An Interview with Psychologist Daniel Keating
Daniel Keating, Ph.D. is a Professor of Psychology, Psychiatry, and Pediatrics at the University of Michigan, Ann Arbor. He specializes in adolescent development and adolescent psychology.
Mai Tran: Awesome. Okay. Hi, everybody. Thank you for joining us today for another interview in our Seattle Psychiatrist Interview series. My name is Mai and I'm a research intern at Seattle Anxiety Specialists. We are a Seattle-based psychiatry, psychology and psychotherapy practice specializing in anxiety disorders. Today, I'd like to welcome Dr. Daniel Keating.
Dr. Daniel Keating is a professor of psychology, psychiatry, and pediatrics at University of Michigan, Ann Arbor. And Dr. Keating is an expert in developmental psychology and he specifically focuses on the integration of knowledge on developmental processes, social factors, and population patterns in developmental health and how they affect individual and population health.
He's made significant contributions to research in the field and some recent academic articles that include "Cognition in adolescence and the transition to adulthood", "The Kids Are Not All Right: Adolescent Sadness, Hopelessness, and Suicidality are Skyrocketing. What to do?" And his book "Born Anxious: The Lifelong Impact of Early Life Adversity - and How to Break the Cycle."
All right. So before we get started today, can you please tell us a little bit about yourself and why you initially became interested in studying developmental psychology?
Daniel Keating: Sure. So it's a long story, but I'll condense it. I did my graduate work, my PhD, at Johns Hopkins. And the work that I was doing at that time was really focused more on individual differences rather than developmental differences. But the focus was on early precocity, that is to say individuals who were advanced in during their early adolescence in terms of their math and scientific expertise and measured in a variety of ways. And so there was a developmental component to that obviously in terms of how people came to those things. There was also one of the giants in the field of developmental psychology was also was a professor at Hopkins when I was there, Mary Ainsworth, who is responsible for a lot of the work that's been done on attachment and the sequelae of attachment from early childhood. So I managed to come by some of that knowledge through her being on the faculty.
My first tenured position was at the Institute of Child Development at the University of Minnesota and increasingly began to focus on a variety of things having to do with how the differences develop as opposed to just that they exist and how we might deal with them.
And then I subsequently moved to the University of Toronto and was invited then somewhat out of the blue to take on the task of setting up one of their networks in a think tank called the Canadian Institute for Advanced Research. And it was on human development and it went across the board from sort of molecular and single-cell neuroscience all the way through anthropology, sociology, and so forth.
And then that really sort of provoked my interest in how both, individually, how the things develop, but also in terms of the population impact of a variety of things, focusing as I think the evidence led us to look at what are the circumstances that lead some individuals to thrive and other individuals to struggle. What are the kinds of things that are going on? And, of course, in that context, early life adversity plays a major role. So that's the very thumbnail version.
Mai Tran: Yeah. And I also recall reading some of that in your book "Born Anxious."
Daniel Keating: Right.
Mai Tran: And I'm really interested in one of the concepts that you kind of laid out in the book, social epigenetics, and the links to stress dysregulation. So can you explain what these are to our audience in layman terms?
Daniel Keating: Sure. So let me break it apart a little bit. So epigenetics is a relatively new field of study, certainly as it bears on behavior. And basically, the idea there is that of course we all know that the DNA you get at the moment of conception is the DNA blueprint that you'll carry throughout your lifespan, that doesn't change. But what does change is when we take a closer look at how genes function, and among the things that how genes work, basically, is that they're, if you think of them as little manufacturing centers and they're producing certain things that they're designed to produce. All of them have a region, it's called a number of things, the promoter region or the regulatory region of the gene. And what that does is in a sense, whatever it is that that gene does, the promoter region tells us when to do it, how much to do it, when to turn off, when to turn on, et cetera.
