The Table Podcast /

A Christian Perspective on Anxiety

In this episode, Kymberli Cook, Kelly Cheatham and Jenny Wang discuss a Christian perspective on anxiety, focusing on how to respond to it and help those who suffer.

About The Table Podcast

The Table is a weekly podcast on topics related to God, Christianity, and cultural engagement brought to you by The Hendricks Center at Dallas Theological Seminary. The show features a variety of expert guests and is hosted by Dr. Darrell Bock, Bill Hendricks, Kymberli Cook, Kasey Olander, and Milyce Pipkin.

Timecodes

00:15: Guest introductions
00:52: What is anxiety and when does it becomes a problem?
04:43: Is anxiety more common among Millennials and Generation Z?
08:26: Increased anxiety in the age of information overload
11:03: Anxiety, worry, and burnout
14:06: How should Christians think differently about anxiety?
22:45: How anxiety affects people in ministry
27:05: Advice for ministry leaders in helping people with anxiety
30:06: Practical ways to address anxiety
34:46 When: is it time for clinical help?
37:46: Preventative measures and self-care

Transcript

Kymberli Cook: Welcome to The Table podcast where we discuss issues of God and culture. My name is Kymberli Cook, and I'm the Senior Administrator here at the Hendricks Center. And today we're gonna be talking about anxiety. So we're not worried about this podcast at all. We're joined by Dr. Kelly Cheatham who is the Director of Counseling Services and an adjunct professor of Biblical Counseling here at DTS, and Jenny Wang who is a Senior Therapist, Lifeologie Institute, Frisco, and a DTS grad. And one of Jenny's specialties just happens to be helping people with anxiety. So we're happy to have you here, as well
Jenny Wang: Thanks.
Kymberli Cook: Thank you so much for joining us.
Jenny Wang: It's good to be here.
Kymberli Cook: So we're just gonna jump right into the conversation today. And anxiety, I think, we all know sort of what it is. I think it was a respectable thing that I looked that up on, though I did not note what it was. Approximately 18 percent of US the population each year is dealing with anxiety, is what I found, at least online. So something is saying that, which is a lot. It's a lot of people. And so I'm assuming that you all see many cases of anxiety in your practices, and in your offices. So first off, let's just talk about what it is. What is anxiety? What's normal, a normal way that people, just how God made us. I have to imagine that there's some kind of automatic response that happens, and it's totally fine, and then it becomes a clinical issue if it gets past a certain point. So Jenny, why don't you start us off? How should … what are we talking about when we're talking about anxiety?
Jenny Wang: Well, absolutely anxiety is normal. Right now I feel a little anxious. Normal anxiety tends to be specific to a situation. And it also is periodic. And, for example, right now, being anxious about being on this podcast, it's my first one, my stomach's fluttering a little bit, I might be talking a little bit fast. There's physical symptoms to it. It's just this feeling of apprehension. That's normal anxiety. When we're talking about an anxiety disorder, we tend to be talking specifically about a few things, that it tends to be more chronic. When we follow the DSM5, which is our handbook of mental disorders, it's six months or more. It is persistent, and there is an intensity to it, and there's a lot of physiological symptoms, as well, such as, actually mind fog is a huge one. So a lot of people might come in to counseling and they say, "I can't think clearly. I can't do my job clearly. I don't know what's going on." And one thing we'll say is, "It sounds like you might have anxiety." There is tiredness that goes along with it, so there's some very consistent physical symptoms that go along with anxiety, as well.
Kymberli Cook: Kelly, would you have anything to add?
Dr. Kelly Cheatham: I would just agree with everything she shared there. I think it is important to recognize that there … I think of it as normal anxiety and problem anxiety, just as far as terminology. So anxiety is normal. It's part of our condition. In fact, we need to have some anxiousness at times. Keeps us safe, keeps us … we need to have a little bit of fear about certain things. Keeps us from walking in traffic and touching a hot stove, those kinds of things. But it becomes problematic when it is … our anxiety should rise and fall. But when it stays high, at this heightened level, then we do experience those symptoms that should, again, diminish. But if they stay, our anxiety stays too high for whatever reason, and we are experiencing more of a disorder, then it's very uncomfortable, and it really is hyperactive, in a way. And so that's when it's more problematic, and we see all kinds of stuff comes from that. It's not… it has a long-term, prolonged effect on our health, and so it's a real pervasive physiological, mental, emotional, relational impact.
Kymberli Cook: So, that heightened sense … tension or, as you're talking about it, seems to be more pervasive, or at least is named more. Maybe that's more of an accurate assessment. Who knows? Seems to be more called out, at least, in our society, particularly amongst Millennials and Gen Z, especially it seems like Gen Z. American Psychological Association has giant pages about it, and a variety of other studies have been done, particularly as related to social media, but just overall about that generation. So is that something that you all have seen in your practice? And if so, what do you … why do you think maybe Millennials and Gen Z specifically are struggling so much with that? Dr. Cheatham, let's start …
