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Lori Gottlieb
Behind every successful business is a vision. Bringing it to life takes more than effort. It takes the right financial foundation and support. That's where Chase for Business comes in. With convenient digital tools, helpful resources and personalized guidance, they can help your business forge ahead confidently. Learn more@chase.com business chase for business Make More of what's Yours the Chase Mobile app is available for select mobile devices. Message and data rates may apply. JPMorgan Chase Bank NA Member FDIC Copyright 2025 JPMorgan Chase & Co. Time is.
Dutch Vet
Precious and so are our pets. So time with our pets is extra precious. That's why we started Dutch. Dutch provides 24. 7 access to licensed vets with unlimited virtual visits and follow ups for up to five pets. You can message a vet at any time and schedule a video visit the same day. Our vets can even prescribe medication for many ailments and shipping is always free. With Dutch, you'll get more time with your pets and year round peace of mind when it comes to their vet care.
Lori Gottlieb
Pushkin there's no Way Around It Sometimes life is tough. Awful, even bad things happen all the time. Whether it's an unanticipated health problem, a new relationship woe, or dire news on the job, sometimes these nasty circumstances result from our own behaviors and choices, and sometimes they have nothing to do with us whatsoever. Every day, people become the victims of random accidents, natural disasters, or even unprovoked attacks. In the aftermath of awful events like these, it's easy to feel upset and broken. And when things are really bad, you can even start wondering whether you'll be able to pick up the pieces of your life again. It is so fabulous to be back in Miami in this beautiful city and this beautiful weather with you.
Dr. Sue Varma
Beautiful.
Lori Gottlieb
This spring I was invited to host a discussion at the World Happiness Summit in Miami, and that gave me the chance to interview someone who's dedicated her career to helping people whose lives have been impacted in awful ways.
Dr. Sue Varma
Thank you so much.
Lori Gottlieb
Meet this amazing audience who's like, so excited to see you.
Dr. Sue Varma
I am so excited to be here.
Lori Gottlieb
Psychiatrist Dr. Sue Varma sue was the first medical director at the World Trade Center Mental Health Program at nyu, where she treated people caught up in the attacks of 9 11. Sue has now gathered her insights from decades of this kind of work into a new book called Practical the Art, Science and Practice of Exceptional well Being. In the book, sue explores strategies we can use to deal with the difficult chapters in life, and her biggest recommendation is to adopt a particular form of optimism, what she calls Practical optimism.
Dr. Sue Varma
To me, optimism has head to toe benefits, but at the end of the day, what optimism is, is a mindset.
Lori Gottlieb
The World Happiness Summit, or Wahasu as we call it, is an amazing event. If you like this podcast, you would have an absolute blast at Wahasu. But with so many speakers scheduled, I only had time to chat with sue about a tiny part of her work. So I asked her to record a fuller interview just for you.
Dr. Sue Varma
Nice to see you. My pleasure. Looking forward to it.
Lori Gottlieb
So I got her back to join me on Zoom.
Dr. Sue Varma
Yeah, I'm fine with whatever works for you. I don't mind doing like a full episode. Yeah.
Lori Gottlieb
And began at the beginning with her story of the morning of September 11, 2001.
Dr. Sue Varma
So, you know, on 9 11, I was a medical student and I was working in a New York City hospital. And I remember getting the call to say, you know, discharge as many healthy ish people as you can because we need to make beds for people who are going to be coming in who are injured. And we did that and we waited and waited and waited and we just simply didn't see the kind of numbers that we were thinking because the death toll was so high.
Lori Gottlieb
Do you remember where you were when you first like heard about the towers? Like were you already like at work and saw it on TV or something?
Dr. Sue Varma
Yes, I remember like we would come in at 5am so I'd already been there for like three plus hours when we were hearing the news and seeing it live as the towers were coming down and as a plane crashed. So you know, it was freakish. And I remember like, you know, my sister in law was working downtown in so many friends and family members were somehow down and around there and we couldn't get through to anybody. Like nobody was answering the phone. And we did lose loved ones, friends. I mean, there were so many stories of people getting caught in the dust cloud, seeing people jump out of the buildings, getting trampled on. And in the days after, myself and my colleagues, we volunteered in a variety of ways with first responders, with cleanup, rescue, recovery at the morgue, getting trauma training. You know, being a New Yorker my whole life, like this is a place I identified with. But I think no matter where you were in the country or in the world, I think a lot of people felt somehow connected and traumatized. Rightfully so. It was devastating. You know, when I think of trauma like you're never left the same. There's a you before it and then there's a you after it. When I think of mass disasters and terrorism. It's really intended to chip away at your morale and your sense of self and your self confidence and trust in the world. And so what I saw in, you know, this whole concept of, you know, New York strong, it really, to me came from this idea that great tragedy not always, but sometimes can bring out a sense of grit and toughness and community. And it wouldn't be until years later, after I'd finished my residency training at NYU in psychiatry, to be recruited for this role that I really didn't feel prepared for, but felt so honored to be considered and thought of for it. And, you know, it was a massive effort. It was a new program. And so when I came on, you know, I remember the early days. They're like, there's several hundred patients who are on our list. You're going to be treating first responders and civilians. And I was like, great. How many psychiatrists do we have? Like, six, seven? They're like, no, it's just you. I joked. I'm like, these are big shoes to fill. And they're like, no, no, no, you're breaking your own shoes because there are no shoes. Like, this is the first program of its kind. So incredibly daunting, challenging, but eventually extremely meaningful and rewarding.
Lori Gottlieb
But you had, if I understand, I kind of someone to look up to who. Who kind of dealt with difficult situations with optimism. I'm thinking your family that you talked about in your book. Tell me the story of the inspiration that your dad was giving you.
