Get “Gritty” in Midlife! Here’s how…

Dr. Sue Varma (00:00:00) - To me, practical optimism. It's a philosophy. It's a lifestyle. It's a mission. It's a movement that you keep coming back to that you're like, I got this like.

*Dr. Sarah Milken * (00:00:13) - Hey peeps, welcome to the Flexible Neurotic Podcast. I'm your host, doctor Sarah Milken. Yeah, you heard that right. I'm a real PhD doctor. Long, long ago, like last fucking year, I was sitting in the midlife funk wondering, was this it for me? That day, I realized I needed to get off my ass and start my midlife remix. I dusted off my PhD, wipe the menopause sweat off my forehead, grabbed my golden shit shovel, and started digging deep to all my midlife bitches. It's not just luck, coffee, and hormones that get you through your midlife remix. It's action steps. Let's do this. Hi good peeps, this is the next episode of the Flexible Neurotic Podcast. I'm Doctor Sarah Malkin, the flexible neurotic. Today I have a guest who you will love as much as I do.

*Dr. Sarah Milken * (00:01:06) - You will hear her speak and read her brand new book that I couldn't put down, even though it was the electronic version she sent me. Practical optimism the art, science, and practice of exceptional well-being. She's a distinguished psychiatrist and cognitive behavioral therapist based in New York City, with over two decades of private practice experience, and she served as the pioneering medical director and psychiatrist for the esteemed nine over 11 Mental Health program at NYU. Working with all the survivors and families of 911, she's a clinical assistant professor of psychiatry at NYU. This guest has has garnered national claim as a sought after medical commentator, appearing on major news programs and network. She can frequently be seen discussing breaking news on the morning news shows, including The Today Show, CBS mornings, Good Morning America, and she's an international speaker on a million mental health topics, including all women's health initiatives and work life balance. And for today, she's going to explain how we can cultivate the lives we really want in midlife, with a mindset that she calls practical optimism.

*Dr. Sarah Milken * (00:02:18) - Her name is doctor Sue Varma. Hi.

Dr. Sue Varma (00:02:23) - , what a sweet.

*Dr. Sarah Milken * (00:02:24) - I'm so happy. I'm so happy you're here. I know you've been on a crazy book tour. I missed you in LA and now you're in New York. But I'm glad we got to, like, squeeze this in. I think when this comes out, your book will have just come out so everyone can go and buy it, which I'm really excited about, because sometimes you're like, oh my God, I can't even buy it. But in this case, you can.

Dr. Sue Varma (00:02:44) - Yes. Thank you, thank you.

*Dr. Sarah Milken * (00:02:45) - Oh my God, oh my God. So happy to have you. And we just had this whole like pre fun conversation that I didn't record about kids and I don't know significant others and kids, boyfriends and girlfriends, the whole thing. And her kids. She has two sons that are a little bit younger than my kids. I'm like you just wait.

Dr. Sue Varma (00:03:04) - Yeah, you just wait.

*Dr. Sarah Milken * (00:03:06) - They're going to you're they're going to be like, don't psychiatry me, mom.

*Dr. Sarah Milken * (00:03:11) - Yeah. You just wait. They're like, just because you have a PhD, mom, doesn't mean you understand what's going on in my mind. I'm like, okay, all right. Yeah., the intention of this episode is to dig deep and find out why and how midlife women feel so stuck, and we can all learn to take ownership of our lives through feeling our feelings, even the hard ones, renewing our purpose and finding joy even when things feel really hard. Anyone listening to this podcast is probably on the menopause spectrum of perimenopause. Menopause post menopause listeners, I promise you want to hear this episode. Sue wants to teach us how to dig and what she calls the joy bucket, and not dwell in the drudgery drawer. We all have the drudgery drawer. I read Sue that when you were working with 911 survivors and families, you realize that there were two camps of people. There were the people who were. It's just shattered. Couldn't get out of bed. Completely traumatized as they should be.

*Dr. Sarah Milken * (00:04:15) - Anxious, depressed. And then there was another camp of people who had a very different response and were manifesting the feelings differently. And it kind of led you down this path. Do you want to talk about that with us?

Dr. Sue Varma (00:04:28) - Yes. Thank you. So, you know, when I was working as a nine over 11 medical director of the mental health program at NYU, you know, first of all, it was, you know, a unique opportunity to be able to see what it looks like to have mental health in the fold of, like, a primary care setting. And like, that's something I've always wanted for us to have. And I want to see more of it. Where, like you as a therapist can communicate with their GI doctor, their allergist, like across the hall. And I feel like that facilitates communication between providers and leads to better outcomes that we know. The second part is I never want to take away or diminish a person's experience if for some reason they experience a traumatic event and then they're not resilient afterwards, right? Like there's so many factors psychological, prior history of trauma in their own lives, intergenerational trauma, history of anxiety, family history of anxiety or depression, incarceration and the parents abuse.

Dr. Sue Varma (00:05:25) - Things that we consider adverse childhood events. There's any number of things that puts a person at risk for being more likely to develop symptoms of post-traumatic stress disorder or mental health problems right after traumatic event, so I never want to minimize or diminish that. They did notice that there were some people who, after experiencing a traumatic event, not only were able to sort of bounce back what we when we look at resilience, that's what it is. It's bouncing back from adversity, but also really flourish, which is thriving in the face of it. And so I became very curious as to what features did these people have that allowed them to be sort of more buoyant in the face of disaster?

*Dr. Sarah Milken * (00:06:08) - Wow. I know I had this really interesting experienced yesterday, and it was kind of a little synchronicity, I think, because I knew that I was meeting you today and I went to this event. It's a friend's home, and she had a woman whose son was literally executed by Hamas on the highway to the head. And she saw the video of it and we were all just sitting there in tears, like streaming down.

*Dr. Sarah Milken * (00:06:37) - But we couldn't understand how this woman could fly here from Israel, having seen what she's seen, lost her son and have such a tremendous amount of energy to give to us, and to tell her story, and to honor her son and herself and her family and Israel, and raising money for families in Israel. And I said to her, I said, I'm meeting with a psychiatrist tomorrow. Who is who talks about that? There's 25% of us are born with this optimism, gene, if you call it. And the other 75% of us have to work on it. And I was like, thank you so much for being one of the 25% kind of representing the other 75%. She was like, oh my God, I think I need to buy that book.

Dr. Sue Varma (00:07:31) - Thank you so much for talking about it. And, you know, it's you're right. Like what we see is actually one of the key features of resilience is altruism and giving back. And that's what I really saw is that what a lot of the patients did whenever I made it into my part of the program, the mental health part, you know, they were there for their routine screenings and make sure that everything was physically checking out okay with them, but they were there to support other people like these folks who were super resilient.

Dr. Sue Varma (00:07:59) - They would come to the clinic not because they had an appointment, but because their, you know, fellow colleagues, people who were working down there, who were living down there or experiencing panic or agoraphobia, and they're like, I can't take the train. I can't take the subway. So when we see, like, it seems so counterintuitive that in the midst of your own loss and tragedy and grief and disappointment, that you're there to help somebody else. But really, that is what helps us transcend that grief and creates meaning. And something what's called post-traumatic growth is how do you take some really, really horrible situation and become, I think, stronger. And I think it takes time. You have to grieve, but then you also have to at some point say, all right, how can I turn pain into purpose? And I talk about that of turning pain into purpose. And, you know, altruism is a huge part of resilience, but so is optimism, you know? And up until now, people only thought of optimism as something you were either born with or not.

Dr. Sue Varma (00:09:00) - And it's the reason why no one's really ever taken the time to say, let's think about this. Let's think about how do we utilize this to maximize our potential in relationships, in money and finances, at work, with our own mental health, with our own set of goals? How do we turn a trait and turn it into a skill? And that's what I'm doing by talking about practical optimism is like for the 75% of us that aren't necessarily born with this glass half full outlook, what can you do? And that's what we saw is that researchers found that really these genes that they thought coded for optimism actually code for a set of skills. And guess what? We can learn skills. We can teach skills and we can learn them.

*Dr. Sarah Milken * (00:09:45) - So what are the specific skills that like if you were teaching a course on how to teach optimism? I mean, I'm sure it goes into sort of Martin Seligman work on positive psychology, but what I liked about yours, it wasn't just like a self-help book on like How to Be Happy.

*Dr. Sarah Milken * (00:10:03) - It was really digging more into what a lot of us midlife women are going through is kind of rediscovering our purpose.

Dr. Sue Varma (00:10:11) - Yes, yes. And that's actually the first pillar of Eight Pillars. And while there's no particular order for me that the order in which I laid it out had a special meaning and arc, because it starts with having a purpose, and purpose can be capital P is. And what's my purpose in life? Or it could be smaller case lowercase p as. And what's my purpose in this specific relationship in this goal?, and what's interesting about purpose is that it's not something a lot of times people think that they have to find it, right? And they're waiting to be inspired or waiting for motivation to come from the outside. And what I've learned as a cognitive behavioral therapist as well is sometimes we have to put the cart before the horse. And this is a technique from behavioral activation, which is you create motivation, right, by engaging in an activity first. Right. And that,, productivity begets more productivity.

Dr. Sue Varma (00:11:06) - And if you're saying if you say, for example, like, I'm not really feeling inspired to do anything today, right? Whether it's today or my next steps, the research has found is that exercise boosts a sense of purpose in life. So if you're lost, if one day you wake up and you're like, I don't feel like doing anything, first of all, if that's pervasive, then you want to you maybe want to get that checked out, right? Because we know that people. A purpose gets obscured in the midst of depression, and it's harder to feel motivated.

*Dr. Sarah Milken * (00:11:32) - So for midlife women who are in like hormone hell, like you could have all the great intention in the world, but you literally can't get your butt out of bed.

Dr. Sue Varma (00:11:41) - Yes, yes. So getting like a, like, medical workup, like finding out like what? Can you like hormones, like thyroid blood and B12, vitamin D, there's any number of like, medical things, right. And also talking to the primary care doctor to talk about low mood and depression.

Dr. Sue Varma (00:11:55) - But let's say you've got that taken care of and you're like, no, I just I'm feeling lost. Also, recognizing that your purpose doesn't have to come from your paycheck, right? Like that's a really key thing that a lot of times people are looking for purpose from their job. And so recognizing that your purpose can be raising the family, that purpose can be starting a podcast, like any number of things that maybe don't provide financial compensation right now. Hopefully they do at some point. But that doesn't have to be a paycheck tied to be able to derive personal significance and personal meaning to it. The other thing I say is that your purpose ten years ago does not have to be your purpose today. Your purpose today does not have to be your purpose tomorrow. So if you're able to ask yourself key questions. What brings me great joy in life? And when is the last time that I did it? Because I find that a lot of people, they'll say, I used to love playing a musical instrument.

Dr. Sue Varma (00:12:45) - I used to love fill in the blank pottery, knitting, gardening. I don't do these things anymore. They they fell off the wagon. The other thing about purpose is, as much as possible, try to get yourself into a flow state. So I did an interview with the New York Times in the beginning of January Jancee Dunn, a well writer, did a six day and New York Times Well energy challenge, and she interviewed me for two of those days, and one of them was about what's called low stakes flow state, where you're finding an activity where you feel completely immersed with what you're doing. Time passes, whether it's writing a blog, whatever it might be, painting, there's an idea of your learning, but you're also challenged finding the sweet spot. So there's so many like nuggets that I give folks when it comes to purpose. But exercise, if you feel like I'm lost. Scheduling like a 30 minute whatever it is a walk around the block, hitting the gym, hitting weights, whatever it might be, the the serotonin, the dopamine, all of that boost productivity and mood.

