In the follow-up interview below, MedCircle Host Kyle Kittleson and Dr. Ramani discuss behind-the-scenes of the interview and Dr. Ramani’s thoughts on Jenner and the overall experience. Plus, Dr. Ramani provides additional insight and actionable steps for those struggling with social anxiety and adjusting to a post-COVID world.
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The transcript below has been edited for clarity.
Kyle Kittleson (KK): Hi, Dr. Ramani. Great to see you. Congratulations on your interview with Kendall Jenner and Vogue. That is a really big deal, I think.
Dr. Ramani (DR): Yeah, I would be the worst dressed person that Vogue has ever featured on their interview platform. So, I carry that with tremendous pride.
KK: I actually really do love that. MedCircle, Vogue, YouTube, Kendall, and all of us came together for Mental Health month to produce a lot of different types of content. And you sat down with Kendall to talk about social anxiety. And the first thing that really comes to mind is, how can one of the most famous people in the entire world struggling with social anxiety?
DR: You know, it is so interesting because when you really stop to think about it, I thought I was the perfect person (I thought) to do the interview. Because I didn’t know much about her going into this interview. So, apparently, she’s one of the most famous people in the world. But when you’re my age, you don’t know this. Days before the interview, they sent me materials to learn about her and it was no different, honestly, when seeing a traditional client in my practice and reviewing the intake forms. That’s how little I knew about this person. And so I honestly think it was as though you found, like, I was like some living on some sort of remote Pacific Island and didn’t know there was a pandemic. I was like, ‘Oh, how interesting?’ You know?
And so when I finally met her, I had the curiosity I would have as a clinician and not the curiosity I would have about a celebrity, which actually worked out really well because I think I was, I was in my clinical mind. What did strike me is I had no idea how well known this young woman is. And then I thought to myself, ‘this is really hard in the sense of the amount of scrutiny that she is under.’ And I think at an age where even developmentally, it’s not easy, that the kind of scrutiny she’s under would be more than any adult could handle. If she makes one wrong move, if she says one wrong thing, anything which is sort of normative for youth, she is really, really going to take it. You know, it’s going to be a very harsh experience for her.
And so I think that what we learned is that no matter what space you occupy in this world, it’s sort of universality. Anyone can be impacted by social anxiety. And actually, as she described it, it all made sense to me as a clinician. It made sense. To be honest with you, I had a big concern going in. I came to find out in the days before doing the research on her, how famous she is that there’s always a risk when you interview an incredibly famous person about their mental health concerns, you lose the humanity of it, right?
I was actually trying to capture the universality. And as she talked, I have to say, she was very warm and she was very self-effacing and she was very insightful, which made my position a lot easier. She was not defensive. She’s not resistant. To be frank with you, she’d sort of be a dream therapy client because she was really motivated, even in that short period of time I had with her, to do the work as it were. And so the way she described it, it felt so universal. And in the moment of the interview, I saw a young woman in her twenties struggling with anxiety. I did not see one of the most famous people in the world.
I wish that there was in a strange way, there was a camera in the room so people could see how universal their struggles are. What she did was bring that universality in. And whereas many people might be scratching their head and say, ‘Oh, what problems? Cause she’s young. She’s beautiful. She’s rich. She’s famous.’ The way Kendall described everything didn’t make you roll your eyes. It was in a way that made you think, ‘Oh, I get it.’
KK: So, let’s go back to that. Because that was my next question. There are plenty of people who did roll their eyes when they saw Kendall Jenner talking about mental health, because they may think, ‘how is that person struggling when I’m over here and I have no money, I have no family, I have no resources.’ She can have the best mental health team in the world by snapping her fingers. What is your longer response to those people who have that reaction?
DR: I get it. I mean, I completely get it. I’m not going to sit here and say, no, no, no, we’re all in it together. Uh, heck no. I mean, we know that we have a mental health service crisis in this country. The pandemic put a really stark focus on it. And it is heartbreaking because every day I hear about many, many families, many, many individuals who are really struggling, who are fighting insurance companies, who can’t get what they need for themselves, for their families. So yes, I understand that. And that’s a larger systemic and structural issue. I also though think that it’s a bigger sociological discussion. When we can identify ourselves in people that are put up there as sort of culturally important or culturally relevant, it does actually humanize the struggle of others.
My hope has always been that when somebody speaks about their concerns, you say, ‘okay, they’re having a tough time. I’m having a tough time. Having a tough time is okay.’
Another one that came out in the interview with her is that social anxiety, like all mental health issues, isn’t black and white. It’s not simple – as in you got it, or you don’t, you know? It’s not a blood test. We don’t say, ‘Oh yeah, you’re anemic. Let’s go do this, or do that for you.’ We recognize that all mental health issues are very multifaceted, which is why I know too many times two socially anxious people don’t look the same. Two depressed people don’t look the same and on and on and on. It can look very different in terms of how a person functions in the world in terms of how they might talk about their patterns.