Dr. Sue Varma
So, you know, my dad still is an inspiration. Like, he's gonna be close to 90 soon. And he literally looks and acts and thinks 20 years younger, if not more, and one of the kindest, sharpest, and healthiest people that I know. There's such resilience. You know, he came from very little in India, and, you know, he was born in late 1930s and has seen so many decades of trauma and tragedy. And the things that I take away from him, you know, he would always say, simple living and high thinking. And this was a big saying in my family. And I always make fun of him. I was like, but, dad, why are you always laughing? Why are you always smiling? Like, what is there to be like? Especially now, I'm like, what is there to be so grateful for? He's like, I mean, you can laugh or you can cry. I mean, you make the choice. He's always sometimes, like, laughing at his own jokes in his own head, telling himself stories, not in a delusional way, just, like, laughing. And I was like, but, dad, you didn't have electricity. You didn't have running water. He's like, what are you talking about? We had like dance parties and slumber parties on the rooftop and camel rides and, you know, hurricane lamps. I'm like, that's because you had no electricity, dad. He's like, life was great. Life is great. He's like, how do you want to look at it? Like, how do you want to tell your story? And so, you know, I just saw him this morning and he's like standing there and he's like, cutting fruit. That's how, like, immigrant dads show love in the house. He's like, what do you want to eat? Like, you know, cantaloupe. I'm cutting this, I'm cutting that. I was like, wow, you spend three hours cutting fruits for the whole. Like, yeah, he's retired now. He's like, you know, we've got to spend our time some way. So I was just thinking about him and I'm like, you know that saying, like, you don't want to just add years to your life, you want to add life to your years. And he is like the perfect example of that, of just always enjoying himself, no matter where he is, no matter. He's always reading new books, always coming back and listening to podcasts and interviews and sharing things. So keeps himself intellectually stimulated.
Lori Gottlieb
So it seems like part of his story is that even though he came from circumstances that might feel kind of negative or feel sort of harsh to other folks when they're listening to it, he seems like he's really happy and optimistic and resilient. And this sort of seems to fit with the question that you face when you saw your patients. I mean, talk about the puzzle. You sort of experienced as you saw different patients reactions to the trau 9, 11.
Dr. Sue Varma
Yes. So, you know, first thing I want to say is I never want anyone to feel less than if they do end up experiencing mental health disorders. Whether it's related to an event or an incident or not. Most people, 20, 30, 40% of folks in their life will experience a mental health disorder, and 70 to 80% of people will experience a life threatening event at some point or another. Right. But what's interesting that when it comes to post traumatic stress disorder, that while 80% of people will experience a life threatening event, only about 8 to 10% of people will actually meet criteria for post traumatic stress disorder. So what that says to me is, wow, right? Like, at least 90% of people will have really bad things happen to them in their life. Big bad Life changing things, and yet they will move on. We had a lot of patients who were in the medical monitoring program but never met criteria for anxiety, depression, ptsd. So our brain has a great ability to bounce back, right? But to me, bouncing back from adversity, that's only part of the equation. It's important part, but it's only one part. I wanted to help people thrive in the face of adversity because which one of us will escape this world, you know, without anything bad ever happen to us? None of us. That is where practical optimism came to me, is because I would see these folks who, a lot of these patients who never became anxious or depressed, they would still come to our program and helping other folks, they'd bring them to their appointments. In the aftermath of 9, 11, a lot of patients would have agoraphobia or like avoidance of people, places, things. Reminders is a feature of ptsd. So is hypervigilance, insomnia, nightmares, irritability, so they don't want to leave their house. And we would have these other patients who are like, I'm fine, I'll bring you, I'll take the subway with you. Because they were so afraid of there being another attack in the days after, or just having triggers and reminders. So these folks who never made it into my program, I would see them in the hallways and I literally would be like, what is your secret? And I started to see common threads of specific things that they did. But resilience, in my mind was always something you either had or you didn't. And one feature of it was optimism. But there were other features, like altruism, social support, moral compass, cognitive flexibility. But optimism was again, one of these things that you had or you didn't. And so was resilience. But what about the rest of us? And it wouldn't be until years later that there was a paper done with researchers from ucla and they said, you know, there is a genetic linked to optimism. So that was my first question. Is it genetic? Is it something you're born with? And I love it when I find science to back up things that I'm already thinking. And it said, yes, there is. And it's this oxytocin receptor gene, and if there's some variation in it, you know, you may not be as optimistic. And what did that mean? Well, if you're pessimistic or have pessimistic tendencies, then you're more likely to get depressed. And then they looked at this gene and they said, well, what does it actually code for right It's a mindset. Yes, but in addition to being a mindset, it's also the ability to regulate your emotions, to be able to ask for help. And I was thinking about so many of these things that in my therapy with patients, what is it that I'm helping them with? And can I teach people optimism? Can I teach them the things that optimists do? How do we codify this? What does this look like behaviorally in the world? And I found data in every field of medicine talking about it. People who are optimistic and do a brief optimistic intervention recover faster from colds or have less colds or infections, or looking at exceptional longevity. In this study in jama, that was a meta analysis of over hundred thousand people and said that people who are optimistic live 10 to 15% longer. And not just longer lives, but healthier lives. So the concept of health span, because lifespan may be increasing, but we're spending the last decade of our lives, especially women with dementia, living in a nursing home or dependent on other people. So I was like, head to toe. Optimists have less anxiety and depression, 30% less likelihood of getting strokes or dying from heart attacks or really all cause mortality. They're happier. They're 40% more likely to get a raise in the next year. They have more friendships, stronger and longer bond from childhood. They are happier in their romantic relationships. I was like, why is no one talking about this? This to me is the jackpot. This is the wellspring of health.
Lori Gottlieb
So I wanted to talk a little bit about how people tend to think about optimism, because I think when we hear the word optimism, we sometimes get it wrong. So what is optimism?
Dr. Sue Varma
Yeah, so I think a lot of people I know I did think of it as like this woo woo thinking and just look on the bright side and everything will work out. And that is definitely not optimism. That is toxic positivity, asking someone to just get over something or look on the bright side. Optimism simply is the tendency to have a positive outlook in an uncertain situation, to kind of expect the best possible outcome. But to me, optimism by itself is only part of the equation, because it's like I can have all the positive thinking in the world, but if I'm not doing anything actionable and proactive, I'm not going to be able to translate those positive outlooks into positive outcomes. And so in my mind, I needed something more. I needed skillset and a tool set. And that is what practical optimism is. And that is how practical optimism differs from optimism. So if you're in that 25% bucket that is born naturally with a positive outlook. Excellent. But the reality is that 75% of us are not skewed that way. You know, we might be sort of somewhere in the middle or maybe skew more pessimistic. So optimism is having a very favorable outlook, but by itself it's not sufficient.