Dr. Sue Varma (00:13:44) - And then all of a sudden you're like, all right, I'm ready to tackle that difficult email, that message that I needed to send and that one message, that one email, that one phone call can often change the trajectory of the day, the month, and even your life. Right. But you need to put the cart before the horse. That's the bottom line when it comes to purpose.

*Dr. Sarah Milken * (00:14:02) - So from what I hear you're saying is it's it's kind of identifying small things you can do to get that small win. So even though you don't want to run the marathon or whatever, and I always joke, I'm like, where are my fucking endorphins? Like, why don't I love exercise? Like I just posted a real I'm like, I'm looking for them. I don't know where they are, I love it, I do it because I know that I need to. Yes, for my body, my bones, my heart, like all the things. And I'm so happy I did it. And so in some ways I think it's endorphins.

*Dr. Sarah Milken * (00:14:36) - And at the same time it's like something you can check off your list.

Dr. Sue Varma (00:14:41) - Absolutely.

*Dr. Sarah Milken * (00:14:41) - And like, I can't work out at four in the afternoon. No way.

Dr. Sue Varma (00:14:45) - Yes, yes it check off your list and then it sets your whole day for success. Because like most of us have it ingrained, whether we do the exercise or not, we have an ingrained that it's something very beneficial. And what you're doing is in tricking your mind into creating an identity around accomplishing things. You say to yourself, I am someone who exercises right? And like this. Then brings me to my last pillar and I said that there is an arc which is practicing healthy habits. And if you want to think of it as an art where arc where you're starting with purpose being very deliberate, very clear, very focused, very intentional, you may know what you want to do, you may not know what you want to do, but then it's creating steps towards building a life or building a goal. Within the end is the execution of those, those, those goals and those habits.

Dr. Sue Varma (00:15:31) - So when it comes to maintaining healthy habits, you want to have an identity around it. So, you know, there's eight steps of starting with a clear intention. And then the next several steps help you with obstacles and challenges along the way, one of which are your own emotions. You know, like a lot of times people don't realize that when you talked about where my endorphins, sometimes we wake up and we're like, I'm in a horrible mood. I have no desire to exercise. Right. But if you recognize that those negative emotions are interfering with the execution, right. So then the next pillar is processing those emotions. So there's a variety of things that you can do to go from the first step, which is I want to I want to either find meaning or I want to find more meaning. And that's another part that I talk about is role remake or job crafting. You know, some people are like, I'm in a 9 to 5 job or whatever job, and I don't love it.

Dr. Sue Varma (00:16:18) - And I'm doing I feel like there's a drudgery, like the drudgery draw, like I, I don't this is not pleasurable to me anymore. So it's totally okay to accept that what you did a long time ago that brought you meaning and joy.

*Dr. Sarah Milken * (00:16:29) - Yeah, I love that part. When you talk about how you do need to recognize that, like something that brought you joy or you did in the past, or you've done up until now, may not serve you anymore and it's okay.

Dr. Sue Varma (00:16:42) - Yes, it's okay to outgrow people, right? It's a it's okay to outgrow hobbies or interests or to say like, I've, I've done this and it could be a really great thing that you outgrow. And it's and it seems so weird because you're like, if it's great, why would I outgrow it? But, you know, one of my favorite lines and I've used this and it came to me and it was something I read once in the midst of like a low point in my life. And I remember reading it says, people come into our lives for a reason, a season or a lifetime, and you know, what that means is like, let's say you meet somebody and they help you cross the street, you know, and like they were your friend, like the metaphor of somebody who made a connection for you or, you know, lend to you something, let you sleep on their couch.

Dr. Sue Varma (00:17:24) - Maybe they're not a friend that you would open up to or have a deep relationship with. They came through for you in a time of need, right? So that's a reason. And then the season could be someone five months in your life, five years. And then a lifetime is like that lifelong partnership or journey. In the same way I look at our purpose, right? Your purpose can be something that brought you fun and joy for a portion of time in your life. And it's totally okay to say, you know what? My purpose has changed. And that's a fact because we change as people.

*Dr. Sarah Milken * (00:17:51) - Yeah, I love the fact that you talk about the evolution of purpose, because obviously, I mean, not all of us are moms, but many of us are moms. And as we approach those midlife years and we're in those years, we experience empty nest. I'm in half empty nest right now. And I think this is a time where a lot of midlife women tend to kind of rethink their purpose in life, because a lot of moms, a lot of people have been stay at home moms or they've been career moms, whatever it is.

*Dr. Sarah Milken * (00:18:23) - And then they get to this point where they're not needed. And I say that in air quotes needed as much anymore, and they feel less relevant to the everyday mothering needs of feeling need it. And now they're like, oh my God, what do I do with this extra time? What's my identity? I'm not Suze everyday mom anymore. Like she's off in college. I mean, that's how I feel with my son. Like I adore him, but he's not in my, like, everyday orbit. I mean, I'm thinking about him and I'm like, why the fuck are you not texting me back? But you know, I'm not managing his day to day of like, did you buy the Tylenol that you said you were going to buy? Yeah. And so it's sort of like, well, what's my new role now? And for me, that's why I started this podcast and the whole platform. But a lot of my friends like I've talked about have like started mahjong and hobbies and pickleball.

*Dr. Sarah Milken * (00:19:20) - My husband has become like a golf freak and everyone has their thing. And I think sometimes people feel like their thing is too small or their thing is like maybe embarrassing, or they're just a beginner at it and you address that.

Dr. Sue Varma (00:19:39) - .. Yes. And like you know I feel like it's so key that like our purpose is just for ourselves. Like no one needs to understand it, no one needs to agree with it. And it doesn't have to be fancy., but it has to bring you joy. That's the minimum requirement. Like what brings you joy? What makes you feel maybe like a kid again? What makes you feel curious about the world? What have you always wanted to learn that maybe you didn't get to? You know, I could say that for me. Like, and it's funny that we're talking about emptiness because I'm, I'm not at that point just yet, but it's something I think a lot about. And,, you know, I can just share like a little anecdote and it's something so small, but like, you know, I love languages.

Dr. Sue Varma (00:20:16) - So my parents are from the East. I learned how to speak Hindi growing up. I ended up teaching it as a kid. It was something that was a part of our family. We spent summers, you know, going back to India, spending time in Europe. So travel is a big part communication, being able to communicate to people in different languages. And I learned Spanish as a kid in school, and I just loved when I would go to Spanish speaking countries that I could feel like I blended in, and we would have these enriching conversations with people who are like, you are, of course, you're from the Dominican Republic, of course you're from Puerto Rico. Of course you're from Costa Rica, of course you're from.

*Dr. Sarah Milken * (00:20:46) - And you have there you do.

Dr. Sue Varma (00:20:48) - Yeah, yeah. So, like, I could be from any of those places, right. And I just loved how I could go to ten different countries and everyone feels like I'm one of them. And being able to blend in and have like, juicy, gossipy, relevant conversations in someone else's language and to feel like at home.

Dr. Sue Varma (00:21:06) - I've always thought of myself as like a global citizen or universal citizen, citizen of the world. Right? And but one thing that I never got to do, like, and it was important for me, but I wanted to always do a semester abroad, and I never got to do it. And it was like, in those days you didn't college courses, like I was pre-med and wanted to go to medical school and did, but they didn't offer organic chemistry in English in Spain, for example. So it really and you're on this track and I was working full time in college. So there was a variety of things, barriers that why that couldn't happen. And I've continued doing medical missions abroad and I in 911 program, we spoke Spanish. But, you know that I know that there's a time and a place when your brain is developing. And if you were to spend 3 or 4 months at a younger age, fully immersed, having that freedom and that time it would have been a different outcome.

Dr. Sue Varma (00:21:54) - And that's just a small personal value of mine, right? To be proficient in one more language. And I'm very good intermediate. But it's not like native. So that's something I have in my mind that like when the opportunity arises, maybe I'll get one of my kids to do with, you know, a semester abroad and maybe I'll be one of those, like, soccer moms who gets an apartment off campus and I'm doing my thing.

*Dr. Sarah Milken * (00:22:14) - I could be one of those two. I totally get it.

Dr. Sue Varma (00:22:17) - Yeah. So, you know just where. So for now, it's Duolingo and me talking to any Spanish speaking person that'll have me and converse and whenever opportunities arises. But that's just one small example of like, what are those unfulfilled dreams that you put on the back burner? And like if you are in a position, even if it's just taking a local class as an. Artist. As you know, someone who likes to knit or weave or magic like. So what brings you joy and populate your calendar? That with that? Like today? Like that.

Dr. Sue Varma (00:22:46) - Like if that's the take home they're going to take is the joy and scheduling it in your calendar. And I literally before I was talking to you, Sarah, like I had sessions with patients and one of them, I said, I, I, I talk about the forms of mental health and we'll get to that. But they're like four science backed habits. And I was like back in the day when we didn't have digital and we would write patients prescriptions. I would write movement, you know, seeing friends and purpose. And I on in person. I would put that on the prescription pad when we had it, because I wanted to impart the importance of like, this is as important as any other pill or any other prescription a doctor would give you. So like they loved it and they were also like, what the hell are you doing? Like, like I was coming to you for, you know, a Prozac or Zoloft. I'm like, nope. Like medication has its place for sure.

Dr. Sue Varma (00:23:33) - But like, there's so many other things that are free and that are natural. Like for those who need it. Yes, but if you at the end of the day, you're still going to need to do these other natural sort of holistic habits to get better, because we know that once you know, person stops medication, a lot of times the symptoms of anxiety or depression can come back. So what's really going to make a difference are those lifestyle habits, those coping skills that you invested in.

*Dr. Sarah Milken * (00:23:58) - All right. Well let's talk about the forms. Yes.

Dr. Sue Varma (00:24:02) - So the forms of of mental health and these are like science backed my go to non-negotiable habits that a person can and should schedule. Like every day. If you only have ten minutes for each of them, or every week at least the first one is meaningful engagement. And this is by far my favorite. And I feel like we are. I mean, it's not just how I feel. We are in a loneliness crisis and everyone like whether it's teenagers, whether it's Greatest Generation, whether it's midlife moms, like a lot of times women have paid attention to their careers or to their families.

Dr. Sue Varma (00:24:35) - Those friendships have kind of gone on the back burner. So when you meet with a friend, first of all, the intention and being deliberate about it. So when I was in LA, I tried to squeeze in, I even though I was there specifically for taping a podcast and that was there for my book, I try to squeeze in as much social visits as I could, and it was, you know, I give so much respect to you with the LA traffic, like trying to coordinate with people coming all over. Yeah, but and that just showed how intentional we all were and going out of our way to make it happen with all the barriers. It was so easy to flake out and be like, I'm sorry. Oh my God.

*Dr. Sarah Milken * (00:25:09) - Last night when I went to that event for Israel, my friend who hosted it, she's like, how long did it take you to get here from the Palisades? And I was like, it doesn't really matter. She's like, just tell me. I'm like, 55 minutes.