That portion of the gene is malleable. It can be affected by a variety of different things. It can be changed by physical exposures like toxic exposures. One of the best documented is in terms of the impact of cigarette smoking makes a lot of epigenetic changes that are thought to play a significant role in the development of cancer, for example. But the breakthrough from our point of view is the other term, social. And basically what was emerging and discovered and since has exploded is in really around 1999, 2000, was that first with animal studies and later with human studies, it turns out that social experiences, especially stressful experiences also cause epigenetic changes.
And some of the most important of those, we don't know all of them for sure by now, but some of the most important of them, earliest documented and most frequently documented are changes to the stress regulation system, which is basically what causes our stress system to respond, how much does it respond, how long does it take to go back to baseline and so forth. And so obviously, I think we all know that a stress system is essential for survival. We need to have it, but when it gets overly engaged, often because of stress exposure either in infancy or even in the womb, that then can make an epigenetic change that can carry forward in terms of how that stress system works.
Mai Tran: Right. That's really interesting. And I am sure that a lot of people would be curious to know as what specifically are some of the most common environmental factors that can cause changes to your epigenetics?
Daniel Keating: Right. Well, as I say, the stress response and the stress influence on this is the one that's, at this point, the best understood, although it's still not by far completely understood. But basically what we're looking at there is exposure to stress in a variety of ways. And it depends, of course, on the age of the organism.
So in the womb it's relatively straightforward in the sense is that if for whatever reasons the mother to be is experiencing high levels of stress or adversity, all the way from worries about sort of getting the material necessities of life or shelter, food, that kind of thing, or more seriously if they're in an abusive relationship and have stress because of that. So kind of those as the extremes, those, if they are sufficient, or if the mother's response to them is sufficient, that it produces a level of cortisol, which is one of the main products in the stress response system, if that cortisol is at a sufficiently high level, it can break through the uterine barrier and enter into the womb. And if those circulating chemicals then include cortisol at a sufficiently high level, they can trigger the epigenetic changes in the fetus even before they're born. So that would be one pathway that happens.
After being born, the first year to two are the most sensitive periods. And stress can come in a variety of ways. It's largely around the absence or a dysfunctional nurturing of the infants. So if they're not being taken care of, whether it's in terms of meeting physical needs or meeting comforting, nurturing needs like being held and that sort of thing, that then can elevate the stress level as well.
And then as individuals get older, those are the most sensitive periods, but it can happen later as well. But basically what that does is set up the stress response system, that high stress during those critical periods, sets up a system whereby the organism learns, in a sense, biologically, that it's probably a not very safe world out there. It's a dangerous world out there. And so if you're going to survive in a dangerous world, what you want to do is to have a stress response system that's more like a hair trigger. Even things that most folks might see as neutral, they would regard as dangerous and do that and respond excessively. And then excessive cortisol has a lot of negative consequences behaviorally, health-wise, and so forth.
The other thing I just want to point out is that we often speak of it, and I try to avoid it, but it's not easy, is to think of this as a problem or a deficit or whatever. I think it's better to think of it as an adaptation to what the organism perceives as a dangerous environment. So if in fact you are in a highly dangerous environment, having that kind of quick trigger stress response and immediately engage in fight or flight is perhaps survival, helpful.
And it doesn't do a whole lot of good for your body, but it does in fact maybe keep you alive. So think of the predator in the bush or a tiger in the bush. If you're in an area that's relatively safe and all of a sudden it's invaded by new predators, organisms that respond quickly to that are more likely to survive than individuals who don't. And so we have to understand, although in our environment, that's typically not the kind of environment we're living in, but the system doesn't know that, and so it doesn't know where the stress is coming from. And so it's typically more problematic for individuals with that stress response dysregulation, even though it really is evolutionarily an adaptation to dangerous environments.
Mai Tran: Right. Yes, that's really interesting to hear. And speaking of that kind of stress adaptation, how would you describe what it feels like to experience that kind of constantly elevated stress response or as you called it in the book, a stress response system that is constantly locked on?