Lori Gottlieb
So let's walk through this sort of updated version. Practical optimism, how is that different?
Dr. Sue Varma
So practical optimism helps you translate positive outlooks into positive outcomes through action. And practical optimism is a practice like having a yoga practice, learning a new language, learning how to ride a bike, learning a sport. Some days it's five minutes, some days it's longer. But it does require effort and work, and more importantly, it's a skill set. And why that was so freeing to me is like, we can all learn skills and we all should learn skills. And the practical optimism is a practice that requires you to take chances and to put yourself out there in the world and to course correct and to continually learn from mistakes.
Lori Gottlieb
It's time for a quick break, but we'll dive deeper into Sue's idea of practical optimism when the happiness Lab returns in a moment.
Dutch Vet
Time is precious, and so are our pets. So time with our pets is extra precious. That's why we started Dutch. Dutch provides 247 access to licensed vets with unlimited virtual visits and follow ups for up to five pets. You can message a vet at any time and schedule a video visit the same day. Our vets can even prescribe medication for many ailments and shipping is always free. With Dutch, you'll get more time with your pets and year round peace of mind when it comes to their vet care.
Lori Gottlieb
In her book, Practical the Art, Science and Practice of Exceptional well being, psychiatrist Dr. Sue Varma explains that a major pillar of becoming more optimistic is facing up to our emotions and processing them. So why is that so important?
Dr. Sue Varma
When people look at optimists, they want to dismiss their happiness and say, well, they've never had anything bad happen to them, of course they're happy. And what people don't realize is that optimists and pessimists both experience the same number of life adversities. The difference is that optimists are better able to cope with them. And the reason is, is because they are in real time processing their emotions. It requires more effort and more energy to suppress your emotions. And when you suppress your emotions, they say that your body expresses what your mind cannot. And so a lot of my patients will come to me and they'll say, I don't Know why I'm always sick or I have these headaches, or I have these unexplained aches and pains, or ended up in the emergency room from panic attacks. So processing your emotions is such a key pillar of optimism because it says bad things are gonna happen to you, people are gonna piss you off, and what are you going to do about it? And a lot of times people end up suppressing negative emotions. Like when we talk about any kind of addiction or unhealthy behavior with substances, with anything, hours of binge watching, doom scrolling. If it's meant as an avoidance, as a procrastination, you cannot escape negative emotions, they will come to haunt you. And that's why I say manage your emotions before they manage you. Because in some form or another, I see so much suffering. You know, in my practice, a lot of these people look to the world as if they have it all together. And the reality is I know different because I get an interesting inside perspective of what is actually going on in their lives. And so in one form or another, whether it's their relationship suffering, whether it's their work, something is going to suffer. So we know that people who deal with their emotions are less likely to have all sorts of problems. Heart disease, you know, there's something called type D personality. We've heard of type A and type B. And type D is this kind of like angry, holding onto emotions, not expressing them. It takes less energy to express it. I think so many people are afraid of their emotions. They're afraid to be alone. They're afraid to be alone with their thoughts. I know people who will put the music on always in the background because they don't want to be alone with their thoughts. And they're like, what would that mean for me if I actually had to confront how I feel?
Lori Gottlieb
Which I think is so sad.
Dr. Sue Varma
Right?
Lori Gottlieb
Because our emotions are this really useful signal about what's going on in reality and what we need to do differently. I feel like ignoring them. We do that really at our peril, right?
Dr. Sue Varma
Totally. And you know what is interesting, Lori, is that I think a lot of times people are afraid to confront emotions because it means that they will have to make in their mind what they perceive as massive changes in their life. And they're not ready to do that because like, if somebody confronted the fact, wow, I really can't stand my partner and I've been resentful for so many years. And if they were to confront it, it would require something to change. And maybe they're afraid that it would Mean that this would be the end of this relationship, and then who would I be without it? So I get it. I understand. But I would also say that Rome wasn't built in a day. Like, we don't have to deconstruct our lives as a result of figuring out what it means. Like, I had a patient the other day who was sharing with me, like, a lot of things that she was not happy about with her partner. And I was like, what do you think would be most helpful for me to say right now? And she was like, well, I know what I don't want you to say. I know. I don't want you to tell me to break up with him. She knows on some level that the way things are not working, but isn't ready to end the relationship. So that's just one example. There's so many where somebody's like, I know what I need to do in terms of changing my life or changing a job. Like, things. They know that if they were to allow themselves to be enveloped by the emotion either, that they would be debilitated by it. And I always say to patients, think of it as like, dresser drawers. I'm not saying let's open all of them and take everything out and create an entire mess and pile in the middle of your room. I'm saying, like, let's just look at one drawer at a time, and I'll help you pack it a little bit neater. Right? But we're not saying everything, Take out everything. And. Because I think there's a fear of being overwhelmed, and I think that fear.
Lori Gottlieb
Of being overwhelmed can also involve not just being overwhelmed by the circumstances you need to change, but this worry that you might be literally overwhelmed by the emotion itself. And that's one of the reasons I love your book. You share this sort of handy, rhyming catchphrase, which I love, for how we can begin processing our emotions. What is this catchphrase?
Dr. Sue Varma
So it's name it, claim it, tame it, and reframe it. And the naming part is just name the antecedent or the trigger. Just being aware of it. And there's so much evidence that having emotional granularity, just like understanding, putting words, words to what you're feeling and what caused the trigger. You know, when we look at people who have suicidal thinking, as weird as this may sound, we feel that patients who have understanding of what the trigger was probably have a higher chance of recovery and prognosis because they can tie it back to a specific event. And if you can do that, then you're more likely to be able to address the underlying causes and prevent them from happening again. So naming your trigger and antecedents and knowing what they are is really important.
Lori Gottlieb
And so next up is claim it. What does it mean to claim our emotions?
