Dr. Jodie Lowinger – Mental Health and the Toolkit to Help Introduction

Mental health is a big issue. According to a recent report, 45% or 7.3 million Australians, aged between 16 and 85 reported that they have met the criteria for mental illness at some point in their lives. With one in five or 3.2 million reporting, they had experienced some symptoms in the last 12 months. The financial cost of mental illness has recently been estimated to be anywhere between $40 billion per year.

Now, that’s taking into account loss of productivity and labor force participation and a massive $155 billion per year. Now, that last figure takes into account a much more complex model of collective well-being from a social, political, and economic perspective. Whichever way the financial cost is calculated, it’s a huge individual community and social problem with the human costs, dwarfing all those financial considerations. And worryingly, it’s affecting people at a younger and younger age.

My guest today is Dr. Jodie Lowinger. Jodie has worked as a clinical and corporate psychologist for more than 20 years. She holds a doctor of clinical psychology and a master of science from the University of Sydney and was awarded the university medal for psychology. Now, as you will hear, Jodie is passionate and she combines a compassionate and engaging personal style with a very pragmatic solution orientated approach.

Jodie developed her skills in anxiety treatment through her work at the Anxiety Disorders Clinic, at St. Vincent’s Hospital, the Boston Children’s Hospital, Sutherland Hospital, and the Child Behavior Research Clinic in Randwick. No, as that’s not enough, she’s also an experienced leadership and executive coach having worked for and with organisations including the Quarry Bank and PWC, PriceWaterhouseCoopers.

We cover some pretty disturbing issues around anxiety and depression that are affecting a lot of people at an ever younger age. We also talk about what I think we all need to be talking a lot more about and that is the challenge of technology and how that is affecting the people most close to us, particularly the young and vulnerable. Not just them personally, but our relationship with them and with each other. I think Jodie is fabulous. I hope you enjoy this conversation with Dr. Jodie Lowinger. Welcome to the show Jodie.

Podcast Transcript

Dr. Ron Ehrlich: Hello and welcome to Unstress, I’m Dr. Ron Ehrlich. Mental health is a big issue. According to a recent report, 45% or 7.3 million Australians, aged between 16 and 85 reported that they have met the criteria for mental illness at some point in their lives. With one in five or 3.2 million reporting, they had experienced some symptoms in the last 12 months. The financial cost of mental illness has recently been estimated to be anywhere between $40 billion per year.

Now, that’s taking into account loss of productivity and labour force participation and a massive $155 billion per year. Now, that last figure takes into account a much more complex model of collective well-being from a social, political, and economic perspective. Whichever way the financial cost is calculated, it’s a huge individual community and social problem with the human costs, dwarfing all those financial considerations. And worryingly, it’s affecting people at a younger and younger age.

My guest today is Dr. Jodie Lowinger. Jodie has worked as a clinical and corporate psychologist for more than 20 years. She holds a doctor of clinical psychology and a master of science from the University of Sydney and was awarded the university medal for psychology. Now, as you will hear, Jodie is passionate and she combines a compassionate and engaging personal style with a very pragmatic solution orientated approach.

Jodie developed her skills in anxiety treatment through her work at the Anxiety Disorders Clinic, at St. Vincent’s Hospital, the Boston Children’s Hospital, Sutherland Hospital, and the Child Behavior Research Clinic in Randwick. No, as that’s not enough, she’s also an experienced leadership and executive coach having worked for and with organisations including the Quarry Bank and PWC, PriceWaterhouseCoopers.

We cover some pretty disturbing issues around anxiety and depression that are affecting a lot of people at an ever younger age. We also talk about what I think we all need to be talking a lot more about and that is the challenge of technology and how that is affecting the people most close to us, particularly the young and vulnerable. Not just them personally, but our relationship with them and with each other. I think Jodie is fabulous. I hope you enjoy this conversation with Dr. Jodie Lowinger. Welcome to the show Jodie.

Dr. Jodie Lowinger: Ron, lovely to be here.

Dr. Ron Ehrlich: Jodie, you are very focused in your clinic on anxiety. I just wanted to know how do we define anxiety?

Dr. Jodie Lowinger: Anxiety, Ron is really part of being human. It’s part of the core fight or flight mechanism that we have in our brain and it’s really our primitive reaction to threat in our environment. So we have said a worry thought and our body responds, our brain response to that worry thought and it sends a message to another part of our brain called the amygdala, which triggers a physiological reaction, the fight or flight reaction, which is really there as a wonderful survival mechanism to protect us in the case of a real threat.

Now, the challenge in the contemporary society that we live in is that we still have this primitive brain. It’s evolved but not quite that much to deal with the complexity of the world that we live in. And so our brain responds to a perception of threat as if it was a real threat. And so the anxiety reaction, the fight or flight reaction, which is the sympathetic nervous system, is triggered in reaction to a worrying thought. So that’s really what anxiety is.

