Why Patients Stay Stuck - Masterclass for Health Professionals

Well, a warm welcome to all of you to our live event today, What May Be Keeping Your Clients Stuck, Your Patients Stuck. And the reason I wanted to do this event was because I spend a lot of time in the US and Canada and Europe presenting at various conferences. So we present to conferences where there are functional medicine doctors, nutritionists, naturopaths, like many of you, be on this call, and MDs. And something curious that they report to me time and time again is they'll have certain clients whom they'll go through the tests, they'll go through the normal protocols, and they'll have great success with those clients. And there'll be a large percentage of clients with whom they'll follow the same protocols, right? They'll do the tests, the protocols that they know work in certain patients, But for whatever reason, the impact will be temporary, where there's a temporary impact, they seem to improve, and then all of a sudden, a week later, a few days later, a few months later, they'll come back with exactly the same set of symptoms, or indeed, they'll come back with a new set of symptoms. And it seems very mysterious. So then the protocols will start again, the investigations will start again, and sometimes the the labs have come back to normal. Sometimes the labs are dysregulated in a different way. And it almost often becomes a game of whack-a-mole to try and understand what exactly is going on. How can we regulate this person's parameters in terms of the test results? And it can often be very confusing. It can be very frustrating. And time and time again, these, you know, fantastic practitioners, they tell me, we know that there's something more going on beyond our traditional protocols. And we want to understand this. And we want to understand how what we might traditionally call the psychological component, we don't necessarily think it's psychological, but there's some other processes and parameters that we need to understand. And that's where we find that the work that we do, steps in and supports practitioners. So I think it's such an important topic. And so what we're going to do today is the first half an hour, what I'm going to do is talk about the common challenges that many practitioners talk to me about, and help us understand what may be going on underneath the surface in terms of why clients get stuck, why there's ups and downs, what may be going on at a physiological level and a neurological level. So we'll understand some of those processes there. And then many of you already heard my hypothesis, but we'll go through the hypothesis again at a high level and help us understand some latest brain neurology that applies to this hypothesis, which may explain to us why people stay stuck, why patients stay stuck. Then we'll look at some of the clinical evidence, but I know once again, some of you have already you already know our clinical evidence and our 7 published studies, but we have a few more randomized controlled trials in the field right now, and 2 of them are about to be published. So hot off the press, I'm going to be able to share with you some new long COVID study data. And also, I think of high interest to many people, we've just completed a randomized controlled trial on mold illness. And we know more and more people are experiencing mold illness, so I'd love to share with you some of the pre-publication data On that study as well, which is highly relevant. Okay. And then after the half an hour mark, what we'll do is I'll then come to your questions and also, also share with you some new resources that we've now put within the app that can support you in deciding which clients could benefit from Gupta program, from brain retraining, and the types of resources and conversations you can have with them. So we're trying to make this as streamlined as possible. So the reason we have this whole practitioner process and system is because we truly believe that actually it's very complementary to the work that you do. So it's not being dogmatic saying it's only brain retraining, that's the only thing that works, or it's only supplements, or it's only diet. We want to live that dream of true integrative healthcare, and I'm sure Many of us, this is why we came into this particular field, because we saw that actually the mainstream medical model wasn't necessarily addressing the complex needs of complex cases. So, to live that true integrative dream, how can we have multiple components in our delivery that support better outcomes? And I always start my presentations with One of my favorite quotes. One second. One of my favorite quotes from Mahatma Gandhi, which always inspires me, and I think it represents everyone that's on this call, which is. A small body of determined spirits fired by an unquenchable faith in their mission can alter the course of human history. And I truly believe that healthcare, modern healthcare, and the way that people like yourselves are influencing the conversation is so important. We are part of these determined spirits that want to shift the way that we deal with complex cases. And moving on to then the types of conditions that we're talking about that I'm sure you see in clinical practice. So there's the neuroimmune conditions on the left-hand side, the long COVID, the ME/CFS, the kind of Lyme disease, irritable bowel. Then there's environmental and sensitivity-related conditions, which seem to be on the up. So we know that generally in the population, allergies are massively increasing, but also the food sensitivities, the chemical sensitivities, the electrical sensitivities, and so on. And mast cell activation is something that's being diagnosed more and more, as well as the autonomic and pain-related conditions on the right-hand side. So pain in general, complex pain, fibromyalgia, burnout. I mean, I don't know if you find this, but most people I'm speaking to, including clients, including family members, friends, there's now so much overstimulation from screens, from social media, from 24-hour news that people seem to be on the edge of burnout almost continuously. Their nervous system seems to be stretched almost continuously, which makes them prone to then getting one of these other types of conditions. Okay, so these are the types of conditions that we're having success with and that we are treating. And of course, there's many crossovers here because many of these conditions are defined by the cluster of symptoms, and then some are defined by the underlying disease process. And so often someone comes to us because they've had an original trigger. It might be a food that they've eaten, a mold exposure, a