Dr. Kelly Cheatham: It's a great question. I'm not sure, actually. But I think there is something to the … I'd love to hear what Jenny has to say … there's something to this idea, this theory, really, about maybe about social development, social skill development of younger generations, and maybe because of the Internet, maybe social media, those kind of things, people just literally aren't doing things face to face, like we used to, and they're more prone to maybe isolate themself and just have a … 'Cause anxiety's about … The way that we learn to deal with those anxious feelings is to face our anxieties. But if we aren't in the situations to where we can face them, we never really learn how to manage it. And so, when something comes along, or we haven't actually experienced something but we think about what it would be like to experience it, but we haven't really tested ourself to show that it's maybe not as anxiety provoking as it needs to be, or that we can actually withstand the anxiety, the thing that we're facing, the threat or the challenge, then we are gonna be more prone to maybe have things like social anxiety. Social anxiety is … I have found that to be pretty prevalent among my clientele. But I see adults, too, older adults, not just the Millennials. It seems to be more of a gender difference. I think women are more prone to have anxiety disorders than men. But I guess there is maybe something to the generational aspect of it.
Kymberli Cook: Jenny, you work a lot with younger adolescents and younger people, correct?
Jenny Wang: I do, yes.
Kymberli Cook: So what are your thoughts on this?
Jenny Wang: So I absolutely have seen an increase throughout these years that I've practiced. I actually started practicing … I graduated from Dallas Seminary in 2007, and I have seen a change within these 12 years … I'm trying to do math in my head … within these 12 years, an increase. And that is actually something that I noticed probably four or five years ago that I would say to my colleagues, "There's an increase in teenagers coming in for anxiety." So that is definitely something I've seen personally. I also don't know the reason why, but I do have some theories, personal theories. I haven't actually done research on it. Some of my thoughts are, so I completely agree with Dr. Cheatham that one of the hallmarks of anxiety is avoidance, as wanting to avoid something. So I think there's two main things. I think the rise of the Internet, and how much knowledge there is online, that there's so much more to be afraid of. I think part of just living in this world, and living in this in between stage, between when Jesus is … between the garden of Eden and when Jesus will come back again, is there's a lot of fear and anxiety. But now we have all this knowledge that is so accessible, and these young people who don't know how to deal with that or cope with that. So I think that's part of it. I think another part of it is that maybe my generation, we didn't really know how to deal with our stress. And so we're not teaching that to our children. And I think that more and more adults are stressed out, and we're bringing that into our families. But we're not teaching our children how to deal with that stress and that anxiety.
Kymberli Cook: So going off of what you were just talking about with regard to having access to more information, I just think about myself when I was … this reveals my age … but I was 15, 14 or 15 when September 11th happened. And I was a freshman in high school. And I just very specifically remember, obviously, that happening, but also everything and just all of the 24-hour media coverage, and all of that, and the growing awareness of Islam, and the relationship and dynamics there between that religion and the West, and all of that. I remember seeing all of that, and I felt myself … I think everybody was … but that's actually what my question is. Is there something to … You talked about our generation, maybe even those a little bit older than us, I think maybe as everybody has gotten access to more of what's going on, everybody feels like … It's different because … There are some of us, and even myself who couldn't remember when you didn't have access to that kind of information. Maybe you had the news at 6 o'clock and 10 o'clock, that kind of thing. But you definitely didn't have the constant Internet streams. So that's a little bit different for these younger generations. But is part of it that none of us really know how to deal with that? I don't know. What do you think?
Dr. Kelly Cheatham: That amount of information?
Kymberli Cook: Yeah.
Dr. Kelly Cheatham: Yeah. I think there's something to that. One thing I say to my clients is, "Don't go home and start Googling things." I think we have a tendency to over diagnose ourself. I don't know if you … Your abnormal class is probably this way, normal behavior course, where every week we study a different disorder, and we end up finding out that we all diagnose ourself, "Oh, I think I have this, I think I have that." And so I think people do that. There is so much information out there, we can … people can read things into themselves and find that … So sometimes the information overload, or the amount of information can actually maybe backfire. And there was a point, there was a time when people just didn't have those things. And maybe there's a good … there's a trade-off to that. There's some things about that that are good, and things about that that are not so good. But I think we can be more prone to maybe take the information we have and turn it against ourselves in a way that's not rational. So anxiety's often about irrational fear. So it's about how do we … with the information we have, what are we doing with it? The more information we have, the more possibilities there are for us to turn them into irrational interpretation.
Kymberli Cook: What is the difference between anxiety and worry? Is there a difference?
Dr. Kelly Cheatham: I think of worry as a type of anxiety. It's something that … and again, the word anxiety is such a big word. It means so many things to so many people. So fear, worry, anxiety, stress, those are all mingled together. But worry is really about overly thinking about things that we have no control of, things that are in the future, or even things that are going on now, and trying to, for some reason, over think it. I think it's a way for us to feel like if we think about it enough we'll be able to control it. We'll be prepared for it. But again, there's a certain amount of, I guess, worry, for lack of a better word, that's okay, as far as preparing ourself and getting, being prepared for something that may happen. But there's also a point to where it's a point of diminishing return. Now it's actually hurting us.
Kymberli Cook: Jenny, what would you say is the relationship between anxiety and burnout? Or how does burnout play into this conversation? Because to me it seems like if somebody is overtired or overextended, then they may be presenting symptoms of anxiety, or something like that. But that might not actually be what's going on. Or is that what's going on? Just what's the relationship between the two?