Dr. Ron Ehrlich: I mean this sounds like a very natural part of lives. Maybe our preoccupation with a bad news is part of that almost feeding into it or I love horror movies or something. We like to be scared. We like to be made to feel anxious almost.

Dr. Jodie Lowinger: Yes, it can be. I mean that sort of an individual difference I suppose, in terms of people’s desire to get that adrenaline rush because that’s really what it is. It’s adrenaline, it’s cortisol that surges through our bloodstream. Anxiety is a physiological thing. Different people get different sorts of sensations as a result of that and different people have a different level of sensitization, to begin with.

So the amygdala, the part of their brain might be more easily triggered by various things in their environment. And so it’s recognizing that. I often have people come into the clinic, into the anxiety clinic and I’m very goal-oriented in the work that I do with people. Sometimes people have as their goal to get rid of anxiety and I say, “You know what, maybe we need to talk a little bit around that.”

Because to have anxiety is really to be human. In fact, the large majority of the people that I deal with, if not all of the people who I deal with, are really lovely human beings. There’s this double-edged sword of anxiety, a depth of thinking and a depth of feeling, which are really fabulous human qualities. So a deeper sense of empathy and compassion is oftentimes associated with people who experience more extreme anxiety and what comes with that, unfortunately, are the challenges of anxiety as well.

What I do with people is it’s really about empowerment. Helping individuals to recognize their strengths, recognize that they can be driven by what’s in their heart and not the worry thoughts that are in their head, they’re taking them away from their values. This is really what we work through. Understanding around anxiety is really important.

Dr. Ron Ehrlich: So managing a person’s expectations of themselves is a big part of it, I guess.

Dr. Jodie Lowinger: Yes.

Dr. Ron Ehrlich: When does it become a problem?

Dr. Jodie Lowinger: It becomes a problem when it gets in the way of a person living their life the way they want to live their life, so when it causes suffering in their life and when it causes avoidance. If we think about the fight or flight reaction, and what that actually is, some people as a result of this primitive survival instinct respond with fight, so they might be more inclined to be aggressive or agitated.

Some people respond with flight, which is wanting to run, wanting to escape. In our day to day experiences, it’s wanting to avoid a feared situation. And so if anxiety is getting in the way in terms of people avoiding situations that really are taking them away from their values, away from their what their heart and their passion would otherwise really like to be doing, that’s when it’s becoming a problem and that’s when we do something about it.

Dr. Ron Ehrlich: Has it changed very much? Anxiety, what’s the statistics? I mean over the last 20 or 30 years, have you seen … there been trends? What are the trends in being more anxious? Are we more anxious?

Dr. Jodie Lowinger: There is definitely an anxiety epidemic that we’re experiencing in contemporary society, in contemporary Western society particularly. So if we’re talking about prevalence now, certainly statistics vary, but real evidence-based statistics. We’re looking at approximately 25% of children and adolescents, so between 13 to 18-year-olds experience.

Dr. Ron Ehrlich: Wow that’s incredible.

Dr. Jodie Lowinger: This is looking at clinical anxiety. This is anxiety where it is causing suffering and avoidance in a child or an adolescent’s life and then we’re looking at approximately 20% of adults. That’s when it tips into this more severe range and then we’ve got the rest of society, which is really just part of being human. We all experience worries and what we recognize is that society, we are working or existing at a really rapid pace.

The way technology has evolved is it’s taking us away from what our body was meant to do, what our life, what our surroundings were meant to be. We’re biological creatures, we’re animals. We were meant to roam in fields. You know, when threats were in our environment, there were saber tooth tigers and so they were real threats. And in this situation, this fight or flight reaction was absolutely critical.

Now, there’s an incredible number of perceived threat in our society. There’s very little downtime, there’s less and less green, so we’ve got best practice organizations that are saying, have a screensaver that’s green, that will help your mental wellbeing,

Dr. Ron Ehrlich: Get in touch with nature.

Dr. Jodie Lowinger: Get in touch with nature.

Dr. Ron Ehrlich: Get a green screen screensaver. Wow, there’s an ad.

Dr. Jodie Lowinger: It’s a start. I must say organizations are really now moving in the right direction because with the corporates that I work with there’s a real recognition that in order to boost productivity and boost effectiveness, engagement and concentration and capacity to perform, we really need to be looking at the mental health of the people who we work with and obviously ourselves in terms of our day to day life.

Dr. Ron Ehrlich: Yes. Well, of course, there was a report even in the paper today about the cost of mental health to Australia. I think the figure was put at about $40 billion a year. I mean, it’s a big and growing problem, isn’t it? I mean, mental health.

Dr. Jodie Lowinger: Certainly is, absolutely. And in all ages, in all ages and all stages, particularly upcoming generations, children and adolescents, we’ve got a digital generation that is born with technology in their hands. It’s taking us very much away from how our brain is wired and what we are designed to experience on a day to day.

Dr. Ron Ehrlich: Well you said that is also when you’re dealing with people with anxiety, it’s about managing expectations, their expectations of themselves. But our preoccupation with technology has created some really unusual and maybe unrealistic expectations. That’s a huge challenge, isn’t it? Technology, particularly for kids, I guess or for all of us.

