UFYB 296: NAVIGATING PSYCHOLOGICAL AVOIDANCE: A CONVERSATION WITH DR. LUANA MARQUES

Welcome to UnF*ck Your Brain, the only podcast that teaches you how to use psychology, feminism, and coaching, to rewire your brain and get what you want in life. And now here’s your host, Harvard Law School grad, feminist rockstar, and master coach, Kara Loewentheil.

Hello my chickens. I am so excited about this conversation. I love talking to people who have really deep academic expertise in the brain and how it works because all of you know, one of my kind of soapboxes is that self-help and self-development work gets kind of minimized because it’s women doing it. And so when we can talk about how it overlaps really with the science, I think that’s always such a powerful kind of conversation

So our guest today is Dr. Luana. And she is a professor of psychiatry at Harvard Medical School among many other accomplishments that she can tell you about. And she’s the author of Bold Move, which we’re going to talk quite a bit about, which is a new book. So do you want to tell us a little bit about yourself?

Luana: Sure. Thanks for having me, first, Kara, it’s delightful to be here. So I am a professor at Harvard Medical School but I’d say my journey isn’t a conventional one. I grew up in Brazil with lots of adversity, climbed my way out of trauma and poverty to get to Harvard. And my passion really is, is how to take science out of the ivory tower into the inner city. So the last 15 years all of my research and my work has been training para professionals on the skills that I describe in Bold Move.

And this idea, and to your point, Kara that you said already, this idea that we can rewire our brain, that we can train our brain. If we really understand neuroscience and use skills we can exercise our brains to live our best life. And that’s what I’m really passionate about.

Kara: I love it. So I totally want to get into the book and your framework but just already I have questions based on what you said that I want to talk about because I think that one of the big questions that I grapple with as a teacher and students who do this work grapple with is what is the balance between? I think in older times it would have been fate versus agency. And now it’s more like a structuralist understanding of the world versus an individual empowerment understanding of the world.

And how to balance, how do people go from situations that are difficult to get out of, like you said kind of, I don’t remember exactly what words you used but kind of clawed your way out of sort of traumatic experiences and disadvantages to get to where you are. I’m curious, what you think sort of made that difference for you. Why was that possible for you?

Luana: It’s a really good question because often when we find ourselves in a situation like I did, a single mother, lots of domestic violence at home, eventually my father left and she had to have three jobs to feed my sister and I. There’s a sense of how do you get out of here? What does it look like to get out of here? And I think a few things for me were crucial that helped me overcome my childhood trauma. I think one of them was really this idea of just observing what it took my mom to do what she did.

She’s the kind of person that really felt like education was a ticket out. And she was going to figure out a way to get my sister and I the best education possible. And I could see that she, instead of avoiding emotions she’d go through her emotions. And so there’s this piece of a role model of a strong woman taking a bull by the horn and doing it. The second piece really was moving in with my grandmother. And a lot of the skills that I learned that really helped me change my brain, were skills that eventually I got to graduate school and I was like, “Oh my God, this is science.”

I was afraid of talking to strangers. And my grandmother forced me to go talk to strangers in the mall and she didn’t take no for an answer. She forced me to approach instead of avoiding. And so some of this is of course, I also worked really hard and I wanted it really bad. But I think sometimes when we find ourselves in situations of adversity we find ourselves sort of helpless. And I think there is a different paradigm which is small steps towards the things that matter.

And that’s why I’m committed to teach as many individuals that come from the same background I did, a path that potentially can get them there. There’s no guarantees in life. I still struggle but life is not easy. But that’s to me were the three things, my mom, my grandmother and science were my ticket out.

Kara: I love that. I also love that point that I think women historically are sort of a repository of ignored wisdom or a kind of ignored un-legitimated or unvalidated kind of wisdom. And I think about it all the time, my grandmother used to say this thing that I, of course, used to find infuriating. Now I say to myself and other people, that’s for me definitely part of getting older is just being like, “My parents were right about that.” My mother used to, this is a little bit of an aside.

