Overcoming Anxiety: Sarah E F O’Brien of Thrive & Shine Counseling On Five Effective Strategies for Mental Well-Being
An Interview With Nancy Landrum
As cliche as it may be, deep breathing is a remarkable strategy for reducing anxiety, and really any elevated or intense emotion or symptom of a mental health disorder, as I mentioned above. It might be cliche, but it works! Deep breathing has been proven in neuroscience to reduce the brain’s output of cortisol (stress hormone that starts pumping when breathing becomes shallow when we’re anxious) and calm the physiological system. And did you know that it does this, has a calming effect that you notice in your body, faster than Xanax?! That’s right, that’s science! That’s why deep breathing techniques will always be my first go-to strategy for managing anxiety, and the one I first suggest to others.
Anxiety seems to be the dis-ease of our times. More people than ever are taking medications to help them cope with stress. Nearly everyone I talk to is consumed with anxious feelings that hijack any pleasure they could be getting from their lives. The pressure to “produce” combined with a perception of “not enough time,” combines to create anxiety, self-doubt, frustration and resentment. Resentment, then, is often taken out on your closest, most important relationships. As a part of this series, I had the pleasure of interviewing Sarah E. F. O’Brien.
Sarah E.F. O’Brien is a dynamic and innovative trauma informed professional. Not only has she been a Licensed Clinical Social Worker for the last 15 years, she is a 2x Founder and currently operates both her Psychotherapy Practice and Coaching & Consulting Business as a solopreneur. She is a vetted Subject Matter Expert in mental health and trauma informed care. She recently became a bestselling author and started a new role as Chief Mental Health Officer for an advocacy and education community dedicated to reducing the stigma related to mental health. She is a leading voice in trauma informed leadership strategy and she strives to help folks wrap their minds around trauma-informed skills in leadership, in both clinical and non-clinical settings. Neuroscience and evidenced-based practices are the driving forces behind Sarah’s approach to understanding how people create lasting and transformational change for themselves and their businesses.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” better. Can you tell us a bit about you and your backstory?
Sure thing. I’ve been a practicing licensed psychotherapist for over 15 years. Initially, I had planned to obtain an PhD in Clinical Psychology. However, a really great college advisor asked me some important questions to narrow down my career goals. Did I want to do research and teach at the collegiate level some day? No, not really. What exactly did I want to do with that degree? Practice! I wanted to practice psychotherapy with clients. She educated me about clinical social work, the graduate programs available, and informed that obtaining a clinical social work degree and licensure for independent practice would allow me to practice as I desired, without trudging through doing a lot of research. See, I love research…but reading it, interpreting it, analyzing it, applying it to practice. I don’t at all enjoy doing, or conducting, the research. Some tedious and repetitive tasks I enjoy, however, the ones that come with doing my own research did not appeal to me, and still doesn’t!
I went on to apply to several big-name graduate programs for social work, including my dream school: NYU’s Silver School of Social Work. Well, I got in! And was offered a bit of scholarship money to attend. I really had to sit on the acceptance letter for a few days before ultimately turning it down. The incredibly high cost it was still going to be to attend an out of state graduate school did not make sense knowing that I would make little as a social worker post-graduation. For that reason, and with a parent here in Virginia who was terminally ill, I chose to attend my ‘fallback’ school: Virginia Commonwealth University. Affordable, and, a well-known and fairly prestigious graduate program for social work, ranked 11th in the nation at the time. It was good choice. Because I feel in love with Richmond, Virginia. And I still love RVA to this day. It is my home, and it is wonderful. I’ve been a lot of places, and I choose to live in Richmond because it’s such a great city.
Fast forward 15 years, as I said, and I’m still living here and still working here, and still loving it here. Now, I specialize in the treatment of Anxiety Disorders, Substance Use Disorders, Partners/Spouses of someone with an addiction, Relational Trauma & Developmental Trauma Disorders and responses. I managed to take my completely in-person practice and flip it to a virtual practice overnight during the pandemic. I have remained in virtual practice because it works better for me at this point in my life, and it actually reduces my anxiety on a day-to-day basis. Not commuting is a big plus. Controlling the temperature, wearing super comfortable clothes from the waist down, taking off my shoes, and seeing my pups throughout the day are other anxiety-reducing perks to working from home now.
