The Best Approaches to Manage Anxiety

(helpful for all physicians for their patients during this pandemic)

In this episode, Barbara and Katherine discuss:

  • Taking care of ourselves first – it’s not selfish!
  • Top relationship practices to promote family health.
  • Managing this time of uncertainty and finding purpose and focus.

Key Takeaways:

  • Self-care is about a relationship with ourselves. It goes far beyond just activities that we do once in a while.
  • Communicate consciously, don’t make assumptions.
  • Build both family time and personal time into your schedule with your partner, to help provide everyone what they need.

“One day at a time. Bring it into a threshold that feels like you can breathe and you can do. And that’s enough.” —  Katherine Jansen-Byrkit


Barbara:         Welcome to an episode of Marketing Tips for Doctors. I’m your host, Dr. Barbara Hales.

Today, we have with us Katherine Jansen-Byrkit who received her Master’s in Public Health from the University of Washington in 1992 and spent over a decade in Public Health managing violence prevention and teen health programs. But over time, she experienced an inner stirring. What ensued was a process of reflection, curiosity and ultimately trust as she dove into her current career as a licensed professional counselor.

Following in the footsteps of her father who was also a therapist, she graduated in 2004 from Lewis and Clark College and has now enjoyed over 15 years in private practice offering not only holistic psychotherapy but retreats and workshops as well. And we’re going to get into that because I want to hear all about your retreats and I’m sure our listeners do too. But anyway, that’s just an aside.

Katherine:     Okay.

Barbara:         Last year, Katherine published her first book, River to Ocean: Living in the Flow of Wakefulness. Her book reflects the human voyage of finding your way to an awakened self. As with a river that traverses steep mountains and winding valleys, our inner and outer worlds can be encumbered by a lack of connection to ourselves, old beliefs and anxious mind, preoccupation with death. Like who isn’t if they watch Fox News all the time? Or compromised relationships to others.

Each and all of these can interfere with living our most authentic and loving life. In River to Ocean, Katherine explores nine aspects of wakefulness, offering insights, practices and her own and others’ inspirational stories from the field. Welcome today, Katherine.

Katherine:     Thank you so much for having me. I’m so happy to be here.

Barbara:         Well, especially now in times of stress, how can you practice self-care? And what are the best approaches to managing anxiety and uncertainty?

Katherine:     Wow! Such good and big questions. So, I’ll go with the self-care piece first. I think a beginning statement might be self-care is about a relationship to ourselves. So beyond it just being activities and maybe a massage once in a while or, you know, things that we traditionally think about, it really is a gesture. Self-care is about having a nurturing and loving relationship to ourselves. So, we take care of that self like others. So it can involve a lot of different things. But in times of stress, it is so important. You know, often, when stress goes up, self-care goes down which really is the opposite of the algebra that’s needed. When stress goes up, self-care needs to go up so that we are resourced and really tapped in to our resilience to manage that stress.

Barbara:         Well, not only that but increasing self-care is actually going to improve our immunity. Wouldn’t you say?

Katherine:     Exactly. I would absolutely say that. And then I would say self-care, I believe so strongly in the mind-body connection as you speak of. Whatever we do, you know that it isn’t just physical. A lot of times, people think of self-care in just the physical realm, not emotional care. And at times of stress, our bodies as much as our, you know, minds and hearts and soul need emotional self-care which includes how we are with emotions, how we work with in times of vulnerability as much as having resources of support from other people, you know, to be comforted and to not go at it alone.

I love the wide net you’re kind of throwing here in that self-care is, there’s a breadth and depth to that. And then kind of going into the idea that we’re in a family life. I have now raised six children and they’re all gone and I have grandchildren. But in times where I was navigating —

Barbara:         What a woman!