Daniel Keating: Right. So basically the experience of it is just an elevated version of what all of us experience at one time for another. So if we're all we're anxious about a big test coming up or we're fearful about something that's happened, we respond with... And one of the adaptive purposes of cortisol is to activate your system. So it's actually in many ways beneficial. It focuses attention, it increases heart rate, lung capacity and all those other sorts of things that make it possible to react and to do stuff. In a system that is more or less locked on, not totally locked on, but sort of on a continuum, it's certainly more so. You have that experience a lot all the time. And so you're kind of on edge, nervous, agitated, concerned about things that may not really exist as dangerous to you or as problems or challenges for you, but you perceive them to be so.
And so it's important to recognize that, of course, once you've activated that, and it can be an internal activation, it doesn't have to be an external threat. And that is a lot of the anxiety disorder, you're activating a system that's actually not in response to some challenge in the real world. So if you're doing that a lot, you're constantly kind of on edge or restless or concerned, and the body doesn't know whether that stress response has been triggered by an internal thought or an external threat. It activates and then it causes these changes. So essentially you're looking for a flight, fight, or you're looking to run away, even though nothing particularly problematic is actually out there in the external environment to provoke it.
Mai Tran: Yeah. And I know that sometimes it can get pretty serious. So what do you think would be the short and long-term consequence of that?
Daniel Keating: Well, they're very similar in some ways in the sense that they're across the board. So it can have behavioral consequences. So you are quick to anger, you go into reactive cycle more readily than other individuals, which then certainly doesn't endear oneself to people around you because they can't predict your behavior, what's going to set you off. So there's a behavioral consequence, which is then because of the accumulation of various kinds of things, can cascade into various kinds of psychopathology, externalizing being kind of the excessive fight response or internalizing being the excessive flight response going inside or at another level of freeze response where you just don't react at all to anything because it seems too dangerous. So there's all those behavioral consequences, there's mental health consequences. And I think what has now started to enter the common understanding is that it has massive health consequences.
So individuals, some of the earliest studies, this is prior to epigenetics, but some of the earliest studies showed that the sort of fetal environment is predictive of cardiovascular risk in your fifties and sixties. So it is a lifespan kind of thing. We now understand that most of that is occurring not only, but largely through the stress response system. So one of the superb scientists in this area, Bruce McEwen, who passed away relatively recently, is responsible for a lot of that work and showing why it is at a stress response system that is dysregulated, remembering it's adaptive in some sense, but this kind of dysregulation provokes this kind of sustained cortisol level. And his term for that was "allostatic load". You're carrying too much around all the time. And as it turns out, cortisol can be toxic to almost all organs of the body.
So essentially it can show up in health as cardiovascular problems, as a whole host of other kinds of metabolic problems, and so forth. The link to cancer is not that clear. There's probably a link, but it's not as clearly strong because a lot of those come from exposures to carcinogens in one version or another, physical exposures. But a lot of these things that we, sort of at a population level, of course, we wouldn't know these things if we didn't look at populations. For a given individual who shows up with a medical problem at some point in their life, what the decades long history that brought them there, we don't know all of that. But if we look at populations, it gives us an idea of what kind of consequence or sets of consequences it has.
Mai Tran: Right. Yeah. And what do you think when the stress response becomes maladaptive to us, what do you think is a good way for us to receive help or help ourself in those situations?
Daniel Keating: Right. Well, for that, I think the place that we would be looking is into the literature on resilience in one way or another. And so the literature on resilience has mushroomed in recent years in parallel with our better understanding of trauma and stress and so forth.
And again, this is far from settled issues, but I think that if we look at the big picture, one of the big, and probably the most well-documented way to redirect that maladaptive pathway is through social connections. That is through positive social connections. And so that can come in many, many different forms. So it can come in childhood by sort of having a responsive extended family network who can help to deal with issues that are not working well, parent, child. And so that's one example where it can happen. We have good evidence that particularly in late adolescence and early adulthood, close friendships, intimate friendships, romantic relationships can have a similar effect, if the romantic or friendship partner is supportive and has the capability to help one learn how better to regulate these sorts of things.