My mother used to constantly tell me when I was a teenager, “When you’re older, things just don’t seem quite as dramatic.” And I was like, “Oh.” Now of course, I have teenage cousins and I’m like, yeah. Anyway, my grandmother used to say all the time, “This too shall pass.” Which I used to find so kind of invalidating or something. But of course now I realize it’s not enough to just say that, you need to flesh that out more. But the kernel of wisdom of that is that feelings are transient, states are transient, challenges are transient.

But so much of resilience is broadening your perspective out from I’m in this crisis feeling to my life is long. There’s more coming. I’ve been through hard things before.

Luana: 100%. And I think I’m so glad that your grandmother also empowered wisdom. And you’re right. As a teenager my grandmother would be like, “Is there a different way to think about this?” I’m like, “No, there’s no different way to think about this.”

Kara: Why are you asking this dumb question?

Luana: [Crosstalk]. My view is the only view, but you’re right. But today we know that emotions shall pass. You’re right. And the same way that a thunderstorm passes, it’s just that when you’re in a thunderstorm, you get wet. And we try to sort of get upset about it. But I think you’re so right, elevating the voice of grandmothers.

There was great research actually in Africa I believe of grandmothers teaching therapy on a bench. And how they just sit on the bench and they were trained on a type of cognitive behavior therapy. And every kid that came and sat the grandmother is literally teaching them to rewire their brains. I think we need to do so much more of that in the world.

Kara: That’s amazing. I mean one of the reasons I’m so passionate about coaching is that I think obviously there’s a lot of important space for more specialized professional intervention. And also some of these tools, people can use themselves or use in peer or communities in ways that take that kind of sort of decentralized or democratize that knowledge and help people use it themselves which is one of the things that I think is super important in terms of bridging these kind of different fields and disciplines.

Luana: So I, 100%, I talk about skills not therapy all the time. I’m a highly specialized therapist, but there’s very few of me trained and I believe not a lot of people that need me if they can learn the skills upstream. If they can learn it from their grandmother, if they can learn it from their teachers, if they can learn from their parents. Ideally we build a much more resilient and bold world so that there is very little need for psychological surgery, which is sort of what I do versus being able to learn that emotions shall pass. Everybody needs to know that. And so I agree with you, I think coaching is crucial.

Kara: That’s so interesting because as I’m thinking about this I’m like, we’re always saying everybody, well, needs therapy but maybe that’s partly because people are not taught these basic emotional or cognitive skills. And if everybody was taught that the parts that can be done just by you yourself or with a trusted person in your community, then not everybody would need therapy or the specialized gate-kept level.

Luana: I am so glad you’re saying that because I think more people need to hear that. Not everybody needs therapy and I’m a therapist. And the funny thing is I say to people, “My job is to work myself out of a job.” Because I need to teach you to be your own therapist and I think you’re right, most kids don’t learn it. When we become adults, I have a five year old at home and we talk a lot about the emotional brain, the thinking brain. And the other day he said to me, “I have my thinking brain and my emotional brain, you can’t get me out.” And I was like, “No, I can’t.”

But just the fact that he knew he was angry and upset and he’s five. I think when he becomes an adult maybe he will need therapy but at least he has the foundation he needs to understand what’s happening to him.

Kara: Yeah. Or people will at least be able to, if you’re going to get expert support it’ll be for something bigger, more self-actualization, it won’t be for the basics of okay, how do I be a human with a feeling because this is terrible? And I think getting him so young is so key. I see even with the children in my life, the sort of age at which you can start to teach about this makes a big difference. Even the difference between five and ten, much less once people are teenagers.

So let’s talk about, you go over three skills in your book, I love this, this is how I talk about coaching too, this is a skill. I don’t want people dependent on me. I am not trying to be your guru. I do not want you following me. I want you to learn how to coach yourself. And it is, it’s a skill based paradigm. So can you talk about, you have three skills in your book. You talk about shift, approach and align. Can you kind of talk us through those?

Luana: Sure. So I’m going to back up just for a bit if I may just because before the skills I think the thing that I want everybody to understand is, although anxiety is painful. Anxiety itself is not what gets us stuck, really is what we do when we are anxious. And a lot of us are really engaged in what I call psychological avoidance. This idea that we want a quick fix. So anxiety comes up, you feel discomfort and you might not make that phone call to somebody that you’re upset with. You might not ask for a raise. Women in particular really have a lot of challenge in that domain.