*Dr. Sarah Milken * (00:25:21) - And it's like five miles. I mean, it's like ridiculous. And she's like, thank you so much for doing that. You really do have to make it intentional.

Dr. Sue Varma (00:25:31) - Yes, absolutely. And if you don't like it's not it's not going to happen. So think of it like I would say, like all of these habits just every single day. Think of it like my life depends on them. Because we do know that when you look at midlife women, whether it's the weight lifting, whether it's the in-person, meaningful friendships, all of this if you want to, if you want to predict how someone's health is going to be, of course, barring things that we cannot control health wise, but the chronic illness and that's like the vast majority, you know, I want to say, at least when you look at the number of people over 65 that are on 4 or 5 medications, it's more than half. And so chronic illnesses are what most people are dying from., your your quality of your life is going to depend on the quality of your relationships.

Dr. Sue Varma (00:26:13) - And midlife has a lot to predict on the quality of your relationships at 80, like so. This is the time, because a lot of times people feel like, oh my God, like the time has passed, I lost my childhood friends, or I'm not in touch with the college friends and even the ones when when my kids were really young, were no longer in touch because the kids are all doing their own thing with their own phone. So like, I'm not in the mix of those women and those friendships, but it's never too late. So the meaningful friendships are so key because we know that active listeners live, on average, four years longer. People who have sorry, people who have active listeners in their life will live on a on average, four years longer. So and people who have active listeners, listeners are less likely to have cognitive decline. So and loneliness kills people. Right. It's like the equivalent of smoking 15 cigarettes a day. So I can go on and on about the neuroscience of loneliness, how it has the same neural circuitry in the brain as depression, and all the reasons why you don't want it.

Dr. Sue Varma (00:27:08) - The likelihood of dying of any cause increases for people who are lonely. Loneliness is not just about the number of people in your life, it's about the quality of the connection. Do you feel seen and do you feel heard? And I think a lot of barriers to really developing meaningful relationships that no one talks about is our hustle culture of accomplishment, achievement, and wanting to seem like we have it all put together and figured out. And I think that's preventing people from just being very raw and honest, authentic and vulnerable with one another.

*Dr. Sarah Milken * (00:27:43) - Yeah, I also think that it relates to something that you talk about in the book called The Iceberg. Was it called the iceberg? Yes, yes, yes. Tell us about that. It made me it's making me think about that.

Dr. Sue Varma (00:27:54) - Yeah. Totally. No. And thank you so much, first of all, for taking the time to read. And you're like you're like a subject matter expert on it. I like, and I love it. It makes me so happy.

Dr. Sue Varma (00:28:04) - Like, you know, because you, you spend years and years like sitting in a cave writing this, doing tons of research and, and that somebody can appreciate and understand and like, nerd out with you. So thank you for that., yeah. The iceberg effect is like we only see 10%, right? Like we see the finished product, we see just the success and we're not seeing there's something else also called the duck syndrome where like person like you see the the ducks head above water and everything looks fine. And then underneath the water there's like, oh my God, I'm drowning and drowning. So the iceberg effect is a little bit different. It shows the success. But what you don't see, you just see the head that like let's say the hair is all done. Like the metaphor of the person's head looks perfect, but you don't see the years of hard work, the years of sacrifice. And I feel like with social media, the the finished product is is what the takeaway is.

Dr. Sue Varma (00:28:51) - And we're seeing everyone's finished product, everyone's highlight reel, and not just the people that are in our social circle, but the billions of accounts that we have access to. And it's constantly diminishing our sense of self. Why haven't I achieved this by now? You know, and so the comparisons really is the thief of joy and it's endless. And success is a moving target. So I feel like when we talk about the forms of mental health, the meaningful engagement is being honest. Share something about yourself that makes you feel uncomfortable, that makes you slightly feel embarrassed. But it should be with people you trust. So that's the other thing. It's not just opening up to anyone and everyone. It's opening up with people that you trust and also never minimize the importance of superficial connections. I see that a lot in sort of like hustle culture. Will people like, I don't have time for chit chat, especially like maybe sometimes younger folks, they're like the ones who are like super busy and on a mission.

Dr. Sue Varma (00:29:45) - When you got the headphones on, you're telling everyone do not disturb, not open for business, do not look at me, don't make eye contact. And that's something that we kind of lost in the pandemic is it was built in layers of like, you know, talking to the barista, talking to the grocery store clerk. Like people laugh at me. I shared this about myself, and I think people literally want to like, I don't even know what. But I tell them I talked to my Uber drivers and they're like, you do what? So why? And I was like, because I like learning. I want to know people. People are from if I'm busy and if I'm like, totally tapped out. I love the feature that you can like request a quiet car. And I don't know if the quiet is just no music or like they're also not. Going to talk to you. Or maybe I'm just interactive and engaged and people like talking to me. But anyway, the point is, don't overextend yourself if you're not feeling safe.

Dr. Sue Varma (00:30:30) - No need to talk to anyone that you're not feeling comfortable with. The point is, just keep your eyes and ears open for social interaction and look at that.

*Dr. Sarah Milken * (00:30:38) - As like social and the extra minute, like, my kids always laugh, but now they do it because they've watched me do it for so long. But like, if there's a server in a restaurant or somebody working in a pharmacy and they're wearing nametags, I use their name because I want them to feel like, oh, I'm a person, and she sees me and she knows that I have a name and I'm not just like a server. And at first when my kids were young and they're like, that's so annoying and so embarrassing. And now, like, I'll be on the phone with my son. And he's like getting a package from like, his Amazon packages. And he's like, knows the guy's name at the desk and he's totally referencing him. And I'm like, see? Like he feels safe because you did that.

Dr. Sue Varma (00:31:19) - Yes.

Dr. Sue Varma (00:31:20) - And you know, it's I love what you're saying because it makes me think. The other day I was talking to somebody. And, you know, one thing I remember growing up is that my parents were always so kind to other people. And no matter where we went, they exactly what you're saying, knowing the person's name. And then they would invest, like, let's say they were their favorite restaurants. They would know about the server, the managers, family members. They would bring gifts. Like if it was their favorite restaurant, they would be there a lot. They would be like, I brought you something. You mentioned it's your daughter's baby shower or whatever it is. So they developed personal relationships with people wherever they went. And then they were also very calm and pleasant. When things didn't work out their way, they would be like, I totally get where you're coming from. At the same time, here are my needs. So, so much of what I know I, I learned from watching them, and I love that your son is picking that up from you.

Dr. Sue Varma (00:32:05) - , and that respect and the human connection that you go out of your way to establish. That's beautiful. Yeah. And I feel like everyone needs that.

*Dr. Sarah Milken * (00:32:12) - Yeah. Like like even the parking guy at school when my kids weren't driving, like, I always, like, knew all of their names. Because when you're asking someone for a favor and you need to park here and you need to do that like they everyone wants to be a human being and has a name and wants to be recognized for what they're doing., it just takes that like extra step. And like you said, I think with like social media and quick interactions, like you were even talking about how, like, even with teenage relationships, it's weird because, like, you and I, when we were dating our husbands, like, we would have, like, long phone conversations and in-person conversations. And now with this Snapchat thing of undelivered, unopened, I don't even know what they're talking about. I'm like, how is that a relationship?.

*Dr. Sarah Milken * (00:33:07) - Like, how has these weird three word yes statements or three letters? Idk, I don't even know what those are. I have to google them.

Dr. Sue Varma (00:33:20) - Totally. And you know, you know, what's so interesting is that there's something called the shallow wing hypothesis, where as a society, everything is getting dumbed down. So I don't know if you've ever read the book 19 I want to say with George Orwell's 1984.

*Dr. Sarah Milken * (00:33:35) - But like but of course I know about it.

Dr. Sue Varma (00:33:38) - Yeah. And like the, like the, the, the thought police and like the dictionaries, like they just got smaller and smaller and less words. And so the shadowing hypothesis is like our connections are superficial, the way that we consume information like short form content, like literally I remember it went from, oh, a real could be or like a short form video, short form was considered, let's say three minutes. And now it's like 30s and then it's turning into 15 and maybe even three. It's like if you don't capture the audience attention in the first three seconds.

Dr. Sue Varma (00:34:05) - And so we have no bandwidth for people. And that's a problem because we expect people to not create frustration. Right. And then what happens is that you have no frustration tolerance when you can't handle. And so that's why relationships like when you talk about the whole swiping, we are treating people like commodities that I can order a person on Tinder, I can order a food from Grubhub, right? I can order a package from Amazon. People and relationships are getting watered down. Our communication is getting dumbed down. We're not having these negotiation skills. Kids are losing opportunities to break up with people in a normal way. Right? It's like I'm not feeling it. Sorry.

*Dr. Sarah Milken * (00:34:45) - Like it's like you're missing the tone of voice. Like my daughter says to me, oh, can you send an email to school this morning? Because I'm leaving early. So I send it and she's all, she's like my supervisor. She's she's like, make sure you cc me because she wants to make sure I did it right.

*Dr. Sarah Milken * (00:35:00) - She's like mini me. And then she's like, then she texted me and she goes, I just don't understand why you have to use annoying emojis. And I said, I use emojis because I feel like the tone of voice is missing from the writing, and I don't want to spend five hours writing to the lady that works as like the apps. You know, the what do you call them? Like the in enrollment absence supervisor, whatever. I don't want to, like write an extra five sentences to be all sweet and cute. If I just put an emoji like road closure and then like a screaming face, it's like, okay, she gets it. And my daughter is like, I don't know what you're doing. That's so awkward. It's so.

Dr. Sue Varma (00:35:50) - So it's so funny. And also like the when we look at the generational differences, you know, and something that you had said that I thought was really funny when you're, when you were like your kids were watching you and you're talking in the beginning, they would make fun of you or be awkward about it, like my kids will.

Dr. Sue Varma (00:36:05) - If I'm talking to somebody and I'm friendly and I'm asking them questions about themselves, like genuinely wanting to get to know them, one of them was like, mom, don't be such a stalker, you know? And it's like, no, like being friendly. Why? Or even showing eagerness, showing interest. Why? Why is that like it? And, you know, cringe. And, you know, one thing I remember, I think. Talking about Taylor Swift because, you know, that's that's on everybody's mind is.

*Dr. Sarah Milken * (00:36:31) - Thinking about these days. Yeah.

Dr. Sue Varma (00:36:33) - I think it was at a, at the NYU commencement speech that she had given like several years ago. But it was something about like, don't be afraid to let people know that you're interested, that you're earnest, that you're eager. And I like, love that because I was like, that is how that has helped me succeed or get to where I am in life is not being afraid of showing my enthusiasm and showing my interest. And I feel like everyone now, like a lot of times people are like, we're too cool or we want to seem cool.

Dr. Sue Varma (00:36:59) - And I'm like, great, I don't have time to play games. If I'm interested in something, a person, an idea, whatever it is I want to, I want to make it clear that I'm interested and I want to know and I want to.

*Dr. Sarah Milken * (00:37:08) - Learn says no or they don't accept your invitation or whatever. It's like, okay, next.

Dr. Sue Varma (00:37:13) - Yes, exactly. Okay. Next. And that so that is that is the essence of practical optimism, right. You try and it doesn't work out okay. Next moving moving right along. Moving right along. Right. And like you could.

