What if the stress that’s harming your body isn’t the thing that happened but the thing you’re afraid might? In this episode, Fiona speaks with UCSF stress researcher Associate Professor Aoife O’Donovan, whose work reveals how simply anticipating threat can accelerate biological aging, even when the threat never arrives and what you can do to stop it.
Together, Aoife and Fiona explore:
– How anticipatory stress affects cardiovascular, immune and cellular function, including signs of accelerated aging
– Why the brain can’t always tell the difference between real danger and imagined fear and how the body pays the price
– The often-overlooked power of social connection, even in fleeting micro-moments
– How visualisation, when used intentionally, can help the body step out of threat mode
– What Aoife’s research into a PTSD app and psychedelic therapy is revealing about trauma, healing, and personalisation
This is a conversation about stress but also about imagination, memory, connection, and the biology of feeling safe.
For more from Fiona visit www.fionamurden.com
Aoife's research can be found here UCSF Profiles
Aoife is Associate Professor of Psychiatry and Behavioral Sciences and Director of THRIVE Lab at the University of California, San Francisco and San Francisco Veterans Affairs Health Care System. Dedicated to uncovering the mechanisms by which psychological stress causes ill health and developing new treatments for stress-related health conditions.
Here are key takeaways from the conversation:
1. Small social interactions matter. Even brief, friendly interactions can positively impact your physiological stress response.
2. Practice resilience during calm periods:
3. Start small with physical activity. If a full workout seems overwhelming, just start by moving a little - standing up, walking for a minute, or doing a short activity.
4. Recognize that stress is inevitable, but you can manage your response:
5. Prioritize physiological health to support psychological interventions:
6. Be compassionate with yourself and others:
Fiona 00:39
Aoife O'Donovan has done some amazing research and does really interesting studies, which you're bringing to the world in multiple different ways. Who are you, for people listening in?
Aoife 00:57
Thanks for starting with such an easy one. So, yeah. So I'm an Associate Professor of Psychiatry and Behavioral Sciences at the University of California San Francisco, and I am a stress researcher. I'm really interested in understanding how it is that psychological stress causes ill health, and I'm Irish. I lived in Ireland most of my life, and I'm a mom of two
Fiona 01:28
When it comes to your research, so I was fascinated when I found your research. I think one of the things that really fascinates me is the multi disciplinary approach you take. So for people listening who wonder what the hell I'm talking about? It's going beyond just behavioral sciences or psychiatry, and it's pulling in more of the neurobiological and other factors to really explore things and physiological and you can give the right words to all this, but you're exploring things fully and across, rather than just down. And I think one of the problems we often have with research is people dive very deep into one specific area, but then we don't understand how that influences other things, or also how it then realistically plays out within the real world. So what brought you to this sort of approach? Was it something that just was through interest, or was it something you purposefully pursued?
Aoife 02:34
Yeah, that is such a great question and description, and it's such a joy to be on your podcast, because I love how you think about health and all these different issues, and my journey to the interdisciplinary research program I have now sort of starts with time I spent in my home town of Cork in Ireland, where I was working at a newspaper, a local newspaper, and I was tasked with doing a series of articles about people living with chronic medical illnesses, and I went out to their houses, and I met their families, and I saw their communities and their struggles, and what was so striking to me was how much the psychological factors in their lives influenced their experience More than the objective physical symptoms that they had. And I was already an undergrad in psychology at University College Cork, and I started to get really interested in health psychology. So this is, you know, how psychological factors influence our physical health. And once I got into that, I started thinking about the physiological effects of psychological stress, but also of our feelings. Because we all know that we feel our feelings in our bodies. They're not just in our brains. It affects, you know, one classic example is if you're feeling highly stressed or threatened, your hands get cold, your heart rate increases, you might lose your appetite, or you might crave sugar and Fat. The psychological stress response is a whole body response. And the other piece to it is I sort of knew from my own life, because I'm quite sensitive person to stress. I think that, like you know, I would get, I would get physically ill when I did my exams or went ahead of me. Major stressor in my life, and I just knew that there must be effects of psychological stress on these systems that are important for our health. And so my first studies were at University College Galway, where we looked at the effects of social support on cardiovascular reactivity. And I ran all of the participants in this study. And our manipulation was we either offered them social support by saying, you know, I'm here to help you. If you need any help, I'm going to be right outside the door. If you need anything at all, just ask. Nobody asked for anything. Or we said, I'm here to run this study, but I can't give you any help, so I'm going to be outside the door, but I can't help you. And in another condition, we didn't mention support, and these manipulations changed their cardiovascular responses to the tasks that they were experiencing. And there was no objective difference, you know, in all cases I was sitting outside the door, but it changed their responses to stress. And so cardiovascular reactivity was kind of my first foray into the biological effects of stress. Awesome thing about that.