virus, a bacteria. That's often the trigger for then this dysregulation that they come to see us for in clinical practice. But what we then notice is these symptoms seem to generalize across multiple systems. So someone who you were originally treating for one thing, do we then notice that the system, The situation becomes more complex because now multiple systems seem to start being affected. They often then become more sensitive to internal and external triggers. There can be a fear of setbacks that starts setting in. There can be boom-bust cycles where they seem to do well for a while, overdo it, push themselves in some kind of stress, which can be emotional stress, But it can also be overdoing it. Physical stress can also then impact. And then there's a bust cycle. And then they start then avoiding situations, foods, people that then may increase their symptomatology, which can then reinforce some of these danger mechanisms in the brain. There can be hypervigilance on symptoms, and there can be repeated treatment changes without that kind of durable improvement that we're looking for in the longer term. And many of us then as a default may look at nervous system techniques. Nervous system regulation is now kind of in vogue, vagus nerve, and all of those things are very important. And what I'm going to argue here is that whilst they can support the system, they're essentially a band-aid because they're not getting to the underlying disease process. And of course, once again, we're not dogmatic saying what we're talking about here is the only underlying disease process, but I believe that it's often either a core process or an overlapping process that is stopping these patients from fully getting well. And something that I'd like to introduce there is some concept in neurology is predictive processing. All right. And I know that some of this neurology, for some of you, is you're very aware of it. For some of you, it may be very new. But the example I like to give of predictive processing is this example that we often talk about in terms of visualization and imagination. So imagine now, and some of you have heard me do this, I take a lemon. All right, and I slice that lemon in half. All right, and the key thing I want you to do is not salivate. All right, whatever you can do, the instruction is don't salivate any more than normal. So I'm going to take that slice of lemon. It's very tangy, and imagine placing it on your tongue right now, but don't salivate. All right, so that slice of lemon is on your tongue, and you can feel some of those very sour, bitter juices beginning to roll off your tongue into your mouth. Okay, but don't salivate, most importantly. And now you bite into that lemon. Yeah. And you imagine that lemon and all the juices swirling around. All right. Now, most of you haven't got your cameras on, so I can't take a poll here, but does anyone with their cameras on notice that they had a bit more saliva in their mouth as a result of that? Yeah. Okay. People are nodding. People saying yes. Now, that might seem like a fun little exercise and you can do this with your clients, but actually what's happened there is profound neuroscience. All right. As blasé as that comment may seem, just imagine what's happened. Your brain knows that that's not real. You are deliberately not trying to salivate. But look at how trained our predictive processing is. It says, if there is a real lemon, or even if there's a hint of a lemon, even a pretend lemon, there is a set of processes that I need to follow In order to ensure survival, or in order to respond to that trigger or that threat or whatever. So you're seeing predictive processing in action, which is the brain continues with a specific response because it knows that that's what it's always done in the past, and that's probably what it needs to do now. So the brain doesn't respond to every unique event in a custom way; it responds to today's events based on. Last week's events and last month's events. Now what this means is that following that initial trigger, virus, bacteria, mold, food, whatever triggered then this dysregulation in the body, that has created a learning event in the brain where the brain now starts predicting that that trigger or that issue is here all the time. Right? So let me repeat that because this concept in predictive processing can help us explain the dysregulation in our clients. So it's very, very important. Normally, our clients are at baseline in terms of their nervous system and immune system. Then along comes a threat— virus, bacteria, mold, toxin. As a result of that threat, the body then has to go into an adaptive mode, right? And that adaptive mode is 2 essential systems The nervous system, the immune system, but also how the gut responds. Right? These are all unique systems that respond in their own particular way. Now normally what happens is once that threat has been dealt with, the system should go back to homeostasis, back to balance. Right? That's what we would expect. And then the client goes back to normal life. The system is functioning perfectly. But obviously the patients that come to see us. The system now becomes dysregulated, right? The gut is not functioning correctly. It's not absorbing the nutrients correctly. It's tight. It's— there's dysbiosis in the gut. There's cortisol impacting on the gut. There's inflammation, right? There's widespread inflammation in the body. Then there's a dysregulation in the nervous system and the immune system and all the various symptoms that come as a result of that. And once the system gets stuck at that state, Yeah, it's now learned a new state of predictive processing. It thinks now that this is the correct thing to do almost continuously. Yeah. And what's then happening is that when we do the great work that we're doing in terms of the, the diet shifts and changes, the supplements, the medications, the lifestyle changes, that is all important work that supports the body In being able to handle that dysregulation. Yeah. Now sometimes, and often, just those components enough can help a patient come back to homeostasis. It can shift the predictive process and it's got stuck in. But often it's not enough. And what happens is new stress comes along, changes in lifestyle, other things. The system becomes highly dysregulated again because it's highly sensitive. It's been affected by that trigger, and it can't go back to baseline. And then there is an excessive amount of interoception. So interoception essentially meaning meaning that focus on the body and sensing and interpreting signals in the body that are a proxy for the original threat. That's the key. So your body and the symptoms