Jenny Wang: I think they're very tied together. So, all those words, worry, fear, I think have more to do with our thoughts, what's going on in our head. I think anxiety, burnout, how they're correlated is that it's more of an all-encompassing thing. It's when that worry and fear has become physiological, and has become something that is causing dysfunction in our life. So I think they're definitely correlated with each other.
Dr. Kelly Cheatham: There's a strong correlation between the mental and physical aspects of anxiety. If you look at an anxiety assessment, for example, a lot of the questions have to do with physical symptoms, which Jenny mentioned earlier. So there's very much of a correlation there. So it does manifest itself physically. Sometimes people don't make that connection, that they realize that they're having … For example, people will often go to an ER thinking they're having a heart attack, and it's an anxiety attack. And they have no idea. And it can be out of the blue. They're not necessarily in a stressful situation. That's why they're confused. But they do probably have a low state of, at least a lower state of anxiety that they just aren't really that aware of, but it's contributing to maybe a panic episode. So there's this connection there, and burnout, yeah, I agree that there's certainly a connection between the … we think of burnout as being more a physiological manifestation, and just a fatigue, and all those kinds of things that people, again, may or may not be associating with their stress and their anxiety. So there's all kinds of preventative things that we can do to avoid burnout. And one thing is to have good boundaries and … probably gonna get to that here in a minute.
Kymberli Cook: So these are all very clinical answers, and that's lovely, and that's what I've been asking for. How do we, as Christians, think differently about anxiety? Is there a way? Is it just … it's a human condition, and it's something that we just have to navigate? Obviously we've all been educated here at DTS, so I don't think that that's fully gonna be our answer. But is there a way that we need to think differently about it? To me, when I consider when I'm anxious and worried about something, I always think about the verse that, "my yoke is easy and my burden is light, " "be anxious about nothing, but in everything by prayer and supplication …" And I think about that. And then I think, "Oh, no. Well, now I feel guilty because I'm … because I am being anxious." So now I'm either anxious about being anxious, or I'm guilty about being anxious, and that doesn't help anything. And so, how do you all help people negotiate anxiety and being a believer and the commands that we do see in Scripture, and is it sin to be anxious? If it is a natural thing … Jenny, open us up. [Laughter]
Jenny Wang: I definitely think that the reason why the words, "do not fear," or, "fear not," are, is in the Bible, is because it is a human condition. Like I had mentioned before, just in this living in this world, it's anxiety provoking. And the verse that I think of actually … it's many … it's the whole passage, is in Luke 12 where Jesus talks about, look how He clothes the lilies of the valley, and the birds of the field.
But the one verse that really stands out to me is actually Luke 12: 32, where He says, "Do not be afraid, little flock." And those words, “little flock,” help to remind me, helps me to remind my clients that God cares for us deeply. He sees our condition. He knows where we're at. He knows that we will be afraid. I think about when Mary was … the first thing that the angel told Mary is, do not be afraid. And just … I know that I've heard passages or I've heard sermons where they've said it’s this imperative that God gives. He doesn't want us to be afraid. And we just need to … But I feel like God says it so often because He knows we're gonna be afraid. And so He's reminding us. So is it a sin? Fear? Like any emotion … I don't believe that any emotion is sin. It's how I respond to that emotion. If we go to God in that emotion, or if we start to just go within ourselves, or hurt ourselves, or hurt other people, those …
Kymberli Cook: Try to resolve it in our own strength.
Jenny Wang: Right. Exactly. Yeah.
Kymberli Cook: Dr. Cheatham, what would you add?
Dr. Kelly Cheatham: I very much agree. I don't think of it so much as a sin. I think it's more of an indication, or more of a symptom of our condition. It's not a volitional sin. But it is destructive, as sin is. But I think I agree. I think that Jesus' words, too, Matthew 6 in particular, it's more coming from encouragement, rather than condemnation or something like that. He knows we're gonna struggle with it. So I think that it's really just looking at it as something that, it's coming, as far as Scripture goes, as far as the Gospels go, of recognizing we're gonna struggle with this. It's part of our condition. But to really turn to the Lord, and not try … I think it can become more of a … actually become more sinful, if you will, when we experience the condition, we're experiencing things that are causing maybe stress and anxiety, and yet we continue to refuse to go to the Lord with it, and just try to do it on our own. And that's when it really becomes … So I even think maybe when it's talked about in Scripture, we're talking about more of this chronic anxiety and not just a feeling of anxiety here, and something that's really debilitating, maybe more like an anxiety disorder. This is before the DSM. But it's really, again, not choosing to try to do it on our own and be our own god, and that kind of thing. And that's when it's, I think probably we'd say that's more of a sin. Now we are actually not choosing to trust or obey God's call to go to Him with these things. In Matthew 6, Jesus is talking about how … look what God has … it's more about His providence for us and taking care of us, and why are we worried about these things? And then, Paul, in Philippians 4, talks about, again, he says not to be anxious for anything. And it's the same idea that, hey, go to the Lord with it. Find peace in Him. So they're almost, these verses I think are more, again, about not so much about not having it, but more about not letting it control you, and facing it, which is the way we've found that, even in the secular world, this is the way we handle anxiety, is to face it with courage and not avoid it, like Jenny said earlier.