Fiona 06:22
Have you heard of Barbara Fredrickson? Professor? Barbara Yes. So what I'm thinking of there is her second book, Love 2.0 where she's looking at micro moments and the the effects on our physiology of connecting with someone, and that feels to me like it's reflecting the same thing. Because I think there's part of us that feels like that social support has to be deep, meaningful relationships that we've had over time, but you then you're a stranger, and it's still having that effect
Aoife 07:03
Exactly. I mean that that's really I think that's really important piece too. I think we have different types of relationships and connections and the community around us, even if we're not close with them, really matters. So you know, if you go to pick up a coffee in the morning and the person who makes your coffee is friendly with you, or you even know them from going there every day, it really changes your mood, these small interactions. And not to dive into this so early in the podcast, but I think during the COVID 19 pandemic, that's a lot of what we lost. You know, we were often still with our close contacts inside our houses, if you had people living in your house. But we completely lost those small interactions in everyday life. And I think it was hugely impactful. And what we know now is that the people who suffered the most psychologically during the pandemic were older adults and young people. And I think that might have been a, you know, that was certainly a piece of it.
Fiona 08:21
It's fascinating. It's something I've reflected on quite a bit. I don't have the evidence behind it, but I think particularly with that younger group, where the social brains are so where they're developing still, and so there's that need for not just those interactions, but what it's teaching them and the things that we don't realize, we're learning through those micro moments of interacting with people
Aoife 08:51
I know, and also this is not evidence based, but just being a worthy human being in the world who's connected with other human beings because somebody gives you respect and time,
Fiona 09:05
you know, makes you feel like you matter, yeah, which is incredibly powerful. So you're seeing this physiologically in the cardiovascular responses that they to this experiment. And what sort of, I mean, what sort of data, what you're looking at.
Aoife 09:23
So we were looking at their heart rate and blood pressure responses to this manipulation, and we were so this is something I've done a few times in my career, where we've exposed people to a standardized acute stress task. So we, you know, we get asked them to give a speech in front of a video camera, and we get them to do a math task, which is very stressful, and it because it sounds simple, like something like subtract, serially subtract 17 away. From 2983 and you're like, I can subtract 17, but when you start to do it, it's really challenging. And so we look at their heart rate and blood pressure responses to those kinds of standardized situations, and what we found in that study was the people who had the lowest levels of social support in their daily lives had got the most benefit from being offered help in the laboratory. So I know that's, that's, it's heartbreaking and hopeful, because it means that little, little things can make a big difference to people who are in one study we had looked at loneliness, and another study we looked at perceived social support, and those People seem to benefit more from being offered support. So I think that's quite hopeful that we can have interventions that can really help people who need it. It's not that they can't benefit. It's that maybe they're not getting enough opportunities.