Katherine:     Oh! I loved every minute of it. And there were some really intense moments of it for sure. But that balance of how to take care of one’s self as a parent and as a partner really, you know, having those needs not compete with the needs of children or marriage or even my professional life. So it is really quite a thing to have that be, have a secure place in one’s life, our activities of self-care again kind of inner and outer self-care. The other thing is just to remember that if we are going to — Kind of like the oxygen mask. If we are not taking care of ourselves, we cannot really be a resource to others long term. So, it’s not selfish at all to really be generous in our care of self.

And I think it segues to your second question. How do we deal with times of uncertainty? The more resourced and well we are emotionally and physically, the better we will fare. I would also say that we can live with uncertainty sometimes more than we realize.

Right now, with this pandemic, there’s a ton of uncertainty. So it’s at a whole another level and that’s having its impact. But if we really check in, you know, we don’t really control things as much as we might believe. We can’t always predict things though we plan that we can predict. Our system actually does know how to deal with a certain amount of uncertainty. I’ve been coaching people just to find their feet, find what’s familiar and known, that you can kind of feel and be in touch with knowing that your uncertain future or, you know, whatever the future does hold for us, we travel forward with our resiliency and inner and outer resources.

We can trust that for a future moment. But you know, right now, it’s kind of like, oh, daffodils still look like daffodils. And if I play with my dog, that’s really familiar to my system. So that really is grounding in terms of having not everything feel so topsy-turvy. Did I kind of get to it?

Barbara:         It does. I think that’s a good tip. What are the top three to five relationship practices that promote family health?

Katherine:     Well, I really love that question. And especially in times where, whether it’s a shelter at home or not but we have a lot of availability and proximity, relationships fare pretty well with breathing room when we are in that close proximity.

Certainly, there can be challenges and relational dynamics can come up. I will always lead with regulate your anger. My own journey has been to really work with my temper and to realize that my anger itself isn’t a problem but that I needed to learn how to regulate my anger. So that is a huge thing in terms of relationship health and family health. Just that people stay calm. And if you can’t stay calm, if you’re triggered, you know how to take five, you know how to self-soothe and get back kind of your nervous system in a whole brain state. So that’s always my lead.

I would say communicate consciously kind of with I statements as the good tradition and not you statements which can put people on the defensive. So, another communication piece is not to make assumptions. Sometimes, somebody is quiet and we assume they’re mad at us or we assume that there’s a problem. And they might be fighting a migraine and they’re just quiet. It’s important to check out what we’re thinking and believing. I would say engage in quality time so that there’s really ongoing bonding, not just we are in relationships so we just exist. But also practices of autonomy again are especially important in times where we’re in close proximity. It’s really okay for everybody to take some space so that we can not get tired of one another ultimately and step on each other’s toes and be annoying.

Barbara:         Well, that’s a little bit tough at the moment with everybody home.

Katherine:     I know.

Barbara:         And being homeschooled.

Katherine:     Yes, yes.

Barbara:         So what would you advise physicians in addressing these issues with their patients in terms of like being in close quarters with their children and their spouse, not being able to get away and have that seclusion or the area that they can hide in, making sure that the kids are taking care of their homeschooling and that there are not that many friction between the family members?

Katherine:     Well, I guess as a provider I think when we can make it safe to talk about it, that’s the first thing I would hope my physician does with me. Sometimes, it’s hard to say, I’m struggling at home, we’re fighting more, I’m feeling kind of lost and I can’t afford a therapist.

I think just normalizing the conversation that family life is amazing and can be incredibly intense and difficult. So just that and just a piece of I’m not alone because you’re my physician and we’re talking about it. So that’s super helpful. I think the sense of how to encourage people to have boundaries.

Obviously, you’re not going to leave a young child unattended to so you can’t go on a run and leave the house, you know, even doing our social distancing or being outside. But I actually think of kind of creating a map of times when we are available. If we have a partner, we’re coordinating when we are available to children. But also putting into those, the mapped times where we have autonomy and some self-care. You know, respites are very important for parents just because it’s just important for parents to feel like they can get a break in some form.

Barbara:         Absolutely.