Kymberli Cook: It gives you a new perspective on the kingdom, too. Like in eternity, when … and maybe that's also another way that Christians can think differently about it ... is it's a new place for hope.
Jenny Wang: Right.
Kymberli Cook: Because you don't have to be afraid anymore.
Dr. Kelly Cheatham: Right.
Kymberli Cook: I can't even imagine … I feel like the older I get, the tighter I get in my shoulders. Because you learn so many more things that can go wrong, and tragedies that happen, and that kind of thing. It's like the older you get the more you actually have almost to worry about. I don't know. Maybe not. But then eventually one day that tension will be gone. Hopefully.
Dr. Kelly Cheatham: And I think there's something to be said for just accepting the reality of this world, and Jesus never promised that this world was not gonna have the difficulties we have. And again, it's this same theme of, you're gonna have them, you're gonna face them. What are you gonna do? This is what you can do. Take it to God Himself, and lift them up to the heavenly Father, and … yeah. But there will be one day, in glory, we won't have these issues. But until then, this is where we are. So we accept them. This is part of the world we're in. But the good news is, there is an answer, and this is something we absolutely can address. This is not something that we should feel doomed by. Often anxiety can turn into more of a depression. There's a big overlap there. And that's when I think people do get into this, I shouldn't feel this way, I shouldn't … and use these shoulds. I shouldn't be anxious. I shouldn't be afraid. I should trust God more. So what's wrong with me? And I'm … no. And then it turns inward to this depressive state. So I think we have to guard against that with our clients, and recognize that there's something to be said for accepting challenges and difficulties, and actually looking for the ways that we can grow, the trials and tribulations that Paul talks about in Romans 5 about that, and how we can learn from those things, and not let it be something that we, again, are trying to hide from or deny or avoid, but say, "Okay. This is where we are. But again, that's not the end.”
Kymberli Cook: So theologically it is a symptom of the fallen world in which we live. And we're all probably gonna have to deal with it. And so experiencing it isn't necessarily a sin, it's what you do with it. That's what I'm hearing you all say.
Dr. Kelly Cheatham: That's the way I think of it.
Jenny Wang: Yeah. Absolutely.
Kymberli Cook: As far as sin, it is a part of the broken, sinful world. And so we all experience it. And so in that way we're experiencing …
Jenny Wang: Right, right, right. Exactly.
Kymberli Cook: But it's about how you respond, and whether you let it control you, whether you let it master you, or you are trying to master it, rather than taking it to the Lord and taking it to the community of faith and saying, "I need help here."
Dr. Kelly Cheatham: Exactly.
Kymberli Cook: Okay.
Dr. Kelly Cheatham: Not isolating yourself.
Kymberli Cook: Yeah. So how does taking it a little bit, narrowing the conversation a little bit, how do you all … and Dr. Cheatham, you are, like I said, Director of Counseling Services here at DTS. So you're regularly working with people who are either in ministry or headed into ministry, most likely. And so how do you see anxiety manifesting itself specifically for those in the ministry world? What does that look like?
Dr. Kelly Cheatham: It's a good question. And I've been … I've seen, of course, people in and outside of seminary. And I see probably definitely more commonality than differences. I think that people in ministry … I alluded to this earlier … we can be prone to trying to do too much, and maybe burning out, like you mentioned earlier. That's … not maybe … definitely burning out with good things. We're trying to do so many good things. And I've experienced this myself. I've tried to do good things that were too much. And that can lead to anxiety. So it's about recognizing, even though it's a good thing, we still have our limits. And so ministry is a fertile ground for that, to have good things we're excited about, but to get ourself in situations where we can maybe be more prone to anxiety because we aren't exercising good boundaries. We're getting things out of order sometimes. And when that happens, we … all kinds of things can result from that. So, I think again, there's more commonalities than differences, but I think there are some things that are probably more specific to ministry. For seminarians in particular, there's the stress and anxiety of, of course, the coursework itself. And often we have students that come in to Counseling Services when they're getting close to the end, actually, usually the beginning and the end. They're adjusting to seminary, and moving here from all over the world, literally, all the adjustment that goes with that, which, anxiety often is related to change and adjustment. And then, this idea of, "Oh, actually I'm gonna graduate now. I’m gonna have to go off and go to … start a church, or join a church, or whatever it might be, or become a counselor,” and the change of that. So that's not dissimilar from someone graduating from another program, or any other kind of degree, for that matter. But that's something I've seen, is that people preparing for ministry, and even though they're excited about it, there's also some fear about, what does this mean? How am I gonna be able to provide for my family, maybe. There's a lot of unknown about that.
Kymberli Cook: You mentioned getting things out of order, as far as it relates to ministry. Would you just unpack that a little bit?