Dr. Jodie Lowinger: Absolutely. A technology is a real challenge when it comes to everybody. Certainly children and adolescents, but also in the corporate world. So we think we can multitask, but our brain is actually not wired to multitask. Our brain is wired to focus on one thing at one time. And what the research demonstrates if we’re talking in a corporate environment, is that when we‘re distracted, so this thing that is termed a digital distraction is it really has a huge impact on our productivity.

It takes us a real chunk of time you know, some research has shown sort of 15 minutes to get back on track in terms of concentration on our priorities and our goals. In a work environment, it’s huge. In a child and adolescent environment, it is profoundly damaging. We talk about the connected age as far as technology goes. Now, of course, technology is incredible. You know, we all use it.

We’re all connected, which is fabulous, but we are actually very much disconnected at the same time. When we’re talking about children and adolescents, what is being impacted is children’s capacity for empathy, because with technology, not only is everybody presenting the social face, their let’s say, airbrush to face literally. We’ve got this situation where it’s an artificial connectedness and children and adolescents are actually missing a lot of cues.

There’s a real contrived communication amongst each other. And so really they’re not learning about emotional intelligence. And when we talk about success in life, Daniel Goleman, who’s one of the preeminent research is in emotional intelligence, talks about EQ being four times as important as academic ability, as intellect, as IQ success in relationships. Whether it’s in business or in interpersonal interactions.

And so there’s a limited amount of learning that’s taking place. So what is also happening is it’s not just children that are digitally distracted, it’s parents that are digitally distracted. So we’ve got less connection that’s happening between parents and their children. This is a real challenge because there are hours upon hours that individuals are in front of their screens. So it’s not just the younger generations.

Dr. Ron Ehrlich: I mean this is an epidemic. I mean it is everywhere. No one escapes or do I know anybody? I don’t think I know anybody that could escape it. We’ve kind of been given a new toy and we haven’t quite learned how to control it. What are some of the strategies that you offered to say, let’s start with child, I know you do a lot of corporate working and we’re going to talk about that. I’m intrigued about this in the adolescent child. How do we deal with a child that is disengaged, that is addicted if you like? I’ve have heard it said it’s addiction to technology.

Dr. Jodie Lowinger: Absolutely, and I talk with schools. I go and speak at schools about managing digital distraction and cyber safety and engaging responsibly with the Internet and when I speak with schools, which is something that I’m really passionate about because there is so much that can be done to help.

So if we just take a step back and we think about sleep because I didn’t mention sleep earlier and of course technology is impacting on sleep, which is fundamental to mental health and wellbeing particularly well, with all of us, but certainly with children and adolescents. What we really need to do is create healthy boundaries when it comes to use of technology.

It really is a parent’s responsibility to role model effective behaviours when it comes to healthy boundaries and to display desired behaviours and to reinforce those expectations within the home environment. From a parent’s perspective, it’s also seeking out opportunities to connect and utilize those times when there’s technology free times and demonstrating it as part of the family values of getting back to some of the basics of talking around the dinner table where there’s no technology.

In the car when this is precious opportunity to connect with your children, when you’re taking them to school sport or when you’re taking them to parties, when there’s a really beautiful captive audience, make that a technology-free zone. They’re the precious opportunities, at bedtime as well.

Technology free zone where we can talk with our children about emotions and what we can do is not leaping to problem-solving, but we can actually engage at an emotional level, validate their emotions, and really teach around emotions. It’s incredibly powerful because what you are teaching your children in this space is empathy. When we can teach empathy to our children, we’re facilitating the development of a compassionate generation because the last thing we want our children to lose is the capacity for empathy.

Dr. Ron Ehrlich: I was reading some research recently which talked about sleep and amygdala and empathy and how that’s all suffering. Technology is also challenging because it’s so pervasive. And I have heard it said that it’s the same kind of neurotransmitter dopamine. The same addictive transmitter, neurotransmitter that’s associated with any addiction. Here we are cross-generationally addicted.

Dr. Jodie Lowinger: Yes.

Dr. Ron Ehrlich: What a challenge. I mean we’ve got to start talking about it. That’s what this is about, but it’s about having the conversation.

Dr. Jodie Lowinger: It is. It really all does come back down to neuroscience and understanding the neurochemicals that are going on here. There’s a couple of things that take place. Of course, it is dopamine, now dopamine being one of the neurochemicals involved in positive mood states, and we crave it and teenagers particularly. The teenage brain is particularly craving for dopamine. We have developing brains until the mid-20s, even late twenties, and so the developing brain is really craving the stimulation.

They are less risk adverse the teenage brain. And so the rush, let’s call it, that comes from these sorts of things, is really something that people are motivated towards and the way apps are programmed that target the teenager, is that they are really targeting this drive for dopamine, for that stimulation. The likes on social media, who doesn’t crave external validation. Of course, we all do, but this is perpetuating this need and exacerbating this need for external validation.

