Ep. 42 - Why Anxiety Feels Like Being Trapped and What Actually Helps

A lot of anxiety comes back to one uncomfortable feeling people don’t always have words for — feeling stuck, like you need to get out but can’t.

Dr. Andrew Rosen and Dr. David Gross sit with that idea and follow it from everyday situations like traffic or crowded spaces to something deeper and harder to explain. That sense of being trapped isn’t just about the moment. It connects to fear, loss of control, and even the way we think about uncertainty and mortality.

From there, the conversation shifts into what actually helps. Not quick fixes, but small, practical things people can try in real life. Exercise, even something as simple as a walk. Meditation, even when it feels like it’s not working. Apps, breathing techniques, and getting outside. They talk honestly about why these things are hard to start, why people resist them, and why they still matter.

They also come back to something they see all the time. People think they’re the only ones feeling this way, or that it means something is wrong with them. It doesn’t.

There’s a steady thread throughout about learning to manage anxiety rather than trying to eliminate it, taking small steps, and finding ways to feel a little more in control again.

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Email: twoshrinksandamic@gmail.com

Transcript

SPEAKER_00 0:05

I am Dr. David Gross, a psychiatrist.

SPEAKER_01 0:08

And I'm Dr. Andrew Rosen. Welcome to Two Shrinks and a Mike for our just about weekly podcast that we are doing with you guys and enjoying it immensely. This week, we want to continue with the subject of anxiety and all of the anxiety disorders, but we'd also like to have a background to it that uh this morning Dr. Rose and I started a conversation about. Let me start with that and repeat to you, David, what we talked about a little bit. So many anxiety disorders have one central focus or problem that people complain about, and that is the feeling of being trapped. And typically having this statement, I gotta get out of here. Which is fine if you're in a situation like the room is a little warm and I could just get up and leave, or I'm not happy with the noise in this place, I can get up and leave, and so on. But there are situations in life where you can't just get out of here. Now, why would that be more than just bothersome or a little bit anxiety-provoking for people? You know, you're stuck in traffic, or maybe, you know, the plane is late, or maybe the movie that you went to see, you're in the middle row and it's a little cramped. Why would it be that for some people it's absolutely triggering of severe anxiety, or even talking to people, talking to a group of people? We've talked in the past podcasts about the fight or flight mechanism that's related to a piece of our brain that kicks in when we are in a situation where we feel threatened, and it kicks in this fight or flight mechanism, which means get out of here before you somehow either get hurt or feel sick or go crazy. This morning I was talking with David about the concept of it's not just the fear of getting hurt, but the why the needing to get out of here immediately, I think, comes from not only the fear of being killed or hurt, but also the fear of being dead and knowing you're dead. Somehow being in that box under the ground and knowing that you're no longer here, but you're trapped, you can't talk to anybody, and we could all relate to that feeling of how unbelievably difficult that must feel, if indeed we were aware. And I think for some people that's a very sensitive part of their brain and their nervous system that's based on evolution, that we're all very aware of how mortality is pretty much terrifying for most of us, and especially if it's related to not being able to cope with the fact that we know we're dead, but we're knowing something about it. I know that sounds strange, but I think it may be the core of many types of anxieties. Dave, your thoughts?

SPEAKER_00 3:15

My my thinking is that we've talked so much about some of the facts about anxiety, but we're leaving folks with very little in the way of h help and techniques on how to cope with it. And I think that really needs to be expressed because I've heard from people that it you can read about anxiety and learn about it, but what are we left with? How are we going to learn how to cope with it? So I think it's helpful to talk about first recognizing that you can deal with your anxiety. And over the years that you and I have worked together, I've learned a lot about the techniques that you taught people, one of which you figured out decades ago related to exercise and activity, that exercise itself can be a tremendous stress control technique and a way to deal with anxiety. And it doesn't have to be lifting weights or tremendous aerobic exercising, but it can be nothing more than going for a walk.