Fiona 11:19
It's so it's so interesting. And I think it then comes into medicine as well. And I do work with doctors and surgeons, and we we know that the way a doctor responds to a patient, in the way their health is then unfolds over time, and it can be again, those beautiful things that you're talking about just being a little bit more caring or seeming really interested in that individual
Aoife 11:49
Exactly. I mean, I think this, this really matters. So my husband ended up in the emergency room in Ireland days before our wedding, and it was a pretty tough time, and the emergency room was completely overwhelmed and had far too many people, and we just happened to meet a nurse who was so kind, who explained everything, and who really changed the experience. Because, you know, it was few days before our wedding, I was Googling, like, how to cancel this and that. Super stressful, but like that, somebody being compassionate, who's saying, Okay, here's, you know, here's what's happening here, and here's what we know. When a lot of the staff in that emergency room were, everyone was busy, but the little intervention for us of somebody explaining what was going on. You know, it's three o'clock in the morning. If you're not, if you're still here at eight, you will get a bed. You know, this sort of updates. But yeah, these things really matter. And and I think a message to all of your listeners is, you know, this is another hopeful piece. So we're in a time of upheaval to understate things, and here in California, you know, it's people are trying to recover from the fires that happened in Southern California in in January, and we can all make a difference by being decent to the people around us, potentially affecting their physiology.
Fiona 13:27
It's a huge, hugely and that understates it important message. One of the things I was actually incredibly I felt incredibly humbled and felt a real warmth and hopefulness was the way people responded during the fires. Because there was one teenager, for example, that pulled a spreadsheet together of all the websites, everything, all the volunteers needed, where they were needed, and you had to race to get a volunteer sport somewhere, because there were so many people wanted, yeah, that was, and it wasn't just one area of LA that was across. And the the issue becomes, in this particular case, and I don't want to talk about this too much, is that, then people forget, and so the people that have lost their homes now. I mean, I've spoken to some of the friends house to rent, and the way the landlords, the real estate agents, are being is just tremendous. You just think from one extreme to the other
Aoife 14:34
well, and you raise another really important point there, which is giving support. Also, there are lots of studies showing us that people who give support benefit from giving support. And I think that's hard to remember when you're the one needing support, that you're actually, you know, maybe helping someone else with their mental health too, and particularly in the case of something like a. Traumatic event that everybody's witnessing. There's a helplessness that everybody feels that I think can be partially buffered by being able to do something so people who get support really do benefit the support givers by accepting that help and support
Fiona 15:26
and all messages that were somehow trained not to receive through society. So whilst I think religion and more traditional ways of life would see that as something you just do today. It's not the message that we're receiving. It feels a bit strange to say, actually you're helping yourself if you help others. Yeah. But like you say, there's a load of data around pro sociality and yeah, even studies on the by the in the UN happiness report about the economic impacts of it. So it's economically beneficial for us, for a community and a society to be pro social and to help one another. Yeah, it's a shame that we're not hearing these messages more loudly. Yeah,
Aoife 16:18
I know. And it has, yeah, it has implications for society all the way up to policy, you know, how do we, how do we structure our societies so that people have time to volunteer or help others? And how do we, yeah, and I I do feel like one of the big one of the differences between Ireland and the US is that Ireland is still a more collectivist society, and I think that has a lot of benefits for everybody. And
Fiona 16:55
interestingly, I know we're going off topic, but my experience of Ireland would be the same, more so than you, which is more individualistic and not so much potentially as the US because of the way policy is set up and social support. But, yeah, really interesting. So you were doing that? Cardi, yeah. Sorry. Cardiology, yeah. Took over my words here, doing that study, vascular, yeah, outcomes and what happened next. So
Aoife 17:35
I became really interested in the immune system. So when Yeah, when I was doing my final exams in undergrad, my parents separated, and I also just felt a lot of stress about these first year of exams in college, and I developed this photo sensitivity rash like this, actual rash on my hands, and the more that the sun came out, the more I pulled up my sleeve, and the worse it got. And it was terrifying, and I thought I would be living with this for the rest of my life. But actually, when my exams passed and things settled, I've never had it again, but it really made me wonder about the immune system, and this isn't partially an immune reaction, and how stress affects the immune system. And so after my time in Galway studying cardiovascular reactivity, I got a position at University College Dublin to work with a psychiatrist, a psychologist and an immunologist on my PhD, and it was in the field of psycho, neuro immunology, ridiculously long