Dr. Kelly Cheatham: Counselors, we love clichés. And one of them that I often use is, make your family your first ministry, whatever that is, whatever your family is. So I think if we get things out of order and we aren't really ministering to our family first, as an example of what I was talking about there, then we're gonna feel the consequences of that. Maybe not immediately, but eventually, that we're gonna start finding things that are not the way they need to be. So God is a God of order, and we need to proceed in that way, too. We need to make sure that we are doing things in order. We need to make sure that we are living by our own values. I often have clients that'll … they realize after we talk that they're not really sure why they feel the way they do. But then they realize, "I'm not really living the way that I want to or supposed to or need to. Things are out of whack, and how did I get here?" And maybe trying to keep up with the Joneses or trying to compare ourself to other people, those kinds of things, and not really just taking things as they come. So, I don't know, there's something to be said about that, about recognizing that we only have a certain amount of time, resources, energy. We've got to be good stewards of those things, and we've got to keep things in the right order to be who God has called us to be. It's a matter of balance, often. So order, balance … yeah.
Kymberli Cook: So Jenny, what would you … So I was talking with Kelly about addressing anxiety as it manifests itself in those in ministry. But maybe turning the tables a little bit, what would you, if you were talking to pastors and ministry leaders about, "Hey, you're gonna face this in people in your ministry. The people in your ministry are gonna be manifesting this." So how would you suggest that, one, they identify it, because a lot of times pastors see people way before clinicians do. And so how do they identify it? And how would they begin to walk somebody through that? And maybe not to the point where they need to hand it off to a practitioner, but what should they be keeping in mind, and have their antenna up for?
Jenny Wang: That's a good question. I think probably one of the things definitely, we talked about those physical symptoms. And I actually have more … I do have quite a few clients that come see me because they have gone to the ER, and had the heart palpitations. And the doctor said, "You should actually see … you're actually have anxiety, and you should see a clinician." So to be aware of what those physical symptoms are. And also I think just…. so this isn't even necessarily about if they have a congregation member talking to them, I think even opening it up within the church environment itself, to be more open about anxiety. There's so many passages that we can talk about. What does that look like? And to build an atmosphere in general within a congregation of openness and vulnerability, that this is something that we all deal with. And if you need to, in a sermon, to say what we talked about here, today, if we have these symptoms, there's no shame in going to see a counselor and having those resources available to them. I think even just having that environment, just opens it up, giving them information that they may not get otherwise.
Kymberli Cook: And maybe even taking another step, as you look at the ethos of your ministry, and are you causing anxiety in people?
Jenny Wang: Oh, interesting. Oh, that’s an interesting thought, yeah.
Kymberli Cook: I don’t know, I just … as you were talking, I was like, well, but it also is a matter of not just … If you're opening it up for conversation, then that opens it up for self-reflection, and saying, "Am I creating an environment where people are feeling like they have to go beyond themselves, or put me and us, the ministry, before their families? Have I communicated that that is not our expectation? Is that my expectation?" It's not a God-honoring expectation. That whole conversation. So maybe that's an additional way.
Jenny Wang: Yeah.
Dr. Kelly Cheatham: Um-hmm.
Kymberli Cook: So we've tiptoed all the way around what it is, and what it looks like for a Christian, and in ministry in particular. But practically addressing anxiety, which if anybody is listening to this, they're probably like, "Okay. Yeah. I get it. I get what it is. I feel it every day. What do I do about it?" So, it doesn't seem like it's something … at least how I've experienced anxiety within myself and in my family … to me it doesn't strike me as something that you can just white knuckle your way through. That kinda … It almost seems like that goes the opposite way, because that makes you more and more tense. I don't know. I'm just thinking physiologically. So, does it make it worse? What does it do when somebody tries to push through it?
Jenny Wang: Absolutely makes it worse.
Kymberli Cook: Jenny, why don't we start with you?
Jenny Wang: Yeah. So one of the things I also incorporate in my practices is neuropsychology. I'm kind of a brain nerd. And it's amazing the way that God has made us. But just through the way that our brain operates it absolutely actually makes it worse if we're trying to white knuckle it through, or trying to problem solve, because what happens is, anxiety happens in the lower half of the brain. Our intelligence, problem solving skills happen in the upper half of the brain. And what happens is it's actually a sense of danger. So anxiety is when we feel threatened by something, we have this fear, we feel threatened by it, whether it's real or not. And we have a very neuropsychological way that we deal with danger, and that is by adrenaline pumping into our body, and our body has this reflexive response, and we want to fight or flight. In order to do that … or freeze. In order to do that, it actually, there's this part of our brain called the amygdala. It closes up that pathway from the lower part of the brain to the upper part of the brain. So we can't actually can't access that problem solving, that intelligence, which is why people feel like they're in brain fog when they're in anxiety. So we have to learn how to calm ourselves down. And one of the very simplest most basic ways to calm ourselves down is to breathe, to take that deep breath, and to use our senses to focus in on a sense for one minute. I teach my clients 30 seconds to 1 minute at a time, just focus on a sense, whether it's sight, look at something around you, or smell. Those are the ways that we can lower anxiety, not by white knuckling through, or trying to think our way through it. So we have to start from something that seems very counterintuitive.
Kymberli Cook: Kelly, what would you add?
