Election Stress: Mental Health and The 2020 Election : It's Been a Minute It's Election Day, but instead of the latest politics news, we're giving you some therapy. Sam shares listener questions around mental health issues with psychotherapist Lori Gottlieb. In addition to her clinical practice, Gottlieb is the New York Times best-selling author behind Maybe You Should Talk To Someone: A Therapist, HER Therapist, and Our Lives Revealed. She and Sam discuss burnout, white guilt, and when the right time is to reach out to a therapist. Gottlieb also co-hosts the podcast Dear Therapists and writes the weekly advice column 'Dear Therapist' for The Atlantic.

How To Take Care Of Yourself This Election Season

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UNIDENTIFIED PERSON #1: Well, this has been a hard year for many people, but...


JOHN OLIVER: Our main story tonight concerns the 2020 election.




UNIDENTIFIED REPORTER: The staggering and rising death.




UNIDENTIFIED PERSON #4: There is a lot of anger in the country.


KAMALA HARRIS: Everything that's been going on in the country over the past few months - it's been a very difficult stretch for so many people.



Hey, y'all. From NPR, I'm Sam Sanders. IT'S BEEN A MINUTE. So this year, this election season, this everything, it has been a lot. In fact, a lot of you might be hearing this on Election Day, which for many reasons seems particularly stressful. Knowing all that and knowing that we all could use a bit of help dealing with everything, this episode, we are giving you a therapy session.

LORI GOTTLIEB: I think that a lot of people are starting to say, wait a minute; I really need to focus on my emotional health in a serious way. And I think it's also a time where people are saying, wait a minute; I can feel my feelings, and it's not going to kill me.

SANDERS: That is psychotherapist Lori Gottlieb. She is the author of the bestselling book "Maybe You Should Talk To Someone." On top of that, Lori is a podcast host and columnist, and she is still seeing clients. So for this episode, we asked all of you to send in questions that you wanted us to ask Lori, and we got so many - questions about burnout and hopelessness and relationships and guilt. Lori answered a few of them, and you'll hear them now. But first, she told me what she's been hearing from her clients right now. Enjoy.


GOTTLIEB: You know, a lot of people are so afraid of saying, oh, I'm feeling anxious or I'm experiencing depression or I have insomnia or I'm going through a lot of grief and loss. And now people are saying, it's OK. And I think that our culture is making it more OK since we're all going through a big event together, even though people are responding in different ways. I think everybody's saying, it's OK to feel your feelings. And not only is it OK, but it's better for you, it's better for the people who live with you, your families...


GOTTLIEB: ...And it's better for society at large.

SANDERS: Yeah, yeah. You know, so I want to get to some questions that our listeners sent in. We tweeted a call out a few weeks ago saying, hey, we're going to have a real, live therapist on the show. We'll ask her your questions. Send them to us. We got so many, and I want to share a few of them with you.


SANDERS: This, perhaps, is the one theme that we got the most. It points to this general feeling of, like, oh, my God. The question from Kristen (ph) reads, I have a lot of questions, but I think it boils down to this. How do you not lose it when everything feels totally hopeless?

GOTTLIEB: So here's the thing about hopelessness. There's a difference between saying, there's a lot that's wrong...


GOTTLIEB: ...And I can do nothing about it, or there's a lot that's wrong, and here's what I do have control over. Here's where I do have agency. And that's where you go from hopelessness to a place of feeling like you are engaged and you are doing something. So I think that staying in the present is really important, instead of saying, you know, this might happen and that might happen, and that starts to get you down, to say, what can I do right now that would be productive?

We talk about these two kinds of anxiety. There's productive anxiety and unproductive anxiety. So productive anxiety is where you're reasonably worried about something, and it motivates you to take action to keep yourself safe. So we're reasonably afraid of getting a deadly virus, and so we are doing all the things like wearing masks and social distancing and sheltering at home as much as we can. And that's productive. If you weren't worried about the coronavirus, you would just go on as usual, and then you would endanger yourself and your community.

Unproductive anxiety, on the other hand, is where the hopelessness comes in. It's obsessive rumination. It's like you're checking all the headlines. You're reading the news more than you need to. And you're just sort of bathing in, like, all the despair instead of saying, what can I do right now? Part of it might be self-care. Maybe I can take a walk right now. Maybe I can read a book right now. Maybe I can connect with somebody right now. And part of it might be, how can I help my community? Is there somebody who needs a meal right now and I can drop it off on their doorstep, like a neighbor, for example? Is there something I can do about a political situation that you're not happy about or a social justice situation that you're not happy about? And there's so much that people can actually do from their laptops that matters.