SPEAKER_01 4:08

Yes, it discharges in many respects the buildup of tension that accumulates in the nervous system, and it also gives you something that you know works. Oh, if I go for a walk, I feel better when I do it, and I feel better for a little while afterwards. It immediately has an impact on the experience of anxiety. That's one example for sure.

SPEAKER_00 4:32

And you have to really get people to take you on your word for it because they say to themselves, how could going for a walk or going for a run or doing some push-ups or jumping jacks help anxiety? And the only thing you can say to people is give it a try and see what happens. And more and more I hear from people that they're going to the gym on a regular basis makes all the difference in the world. That's the way that they relieve some of their stress and some of their pressure. The other thing that I've found very helpful, and I know you have as well, is the letting people know that one, they're not a crazy person, and two, they're not alone, that anxiety is extraordinarily common. And one of the major emotional challenges that modern societies face.

SPEAKER_01 5:15

Even something like going for a walk for some people, though, is anxiety-provoking. As a matter of fact, years ago, I had somebody who was actually terrified to go to the gym or even go for a walk because he was afraid that what if he didn't feel well, or what if his heart raced, and those kinds of things. So some people catch on pretty quickly to the recommendation. Others you have to really give them a lot of understanding and reassurance why actually that won't hurt them. So that's one. Another one that a lot of people hear about, and it's completely effective, is mindfulness meditation. People very often, when I recommend it, they'll say, Oh, I tried that once and I just couldn't get into it, I couldn't focus, or I couldn't concentrate. It's the kind of thing that when the person says that to me, that's exactly the person that needs it, because they have a hard time letting go and letting their thoughts drift and just discharging some of that overthinking that they do. I tell them, just stick with it. Even if you feel like it's not helping, it's going to be cumulative. Just like if you do go to the gym, you don't feel strong right away. It could take you weeks and months till you get the effect. So, yeah, exercise is definitely on the top of the list. Meditation is another one that's on the top of the list. And there are other things now that we didn't have just a few years ago. There's so many new apps on the cell phones or on the computers that really do have some empirically based data that shows how it can help. Some of it's meditation, some of it's guided imagery, like teaching you how to do the right kind of breathing techniques, which are also very helpful, especially if you're in a high anxiety situation. So don't shy away from some of the apps. You don't necessarily want to commit to the apps in terms of a subscription right away. You can most of them you can try and see which ones you connect with better. I'm a big fan of what's been around a while, the app called COM, C-A-L-M, which has a lot of research data to support its efficacy, even showing that it has dramatic impacts on functional MRIs of the brain, so you can actually see it's a physiological benefit over time. Uh so apps that deal with meditation and guided imagery and positive thinking are all helpful. So if you don't engage with a professional for different reasons, those are also very helpful. And in fact, on a day-to-day basis, that's what we have most of our patients do is when they're not seeing us working on maybe more specific aspects of anxiety, we have them engage in these activities anyway, because they really are what you need to get immersed in something that will change your anxiety.

SPEAKER_00 8:11

And that's all great advice and very helpful for folks. And I know over the years, talking with individuals who have worked on those apps and techniques, the people have told me very often that if they can get out to nature. We live in a society where there's not much in the way of nature, especially in the big cities, but just something as simple as going to a park and allowing yourself to enjoy the nature, even going for a walk and getting some exercise in the park. Recent research has suggested that it's more effective than any other form of exercise.

SPEAKER_01 8:40

Yeah. They all add up, and everybody will have maybe their favorites that they uh gravitate towards, but they're all effective.

SPEAKER_00 8:49

Getting back to uh the concept you raised earlier about people feeling trapped, what that means is that people have had a hard time establishing a sense of hope. And hope is a critical component of what makes human beings unique. We have this sense of there is a future, but a lot of people trapped in anxiety as you describe it, and I've experienced with folks, feel stuck and have lost that sense of hope. And both of us, I think, as we've worked with individuals, have to instill the notion that it's not going to be this way forever and that things can change and the future isn't as dark and dismal as you think.