Dr. Kelly Cheatham: I agree totally. It's, again, fight or flight response, our brain changes. We go into a survival type mode, almost. And our executive functioning's not there. So we really just need to calm down. We need to … at that point we're calling … it's often called flooding. That's what John Gottman calls it. And so we need to be able to calm ourself. So to just take a minute and to breathe deeply. And that's something we teach our clients. Another thing is something called progressive relaxation. So it's a way of relaxing different parts of your body in a systematic way, tightening and relaxing them again, and there's a whole process for that. There's a lot of good workbooks and things like that out there that people can look up and find, or go to a counselor themself. But when people are really having it … some of this may depend on the intensity or the degree of anxiety someone's having, whether it's something they really could or should try to work on on their own, or maybe they really need to think about going to have a counselor step through some of these things with them. I think of it often as more of a panic time or a time of intense, acute anxiety symptoms, and us being able to step in and intervene and do things like progressive relaxation or deep breathing. But then there's also more preventative things that we could do. Just self-care kind of things, like exercise and things like yoga and mindfulness and these things that really just calm our mind and make us less likely to develop anxiety symptoms. So, but there are definitely some things that we can do, and it's about stepping in, but not trying to just white knuckle it, and not trying to deny it or avoid it, like we mentioned earlier. But just to say, hey, this is the way I'm feeling. And it is physiological. I can't fight it. And the more I try to fight it, the more … the worse it's gonna get.
Kymberli Cook: So, you talked a little bit about when it is time to actually go see somebody. What does that … And you said acute anxiety, like panic, that kind of thing. What else? Let's talk a little bit more about that. What does it look like, either for if you are a friend, family member, pastor, ministry leader, whoever it is, if you're interacting with somebody where you think, "Hi, this is kinda getting out of hand." I think anytime you think that, obviously you typically think, "Maybe you should see somebody." But what are some of the things that you all would say, if they're … using very medical language … but if they're presenting these symptoms, then they should be … you should really be encouraging them to go see a clinician? What would that look like?
Dr. Kelly Cheatham: For me the real litmus test about that is not just the symptoms, but how, again, the degree of the intensity of them, the frequency of them. And the big thing, is it causing daily problems? Is it causing dysfunction? Is it affecting their daily life? Is it affecting their jobs, their relationships, their mental health? Is it contributing to depression or other things? So really, what is the impact on them? And when it's really to that point of. this is really causing a dysfunction for them. for you, it's a ripple effect, it's pervasive, it's … So depending on … There's all kinds of different types of anxiety, but for any type of anxiety, really, that's the point where this might be time to really have someone step in and walk along with you through this.
Jenny Wang: I think one of the symptoms that actually maybe a lot of people don't know about is actually anger. So for kids, for children, for teens, it can come out as temper tantrums, or it looks like defiance. Maybe school refusal, not wanting to go to school in the mornings. But it can look like this defiance. But it's actually anxiety. So that can be … And for men, actually too. So, it tends to look more like anger for men, as well, than the panic attacks. Anger outbursts. So those are times when, like Dr. Cheatham said, when it starts interfering with their daily lives, they're not able to do the things that they normally do, it's interfering with their work, that would be times when they should see someone.
Kymberli Cook: Would it … So not only just straight up anger, but would that also include irritability, any of that low-lying, just like … There are just some people who are like. They're not … You wouldn't call them angry people. And maybe they really love the Lord, and do their best not to be angry. But there's just this edge to them. That could be … I'm … Obviously, people could just be people, too. But …
Dr. Kelly Cheatham: Yeah.
Jenny Wang: No, definitely that … One of my clients calls it, "I just feel grumpy all the time." The grumpiness.
Kymberli Cook: Interesting.
Jenny Wang: Uh-huh.
Kymberli Cook: Okay. So those are some things that are a little bit more red flags. Hey, if there are outbursts of anger, or if there is a certain level of dysfunction, you're no longer able to do life, this is actually getting in the way of something. That says, "Hey, you need to go see somebody." But, for people who would be below that level, you talked about getting rest and exercise. Let's chat a little bit about preventative ways or … preventative, but also ways to manage the anxiety that people encounter. What are some other things? And Kelly already talked a little bit. Jenny, what would you add?
Jenny Wang: I would definitely add quiet time. Quiet time in nature, like seeing God's creation. I think that adds to our information overload, is also that we're not outside enough. We don't … We're looking at what man has made vs. what God has made. So spending time in the Word, in nature. That sense of gratitude I think can help, as well. Just being thankful. I think one way that I like to look at it that I tell my clients is, just like we want to work on our physical health by seeing a doctor regularly or exercising, eating well, we also need to work on our mental health, as well. And there's many ways to do that. And the Bible talks about it, seeing what is good and true. Focusing on things that are healthy. And some of the things we already talked about, taking the time to breathe, taking that time to spend time with a friend. Have connections. Healthy connections are super important. You have mentioned being able to talk with our friends when we're anxious. Being able to do that, having those vulnerable relationships, that's helpful as well. So incorporate all of that.
Kymberli Cook: I feel like I'm hearing slow down. Is that what I'm hearing?
Jenny Wang: Yeah. Uh-huh. Yes.