word, but the project was to understand effects of psychological stress and personality factors on the immune system and on on the first week of my PhD, I sat down next to a new faculty member at UCD in our journal club, and she had this paper in front of her, and it was about life, stress and biological aging. And the paper was by Alyssa apple, and I devoured this paper, and it turns out this new faculty member was studying biological aging. She was studying biological aging in the context of cancer, and Alyssa was studying biological aging in the context of psychological stress. And the paper, what the paper showed was that women mothers, so she had half mothers of kids with autism. And half mothers of typically developing kids, and what she found was, across the whole range of stress levels in the sample, the higher the their perception of the stress in their lives, the shorter their telomere length. And telomeres are these markers of cellular age and so it looked like something that that had been like thrown out there anecdotally a lot, you know, like we, we often see pictures of US presidents before and after their time as a US president, and they look a lot older at the end of their term, in general. And, you know, time has passed, but still it's, you know, the the idea was always out there, maybe there's accelerated aging and people who are under psychological stress, and Alyssa was one of the first people to show this. And so I started being obsessed with telomere length, this marker of biological age, and I eventually so was collecting data in Dublin to look at whether pessimism and depression were associated with shorter telomere length or older biological age. And I also applied for scholarship to come to the US, to UCSF, to work with Alyssa apple and her colleague, Liz Blackburn, who's a telomere biologist. And based on my PhD work in Dublin, we found that pessimism, which is the tendency to expect negative outcomes in the future, is associated with shorter telomere length, older biological age. And working with Alyssa, we also went on to find that people with higher levels of childhood trauma had older biological age. People who perceived one of these standard acute stressors as more threatening had older biological age, and so many studies came out after that indicating that psychological stress accelerates biological aging. And so that was kind of my next chapter, and it it sent me a lot of different directions with my thinking. But one of the most striking studies that we did was about threat perception and biological aging, and so we expose people to one of these standardized short term stressors, the speech and the math task and the laboratory, and we asked them before the tasks a range of questions about how threatening they thought it would be, and then how threatening they thought it was when they had finished. And threat is the potential for harm, loss or damage. And we also asked them about how challenging it would be, how much they might enjoy, you know, how much they might benefit from this experience or be challenged in a positive way. And what we found was the women who perceived, and these were postmenopausal caregivers, the women who perceived this, the upcoming stressor, as more threatening, the ones who had more anticipatory threat, had the oldest biological age. What was even more interesting was that their perception after the task, when they knew how threatening it was was not associated with their biological age, only the anticipation of threat was associated with biological age, and this was just so mind blowing and eye opening, because what we realized was number one, there are no constraints on how threatening an upcoming stressor might be. And this is true in our daily lives. There are almost no constraints. You can imagine the worst at all times. Once a stressor actually happens. You can really only interpret it through the lens of what actually happened. The second piece is that we can anticipate stress for much longer than we usually experience a stressor. So you know, I'm coming on this podcast, I could your your body doesn't really respond differently to an actual stressor and an anticipated or potential stressor. It doesn't know the difference. That's one of the amazing things about humans. We can just imagine something and. And activate all the bodily responses that we would have if that thing actually happened. So the second piece about anticipatory stress is that it can go on for really long time, so it can be unconstrained by the facts, and it can go on for really long time. And these two factors together mean that our tendency to anticipate stressors can be very harmful to us physiologically, because and the third piece of it is it's not really beneficial to activate your stress response far in advance of a stressor. So this study just got me and Alyssa and our whole team thinking about threat, threat sensitivity, who perceives more threat, who perceives less threat, less threat. And that brought me into thinking a lot more about traumatic stress, which we can talk about a little bit further too. Yeah.
Fiona 26:05
I mean, it's absolutely fascinating, and the piece around our body doesn't recognize or the difference between something we're visualizing in effect and what's real, which is why? Yeah, within more of the field that I work in, visualization is so powerful when you're working with performance or leaders, or what we've seen with the studies coming out of sport is immense. The difference that it makes through positive I mean, it's difficult to do a randomized, controlled study in that sort of situation. So to people listening, that means making it very fair the way you're looking at it, and removing chances of other factors coming in to influence the results you're getting.
