Dealing with Hometown Anxiety with Susan Albers-Bowling, PsyD

Podcast Transcript

John Horton:

Hey there, and welcome to another Health Essentials Podcast. I'm John Horton, your host.

Traveling to your childhood home for the holidays or a big event can be a heartwarming experience. After all, we love our family and friends.

That being said, reconnecting with your roots isn't always easy. A lot of powerful emotions may come into play, and that can leave you feeling uneasy and maybe even a bit uncomfortable. What can you do when this hometown anxiety hits? We're going to talk through that today with psychologist Susan Albers-Bowling. She is one of the many experts at Cleveland Clinic who visit us weekly to help us better handle life's obstacles. Now, let's get going because we've got a lot of unpacking to do before this visit. Welcome to the podcast, Dr. Albers. We have been looking forward to having you on for so long now. Given all the interviews you do, I honestly don't know how our paths haven't crossed at this point.

Dr. Susan Albers-Bowling:

I agree. Thank you so much for all of your content and helping people to understand what psychology is really about, how to use it in very practical ways.

John Horton:

And that is why we like to do this. And I know that is what you spend so much time doing. As I hinted at, you are a regular on local and national broadcasts where you talk about a wide range of mental health matters. Why are having these discussions just so important to you?

Dr. Susan Albers-Bowling:

It has always been my mission as a psychologist to take research that is often in studies or in textbooks and take it out and help people to use it in practical, easy ways, because we use psychology every day — from the conversations that we have with our boss to what we decide to eat to how we manage stress. And sometimes, it's been some of my most exciting moments when someone will contact me and say, "Oh, I saw you on TV." Or "I read a tip from your book." Or "I've been working with you one-on-one." And one thing that you said was a game-changer to me and changed my life. I was happier, healthier by one simple tip. Also, it has been really important to me to have these conversations and the opportunity to talk on the media to help destigmatize mental health issues. We all benefit from having these conversations. And if one thing could be helpful to let somebody know they're not alone, I'm really grateful.

John Horton:

Well, it's definitely so important. And as I told you before, you make everything so approachable and you feel good even thinking about these things and even dealing with.

Dr. Susan Albers-Bowling:

Well, thank you. Like I said, today is a topic that I think all of us can identify with in some way, shape or form. We've had this experience. And so having a conversation about it can really help to wrap our minds around it, understand about it and cope with it a little bit better.

John Horton:

Oh, absolutely. Because hometown anxiety is something that I think, it does touch everybody. I mean, once you move away from home, you go back, things just … they don't feel quite the same.

So I heard you, in talking about this in an earlier interview and describing it as a minefield of memories that we're navigating as we go back home. Can you walk us through what hometown anxiety is and this whole phenomenon?

Dr. Susan Albers-Bowling:

“Hometown anxiety,” it's not a diagnosis. It's not a clinical term, but it's a psychological term that many of us can identify with. And it's very useful. It's very useful to have this term. And what it is, it is when you are feeling distressed, unease or anxiety when you go home to your hometown or to your childhood home. And you may go home for many different reasons. Maybe you're going home to an important football game, a funeral, a family gathering. The number one time people often experience this is during the holidays. When they're going home, sitting around the table with their family or going to their home of origin, this is when it stirs up a lot of emotions. And often, it can feel really bittersweet. On one hand, it's really great to go home, but on the other hand, you may be scratching your head, "Why am I feeling so anxious?"

John Horton:

What are some of the feelings that drive this hometown anxiety and really put the power behind it, where you start feeling a little uneasy and uncomfortable?

Dr. Susan Albers-Bowling:

There are so many things that can trigger it, and it varies from person to person. One of the number one issues is that you become flooded with all of these old memories. As soon as you walk into your kitchen at home, you are flooded with memories that are attached to being in the home.

John Horton:

Yeah, just that smell.

Dr. Susan Albers-Bowling:

The smell.

John Horton:

You walk in, you just recognize it as soon as you get in the door.