Katherine:     It’s about coordinating those needs right now so that when you want to Zoom with your friends, Barbara, that’s not actually at the same time I’m trying to meditate. And so having a map and having a schedule can really, really help. Everybody gets what they need. So that’s another piece of family health in a way and again kind of an encouragement a physician might be able to give families and parents.

Barbara:         I think that’s key. For me, what I found always helped was a sense of gratitude.

Katherine:     Oh, that’s beautiful. Yeah.

Barbara:         And you know, despite the uncertainty that we’re all experiencing now and the anxiety and stress that everybody is under now, just having a feeling of thankfulness, you know, that we’re okay, that our family is okay and that we are getting to see the wonderful relationships that we have with our children that as working people we may not get to see ordinarily.

Katherine:     Yes. I think that’s such a good point. And I think for some, we’re kind of at week 3 in this as we’re taping this. I’m not sure when this will air. And so week 1, it was different than week 3.

There’s kind of an endurance. And as people both are needing to think of this more as a marathon and not a race, they’re also adapting to being at home when maybe professionally they had not been at home as much. And what an incredible opportunity because people are getting burned out on screen time on their own which is the best. And so we’re playing games or we’re doing puzzles or we’re actually playing charades or we’re having different conversations.

And my encouragement is we are different because of any moment and time like this and that it informs our future such that we may not get back on all the horses once we can whether that’s self-care stuff or time with our children. And I think having the gratitude, working with a difficulty but keeping in mind what we have as well as opportunities to add new things, you know, different rituals we’ve not done before or connecting with friends that we have not normally connected with because we have a little extra time.

Seeing the kindness that’s happening on the planet. The creativity, the resilience that we’re seeing. When the people in Italy were just singing with and for one another, you know, and they’re locked down, like, you know, that faith in our humanity, our shared humanity is huge. I love that lead.

Barbara:         Yes, it is. What role does the structure play in the well-being of family members? I know you mentioned that everybody should have a plan or a schedule for how they’re going to have their allotted time. Is there anything else about the structure that you would mention?

Katherine:     I think it’s about really now understanding that structure is scaffolding and that scaffolding is a mental health issue. And because we kind of can dance with that in our own way and not maybe have such open space that it’s gone unless we create it within our own life and with some self-discipline.

That’s the relationship that I’m watching people see. Like, wow, I actually really — To not be in an almost like dissociative state where I’m kind of numb and I’m kind of foggy. I really need that structure. Now, structure is best not too rigid. So all of a sudden, if it’s sunny, maybe we wouldn’t read right now. Maybe now is the time to go for the walk. But the relationship to mental health could not be understated here, I guess. And that’s the discovery. But for some people, they’ve always kind of had struggle with structure. They kind of like their freedom. They like not being committed to a routine.

I think those folks are up against a harder walk right now. But maybe the opportunity is now to see the consequence of not having much structure other than what they produce for themselves and realizing that it actually really serves and is helpful.

Barbara:         Sure.

Katherine:     I’ve always been a big fan of it, again not rigidly so including having unstructured time as part of what you plan for and is within the structure. Yeah. I would add that piece to what we’ve already spoken of.

Barbara:         Can a person watch too much news and hear too much of what’s going on? You know, it’s important to be informed. But can watching a lot of news actually be detrimental for our mental health?

Katherine:     Well, I liken information to kind of one of the drugs we don’t talk about. I believe we’re in a society where we kind of, it’s a lot about getting information. And sometimes, even as a therapist, it’s about getting information about what happened to me. And that can be helpful. It can go a distance.

But more information doesn’t necessarily make me more safe. And so, I think we have to know where that line in the sand is, of how much and so that’s — For you, Barbara, it might be different than what it is for me. But at some point, there will be a threshold that I’m not learning anything.

Now, I’m just using only maybe the left side of my brain to think of it and the old way we used to think of it. I’m not doing something that is fulfilling and creative and more life sustaining. So it is important especially now to stay informed. You know, when is the shelter at home going to be lifted? What are the latest, you know, things happening with school districts? That kind of thing.