And then we end up stuck, feeling more and more anxious. And so the way the book is designed is shift is really to widen your perspective. You and I have started to talk about that already. As a teenager there is only one view of the world. As our brain develops sometimes we get stuck on this black and white all or nothing kind of mentality. And so shift is really, is there another way to see this scenario? So when you’re anxious, can you start to talk to yourself as if you’re your own best friend?

Because I don’t know about you, Kara, but sometimes my brain is my worst enemy, it tells me things that are just not so helpful, that I would never say to a friend. So that’s the idea behind shift. Approach is really designed to go towards the fear instead of walking away. So the idea of opposite action So if anxiety tells you, you can’t ask for a raise. What is one step towards that raise that you can do? Can you write down the things that you do well in your job? Can you practice asking for a raise with your partner or a friend?

And really slowly training your brain, that is a perceived threat, not a real threat. And then finally, align is really this idea that stress happens when our daily actions are not aligned with our values. A lot of us live a very emotion driven life. Our emotions dictate our actions. And instead of carried right and left, based on how we feel, versus choosing our engagement in life based on our values. And what we know scientifically is a value driven life leads to more contentment, happiness, less oppression, less anxiety. And so that’s in a nutshell the three skills.

Kara: There’s things that I want to say about each of those, it’s so good. But I want to talk about that last thing, maybe first going backwards because I think that point about values is crucial. This is something that we teach and talk about in The Clutch too. And I think that women in particular have a hard time because they’re not socialized to live by their own values. They’re socialized to live based on, what do other people think of me, what are other people’s opinions of me?

The sort of subconscious values, so really am I matching up to what patriarchy tells me I’m supposed to do at all times? And so it’s the exact opposite, if a value is like an anchor or a compass so you know where you are going. If you are constantly trying to people please everybody around you or live by these impossible social expectations, it’s like in a cartoon where the character is some place where the compass is just spinning and spinning and spinning around and can’t get, the magnet confuses the compass.

And I feel like my experience, this is a really profound revolution. I work for women in particular because they have really often not had anything to navigate by other than this is what I was taught to do, this is what I was told to do or this is what I’m supposed to be or this is what my parents think or this is what my husband thinks. It’s all external, instead of course decision making is impossible, plus we’re socialized to believe that we’re not leaders and not capable of making decisions and emotional and irrational and all the rest of it.

So I just want to echo that that process of identifying your values and to make this actionable, literally people, chickens, you can Google this list of values. You can Google a list and pick a few that resonate with you. You don’t even have to change your whole life, just try it out. Okay, these were my three life values, and you can do it in different areas of your life. We have values in my business that are this is how we make business decisions. In my relationship my partner and I have articulated shared values, this is how we make decisions in our relationship.

I think that’s such powerful and very actionable advice that to your point, you don’t need to go to a specialist for. I know specialists can tell you what your values are. You have to figure that out.

Luana: So there’s so much in what you said. I’m so excited. So I think the first piece is this idea, you’re right, that we need to stop this narrative in our brain on how we need to be. As women there is all this narrative of what makes a good woman, what you should do, how you should do it. I love the picture of this cartoon with the compass spinning because that’s how women behave a lot of the time. They’re spinning. And this is, I see this a lot when values collide, family and work. And then women have to choose family.

Why do you have to choose family? Who’s told you, you have to choose family? And it’s really not about choosing one value versus the other. It’s really prioritizing values in the different moments of your life. And I also think a values assessment is the most important thing any human being can do. And list of values are very helpful but there is another exercise that I want to share with our listeners, your listeners here, that I think are very helpful, which is to really think about, if you’re listening to us, think about the last two weeks of your life.

Imagine your mind’s eyes a moment that was really happy, a moment that you felt like you’re in flow. And really visualize who is around you, what are you doing, what is the smell like. What about this moment means so much to me. By leaning on moments that are in flow, often we can identify what are the values behind it. I had to do this myself because I was struggling with my health tremendously and I wasn’t going to the gym. And I was really having a hard time, I put on nearly 50 pounds in the pandemic, was really a hard time.