Dr. Sue Varma
So when I say claim your emotions, where in your body do you feel them? A lot of times people will say that I have insomnia, or I have frequent urination or frequent bowel movements, or I have headaches, or I have a lot of tension in my neck and my shoulders. So I say that the body expresses what the mind cannot, and a lot of times our painful or forbidden emotions shows up physical symptoms.
Lori Gottlieb
Another reason you talk about the importance of claiming emotions is it allows us to think about what we might call our forbidden emotions. What are forbidden emotions?
Dr. Sue Varma
So I think for some people, women especially, anger might be really forbidden. I have so many patients that I work with that end up crying when they're angry. It's scary because either I think that they're afraid of pushing the other person away or that it means confronting or challenging the person. And then what? I think we've all created stories in our head about if I were to say something to someone, they're not going to like it, they're going to leave me, they're going to be mad at me, and then what? And I think it's helpful to be like, okay, yeah, and then what? There's a statistic that says that 85% of the time the things that we worry about never actually happen. And the 15% of time that they do, we're better equipped to handle it than we think. So I think that's really important to just keep in mind.
Lori Gottlieb
So that's claiming our emotions. But next up is that we have to tame our emotions. And one way that you suggest doing this is to really try to tame our ruminative loops. What do you mean by ruminative loops? I think I know what you mean. I think I've experienced this myself firsthand.
Dr. Sue Varma
I definitely have experienced ruminative loops. And it's just like you're going in circles with the same thought. And what that does is end up creating powerlessness. And it strips us away of our agency. Because you're repeating the same emotion, what if? Or you're catastrophizing, assuming the worst case scenario, or you're projecting. But taming your emotions is like short circuiting and creating a break in that and saying, all right, I am feeling angry, anxious, helpless. What am I going to do to self soothe and so taming is really about soothing. And what I say is pick an activity that's is not going to create a negative habit on its own. So somebody may say, a glass of wine helps me soothe. Right. Then what happens when you need two or three or four to have the same effect? Right. So we don't want the soothing activity to take on a life of its own. So I would say pick something that seems relatively healthy. Ish. Can you make a five minute phone call to a friend? Can you text someone that you know is going to be supportive and helpful? Could you do a one minute meditation in place wherever you are, just closing your eyes and taking a deep breath? For me, walking is one of the most soothing activities. And I was fascinated by the science of walking, that there's something about when you're walking, your eyes have to track what's out there in the world. Like, so you don't want to get hit by a car. And all of that forces you, those eye movements to get out of your own head. So going for a walk or any kind of exercise just gets you out of your own head and gets you out of routine. So whatever you're capable of doing, it could be a five minute stretch. So we just want to keep it simple and lower the bar. But what's soothing for you? That's the big take home point.
Lori Gottlieb
You also mentioned this other strategy that I'm totally going to adopt myself, which is this idea of empathy. Emptying your emotional spam folder.
Dr. Sue Varma
Yeah.
Lori Gottlieb
What is this?
Dr. Sue Varma
For me, I do that in journaling. And I think that there's so much value and there's so much science behind two 10 minute journaling sessions. And there's no one right way to journal what works for you. Like sometimes it's literally for me reiterating what happened in the day and it's getting it out of your head and putting it on paper and you're like, all right, that's it, I'm done. You know, when I was a patient and going for my own therapy, I learned a technique called worry journaling. And somebody may say, well, that seems counterintuitive. Why would you keep a journal of your worries? And what I learned is that when you write the same thing over and over again, you start to see that there's a trend in your worries. There's a common theme. You're worried about the same types of things and that the things that you're worried about are not actually happening. And if you're willing to write down how you handled it, that Creates a sense of mastery as well. So putting it on paper is one way to unload your worry spam folder.
Lori Gottlieb
And so that's a nice transition to the last of our four tips for kind of processing our emotions. We need to reframe them. What is reframing our emotions? Why can it be so important?
Dr. Sue Varma
So reframing is one of the best techniques to try to put a different spin on a negative situation that happened. And I just want to say that there are some negative things that happen to you, that there will be no positive spin, There will be no silver lining. And I 100% get that. But other than the sort of big tragedies ask yourself, and sometimes it may not be until you've created some distance between you and this bad thing that happened. But reframing allows us to take back some control and says, you know what? I'm not going to allow myself to be debilitated by this. And one way might say, is there another way for me to look at the situation? Could I look at it from another person's point of view? Could I understand it in the context of the larger plan for my life? So sometimes it might be a rejection. And there's this catchy saying, rejection is really just redirection. There were so many things that I wanted to do at certain times in my life, and I am glad, in retrospect, that they didn't happen at that time, because for any number of reasons, I might have thought I was ready, or maybe I gained more experience later on, or I was better equipped to handle the challenge. And you could say, well, that's just you trying to be an optimist. And I'd say, sure, but the point is, I couldn't control it. I couldn't change it, so why not reframe it in a way that puts me at ease? So reframing it really just. It's taking back control, and it's saying, I don't have to choose to allow myself to be a victim of this situation. Reframing is one of the most powerful techniques used in trauma processing therapy. But I recognize, you know, I had nine, 11 survivor patients and friends, and they would say, you know, when we would talk about reframing, and they're like, you know, I don't see there's no silver lining. And I'd say, absolutely. And it would be later on that I would recognize that there are some things that there'll be no positive way to put a spin on it. And then I realized from my Eastern upbringing, something my parents Would say to me, is that, is this a problem to be solved or a truth to be accepted? And sometimes you cannot reframe something and then it just becomes about acceptance. And I think, you know, my Western upbringing would have me believe that acceptance was resignation, surrender, passive, meek. And Eastern upbringing says, no, acceptance is a very strong place to be when you don't have a choice.
Lori Gottlieb
We need to take another quick break, but when we return, sue will explain how she's been inspired by the Japanese art form of kintsugi, taking broken pottery pieces and reconstructing them to be even more beautiful than an undamaged face. The happiness lab will be right back.