*Dr. Sarah Milken * (00:37:24) - Start an entire practice with this,, with this topic for college admissions. And the bottom line is it's not personal.. Like it's not personal. You're not getting in that college and that person got in and this and that. Because at the end of the day a lot of these kids really look the same on paper. And it's like that person got lucky and you didn't and blah blah blah. But it doesn't mean they don't like you and it doesn't mean you're not smart, and it doesn't mean you're not a good person.

*Dr. Sarah Milken * (00:37:55) - And having gone through with my son and now I'm embarking on it again with my daughter, I'm happy that my daughter has had the experience of seeing my son go through it, because it kind of gives her a sense of resilience, like, oh, that happened to him and he was fine, and that happened to him, and he was fine.

Dr. Sue Varma (00:38:14) - Yes, yes. And, you know, you're making me think that, like how our identity has to come from more than one place. And I feel like what I'm seeing now in this generation compared to, like, the way maybe like we were raised. Of course, it depends on the family. And every family has different amount of emphasis. But like, you know, traditionally, you know, the growing up in the, I don't know, 70s, 80s and 90s, it was like go, go be, go, child, go play. Right. And then the parents get involved on a need to know basis. Right. And so we are way more involved in, in our children's lives, social, emotional, academic than any other generation ever has been.

Dr. Sue Varma (00:38:48) - Ever. Oh my God.

*Dr. Sarah Milken * (00:38:49) - Like my mom, both my parents worked full time. Like my mom didn't know what grade I got on my math test at 130 in the afternoon, and I was telling Lisa D'Amore like when I did my podcast with her and she's the teenage expert, I was like, I didn't I didn't have a phone. Like, I didn't text my mom. What happened five minutes ago? Like she would get home from work at 530 or 6 and like, maybe I remember to mention it, maybe I didn't. But now we're all seeking that, like instant response. Why? My kids are like, why didn't you text me back? I'm like, you need to chill. Yes. Like yes. Not everything is instant.

Dr. Sue Varma (00:39:29) - Totally. No. And that's such a great point because whether it's instant gratification and like not having the the ability to deal with rejection is what you're saying. And then be not dealing with an instant response and like that's going to be a problem. And like and here's the problem is because you're that's fine to expect it from your app.

Dr. Sue Varma (00:39:49) - Right. Like we are no longer living in the dial up internet days where like, it can take five minutes to get to load a website 100%. But that same kind of lack of frustration tolerance and lack of ability to have delayed gratification that is going to cause problems. And if you were to ask me, when we look at mental health problems and young people, it has to do with delayed gratification, right? Like and also where's your sense of meaning and identity coming from? And if, if, if college and I understand the pressure and all parents want their kids to succeed, and I feel like we are putting in an inordinate amount of pressure because we as parents, our entire meaning and our entire world and our lives are focused around our children, their happiness and their success. And I feel like that's too tall of an order for us. It's too tall of an order for them. And also that equating happiness and success. We're also, I feel like is a fallacy because they're not related.

Dr. Sue Varma (00:40:45) - Right. And one of, you know, some of the books that I love talk about this idea of happiness, meaning let's say mental health has to come first, success comes as a result. And I think all too often we're pushing our kids that like, if you get into a good college, therefore you will then be successful and therefore you will then be happy. And it's like, let's.

*Dr. Sarah Milken * (00:41:04) - Back up that book. I'm now I'm of course I have midlife brain. I can't remember what it was called, where the author was talking about all these kids who were, like, dying to get into Yale. Yes, yes. Then they get to Yale and they're like, I hate this. Yes. Why did I do all that?

Dr. Sue Varma (00:41:19) - Yes, I think I know, like Shawn Achor has talked about like the and the happiness advantage. And I want to say that there was a study, if I'm not mistaken, and they talk about kids at Harvard and they're like over the course of like those four years they only had.

Dr. Sue Varma (00:41:32) - And this is, you know, the book is several years now, right? So don't quote me on the study, but how over the course of four years, they might have had like one serious relationship, you know, like romantic relationship. And they're like, you know, we want people to be out there and have lives and make mistakes and interact, like, your whole world cannot be about achieving success. And so in my practice, I'll often see young adults like, you know, whether it's like high school into college, college into first job, first job, you know, and onwards. And they have never paid attention to their mental health. They have never paid attention. So like things worked out because they were brilliant until it didn't. And then it's like you're hitting a wall, like your whole life. You've done well in school, you've done well in sports. Let's say you're also likeable. The world has pushed you along and you keep getting more and more forward until, like that first job, let's say, out of college, where either you didn't get the job you wanted or you got the job, you wanted it, and then the boss isn't giving you the promotion or the salary like they're they're factors and circumstances outside of you.

Dr. Sue Varma (00:42:31) - And it's kind of like what you're. Saying like, don't take it personally, but it's hard if you've always been successful, if you've always gotten things have always worked out your way, it can be a very rude awakening, I think.

*Dr. Sarah Milken * (00:42:40) - Yeah, that's what's happening. I think in the college acceptance scene right now, as these kids are used to like getting good grades and getting good scores and getting things how they want them, and then the admissions come and they're like, wait, what? I don't this doesn't make sense to me. And then you feel badly for the kid. You feel badly for the parent. And it's like, oh my God, what's happened here? But related to that, I like the story you tell in your book. I can't remember what the patient's name was, but it was a man and he was talking about how he had been going on in his life. He was married, he had a job, whatever. Everything seemed fine until it wasn't. And it kind of reminds me of that.

*Dr. Sarah Milken * (00:43:18) - It's like you plunk along, you get to midlife, and now you're like, I'm kind of dissatisfied. Now I'm kind of being snippy with my kids. My wife is annoying me, and the woman at work is flirting with me, and that seems really fun. And your response, I'm sure over more than one session was like, hey, you can blame all these other things, but like, where's your ownership in this? And I think the ownership and self responsibility and self agency piece is so key in the midlife journey. And I and I want you to talk about that because I feel like so many of us, including myself, like we're waiting to be rescued. We want the magic pill. We want the like knight in shining armor to come down and be like, Sarah, I have this great career for you right now and it's in a box ready to go.

Dr. Sue Varma (00:44:09) - Yes, yes. Look, I 100% respect and can appreciate that wanting to be rescued because I think we're exhausted. Right? Like, if we're talking to women, you know, even men.

Dr. Sue Varma (00:44:21) - Right. But we've had to do a lot for ourselves. Like assuming that, like, you didn't born with the silver spoon in your mouth and you're, you know, you didn't have 17 people come and wipe your butt. I'm thinking about, like, the movie The Little Emperor, you know.

*Dr. Sarah Milken * (00:44:33) - Like you didn't have.

Dr. Sue Varma (00:44:34) - Like, you know, the whole staff coming after you and picking up your clothes, like, five times a day. You know, you're tired, you know, we're exhausted. Like, and especially when you add in the, the midlife piece, right, of the hormonal changes or you're emotionally exhausted of caring for everybody else carrying the mental load. Yeah.

*Dr. Sarah Milken * (00:44:49) - Aging tickets.

Dr. Sue Varma (00:44:51) - Yes, yes. The sandwich generation of like, you know and I and I know exactly what that's like. So I don't blame anyone who wishes and wants to just kick back, relax and be taken care of. Like feed me the grapes, fan me like, bring it on. Right. So maybe you know, and find out what's your version of that that doesn't cross the line right in your marriage if that.

Dr. Sue Varma (00:45:11) - Assuming you want to stay married, right? Or whatever that rescue fantasy is, right? How can you like it could be a women's trip. Like there's all these articles being written. I want to say maybe Wall Street Journal about women going like 50, 40, 50, 60, 70, going on girls trips. And a lot of times I'm seeing women are like very much fulfilled in each other's company and nourished in a way, sort of emotionally that like maybe they wish that they got from their partners. Right. But like, often, maybe not. That's a that's okay to have.

*Dr. Sarah Milken * (00:45:39) - To, because not one person can fulfill all of our needs. And I think that that's a really important point, because, you know, what your husband brings to you is different than what your three girlfriends and a trip to Cabo is bringing to you. Yes. And our job is to find all those little pieces to fit together, to cultivate what we define as a meaningful life. Yes. Everybody's definition definition is going to be different.

Dr. Sue Varma (00:46:10) - Yes, totally. And you know, this this week actually,, you know, I don't know if you follow Esther Perel, but like, you know, I love her work. Yeah. And she was kind enough to mention in the, in her newsletter that she's reading practical optimism. And it's like a conversation starter and people should get it. And I love her work. And what I love is that she always talks about how, you know, there's so much pressure on our relationships these days that we want that one person to be everything our savior. You know, when it used to take a village and a tribe that we would get our emotional intellectual needs met from, now it's all one person. And I think of that in terms of the pressure on the nuclear family. Right. Like there are no extended family members, cousins. We're not we're not living in the same small hometown that we grew up. We're all seeking opportunities bigger, better, maybe urban, you know, there's some stat that like by 2050, I don't know, 60 plus percent of the population, it's all going to be in urban areas.

Dr. Sue Varma (00:47:04) - Right? So you have these densely populated areas where, you know, people are coming for betterment, socioeconomic education, whatever it might be. But we're leaving behind small town values, small town friendships, being there for one another, like, okay, what do you need? You moved. I'm going to bring you food. Somebody passed away. I'm bringing you food. What? You know, like, am I thinking is the only love language? Yes, but caring for one another. So I think the reality and the disappointment and a lot of times you're seeing a lot of divorce. Midlife. And that can be a lot of it's a very interesting transition. You know, I remember. I remember like whether it's divorce or recognizing gaps in your marriage, like, you know, I remember I don't know if it was Oprah that had said, like the wisdom of menopause of how like there's an awakening where women experience,, like finding who you are and recognizing, like, do I even want to be married to this person anymore? And that's an interesting transition when when you do become an empty nester, a lot of times people are like, yeah, like our kids were the only glue that kept it together and they're not in the picture.

Dr. Sue Varma (00:48:02) - Do we really even want to stay married anymore? So all sorts of things happen, you know, people being.

*Dr. Sarah Milken * (00:48:07) - So much longer, like, my husband and I were laughing the other day, like, we're going to be 50 when we're empty nesters. And so we have so much more life ahead of us because people are living longer. It's like we have our whole next chapter. And so if you don't like your spouse, like, this is the time to kind of like dig in and figure things out. Like, I'll be honest, my husband and I laugh like he's a hobbyist. I'm not. I feel like I'm going to have like, dementia and being an old age home, and he's going to be like on the golf course with some, like, hottie, you know, whatever,, riding around in a golf cart because he is constantly, like, immersed in his hobbies. And we don't have any common hobbies, like our common hobby is like walking the dog, walking, watching a TV show.

*Dr. Sarah Milken * (00:48:59) - But like, he plays the piano, I don't he plays golf, I don't, so I'm like, we got to think of something where we can meet halfway and I don't cook and neither does he. So we've started this thing and where I think we've made 2 or 3 meals together. Are they like the most amazing thing? Would I serve them to you? No, but it's like a nice little joint thing where it's like, I love it. Wait, do you know how to chop an onion? No, wait. Do you do you have to take the skin off? I don't know if you have to take the skin off. And then we're, like, googling it like that's how basic it is. Yes, yes.