Getting the likes, getting that reinforcement, we become very native to it. Now, the other thing is that when we are in this state of heightened stimulation, it goes against the oxytocin and the melatonin that when we’re using our digital technology, that we need to go to sleep.

Dr. Ron Ehrlich: Yes, I’ve heard the oxytocin described as the hugging hormones.

Dr. Jodie Lowinger: The hugging hormone, we do love our oxytocin. It is the love hormone and it’s fabulous. Oxytocin, melatonin, now when we are in this fight or flight mode, this is the antithesis of the opposite of oxytocin and melatonin. What is being stimulated is cortisol and adrenaline. And it’s keeping us in this awakened state.

So when we’re on technology, what it can trigger is this real sense of fear of missing out, fear of not being good enough. We talk about compare and despair. It’s perpetuating teenagers being in this state of fight or flight, fear of not being good enough. “Have I got those likes? No, I haven’t got those likes. Oh, my goodness-”

Dr. Ron Ehrlich: How many friends do you have?

Dr. Jodie Lowinger: How many friends do you have? Spot on. And so it is something that is actually perpetuating this anxiety epidemic. It is leading to depression is actually leading to a real state of isolation and fear of not being good enough amongst teenagers. And we haven’t even talked about cyber-bullying and the horrendous-

Dr. Ron Ehrlich: Absolutely, my next question because that must be becoming a huge problem. We’re certainly hearing a lot about it.

Dr. Jodie Lowinger: Absolutely, cyber risk is tremendously scary and our beautiful children, beautiful teenagers with their evolving brains and their evolving need to learn from responsible peers and from responsible adults are rendered an incredibly vulnerable in this cyber world. If we consider the cyber world like a community, it is a community, it’s a digital community.

And so what we recognize is we wouldn’t necessarily be comfortable with our teenagers going to dark streets let’s say in the middle of … let’s say for want of a better example, Town Hall at night, our 12 year-olds, we would want to keep them safe, keep them protected. But when our children are venturing out in the cyber world, all of a sudden, they’re engaging with strangers, people that they don’t know.

Dr. Ron Ehrlich: Of all ages and all backgrounds and all mental health issues themselves.

Dr. Jodie Lowinger: Exactly right. And so there’s this awful thing called grooming. You know, the danger of the cyber world. There are predators who are trained in how to seduce young, innocent children, young innocent teenagers who like to think the best of others. And really we don’t necessarily know who’s out there. People might pretend that they’re teenagers. We might have a 12-year-old boy who thinks that they are chatting with a 12-year-old girl when it might be a 50-year-old guy.

We just don’t know. And so really being as a parent, I have three children myself and as a parent, we really do need to be informed and aware of what our children are doing so we can just be cognizant of the risks and we don’t want to be hyper-vigilant, we don’t want to be overly concerned and paranoid, but we just want to be educated and we certainly want to make sure our children and our teenagers are educated. Unfortunately, schools now are doing a really good job.

Only about a fortnight ago, I went to speak with a high school on the responsible use of the Internet. Engaging, recognizing how incredible the Internet is and how it is a part of life. We all use it. I love the Internet myself. I’m on it very often, but we want to engage in it safely and responsibly.

Dr. Ron Ehrlich: I mean, there’s another aspect which is quite frightening. I had a patient this week when we were just chatting and they have 10-year-old twins, a boy, and a girl. And she already knows that her young 10-year-old son has been exposed to some very explicit pornography which is so accessible. You may switch it off on your home computer, but the impact of that on developing minds that in itself, can you speak about the impact of that?

Dr. Jodie Lowinger: Unfortunately, yes. I can speak a lot about the impact of it. Through the Anxiety Clinic, I work with children and adolescents and I have seen it all, unfortunately. I’ve seen the consequences of predators. I’ve seen the consequences of a society of generation where a sexualized generation before they’re ready for it and a desensitization to these things when their developing brain just isn’t ready to be seeing these things.

I’ve also seen the unfortunate consequences of predatory behaviour and grooming online. And beautiful, beautiful human beings, children and adolescents who have been duped by this and who have been traumatized. Then so having to work with these children, with families on trauma-based therapy and the anxiety and the consequences.

Not to mention the social anxiety, unfortunately, this isn’t being melodramatic, but this certainly, of course, are extreme cases, but what I do work with a lot in the clinic is social anxiety and performance anxiety at all ages, children, adolescents, and adults. And this fear of not being good enough and fear of I’m not being accepted.

Dr. Ron Ehrlich: I was staggered at that statistic of people that actually are presenting with anxiety and then you said 25% and that’s who are showing up. There are sub-clinical, those people that are on the … it’s not a light switch, one minute you’re perfectly fine, and the next minute you’re showing up in your clinic and there was a spectrum there. You also mentioned depression and that’s a growing problem as well. Can you talk to us about that? Particularly in children, but generally?