And I think that, and this is almost sort of a, you know, as people watch the interview between her and I, there were some interesting insights that even came out in real-time while her and I were talking, as she spoke about what makes her anxious. I thought, sure, it’d be great to be young and gorgeous and have all the money in the world. But I also have to say, I don’t know that I’d want to live in a world where everywhere I went in public, people were always surrounding you. And if I was even in a private-public setting, I don’t know, like a dinner party or something, and people were always surrounding me – I would actually feel like I was being choked. I kind of liked that I can go into a grocery store and nobody would know who I am or go to run an errand or whatever I did after I left that interview. I thought, my goodness, what a gift. This is because actually, I think I went to the grocery store that evening and nobody cared who I was. Yeah. Wow. This is a luxury and privilege. It is a privilege to be able to walk through the world unrecognized and she doesn’t have that. And so we recognize that social anxiety takes so many forms and we have to remember, and this is where this Kendall Jenner interview is so interesting, a lot of people think, ‘oh, if a person has social anxiety, they can’t be a public person’ – and nothing can be further from the truth. And there are actually many public people who are socially anxious, and it actually speaks to almost what we’d call ‘the power of exposure therapy’, right? And so much of anxiety is about avoidance.
We have to recognize that there is incredible discomfort. And part of the treatment for anxiety is helping people get a little bit more comfortable with their discomfort. She did reveal talking about things like mindfulness and meditation. She does build in a lot of daily practices. And going back to the original premise of your question, what we got to remember is mindfulness and meditation. These are interventions that are free. It can be done every day. Then you can learn in spaces out there that are at no cost. Those are things that she was doing every day in all kinds of daily practices. And we know mindfulness and meditation are amongst some of the more stronger, what we call adjunct tools to manage anxiety.
She was even citing stuff she was doing that was just available to everyone. But I did have to reflect on that. That idea that just because you’re public, doesn’t mean you can’t be socially anxious. Socially anxious people can be public. They can go on stage. And I think it’s important for people to see that. So somebody who is socially anxious may say, ‘I can make this presentation in my class. I will be able to do this sales presentation. I’m going to be uncomfortable as heck, but I’m going to come through the other side and maybe I’m going to need a long nap when it’s done.’
KK: Makes sense. How was the vibe on set? You know, as we mentioned, nobody is bigger than Kendall Jenner, except, you know, maybe her siblings. So what was it like on set?
DR: Shooting in COVID times is something I’ve done 10 or 11 times now. And it’s so much testing and masks. These sets are very carefully controlled. The number of people they have, COVID compliance officers, there’s healthcare professionals. It’s a whole new game. I have to say this, like all other sets, there’s a tension on sets, right? Because everyone’s trying to be so careful and COVID safe. What happens is there’s only a certain number of people that could be in the indoor space. So they chose a space that could be indoor-outdoor. So I actually find myself sitting outside quite a bit. And one thing that they did, which was an interesting device, which I think is actually a good thing, they did not want Kendall and I to meet until the moment of the meeting.
In other words, she’s coming into a therapist’s office. And so I was kept in a separate part of the space than her. And so only at the actual moment of meeting, did we actually meet. And, um, and remember my, I guess my superpower on the shoot was, I didn’t really know who she was and I barely even knew what she looked like again. I’m the last person on the planet who obviously didn’t know. And so when I saw her again, I guess maybe it’s the mom in me cause I have a daughter a little younger than her, I guess I just saw someone that reminded me of my daughter’s age group. All of this was really beautiful poised young woman who received me very warmly.
And I’ll be honest with you, when I heard she has a trillion followers and all of that, I thought, ‘I wonder if she’s not going to be very nice’, you know? And she was actually quite warm, quite lovely, very receptive. I found talking with her to be incredibly easy. We could have kept talking for a while. There was actually a hard stop to the shoot. So we actually ended up ending a little bit more abruptly than I would have liked. When I meet people in these media interview setups, I wonder, ‘is this someone I’d love as a client?’ She’s actually someone who would actually be a very nice person to work with in therapy because she’s insightful. She connected the dots.
That’s all we want for anyone. She’s absolutely beautiful and she’s very, very tall. I mean, I have tall daughters, so I’m sort of used to having to look up to young women at this point. She’s very, very tall and again, a beautiful young woman. And I really applaud her for using this platform to talk about social anxiety in a way that will de-stigmatize it because it is so, so common. And we live in a world where, you know, extroversion is so overvalued. And not that extroversion and introversion and social anxiety are all the same thing – but I feel that people feel that when they’re not ‘out there’ they feel that they’re lacking.