I think we always need to have a healthy relationship to information and in particular the news but especially now to not fill that empty space with just kind of binge watching, you know. Probably people were doing it in the beginning and they’re kind of like, okay, now, I need to find a different landing place.

Barbara:         Yes.

Katherine:     I would encourage you to answer that question. Like have you had to find how much is too much for yourself? What would you say?

Barbara:         Well, I think it’s important to be aware. But I think that, you know, doing important things like playing Scrabble and Rummikub with kids is way too much more important.

 Katherine:     Yeah, yeah. Right. Am I making a memory? And did I kind of already know what I’m learning from the news? There’s an interesting — I’ve heard many stories through my practice this month of people doing kind of little OCD stuff like a little compulsivity happening because it’s kind of this artificial sense of control. Like if I watch more news or if I do another cleaning when actually the next level of cleaning is unnecessary. It is sanitary. But it’s a way to channel that anxious energy.

Barbara:         Yeah.

Katherine:     And so I love your idea of knowing that there’s a restlessness and an energy and a hunger. But that’s not really what we need. That’s not really what satiates more than that game of Scrabble.

Barbara:         Yeah. Well, I was joking a little bit. But the fact of the matter is that now is a great time for us to have that inner growth with the extra time that we have.

Katherine:     Yeah.

Barbara:         Like learning how to telehealth and get online and how we are going to move forward so that we can stay in touch with our patients and take care of their health.

Katherine:     Yes. You know, for those that are switching to telehealth that are in a provider role like I am, you know, the obvious assumption would be it’s different, it’s kind of a less than. And delightfully, some of my clients have actually — There’s an intimacy with it that I’m seeing people’s homes, you know.

People have sometimes had to go get in their car because that’s the place that is — Like there is such a vulnerability and intimacy and that’s a connection. I’m seeing people’s pets because the cat walks across the screen. And so I think there is, as we are making adjustments this is now something in our pockets, certainly in mine that I can tell my clients, hey, if you don’t want to drive across the river in Portland, Oregon, traffic is not great today, we can do Zoom. And we know how to do that now and still feel super connected.

Barbara:         That’s great. What are the opportunities available to us at times of adversity and loss?

Katherine:     Well, I kind of think about that in a small picture and a big picture way. You know, we’ve been talking about practicing self-care but now really understanding how necessary that is and maybe realizing we want to be doing this kind of self-care on the other side when life is going to get busy again and there’s going to be more competition.

I would say connecting with others that we, as I mentioned before, that we might have had less contact with or deepening our connection with those we live with. You know, sometimes, we can be ships in the night with our family and even our friends. And so I think, yeah, just that.

I would say the big picture is to find purpose. You know, I’m noticing that even a few of my clients this week have talked about they’re making masks because they know how to sew and how that is changing their just wait and see. You know, am I getting my stimulus check?

When can I go back to work? When will the restaurant open? It really gives a focus and I think always there’s a — Even if it’s just getting groceries for the neighbor that you normally wouldn’t, I think that is huge to our mental health and that’s the opportunity here.

Certainly, with some time, I think you’ve said it a minute ago, we can go inward and this is a time to really look at our life. And does our life reflect what we want and who we are? And this kind of came to us. We’re kind of taking a sabbatical because life has given us this. But it’s still that moment. And I think there will some, if not a lot, for many people that might be different on the other side. So those are the things that I think about in terms of the opportunity here.

And I guess opportunity is about being opportunistic so that’s actually kind of a mindset. So, if we slow down and in times where we don’t have to have social distance and some kids are playing — You know, the moments I remember when I’ve traveled is when I joined a soccer game when I’m in another country. And I don’t know what the kids were saying but we’re having a moment. That’s being willing to engage because there’s an opportunity there. So of what I’ve described, I think every day is an opportunity for much that can be missed in normal life.