And one day I was exercising with my five year old and I had so much fun. And I was like, “What about this, why was this so fun?” And was because it allowed me to connect with him. And so by then getting to connection I then started to create more moments that I could align ‘exercise’ but align it with connection. How do I do this with girlfriends going to yoga? How do I do this with dancing to La Bamba with my five year old? And then you start to align your daily actions with your values and it really is transformative.

I mean I’ve been a psychologist for nearly 20 years and not until I hit a major wall two years ago, I started to really practice this. And I have to say to you guys, it really changed the quality of my life.

Kara: Yeah, I love that. I don’t know that I would have known how useful it was if I hadn’t started a business because going through the process of creating business values and then using those. Because when you run a business you are just constantly coming up against decisions that have competing considerations. It’s what the employee wants or what the clients wants. Or what you want to do in the program or what doesn’t. And there’s just so many decisions in which there isn’t an easy right answer or something that feels good necessarily.

And using values has been such, it’s not that it makes a decision feel totally great all the time but it tells you what direction you’re going in. It’s interesting, some of my values definitely go all the way across different domains of my life. And then some of them feel like they’re more limited. But just with that process is so, I think especially for women or other marginalized people who are just not really socialized to think of themselves as having autonomy and agency and being a subject in the world to be like, “No, this is, you know what, I personally am not family oriented really.”

I mean I have a family, I love them but family values is not one of my core values. And I look at my brother and it totally is. Family is one of his core values and that doesn’t mean, to work up to saying that especially as a woman, it doesn’t mean that I don’t love my family. But it just means it’s not my driving force in life.

Luana: I love what you’re saying because I think there’s so much parallel even outside of running a business. Women have to decide if they’re going to show up for the soccer game or not. They have to decide if they’re going to cook dinner or not. They have to decide if they’re going to take a business trip or not. And I think choosing based on personal values and the thing is, I think we’re taught to have this balance. I don’t believe in this idea.

I think what I believe is this, what I do for myself is every Sunday I look at my next week and I look at my values and I go, for example, impact is a value that really matters to me right now. What am I doing that aligns with impact? So family for me matters. What am I doing that’s allowing me to spend time with my husband and my kid? Health matters, when am I moving my body? And some days it’s not about impact. Today I’m recording, I think, three podcasts. I have four business meetings. It’s going to be an insane day.

Tomorrow in the morning I’ll take some time to take my son to school and so there’s no balance today. Today’s all about impact. But I don’t feel bad because it’s a value driven decision.

Kara: Yeah, I love that. So can we talk a bit more about avoidance because I think that that’s something that people, at least listening to this podcast will probably have some awareness that they do. We talk a lot about why we’re avoiding certain things. And I’d like to sort of if you could expand a little bit on, you talk about how it keeps you stuck in anxiety. I mean we’ve touched on this a little but it’s so important I think because I think people think that when they kind of numb out or whatever, to get away from anxiety that that’s like working somehow. And that’s why we keep doing it.

So I would love for you to talk about why that’s not working and how it keeps us kind of stuck in that cycle.

Luana: So this is the paradox that is so interesting. It does work but it works momentarily. So I define psychological avoidance as any response to discomfort, that gives us immediate relief but it comes with a price tag. So there’s this idea, and we are biologically wired to move away from threats. If there was a lion in front of us, fight, flight or freeze. When it comes to avoidance, our brain can’t distinguish real threat from perceived threat. So if you get an email from a business partner that you’re upset with, your brain goes in the same fight, flight or freeze but now it’s a perceived threat.

And so I separate them as the three R’s of avoidance. Some of us in situations of discomfort totally we react to avoid. And this is what I mean by that. We feel so uncomfortable that we want that discomfort to go down. So you basically in a knee jerk response you do something and you send a hasty email. You raise your voice. You quit your job without thinking. Momentarily when you send that hasty email you feel better. The problem is you are in your emotional brain, you’re not thinking logically.

Now you have to clean up the mess with your partner or business partner or whoever it is. So some of it is reacting. Some of us when we feel discomfort, to your point, we numb out, we retreat, we move away from that discomfort to avoid. So we have a little too much wine or we scroll on social media mindless, sometimes even do things like I’m going to take a walk to calm down. But every time you’re interested in taking a walk you’re never actually doing your work.

