Understanding Anxiety with Dr. Kathleen Smith

If sitcoms taught us anything, it’s that you can be highly allergic to your family and still be close to them.

Hi friends, 

I hope you are all safe and healthy as we wind down 2021 with more uncertainty. 

Maybe you’re getting together with loved ones over the holidays, maybe you’re suddenly changing plans… or maybe you don’t know what you’ll be doing in two days, let alone two weeks. 

This latest episode of Everything I’ve Learned might be relevant. Dr. Kathleen Smith is a therapist whose specialty is anxiety and relationships — she’s an expert in Bowen Family Systems Theory, created by Dr. Murray Bowen to examine the way families operate as a unit. We don’t exist in isolation — we are constantly reacting to other people or projecting our anxieties onto others. And it’s not just about traditional family. It’s friendships, work colleagues, and the connections we make on social media. 

I first discovered Dr. Smith’s work via her excellent newsletter (go sign up here). Her book is called Everything Isn’t Terrible: Conquer Your Insecurities, Interrupt Your Anxiety, and Finally Calm Down

Dr. Kathleen Smith

The mental health world today is very individually focused. But Dr. Murray Bowen had this idea that the individual’s not really the smallest unit when you’re thinking about emotions. He saw the family as sort of the smallest unit. Because we’re social creatures, we do things in relationship to each other to manage anxiety, to manage stress or threats, and that there are patterns in a family, in a group, in an organization in society that get activated. If you introduce enough stress or enough anxiety, we kind of get locked into these ways of managing it. 

As a first step, Dr. Smith talks about putting on your “researcher hat” and observing your own behavior when getting together with loved ones: 

If a person is thinking about this for the very first time, I would say set the bar super low — not to focus so much on change, but on the capacity to observe what’s happening.

Go home as an anthropologist, and just see what patterns get activated when people get pissed off at each other. What does the family do to keep things calm? And can you appreciate that. It works, to a degree. Maybe you don’t want to participate in it, maybe you want to do something differently. But have an appreciation for these patterns, they’re adaptive. I don’t think of them necessarily as maladaptive. We’re trying our best, in how we relate to each other. And then ask yourself, What’s my part in all this? 

Give it a listen—and if you like the episode, maybe share it with a loved one so you can compare notes. 🙂 

Wishing you a peaceful holiday season — see you in 2022. 


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By Mark Armstrong

Founder of Longreads, creator of Everything I've Learned.