Aoife 26:55
But Well, Fiona, if you don't mind if I jump in, I think I've never actually thought about this before you just said that, but visualization is a way of constraining your perception of the upcoming stressor as well, because the often if we have a potential stressor in the future, it's very amorphous, and the more threatening it is, the more time we spend worrying about it, the less time we actually spend on what really might happen, and the more we avoid practice or planning and avoidance fuels anxiety. I mean, that's one of the strongest findings that we have in psychiatry, psychology, psychiatry, but visualize it. I think that. I mean, maybe you already think about it that way, but for me, I didn't actually think about that before. Visualization is a really good way, and it's very similar in that way, to like prolonged exposure therapy, which is or exposure therapy in general, where you gradually expose somebody to a feared situation or feared stimulus, and it constrains your perception, you can no longer have this amorphous, generalized feeling of threat.
Fiona 28:19
It becomes more concrete, particularly if, if that's scripted. So one way that, because visualization, we all visualize through daydreaming and all that sort of stuff a lot of the time, but it's not under our intentional control. With someone in that sort of situation, I would imagine, if you help them to script how they would like something to turn out, looking at all the factors you would with an athlete or someone to do a big talk or something like that. So what can you see? What can you smell? What can you touch? All the five senses are brought into it, and that you could make it quite fun as well, because it's yeah, let's forget all your worries for a minute. Let's just Fanta fantasize about the ideal outcome, and allowing them to do that with the cognitive processing that that provides through going into a written piece of work. And then there are things. I mean, I'm really interested in whether you know this is something that would help people, but you could then record that, whether it's in your voice or someone else's voice, and listen to it so that you're you're listening to the pattern of something more positive and constructive that you've actually constructed yourself, yeah, rather than playing through That amorphous concern about what you know, catastrophic thinking, or whatever's coming up is going to Yeah, absolutely disastrous,
Aoife 29:47
yeah. And I think so, like I said, we measured threat perception and challenge perception. The challenge perception is the potential, potential for gain, for. A benefit for positive feelings that might occur in a stressful situation. And, you know, we have capacity in a lot of stressful situations, not all, to actually really benefit from them and enjoy them and flourish. And
Fiona 30:18
I think that's so interesting, and that something else that we're not taught is the stress versus eustress, which, yeah, about the meat. But again, to people listening, you stress is a positive form of stress. But again, I imagine what we find a positive form of stress would also be influenced by our perception of that stressor. But if we talk like we again, teach in a more high performance setting that you you have an optimal stress response which stimulates action and makes you go out there and do something. Yeah, but people aren't taught this stuff.
Fiona 30:58
No, I know, and the way I think about some of this lately is it's these are resilience factors and you really need to practice before the stressor occurs. So as much as possible, like when you're in the midst of a stressful situation, it's much harder to engage in any of these kinds of activities, but in the down times from stress, because stress is inevitable, we are all going to have stressors. It is not something to avoid. None of us want traumatic stressors, purely negative stressors, and yet they're going to come. That's the reality, unfortunately. But what we can do is in moments where we have capacity, in times when is to build resilience. And I think that's, you know, this is one way, and then they're, you know, building our social relationships, having like physical activities, is an extraordinary resilience factor, but also maybe meditation and mindfulness and breathing techniques and things that we can bring to play when the stressor occurs. And now you're really making me think about visualization as another one. I'm a bit of a geek around all this stuff, so I have to look through my studies and send some of your way.
Aoife 32:34
Great. I love that to me, but I've got no that would be great.
Fiona 32:40
So another on the opposite side of things, because, to an extent, perceiving a threat is as as a threat, rather than as something that's a challenge or an opportunity, is a pessimism or optimism perspective. And I think you did research on having an optimistic outlook as well, and how that can impact your health.