SPEAKER_01 9:27

Yeah, and it's a challenge because many people that do come to see us have struggled with anxiety for so long, and whether they've tried their own methods or they've seen professionals, many very often people come in and they say, I'm no better. Matter of fact, somehow I've become worse. And I'll say sometimes that's because life has its different challenges in different parts of life. So different decades of life bring on new problems. It's understandable that we feel anxious, that everybody has anxiety. It's not an if, it's just a how much and when.

SPEAKER_00 10:00

And related to that is the concept of empowerment. Part of what we do with individuals is to help them understand that even though I may be teaching you a cognitive behavioral technique or I may be prescribing a medication, you're still the one who's taking the medication, coming to our office, deciding to pursue relaxation techniques or the cognitive behavioral techniques that are being taught, which means you have that control back in yourself. You're empowering yourself, which gets back to the concept of self-assertiveness and believing that you have some value and worth. A lot of folks I've seen with anxiety just lose that sense of self-worth. They feel totally worthless and hopeless and just stuck.

SPEAKER_01 10:42

And I think some of that comes from a misunderstanding that normal people don't have anxiety, and I do. So it makes it even more hopeless that somehow I'm different or I wasn't given something growing up, or I was born without some mechanism that somebody else has. And I'm I'm free these days to tell patients that I see examples of where I have had a problem with anxiety or just changing my focus. Years ago I was at a heat game, and when I sat down before the game with my son, there were two guys sitting in back of me, and they were just, they weren't regulars, somebody had given them tickets, and they were talking about business, but they were talking so loud it got into my head. I couldn't stop hearing them. So now the game starts, and all I could do was hear them, and I couldn't enjoy the game, and I was actually ready to leave. At which point I said, Rosen, you're a psychologist. What would you tell somebody? Other than trying to not pay attention to them. So I focused on one player for the next 10 minutes. I wouldn't take my eyes off that player. And before I knew it, I wasn't thinking about these guys in back of me. It's a little technique, but I was victim of doing the same thing that could make somebody else feel trapped. Yeah, but if you were a reality therapist, you would have probably thrown a French fry at them. Well that didn't work, so I moved on. Yeah, it's important to normalize it for people. And so anybody who's listening, I just want you to know it anxiety isn't something you get rid of, it's just something you manage, and sometimes it's harder to manage than others.

SPEAKER_00 12:21

And I don't know that people really understand that whole concept of normalization. What for me, what it means is that it's you're not the only person to have this problem. It's very common. And lots of folks have dealt with it and succeeded in overcoming it, and you can too, but you have to give it time. And it does take effort. It's not easy, it takes work, but it's worthwhile work because so many individuals who have anxiety feel like they're not in control. And what we do for them, I think, is get them to get back on the horse and feel like they're in the driver's seat and can get back in control again.

SPEAKER_01 12:54

Yeah. And it's easier to do if they know that they're talking to somebody who really understands it or has somehow experienced anxiety in their lifetime, and also can give them things to do when they're not with us, which is I think what you're talking about too today, and that is there's many things that you could do on your own. Don't just rely on that appointment once a week with us or however long it is.

SPEAKER_00 13:19

And I think we've both found that it's the questions we ask individuals when they're first coming to see us that indicate to them that we know what they're going through. For example, has the anxiety been so bad that you've been staying at home more than going out, that you're reluctant to go to that party, or that you'll take the stairs instead of going into the elevator. And people look at me and they say, How do you know that? I said, only because uh we've worked with this for so long and it's so common. And what that does, I think, is give people a sense of we've been there before, they're not alone, and there are directions to get to make progress and to come out of it.

SPEAKER_01 13:55

If you were to go to an emergency room later for something, and you walked in obviously concerned and scared, can you imagine if you went in and the doctor looked surprised and had this look on their face? I never saw one of these before. These are very unusual. It would definitely make you more nervous. So it's important to not to just sugarcoat it, but just it's okay. We've been here before, we know how to make this better than it is.