And she herself also noted she, despite being younger than her set of siblings, she is very much a caregiver and she’s often worried about other people. So we talked about how social anxiety generalizes into other areas of anxiety. Anxious people worry. And during the pandemic, she was very worried about the health and wellbeing of her family. She often views herself as sort of like a bit of a mother hen. While it’s a lovely role, it’s also an anxiety provoking role, especially in a really big family.
KK: I used to live in LA. I was there for almost 10 years. And being in that space, you hear a lot about celebrities and their reputations. And without exception, I have only heard great things about the Kardashian/Jenner clan. I’ve heard they’re professional, they’re kind, they’re considerate, that they work great with others. They work hard and they dominate the industry that they play in. But they do so in a way that people seem to really give them a thumbs up after working with them. So it’s nice to hear that again.
DR: Yes. She was lovely. I have to say, I have met people in the industry who are actually standoffish, and I kind of leave thinking, ‘okay, I wish I could have that 20 minutes of my life back,’ but I didn’t feel that at all. I actually thought there were some things we talked about that if the world could hear them it could maybe benefit some people and open them up to say, ‘Oh, I could see how this might apply to my life.’ And also, that many times it looks like people have absolutely perfect lives and nothing goes wrong in their lives. And I think it’s important to see that nobody’s life is absolutely perfect and we all have our thing.
DR: Another interesting thing that came up in the interview with her is how important things like temperament and how we come up in the world are. She did talk about herself as a little girl. That’s what I was curious about. When a person’s very socially anxious, one of my questions is, ‘how were you as a child?’ You know, and what we do see is that socially anxious adults were often slightly more, reticent, reluctant children. They would keep to the corner. They wouldn’t be the child who was sort of cartwheeling through the living room. Like they were the one who was just kept to themselves. And she definitely described a very robust, busy childhood home and that she would get overwhelmed by all of that. You know, she did not like so many people and everything. So that’s something that’s been with her.
And she contrasted that to siblings who are very much willing to sort of be center stage. And I think that people also need to remember is that our temperaments can often intersect with the demands of our lives. In her case, she became a public person and there’s attention to that. You know, I could easily see someone critically watching this and saying, ‘well, if you’re so socially anxious, why did you become a public person?’ She’s good at what she does. She likes what she does. So I think it’s a wake-up call that social anxiety shouldn’t necessarily stop someone from creating the path that they could potentially be quite good at. It just may be more exhausting for them.
KK: That is really good. Now we are moving into a world that is post COVID and restrictions are easing up. People are leaving their homes more frequently and I’m getting feedback that this is creating a type of anxiety. Perhaps it is a type of social anxiety. So I’m sure this interview resonates on that plane. Dr. Ramani, what can people do as we move into this ‘new normal’ of being back and around people who are a little afraid about it?
DR: This is a big problem. I call it the ‘post-pandemic bends’. And by that, I mean, you know, if you are a scuba diver at the end of your scuba dive, (I used this as a teaching point with Kendall in our interview) you have to come up very slowly or you’ll get the bends, right? And the bends can actually be a deadly condition. So you must complete what’s called a safety stop at the very end, about 15 feet under the surface, you kind of hang out for about three minutes, four minutes, and then you slowly ascend to the top. We need to slowly ascend back to life.
There’s a lot of emotions people are having right now. One is pandemic guilt. Everybody knows somebody who suffered the ultimate loss, secondary to the pandemic. We know people. And if it wasn’t that they literally lost a family member or a loved one, then they may have lost jobs, they may have taken financial hits. They may have lost their homes. Interestingly though, with people saying, ‘I feel really guilty but being at home and not having to commute and not having the meetings and the idle chit-chat has been the best thing that’s ever happened to me.’ And people are saying, ‘I’ve liked working at home. I’ve really enjoyed this.’ And in the same breath, they know families are suffering.
I know kids are suffering. So they feel bad that it’s almost like so many had to suffer and yet they got something good out of it. So there’s a strange form of survivor guilt, if you will. And I think for those people, they’re thinking, ‘I don’t want to go back. I don’t want to commute. I don’t want to go back to an office. I don’t want to have the office gossip. I’m not interested. I just want to do my job. And now it’s clear to me after 15 months of doing this, I can do my job at home.’ And that’s one group of people. I think there’s another group of people where we have played by one set of rules for so long that there’s what we call a classically conditioned fear, no mask, or a group of people means I’m going to get sick.