As a successful person in your field, have you or do you experience anxiety? And if so, how do you manage, reduce or eliminate anxiety so you can work efficiently and enjoy your non-work hours?
Yes, I have experienced anxiety, and do regularly. I have been diagnosed with Generalized Anxiety Disorder myself. Some of the things I’ve learned to do to manage my anxiety symptoms include slowing down — slowing down the pace of walking, driving, eating, talking, moving about. Intentionally slowing down movements and transitions to reduce rushing and feeling frazzled.
I also engage in healthy body movement 4–6 days per week which includes walking, yoga, Zumba, body weight training, and stretching. This helps dispel anxious energy that gets built up, and it also helps alleviate acute anxiety symptoms in the moment. For example, if I’m feeling anxious (and notice it), it can be helpful to take a walk or do a yoga class.
I prioritize sleep, above everything else. As a person with chronic insomnia from past trauma, sleep does not come easy for me at all. In fact, my body fights sleep like it doesn’t need it. Except, we know we do need it. Successive nights without adequate sleep will absolutely increase my anxiety symptoms AND make it more difficult for me to cope with the symptoms (due to fatigue, brain fog, sluggish feeling) and the energy necessary to apply healthy coping strategies. Lack of sleep will make it much harder for me, and anyone else, to cope effectively with symptoms of anxiety, and lack of sleep actually increases the symptoms, too. Sleep is #1.
Have you gone through a period of time in your life where you felt as though you were drowning in anxiety? If so, please share your experience and what you perceive as the reasons.
I was extremely anxious while in school. Grade school all the way through graduate school. As many with anxiety, perfectionism rules my behavior a lot of the time. This means trying to be perfect in school. Perfect in school = straight A’s…forever. For nearly 20 years straight, I tried to be a perfect student, getting perfect grades, so I could set myself up perfectly for a future career and financial independence. This drive to be perfect and to succeed meant I was running on adrenaline fueled by anxiety. Hypervigilance about assignments, projects, tests, grades, and my efforts always close by my side. Did I mention I had perfect attendance too? Yea, anxiety about missing class, missing information, and doing poorly. I was so anxious at times in college, and hell bent on doing the absolute best I was capable of (all of the time), I would get sick, get stomach ulcers, and have panic attacks. It took a lot of time to realize my constant anxiety was causing physical symptoms and illness. And then it took even longer to address my anxiety, and the catastrophic and ruminating thoughts associated with my anxiety.
What or whom did you lean on to help you cope with anxiety?
After so many bouts of panic attacks and stomach ulcers, my roommate suggested I consider therapy. No one in my family, no one in my life that I was connected to personally, had ever been to therapy. Even though at this point I was in college to become a therapist, I had never been to therapy and never considered it. This was new to me. And I didn’t know what to expect.
But I heeded their suggestion, and set up an appointment with a clinical psychologist at the university counseling center. This was my second year in college and I was 20 years old. I did individual sessions with that person and attended group psychotherapy sessions with other students experiencing anxiety, and all of this helped me to understand that I was not alone in my anxiety, in my symptoms, others were experiencing them as well. It also helped me to learn some coping strategies (like talking it out, exercise).
What lessons did you derive from that dark period of time, that serve you now?
I learned to look outside of myself, my current feelings and worries, and see the people and world around me. That still helps me to this day, albeit still hard at times, to redirect my anxious thinking.
I learned that mental health treatment is available, and that it is helpful. This helped me to normalize seeking out help when I was struggling, or drowning in my symptoms and unable to function in typical ways, or getting physically ill due to constant anxiety and panic. The fact that I actually went to therapy, individual and group, and that it was actually helpful, reduced any stigma associated with mental healthcare for me from then on. I was going to get here eventually, since I was on the road to becoming a mental healthcare provider myself. But having my own personal experience with symptoms, with treatment, and with relief really solidified this professional pathway for me. And cemented the benefits of seeking out help and support from a professional when I can’t get to where I want to be or who I want to be on my own.
Do you have days or circumstances that still cause excessive stress?