Dr. Susan Albers-Bowling:

And it triggers two parts of the brain, the amygdala, which is the emotional part of the brain that attaches memories to a place. And then also, the hippocampus, which stores those memories in an unconscious way. And it comes to the surface when you're in those situations. It can also be due to familiarity that when we are really comfortable, it can feel great, but it can also feel really claustrophobic. Maybe you go home, and all of a sudden, your parents are telling you to put your jacket on or you're rolling your eyes like you're 13 years old. All of these familiar senses and smells and conversations come right back to you, and they can really trigger a lot of uneasiness.

John Horton:

I've had that happen. I've gone back and it's like, "Are you going to put on a coat when you're leaving?" And it's like, "No, I'll be fine." And moms and dads are going to mom and dad, no matter how old you get.

Dr. Susan Albers-Bowling:

Absolutely. When I go back to my hometown, I'm no longer Dr. Albers. I am Sue, the childhood name that I've been called and no one else calls me.

So it happens to everyone in a lot of different ways. It can also be that rule regression that in your family, you might be a nurse during the day and you're giving people orders, but you walk into your home, and suddenly, you are the little sibling, and you shut down and have nothing to say. So these old roles, expectations, conversations, family dynamics all become very present once again.

John Horton:

Yeah. I mean, it almost sounds like you're dealing with an identity struggle even when you walk in. Like you said, with your example, you’re Dr. Albers everywhere, and all of a sudden, you go home and you're, like you said, you're Sue. I mean, that's got to be a little discombobulating.

Dr. Susan Albers-Bowling:

There can be really a mismatch between who you are now and who you were in the past. And the people around you may see you in that way. Perhaps you are going to the store and you run into an old friend, and you used to be the troublemaker, and all of a sudden, now that label comes back out to haunt you in a lot of ways. And that's not who you are anymore. Maybe that version of yourself at 55 resembles nothing to the person that you were at 15. And this mismatch can cause a lot of anxiety as you think about it. There can also be a lot of judgment when you go to your hometown or to your family. Perhaps some of those conversations that they ask you about, your career or your relationship. You may feel like [inaudible 00:07:36].

John Horton:

It does come up.

Dr. Susan Albers-Bowling:

Yes.

John Horton:

No, they definitely do. And that judgment thing is a huge issue because I know that's something … you brace for it when you go back, some of the questions and the things that are going to come up, and you know they're coming at some point, and then they inevitably do land.

Dr. Susan Albers-Bowling:

There could also be a lot of guilt that you may have some conflicting of emotions. You may be very thankful about some of the memories that you have, the way that you grew up, some of the experiences that you have. But at the exact same time, feeling a little bit of relief that you have moved on or that you have grown. And sometimes, it's really hard to hold those two conflicting feelings at the exact same time. There can also be a lot of unresolved issues. Perhaps you go to your hometown, and suddenly, you're thinking about your ex-relationship that didn't have any closure or a friendship that you lost. So all of those things can cause and be at the root of this anxiety.

John Horton:

Now, where does this thing called “holiday regression” fit into that? Because it seems like it's one of those things where when you go back, all of a sudden, like you said, your 50-year-old self gets home and you're a teenager again, or something like that. Is this just something that naturally happens when you return to this old environment and maybe spend a few nights in your old bed?

Dr. Susan Albers-Bowling:

“Regression” is also not a diagnosis or a clinical term, but it is a psychological phenomenon. And what regression is, is when you revert back to earlier developmental periods as a way to cope with stress. And for many people, they may know what anxiety feels like, but regression is a little, sometimes, harder to put your finger on. And what it works on is what is known as “implicit memories.” Implicit memories are the memories that happen on that automatic level. Although they're there and you're not conscious of them, they determine how you think and feel and act. It's almost like riding a bike that you don't have to ... even if you haven't ridden a bike for years, when you hop on, it comes right back to you. And I think that's what's happening with this regression, and going back to those old roles, is that it's happening on an unconscious level. It's stored in your memory and it can very quickly turn you from being in the present to acting in ways that you did in the past.

John Horton:

Well, I have to tell you, the regression I see when my kids come home is they revert to being messy. Whenever we go to visit them, their places are immaculate and they come home and they walk in the door, and it's like they explode and there's just stuff everywhere. So that is the one thing, the form of regression, I know we deal with whenever our kids come back.