GOTTLIEB: So I really encourage people to turn that helplessness into action.

SANDERS: Yeah. Well, then I also think part of it has been, in this moment, realizing that, like, we aren't as big of a deal as we thought we were. We can't do as much as we thought we could. I think the pandemic has been humbling for so many of us. And sometimes I think, at least for me, when I have that unproductive worrying or I feel like, why can't I change everything, it's a moment for me to say, well, Sam, you could never change everything. You're one person. Don't think so highly of yourself that you think you have control over all of these things. And it's just been this kind of moment to say, I can't do everything, and that's the way it's supposed to be.

GOTTLIEB: You can't do everything. But I think that most big transformations come about from the tiny, almost imperceptible steps that we take along the way. So what I want to encourage people to do is to take those tiny steps. So, yes, you're right.


GOTTLIEB: It can feel really overwhelming to say, this is a huge problem. And what can I, as one person, do? It's another thing to say, what small step can I take today, just one thing that will have an impact over time if I keep taking more steps every day?

SANDERS: Yeah, step by step. You know, one of the things that we got in the inbox was from folks who know that they should probably talk to someone, know that they should probably reach out to a therapist, but they're worried about affording it. You know, for folks out there who want to do this but don't have good health insurance or are just broke, are there any ways around that?

GOTTLIEB: Yeah. So most cities have clinics where the services are either low fee or no fee. And everything is moved online. So it's a great time to just Google your local mental health clinic and see what resources they have.

SANDERS: Coming up, Lori answers listener questions about feeling guilt in this pandemic and how race might play into that.

GOTTLIEB: It was a real wake-up call for me that this has to be part of the conversation with everybody.


SANDERS: The next question is from Mike (ph). It reads, my question is in a bit of a different direction. Since the beginning of the pandemic, I got engaged. My fiancee got her first full-time job as a teacher after getting her master's degree. I went from working in an office with a 45-minute commute to working from home full-time. And we purchased our first house in a great area of Portland. All in all, as terrible as COVID-19 is - we both got it in late February - in this moment, our lives have gotten better. This has filled me with a deep sense of guilt and helplessness.

On top of that, the social justice movements in Portland make me feel equally guilty for my privilege. I march. I buy local art to support artists in town. And I donate money to BLM causes as well as climate causes. I almost feel guilty for even sending this email, taking up inbox space and your time when we should be listening to our BIPOC neighbors. How should I address these feelings of guilt and helplessness? And what else can I do to support the less fortunate members of my community?

That's heavy.

GOTTLIEB: Yeah. I really like that Mike is so thoughtful about this and that he can acknowledge both his privilege and his guilt. And also, I think he needs to get comfortable with something that so many of us are uncomfortable with right now, which is experiencing joy in the midst of pain. So a lot of people feel like, well, I'm not allowed to laugh. I'm not allowed to say I really am glad I don't have to commute to work every day right now because we're working from home.

SANDERS: Oh, yeah.

GOTTLIEB: I get to wear sweatpants every day. Like, these little quality of life things are actually improving people's lives in certain ways. And we feel guilty for anything - for feeling anything positive right now because there's so much suffering going on around us. And I like to think of it as - you know, I write in my book about the hierarchy of pain, that, you know, people don't want to acknowledge how they're feeling because they place it on a hierarchy. It's almost like - we don't do this with our physical health, right? So if something were to happen, like you broke your arm, you wouldn't say, I'm not going to go to the doctor and get a cast for my arm because somebody else has Stage 4 cancer, right?

SANDERS: Yeah. Yeah.

GOTTLIEB: We just don't know that.


GOTTLIEB: But we do that with our mental health all the time. We say, you know, I'm not going to talk to somebody if I'm feeling, you know, anxious or, you know, sad or I'm having trouble in a relationship right now because so many other people have it worse, right? So Mike's situation is a little different. It doesn't sound like he's struggling. But it sounds like what he is struggling with, if anything, is this sense of, am I allowed to experience contentment in a time when there's so much struggle?


GOTTLIEB: And absolutely, we - so the thing about the human condition is that it's not binary. It's not like it's - you can only feel one thing at a time. We can feel many things. And feelings are sort of like weather systems. They blow in, they blow out. So right now, he's, you know, sunny where he is.


GOTTLIEB: But at another time, it's not going to be. And you don't need to, you know, like, not experience your joy. It doesn't take away from other people's situations. It doesn't mean that you're not compassionate. It doesn't mean that you don't care about other people. In fact, it sounds like he is quite involved in his community. But I think he has to get comfortable with the fact that you can be involved and try to help other people at the same time that you can enjoy being OK.