It’s almost become physiologically associated. Like Pavlov’s dog would salivate to the bell. People think ‘crowd means sick.’ And so they immediately think, ‘I gotta get outta here.’ And so that is also going to be an issue for some people as they come back into the world. Some people feel as though there are people who are having vaccine guilt. They’re vaccinated and others aren’t. Now, in California where I’m located, it’s getting interesting because pretty much everybody’s eligible now. So now there’s plenty of appointments. So the only thing stopping someone from being vaccinated now is pretty much themselves because you can be vaccinated. But I think in the early days of vaccination, some people felt I can kind of go out safely, but other people can’t. I think that was creating some struggles for people as well.
So I think that we have sort of this combination of factors, but more than anything, anytime we make a switch, Kyle, let’s say you go on a two-week vacation – coming back into your life, takes a minute. Let’s say you move to a new city – takes a second. Move to a new apartment or house – takes a second. So transitions take time. This is a massive transition. And I will tell you for the rest of our lives, everyone is going to remember their lives before the pandemic and after the pandemic. And there will have been significant changes. I’m already seeing it. I’m seeing anxiety across my clients.
What does this mean? I’m seeing in couples, one person wanting to socialize very quickly while the other one doesn’t want to socialize. I was actually pretty content that we got to stay home together for the first time in our relationship. So I’m seeing it in relationships. I’m seeing it in families. I’m seeing people have different approaches to wanting to return to school. P leaving jobs, people reconfiguring their careers, people saying, ‘okay, pandemic is done by ending relationships.’ We couldn’t do this during the pandemic and filing for divorce. So you name it, I’m seeing it. And a lot of it is adjusting to this post-pandemic world.
KK: Well, I love the reminder of no matter what it is, whether it’s coming back from a pandemic or coming back from vacation, that slow introduction into the new life. Take it for yourself. That is a good reminder for all of us. I’m actually thrilled that you did the interview with Kendall Jenner. MedCircle has not done a lot with celebrities and Kendall Jenner is, of course, the biggest celebrity that, MedCircle, or you as a representative MedCircle have worked with. But I like it because a lot of people just discovered Dr. Ramani because they watched the Kendall Jenner interview and a lot of people discovered mental health resources because they watched the Kendall Jenner interview. That is really great. If we can leverage somebody else’s big platform to help more people – that is something that I will probably say ‘yes’ to as many times as I can. It makes sense. I really thank you for doing that. It’s so great to see everything that you’re doing and how many more people you’re reaching Dr. Ramani. It’s awesome.
DR: Well, I appreciate that. This is why MedCircle is so important to me. What I love about MedCircle is that it takes on the entire spectrum of mental health issues. And it does it from the perspective of a variety of practitioners. Because I think that while I feel privileged to have done that interview, where MedCircle really does such a great service, is it lets you hear the voice of many practitioners. People will say, ‘well, what kind of therapists might I like?’ And by having a whole range of practitioners on the MedCircle platform, you also get to say, ‘I like a little of that, but I don’t know if that would work for me.’ And people get to hear different voices in mental health. But you know, again, I’ve pretty much been working with MedCircle since your beginning as well. And we have that shared sense of purpose.
Mental health, unlike many other healthcare areas, still remains a frontier where people are anxious about getting information. There is still stigma. Families don’t always fully understand it. People don’t know how to get help and there’s still people out there saying, ‘you’re in therapy? What does that mean?’ And so I think that anything that sometimes psycho-education, which to me is the crux of what MedCircle does (it’s the crux of a lot of what I do), teaching people about mental health and what it means and what it looks like, and what’s the difference between just being worried and having an anxiety disorder, what’s the difference between sad and being depressed, what do different kinds of therapy look like, etc. We’re not drilling a hole in someone’s skull. We’re not doing anything outlandish.
And so I think that the more and more we see of this, the better it is for people. And many people say, ‘gosh, this didn’t exist when I was an adolescent or a young adult.” Now, they’re in their forties or fifties and say, ‘I’m learning now.’ And I’m also grateful that the younger generation have this because mental health doesn’t really know age barriers. People at every age can be struggling with mental health issues. It’s also wonderful to see MedCircle’s global reach. And in fact, we think we have a mental health crisis in the United States? It’s worse in other parts of the world. There’s just nobody trying to do the work. It’s not valued properly. And so there’s a lot of people suffering in silence. If this was a medical issue and there was this lack of access to help, we would consider this an absolute catastrophic calamity. But for some reason, the lack of access to mental health is still not viewed as the cataclysm that it really is.
KK: That’s very, very true. And like Dr. Ramani has said, what you can do for yourself and for those around you is to get educated. You can do that right here on this YouTube channel. Like and subscribe here. Dr. Ramani also has her own YouTube channel. Go check that out as well. A lot of content out there on narcissism. Thank you for supporting this channel and supporting mental health education. Dr. Ramani, lovely to see you. I’m sure we’ll see you very soon. I’m Kyle Kittleson. Remember whatever you’re going through, you’ve got this.