Dr. Sue Varma (00:49:33) - No. But that's so that is so endearing to me. And I think it's so sweet that even if it didn't work out, what I love about that is just your intention of like prioritizing your relationship and saying, we need to invest in it and let's find something, right? Because most people never even get to that point of number one saying, I see you, I like you.

Dr. Sue Varma (00:49:53) - I remember like only in the last couple of years, like my husband and I were in a place where we could take trips, like together, right? Without the kids. Right? They're a little bit, like, able to function by themselves. Grandparents are in the picture. They were in school so we could take like an extended weekend. And it was so powerful. And I remember when my husband would get back from these trips, and they're not often, but they were very meaningful. But when he would get back, his coworkers would say to him, you went alone with your wife, just the two of you.

*Dr. Sarah Milken * (00:50:20) - Like you didn't bring girlfriends with you?

Dr. Sue Varma (00:50:22) - Yeah, yeah. He's like, they were like, you must. Actually, you and your wife must actually like each other. Like, it was bizarre because I want to say half or more of his coworkers had already been divorced or were going through it. And it was a foreign concept that, like, you wouldn't come with the entourage or some, or you're going someplace where you were asking for, yes, a buffer, totally.

Dr. Sue Varma (00:50:43) - And children out of their buffer, alcohol going to all inclusive resorts where you're just drinking yourself into alcohol, into oblivion, like anything, the escapism to not have to confront the reality of you are not happy with where you are in life, where you are with this person in life. So and that's another thing, is that like, like you said, about taking agency and taking responsibility, that's really what practical optimism is about. It's about recognizing, okay, waking up one day and taking ownership of the fact that maybe you're not where you wanted to be right now, and that's 100% okay. It is okay to.

*Dr. Sarah Milken * (00:51:16) - Have extra pounds. You might have whatever. It's so many different manifestations of it.

Dr. Sue Varma (00:51:23) - Yes. And that a big part of it is self-compassion is recognizing it's okay. Don't beat yourself up. Like, imagine if you had a small child, whether it's yours or somebody else's child that you're close to or that you love. And they were like, oh my God, I spilled the whole cereal, right? You look at the cereal on the floor and you're like, oh my God, that is a disaster.

Dr. Sue Varma (00:51:41) - But imagine them crumbling under the weight of it like I'm a horrible person and starting to beat themselves up. Literally, like self-flagellation, you would immediately get over the anger of the cereal being spilled and you'd be like, listen, listen, this is this is on a 1 to 10. This is not a great this is not a really serious issue. We'll figure it out. Come here. And you'd hug them and you'd soothe them, and then you'd work on the problem solving of the cereal, cleaning it up. So think about the next time you wake up and you're like, oh my God, how did I end up here? Do that for yourself, right? I like that, that inner child and say, it's fine. It's okay. You're not a horrible person. And then what? And then we see studies show in self-compassion that once you don't engage in shame and blame, and you're able to recognize and be mindful and be like, you know what? Everyone goes through something like this.

Dr. Sue Varma (00:52:26) - Everyone spills cereal in their life. Like, what are we going to do? How are we going to clean it up? And that's what self. Compassion does is it shuts down shame and blame and it gives you a road to recovery. It gives you a road to to be able to clean up whatever the mess is.

*Dr. Sarah Milken * (00:52:40) - I love that, and then what I do is I'm like, my husband's out, the dog vomits and I text him and I'm like, the dog vomited, I went upstairs, the dog is in your domain. I already did kid vomit. And he just laughs. And then I send the barf emoji where the guy's throwing up, and then he comes home and like, whatever cleans it up. But it's like a partnership. It's like, you got to, like, bend on certain things, meet people halfway. You know, it's just. Yes, but it's not always perfect.

Dr. Sue Varma (00:53:09) - Yes. But you know, the I love the hobbyist thing and I would say, like, I love that you're doing this podcast and like, you know, expressing your own creative interests and, you know, like things that are and causes that are, that you're passionate about and meaningful and like that's all key because when you look at optimism, these folks live longer.

Dr. Sue Varma (00:53:25) - They live to like 80 or 90 because and not just longer years, but longer year spent in good health. Because what good is longer years if it's spent debilitated? Yeah, yeah, yeah.

*Dr. Sarah Milken * (00:53:35) - And there's a I'm sure you know Brodsky and she's been on my podcast twice and she talks about like, being interested and interesting. Yes. You know, you don't have to be a New York Times bestseller to be interesting. But like when you sit down at a dinner table and the person sits down next to you like you don't want them, especially if you're a stay at home mom. Like the worst question to be asked because I've been there is so what do you do? And I'm like, okay, can you not ask me that? What am I supposed to say? Like, I'm a mom, I'm an alumna. I hate that question. But like, even if some you're just talking about things and you're like, oh, I just took up golf or I just took up mahjong or whatever, it's like, you have something to talk about.

*Dr. Sarah Milken * (00:54:18) - You're doing yoga. You just, oh, I just started meditation. I'm the worst meditator, but I'm working on it. It kind of gives you something to bring to the table.

Dr. Sue Varma (00:54:28) - Totally. Totally. Yeah. And at the same time, I would say, like, you know, own your life choices. Like, you don't have to explain yourself to anyone. They don't have to get like, if this if being,, a mom is fulfilling and that's where you derive meaning and pleasure and and sometimes maybe not, maybe sometimes you're like, this is really effing hard and no one's patting me on the back. Like to be able to own that, to be able to own all of it. But again, you don't have to answer to anybody. Right? So I feel like a lot of times people feel that pressure of like, I'm not interesting. And it's like, okay, I love what you said, Sarah. Like if you feel that way, then take up something so that you are so, you know, but really.

*Dr. Sarah Milken * (00:55:03) - Do say even if it's like an activity or a hobby, like my husband's not talking about his career, like he's talking about, like his golf swing. And he found this like this teacher that's 45 minutes away. And now he watches this weird guy on YouTube and I'm like, oh my God, you sound like you have, like, some kind of obsession or something. Yeah. But yeah, you know, you you pick the topic for the audience.

Dr. Sue Varma (00:55:28) - Yeah, yeah.

*Dr. Sarah Milken * (00:55:29) - You know, and it's but.

Dr. Sue Varma (00:55:31) - But the most important audience is you, right. So like the fact that he's, he's doing this for himself, like it brings him meaning and joy and then. Yeah, if anyone else gets pleasure from listening about it, great.

*Dr. Sarah Milken * (00:55:40) - But like I don't but yes.

Dr. Sue Varma (00:55:43) - But somebody else.

*Dr. Sarah Milken * (00:55:45) - I know, I'm like, oh my God., okay, wait. So wait, let's get back. So I do love the piece about doing things because they feel good to you. So how do we is there like a specific tool, like how do we ignore the social comparison or like how do we ignore like, oh my God, I want to write a book.

*Dr. Sarah Milken * (00:56:08) - And Sue wrote a book, and she's been on this crazy podcast tour and she's going to make the best seller list. And I'm random, like, how do you get around that?? Your inner vision?

Dr. Sue Varma (00:56:21) - Yes, yes. And just say, you know what? So I always say, like FOMO, fear of missing out is often an opportunity for yourself to figure out. Do I actually want to scratch that itch? Right. So if the itch is anything, fill in the blank. Writing a book, doing a crazy podcast, or being on a cool podcast like your podcast, for example, traveling, like whatever it is that you're seeing everyone live this life a recognize that, get the full story. That's the first thing I would say, right, is to ask that person, tell me the not so glamorous moments of your life, right? So like if somebody asked me, I would be like, oh, how long do you have to hear about the not so glamorous, oh my.

*Dr. Sarah Milken * (00:57:01) - God, me? I'm like, do you want to talk about the midlife vagina? Let's talk about that. You know, and my kids are mortified. My husband's mortified. But I think it's that's part of this podcast and platform is there has to be like a relatability factor. Like, yes, he's not perfect. She fucking hates working out. She doesn't want to ruin her hair, her blow dry. She wears makeup, she doesn't want to redo her makeup. So she has to figure out how to work out to not sweat. And it's like real people. Real shit. Yes. Real life.

Dr. Sue Varma (00:57:33) - And I love I love that because, like, it's very practical. Like, if you, you know, if you've mastered that art, like tell me please. Because like, I want to know. And at the same time I say, you know, look at the FOMO and if you're feeling it, ask yourself, like, all right. Like when you look at that, like for me, for example, when I look at that perfect, let's say six pack app, I'm like, yeah, but I don't I know what went into that.

Dr. Sue Varma (00:57:52) - Right? And like, I respect that person for doing it. But I don't know if that's for me. And like commitment. And I could say the same thing. Like if somebody is like I wanted to do what you do, I'm like, okay, but you know, what it involves is years of sacrifice, being in a dark hole and a cave and spending hundreds of hours a week doing research, not having a life like you show up just for the, you know, moments of doing this and this, but that. There were a lot of sacrifices made and like the other the other person like anytime we want to embark on a journey, do the due diligence, do the homework and the research to say this is how that person got from point A to point Z. I love the finished product, but I have no interest in doing A, B, C until Z, and then a lot of times that helps quiet that voice of I want to be on this journey simply because this other person has made it because you don't know what they've had to give up.

Dr. Sue Varma (00:58:41) - And here's the problem. No one wants to admit that they were sweating. You know, a lot of times people will say, oh, it was easy peasy and effortless. Like the effortless look, the effortless glam, the no makeup makeup look. It's like, no, bro, tell them what you went through, right. And and and then let the people decide if that's what they want, right? Because that's what they have to do. These are the sacrifices and the challenges. So I feel like it's never meant to not inspire someone, because if someone came to me and said, I want to write a book, I really want to do it. I understand there's a lot involved. That's a different question. You know, lead me, guide me to the logistical steps that are involved because I'm ready for it. But, you know, I think it's I talk about this under the pillar of proficiency that like there's four ways. And Albert Bandura, the researcher, talks about like learning.

Dr. Sue Varma (00:59:27) - How do we learn, how do we develop self-efficacy. We do this from the best one is doing things ourselves. Another one is by role models, vicarious learning,, getting feedback. So I feel like doing your homework to be like, what do I want? What was involved? What will be entailed? What do I have to give up? Am I willing to make those sacrifices? But at the end of the day, if your FOMO is telling you this is something you need to do, that it's creating. FOMO creates anxiety. It creates irritability. It creates a feeling of like longing and wanting and wishing. Ask yourself if I really do want it. That's maybe why I'm feeling this way. And then what are the steps so I can get it. If I see people traveling as I see people having fun with their friends, why am I craving that? You know, and there's nothing wrong in craving mastery and career success. More friendships, more love, right? Like more travel.

*Dr. Sarah Milken * (01:00:17) - Saying like the things that you have a little bit of envy on are sometimes the things that you want and use that as inspiration rather than a trigger.

Dr. Sue Varma (01:00:27) - Yes, exactly. And then if it is a trigger, recognize it. And you know what? What can be helpful is to be like, yeah, I want that, but I don't have what it takes. Or maybe I don't want to do it right now and then shut it off right then just be like, listen, this is where it maxes out. There's going to be a tipping point when it's the inspiration, then turns to sort of criticism.

*Dr. Sarah Milken * (01:00:45) - Yeah, like I want to pack, but I'm not willing to give up all sugar. I'm not willing to not eat carbs. It's like, what's your good enough? And like, what are you willing what stakes are you willing to put? Yes, yes. And everyone's so different.