Barbara:         Sure.

Katherine:     So that’s what’s at hand.

Barbara:         Now, you have a very interesting blog where you titled it One Day at a Time. I found that very interesting. And you asked which I’m sure a lot of people are asking, what are the opportunities embedded in contending with the COVID-19?

Katherine:     Well, it’s kind of going back to the uncertainty thing in terms of using the serenity prayer. I love traditions and teachings from all walks of life. In the 12 steps, one day at a time comes from that tradition. And so, boy, in times when I was raising children and not just managing life in a pandemic, I had to do one hour at a time.

I encourage people to not get overwhelmed with looking at the whole when it’s kind of like looking up at Mount Everest and you’re about to climb it. It’s too big. You can’t imagine yourself getting to the top. One day at a time and just bringing it in to a threshold that feels like you can breathe and you can do which is always how life is happening. It’s happening actually one minute at a time, one breath at a time.

We just have the capacity to see so much more. Yeah. So that was where that came from and just really giving people explicit permission to just bring it in and that’s enough. You just have to do this today. You just need to do this hour. You just need to do this. I’m working with a lot of actually healthcare providers. This shift. They’re scared. They’re going into frontline work with a virus that can be quite deadly. And there are lots to protect them but it’s still a human. You know, it’s frightening. And so to really help them manage that as it’s also incredibly meaningful to those that are reporting that work to me.

Barbara:       It’s very scary.

Katherine:     Yeah.

Barbara:         Especially when you hear about not having protective gear.

Katherine:     I know.

Barbara:         And they’re getting sick or getting exposed and then going home to their family. It’s very scary.

Katherine:     Exactly. Or they can’t go home to their family. They’re both outsourcing and just really providing such an incredible thing to their community and to others and then not necessarily being fed in the ways we at a human level get fed so that we can give to others. It’s a really intense time that way. Yes, yes.

Barbara:         I think that feeling the purpose of this is what I went into Medicine for, to help people.

Katherine:     That’s so great.

Barbara:         It goes a long way to help us cope with that.

Katherine:     Yeah. That’s right, that’s right. And I think that can be in a professional way. Sometimes, I work with people that feel like I can’t land on that thing. Maybe, Barbara, you and I did.

We were very clear about the form that took. And that’s why to me every day there is a chance to bring that form of meaning into our lives by having a purpose. You know, I’m really going to notice the garden that my partner just planted last week. But yes, I think that that’s ultimately part of our greatest well-being, is to have a purpose in life, whatever that is to be whether — For me, it was in writing a book.

I did publish a book that just came through. But definitely, being a healer and offering what I’ve been given to others and how that serves my own well-being and just contentment in life and fulfillment, for sure.

Barbara:         Yes. 

Katherine:     Yes.

Barbara:         How can our listeners buy a copy of your book?

Katherine:     Well, thank you for asking that too. You know, it’s on, We have a local really but kind of famous bookstore here in Oregon called Powell’s so It’s an eBook. This year, we’ll do an audio book but it’s not an audio book yet. And then if they visit my website, I can actually also send them an autographed copy of that if they want that.

Barbara:         Oh, exciting. Yeah. And what is your website?

Katherine:     So it’s harborglowholistic. So do you want me to spell that out? Or is that clear? Dot com. So harborglowholistic.

Barbara:         I think that’s clear. Okay. Well, that’s great. I really enjoyed speaking with you today.

Katherine:     Oh, me too.

Barbara:         This has been our guest, Katherine Jansen-Byrkit and another episode of Marketing Tips for Doctors with your host, Dr. Barbara Hales. Thank you so much. Until next time.

Katherine:      Thank you.

Connect with Katherine Jansen-Byrkit:  

Facebook: Harbor Glow Publishing & Innergy Counseling


Book: River to Ocean: Living in the Flow of Wakefulness


Connect with Barbara Hales: 

Twitter:   @DrBarbaraHales



Show website:



YouTube: TheMedicalStrategist