Dr. Jodie Lowinger: Yes, depression is an interesting mental health concern because it is really prevalent and there’s a lot around depression that is not necessarily recognized particularly with everybody, but certainly in the corporate side of things. A lot of the males that I work with, don’t necessarily recognize their own depression and so if we talk about depression, there’s a composite of symptoms that are part and parcel.

Often it does present as agitation and a certain anxiety as well presents as agitation. Just sort of going away from talking about depression for a second. Often when I’m talking, working with children and adolescents, sometimes in quite commonly it can happen that a child is labeled as a naughty kid or an oppositional child when in fact they are anxious.

Just something to be aware of, but just going back to depression, things that are symptoms of depression is commonly fatigue, poor concentration, sometimes forgetfulness, poor sleep, as I said, agitation, of course, low mood. It might change in appetite, so it might be the loss of appetite or increased appetite. I think that they’re the … I might have forgotten some, but they’re the core symptoms.

It really is a compilation of symptoms and really important to recognize that because when depression does take hold, it can be this nasty beast of a thing that takes us very much away from value-driven living. It can kind of close out world and we disengage. So in terms of treatment of depression, really what we want to do is help an individual to re-engage and this is where doing exercise is really powerful.

Connecting with others is really powerful, ensuring that there are good sleep strategies and cognitive strategies. So standing up to the depression, recognizing that it’s not what defines these individuals. Black and white thinking can be part and parcel of depression. This all or nothing kind of thinking is a real mental kind of a thought process that can take hold with depression.

But Ron what I really am big on communicating with people, whether it is with children, adolescents, or adults in the clinical space, but also in the corporate space, is a hopefulness and a message of empowerment about the fact that there is so much that can be done to help. If we’re working with anxiety or we’re working with depression or if we’re just talking about resilience and mental strength. So my corporate business is-

Dr. Ron Ehrlich: Yes, I was going to ask you about that. We’ll get on to that.

Dr. Jodie Lowinger: Yes, so it’s very much about not suffering in silence. It’s about knowing that if you are experiencing a sense of avoidance or a sense of low mood, some panic attacks or anxiety that is kind of creeping up or depression that’s creeping up. There is a whole realm of practical effective strategies that are evidence-based strategies that enabled people to turn these things around.

Dr. Ron Ehrlich: While we’re on that subject, I think one of the things about medications, which people often jump very quickly to not always so good with the younger minds are they, I mean, there are some problems with antidepressants and children.

Dr. Jodie Lowinger: Well, I am really open minded, quite frankly. I’m not anti- antidepressants. I always communicate the message that it’s not a one size fits all. In fact, with mental health challenges, oftentimes they’re really on a continuum, which as we’ve talked about, can span from normal human behavior through to quite extreme anxiety or depression. If we’re talking about medication for anxiety, antidepressant medication is really the medication of choice for anxiety as well as for depression.

But really when we’re talking about medication, this is the realm of a medical doctor, a GP or a psychiatrist to give some really fabulous specific advice on. I really embrace the message that it’s really treated at an individual basis. So when we’re talking about extremes, what the evidence says is certainly we can look at psychological intervention.

Oftentimes it’s cognitive-behavioural intervention, but there are a whole realm of evidence-based interventions that are very effective. I consider myself a hybrid-therapists, so I engage with a whole lot of different modalities. I use CBT, I use ACT.

Dr. Ron Ehrlich: Cognitive behavioural therapy.

Dr. Jodie Lowinger: Cognitive behavioural therapy, acceptance and commitment therapy. I use narrative therapy techniques. I use some psycho-dynamic techniques. I use schema techniques. These are a lot of technical jargon, but-

Dr. Ron Ehrlich: Yes, but different approaches to … they’re a collective approach.

Dr. Jodie Lowinger: A collective approach. Again, no one size fits all, but having said that, I’m very practical. I’m very behavioural because certainly with anxiety it’s really responsive to good behavioural intervention. I have a business background and so I really bring on board my business background, being very goal-driven and very practical into the nature of the therapy that I use.

Sometimes it’s a psychological intervention alongside antidepressant medications and that’s absolutely fine. I do not consider medication a weakness. I’m all for whatever is required on a case by case basis. Having said that, we can get enormous traction out of psychological intervention without medication.

Dr. Ron Ehrlich: The other thing that I was going to ask, taking a step back from this whole mental health story and acknowledging that technology is a challenge, poor sleep is a challenge and we’re going to talk a bit more about that. There is something about the way disease is defined now, isn’t it? I used to believe it or not consider myself a shy person, but I could be described as now I could have a condition called, what is it? The social anxiety disorder, and I think you’ve mentioned that along the way too.

I know I felt better in summer than I did in winter, but I could be diagnosed with a seasonal effective disorder. The DSM five, the diagnostic statistic manual, which is kind of the way of categorizing mental health, has thrown the net out there very wide. Do you think that’s part of what we’re seeing in this epidemic of mental health?

Dr. Jodie Lowinger: There’s absolutely a time and place for the DSM. The DSM is brilliant in and of itself because it does help with consistency of communication around particular mental health challenges and can be really helpful. I would never discredit the DSM. I think that there’s real value in this on many occasions.