Of course. Financial insecurity still causes stress and anxiety. As a mental health provider, specifically a clinical social worker, I do not make tons of money. Direct result of an entire profession being undervalued since its inception. As a provider that accepts insurance, I am at the mercy of those big businesses and their choices about what to reimburse for the treatment I provide. It’s really frustrating and disappointing to have not seen rate increases since 2020, especially since inflation is off the charts. Being out control of changing this reality kicks up a lot of anxiety. In fact, most times I cannot be in control of something, in walks my anxiety, shouting all of the problems and potential pitfalls of the situation. It’s really quite disruptive!
Also, have you ever built a house? Incredibly stressful! Several years ago, my spouse and I set out to build a new home. Even though we vetted the builder, it was still THE MOST STRESSFUL and anxiety-provoking experience of my life! I do not recommend. Especially if you already have or feel a lot of anxiety or stress. Building is like moving (one of the most stressful things for a person) times one million! There was so much stress, anxiety, and uncertainty during this time, it was nearly impossible to manage my anxiety, let alone reduce it. Due to many factors, including not being in control at all of the process, and poor communication with lack of transparency from our project manager, my anxiety remained heightened for the duration of the process. Not fun! I’m back to a nice, slower pace of life now, so I’ve returned to baseline, and it feels so much better in my body and my mind!
What are your dependable “go to” strategies that you use to restore balance to your emotions?
The number one thing I use, and also suggest and encourage my clients to use, are deep breathing techniques. Specifically, ones that calm the nervous system and turn off the amygdala (fight/flight/freeze/fawn). Techniques like 4–7–8, and where you extend the exhale for longer than you inhale, actually works at calming your physiological system (where we feel emotions) faster than anything else on the market! Seriously. That’s true. Deep breathing strategies and practices are extremely helpful, don’t require props or tools, and can be taken anywhere and used anywhere at any time! It’s literally THE BEST strategy to relax and calm yourself.
The other go-to for me is music. If I can put on tunes, that I enjoy, and even sing and dance around, there’s a strong likelihood it will reset my stress and anxiety. And at the very least, it distracts me from it for a while, and allows the other part of my brain to bloom for a bit. In one of the most stressful periods for me (I’m pretty sure it was during that house-building phase), I listened to over 84,000 minutes of music in one year. Music was my go-to escape to find fun, peace, and calm. And it still is. Without music I would die…at least, without music, I would not thrive!
Please name five tips, practices, beliefs or affirmations that you recommend to anyone going through a highly stressful time.
1 . A phrase I’ve come up with to help clients through spikes in anxiety and stress is this: Focus on what is, rather than what isn’t. This is a twist on ‘be grateful for what you have, stop comparing what you don’t have to what others do have.’ It’s just not helpful to be focused on what you’re not getting, what you don’t have, what’s going wrong, what’s ‘bad’ in your life. Or worse, what’s bad in your life compared to what others have going on. This keeps folks in a scarcity mindset, which reinforces fear, fear about what you need but don’t have or can’t get, which leads to anxiety, which leads to negative and obsessive thoughts about the ‘problem’ and ways to ‘fix it.’ All of this just keeps us in an anxiety loop, and keeps pumping out stress in our bodies. Redirecting focus to what you already have, what already is, moves us away from a scarcity mindset and into an abundance mindset, which is more positive and, certainly, a less anxiety-provoking place to be.
2 . As cliche as it may be, deep breathing is a remarkable strategy for reducing anxiety, and really any elevated or intense emotion or symptom of a mental health disorder, as I mentioned above. It might be cliche, but it works! Deep breathing has been proven in neuroscience to reduce the brain’s output of cortisol (stress hormone that starts pumping when breathing becomes shallow when we’re anxious) and calm the physiological system. And did you know that it does this, has a calming effect that you notice in your body, faster than Xanax?! That’s right, that’s science! That’s why deep breathing techniques will always be my first go-to strategy for managing anxiety, and the one I first suggest to others.
3 . Movement. Getting the heart rate up is helpful to dissipate energy from anxiety. It is also using the cortisol being pumped out in an effective way — energizing the extremities — usually for fight, flight, freeze, but in this case for exercise! Just 15–30 minutes when feeling anxious can help reduce the intensity. Ongoing movement routines will assist with keeping anxiety low overall. In addition to heart-rate raising exercise, mind-body movements are also quite helpful. Yoga combines movement with breathwork, and this combined effort works to ease and elongate your tense muscles, as well as, increase oxygen to the brain (which we already know is helpful because, yes, deep breathing is helpful). Don’t knock it till you try it! And stick with it for a while, this is not a one and done suggestion. Practicing these things regularly is what has a positive impact on your anxiety.