Kymberli Cook: Or am I just hearing that through my busy schedule ears? But it seems like … that, again, like you were talking about, if your brain is starting to go, the necessary thing is to just make it slow down and calm down.
Jenny Wang: Right. Yeah.
Kymberli Cook: Okay. So I'm gonna get real real and maybe be the devil's advocate/most people's advocate. It's really hard to slow down. So how do you do that in the midst of a reality that you might not be able to take an afternoon and go to the art museum, or … In reality … How do you guys help people who are like, "That sounds really great, and I would do that in a heartbeat, but this is my life." I don't know. Is that just being problematic? Or is it like, "No. Then you need to change your life?" Or is it, "Here's some other things?" So any other thoughts?
Jenny Wang: All of the above. I'm thinking about myself as well. I'm a mom of four.
Kymberli Cook: Oh my word, four?
Jenny Wang: And so I'm like, "When do I incorporate that?" It's discipline. The more that I … the older that I'm getting, the more I realize that so much is about discipline. You talked about order, and there is a discipline that we need to incorporate in our lives, whether it's, maybe we don't have that full hour. Maybe we incorporate ten minutes here and there throughout the day. Maybe we incorporate a Sabbath. It really is about incorporating that discipline into our lives to really spend time with God, and take care of our health, our mental health. Our body is our temple.
Kymberli Cook: Kelly, did you have anything to add?
Dr. Kelly Cheatham: I would, again, agree totally. I think there's something to be said for … and this is where counseling can step in, too … if people are really struggling, first of all, to be challenging this idea that they can't change it, they can't help it, or they can't stop it, or do I just have to quit everything? That kind of … let's talk about that. And then really get maybe into the deeper beliefs, thoughts, that they may be having about why are they pushing themself, if they're pushing themself too hard, or really to the brink, what's going on there? What are they trying … what are they searching for? What are they looking for? What's the meaning of this? That kind of thing. And sometimes it's other things that are really there, that really need to be addressed and brought to the front, that's really driving them to push themself. So it's … sometimes it's digging deeper and not just saying, "Well, okay, then just do this. We can do that, too, but we need to … let's talk about this. What's going on here? Because if you're saying that you are pushing yourself and you can't help it, so to speak, why? What else? What is there there?" And then it is, "Well, I'm …" Sometimes there isn't a whole lot more maybe someone can do, I don't know. But then we're talking about coping with it, and some of those are the self-care things we’ve already mentioned. And to me, one of the best things is sleep. And that's back to the resting. Often the clients just aren't sleeping enough. And that's so important. I don't think there's enough … I think there's more now than there used to be. I don't think there's enough awareness about the importance of sleep. And I'm being totally hypocritical here. But it's so important.
Kymberli Cook: That's what I'm talking about. It's really easy to say, and it's really hard to do.
Dr. Kelly Cheatham: But it takes discipline, like Jenny said. You have to be disciplined. You need to have a plan. Maybe accountability. Don't do things like have a TV in your bedroom, or look at your iPad two hours before, or your phone two hours before. There's all these little things, these rules. And it's … we know what to do. But doing it … Saying and doing are two different things, obviously.
Kymberli Cook: And I will add that that's actually where counseling does come in. Because there are gonna be blocks to that, what we know we should do. And that's where counseling comes in. We kinda dig into that. And that it's … there's a reason for those blocks. And … I lost my train of thought with that.
Dr. Kelly Cheatham: Maybe, one thing is, we often will help, depending on the approach we're using, we are helping our clients come up with a plan or strategy that they're gonna take home with them. And one of the parts of that is looking at, what are maybe some obstacles that you're gonna face, knowing your past? You can use your history to your advantage here. What's been a problem in the past? So we do what we can to minimize those and … But it's a, you're not always gonna get it right every day. And you're gonna have a step back once in a while. But we persevere and keep pushing forward, and we don't … it doesn't have to be all or nothing or perfect. We just still … Sometimes it's a trial and error kind of a process. And what works for me doesn't work for you, and vice versa.
Kymberli Cook: So in general what I'm hearing is slow down, take a deep breath, maybe even pray. Most likely somebody's already done that. If you're gonna try to white knuckle, which isn't a good idea, but if you're gonna try to white knuckle through it, you should probably do it on a discipline, as far as giving yourself an hour here or there, whether it's you take one lunch break and that's your time, and you do whatever is relaxing to you, or you just go out for a walk, or you go find a puppy to play with, or something. And if you're going to try to, like I said, white knuckle … I'm saying that tongue and cheek … but you do … there is an element of discipline that is necessary. But it's not in avoiding and trying to push through, it's in disciplining yourself with margin, it sounds like.
Jenny Wang: Right.
Kymberli Cook: Something, a place where you can breathe and everything can breathe. And if it gets to a certain point and if, like we’ve talked about, then it's absolutely acceptable to go pursue a clinician, and they can help you really walk through and dig in and figure out what's going on. So, thank you so much for joining us. It's been a lovely conversation, and I hope that it was helpful for everybody who was listening.
Dr. Kelly Cheatham: Thank you.
Kymberli Cook: We really appreciate y'all's presence here.
Jenny Wang: Thank you.
Kymberli Cook: And thank you for joining us on The Table. If you have a topic you would like for us to consider for a future episode, please email us at [email protected]. And be sure to join us next time as we discuss issues of God and culture.