Dutch Vet
Time is precious, and so are our pets. So time with our pets is extra precious. That's why we started Dutch. Dutch provides 24,7 access to licensed vets with unlimited virtual visits and follow ups for up to five pets. You can message a vet at any time and schedule a video visit the same day. Our vets can even prescribe medication for many ailments and shipping is always free. With Dutch, you'll get more time with your pets and year round peace of mind when it comes to their vet care.
Lori Gottlieb
Treating people caught up in the destruction of the World Trade center had a huge impact on Dr. Sue Varma's career. Of course, doctor patient confidentiality prevents sue from talking in detail about the specific cases she treated. But she wrote about one inspiring person who escaped the collapsing towers. A woman that sue calls Shelly.
Dr. Sue Varma
So, you know, Shelly was one of the first patients I worked with and I had imposter syndrome. I was like, this is like a big job and like, how am I qualified to be here? And I was scared and I was like, how am I going to help Shelly? Because Shelly in some ways represented a lot of the themes that I was seeing, which was these amazing people, many of them high achievers, many of them leaders in their community. You know, Shelly's a mom and just like a very honest, hardworking, strong human being. And, you know, she was someone who considered herself an optimist Go getter. She's like, I'm the one always doing the 5k races and throwing the company get togethers. And so I never saw that something could break my spirit. And that was literally what she said. She was like, you know, on 9 11, here I am. I'm getting trampled. I'm getting caught in the dust clouds. I'm wearing heels that day. I love to look cute when I come to work. And the heel broke. And then I'm walking barefoot and I'm asking for help. And next thing you know, like, the dust cloud, like, just. I. Like, there's no ways to even put words on what happened that day. You go to work thinking this is just a regular day, and then you're seeing people die in front of you everywhere. And she was like, I couldn't get home that day, and my husband couldn't reach me. Like, she wasn't able to go back to work in that office. And eventually, when she did, she never took a day off and never asked for help. And it was really, like, only through the program that a lot of people were told that they're going there for physical reasons, for checking up, like, asthma, GI problems. And then they got mental health screenings that she wasn't even thinking that, like, I need to get help. And in her story, as she's unfolding it, she just starts crying, and she's like, I don't cry in front of people. And I don't think I've ever cried about this in front of anyone before. And, you know, at the end, she's like, I feel broken. You know, that was one of the hardest things to hear because I was like, what role do I possibly even play in helping you? Because everything you're saying to me is a thousand percent legitimate. There's no silver lining. How do I get you to reframe? There's no positive spin. So the theme was the brokenness that Shelley was sharing. And it made me think of this art of broken ceramics, Kintsugi in Japanese culture, which is. Is preparing something to beyond its original form. It's restoring it, but bringing upon a level of beauty that is like the 2.0 version in Kintsugi. Like, you're putting these broken ceramic pieces together with a golden glue, a golden lacquer, and it ends up being even more majestic and expensive and valuable. And so when she said that, it reminded me, because I remember when I was in therapy and I saw this art form in my therapist's office. It's something that my dad had from one of his trips many years ago in Japan. And I thought to myself, is this an opportunity? Could tragedy ever be an opportunity for us to come back stronger? And so then became the journey. I think it was a parallel journey of me becoming a therapist. I think learning so much from my patients and just going home and saying, you know what? Like, I'm on this ride with them for better or for worse, and we're gonna. We're gonna get through this together. I don't have all the answers, and I Don't have them right now, but we're gonna co create and co construct a new reality that hopefully will be just as good. It's never gonna be the same. I get it, that Shelly, who wore the heels is the shel wear sneakers or if she wears kitten heels and she brings like a book bag, duffel bag and had a change of clothes, always anticipating in a way, like, what if this were to ever happen again. So in some ways she was right. She was never going to be that person. But after the treatment ended, you know, I sat with her and her husband and he's like, I used to be the worrier in the relationship and like I finally have my wife back and she's able to function and she was able to ask for help. But it's returning back to a person that sense of self that they lost of like that ability of I can do that.
Lori Gottlieb
It seems like going through trauma. So many people that you've worked with went through this idea of the sense of inner brokenness. And you talked about this as the effect that trauma has had on people's self efficacy. What is self efficacy and why is it so important for mental health?
Dr. Sue Varma
Self efficacy is your confidence in your own abilities. And I think it's so interesting because it's not really saying anything about your actual abilities. And you know that saying, like fake it till you make it. I think there is some truth to it, but not the reality is nobody's saying completely fake it. Like you need to do the work, whatever that work is, if it's training to become a musician, like you need to train. But you also have to have faith and confidence in your ability to achieve the thing that you're working towards. So there's two aspects of it. One is continuing to push yourself to develop that ability, but then eventually believing that it is going to come to fruition. And we see there's so much work. Like Albert Bandura had done a lot of study on self efficacy and he says that this sense of confidence comes from your own personal experience, from vicarious learning, looking at role models, getting feedback from trusted people, and then also just a sense of how does it make you feel, your own physiological feedback.
Lori Gottlieb
It also seems like self efficacy involves some specific expectations. Both expectations about ourselves and outside ourselves explain what the research shows about that.
Dr. Sue Varma
Yes, there's two features to it. One is just the belief that you yourself have the capacity to achieve this and then the fact that this outcome is achievable, period. So I'm just going to use weight loss as an example, somebody may say, I'm doing all the things I know. Like I know what I need to do. And that could be anything. Like if somebody says, I'm trying to put on more muscle, I need to eat more protein, I know what I need to do if I need to wake up. Like better sleep, hygiene. So intellectually knowing what the steps are, that's a part of it. Number two, you carrying it out. But number three, will my work in the end be impactful? Will I see results? Because there'll be people who say, I'm still not seeing the results. Result. Sometimes the results are not in your hand. You may say, I'm working really hard at work for promotion, I know what I need to do, but I'm dealing in a very stressful work environment that feels unfair, that feels biased, that feels like I'm walking an uphill battle. So I think that there are two parts that you need to feel efficacious because your environment lends itself to making you feel that way. And the environment needs to be supportive because you can do all you want, but if the system feels rigged against you. And again, it could be a matter of perception or it could be reality. So we have to entertain both. And I always try ask my patients. I said, listen, I just want to get a better sense of your work. Tell me a little bit about your boss's personality, give me a sense of the interactions, how do you feel? How do your colleagues feel about this? So I never want to deny the reality if somebody says, I'm trying, I am doing my best and things are still not working for me.