4 . Do something creative. Draw, paint, play music, color, write, doodle, sing, dance, hum, whatever your creative outlet, get to it! Tapping into the right brain (where art and creativity live) helps balance out the left-brain over-activity (analyzing, logical, problem solving, decision-making). Anxiety naturally leads to trying solve a problem and shifting that brain focus to creating something is an effective way to redirect anxious thoughts. Creativity can release chemicals like serotonin, dopamine, and oxytocin which help a person feel calm. Creative activities can also promote feelings of self-worth and self-esteem.
5 . To address all the anxiety and stress that comes with perfectionism, I’ve adopted an affirmation that speaks to how I view myself and my efforts. Saying “I am enough. I did enough” is helpful to move me from anxious thoughts about how well or how much I did, to settling in to self-compassion about my capacity at the time and what I was able to accomplish out of that capacity. Perfect is impossible, but that doesn’t stop those of us with this hang up from trying! But it’s in the constant trying to be perfect, to get it or do it just right, that anxiety actually lives and gets exposed. We have to slow down, stop striving, and rest in what we’ve already done. And if you’re a recovering perfectionist like me, this takes practice, continued practice, to unravel a faulty way of thinking, a faulty way of being, into a healthy way of thinking and a healthy way of being. Which is not perfect. But just enough. Find your own self-affirmations to ease anxious thoughts about your performance.
On a scale of one-ten, if 8–10 was your former, chronic level of anxiety, how would you score your usual level of anxiety today?
Today generally my anxiety hovers around 5–6. It can spike up if I’m tired, as mentioned before, dealing with other stressors, or if I’m experiencing relational disruption or uncertainty.
Do you have daily practices that support you in maintaining peace, calmness or balance in your life?
Yes. I walk for at least 1 mile just about every day of the week, weather permitting. I take vitamins, supplements and, prescribed medications daily. Drink beyond the suggested amount of water, and only drink one cup of coffee per day. I get outside for at least 30 minutes, every day, even in the winter. I eat 3 balanced meals and spend some time everyday doing something just for fun that I enjoy, even if it’s just 15 minutes. I like to craft! So, I color, work in my bullet journal, make jewelry. Doing something that I enjoy daily helps me to feel like there is more to life than work, eat, sleep, repeat.
Was there any particular saying, person, or book that taught you the skills that enable you to escape or avoid the higher levels of anxiety that used to plague you?
Years of therapy, self-work, self-reflection and awareness, learning and then practicing coping strategies that work for me — and doing all of these things regularly and on a continuous basis. Although my general anxiety doesn’t run as high, it still exists, and still requires my efforts to manage the symptoms when they arise, and to do so in healthy and effective ways.
However, there is one thing that I can say to myself that can be helpful: “I don’t have to fix this or have an answer right now.” This allows me to take some space before doing anything or even thinking about what to do, and instead of allowing my brain to go directly into hyperactive problem-solving mode. This problem-solving mode is familiar to others with anxiety, I’m sure. As it’s this rapid, rumination about the problem (whatever is making me anxious) and how to fix it (make the anxiety go away by fixing the problem or issue) that actually keeps me, and others, stuck in the anxiety gear.
Thank you for sharing your wisdom with those who are reading this article. Are there also other ways you are sharing your wisdom?
Absolutely. I write blog articles, book chapters, and contribute to other publications regularly. Blogs are published on my website, on Integrate Trauma Informed Network’s website, and on Circle of Friends Club website. You can find a complete list of works, media and publications on the Media & Press page on my website, where you can access my media kit. You can also subscribe to my monthly newsletter, which includes free resources and handouts in every issue.
I speak on podcasts, at symposiums, and LIVE shows. I also train others in trauma informed care and compassionate self-care through formal professional education programs. I also offer formal training and education to businesses, C-Suite executives, organizations, and healthcare systems. If you need a trauma informed professional to walk you and your team through better practices for being and working together, reach out today!
