because of that you know trauma little traumas that you kind of need to process through. but
01:58:45
Burke Hahn
um couple of things that they really, really like, um, uh, that I will never forget and I will always be thank thankful for them for is just the values of like never giving up.
01:58:58
Burke Hahn
Um, truly like never giving up and also not in the sense of just like, you know, bashing your head against a wall for, for the rest of your life, but like never giving up in terms of like being, uh, you know, doing, uh, pursuing the things that again, you value and that you want to do.
01:58:58
Tony Montgomery
Hmm.
01:59:15
Burke Hahn
um And just not letting things kind of stand in you in the way of that. And for me, again, that was like, as I kind of ah found my own values of like being kind to other people and being understanding and empathetic, but then also, like you mentioned, like challenging myself, lifelong learning, um building community, i'm just never giving up with those things.
01:59:39
Burke Hahn
um was like very very formative for me and you know my parents always pushed me to to be like a better person like sending me to different sports like ah making me make sure that like even if i didn't want to like you're gonna do these guitar lessons for at least a year you know and if you don't like it then then we can move on to something else or you know sending me to working really hard to send me to like good schools and again very privileged in that regard um but yeah i would say that
01:59:45
Tony Montgomery
Right.
02:00:07
Burke Hahn
having those kind of like really early on those values of like determination and ah you know hard work but then also ah like being true to who you are into your values and then later in life being able to explore those in full detail um and like having this desire to have lifelong learning um was was very helpful for me um to like maintain that and to not let myself fall into just, you know, like lay out like you said, like, just um
02:00:41
Burke Hahn
you know, doing nothing, you know, because like, it's be really easy to do that.
02:00:43
Tony Montgomery
yeah
02:00:46
Burke Hahn
You know, I, I always I laugh with my friends. I'm like, you know, somewhere in me, there is a, ah like, just like, ah just a guy that just wants to work at this local board game store.
02:00:58
Tony Montgomery
Yeah. Yeah.
02:00:59
Burke Hahn
and watch WWE and not really do anything else. And you know ah that guy is still in there and I love that guy. So much fun to hang out with. um In addition, there's other parts of me that are ambitious, that are emotional, that are um lots of different things. And so being able to give like that guy space in the fantasy realm but then also sometimes in my real life and then also like other parts of me space is just um I think really important because it allows you to be a multi-dimensional person but also to be able to like really explore who you are. um Yeah.
02:01:34
Tony Montgomery
Yeah, I think one of the strengths of anxiety disorders is is that introspection piece, right? Is that ability to self-actualize? Once you have the tools to overcome the the negative thoughts, I think that ability to look inside is something that anxiety can provide to people, that people that don't suffer from anxiety,
02:02:00
Tony Montgomery
usually never never do because it's scary to look inside which is why you could probably have those intrusive thoughts in that rumination but being faced with that and being forced to look at it and then developing the tools to overcome the negative stuff and then only focus on the positive stuff of anxiety um is ah is an extremely valuable tool because then you start to learn those values. You start to challenge your beliefs. You start to form a true identity of who you are by looking in. And I think based on what you just said, like all those things were able to manifest themselves probably um because of the anxiety that you have and that
02:02:37
Tony Montgomery
ability to to internalize and introspect and stuff like that. and um Which brings me to the kind of the last thing I want to talk about is this idea of um having having gone through these mental health issues, do you feel like that makes you a better therapist? Do you feel like by suffering you're able to empathize, you're able to um understand better because I know talking through my military friends, a lot of them have issues with therapy because if you're not a veteran, it's going to be hard for me to talk to you about war and what I've done and what I've seen because you you don't know and you're going to judge and you're going to have all these other things, right? So having that shared experience can make it a ah very powerful um alliance that you can build. Do you feel like that's something that helps you or hinders you?
02:03:30
Burke Hahn
ah without a doubt something that helped me. um Not only was it one of the big catalysts for me getting into the profession, but just like you said, it really helps me to have um like real empathy. And I don't just mean like you know having unconditional positive regard for for clients and other people, which obviously like that's a very important part of being a therapist. and I work to like make sure i I do that. But by empathy, I literally mean imagining myself in their scenario and imagining what it would be like to feel what they're feeling. um It is such a critical part of therapy. And in my opinion, like being a good friend um is being able to like listen to somebody and imagine yourself in their scenario truly and say, oh,
02:04:21
Burke Hahn
Well, of course that they would be responding this way or acting this way because I mean that that would be just a really difficult situation. um And or or like, because, you know, the there's a ah common phrase that I really like that I don't attribute. ah Don't attribute to something to malice that, ah you know, and as that instead understand misunderstanding or something along those lines. I really like that because that's what I found for like ninety nine point nine percent of interactions.
02:04:50
Tony Montgomery
Yeah.
02:04:51
Burke Hahn
ah you know Everyone has their their own story, has the reason why they acted a certain way. um And whether that be through their own mental challenges, or whether that be through just like some of the the biases they have that they need to like work through, whatever it might be, um like being able to understand where people are coming from allows both me as the therapist, but then also the client to be very open in that regard and really talk about what's actually going on. Instead of having all of this, like, you know, facade and and not feeling like I can really express myself or whatever it might be to actually talk about like the true emotions and break down those barriers. Um, and although I don't think it's required that therapists have like experience with everything, right? Like
02:05:41
Burke Hahn
I don't personally have any experience with like severe substance use, but I've worked with people that have and been able to have successful treatment um and ah it's not required.
02:05:53
Burke Hahn
However, I will say being able to pull from personal light challenge and experience to make that connection with clients and patients and just other people um ah can be an incredibly powerful tool to allow the other person to open up and really to be themselves. And just like you mentioned with some of those um like veterans that that experience PTSD and talking with people that haven't like experienced war um And stuff like yeah that's that's like very real and um I don't think it's like obviously not required for a therapist I've you know gone into like active duty or military service or anything like that to be able to do successful treatment But to be able to like show that you as the therapist can provide that safe space and truly empathize with them and say like I'm Not gonna judge you and not just telling them but like literally showing them by your actions um in the therapy room
02:06:50
Burke Hahn
um like that's really what it's all about. um And so I would say my mental health difficulties, while yes, have been um certainly a challenge for me over the course of my life, um has been something that I ah i want to say i'm I'm glad to have because it's made me do who I am. And like I said, I love what I do. I love where I am right now. um So yeah.
02:07:14
Tony Montgomery
Yeah, man, we need more people like you and in therapy, right?
02:07:18
Burke Hahn
Oh, thanks, Teddy.
02:07:19
Tony Montgomery
and Yeah, yeah you're gonna do you're gonna do great things, man.
02:07:19
Burke Hahn
I appreciate that.
02:07:22
Tony Montgomery
Thanks for coming on the episode and sharing your story and hopefully sharing some stuff that people can find to be tangible and that they can use in their everyday life experiences, whether they suffer from acute bouts of anxiety or chronic bouts of anxiety.
02:07:37
Tony Montgomery
So I appreciate your time. I appreciate your knowledge.
02:07:41
Burke Hahn
Yeah. Thank you so much for having me. This was, this was a blast. Um, and, um, yeah, just, um, thank you for, for having me on and and talk with me about this stuff.
02:07:50
Tony Montgomery
Yeah, I know.
02:07:50
Burke Hahn
Hope I was able to help out.
02:07:50
Tony Montgomery
I appreciate you, man.
02:07:52
Burke Hahn
Yeah.
02:07:52
Tony Montgomery
Yeah, yeah, yeah. Thank you so much.