Aoife 33:03
Yeah. And so, yeah, that was, I was really this was during my PhD, I spent a lot of time thinking about optimism and pessimism, and I didn't even know that that was leading into our study about the anticipatory threat response and biological aging. You know, that's where we kind of landed. But optimism and pessimism are, are distinct. I think that's one piece. We think about them as opposite sides of the same coin. But pessimism is, is our generalized tendency to expect negative outcomes in the future, and optimism is our generalized tendency to expect positive outcomes in the future. Now, scientists, psychologists, get really up in arms and have strong opinions about whether those are opposite or not, but I think they're not. And the reason is that I might be someone who expects a lot of positive things and I expect a lot of negative things, or I could be someone who expects a lot of negative but I don't expect positive things, and those are very different, potentially interesting.
Fiona 34:10
And actually, you're making me think from a personal perspective. Yeah, I'm an optimistic, hopeful person, but I'm pessimistic about myself. And so again, I think that there's a complexity.
Aoife 34:24
There is, there is, there is a lot of complexity to it, and I think it's really helpful to think about them as distinct phenomena. And what we know about neurobiology and about the body is that our brains and our bodies have really distinct reactions to expecting negative things and expecting positive things. They're not opposite responses. You know, in one case, when you expect a negative thing, you activate the threat circuitry in the brain, and you activate an immune response and a cardiovascular response, and you prepare. Yourself to deal with a threat, and you actually triage your resources such that you focus on short term survival over long term growth, maintenance and repair positive expecting positive things in the future likely activates the reward circuitry of the brain and the reward circuitry of the brain doesn't may not have the same effects on the stress response. It could buffer or protect against activation of the stress response, but it's not merely the opposite response to expecting something negative, and so I don't think we should expect that we're either optimistic or pessimistic, but that we just think about them differently.
Fiona 35:50
Really interesting. I hadn't thought of it that way, and I think it's testament again, to the fact that you have more of an interdisciplinary approach, because if you look at them in isolation, from a cognitive perspective, not be considering, yeah, how it's impacting physiologically,
Aoife 36:09
yeah, I do. I i Over. So I started out very much as a psychologist, psychology, undergrad, health psychology, Master, psychology, PhD. And over time, I've come to think of things very often through the lens of biology and evolution, and think about psychology through that lens more than thinking about the biology always through the psychological lens. And I find that helpful in trying to understand things. I also find it really helpful in terms of thinking about, how do we counter the effects of negative psychological experiences or negative psychological states? And I think very often, if we start with biology, we we might get to a better place quicker. And by that, I mean start with our physiological resilience. Start with exercise, start with diet, start with and you know, you can definitely do things the other way around, but it's extremely hard to benefit, for example, from psychotherapy if you're physiologically, if you're in a very unhealthy place, physiologically, and partly that's because your physiology impacts your learning and your memory. And in order to benefit from psychotherapy, you have to learn and you have to remember, and you need your your optimal state for learning and memory is a physiologically healthy state.
Fiona 37:57
And again, not something I thought of. Really interesting, really interesting. And then obviously that has implications when you're trying to help people, because often the people that are physiologically unhealthy need help psychologically, yeah, where they can become more physiologically healthy?
Aoife 38:20
Absolutely, I mean it. When it comes to individual people, it can be really tricky for some people. It's much it might be a lower bar to say you're feeling like you're in a bad place today, one thing you can do is engage in physical activity. Can you start with that? And for other people, that's an impossibly high bar.
Fiona 38:49
You know, it's fascinating because, again, it's just sparking a thought one of the people I know who lost their home in the fire when I met them afterwards, east coaster. So for anyone that knows how people behave in the US, sort of very straight down the line, tough gets on with things. And she's saying, I've never felt like this before. I feel jumpy. And I said, Are you moving? What do you mean? I said, Are you are you moving? Are you moving? Are you sat? Are you moving? And she wasn't even really walking. It's not that she's someone who's not physically active normally, yeah, because of everything that had to happen, I think people forget again. It's a bit like trying to do something, yeah? And I just said to please just walk every day, just a minute, because otherwise your body's not processing all of this stuff. That's but yeah, it is. How receptive is that person? How high is the bar for that person is getting up out of the house? Really hard, because someone is treating depressed and agoraphobic, all these different factors that come in
Aoife 40:07
totally i i agree, and it's very individualized. And I think like walking is one thing, and maybe it's also you're in your house and you just stand up more often, do something while you're standing instead of sitting or and I have to say, this is something I struggle with. You know, I have a lot of friends who say I have to exercise for my mental health because they feel it acutely like they have to go for a run. I'm not someone who has to go for a run, like I have to force myself to go and exercise, and it always helps and always makes me feel better. But I, you know, it's not easy.
