Christine’s Clinical Corner
Vol. 1: State Change – Getting to the Root of Anxiety
Here at Resilience Lab, we’ve spent the past year reflecting deeply on a single, complex question: What is clinical quality—and how do you measure it? The answer is not as simple as reducing symptoms on a GAD-7 or PHQ-9. For us, clinical quality is about helping people reclaim meaning. It’s about facilitating State Change—a shift in vitality, perception, health, and connection that empowers clients to live fuller lives. This requires getting at the root causes of imbalance, not just managing symptoms.
This month, our Amplified Learning Series has centered on Anxiety, the most common mental health disorder among children, and one that often persists and complicates into adulthood when left untreated. In our recent Fireside Chat with Dr. Robin Berzin, founder of Parsley Health and author of State Change, we explored how chronic anxiety is not just a mental or emotional experience - but also a physiological state deeply rooted in our bodies, environments, and lifestyles.
Emotions Are Sensations
As clinicians, we know that emotions are generated in the body. They’re signals—sensations that inform us of our needs. When clients are flooded with fear, dread, or chronic overwhelm,these aren’t just mental distortions. They are biological messages. To support transformation,we must treat the whole system.
My own clinical philosophy, developed over the last 20 years, is rooted in this principle. Earlyon, I began referring clients to trusted psychiatrists, nutritionists, yoga instructors, and later,functional medicine doctors. I believed in “building the team”—an integrated approach that aligned mental health with physical, relational, and existential health. That’s how I discovered Parsley Health. And when I personally began to experience unexplained burnout and anxiety that didn’t respond to CBT or hypnotherapy, it was Parsley that helped me uncover physiological drivers that traditional approaches had missed.
Whole-Person Assessment as a Clinical Standard
The Resilience Methodology was developed as a framework for anybody practicing in themental health space, therapist or prescriber, and is uniquely positioned to explore anxiety notjust as a diagnosis, but possibly a symptom of deeper dysfunction—sometimes stemming from hormonal imbalances, vitamin/mineral deficiencies, genetic variants (like MTHFR), or gut-brain axis dysfunction. When we train our clinicians, we emphasize combining:
Comprehensive lifestyle, social, medical, and trauma history to pinpoint the origin of the experience(s):
- Differential diagnosis and fine-tuned screening
- Psychoeducation on the biology of anxiety
- Collaboration with functional medicine when appropriate
Through this lens, we can identify skills deficits, maladaptive thought patterns, or barriersto behavioral activation—but also, physical contributors like sleep deprivation, inflammation,or nutritional deficiencies that perpetuate emotional dysregulation.
From Childhood Anxiety to Complex Adult Syndromes
Anxiety disorders often begin in childhood—with estimates showing up to 31.9% of kids will meet criteria for an anxiety disorder before 18. These aren’t just developmental quirks. They are treatable but, if ignored, can evolve into entrenched adult patterns—complicated by depression,disordered eating, substance misuse, or trauma reenactment.
Take “Susan,” a long-time client who began therapy in grad school after years of untreated anxiety dating back to childhood. By 13, she was prescribed both Prozac and Xanax. She lived with chronic OCD, contamination fears, panic attacks, and binge eating. Through structured ERP work, she made incredible gains—traveling internationally, building a family, and living freely. But physical symptoms persisted: hormonal dysfunction, unexplained weight gain, and a MTHFR gene mutation. Her healing required deeper integration—which is where Parsley camein. Today, she's thriving not just emotionally, but physiologically.
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Clinical Tips: State Change in Action
As therapists, we can guide clients through State Change by integrating the following into our work:
✅ Movement as Medicine:
Encourage clients to view exercise as emotional processing, not optional self-care. Dr. Berzin’s protocol recommends:
- 2x/week of 20 min aerobic cardio
- 2x/week of 30 min mindful movement (e.g., yoga)
- 2x/week of strength-building
- 1 day of full rest
✅ Sleep as a Stabilizer:
Chronic sleep deprivation increases the risk for anxiety, depression,ADHD, and even bipolar disorder. Normalize sleep hygiene as a therapeutic priority.
✅ Nutrition & Microbiome:
Explore dietary patterns, especially in clients with chronic anxiety,mood swings, or unexplained fatigue. Histamine intolerance, inflammation, or keto-stylemetabolic shifts may play a role.
✅ Collaboration:
Don’t hesitate to refer. Work with integrative MDs, especially for clients with resistant symptoms, hormonal changes (like perimenopause), or positive MTHFR markers.
✅ Psychoeducation:
Use body-based metaphors to help clients understand anxiety. Help them see anxiety as a signal, not a sentence.
Final Thought
One of my favorite quotes from State Change captures our shared mission perfectly:
“To create a State Change, you have to change something about your current situation in order to shift something about your future situation. Change requires action.”
As therapists or prescribers, we’re not just holding space. We’re inviting change—real,measurable, embodied transformation.
Until next month,
Christine