Dr. Susan Albers-Bowling:

There's a lot of expectations as well, and roles that you may have played. I know in my home, when I go to my parents' house, everybody goes to their old jobs. I would load the dishwasher, my sister will set the table. So I think that we just naturally revert back. And sometimes, you may not act at all like yourself, that you, again, you may be very in control at work, and then suddenly, you're acting like a teenager or you're rolling your eyes at your parents or getting really annoyed. So there's a lot of ways in which we can instantly just change our demeanor.

John Horton:

And I think we want to emphasize, obviously, going home can be very wonderful. We don't want to make it sound like a bad thing or anything like that, but it does come with some stressors. And I think the one thing I know we definitely want to get to today is how to address those and how folks can better handle it as they do go home and have to navigate these things. So if you could, and I know you're always awesome at this, if you can lay out some easy, actionable tips that we can use when we go back home.

Dr. Susan Albers-Bowling:

Yes. The first thing that we can do is to expect that we're going to experience this kind of anxiety. We can't eliminate it, but we can prepare for it. And when we do that, we respond versus react to this unconscious phenomenon that's playing out.

So number one is to set your expectations, know that it's going to happen and expect that you're going to have some surprises, expect that things are going to change. Your hometown is going to look different. It may appear smaller. It may appear bigger. You may have some disappointments, but you also may have some good surprises. You may have a different relationship now with your parents now that you're older. So you don't want to glorify it or demonize this experience, but just observe it. Be that observer, be curious and not critical.

John Horton:

Yeah, that makes a lot of sense because sometimes, I think we go into these things and we expect everything to be perfect and magical and sparkling, the holiday movie thing. And that's just not the way life usually works.

Dr. Susan Albers-Bowling:

It's not. It's normal to have change, and we need to embrace it and accept it and just know that it's going to happen.

The second thing that we can do is to identify the triggers. As you're listening, think about it and ask yourself, when you go home, what are some of the things that really push a button for you that maybe make you angry or irritable or uncomfortable? This may be a conversation that comes up over and over again. It may be certain memories, maybe people asking about your career over at the holiday dinner or somebody making a comment about something that you've done in the past. What you can do is create what is called “if-then” plans. So creating the expectation that “if” this happens, “then” I will do such and such, is creating a plan. So if someone makes a negative body comment about me that makes me uncomfortable, then I will distract. Or if I have a negative memory, then I will go for a 10-minute walk. That way, your brain is prepared, and that's going to help to reduce some of your anxiety.

John Horton:

Yeah, that sounds like a great way just to get ready for when these things happen, because when it happens in the moment, it can be really tough to just respond the way you want.

Dr. Susan Albers-Bowling:

We also have to remember who you are now. Back in the day, when you were younger, people could put labels on you. They could stereotype you. They might put a label on you as you're the quiet one or you're the rebellious one or the good child. And these are old, outdated scripts. And so to remember who you are in the moment, to help to ground you. Use “I” statements. “I am,” and who are you now. “I am a mother.” “I am someone who speaks up.” “I am in charge.” Whatever it is to help you to bring you back into the present moment.

John Horton:

And that is something that's so difficult, because I know, I even go home and stay with my folks, and I'm 50-plus years old, I'm a grandfather, I'm whatever else, and you get there, and you still, you feel like you're a teenager again. It's really hard sometimes to replant yourself into the life you're in and just stay rooted in that, even while you're in this past experience.

Dr. Susan Albers-Bowling:

It can help to stay connected to your current life. So calling your partner who's still at home or texting a friend from your present life, maybe you have some pictures on your phone of your dog, of your kids, things that are happening now that can help you to stay connected to who you are in the moment. You also may need to build in some breaks while you are visiting. You don't have to be there the entire time. Maybe some me time. Go for a walk. Plan a certain amount of time that you're going to be at a family event. Make sure that you do something that is fun and engaging. Maybe you plan to go see a museum while you're visiting your family or go to a special place, an ice cream shop that you used to love. That can help to break up some of the anxiety that you may feeling, making sure that you take care of yourself and some of your needs.