SPEAKER_00 14:21

And you're right, to help people understand this concept of the unknown, which is a major factor for individuals who have anxiety, it's not difficult to deal with it. But for example, if you move into a new house in a new neighborhood, you're going to be uneasy and off-balance and not sure but between uh up and down at times for a few days or weeks just because it's new. And novelty causes people to feel very much uneasy and off-balance. And asking people to go in an elevator who have phobic anxiety or to go to a social event when they're anxious about it, it's all the unknown. And they have all this anticipation of the worst-case scenario, and that's where we step in and help them recognize that small steps, but you can do it.

SPEAKER_01 15:06

It's wise when you're going into a new situation to think of the negatives and to think of the things that could go wrong or the danger spots. It's how we stay safe and how we plan. But sometimes it just gets out of whack and it just bec all you can see are the bads, and all you can you can't see the goods much at all anymore. So it's just becomes more and more frightening. So again, it's to normalize it is to say, of course you're thinking about the bads. But that doesn't mean they're going to happen.

SPEAKER_00 15:35

And I always ask people, what's your worst fear? I found over the years that if you can get somebody to get their thoughts and ideas and fears out of their head and either say it out loud or put it on a piece of paper, suddenly it's not the wizard of Oz or the Emperor who has no clothes.

SPEAKER_01 15:54

Yeah, there's that's just another one that we try and get people to do is just get the brain to shift away from all of the scary thoughts and look more at the situation in a real way. Example, if you have little children and they're scared of the boogeyman at night, you know, what would you do? Would you tell them, look, don't worry about it, he's probably not going to bother you. Isn't he and even if he's under the bed? Or would you, no, let's go show you there's no boogeyman. Let's look at it more objectively and realistically. You could see there is no such thing. So, another little thing that we teach adults how to do that. It's the same principle.

SPEAKER_00 16:33

It's really the dialogue we have with individuals that helps give them a sense of the future. I find that one of the biggest challenges I have is since I'm a psychiatrist, I prescribe medications a lot. And individuals just believe the concept I have to take this medication means that they're inferior or they're a lot sicker than they think they are. And so a lot of the work I have to do is convince them that's not the case, that if they had a problem with high blood pressure or they had a problem with their thyroid, they wouldn't have the same kinds of thoughts about taking medication. So a lot of education is required in the beginning.

SPEAKER_01 17:09

I also tell people when it comes to that issue, I said, look, medication is just going to help make the change process easier to occur, changing the way you think, changing even the things you'll try to do and expose yourself to that you've been avoiding. Medicational just give you a little bit better chance to do those things, and then you'll see, oh, I can do things, and you'll start to feel better because of that.

SPEAKER_00 17:31

Yeah, I guess you're left with doing damage control, because I over the years I have memories of individuals who I think I did a good job in explaining the reason for medication and what's wrong with them, who you've been seeing, and they come back to you with all the concerns and questions, and your job then becomes let me help explain it some more and help deal with your anxieties and worries. Yeah.

SPEAKER_01 17:52

I try to facilitate the process so that they don't feel as scared. Because medicine's the same thing. If they're gonna be scared of everything else in life, why wouldn't they be scared to take a pill? You take I always say, sure you're scared of it. You're taking a pill and you're putting it in, it gets down there, and you feel like you've lost control of what it's gonna do to you. That's scary. So once they hear that, they go, Yeah, that is scary. But now I understand why I'm so scared. I think I can do it now. So, same thing.

SPEAKER_00 18:18

Plus, all of us in uh Western modern societies have been convinced that we can do anything we want just by putting our willpower to it. Sure. And when we suddenly suggest to them that you can't just do it with your willpower, but that you have to do specific things, whether it be medication or cognitive behavior techniques, you're overcoming the concept of I must be weak, I must be inferior. And that requires a good bit of work and discussion to help people overcome that belief system.

SPEAKER_01 18:45

You know what a good example probably is? Do you know anybody who isn't fearful of anesthesia? They know they have to go for an operation or whatever it is electively or not, and they go, What do you what are they afraid of? They're not so much it's not going to be they're gonna tell me I'm afraid of the pain afterwards. Millennial people are afraid of going under and not coming out.