SANDERS: Yeah, yeah. And we're often in a better position to help those who are suffering if we are fully taking care of our own mental health, which means, for him, learning to be OK with being OK (laughter).

GOTTLIEB: That's right. So many people are not OK with being OK. They feel like something's wrong if I'm OK. Something's wrong if I'm not struggling.

SANDERS: Yeah. Yeah, it's OK if it's OK. Yes. Well, you know, a thread in this question and some others that we got from listeners was a sense of how race informs this. Like, you know, there's guilt about being successful on his behalf, but there's also white guilt working there. And I think there are a lot of conversations happening in the culture about how to use those feelings of white guilt for good. But in terms of, like, a clinical conversation, how do we - how do you, I guess, talk with folks when their feelings of contentment are also informed by things like their race and other people's race?

GOTTLIEB: Well, I think race is so important to bring up in therapy. You know, it used to be that people would think, well, what you want to do is you want to be colorblind, which is probably the worst thing you can do...

SANDERS: Yeah, yeah.

GOTTLIEB: ...Because you're denying somebody's entire identity, right?

And so I actually wrote about this. I wrote a piece about how I had had a patient who was Black, and she and I were so - I'm white - and she and I were so similar in, like, every way. We, you know, had similar backgrounds. We went to the same schools. We both were similar professionally, our families, the number of kids we had - you know, everything - the ages of our kids, our personalities.


GOTTLIEB: And we never talked about her Blackness, and this was my fault. I made the assumption that because we were so similar, you know, I think I was being overly careful without realizing it, that somehow I would offend her if I brought up race. But it was quite the opposite. And one day she came in, and she said, this thing happened at work. And she was really upset because it was - clearly had to do with race. And it was the first time that we started talking about race and how much it permeated her life all the time. No matter how similar we looked, we had different experiences because she's Black, I'm white.


GOTTLIEB: My experiences are different from hers. Her experiences are different from mine. And it was a real wake-up call for me that this has to be part of the conversation with everybody, right?


GOTTLIEB: So people will come in and say, I'm really struggling with guilt because, you know, I'm white and I've had privilege in that way. And it's really important that we talk about it. And it's not only, how do I think about this and talk about it, but what do I do about it?

SANDERS: Yeah. Well, and how do I let - or how do they let their whiteness not get in the way of being good to others and themselves? Like, so part of the work is acknowledging how race plays into this. But then I think the next step for a lot of folks like the listener who wrote in is not letting your whiteness get in the way of actually doing something productive, either for others or yourself. Like, it would be awful if Mike, who wrote in, lets this white guilt cripple him, you know? Instead, he should look at it, acknowledge it, and then say, how do I move forward from there?

GOTTLIEB: Yeah. You know what? I think there's freedom in truth, always. And I think that what happens is if you hide behind the guilt - and I don't think that people do it on purpose, but I think that it's more comfortable to say, I feel guilty about this, than to deal with the discomfort of, I'm part of the problem, and I need to do something about it. And I think when you acknowledge the truth of, yes, you are part of the problem, we are part of the problem, and we need to do something about it, that's really uncomfortable.


GOTTLIEB: It's so much easier to say, I feel guilty about this. And then you almost feel like a good person because you feel guilty, but you're not.


GOTTLIEB: You're not being a good person by sitting there and feeling guilty and doing nothing.


GOTTLIEB: So I think the conversations we're having are much more honest. And I think that's where, you know, I think true emotional freedom, and then also just literal freedom, lies because we're going to be doing something about this.

SANDERS: Totally, totally. This is a question about some practical techniques you can use to just cope. This question comes from Madison (ph). She writes, what are some very small moments of Zen or coping mechanisms to try when everything feels overwhelming?

GOTTLIEB: So I think it's going to be different for each person. And now's a good time to say, what is it that helps me? We are so concerned right now about protecting our physical immune systems with the virus, but we have to also bolster our psychological immune systems. We can't do things that are going to overwhelm our psychological immune systems. So all the things that are - for some people, it's there's this person that they want to call, you know, that really is rejuvenating for them and feels connecting for them. For other people, it's, I need some time by myself and I need to take a bath, or I need to do something creative. I want to get out those art supplies. You know, it's different for everybody. But I think you have to know what those things are.