And there's very good evidence of this in many ways, what is come to be known as a Romanian orphanage study. Looked at infants who, for a variety of political and economic issues at that time, there were many, many orphans who were not being cared for. There was large numbers of them, a government policy of promoting birth but not supporting families. And basically those individuals, those infants were in situations where basically the most minimal things to keep them alive were done. So they were provided with physical nourishment, food, water, milk, that kind of thing, but not much else. They were pretty much left unsupported or non-nurtured.
What we know is that those individuals, certainly up to about age one, maybe a little after that, if they were adopted from those circumstances, and there are some, it's a very tragic story, but individuals who were adopted into highly nurturing families by around age six or five or seven, looked pretty much normal. They didn't seem to have that stress dysregulation going on, or at least it wasn't affecting their behavior in major ways.
After that time, they pretty much do have lifelong consequences. So there's something about it becoming biologically embedded during sensitive periods that make it difficult to deal with. But the way that it does, those circumstances where it does work almost always involves some level of a change in the social network of closer affiliations and so forth. And so I think that stands out as the most well-documented one. Certainly in terms of particularly in childhood, things like parent-child therapy can help, right? To establish if there's enough capability for change to change what is a dysfunctional relationship in a direction that is encouraging of relational health, for example, can have a similar kind of effect, but that's of course a person to person thing as well. It's just guided person to person kinds of interactions.
The other one that stands out, and it goes by so many names, it's hard to give a comprehensive one, but it has aspects of the mindfulness approach, aspects of acquiring a set of purposes and goals and values and wanting to do some particular kind of thing. Having a focus can also be helpful and restorative in terms of giving some shape and substance to what it is that one might want to do.
Mai Tran: Right. Thank you. That was a very extensive answer. And now I'd like to move on to your recent Psychology Today article, which is really useful. It takes on the really crucial topic of dealing with adolescent sadness, hopelessness, and suicidality in a society that keeps on triggering these responses. You mentioned a misdirection to avoid is to ignore the existential stressors in favor of the seemingly more manageable phenomenon of screen time and social media when you were discussing the effects of issues like gun violence. So how do you think we can offer help as loved ones for adolescents and prevent this epidemic of adolescent sadness, hopelessness, suicidality as these situations keep on occurring and we don't really have control over it?
Daniel Keating: Right. So I think one of the things is that I largely think the high focus on social media as the cause of all of these mental health problems in teens is misdirected. Which is not to say that it might not be harmful for some individuals, but careful studies with large samples followed longitudinally essentially say that if there is an effect at all of screen time and social media, it's really kind of small. It's not that big a deal for most individuals. If you break it down a little bit further, it does look as though individuals who may have preexisting difficulties or challenges may accentuate it. On the other hand, there are individuals for whom it is beneficial, who might have difficulty maintaining positive relationships, and social media may well be a boon to them. And of course, we saw examples of that every day during the pandemic where teen peers are just enormously important and salient. We can see it in the brains to teens.
If you say, "No, that's it. You can't have any connection," it is likely to be very dangerous. So individuals who were in social groups and maintained them through a variety of uses of social media was beneficial. So I think we have to weigh that. And it's probably just for the vast majority of kids in the middle, it doesn't matter one way or the other, right? Particularly so, or at least we don't have any evidence that it does. So there may be effects, but the effects are relatively small. My problem with that view that it's the source of so many of the problems is that it blinds us to the fact that the other problems are much more important. So I've started to call this a stress pandemic. And it's not just in the US, it's not just teens. It really is a kind of universal phenomenon. And it's hard to ignore the fact that that's because so many things are going wrong, taking the US as our prime example, right?