From a clinical perspective, absolutely. It’s absolutely fine. Personally, I am reticent to use the term disorder. It doesn’t sit comfortably with me because we’re all in this together and that’s my philosophy. I just really love to communicate and empowering strength-based philosophy with people.

I just don’t like using the term disorder. I think it puts labels on individuals and it puts just a real negative spin from time to time. I tend to talk about mental health challenges, mental health difficulties. It’s just the semantics that sits comfortably with me, but I don’t like putting things down so to speak.

Dr. Ron Ehrlich: We’ve identified a couple of problems and the challenges I was drawn to the fact that you also felt sleep was such an important part of it. In your experience with schools and with children, how often is sleep an issue?

Dr. Jodie Lowinger: Sleep is a huge issue with children, with adolescents, with adults. Of course, we’ve talked about technology and the impact that technology is having when we are using tools the iPhones, whatever the tool might be in bed at night as we touched on, suppresses the production of Melatonin, which we need in order to go to sleep.

What’s happening is it’s disrupting our sleep-wake cycle and we’re all getting less sleep than we need. Really when it comes to mental health, I am so big on the mind-body connection. It really is where I start with everybody. There’s no doubt about it. I talk about the foundation stones of wellbeing. Your book, Ron, is fabulous. I absolutely love it.

Dr. Ron Ehrlich: Thank you.

Dr. Jodie Lowinger: Absolutely. Anybody who is in the wellness industry and helps with exercise helps with people’s well-being from a physical perspective. I am so behind that. I’m really about holistic care and sleep is one of the pillars of well-being as you talk about in your book.

Dr. Ron Ehrlich: Part of your professional life is dealing with anxiety and you focus a lot in schools and in professionally on the children’s mental health, but you also do corporate work with companies and you use this term mental strength.

Dr. Jodie Lowinger: Yes.

Dr. Ron Ehrlich: Please explain.

Dr. Jodie Lowinger: Mental strength is really what we can all achieve, whether it’s in the corporate environment, in business or in our personal lives. What I talk with people about is that we can go down various paths in life. We can be driven by our thoughts and recognize that our mind will just think it’s what minds do. We have this inherent negativity bias in our mind and its part of our primitive survival mechanism.

We are programmed to seek out the saber tooth tigers in the field rather than the bunny rabbits in the field. If we it will, the people in days gone by, the ones who didn’t seek out the saber-tooth tigers and loved to see the bunny rabbits, the so-called positive thinkers were gobbled up by the saber-tooth tigers.

Dr. Ron Ehrlich: We’re hardwired to negativity as a protective response.

Dr. Jodie Lowinger: Exactly. We are hardwired to negativity and it’s important in the case of a real threat, but what happens is that we are hardwired to worry and so this element of positive thinking is not really our default. We are really in a privileged space if we can be positive thinkers. What I speak with people about is getting a level of objectivity with our thoughts.

Looking at thoughts at a process level and thinking about worry as a mental process and recognizing that we have the power to choose what we want to engage in and what we don’t want to engage in with the content of our mind. Now, I’m talking about this in a very succinct way, but in terms of mental strength. What we want to do is be in touch with our passion and our purpose and our values and move down a values-driven path.

Whether it’s our corporate values and best practice organizations and now really becoming much clearer on corporate values and a consistency and in alignment with their corporate values to drive best practice in business and we need to get clarity and awareness with our own personal values.

Really awareness is a large part of what I do with people in the initial stage of embracing mental strength. What awareness looks like is really getting a sense of what the worry thoughts are. What is worry telling you? Almost personifying worry, I talk about a worry bully, bossing us around. We get a sense of what the key messages are that worry is telling us.

Worry tells us to avoid certain things because something bad might happen. We try to get a sense of awareness around what is telling us to avoid. What are we avoiding because of the worry bully? Sometimes we have a critical voice in our head that says that we’re not good enough. What is the critical voice telling us?

There’s another thing called safety behaviours, these are unhelpful coping strategies in the corporate world, we might do a lot of checking or we might be perfectionistic or we might seek reassurance or we might be aggressive or passive. These are all examples of unhelpful coping strategies.

We would get a bit of awareness around some of those things. Then with the mental strength, we approach avoided situations and we let go of some of these safety behaviours. This is the path to peak performance in life.

Dr. Ron Ehrlich: It’s like we’ve got these voices playing around with our thoughts in our heads and were trying to control those that give us the strength and understand those that are challenging it?

Dr. Jodie Lowinger: Absolutely, and we embrace being hot, driven, passionate in life. I’m very passionate, I’m very hot driven in what I do. Sometimes we might be out of alignment with our values. Sometimes we might be struggling in work and just not doing well and maybe that’s because we’re not aligned with our values and we’re not productive and it works both ways.

We’ve got to be satisfied with our work. If we’re out of alignment, this can be a challenging situation to be in, so being heart driven is really powerful in life.