And the other part of it is, again, to stay grounded in the present. And you can do a quick little exercise where you just sit very quietly by yourself in a comfortable place, and you feel your feet on the ground. You just sit there, and you feel them. And you go all the way up your body. And now you feel your knees, right? And you just feel this sense of calm moving through your body, all the way up until you get to your head. And it just really grounds you in the moment. And you're just breathing throughout it.

SANDERS: One more break here. When we come back, more listener questions and more therapy.


SANDERS: All right. This is from Dave (ph). He writes, my question is, if you've spent 2020 minimizing everything as a coping mechanism, how can you un-compartmentalize to recognize it as a trauma it is?

GOTTLIEB: So people are so afraid of feeling. And I think that people's fear of their feelings is always bigger than the fear itself, when you actually feel your feelings...

SANDERS: Yeah. Yeah.

GOTTLIEB: ...That they're not as scary as we think they are. What happens is people start to minimize, as Dave said, or kind of stuff down their feelings. And what happens is those feelings don't go away. They actually become bigger because feelings need air. So they come out in other ways. And they're kind of stealthy, right? They come out in these kind of sneaky ways. So they'll come out in your - you notice that you're eating too much junk food.


GOTTLIEB: You notice that you're drinking too much alcohol. You notice that you're getting in these petty arguments with the people around you. You've got this sort of short-temperedness going on. You're not sleeping well. You have insomnia. You're either not falling asleep well or you are waking up at odd times. You're scrolling mindlessly through the Internet for when you get that screen report at the end of the week, and you're like, you spent six hours a day online.


GOTTLIEB: Wait; what? Did I?

SANDERS: Yeah. Yep. Yeah.

GOTTLIEB: You know, that's because you weren't wanting to feel your feelings. And so what you do is you try to numb them out. But numbness isn't the absence of feelings. Numbness is the experience of being overwhelmed by too many feelings. So when we talk about minimizing our feelings, it's not protecting us. We're doing that to protect ourselves. But it doesn't, in fact, protect us. In fact, it puts us more in jeopardy.

SANDERS: Yeah. Yeah. You know, in that same vein, I think, like, there's also this kind of - there's also this kind of negotiation people are having to have with themselves about figuring out if it's time to talk to somebody, you know? How do you know when it's time to seek help? How do you know that it's time to have a conversation with a loved one about your drinking or about your eating or whatever? How do you know when it's time to just call that therapist? Like, are there some telltale warning signs?

GOTTLIEB: I think if you're asking, the answer is yes. And so people want some kind of sign. They want to know, well, is it bad enough? Is it severe enough? And it's kind of like what I was saying about the difference between how we treat our physical health and our emotional health. You know, if you are experience - like, say you have, like, something feels weird in your chest, like, you have some kind of chest pain. You're going to go to the cardiologist before you have a massive heart attack - most people will. Most people will say, wow, that's - this is not normal. I got to get this checked out, right?

SANDERS: Yeah. Yeah.

GOTTLIEB: But if something feels off emotionally, we go through this whole series of, well, is it bad enough? And compared to other people, is it bad enough? And do I really need to get this checked out? And what happens is people don't land in my office until they're having the equivalent of an emotional heart attack.


GOTTLIEB: So they didn't come when they first had - when they had the first signs of something feeling off. And what happens is - when you wait that long, not only is it harder to treat because now you're in a much different position, but you've suffered unnecessarily for so long. So why do we want to do that? Why do we want to suffer unnecessarily and wait until the problem gets worse and then go see someone? The time to see someone is when you say, oh, I wonder if I should talk to someone. This doesn't feel right to me. That's the time to go.

SANDERS: Yeah. Yeah. What do you - how do you think - you know, from what you see with your clients just in the world, like, how strange of a place are we all in collectively? And, like, at what point do you think we'll be able to feel either more at peace with whatever we're in right now or rounding the corner towards something else? You know, and it's hard to answer that question. But I'm just selfishly asking, like, when will it start to feel different or normal or better again? (Laughter) Is there any way to know?

GOTTLIEB: I don't think it happens all at once. I think that we are - you know, I think if you had said to all of us back in, like, January, in a couple of months, there's going to be this global pandemic, and everybody - everything's going to shut down, and people are going to shelter at home, and people are going to die and get very ill, and everybody's going to be wearing masks, and your kids are not going to be going to school, and you're not going to be going to work, or if you are, it's going to look very different, I think a lot of people would have said, well, I can't tolerate that. I'll never be able to, you know, get through that.


GOTTLIEB: And yet, look at how resilient we've been. Look at how flexible and adaptable we've been.

SANDERS: Yeah, yeah.