Fiona 40:53
And again, another barrier is when we're talking about preparing for being resilient. It's, it's a similar sort of thing. It's like, we know the outcome is going to be good, but it's not, yeah, right now. I don't need to meditate right now, or I don't need to. So there's, it's so complex, and I want to dive into a bit more of your research.
Aoife 41:16
It's such a pleasure to like. I always feel this to talk about the implications of the work, because so much of the time in academia, we are mired in the data and the nuance and very specific, tiny details that no one would care about outside of our fields, and yeah, so great to have a chance to talk about why it might matter.
Fiona 41:49
But you clearly do think about these things. You're not someone who is just head lost in your data. You're thinking about the social implications, the societal indication. Sorry, that was a big breath I take there. What were you not at all.
Aoife 42:02
I could say, I can say, well, so I'd love to say something about that, which is what happened to me was I spent many years studying psychological stress, and then the COVID 19 pandemic happened, and I felt so paralyzed. I had a lot of people coming to me saying, what should we do? We're in the stressor right now. What should we do? And I was actually working with infectious disease doctors at the time, and they were working with me and some colleagues who are PTSD researchers, and they were really concerned about their colleagues developing PTSD from what they were experiencing, and we had some thoughts and ideas, but I don't think I'd ever felt so intensely before that if for this part of my career, for the next Part of my career, I want to focus on translating what we do into interventions, into insights that would actually help people who are experiencing stress or who are likely to experience stress, and that's Been really energizing to think about it that way,
Fiona 43:23
and that's what you've been doing with the PTSD app. Is that right?
Aoife 43:29
Yeah. So we developed an app a number of years ago, and the goal so our app is called reps, resolving psychological stress. You can find it in the app store, but you can't use it because it's still just in research studies. It's not available, but we have been using it now for quite a while in people with PTSD. And the first striking thing about our app, and the app is designed to alter people's responses to threats. And the first thing we found was that we had incredible demand. So when we launched the study and we advertised it online, we just had huge numbers of people trying to take part in the study. And that was really telling, because I think people are seeking out anything that could help. And this goes for PTSD, but also depression, anxiety, these, these conditions and states are just really, really common, and we need better interventions for people. We're still studying the app. We're trying to optimize it and figure out like which version of the app works best for for which case, because when we analyze the data from our first app study, I. Um, which was run by Andrea Niles and Paige Tripp, what we found was that different people seem to benefit from different types of intervention. And of course, this is true. There are 590,000 different ways to get a diagnosis of PTSD, 590,000 that's correct, the combination of symptoms is such that you could have, you know, an auditorium with 590,000 people, and they all have different constellations of PTSD symptoms. And we know that everybody's different, that traumatic stress that people experience is different. People respond to different interventions differently, and people have different goals. So what we're trying to do in our latest app studies is to better understand individual trajectories, individual patterns of threat sensitivity, and how we might target those different patterns. So, yeah, that has been that has been very rewarding line of work, because it's relatively easy for us and relatively easy for participants. You know, we create the app and we put it out there. People can download it, and we can learn a lot, and actually like the great the during the pandemic, we reached out to our app users, and we started a study, a new study, of those app users, to look at their experiences during the pandemic. And we learned so much from that study about people, how people were responding to COVID 19 as well.