Dr. Ron Ehrlich: It was interesting to hear you say we’re hardwired for negativity because we are bombarded by so much of it and it’s hard to imagine, I read this in a wonderful book that I also reference in mine and the Harari’s, Homo Sapiens: a brief history of humankind and he makes a really good point about we’re actually living in one of the best times in human history.

I know we are seeing some terrible things going on in the Middle East and all that, but 100 years ago, tens of thousands of people were dying on a daily basis. The negativity, the hardwired negativity is being played to us a lot too, isn’t it? How do we wade through that?

Dr. Jodie Lowinger: How do we wade through that? That’s a really fabulous question. I think awareness is incredibly important. Self-awareness. If we talking about emotional intelligence, the first part of emotional intelligence is awareness and it’s awareness ourselves and it’s awareness of others.

In this space of awareness, we want to be aware of what’s working for us, what’s not working for us, and what is heart-centered, what his values-driven. Once we work on this awareness, what helpful behaviours are that we’re engaging in, what are unhelpful behaviours are that we’re engaging in, we can adopt more effective action, we can embrace helpful behaviours and we can stand up to unhelpful behaviours and move forward in a values-driven direction.

We can stand up to that negative voice in our head. There’s another whole realm of things which is around positive psychology, which I use a lot of strategies from positive psychology. We’ve already talked about positive messages and our capacity for empowerment. I truly, deeply believe that we can all live wonderful lives with positivity and empowerment, but there are certain things such as acts of kindness and reflection on what we feel grateful for.

These are also things that can stimulate dopamine. These do stimulate dopamine, that happy neurotransmitter. These are part and parcel of positive psychology. It’s really looking at a whole realm of things that can be helpful. We haven’t even talked about meditation, which is another motive, therapeutic techniques, mindfulness, which is what I work with a lot. There is a massive toolkit that I work with, with people to embrace positivity and empowerment in life. Mindfulness is a very powerful therapeutic tool.

Dr. Ron Ehrlich: I love the fact that here you are, you sitting there a psychologist and here I am, a dentist and I have always thought of a holistic approach is a certain thing from that perspective. You’ve raised some issues about what’s in your toolkit, sleep, meditation. What are some other apart from the sort of therapy side of things, the psychological side? What are some other things in the toolkit?

Dr. Jodie Lowinger: Things in the toolkit are really all evidence-based. So I’m really big on embracing best practice, evidence-based care. Really the toolkit is around things from Cognitive Behavioral Therapy as well as Acceptance and Commitment Therapy predominantly as well as Narrative Therapy. These probably are the three main therapeutic modalities that I use. Those are quite a bit technical stuff-

Dr. Ron Ehrlich: No, Acceptance and Commitment is an interesting one because … I think that one is called ACT… but on CBT, Cognitive Behavioral Therapy, which is where you tell us what in a nutshell, Cognitive Behavioral Therapy, what is the essence of that?

Dr. Jodie Lowinger: There’s a lot of overlaps across all of these modalities, but the essence of Cognitive Behavioral Therapy is cognitive is our thoughts, our cognitions, and really does come down to looking at what are helpful cognitions, helpful thinking styles and what are unhelpful thinking styles. Then there are behavioural interventions. How to engage with behavioural things in order to challenge some of those unhelpful cognitions? That’s Cognitive Behavioral Therapy in a nutshell.

Dr. Ron Ehrlich: For example, if you were having a bad thought about something that was leading you to behave in a particular way, you’d recognize that connection, make behavioural changes accordingly?

Dr. Jodie Lowinger: You would make behavioural changes. One of the tools that I use in the toolkit is something called behavioural experiments. What behavioural experiments are is a really powerful intervention. It’s actually imperative in the work that I do, particularly with anxiety, is worry tries to trick us. Worry tries to trick us in several ways.

Worry tells us that bad things are really likely to happen, we need to avoid them because the outcome will be a catastrophe. Really the only way we prove worry wrong is by approaching avoided situations. This is where the experimentation comes into play. We approach those avoided situations. We take on a scientist hat and we get evidence, we get evidence that, hey, nothing bad happened, lo and behold, that spider didn’t kill me or that it wasn’t a catastrophe when I went to that party. With children, we do what’s called step ladders. We create a gradual exposure to fear situations, and with children and with teenagers, we set this up in a really playful way.

When I’m working with children, I’m really big on parents being involved because really what I’m all about is efficient treatment. Short-term intervention, I try to get people in there and out of there as quickly as possible, even though I love the people I work with, I really don’t like holding onto people. It’s all about ethical practice, of course. Needless to say, and I find that the best way to get that happening is for parents to be involved so they become the experts of this process and the parents end up actually helping themselves with their own anxiety by a lot of the awareness that comes through that.

Back to your question on the toolkit, mindfulness is a really powerful tool. Mindfulness is not a relaxation technique. The mindfulness is often thought of as a relaxation technique because the by-product of mindfulness is often relaxation. We engage in mindfulness with no actual purpose. Mindfulness is intentional, but it is simply being in the moment without purpose.