Concerns about climate change... Now that will probably affect youth more because they understand they're going to bear the brunt of it than the folks who are making decisions, who are the CEOs of oil and gas companies or whatever. So they're going to suffer. So they're aware of that. Growing up, figuring out how to avoid active shooters is bizarre, right? That's just an enormous stressor. It is a huge stressor. And you can go on and on with other kinds of things. And so what I think we need to think about are at two distinct levels of this. And one of which we should focus on and we focus on a lot, but we don't focus on the second one.
The first one, Desmond Tutu, or at least a quote attributed Desmond Tutu, is that in addition to trying to scoop folks out and help them who are coming down the river with all sorts of problems and try to support them, we need to go upstream and find out why it's happening. And so the downstream stuff, I think, is what we are attempting to do when we do sort of psychological interventions, when we try to create therapeutic circumstances for individuals to figure out how to do it, and more broadly, sort of communicating effective techniques for coping with stress.
And of course, we know that some individuals are resilient without intervention, they wind up doing fine. The problem with relying only on that is that then we can tend to blame the individuals who don't succeed, who have had long histories of problems and stressors, and most of them without some kind of major support will not succeed. And so we don't want to blame them for that. We created the burden. We don't want to blame them for carrying the burden and not being able to overcome it on their own. And I think the techniques there, a lot of them are out of the resilience literature that we just talked about, which can be therapeutically supported by intervention, clinical, if it's serious enough by prevention programs or just general education. So you can have universal programs, targeted programs, clinical intervention programs, all of which are helpful, but it's not helpful enough to save everybody or the vast majority of people.
And the more folks who are coming downstream, succumbing to the stress, the less effective we are in terms of how many people we can help. The upstream problems are what we tend to ignore. Why have we created a world in which the stress level is so high? And I think if we fail to attend to that, it's a problem. That, by the way, in terms of the resilience literature about the second issue around purpose and goals and so forth, I do think that for youth, for teens and young adults and so forth, I do think that a lot of them have figured out that focusing on trying to change the big picture is actually beneficial individually. They feel efficacious, they connect with other people with similar views and so forth. And we often talk about adolescent risk-taking, which is another area that I'm working on now as a negative thing. And we're concerned about it when it is a health risk like reckless driving or substance abuse and that kind of thing.
But there's this tendency to be exploratory, to try new things, to push ahead, this also has positive sides. And that's what I think we need to encourage. So coping with the stress that you can't avoid, yes, but also breaking out of yourself and figuring out how do you create networks and alliances to address the upstream problems is something that I think is also a very valuable. We don't have as much evidence of that as we might like to have, but I think the evidence is trending in that direction.
Mai Tran: Yeah, I really appreciate your perspective on trying to address the issue at the roots instead of shifting blame on other miscellaneous issues that may or may not contribute to the problems.
Daniel Keating: Right.
Let me just mention, I do think on the social media side, let me just be clear. I think we do need to change how we're approaching social media. It's a proprietary, obviously, setup, so we don't have, from outside, much influence on it. But to the extent that the algorithms aggravate problems, I think we should be addressing that. I think we just shouldn't be laying it all off on that and ignoring the other big existential problems out there.
Mai Tran: Yeah, definitely. And I also know that you advocated in your article that psychologists should not, quote, unquote, "stay in their lane" by helping kids with the consequences and ignoring the roots of those existential stressors like you just mentioned. So how would you recommend for professionals in the field to take steps towards addressing the roots of these issues?
Daniel Keating: So I think there are a couple of ways. One is, in the individual therapeutic relationship, I think creating the space rather than focusing down on what the sort of immediate stimulus was for the problem the individual's experiencing is creating enough space for kids to open up about what it is that's truly worrying them. And that is happening. There are some relatively new therapeutic interventions that focus on climate fears, for example, or other kinds of things. And I think we need to create a space for individuals to be able to do that. And so I think that being more broader in the therapeutic content that we would entertain, I think is potentially a very helpful kind of thing. I think the other thing about not staying in the lane is essentially to say, "Well, my goal," and I'm working very hard at it as a therapist, "is to get as many kids out of that downstream before they go over the falls as I can." And that occupies me. That's what I'm doing.