Dr. Sue Varma (01:01:01) - Yes, yes. And recognizing that like, you know what, I love what they've done and I'm happy for them. And maybe it comes easier to them. Maybe it's what drives them. Maybe it's what they need. Right? And it's like, what?

*Dr. Sarah Milken * (01:01:12) - What do you want to do when you like? Not every day, but most days, like you wake up.

*Dr. Sarah Milken * (01:01:18) - And you love your job like you get purpose out of that. You get meaning out of that. Like you look forward to it. It doesn't mean every day is a walk in the park. But if every day you dreaded that, you wouldn't do it.

Dr. Sue Varma (01:01:32) - No, no, exactly. And I want people to listen to that signal, because I think a lot of times we try to quiet it because society wants us to do something. It's kind of like, think of your parents or like a, like a like society, because I know that this was something I grew up with. Like, not for me personally, but friends of mine. Where their parents had drilled it into their head. You need to have this kind of partner with this kind of income, with this kind of socioeconomic family background, like all of these checklist criteria. And your heart knows that's not what you want. You know, whether it's a partner or a job. And you just try to suppress it. And then you go along with what other people tell you, and then you're miserable and you're unhappy.

Dr. Sue Varma (01:02:08) - Right? So we never want that to happen where you follow a course, a trajectory in your life, whether it's relationship or career, because it it seems sexy or glamorous or cool when inside you're like, this is not for me and so many people. I hate to say this, and I don't mean this in a bad way. They live a life of a lie because they're not authentic and true to what they really want, because what they want is in opposition to what society wants for them. So I feel like that's to me, the most unfortunate of circumstances. But it's okay because some people will live that way their entire life. They'll never know it. Other people will confronted midlife and they'll say like, oh my God, I've been living this way with this person or with this identity, and I'm ready to shed it so all things are possible.

*Dr. Sarah Milken * (01:02:54) - And what I love about this midlife point, even though it's so fucking hard sometimes, and sometimes I'm like, oh my God, this everything about this feels hard.

*Dr. Sarah Milken * (01:03:03) - Like I said, because we're living so much longer. We have so much agency to make those changes. Like if you see your parents at 80 years old, like not being able to get in and out of the car and like their doctor's appointments three times a week, you're like, okay, I can do X, Y, and Z and probably prevent that, but am I willing to do it? Am I willing to get up every day and walk my ass on the treadmill? Yes. And that's your decision to make?

Dr. Sue Varma (01:03:32) - Yes, yes, I'm willing. And I love that because I was just thinking about that before talking to you, where I was like, you know, when I think so much because, like, we're on social media, we see it, we consume other people's social media. We're like, we're on both sides of it, right? Like giving advice and being helpful and at the same time being being consumers of it and also looking at people and being like, so-and-so is doing this, this and this, you know, on social media or with their social media, whether it's like reals or like being funny or like all sorts of things.

Dr. Sue Varma (01:03:58) - Right? And then the question is, am I willing and am I able, right? And am I genuinely interested? Like, yeah, like for.

*Dr. Sarah Milken * (01:04:05) - Me, reals make me crazy. I'm like, I'm not fucking dancing. I'm not live thinking I'm so bad at all of that stuff. I'm not doing that. Yes. And like I draw lines in the sand of like what I'm willing to do and what I'm not. And there's some things that you're not willing to do because you think they're too hard. Yes. And that's different. This is more just like, I really don't like singing and dancing and that's part of my platform. So we're just going to let that one be. But she's really good at that, so I'm going to let her do that in her space.

Dr. Sue Varma (01:04:37) - Yes, I love that. I love it like to be able to be very clear about what goes into your joy bucket and then what goes into your drudgery drawer, and then to be okay. And I think what most people, when they're experiencing unhappiness is they're not ready.

Dr. Sue Varma (01:04:49) - Like, imagine like like, you know, how like I was thinking of Marie Kondo and she's like, does it spark joy? And if it doesn't get rid of it? Right. So these things that we want, these societal expectations, hold them in your hand and ask yourself, are you struggling with whether to do it or not? And does it really belong in the drudgery drawer? And is it okay to say, I am not somebody who wants to sing and dance to entertain people, right? Like I think of myself as an educator. I like to inform people, but I get it. Entertainment is where it's at, and if one day I feel called, if I have the space suddenly to be more entertaining, whether it's singing or dancing or just being funny, because I know there are a lot of great, engaging mental health videos that people love consuming because they're informative, but they're hands down entertaining. If I feel called and motivated and the stars align, great, but for now, it's going into the drudgery.

*Dr. Sarah Milken * (01:05:36) - Totally, totally.

Dr. Sue Varma (01:05:38) - I can't do it. It's it's not. I'm not called to do it right now, but I'm not saying never. Maybe one day, maybe one day.

*Dr. Sarah Milken * (01:05:43) - Nothing is never. And I feel like that's part of the beauty of midlife is you've gotten to this point in your life where you've checked a lot of boxes, you've done a lot of shit you didn't want to do, but you had to do it right. And you've done all these sort of performance. Performance check Mark. You know, check, check, check. And now you get to a point in your life where you've kind of like, earned the right to sort of do whatever the fuck you want.

Dr. Sue Varma (01:06:06) - Yes, I love that. That should be the title of this podcast. You have earned the right to do whatever.

*Dr. Sarah Milken * (01:06:12) - Like, yeah, it's like midlife self obsession is approved and it's not narcissism. It's like, yes, the season of doing fucking me. That's it. Absolutely.

Dr. Sue Varma (01:06:22) - Yes. And it could be something new that you're learning.

Dr. Sue Varma (01:06:25) - It could be something that you've had to put on the back burner. It's inventing or reinventing. But I would just say, like, whatever it is, be true to yourself. Like at the end of the day, who are you doing this for? What are you hoping to get out of it? And people won't? I think there's something so embedded in human nature that part of us wants. Like often I'll see people taking on tasks or meanings or identity. Or homes or clothing or whatever, because they think it's going to inspire envy in someone else and their goal, even though they would never admit it. The goal is if somebody else doesn't want what I have, does what I have even hold meaning? You know? And it's not until you envy my outfit, my anything fill in the blank it it means nothing. And I would say, f that thinking. That is dangerous thinking. Say to yourself, I'm going to dress or whatever. Look, I mean, I know a lot of people say I'm doing it for me, but really do it for you.

Dr. Sue Varma (01:07:22) - Like if it's not in.

*Dr. Sarah Milken * (01:07:23) - Fashion, this if no one was watching an Instagram, you weren't filming an Instagram reel or, you know, all of those things like, is this really who you are? And I think for me, with Instagram and my podcast. The Instagram resonates and the podcast resonates because it's just me, unfiltered. Like I'm not trying to be that podcaster. I'm not trying to be that person. Like I'm like, okay, you either like my style and you're here for it. You want to be part of the irreverent fuck, fuck, fuck, or you want something that's like, more straightforward and more pristine and more perfectly curated, like, then I'm not your person. And that's cool. Yes. And that's the beauty of midlife and right now, and all of our options that are out there is we can choose whatever we want.

Dr. Sue Varma (01:08:15) - Yes, yes, 100%.

*Dr. Sarah Milken * (01:08:18) - You know, and I just feel like I just want midlife women to be like, okay, this is my season.

*Dr. Sarah Milken * (01:08:24) - I can do this. Not every day feels like a million bucks, but I can do this. And I feel like that's what you're saying with practical optimism. Also, it's like, hey, you guys, there are some shitty days. There's some shitty feelings, some bad things happen, and we can also have joy. And we can also have light.

Dr. Sue Varma (01:08:44) - Yes. And I love that. Like I think in so many ways, midlife is a beautiful time to reassess, to reevaluate, and also to create because you have this long runway ahead of you and you have a ton of wisdom and life experience behind you. And so how great and unique position we're in where we get to learn from the past and take chances in the future.

*Dr. Sarah Milken * (01:09:07) - Yeah. And I do like the idea that you talk about when you say in one year from now, five years from now, ten years from now, from now, what does my well-lived life look like? Like, do I want to be in Florida playing golf and working out every day and being in the sun? Or do I want to be in New York City, like going to museums and cool restaurants and like, running with, like, you know, pretty fast, like those are very different lives.

Dr. Sue Varma (01:09:34) - Yes, yes. Yes. And then to be very concrete and practical, optimism teaches you that whatever path you want because like when you're saying that I'm like, both sound wonderful, right? Like it's a way to do to to to have both.

*Dr. Sarah Milken * (01:09:46) - Oh, totally. My husband and I are like trying to plan that. We're like, okay, empty nest. How are we going to do like our need to be near the beach and the sun and like still wanting to, like, be in a hustle and bustle? Yes.

Dr. Sue Varma (01:09:59) - Yes, exactly. And so, you know, then it works. And it's about like, let's say working backwards, where then you're like, okay, this is where my goal is. And to give yourself grace with time, because a lot of times people wish that they had all of that, like yesterday. And then again they start beating themselves up like, I don't have the economic security, I don't have this. And so rather than getting angry at yourself or envious of other people and their position in life to say, all right, I'm looking at this friend, they have it all figured out.

Dr. Sue Varma (01:10:25) - They seem to have this life that they're able to to have both a cosmopolitan lifestyle and also be by the beach. So what does that look like for me? Right. So maybe I'm not buying the 17 bedroom chalice oceanfront retirement home. Okay. But for me, you know, a Peter, like, maybe a studio apartment by the beach or not even by the beach. Maybe it's two miles. Maybe it's five miles. So, like, work within your own real, reasonable, realistic time frame, budget, all of that that you still afford yourself. And maybe it's not even ever owning the home by the beach. Maybe it's like I do a timeshare, I do an Airbnb.

*Dr. Sarah Milken * (01:10:58) - I feel like there was always that, like that famous research study where they talk about people's happiness and meaning in life and like, they took people who, you know, remodeled their kitchen and they compared it to people who bought homes or condos near a hiking trail. And they found, you know, as you would expect, that the people who bought the homes near the hiking trail ended up happier, because that was the gift that kept on giving, or the newness and the novelty of the new kitchen kind of wore off.

Dr. Sue Varma (01:11:27) - ,.

*Dr. Sarah Milken * (01:11:28) - And it's a little of figuring that out for yourself. Like what's your hiking trail.

Dr. Sue Varma (01:11:33) - Yes, I love that, I love that, but I think the essence is just knowing that, you know, to me practical optimism, it's a philosophy. It's a lifestyle. You know, it's it's a it's a mission. It's a movement that you keep coming back to that you're like, I got this. Like, I've got this figured out. I've got, you know, whether you use it to like, have a friend group, like a reading, like an accountability partner, whether it's one person, whether it's your book club that's like, okay, we're going to take this on, but how are we going to hold each other accountable and like working through these pillars, you know, because each one of them is so different. After you have purpose, you then want to learn how to process your emotions. Then you want to problem solve. You want to develop a sense of pride. And we got into some of the self-compassion.