The purpose of mindfulness is just being present. There is a whole lot of stuff on mindfulness. There are many people out there who mindfulness is all they do and that’s fantastic and I am a really big advocate on mindfulness and it is a powerful tool in my toolkit.

Dr. Ron Ehrlich: Is mindfulness in preoccupation with technology mutually exclusive? You can’t really be mindful while you’re on your technology. I mean it’s almost no, and that’s part of it being present in the moment, live here like we are?

Dr. Jodie Lowinger: Absolutely, let’s engage mindfully without technology. I don’t care.

Dr. Ron Ehrlich: It’s like putting a green screensaver on to get out into nature.

Dr. Jodie Lowinger: We can talk about it. This is looking at it at a very simplistic level of course, and there’s many variants of mindfulness. Mindfulness is a therapeutic intervention. You can do mindful meditation, which is potentially somewhat different but somewhat the same as well. It’s about being in the present moment. It’s about observing. It’s about allowing, it’s about intentionally engaging and it’s about being non-judgmental. I adhere to Kabat Zinn’s definition of mindfulness. These are sort of the characteristics that he talks about with mindfulness because he is one of the pre-eminent people.

Dr. Ron Ehrlich: It’s Kabat Zinn?

Dr. Jodie Lowinger:          Yes, it’s Jon Kabat-Zinn.

Dr. Ron Ehrlich: Zinn.

Dr. Jodie Lowinger: Yes, K-A-B-A-T, Z-I-N-N. He did a phenomenally wonderful job in bringing the concept of mindfulness to the Western world. Now there are many, many fabulous, brilliant people. There’s so much accessibility to mindfulness on the Internet as well, and there are lots of mindful apps out there. There are tremendous things.

Really, mindfulness, we can look at engaging mindfully at various points in the day in the corporate environment. We can talk about mindfulness of breath. We can talk about mindful eating. We can talk about mindful driving. There are all sorts of easy ways to engage in our day to day mindfully.

What we are effectively doing is training our brain to observe our worry thoughts, observe that internal and external experiences to just get a bit more objectivity with those experiences. It’s really powerful to stand up, to worry and to get us out of that sympathetic nervous system and back into the parasympathetic nervous system.

Dr. Ron Ehrlich: We’ve covered a lot of territory here and you haven’t given us a toolbox because you’ve talked about sleep, talked about exercise, talked about all these behavioural techniques as well. I just wanted to finish by asking a more broader question and that was, what I think the biggest challenges for people on their health journey in our modern world through their lives?

The Biggest Health Challenge

Dr. Jodie Lowinger: It’s a really big question there Ron. There are lots of big challenges. Certainly, the lack of downtime is a real challenge. The detachment or disengagement from nature is a real challenge. Sometimes my family, we just do a good old-fashioned picnic where we have a technology detox and we get back to green, not green screen, not green on the screen, but actual grass and it’s fabulous.

This is one of the big challenges of the modern world, but it’s also one of the big brilliant things of the modern world is technology as well. It’s about balance. This is the word it really is about rebalancing and making sure we check in on whether we are looking after ourselves, whether we’re embracing values-driven actions, whether we are looking after our mental health and well-being. It’s about recognizing that there’s so much that can be done to rebalance and to look after our mind and to look after our body.

Dr. Ron Ehrlich: Jodie, thank you so much for joining us today. That was fantastic.

Dr. Jodie Lowinger: It’s an absolute pleasure, Ron. Thank you.

Conclusion

Dr. Ron Ehrlich: I was surprised at how widespread these mental issues are and how common they are amongst young people. We are all exposed to a phenomenal amount of information and stimuli. I’ve heard the modern age described as the attention economy. Everyone and everything is vying for our attention and it would seem that to fit it all in our attention is becoming shorter and shorter. Our expectation of ourselves, our relationships, and the people around us is becoming greater and clearly, often unrealistic.

There were so many great takeaways from Jodie in that episode. Interesting to hear a psychologist elevate sleep. A recurring theme on this podcast to such a high level along which along with nutrition, specifically blood sugar and nutrient dense food, all of which have an impact on all aspects of health and mental health is no different. Two things that I will certainly reflect on personally is one, managing expectation.

That will mean different things to different people, but it’s an important one. Expectations of myself and those around me, and secondly, modelling. I hope this doesn’t disappoint too many of my listeners when I say this but I’m not perfect, and when it comes to technology, I can assure you I’m far from perfect and I also can get addicted. What about your expectations of yourself and those around you and also how do you or how will you model behaviour? Food for thought.

Anyway, don’t forget to leave the five-star rating on iTunes and a review. The pen may certainly be mightier than the sword or rather than in this case, the keyboard is certainly mightier than the stars. Write a review as well as just click on the five stars. We want to get this message out. Check the transcripts, check them out, the show notes. We’ll have links to Jodie’s Sydney Anxiety Clinic, and other relevant links on my web page. Until next time, this is Dr. Ron Ehrlich. Be well.

This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.