And I think in many ways, that's great, but I think to not recognize what might be going on upstream and how do we try to deal with that because we are encroaching on other disciplines, we're encroaching on sociology or politics or economics or whatever, we should not be intimidated by that. We are, or claim to be, the experts in behavior and things that cause problems for individuals in their life. Well, let's look at that, right? Let's not be put to the sidelines when the sociologists get ahold of it. And I have lots of very good sociologist colleagues and whatnot. So it's not a matter of individuals, it's a matter of who owns what part of the problem. And our Canadian Institute for Advanced Research was designed specifically to overcome that so that we would have force and interdisciplinary dialogue across these many different dimensions and bring all of that expertise to bear in an integrated fashion.
So I think it's basically, it has an impact on the therapeutic relationship, but it also says we shouldn't just stay in our silos that even if we're doing great work in what we're doing, I think being aware of the fact that the problem is bigger than that and trying to speak to it when we can in whatever way we are capable of or comfortable with, I think is, er, not comfortable with, we should be uncomfortable, but that we should embrace that discomfort and deal with those and try to deal with those kinds of issues.
Another is I don't think we're ever going to be addressing successfully the issue of how racism affects youth in this country without being discomforted, right? It's not just an easygoing, "Oh, okay. Everything's rosy now." No, it's not. We need to figure out what's the impact of the legacy and how do we deal with it? And all of those problems that we're talking about have long legacies. I think we need to understand why and try to figure out how to address those as well and in concert with others who do different perspectives on the problem.
Mai Tran: Yeah, I definitely hope that we'll reach that point in the future soon. And you also just mentioned briefly that you've done research on adolescent risk-taking and risk-taking behaviors. And I also read in your recent review article, "Cognition in Adolescents and Transition into Adulthood", you also discussed the paradox of development versus the high mortality rates in adolescents. Can you explain why this may be the case and what efforts have been done to alleviate this problem?
Daniel Keating: Sure. Well, there are a number of different angles, different angles to it. I think that one of the things that we need to understand is that when it comes to health risk behavior, the big reason we're interested in it, of course, is not just the scientific part of it, but it is in the impact on everyday lives. And so we know that the rate of morbidity, significant illness, injury, and mortality is way higher than it should be based on how physiologically sound that period of life is. So in many ways, it's a pinnacle of physiological health. So that population particularly, so let's say in the second decade of life, is one where individuals have managed to get through exposures to all sorts of childhood illnesses and exposures and whatnot and have arrived at adolescence.
And we also know that in a variety of ways, different things begin to accumulate. So by the third decade and fourth decade and beyond of life, those things start to manifest. So it should be the healthiest period of time, but we know that the levels of morbidity and mortality are much higher than, in a sense, should be just based on the physiological aspects of that age group. The reason for that is what we've come to call behavioral misadventure, in one way or the other, that individuals are engaging behaviors that have a high risk for mortality or morbidity, and that we need to think about how we might... We want to understand the basis of it more. And we want to figure out how that helps inform our approach to trying to mitigate this problem.
Now, we do have some very good examples. There are ways of modifying population behavior in this age group. One of the best documented is in terms of graduated driver licensing programs, where most states now have a period of time where you gradually get to the point of being able to operate a motor vehicle under any circumstances and includes things like not having unrelated gears in the car or minors in the car, maybe some restrictions on nighttime driving or highway driving or other kinds of things.
There's been very, very good essentially econometric studies of that showing that over the last several decades that the rate of mortality attributable to teen driving has dropped in the 40% to 50% range. So it's not impossible. We can do that. Similar things, not just specifically aimed at teens, but in the population or the society as a whole are issues around smoking essentially by changing the attitude about smoking, right?