Dr. Sue Varma (01:12:13) - You then want to develop a sense of proficiency like this I can do, I am capable and how do you do that? Right? The steps of getting feedback and getting role models and mentors. And then how do you stay present in the digital age? How do you cultivate a people practice? You know, we talked about the meaningful engagement part of the forms. Then there's, you know, the other part of the forums where you get meaningful engagement, mastery movement and mindfulness. The last one is practicing healthy habits. And practical optimism is a habit onto onto itself. But it's also the habit that begets all habits, because you could literally take anything you want in life. And I could run it through this eight pillars and I could be like, if you want financial freedom, whatever you want, you run it through the same eight steps. So the eight steps are kind of your guide. Like what would what would I do if I want to be very intentional? And how do you turn your purpose sort of like purpose into passion and then passion into purpose because they really, you know, by directionally feed each other.

Dr. Sue Varma (01:13:12) - You need to sometimes you need to have very just a clear cut, rational set of steps. And that begets passion. You know, it's kind of like you're passionate about someone in the beginning, let's say, in a relationship. Right? But that's not necessarily meant for the long haul. And that's okay too, right? A passion doesn't always turn into a purpose, right? Like you can play around, take on identity. So like, I'm going to be I'm going to try the yoga class. I try that, you know, a lot of times people are like, I want to be like a yoga instructor. Halfway through, they give it up. That's okay. To write. It's okay. So I say pause. Don't stop. If you're on a mission of learning and self-discovery and journey, sometimes you're exhausted by all the learning. You're like, I don't want to learn anymore. I just want to be. That's cool too.

*Dr. Sarah Milken * (01:13:50) - Yeah, no, I love that because I think, like, we should all be able to say when someone's like, what do you do? Like to be able to say, I'm the self expander or whatever that, you know, whatever that is, it can be so many things.

*Dr. Sarah Milken * (01:14:03) - And like, you know, I don't take the summer off for my podcast in the last three years, but like, I recorded a couple extra episodes because I'm going on a two week college tour with my daughter, and I don't want to be stressed about that. So I'm like, it's like a plan. It's like self-advocacy and a plan of like, I don't want to feel this, so I'm going to do this. I'm going to put the extra time. And now and I love the way you talk about in your book, because it's also the way I try to parent too, in terms of like, self-advocacy, like you were talking about how you were in. College and an organic chemistry class. And the teacher was kind of an asshole. And like, he wanted to fail everyone. And you and two women got together and we're like, okay, this doesn't work for us, and we're going to change it. Or talking to your neighbor and saying like, hey, like my neighbor has five barking dogs.

*Dr. Sarah Milken * (01:14:54) - I've listened to them, for I've only lived in this house for three years. I've listened to them for two years, starting at 630 in the morning. Okay. And then I woke up like a year ago and I was like, you know what? I'm kind of fucking done with the neighbor's barking dogs. Like, I'm really done with that. So I went over there and my husband was like, what are you doing? And I was like, oh, I, I'm done. So I was super nice, but I self-advocate and the dogs no longer bark. Because. But it took me twice. It took me going over there and probably 20 texts over a course of four months to say like, hey guys, I'm happy you have five dogs and I'm glad you enjoy them. But I did not move to this house to be awakened by your dogs. And every night and all day while I'm trying to record a podcast managing my nervous system that's listening to your dogs. But not everyone is willing to, like, jump in the arena and stand up for themselves.

*Dr. Sarah Milken * (01:15:56) - And I feel like I hope that I feel like I got that from my mom of like, you don't like this, let's fix it. And it's not about being bratty or high maintenance. It's about making something work for you so that it feels good.

Dr. Sue Varma (01:16:12) - Yes, and the way you handle it is also in a very respect. I mean, I don't know, you'll have to tell me how. What what finally did it? Can I ask you what finally did it? Were they like.

*Dr. Sarah Milken * (01:16:21) - I just I, you know, it was like I first went over there, they apologize, sent a gift, whatever. And then it was, like, quiet for like a week. And then I kind of came back a little bit, and then I texted it again, and then I said, you know, I'm recording this thing in my backyard and filming all day, like, I really can't have any of the barking. And they accommodated that. And then they started. There were a few texts where they were a little upset that I was texting them, and then I just said, if you are an upstanding person in a neighborhood that we live in, no one else is willing to say something except for me.

*Dr. Sarah Milken * (01:17:01) - But I'm telling you, it does not make people feel good because other neighbors are talking about it, but nobody wants to say anything. And so they built a fence. They think that the fence, I guess, is going to help with the dog smelling my dog or whatever, and that's fine. They basically knocked all of our trees over and didn't take responsibility for it. But that's my husband's job. I'm like, I'm not. I'm like, I'm not dealing with that too. So he so we like divide and conquer. Now he's dealing with the landscaper and the neighbor and the contractor and that whole thing. But it's just about when something doesn't work. Yes. And you're 49 years old. It's like, I didn't sign up for this shit.

Dr. Sue Varma (01:17:40) - Totally, totally. And that's the beauty, I think, in midlife is that you finally feel ready to ask for things.

*Dr. Sarah Milken * (01:17:46) - Yeah. And I hope that more women and more girls and teenagers like, find that inner strength like you talked about in College of like, hey, you're teaching this course for people to fail, and it doesn't need to be this way.

Dr. Sue Varma (01:18:03) - It doesn't. And, you know, and it's so interesting to me because whatever it is, like fill in the blank with whatever your own, you know, version of that is that it's like the beauty is it, you know, organic chemistry like, is always been seen as it's very intimidating. It's going to weed people out. And it was so sad that so many people who were meant to be doctors and could have been if it wasn't this one huge stumbling block and it was like, is this system regular? Do you really you just like, is this a like barrier that you're putting in the way on purpose? Because then when I learned it and, you know, we were the first three people to get A's in this class in 30 years. And this professor was like, women don't understand. They don't have this visual spatial reasoning. And I was like, this is such a beautiful like it was. So, you know, kind of like what we're talking about. It's such a beautiful, rational science in the sense that you they gave you all these like, little, like reagents, like these components, like puzzle pieces.

Dr. Sue Varma (01:18:53) - And then they're like, this is what the finished product should look like. And you have to work both forward and backwards to create it. And then they want to see all the steps. And so it's interesting because for me, once I learned it, I was like, life is like this, you know? And like when I work with patients in therapy, I think about the end in mind. I think about the end goal, the product, the finished product. What do I want that to look like, whether it's an organic, organic chemistry problem. And I ended up tutoring for many years. How what do I want the finished product to look like in this case? Like now as a psychiatrist, my life or my patient's life? These are the beginning pieces that I've been given in life. This is the hand I've been dealt. And then how do I go forward and continue to construct work towards the finished product? And at times I don't know. And I don't know what the middle is going to look like, but then I'm going to work backwards and sort of you're joining this chain of events from both ends going forward and then working backwards with the end in mind.

Dr. Sue Varma (01:19:48) - And so it kind of became a metaphor. You know, in many ways, I.

*Dr. Sarah Milken * (01:19:52) - Also feel like a lot of people are like, don't reverse engineer your life. That's so controlling and you're trying to control over everything, but you almost have to. And it doesn't mean that you're deciding every step along the way backwards, but you have to figure out like kind of what your end goal is and like, what are the steps that's going to take to get you there?

Dr. Sue Varma (01:20:14) - Yes. And you know, Sarah, something you said, I think this is really important for like, let's say moms, we're listening right now or people who are raising young people, like if you're raising a teenager, a teenage girl, for example, like one of the things if I were to give in sort of like wisdom of like someone who's lived and you were talking, we were talking about relationships and our partners, that one of the best things like is having a very supportive partner in life. And I feel like that's one of the most important life decisions that you can make.

Dr. Sue Varma (01:20:39) - And the most important one. Right. Like, why do people spend more time investigating their manicurist, their hair colorist, and not the same amount of time thinking and being very careful about who they, you know, attach their wagon to, so to speak. Right. Because like and so I think what I'm seeing and this is maybe top of mind literally because I had sessions with, you know, young women this all this week in their 20s and 30s and finding themselves and making decisions in relationships. And I want to empower like we're we're able to speak about midlife wisdom and the freedom and the agency that comes from years of heartbreak and letdown and disappointment and grief and having to advocate and rejection. And if I could give that wisdom and speak to younger me or younger whoever it would be, do the same due diligence in your relationships, because I see a lot of women are able to speak out, let's say, if they are, and God bless them, if they are in their careers or in their friendships or with their parents, all the talking back, take that fierceness, right? Like you're giving me sassy as a kid, you know, pre-teen, direct that and make the right choice with your partner and and don't put up with a nonsense, because a lot of times people are like, oh, so and so, you know, they're putting me on the backburner.

Dr. Sue Varma (01:21:50) - I don't want to be somebody's option. I'm in their rotation and I'm like, no, that's not acceptable. So even the women that are listening that might be like, you know, post divorce or post-breakup and maybe now finding themselves looking for love again, I would just say it's not easy, but having these high standards that we do have at this point in our life, like keep them, raise the bar, set the bar high for how people treat you.

*Dr. Sarah Milken * (01:22:12) - Yeah. And I think a lot of people also, I mean, all of us do like like we said before, we want a partner who's going to satisfy all those things. But at the same time, we sometimes we need to be those things also. Exactly like I want a partner who cooks because I hate cooking, but like, Jeremy doesn't want to cook and I don't want to cook. So I was more like, okay, fuck it, we'll meet halfway and we'll both be tortured together and cook. Yeah. You know, and it's kind of it's a little bit of the reverse engineering, I guess.

*Dr. Sarah Milken * (01:22:42) - It's like, let's be miserable together and figure out how to cut an onion with the skin or with. Out., but I think, like the summary of all of this in my mind is self agency ownership. Obviously, we're born with certain things. We have certain life circumstances, and all of us are different. And obviously accommodating and managing all of that is really hard. And at the same time, being open to building these skills out of saying yes to more of the things that we want, like that woman from Israel whose son was executed and she's like flying to New York in LA to talk to all of these, all these people about her experience and what's going on in Israel and all of these things. And you're just like, how does she do that? Like, how does she dig deep enough into herself to be able to rise above this? Like, would I be even able to get out of bed? I don't know. I hope so, but when I saw her, I was like, wow, I want to be part of the 25%.

Dr. Sue Varma (01:23:52) - .. And a key part of that is the, the giving back. You know, and I know there's so many studies on in whatever way you're able to like volunteer. We see that like giving giving something back to someone else is the last thing anyone is thinking about in the midst of their grief. And like it sounds like no, but I should be selfish. And it's like, okay, take the time. Grieve. Absolutely. But once your head is able to come above water, be like, how can I make meaning of this? Can I share my wisdom or experience? How do I make sense? Because the loss has already been experienced, right? And then how do I create meaning for myself? And the last thing you want to do is to be alone when you're hurting, right? So for some people they may say, like, I could see this woman even say, because I've had patients who had said to me, thank no, thank you. Because you're like, thank you for coming from from Israel.

Dr. Sue Varma (01:24:40) - No, that's.

*Dr. Sarah Milken * (01:24:40) - What she was saying. She was like, thank you for being here. And I'm like, what?

Dr. Sue Varma (01:24:44) - Yeah, thank you for the opportunity to allow me to feel like I like that, that all this, all this didn't go in vain, you know, like they want to create that, that, that, that if I can do something and you see this a lot, if I can do something to help somebody else, it you know, I it's not going to bring me back my loved one and my loss is right. But if I can alleviate your pain and suffering because that's a very key fundamental human need is mattering right to matter.