Lori Gottlieb
But both of those expectations seem to contribute to the benefits of experiencing self efficacy. What happens when it feels like we're not able to do what we really want to do? What happens when we're not feeling so effective?
Dr. Sue Varma
So I think we end up feeling demoralized, disenchanted, disenfranchised, and we give up. And it's natural to think that you're going to fail, but what you really need to be reminded of is that you can rise up again. And so to me, proficiency is about reminding people at their very core of their capability. And like they did experiments with athletes and they're told, you're not going to win against this person. They're so much better than you. What they didn't know was they were actually matched with an athlete who was at the same level as them. But when you're told in advance you're not going to be able to do this, they can't and when they were told the opposite, oh, this person sucks compared to you, you're so much better, you're going to win. So a lot of times our expectation really predicts outcomes. And like there's an experiment where they tell students going into a classroom, the people there are very friendly or they're not. And the success of the student going to the classroom, being able to make friends really had to do with their expectations of what was to come. So I do believe in this concept of self fulfilling prophecy and I don't think that optimism is at all magical thinking.
Lori Gottlieb
So how can we fight some of these barriers that lead to a lack of self efficacy? What can we do to more proficient? One of the barriers you've talked about a lot is sort of fighting helplessness. How can we fight our inner sense of helplessness?
Dr. Sue Varma
So I think the first thing is just understanding and recognizing it as that and allowing yourself time to rest and to sometimes hit pause, maybe not stop. Validation is a key part of that is just to say, I had a really hard time. Like if you're lucky enough to have someone really like loving and caring and has your best interests at heart to say, I get it, I see you, I see how hard you're working and this was not your fault. Or, or could you learn something from this if you did have a role in it and what can you do differently? So I think pausing, resting, recovering, because I think so many of us just go from one project to another to another and it's this like sort of destination addiction where you're like, I need to get to the next place without really thinking through why do I continue to strive, you know, and to. And sometimes to look at the helplessness and say, is this an opportunity for me to change course? You know, am I meant really for this? Do I really want this? Or is there another way for me to achieve this?
Lori Gottlieb
And that really nicely gets to a second barrier. You've talked about this idea of stuckness where it's like, I just, I'm never going to find a path forward. I'm just always going to be stuck. How do we fight this barrier to proficiency?
Dr. Sue Varma
Fighting stuckness is about finding flexibility. And I talk about, in the book about patients who are like, oh, I must go to, I don't know, fill in the blank, like business school or medical school or whatever it is. And it was actually a patient who, you know, she was like, I have to be a PhD in psychology. Like, this is the only thing she wanted since she was a kid and her parents Were like, no, that's. You're not really meant for that very long course, and we don't have the money for it. Like. And I remember talking to this patient, saying, is there anything else that you can think of? And one thing led to another, and next thing you know, she's the head of a wellness company. And years later, you know, she sent me a clipping of some award that she got, and it said she had written thank you, and this was something you shared with me in therapy. Write your purpose in pen, but your path in pencil. And that was so poignant to me because I was like, number one, I don't remember saying that, but thank you. I'll take it. And then number two, wow. You know, it was something that probably I needed to hear at that time. And, you know, just this idea that we don't have to be fixated on one specific path because there's so many roads to feeling satisfied, to feeling needed, to feeling impactful. And often it's not the road that we thought that we would be, and that's totally fine. So flexibility is a big part of proficiency. Like, you have to be nimble, you have to be quick. You have to say, I have tried, and it is okay. Giving up isn't always a sense of failure. I think a lot of times in this culture of go, go, go and work, warrior, make it happen, too much emphasis is on the final product, on the success, rather than the process, which is about making mistakes and learning and fun and creativity and getting lost. Cost. When my husband and I travel, and sometimes we make plans, and sometimes we don't. You know, we don't like to have fixed, structured itineraries. We like to drive and go to small villages and meet people and see where things take us. You know, And I get that that's not always reality, and it's not always productive or efficient, especially if you're traveling with young kids. But I think as much as possible, I love the idea of getting lost and just think about what feels safe and what parameters and guardrails. How do you want to intentionally and safely allow yourself to get lost?
Lori Gottlieb
It's such a nice way to sort of reframe your perceptions, which I think is an important part of flexibility. And so those are ways we can sort of fix stuckness. But the third barrier is also one that I relate to a lot. It's this kind of just fatigue, this idea that, like, I'm too tired to be proficient, like, I just can't do this. What are some ways we can break through that barrier to proficiency.
Dr. Sue Varma
Lori, I love that you share that because when I think of so many, like really successful and high achieving people, I feel like we are at risk of burnout because we hold ourselves to really high standards. And I feel like in this culture we're often taught that rest has to be earned or that rest is wasteful, unproductive, and it's like frowned upon. And I just think that rest and leisure need to be incorporated as part of the work plan and scheduled with the same type of intention and urgency in a way. So when fatigue sets in, I think that whatever fills your cup, play, I think for me is always a way to do that. So give yourself grace and be gentle and recognize that. Do you want to get to the peak or the summit of this mound? Completely out of breath, weathered and worn down, demoralized. You got to the peak, but at what cost?
Lori Gottlieb
It also sounds like it's just really recognizing our natural limitations, whether those are just kind of mental natural limitations, like we just need some rest, we need to take a break, but also physical natural limitations. I think this is sometimes why we feel so fatigued, is that we're not taking care of our physical bodies too.