Now, I know a lot of youth are into vaping and so forth, but certainly the smoking rate has gone down dramatically. So the point here is that we can identify, or at least in some areas, we have been successful in identifying ways to mitigate that risk for adolescents. The big areas that remain in terms really of morbidity rather than mortality are things like substance use that can turn into substance of abuse or substance use disorders of one kind or another.
The unprotected sexual activity is another one that's a significant contributor to morbidity to various sexually transmitted diseases and infections. And part of that is we seem to be going in the wrong direction, or at least in some places. So there are state by state changes or differences in how sex education is handled in schools. So if we just look at that, there have been studies where we've looked at many different influences in terms of sex education and so forth. And if you put it on a continuum from, "The only thing we're going to talk about is abstinence, that's it. Just don't do it and therefore it will reduce it." So if everyone followed that, yes, that would reduce it, but it's not realistic. That is not how the world works, how human bodies work. So there's that end. And then the other end is a very comprehensive sex education with lots of information and even with community support to get easy and non-embarrassing access to condoms and so forth and so on.
So if we look at the state differences and what's taught in schools, which is not a massive influence, but it's a significant influence, the rates are dramatically different in the sense that the abstinence-only sex education leads to higher levels of unwanted teen pregnancies, higher levels of sexually transmitted diseases and infections, and a whole host of the attendant problems that go along with that. So there's an example of one where we kind of know the evidence is real clear what we should be doing. There's then political and sort of, for some individuals, moral opposition to that. But we definitely know that we have a massively positive impact on that health risk if we just said, "Comprehensive education is what we're going to always do and community support for safe sex."
Mai Tran: Yeah, I can recognize that that's definitely important, especially education-changing policies and community support. And so finally, would you like to share any additional messages or advice to our audience today?
Daniel Keating: Well, I think we've covered a lot of the territory. I think I would sum up by saying I would encourage folks on either side of the therapeutic relationship become more aware that it's not just an issue in your mind. If you're having problems, it's not just a problem in your mind, that it is rooted also in the body. We use the term biological embeddings going back a few decades now. And it really does, it gets embedded in your body. And so you need to think about how at both ends of that relationship, to what extent are those contributing factors? How are they operating? And what kinds of things do you want to do? So for example, I think that a shift towards more trauma-informed practices, a shift towards focusing on the key role of relational health as an adjunct to a specific mental health kind of thing is where we need to be going.
I think that we need to have a broader view and a more interdisciplinary view that brings together the biological, the psychological, and the social. And those directions I think will necessarily point us toward looking at the bigger picture that we need to think about changing if we want to create a more less stress inducing world, less of a stress epidemic. And by we, I mean encouraging youth to become involved in that. They're already more involved in many ways than middle-aged and older adults. But I think that encouraging that youthful effort to change things, I think, is really important.
It can be overwhelming and so just ignoring it, in a sense, in some ways is coping, but it's not the best kind of coping, it's a kind of an avoidance coping. And that it also then can have a very positive impact on the individual's sense of efficacy and self and meaningfulness. And we are already seeing that. I think the, that generation, Gen-Z generation in particular is much more involved in these kinds of issues and thinking about these issues. And we need to find ways to support that. I think in many ways the answers will come from that generation if we can support it or at least get out of the way of the kinds of things they might want to be trying to accomplish.
Mai Tran: Yeah, definitely. Thank you so much. That was really great advice. And if anything, I think we've managed to take away today that to be more aware of environmental risk factors, as you've mentioned extensively about that. So yeah, thank you so much. It was really lovely to finally meet you, and thank you for all the great nuggets of wisdom that you've offered us today. And I will definitely recommend everyone checking out Dr. Keating's research articles and his book "Born Anxious". And finally, thank you everyone for tuning in, and we'll see you all next time.
Daniel Keating: Thank you.
Mai Tran: Yeah, thank you.
Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.
Editor: Jennifer (Ghahari) Smith, Ph.D.