GOTTLIEB: And so when we talk about, you know, how long is this going to go on and how are we going to deal with it and will we ever feel, quote-unquote, "normal" again, I think that this experience will inform how we feel in the future and maybe in some positive ways, like, again, really saying, oh, you know, these things that I took for granted, I'm not going to take for granted anymore, whether that's, you know, your job. You know, so many kids are saying, I really miss school. I never thought I would say that. People are saying, I really miss my job. I really miss going to work and seeing my co-workers every day. Whereas before, you'd wake up and say, oh, I wish I didn't have to go to work today. Now we're saying, I wish I could go to work today.


GOTTLIEB: You know, so I think it's not taking for granted the things that we took for granted - the people in our lives, the different things that give us meaning and purpose in life. And if those things are not giving you meaning and purpose, to really reevaluate. And I think the legacy of this time will be making changes in your life that are long overdue.

SANDERS: Yeah. You know, hearing you talk about this last point, I was thinking back to something you wrote in your book. You say, quote, "I've always been drawn to stories - not just what happens, but how the story is told. I'm listening to narratives for their flexibility. Do they consider what they're saying to be the only version of the story, the accurate version, or do they know that theirs is just one of many ways to tell it?"

And I've been thinking about that a lot, just this, like, what story am I telling myself? And I just had this kind of epiphany over the last week that kind of gets at what you're saying, you know? At the worst of the pandemic, things were just bad, and I was in a really bad place. And every day, I would just kind of be like, how am I going to get through this day? How am I going to get through this? How am I going to get through this? How am I going to get through this?

And then, one day, I just kind of said, I'm not going to say that to myself anymore. I'm going to say, look at what you've gotten through. You know, the getting through this happens every day. You're getting through it. And so instead of asking myself how I'm going to get through it, I can pat myself on the back for getting through it every day and surviving every day and still being here.

And I think that, like, reframing some of those narratives and, you know, congratulating ourselves for our resilience, like you're saying, that's what we have to do. That's sometimes all that we have - our own narrative, our own story. And how are we going to use these stories to, you know, help ourselves?

GOTTLIEB: Right. And I will say that narratives are contagious. So if your narrative is, this is so terrible; I hate waking up every day; it's never going to get better, that's the narrative that everybody around you is going to hear.


GOTTLIEB: And I say that, too, in the context of the stories that we tell ourselves. So when I'm doing public speaking, I will often say to people, you know, show of hands, who's the person that you talk to most in the course of your life? And a lot of people will raise their hand, and I'll say, like, is it your partner? Lots of hands. Is it your sibling? Is it your best friend? You know, you get lots of hands. But the person that we talk to most, the people that we talk to most in the course of our lives is ourselves. And what we say to ourselves isn't always kind or true or useful.

I had this patient who didn't believe me when I said, you know, I think that the stories that you're telling yourself are really hurtful to yourself all the time. She said, no, no, no. I'm not like that. And I said, I want you to write down everything that you're telling yourself over the course of a few days and come back to me the next week. She came back the next week, and she had this whole record of what she said to herself. And she said, I am such a bully to myself. I had no idea.


GOTTLIEB: And there were things like, she made a mistake, and she said to herself, you are so stupid. Right? She said that to herself.


GOTTLIEB: How many of us do that? We do that, right? And so I think it's really important that we listen to the story that's playing in the background and we make sure that we are making room for other, more useful, kind and accurate versions of a story that's going on at the same time.

SANDERS: Yeah. My story is loving and kind and optimistic.

GOTTLIEB: And when we have more compassion for ourselves as the narrator of these stories, we will have more compassion for the people around us, too.


SANDERS: Thanks again to psychotherapist Lori Gottlieb. Her memoir is called "Maybe You Should Talk To Someone," and it's going to be a TV series very soon. Lori also has a podcast called "Dear Therapists" and a weekly advice column for The Atlantic.

This episode was produced by Anjuli Sastry and edited by Jordana Hochman.

All right, last thing - listeners, we have a special surprise for you. In this podcast feed tomorrow, dropping in your feeds, the day after Election Day, I'm going to talk with New York Magazine reporter Olivia Nuzzi. We will talk all about the election. And if y'all know Olivia's work, she has been covering the right and the conservative movement and the Donald Trump White House for years now. And she has, gosh, so much access to the inner workings of the White House right now. She'll talk all about it and what's next for the Republican Party. It's going to be a good chat. You don't want to miss it. That is tomorrow, Wednesday, day after Election Day, in this podcast feed.

All right. Till then, I'm Sam Sanders. We'll talk soon.

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