As Chief Mental Health Officer at Circle of Friends Club, I have the privilege to support and guide other professionals, business owners, and specifically, mental health and other healthcare providers in better wellness and compassionate self-care. I host support groups, clinical consultation, and business consultation groups to better equip folks in managing all aspects of their lives to find the most balance and wellness available, which is typically and historically difficult for those in healthcare professions and/or entrepreneurs. It’s here I offer guided meditations, develop digital products and handouts, list resources, and more for ANYONE looking for a community who gets it; a community who wants to advocate for and speak out for ending the stigma with mental health and mental health treatment; and a community that prioritizes a supportive, inclusive, trauma-informed community to find connection and healing.
Wonderful. We are nearly done. Is there a person in the world, or in the US, with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. :-)?
I would love to have lunch with one of my favorite bands, Little Stranger. I did meet them in 2023, but briefly! I think we would have a blast hanging out, making jokes, sharing in our love for the same kind of music. I like to laugh and have fun, and they seem to be the type for that kind of good time, too. Music is another go-to anxiety and stress reliever for me. Music feeds my soul, takes me to a different place, and it’s fun and happy there. Getting to hang out with my favorite duo would be like having my cake and eating it too kind of experience!
You are a person of enormous influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
I’m on a movement mission right now! Maybe several. Must be the natural advocate in me. 😊 First, a trauma informed future is a win for everyone. Learning how to operate in business, in relationships, in life with trauma informed principles and practices at the helm means moving through life with more ease, and allowing others to move with you, with more ease. Trauma Informed principles ensure everyone is considered, included, accepted as is, supported, cared for, and celebrated — and not for what they do, or what they produce, or how much power they have, or how much money they have, but for their own unique worth and value as a human. That’s the world I want to live in, don’t you?
Next, an extension of this includes specifically addressing bullying, systemic bullying, and workplace bullying, as bullying in general is a traumatizing experience for most. Perpetuating bullying behavior only means further traumatizing the human race. Bullying in systems and leadership has been running rampant for years and years. No good is coming from this! Only further harm to more people is coming from this. We must be in agreement together that bullying people so they do what you want them to do, no matter the context, is not okay. It’s coercive control and it’s extremely damaging to people, their self-worth, their ability function normally in day-to-day responsibilities and in relationships with others. Bullying is not necessarily overt and obvious. Much of bullying that occurs in systems and with adults is more covert, passive aggressive, eliciting fear about financial security, and unfair consequences for inability to produce, produce, produce. So, support for a movement to end bullying? Yea, I’m on board! In fact, I’m one of the captains sailing the ship! People deserve better. And we can all do better.
How can our readers follow your work online?
In many ways. I create mental health and wellness content regularly, and write blogs and other articles on mental health topics a few times a month. People can sign up for my monthly newsletter: Tips & Thoughts from the Timeless Therapist to get a once monthly drop their inbox full of excellent mental health and trauma informed tips, education, freebies and handouts, and a direct link to my monthly blog article. There are also even more resources and content through the organization in which I am the Chief Mental Health Officer: Circle of Friends Club. Find links to all the places you can find me and my work below. Thank you for visiting and checking out my content!
Folks can find me on:
LinkedIn: https://www.linkedin.com/in/sarahobrienlcsw/
Instagram: @timelesstherapist
Website + published blogs: https://www.sarahobrienlcsw.com/blog
Circle of Friends Club: https://www.circleoffriendsclub.com/
Thank you so much for joining us. This was very inspirational.
About the Interviewer: Nancy Landrum, MA, Relationship Coach, has authored eight books, including “How to Stay Married and Love it” and “Stepping Twogether: Building a Strong Stepfamily”. Nancy has been coaching couples and stepfamilies with transformative communication skills for over thirty years. Nancy is an engaging interviewer and powerful speaker. Nancy has contributed to The Washington Post, Huffington Post, Authority, Medium, Yahoo, MSN, Psych Central, Thrive, Woman’s Day magazine, and more. Nancy is the Founder of the only one of its kind online relationship solution, www.MillionaireMarriageClub.com. Nancy coaches couples across the globe in person and via Zoom. Nancy’s passion is to guide couples and families to happy lasting marriages where children thrive and lovers love for life.