And some of us, I’ve seen a lot of this actually as a type of avoidance, Kara, which is we remain stuck. Women tend to do this even particularly on relationships that are no longer working. You know you need to be out of this relationship but it’s like the devil I know is better the devil I don’t know, even though you’re miserable. And so regardless of the flavor of avoidance, the common denominator is you are getting a quick fix but then you’re being robbed from your full life. You’re being robbed from the things that matter the most because you’re stuck.

For me growing up, the way I did I numbed my emotions by eating cookies. Every time I felt, I ate cookies and so my whole life I fought with obesity because as a child I never learned. It wasn’t until I was an adult and a psychologist, so I have cookies to just not feel. That’s what’s going on here. And it’s not that I don’t have cookies anymore, but now if I’m sitting and I’m writing a chapter in my book and it’s sucking, I’m like, okay, I don’t need a cookie. I can just feel that right now writing hurts and it’s hard and it’s okay to be hard.

Kara: So I think that this connects to our conversation on values I think because when you are confronted with the choice of feel the hard feeling or do what I usually do to get out of it, I think that that’s a place. That connecting to your values sort of puts you into your prefrontal cortex or kind of thinking brain because it’s an abstract concept. But also I think our values connect up with our identity in a way that helps us steer the ship.

I was just coaching somebody about this, this week, who had this identity of herself as the black sheep in her family. And she was going through a really stressful time. And she was kind of reverting to behaviors that she thought she’d put behind her. And a lot of the coaching I gave her was changing your identity from black sheep to something else isn’t going to prevent you from ever being challenged. But it’s the thing you can return to. that makes sure that instead of going down the spiral, you keep putting one foot ahead, you get the help you need, whatever it is.

If your belief is I’m resilient, I figure things out versus I’m the black sheep, I’m a disaster, that makes a huge difference. And I think that that value, I think about this, I take cold showers now, that’s my only wellness bandwagon, I think partly just wakes me up. But I think about that as even something small like that, it’s okay, I’m a person who can do this uncomfortable thing because I think it’s going to be helpful later on. Rather than it being a should, I’m not supposed to eat cookies, I should.

Women can turn, I think, anything into a should, so self-development or self-help work also becomes I should feel all my feelings. How can you connect that to a value like I want to live an intentional life or I want to be present in my life or I’m a brave person, I want to be brave, that’s a value for me. And that I think could help you get through that moment where you’re like, “I just want to turn on the TV, I’m going to settle this.”

Luana: Yeah, I love this because there’s three layers that I hear you saying that are super exciting to me. The first one is we have to first pause our brain, for our emotional brain we have to bring our thinking brain back on. And so just acting out of emotions is going to get us stuck. So there’s this pause that I heard you say and then there’s this piece of what are my values, how do I align with them from a place of strength is what I hear you say and a place that changes ultimately the narrative in your brain.

Because you’re right, if your lenses are, I am the black sheep of the family, even when you’re not thinking about it, all your actions are coming from that place and then you wonder why the outcome doesn’t work. It’s because your brain’s distorting everything. And so I agree with you, we have to sort of really learn to understand that narrative and get it out. I think about the brain and the narrative as a show and the curtains coming up. You never know what’s behind that curtain and we often don’t want to lift that curtain, we sort of peek behind it but we don’t open the curtain.

And I think to really integrate in life and be a full human being we have to look at our weakness, our strengths, what we say to ourselves so that we create the show of our lives the way we want, not the way we’re supposed to do.

Kara: Yeah. I’d love to hear you talk a little bit more about what you call the amygdala hijack because I do think a lot of this work, one of the levels is just becoming aware when you are in that state. And not just having enough awareness but I should not send that email right now like I am doing. That thing is happening, I want to snap at my partner. I want to yell at my kid. I want to fire off this email. I feel that urge right now. You have to get awareness of that so you can stop it. So if you talk a little bit about what you mean when you write the amygdala hijack and what’s going on there.