Fiona 46:49
Yeah, we have so many questions too. I mean, I, as I said, I would, I would love for you to come on again. I haven't been able to ask you the life connected questions which I wouldn't need to ask you. And I find it fascinating when someone is actually doing that in depth, individualized work. When we have, we have so much excuse my language crap out there. I mean, there's so much bullshit, so much life will get better. And you know, it's often the people who would fall under those conditions, because we all do to some extent. Yeah,
Aoife 47:37
We all have mental health, yeah. So, you know, we all it is completely in the normal range to have symptoms of depression, anxiety, and if you're exposed to trauma, to have some of the symptoms of PTSD. These are not uncommon and they're not abnormal. It's just that at a certain point, they can be really unhelpful and and make people stuck. And the other Yeah, so the other part of my work, so since the pandemic, I've become very involved in psychedelic therapy research, and that's another, again, it's the same motivation. What is it that we can do for people? And I was very nervous about studying psychedelic therapy and and the risks of psychedelic therapy, and still am. But if you listen to people, to military veterans in particular, and I work at the VA hospital, people have these transformative experiences, and they feel like they they can process things that were impossible for them to process in other circumstances, I will say We have a lot of work to do to understand who will benefit, what are the risks, what are the adverse events? It's very early in terms of our understanding of how these interventions might work in clinical settings. These interventions are not new, and it's not early in the evolution of these interventions out in the world, outside of science and medicine, but in our world, we really want to understand, we hear the amazing stories, the life changing, transformative stories, and we want to figure out, how do we make it safe? How do we figure out who will benefit, and why do they benefit, and how do we make it even safer?
Fiona 49:47
If we know what the mechanisms are, really exciting. It's, it's something I feel almost impatient about, because we know, like you said. Say we know, we see, I've met people who've had these experiences that have almost unlocked, and you use the word stuck, it's as if you know a bottle has got a cork in it, and it's taken that cork out and it said, right now, and now I can be free, and I can pour, I can connect with the world again, and exactly yeah, kind of are not something, but as you say, it's understanding how and why, yeah, and we will get there.
Aoife 50:35
I think we will get there. And I think we're making a lot of progress in mental health research, and I hope it will continue to be supported at a high level. So much to talk about this, I'm fascinated by having questions like your research and anger and anger and stress in women, how does your physical activity? You touched on physical activity, but I'd love to know more about that and the exercise and then really interesting, using yourself as an example there of where you've seen the benefits, you know, the benefits you've written about, the benefits, you still can find it difficult to get up and do exercise. So yeah, it's that knowing and doing piece that I find fascinating, that knowing and doing is really tough, and it's very what's very easy for me is to get into a state of of of stress, where I think, Okay, well, I'm not going to get to exercise this week, but next week and next week never comes, and then it's harder and harder and harder. So just trying to make sure you realize, okay, I can't do the full yoga class that I want to do. Can I do 20 minutes? And that's and just keeping the habit is so powerful. Yeah, my my good friend and colleague, Eli Putterman, who I've worked with on a lot of those exercise studies. He's he has incredible story about himself getting back into exercise after a break, but that's the piece he always emphasizes, just show up. So Eli talks about showing up to the gym and not doing anything, but just showing up until you hit on you just Yeah, do you feel like you need to just being there? You do feel like you have to, but you have to say to yourself, I don't have to do anything. I just have to go and these mental tricks.
Fiona 52:45
Because one I used to use because I actually really enjoy it exercise, but there have been times when I haven't. One I used to use is there's no there's no question. I can't debate it with myself, because I debate with ourselves a lot. Well, if I did this, or maybe if I did that, I would just say, That's it, for doing it right?
Aoife 53:03
I've heard that like, get off the debate team uncertain about your life. I'm eating into your next meeting.
Fiona 53:11
I absolutely love, love, love, speaking to you. Thank you so much. Thank you for what you're doing, and thank you for sharing. And actually, you know, I talk a lot about role modeling, thank you for role modeling to the people that work with you, but it's really important to communicate these things to a wider audience.
Aoife 53:32
Yeah, we try. Thank you so much. Fiona, I love what you're doing podcast, and I'll talk to you soon.