Jenny Wang

With over twelve years of experience, Jenny Wang is passionate about Trauma Recovery. Her sweet spot is helping teens and their parents through depression and anxiety. She has extensive experience counseling in the following areas: sexual assault trauma, crisis intervention, human trafficking trauma, domestic violence trauma, grief counseling, dissociative disorders, OCD, adoption and foster care work, healing for children and spouses of NPDs and BPDs. Outside of the counseling office, Jenny has her hands full with her five favorite people in all the world: her four kids and husband of more than 15 years. They enjoy biking and hiking around Lake Lewisville, serving at Chase Oaks Church, and cheering each other on in all their various activities.

Kelly L. Cheatham

Dr. Cheatham has served in a variety of ministry, leadership and teaching roles in a various locations. In addition to his teaching responsibilities at DTS, Dr. Cheatham maintains a private practice in Dallas where he specializes in providing counseling to couples, adults and adolescents, as well as clinical supervision to counseling interns. He is a Licensed Professional Counselor Supervisor and Board Certified as a National Certified Counselor. He is married to Gwen, and they have four children—Dalton, Drew, Emily, and Luke.

Kymberli Cook

Kymberli Cook is the Assistant Director of the Hendricks Center, overseeing the workflow of the department, online content creation, Center events, and serving as Giftedness Coach and Table Podcast Host. She is also a doctoral student in Theological Studies at Dallas Theological Seminary, pursuing research connected to unique individuality, the image of God, and providence. When she is not reading for work or school, she enjoys coffee, cooking, and spending time outdoors with her husband and daughters.

Contributors

Jenny Wang

Kelly L. Cheatham

Kymberli Cook

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February 25, 2020

Ministry, Public Square

burnout, counseling, Staff Favorite, worry