*Dr. Sarah Milken * (01:25:12) - To somebody else. Totally. And like yesterday was kind of a unique day because my daughter has this initiative that she started called Our Seat at the table, which is fostering belonging community through cooking. Can you believe my daughter is obsessed with cooking? And I'm like, I hate it. Oh, I'm so bad at it., and she had taught 12 foster girls how to bake over the weekend, and they baked cookies and cupcakes and decorated them for women teen girls in a homeless shelter with children.

*Dr. Sarah Milken * (01:25:46) - So yesterday, when we went to drop them off, we spent four hours there with the teen moms and their kids. And I was telling my friend about it last night when we were coming back from the Israel event. And she's like, you know, I feel like I've lost that, like tactile volunteering where like, my hands are getting dirty. She's like, I'm so used to writing checks because I'm 52 years old and I write checks to this organization and that organization. But she was like, can I come next time? Like, I want to organize the diapers and like the food pantry. I want to get my hands dirty. And it made me think, like, maybe some of us are in our own versions, like getting too stuck in the check writing and not the doing.

Dr. Sue Varma (01:26:32) - Yes, absolutely. Like the pleasure that you get. I mean, I think there is pleasure in knowing like, okay, I have contributed resources to somebody else's happiness, but you're not seeing the smile on their face in person.

Dr. Sue Varma (01:26:44) - You're like these.

*Dr. Sarah Milken * (01:26:45) - Two year old kids hold squeezing the teddy bears and holding these like, dripping pink cookies. There was like, you can't even explain that.

Dr. Sue Varma (01:26:54) - Yes, yes. And that boosts oxytocin, right? Like the cuddle and bonding hormone.

*Dr. Sarah Milken * (01:26:59) - Except I went from there to the Israeli mom and I was like, oh my God, I didn't sleep last night. I was like, this is like the most emotional day ever.

Dr. Sue Varma (01:27:07) - Yes, yes, yes. But you know, you're you're making a difference. And I feel like that you're when you're contributing and even in this podcast, like everything that you're doing, it's impact. Right. And you want we all want to feel like we matter that that we're leaving a legacy in some way, that something. Because otherwise, if you think about it, everything you're doing, if it's a 1 to 1, it's like, okay, I did it, but now it's over. Like, I think that's why a lot of people hate cooking, because they're like, I spent, you know, four hours and then the meal was eaten in 15 minutes.

Dr. Sue Varma (01:27:35) - So like, there's nothing to show for it, right?

*Dr. Sarah Milken * (01:27:37) - Totally.

Dr. Sue Varma (01:27:38) - So being able to be to take pleasure in something that's fleeting and ephemeral, but also something that's long lasting. So I feel like the conversations that you're having, the people and the the ideas that you're giving,, you know, a chance to, you know, on your platform. That's that's one very important contribution is people are listening and they're like, I can identify thank you for doing this. Like, you made my day.

*Dr. Sarah Milken * (01:28:03) - I feel like, go get my hands dirty now, you know? And it's like I sometimes we don't know what we're craving until we hear someone say something that's like, yes. Oh, wait, maybe I should be, like organizing a food pantry and a homeless shelter rather than just writing the check. Not that the check is not important, but it's a different feeling.

Dr. Sue Varma (01:28:22) - Yes. And you know what? Different people are capable of different things at different places in their life. So, like, maybe there's going to be a friend that, like, everyone has a different strengths.

Dr. Sue Varma (01:28:31) - So there's going to be the friend that writes the check. We need them. God bless them. Right then the other person is like, I don't have a check to give you, but I can show up and I can do the work, right. Another person. So I think, yeah.

*Dr. Sarah Milken * (01:28:40) - And then the woman I was with, she's like the board chair and she like, loves setting up, you know, board retreats and process and all of that. And I'm like, oh my God, my brain hurts from that, you know? But that's her specialty. And it's like, whatever your specialty is. Yeah, find it, figure that out and bring it to the table.

Dr. Sue Varma (01:29:02) - 100%, 100% I love that.

*Dr. Sarah Milken * (01:29:04) - Oh my God. Okay, I could talk to you for 15 hours. We got to wrap this thing up. Okay. All right. If listeners want to find you, where can they find you?

Dr. Sue Varma (01:29:13) - So I'm going to send Sarah. You're going to get a book in the mail.

Dr. Sue Varma (01:29:16) - But this this.

*Dr. Sarah Milken * (01:29:16) - Is so good.

Dr. Sue Varma (01:29:18) - Practical optimism. The art, science and practice of exceptional well-being. I love the cover. We spent.

*Dr. Sarah Milken * (01:29:23) - Hours and.

Dr. Sue Varma (01:29:24) - Days,, it's going to be available wherever books are sold. Comes out February 20th. It's probably already out by now by the date, and they can find me on Instagram., the word doctor Sue Varma written out Doctor Suvarna and my website. The word doctor Sue Varma comm. So doctor Sue varma.com. So I would.

*Dr. Sarah Milken * (01:29:46) - Love to hear it because I always make people spell their names.

Dr. Sue Varma (01:29:50) - Yeah, because people a lot of times people have the habit of the doctor, right?

*Dr. Sarah Milken * (01:29:53) - Yeah.

Dr. Sue Varma (01:29:54) - Yeah. They're like, I can't find you. And I was like, And I'm across all social platforms, but probably, you know, the whole world right now, but most active on Instagram and I love I want people when they read it to tag me, you know, to share the pillar that interests them. If you're doing the forms of mental health, tag me.

Dr. Sue Varma (01:30:10) - Let me know what exercise what you're doing. Meaningful conversations. If you're on the beach, take a picture of yourself or wherever you are in life. People are sending pictures of themselves in the swimming pool with their dog, like, you know, their child holding it. They're cozying up to a coffee in bed. So I want to know from, you know, from from all of you, how is practical optimism making an impact in your life?

*Dr. Sarah Milken * (01:30:30) - I love that I want everyone to start thinking about what they can start doing today. One small step. I think my favorite part of this conversation for this podcast right now is purpose evolving purpose finding purpose. Aligning with purpose, changing your purpose. Whatever it is, find it because that is what connects us to ourselves and to the world and makes things meaningful. I want to thank you, Sue, for being a new friend and a guest of the Flexible Neurotic Podcast.

Dr. Sue Varma (01:31:04) - Thank you.

*Dr. Sarah Milken * (01:31:05) - Oh my God, talking to you. So much fun. Hey peeps, it's me again.

*Dr. Sarah Milken * (01:31:10) - I listen to this episode with doctor Sue Varma, a psychiatric and cognitive behavioral therapist, so that I could come back and summarize the golden nuggets for you to have actionable items to start using today. Doctor Sue worked with people with PTSD during 911, and her practice is built around the idea of practical optimism. She tells us about how to obtain optimism in our own lives and the importance of understanding our purpose. I know that when I listen to a long episode, I'm like, oh my God, I fucking love that. And then I can't even remember the specifics. That's why I come back and do this golden nugget. Summary. In this episode, we dig deep with our golden shit shovels and an inspiring conversation about optimism and midlife. Golden nugget. Number one practical optimism. Practical optimism is one of the cause of what doctors who teaches in her book, she says, it's a philosophy, it's a lifestyle, and it's a mission that you come back to over and over again. So let's talk about optimism for a minute.

*Dr. Sarah Milken * (01:32:12) - Something I learned is that optimism is a gene that 25% of us are born with, and the other 75% have to work on it. So if you're born with it, lucky you. And if you aren't lucky you, because it's actually a skill that you can build the Uggs and fabulosity as of midlife, right? So peeps, optimism is a skill that can be turned into a trait. It's something that can be built and obtained over time, which is a concept that we talk about a lot in my podcast, specifically with boldness and with confidence. Learning on the go. Like I've said before, it's a muscle that you use, and little by little you get stronger and it becomes more natural for you. It's like the dumb weights. It's not natural for me, but I work at it every day or almost every day because I know the benefits and I feel myself getting stronger over time. You can do the same thing with optimism, Tzu says, and you should do the same thing with optimism.

*Dr. Sarah Milken * (01:33:13) - We have to do this for ourselves because there are so many benefits to maintaining an optimistic mindset. Sue tells us that optimism is linked with living longer and being healthier and more purposeful in those years. Crazy, right? Golden Nugget number two, rediscovering your purpose. This is a big one, and I think it's important to note that your purpose is always evolving, and it's something that you'll discover and rediscover your whole life. And for us right now, it's the fucking midlife purpose. It's our midlife self reinvention time. Purpose does not have to just be a single definition. It is something that can be multifaceted. Sue explains that as big p purpose and little p purpose, there are differences. For example, you can have your life purpose, your purpose in a relationship, and your purpose exploring a new hobby, and they can all be different. I think something so important that she tells us about is that purpose doesn't have to come from your paycheck. This is huge. Your purpose can be raising a family or engaging in your passions, volunteering, learning, you name it.

*Dr. Sarah Milken * (01:34:24) - I think some of us don't think it's worth it if it's not making money. And your purpose will change over the course of your life, which is why we need to make a practice out of it. Coming back to rediscover it. My purpose ten years ago is vastly different than it is today. Even as a half empty nester, I feel my purpose changing and I know when my daughter goes to college, I'll be rethinking my purpose probably all over again. It's a lifelong practice. Golden nugget number three consistency and productivity. Productivity creates more productivity and more productivity creates more passion and motivation. Make this a habit. Motivation doesn't come from the outside. It's an inside job. Sue mentions having to put the cart before the horse, which is a technique from behavioral activation. You create motivation by engaging with the activity first, aka try your passions to find your purpose. Don't let a lack of motivation stop you, because the motivation will come from the action of doing. She suggests trying to get into a flow state where you feel completely immersed in whatever you're doing.

*Dr. Sarah Milken * (01:35:36) - I know this can sound like a lot, especially if you're like, how do I even fucking start? But that's a thing. It's small steps that lead to small wins, which then lead to big wins. This is why it's important to be consistent with this and make a habit out of prioritizing your passions. Because when anything becomes a habit, it becomes part of your identity. Golden nugget number four doing things because they feel good to you. The biggest takeaway about practical optimism and purpose from our conversation today is doing the things that feel good to you. Yep, I'll say it a million times because that is how we learn. But it's time to drop the social comparison. Remember the iceberg effect and the focus on the things that feel good to you. If you have FOMO about something that someone else is doing, use it as a clue. Ask yourself, is this envy? Is this longing is this anxiety? Do I want that for myself? Am I willing to do what it takes to get that for myself? When Tzu says to drop social comparison, she means what is stopping you from your desires? Don't make it about them.

*Dr. Sarah Milken * (01:36:46) - Look inside of you. Use this feeling is inspiration. Play around with different ideas. Experiment with what feels good to you and then run with it. Pause. Don't stop completely and mid lifers. If if something you try doesn't feel good to you, that is just as much a success, because now you have more data to include in your journey. The gold is dripping off these nuggets. Grab it, use it. There are three things you can do. First, fucking subscribe to the podcast. Second, share it with some midlife friends who like midlife shit. And third, write an Apple review. Writing reviews is really annoying. It's an extra step, but it really helps me and the podcast grow so you know what to do. DM me. You know, I always respond and of course follow my Instagram at the flexible neurotic duh. Love you talk soon.