SPEAKER_00 19:06

If you look at the uh benefit of that twilight sleep that they use for colonoscopy and the like, people have anxiety about it the first time they went, but once they have the experience, gee, this is terrific.

SPEAKER_01 19:21

Can I come back for another one? As long as you're not Michael Jackson. But yeah, it's we all don't like the unknown. That's just the human condition. And some people get scared about certain things more than others. Like I always use that example of our workshops we did years ago. I'd rather be skydiving than going out on a blind date. How could that be?

SPEAKER_00 19:45

But it's true. Back in the days of prehistoric cave people, the unknown was lightning and thunder and storms and floods. And so the way that people dealt with their anxieties and fears is they created the various gods of nature and animals to help control those fears and worked for a while until they realized that it wasn't as effective as they'd like it to be. But we all do things to try to uh reduce the fears of the unknown. Just letting people know that make a list on a piece of paper all your fears about moving to this new town that you're moving to, and once people look at it on look at it on paper, suddenly it's just not as bad.

SPEAKER_01 20:24

Or like you remember when they would tell kids if it's thundering out that it's God's bowling tonight? It isn't. Oh, is it's bowling? Okay, I'm not scared now. So little things that we were all told or we went through ways of calming anxiety and fear.

SPEAKER_00 20:43

One of the problems we've talked about over the years with folks with anxiety is the fact that people get stuck in their heads with overthinking. And that's a real major component of it because the brain is very good at broken record thinking. And once the broken record thinking intensifies, people go down the worst-case scenario, and before you know it, you're off to the races.

SPEAKER_01 21:04

And sometimes the overthinking is about things that there's no answer to, like existential anxiety, what's it all about? Why am I here? Why should I bother? You can ask that question for every minute of the year, you'll never come up with an answer other than getting more upset. So teaching oneself how to not go there and ask certain questions, like does anybody ever think about infinity and figure it out? No. It just you get frustrated, you go, I can't figure that out. That's for the geniuses. And then you leave it go. And that's the way it is with a lot of fears and anxieties. I just I leave it go. But some people need help in learning how to leave it go.

SPEAKER_00 21:44

So at the end of the day, none of this is magic or supernatural, but there are ways of approaching it and helping individuals get better. And certainly, as we've suggested today, the first step is education and also dealing with underlying Attitudes that people have about what's going on and what's wrong with them and are they inferior, are they weak? Are they not as good as other people? Am I alone? And nobody else has this problem. And so that's where the education interaction becomes so important.

SPEAKER_01 22:14

We did leave a big one out, though. I just thought about that. We left a big one out, which is the overuse of electronics. It causes more anxiety in people than ever. And it and the problem is it's so addicting. And I heard the term, I don't know if you know about this term called doom scrolling. Doom scrolling. It's when you scroll looking for bad. Whether it's about health or it's about what's going on out there in the world, in the city, in the world, wherever we're doom scrolling. I heard it a few weeks ago. I said, Oh, that's a great way of describing it. I'm gonna scroll, but I'm not scrolling for good stuff. I'm scrolling for bad stuff.

SPEAKER_00 22:57

Well, we're all voyers, and we enjoy that kind of stuff. And I've also seen people just hide their anxiety uh with the internet and the electronics and the screens. And it's no different than having several beers or a couple of drinks to control anxiety. It becomes another sort of problem.

SPEAKER_01 23:16

I hate to say this, but a couple of beers would be better. As long as just as long as just a couple. And don't have the beers while you're doom scrolling.

SPEAKER_00 23:27

Wear two shrinks in a mic and enjoy speaking with you all, and we'll see you next week.

SPEAKER_01 23:32

Yes.

SPEAKER_00 23:33

Have a good week.

SPEAKER_01 23:37

The two shrinks in a mic podcast is for informational and entertainment purposes only. The views expressed are those of the hosts and guests and do not constitute medical, legal, or professional advice.

SPEAKER_00 23:49

Please always consult a qualified healthcare provider before making any medical or wellness decisions. Our content is not a substitute for professional medical guidance, even though our mothers tell us we have the best advice possible.