Hi, I'm June Gruber, an associate professor of psychology at the University of Colorado Boulder, and director of the mental health experts series. We're here today with Dr. Bunmi Olatunji, the Gertrude Conaway, Vanderbilt professor of psychology and psychiatry at Vanderbilt University, to speak with him about his cutting edge work on anxiety disorders. Thank you for being with us here today. Thank you, June, for having me. It's a pleasure. Sure. I wonder if you could start by just telling us a little bit about the kind of mental health research you do. Well, that's a great question. Really, my research program, at least how I'd like to describe it, is that it really reflects a triangulation of three core issues related to the phenomenology of anxiety and related disorders. The three aspects of that triangle is really assessment, mechanisms, and treatment. Really what my research program is focused on is, how do we advance knowledge in those three components, and ultimately, how do we use that knowledge that we've gained from those three components to improve our patients' lives? Wonderful. What are some of the most exciting findings that you've come across in this line of work? Well, I think we're certainly learning a lot about anxiety-related disorders over the last couple of years. One of the really important things that we're starting to clarify is that we actually do have some really good empirically-based interventions for these disorders. We were in a position now where we can really start to ask other questions about who should be getting these treatments, how should they be getting those treatments? So I think what's really been exciting is that we've really started to advance our knowledge in really meaningful ways because we have something that works and now really the question is, how do we get these to the people who actually need them? I saw too that your lab is doing some really exciting work on the role of emotions in anxiety disorders as well. Yeah. This is actually where I got my start in some respects with those three pillars of anxiety-related work. One of the interesting things that was clear to us clinically is that for several anxiety-related conditions, they just didn't seem the clearly fit the typical fear and anxiety profile. There were other disorders, certain phobias, obsessive-compulsive disorder to some extent, that appeared to actually be better characterized by more of a disgust related profile. With that observation clinically, we started asking the questions from a research standpoint, about whether or not we can actually assess this clinical observation, can we really think about different mechanisms related to disgust versus anxiety, and do those distinctions have any implications for how we go about treating these disorders? Is it fair to say that looking at emotions and anxiety was the window or way in which you've got started in this line of work? Absolutely. I tell my students to some respects that a lot of my thinking, excuse me, about psychopathology is actually heavily influenced by basic emotion science research, social psychology research, and is really those paradigms that I've really borrowed from to really help me to understand various anxiety-related processes. A question for you just on a personal note, which is, along the way in this really exciting line of work you're doing, what were some both frustrations as well as successes that you've had? That's a good question. I think that, as most clinical scientists can attest to, the failures and frustrations often outnumber the successes, but the successes can outweigh the failures and frustrations. From a research standpoint, I think that for me, what I've often observed is that I'm actually wrong a lot about my hypotheses, about how things are going to unfold in the lab. But this process of being wrong often, it's actually put me in a great position to learn and refine my research approaches. I'm sure as you know, this has been one of the more difficult things to communicate to trainees, because they tend to believe that experiments should always work, and the papers you submit should always get submitted where you send them. For me, I think that it's really this humility with this scientific process of knowing that more often than not, the experiments are going to be wrong, they are going to fail, but using that as an opportunity to refine your thinking and to refine your methods, as we have ultimately advanced in knowledge in a very meaningful way. Using frustrations and failures in many ways is a core source to learn and grow from. Absolutely. I think that that's something that, because for most of our trainees, what they see is the paper. They don't really see the process behind said paper. I think that having a fundamentally different relationship with experiments that fail or papers that don't actually make it to print, and really using those as learning experiences in terms of how we can refine what we think and what we do, I think is an important process in how we train the next generation. That's excellent, just general life advise and also mentorship advice too. Because you're right, the sheer volume of failures can feel like a lot in our field. To grow from them and see them that way, I think it's just a fantastic way to go about this, and to truly do the best clinical work and science too. Yeah. But it's easier said than done. I have to admit at times in. The reinforcement incentives don't always accommodate as being patient with the scientific process. But I think if you lean into this idea that a lot can be learned when experiments fail or when hypotheses are wrong, I think ultimately the product that you generate is going to be of higher quality. Yeah. I mean, when you think about growing from these things in advancing a field, the next question I was going to ask is along these lines which is, from your perspective, what do you see as the most important next steps in our field? Mental health broadly, as well as anxiety and emotion specifically. That's an excellent question. I think there are different directions that the field can and needs to go. One of the things that I think is really important in terms of future directions is, as I mentioned before, we're starting to really get a good sense of what evidence-based treatment looks like. We're really starting to figure out what are the principles of change that are evidence-based. Where we continue to struggle as a field is really trying to figure out the best approaches of dissemination: How do we really get these principles of change in the hands of the people that need them. But also there are different principles of change, and we really don't have a good handle yet of, what are the things that can tell us who's going to benefit from one treatment versus another? As a patient, when you walk through my door, what are the things that I can decipher from the assessment standpoint, that can tell me whether or not this person needs cognitive behavioral therapy versus, let's say, antidepressant medications? This notion of prescriptive indicators is really still something that we struggle with. I think once we get a handle on that, we're moving more towards personalized medicine in a way that's really going to be more efficient with regards to our treatment delivery. I think that's so well put. As you were saying translating the scientific discoveries into personalized treatment approaches for the individuals that need them, that's the goal and a challenge that, as you're saying, our field needs to really confront and grapple with. Yeah and I think that part of the challenge too is, how do we do that by also leveraging the tools and the resources in front of us? As you know, a lot is happening virtually these days and the COVID era. As stressful, as distressing as this era has been, one has to wonder if there's a lot to be learned from this sort of stress test, if you will, of our treatment delivery approaches and methods. Perhaps there are things that we can borrow from this era to really leverage the dissemination of the things that we know are effective for the people that need them. Yeah. For those watching this conversation today, I wonder what kind of advice you have for other people, students, public at-large, other mental health professionals who are interested in this field. Well, it's interesting because the public at large students, other professionals, I wonder if the things that they should be looking at are different or perhaps the same, I don't know. But I think that we're going to have to start to really think about how we can partner with other disciplines and professionals. If dissemination of the things that we do is really where we're headed, we're going to have to learn about how do we better interact with computer scientists, engineers, and things of that sort. The trans-disciplinary approach, I think is going to be something that we're going to see a greater emphasis on because I do think clinical science lends itself to that. I think this trans-disciplinary framework is something that people should really start to wrap their minds around in terms of advancing clinical science. I think that for the public, the thing that my advisor always trained me to think about is, there's a lot of information out there and there's a lot of misinformation out there. Science literacy is just something that is so crucial and clinical science is not immune to those type of issues. As much as we're learning about treatments that work, there's a lot of information out there, they advocating and promoting treatments that don't work. How do we, as a science, help the public navigate those muddy waters in terms of ultimately finding evidence-based treatments? Those are the type of issues that come to mind for me, both from a discipline standpoint, just where are we going, so being more trans-disciplinary. But in terms of our relationship with the consumer, really trying to be more thoughtful and active in helping people navigate the muddy waters of evidence versus non evidence-based treatment. So in a way, it's public outreach and it's really trying to partner with the very people who want to understand the work our field is doing and want to try to bring it into action in a real-world way. Yeah. Absolutely. I think that as scientists, we also have to be better at how we communicate our information to the public. I think Jean, the work you're doing now is a very good example of that. How do we get the information out there in a way that's digestible for people so they can, in fact, access resources are going to be ultimately be helpful to them? All right. Well, thank you so much. This was a wonderful conversation and I really appreciate your time speaking with us today. Thanks again. Thank you, Jean. Thank you so much for having me.