Dr. Sue Varma
Yes, yes. And I say like, for me, like something I'm really working on right now, and it's something I've been thinking about for a long time, is like sleep hygiene. You know, I think that I've always just taken my physical health for granted. Granted. And sometimes there's, there's consequences to that. And I've just assumed, oh, I'm a machine, it'll work itself out. And I remember a friend several years ahead of me telling me that, so there's going to come a point in your life when you're going to make your schedule around sleep. And I was like, I don't believe you. Like, I make my schedule around everything else. But that, that just fits itself in. She's like, no, I'm very careful about it. And now I'm thinking backwards where I'm like, if I want to protect this time, whatever it is, seven, eight, nine hours, then I'm going to work backwards. And the things that I'm saying yes to and no to to are going to be centered around the sleep schedule. You know, it's about making deposits into this rest account. And so sleep is one way, 15 minute naps is another way. One minute meditations is another way, Exercise is another way. Anything that's going to refill your cup and replenish your energy.
Lori Gottlieb
And so all these strategies that you're talking about for replenishing your energy, fighting helplessness, feeling less stuck. These were exactly the kind of things you talked about with Shelley. What was the outcome there? Was she able to use these strategies to kind of heal that inner sense of brokenness?
Dr. Sue Varma
Yeah. Yes. And it's funny because she would joke. She's like, I didn't often know where you were going with certain things, like when I'm telling you how I'm scared about another terrorist attack happening, or I feel like my sense of safety or calmness or hope has been changed or demoralized. You would say to me, talk to your boss about trying to get time off or sleep. She's like, I didn't understand where we were going necessarily, but, you know, I figured I'm here, so I might as well show up and go with you. And so I think a lot of times when people come in to work with me, they'll come. Come in with one specific problem in mind, and they're hoping to get an answer for that problem. And then I often say, let's back up and sort of take a360 to approach to wellness. Even though you're talking to me about, let's say, problems at work, you know, she wanted to get a raise. She wanted to get a promotion, but she was just so afraid. She thought that if I ask for days off, if I ask for rest, even if it was like, blocking off an hour for therapy, that all of these things would get in the way of promotion because she would be seen as, you're not really serious about this job. And what was interesting was by taking care of her mental health, by resting more, her boss was like, I had no idea that you were going through all of this. I am more than happy to give you pto. No, I'm not going to doctor pay. Like, please consider it as part of the sick leave that you have, which you have tons of. You have never taken a sick day in your life. And she finally felt permission to rest, permission to take care of her mental health, and she ended up getting the promotion. I mean, her life changed. Like, a lot of it is because embracing the fact that your life is not the same, you know, and I think that's the hardest part, because so many people very quickly, after trauma or any. Any kind of setback want to get back to who they were. I mean, it's not possible because this. This event has transformed you and your understanding and framework of the world. But also for a lot of people, going back to baseline also doesn't make sense because your baseline might have gotten you to where you are right now and why you're in my office to begin with. So really think about when someone says, I just want to be who I was, is it realistic, is it possible? And is it healthy?
Lori Gottlieb
Because sometimes optimism really seems like it's about kind of accepting where we are and giving ourselves the grace to be in that spot.
Dr. Sue Varma
Yes, exactly. So it's, it's interesting because when you think about optimism, it's just you think it only means one thing, which is to look on the bright side, not recognizing that it includes a practice of gratitude, of leisure, of rest, of self compassion, of proactivity, of challenging the way that you're thinking. So there's so much more to it, and optimists do it naturally, not to mention having healthier habits and what's involved with that.
Lori Gottlieb
Thanks to Dr. Sue Varma and the folks at the World Happiness Summit who introduced me to Sue's work. If you want to learn more about the summit or sign up for their 2026 event, you can visit WorldHappinessSummit.com that's WorldHappinessSummit.com but my discussion with sue at Wahasu was so insightful and I can't help but leave you with one more of the highlights. This was when sue agreed to lead me and the audience in a name it, claim it, tame it, and refrain it exercise.
Dr. Sue Varma
Okay? So first of all, like just if you want to close your eyes, feel free if you want to keep them open, you know, whatever works best for you. Name the antecedent, think of a problem, right? Think of anything that might have happened today or in the last week that could have triggered you to feeling upset, right? And the more granular you get, the more likely you are to be able to put your finger on it and change the problem. And we see this even as far in extreme as suicide, where somebody can put their fingers on these were the events that led to me feeling like I my life didn't have value anymore. I didn't want to live anymore, right? So that is a dark scenario. But just in think of an everyday problem. Name the antecedent, right? Then I want you to feel in your body, right? So maybe you want to close your eyes for this. Where in your body are you feeling the tension, right? Are you feeling it in your jaw? Are you feeling it in your shoulders? Are you feeling it in your legs? Where do you tend to hold the problem and the stress in your body, right? So now you've named the antecedent you've claimed where it is in your body. Because often the body will express what the mind cannot. Right. And it will take place in the form of medical problems, headaches, things like that. And then I want you. This is the taming part. And everybody has a different form of self soothing. Some people may say that I want to take a one minute meditation. I call these oasis moments where you are shutting the world out and finding your grounded sense of peace internally. Right. It could be a one minute meditation or something that I worked on that is based off of a best possible scenario. It's an optimism intervention. It's 10 minutes, but this is a one minute version of it. So if you want to do this with me, let's go. I'd like to just close your eyes, settle in, let your shoulders drop. And I want. I want to take you on a little journey with me. So now that I've asked you to envision a problem, so you've clearly defined the problem in your mind, I want you to imagine a road, a path leading to the solution to that problem. And I want you to get very specific. What does that solution look like? And what does the road to the solution look. Look like? Is that road straight? Does it wind? Does it twist or turn? And now I want to imagine that we are walking together towards that solution. We're getting closer. You're getting closer. And this solution is the best possible outcome that you could have envisioned. And you're starting to feel the anticipation of excitement, of delight, of success, of satisfaction, of personal gratification. You're getting closer. And now you have arrived at the best possible outcome of your solution. And I want you to feel all the feelings that come with success, with mastery, with resolution. Peace, happiness and success are enveloping you right now. I want you to take a deep breath to the count of five, inhaling gently through your nose and exhaling slowly through your mouth. You're feeling relaxed, hopeful, successful. And just know that this feeling is always at your fingertips. Success is accessible within you through a positive mindset that you have chosen. And take a deep breath and open your eyes.
Lori Gottlieb
Good, right? That's pretty good. Thank you.
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Podcast Summary: The Happiness Lab with Dr. Laurie Santos – Can You Become a "Practical" Optimist?