Luana: So very simplistically there’s two parts of our brain that are competing for attention. We’ve been talking already about the prefrontal cortex, which is the thinking part of the brain, execution, logic, all of this stuff. And the opposite part of the brain, the back of the brain is our amygdala, our limbic system. And what we know is if I were to put anybody in a functional MRI and I gave them a bunch of math tests for example and I measured the reaction time, I would see reaction time is 10 seconds, 20 seconds.

If I then showed you a very scary thing, a big spider or a loud noise and you got really scared, now your amygdala turns on. And the amygdala, because our brain’s designed first and foremost to protect us, the response is pretty strong and it’s involuntary. And what we see is that the prefrontal cortex starts to dim so there isn’t as much energy. So amygdala hijack is when you literally think you are thinking straight but really is that response that you’re fully in that emotional brain. The emotional brain is designed to protect you. So it’s going to introduce something.

Kara: This is important, you think you’re thinking straight, okay. So this is very important and this is why, I am always like, “Unless you’re truly in a life or death situation it shouldn’t hurt to wait an hour and see.” So I think a good clue is when you’re like, “No, I have to do this immediately”, if you’re not actually on the transplant team, that’s a sign that something’s off because I think that is what happens.

Your brain tricks you unfortunately and you’re like, “I’m being very rational right now, this is obviously the right thing to do and I have to do it immediately right away this second.” That’s a sure fire sign that you are not thinking clearly.

Luana: That is avoidance 101. You are so right. If you feel like your life depends upon it and you have to respond and you’re right, you’re not in a transplant, you’re not doing heart surgery. Guess what you’re avoiding? That is the best way to know it because there is nothing that can’t wait five minutes, 10 minutes, half an hour, there is really nothing. Especially when we’re talking about perceived threat, your kid is bleeding on the floor, that’s different, you’d better step in there.

Kara: The thing is when that happens also I think your brain takes over, I mean not if you’re in freeze, but if something, if a car’s running at you, you’re not, should I? Your body just moves you out of the way, it’s going to take care of it.

Luana: That’s it. I think it’s so great, I’m so glad you paused me to punctuate this because that is the biggest glue is this reactivity, reactivity’s just avoidance.

Kara: So good, okay, sorry, continue. This is so important because we could talk about all this but how do people operationalize it? So if you want a concrete thing to look for, look for that feeling that you just want to email and hit send right away. You want to text back right away. You want to say the thing back to your partner right away. You want to say the thing to your partner right away. This is your sign, if it’s hard to not do it and you feel this physical urge to do it, that’s a sign that your amygdala’s in charge.

Luana: 100%. I mean the other way I teach this is, is it going to make you feel much better to do it or is it going to make you feel worse to wait? Because when you wait you feel a little worse and that’s why people don’t like waiting.

Kara: That’s so good yeah, if it feels like you’re going to feel better if you do it, don’t do it.

Luana: Don’t do it. Don’t do it, it’s quick fix. And that’s the thing, the easy way is anxiety will demand an action. Go opposite action always, don’t do what anxiety is telling you to do if you’re feeling anxious. The visual I have is a really silly one. But when I’m in amygdala hijack is when my prefrontal cortex is out having margaritas friends, it’s not my brain, it’s just not, nowhere to be found. And so I love what you say. To me it’s pause and don’t react.

Kara: I love that idea. Do whatever will feel worse because I often teach sort of we’re going towards what I call barf club, but you’re trying to get uncomfortable. That’s the antidote. So good.

Luana: That’s exactly right.

Kara: Okay, so there you have it from the mouth of a Harvard professor, do whatever’s going to feel worse. I’ve been telling you this all along but you need to hear from the experts. Tell us, where can people find your book? Tell us all about the book.

Luana: So you can find the book anywhere you buy the book, Amazon, Barnes and Noble. You can find out more about the book and me at www.drluana.com. And the social media handle, it’s drluanamarques M-A-R-Q-U-E-S. And I just so appreciate being here.

Kara: Yeah. And Luana is L-U-A-N-A for those of you going to drluana.com. So go buy her book, read it, implement it and I am so glad to have had you here. Thank you for sharing your expertise with us. And we’ll put all this all in the show notes for everybody who’s trying to jot this down while they’re driving.

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