John Horton:

Yeah. It does sound like getting a few gaps in there and getting some time away so that you can reset and just maybe process everything. It sounds like that's really healthy just to do.

Dr. Susan Albers-Bowling:

Processing is key. Journal while you were there. And you don't have to write a dissertation. Just a couple notes of things that are triggering to you, conversations that you've had over and over again. And the reason is because you will have data, and this data is going to help you for the next time that you go back, because the same thing plays out over and over again. And if you can see the pattern ahead of time and you know it, you can make a change in the future. So having that data and journaling will help you to process it.

And then, most importantly, stay positive. Our brains for survival are trained to look at the negatives, and you may have had a childhood that was 95% great, but that 5% is going to stand out in your brain. So we have to remember to stay positive, look for things that are great about going home. Maybe you enjoy having your mom doing your laundry or that she's making cannolis for you or whatever … it is that, is really positive can be helpful. And the self-talk about it. If you're saying to yourself, "My family drives me crazy." That's going to escalate some of those stress hormones in your body. So saying some neutral words and positive statements can also help you to feel a lot less stressed.

John Horton:

A lot of times, I go into it, and I know my kids have even said when we do stuff or whatever, sometimes, you just have to embrace that craziness, too, because that is part of the whole family experience. I mean, you go to these things and they're just nutty sometimes. And if you can just laugh and you're in the middle of it, it makes it a little better. Just expect it's going to be delightfully chaotic and you're probably in a better spot.

Dr. Susan Albers-Bowling:

Humor can go a long way. Look for the humor in this situation. Is there a funny story that you're going to tell about it later? That is always helpful. And the main message is to be yourself. It could be tempting to live up to those expectations or fall into old roles, but when you are there, it's an opportunity to look at yourself in a mirror and see who you are now. And you could really embrace that kind of growth that you see being in that environment.

John Horton:

Now, are there instances where somebody gets so worked up ahead of one of these things? They start feeling this anxiety weeks out from knowing that you're going home, where you really should look at maybe talking to somebody. What would be some of the things that are going on that would maybe signal like, "Hey, I should probably talk to a therapist or a friend, family member, somebody." Just to get these feelings out and deal with them?

Dr. Susan Albers-Bowling:

If you are experiencing anticipation anxiety or anticipation exhaustion — you're tired before you even go — you know that that's a red flag, that you may need some additional assistance with unpacking and unraveling what's going on deep inside. If you are losing sleep, it's changing your eating habits, you're having excessive worry about it… These are all signs that it may be helpful to talk with a therapist who can help you to find new ways to respond, new ways to cope and ways that you can enjoy the experience versus dreading it.

John Horton:

Yeah. Dr. Albers, you make all of this sound so simple, which explains why so many folks turn to you for this advice. But before we part ways today, do you have any final words of encouragement or advice for someone who's got a hometown trip on the horizon?

Dr. Susan Albers-Bowling:

It is very normal to experience hometown anxiety. And it doesn't mean that it's a bad thing. It just gives you a lot of information. It's a message to you to understand more about yourself and give you some perspective. So we can take this as an opportunity. And if you're about to go, you have some time to plan and to really anticipate. I would encourage people to close your eyes, mentally walk through what it is like to walk in your front door or walk through your hometown, and start to anticipate and get ready and prepare for this return home.

John Horton:

And keep those positive vibes going, and hopefully, that will power you through the entire trip.

Dr. Susan Albers-Bowling:

Yes, you can enjoy it. You can enjoy it even if you feel discomfort at certain periods of time.

John Horton:

Well, Dr. Albers, thank you so much for coming in. I know, as I said at the start, we've been waiting to have you on, and you did not disappoint.

Dr. Susan Albers-Bowling:

Thank you so much for this opportunity.

John Horton:

Homecomings can be wonderful, but revisiting your past may also dredge up thoughts and feelings you buried long ago. To move away from hometown anxiety, try to focus on the person you've become and the life you've made in your new home. And remember, too, that you'll be back in your regular routine soon enough.

If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Until next time, be well.

Speaker 3:

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