I Am Anxious... Dr. Kathleen Smith
The therapist and writer explains what practical systems she uses to confront her own anxiety.
Dr. Kathleen Smith is a licensed therapist and writer in Washington, DC. She is the author of Everything Isn't Terrible: Conquer Your Insecurities, Interrupt Your Anxiety, and Finally Calm Down, and has written for Slate, Salon, New York Magazine, Lifehacker, Bustle, and more publications.
Her newsletteris one of the very best mental health resources on Substack. Here’s what she has to say about it: “My newsletter is my attempt to describe the theory I use as a therapist, Bowen family systems theory, to a popular audience. People are always curious about what's happening in a therapist's head when they think about a challenge, and I'm happy to write about it.”
How long have you been an anxious person?
For as long as I can remember! Although I think about anxiety a little differently because of my theoretical orientation as a therapist. To me, anxiety is a response to a real or an imagined threat. We all do things to manage that anxiety, so we're all anxious people.
What is your earliest memory of being anxious?
I remember being four or five and needing to turn all my stuffed animals face up before bed, so they wouldn't suffocate. I also remember being concerned about things spontaneously combusting.
Have you ever experienced a panic attack?
I don't think I've ever had a panic attack. When my anxiety symptoms have been at their worst, they manifest as an intense nausea.
What are some of your anxiety triggers? What makes you most anxious?
I tend to overfunction for others when I get anxious. If someone is doing something in a way that I perceive as slow or inefficient, like running a meeting, it makes me want to take over! If I'm not paying attention, I can easily take on too much because I can't tolerate watching other people do something differently.
How do you feel physically and emotionally when you’re anxious?
I tend to tense up and have trouble sitting still. Emotionally I become "allergic" to other people, so I end up wanting to distance from them or start overfunctioning for them.
What do you do when you feel anxious? How do you take care of yourself in those situations? Do you have any anxiety management tips or tricks?
I try and stop, take a deep breath, and pay attention to the patterns. I remind myself that I'm responsible for managing my anxiety, and I do not need to be overresponsible for others. I need to step back and give people opportunities to show me they are capable!
Another trick I use is to estimate how anxious other people in the room are, on a scale of 1-100. And I try to get a couple points lower than they are. So if they're a 76, I don't need to be a 15. I just need to try to be a 70, and I ask myself how to I need to relax my body or change my thinking to get to that number.
How do you feel your anxiety affects your family, friends, and overall social life?
I think anxiety can keep me from having what Bowen theory calls a stronger person-to-person relationship with people. Relationships get stuck in sort of a superficial mode when you're always trying to overfunction for others, or you keep things light so you never upset anyone. By managing my distress in a more responsible way, I give my relationships a chance to go deeper and be more rewarding.
When you're not feeling anxious (simply in your day-to-day life), what do you do for self care?
I love getting coffee with friends. Because I'm self-employed and have a flexible schedule, I have a lot of friends in their 60s and up who are retired. If I could make my Millennial and Gen Z therapy clients do one thing, it would to build more multigenerational relationships. We're often too caught in our own bubbles, and there's benefit to being with people in various stages in life. I also adore reading romance novels and popping into museums by myself. You never run out of places to explore in DC.
How do you feel about the portrayal of mental health and anxiety in Pop Culture (books, movies, music, etc)? Do you feel it's accurate?
Societally, we take a very individual focus on anxiety, and you see this reflected in pop culture. You'll see people having panic attacks on TV, but you won't see many reflections of how anxiety gets managed in the larger group, like the family. I'd love to see more exploration of parents overfunctioning for their kids, or families where there is estrangement. Because these are the footprints of anxiety.
What are some of your favorite examples of Pop Culture that gets anxiety and mental health right?
I was a big fan of the HBO show Big Love, which is no surprise since I study family systems. It was a great example of how anxiety gets passed around the family, and the patterns that families use to manage stress. Lots of triangles, cut off, over and underfunctioning.
What is the best advice you've ever received?
I had a colleague tell me once, "You are responsible for your own distress." At first glance this seems like a mean thing for a therapist to say, but it's true. We might not have caused our distress, but what we do with it is up to us. We can all be more responsible for how we manage anxiety. That's a lifelong process, but it's absolutely worth the effort.
Is there anything else you would like to add?
If people want to learn more about anxiety from a systems perspective, they can check out my book, Everything Isn't Terrible.
Editor’s Note: This interview was edited slightly for length and clarity.
Thank you so much to Dr. Smith for participating in the I Am Anxious… questionnaire. I found Everything isn’t Terrible a really fun and informative read, so I highly recommend it to anyone who might be dealing with anxiety. Thanks again, Kathleen!
If you are interested in being a part of the newsletter in the coming weeks and taking the I Am Anxious… questionnaire, please email me (email@example.com) and I’ll get you on the list! I’d love to have you.
Be well and keep talking.
Anxious Dude is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.
DISCLAIMER: I am, by no means, a medical profession. If you need help, please seek qualified medical attention. This newsletter, while informative and fun, is no substitute for the real thing.