Release Date: April 21, 2025
In this enlightening episode of The Happiness Lab, hosted by Lori Gottlieb and produced by Pushkin Industries, Dr. Laurie Santos explores the concept of practical optimism with guest psychiatrist Dr. Sue Varma. Drawing from her extensive experience, including her pivotal role in the aftermath of the September 11 attacks, Dr. Varma introduces a transformative approach to optimism that transcends mere positive thinking.
The episode begins with Lori Gottlieb setting the stage for a deep dive into the nature of optimism and its impact on well-being. She introduces Dr. Sue Varma, a psychiatrist who played a crucial role in the World Trade Center Mental Health Program at NYU following 9/11. Dr. Varma has synthesized her decades of experience into her book, Practical: The Art, Science, and Practice of Exceptional Well-Being, where she advocates for a nuanced form of optimism she terms "practical optimism."
Dr. Varma recounts her experiences on September 11, 2001, highlighting the immediate chaos and the long-term psychological impact on survivors and first responders.
“When I think of trauma, like you're never left the same. There's a you before it and then there's a you after it.” – [04:19]
She describes the establishment of a new mental health program to support those affected by the attacks, emphasizing the enormity and novelty of the task at hand.
“There are several hundred patients on our list... and it's just you... it's the first program of its kind.” – [05:53]
Dr. Varma differentiates between traditional optimism and her concept of practical optimism. While typical optimism is often misconstrued as naive or "looking on the bright side," practical optimism involves a proactive and skill-based approach to fostering a positive outlook.
“Optimism simply is the tendency to have a positive outlook in an uncertain situation, to kind of expect the best possible outcome.” – [12:32]
She elaborates that practical optimism is akin to a practice requiring effort, akin to learning a new skill, and is accessible to everyone, not just the naturally optimistic 25%.
“Practical optimism helps you translate positive outlooks into positive outcomes through action.” – [13:38]
A significant portion of the discussion revolves around Dr. Varma’s framework for processing emotions, outlined in her book. She introduces a rhyming catchphrase to guide individuals through emotional processing:
Name It: Identifying and labeling emotions and their triggers.
“Naming your trigger and antecedents and knowing what they are is really important.” – [19:10]
Claim It: Recognizing where emotions manifest physically in the body.
“When I say claim your emotions, where in your body do you feel them?” – [19:53]
Tame It: Implementing self-soothing techniques to break ruminative loops.
“Taming your emotions is like short-circuiting and creating a break in that and saying, all right, I am feeling angry, anxious, helpless.” – [21:18]
Reframe It: Shifting perspectives to view situations in a more positive or manageable light.
“Reframing allows us to take back some control and says, you know what? I'm not going to allow myself to be debilitated by this.” – [23:52]
Dr. Varma emphasizes that these steps are not about eliminating negative emotions but about managing them effectively to foster resilience and well-being.
Dr. Varma draws inspiration from Kintsugi, the Japanese art of repairing broken pottery with gold, symbolizing beauty in imperfection and the value of healing.
“Kintsugi is preparing something to beyond its original form... it ends up being even more majestic and expensive and valuable.” – [27:42]
This metaphor serves as a powerful illustration of how embracing and repairing emotional wounds can lead to greater strength and beauty in one’s life.
Dr. Varma shares the poignant story of Shelly, a survivor from the 9/11 attacks, to illustrate the transformative power of practical optimism.
Shelly’s journey from devastation to empowerment showcases how processing emotions and adopting practical optimism can restore a sense of agency and self-efficacy.
“She ended up getting the promotion... embracing the fact that your life is not the same.” – [40:10]
The conversation delves into the concept of self-efficacy—the belief in one’s ability to achieve goals—and its critical role in mental health.
“Self-efficacy is your confidence in your own abilities.” – [30:53]
Dr. Varma explains how self-efficacy influences perseverance, resilience, and the capacity to overcome obstacles, underscoring its importance in recovering from trauma and achieving personal growth.
“Proficiency is about reminding people at their very core of their capability.” – [33:21]
Dr. Varma offers actionable strategies to cultivate practical optimism:
Flexibility: Embracing change and being open to new paths can help break the feeling of being stuck.
“Flexibility is a big part of proficiency. You have to be nimble, you have to be quick.” – [35:44]
Rest and Self-Care: Incorporating rest and activities that replenish energy is vital to prevent burnout and maintain mental well-being.
“Rest and leisure need to be incorporated as part of the work plan and scheduled with the same type of intention and urgency.” – [37:57]
Sleep Hygiene: Prioritizing sleep as a foundational aspect of health and resilience.
“Sleep is one way, 15-minute naps is another way... making deposits into this rest account.” – [38:59]
Self-Soothing Techniques: Engaging in activities like journaling, meditation, or walking to manage stress and prevent negative emotional spirals.
“Choose something that you can do within a short period and that doesn’t create a negative habit on its own.” – [21:18]
The episode wraps up with Dr. Varma leading a guided exercise for listeners to practice the "Name It, Claim It, Tame It, Reframe It" technique, reinforcing the episode’s key teachings.
“Success is accessible within you through a positive mindset that you have chosen.” – [43:01]
Lori Gottlieb highlights the profound impact of practical optimism, emphasizing that it involves much more than superficial positivity. It is a deliberate, skill-based approach to fostering resilience, managing emotions, and achieving exceptional well-being.
Practical Optimism: A skill-based, proactive approach to fostering a positive outlook that can be learned and developed by anyone.
Emotional Processing: Essential for managing negative emotions and preventing them from undermining mental and physical health.
Self-Efficacy: Crucial for overcoming challenges and achieving personal growth, influenced by both internal beliefs and external support.
Resilience Strategies: Flexibility, rest, self-soothing, and reframing are vital tools for building resilience and thriving in the face of adversity.
Inspiration from Art: The philosophy of Kintsugi symbolizes the beauty and strength that can emerge from repairing emotional wounds.
This episode provides a comprehensive exploration of how practical optimism can transform lives by equipping individuals with the tools to process emotions, build self-efficacy, and navigate challenges with resilience and grace.