from your patients' bodies. That information going up to the brain can be interpreted as an ongoing perception that threat is still present. And that's why certainly in the pain literature, we're seeing more and more about neuroplasticity and how even though there's no obvious organic cause for someone's pain, the system has got stuck in a state of predictive processing where the pain networks themselves are over-responding. And thinking as if the original pain threat is still present, even though it is no longer there. And we believe that there are two core brain structures where the core conditioning lies: the amygdala and the insula parts of the brain. So the insula, we know from some fantastic animal studies right now, showing that conditioning of the immune system can occur in the insula, conditioning of the nervous system and the emotional system can happen in the amygdala. So these 2 systems, the core conditioning may lie in these 2 brain structures. And certainly in animal studies, if they, you know, not that this is something I approve of, but when they damage the amygdala in animals, they find that that conditioning process no longer occurs. PTSD can no longer occur. Emotional responses can no longer be conditioned in the same way. And so according to our hypothesis, In a similar way, when someone has that threat— so number one, there can be a genetic disposition to getting one of these chronic conditions. There can be lifestyle, psychosocial, and environmental influences, past trauma, how dysregulated their nervous system is, how much their lifestyle and stress impacts on their livelihood, combined with number 3, this assault. So virus, bacteria, toxin, mold, etc. And a combination of these 3 impacts, but mainly 2 and 3, then cause this maladaptive neuroimmune response in the amygdala and insula. So what that essentially means is the amygdala and insula were originally at their predictive processing states. The body is normal. The body is healthy. But as a result of 2 and 3, the brain goes into a maladaptive state where it thinks, I now need to deal with this threat And I'm going to overrespond to this threat. And as a result of that maladaptation, the brain at number 5 overstimulates the sympathetic nervous system. There's immune dysfunction, there's overinflammation generally, abnormalities in the hypothalamus, pituitary, adrenal glands, and oxidative stress. These processes are only designed to come and go. Switch on, switch off. But imagine if they get stuck as a result of predictive processing. That then causes all the symptoms at number 6 that we often see that overlap. So if someone's got Lyme disease, do they have Lyme disease with chronic fatigue syndrome or chronic fatigue syndrome with Lyme disease? Do they have mast cell activation combined with mold or mold combined with mast cell activation? These are all attempted descriptions, in my humble view, for a dysregulated sympathetic and immune system. So that causes the symptoms at number 6, and then we have secondary cycles at number 7. So many of you will be hearing now about mitochondrial dysfunction, cell danger response by Professor Navajo. And once again, this is often seen as, ah, the mitochondria, that's the smoking gun. We just need to fix the mitochondria. But of course, the mitochondria are continually getting their instructions from the brain. And so I believe that the mitochondrial dysfunction is a downstream effect, getting more allergies and sensitivities, which contribute to the symptoms at number 6. Then this is where the interoception and hypervigilance come in. The brain itself, when it thinks it's under threat, keeps monitoring the body for those symptoms, and those symptoms become a proxy for the original threat. So symptoms in our body become evidence that maybe the original source of Pain is still there. Maybe the original virus is still there. Maybe the original toxin is there. Maybe the mold is still there. And so, as a result of that interoception and the predictive processing, the amygdala and insula magnify all the incoming signals. And the brain at number nine then thinks, "I must continue with my response." Even though it's maladaptive, it's labeled here as maladaptive at number nine. The brain doesn't look at it that way. It says. I ensure survival. Survival is the most important thing. And it then triggers the nervous immune system at number 5. And now we start getting this chronic activation of these systems that was never there before. And so when we are doing the great work that we're doing with diet, supplements, medications, lifestyle changes, we're helping the body deal with the dysregulation. And that's very, very important. Yeah. And sometimes that alone can stop the vicious cycle. What we find is when we combine this with brain retraining, what that does is it actually targets not only number 6 and number 5, but also number 4, going to the source, rewiring that maladaptation in the brain. And from a long COVID study that we did, when you combine the lifestyle changes and diet supplements together with brain retraining, We had— we were— the Gupta program was 4 times more effective than just doing lifestyle changes by itself for long COVID patients and fatigue. And that's a published randomized controlled trial that you can read. So that's our kind of overall model as to what might be going on. And then, of course, continual ongoing threats, which might be viral, bacterial, emotional, they come in at number 9. And the body starts maladapting to continual ongoing threats as well, which is why many patients say that they become more sensitive to stressful events. Yeah. And of course, for those of you who work primarily with the gut or work with the gut as part of your protocols, we know there are feedback loops between the brain-gut axis and they can be— that is a game of tennis. The brain tells the gut There's something wrong and detoxification systems start shutting down, gut bacteria, there's a dysbiosis, et cetera, et cetera. But that feeds back to the brain that there's something wrong. And we know that in depression, 50% of depression cases may well be cases of high levels of inflammation where the gut's actually directly communicating with the brain that there's something wrong. And so these cycles can start. Yeah. magnifying the issue. Okay. So nervous system regulation, is it helpful? Of course, it's helpful. But in our humble view, it's preparation for brain retraining. So regulation can help someone change their state in the moment, but retraining aims to change the learned response pattern that repeatedly gets activated. All right? And so examples of regulation that many of our clients are already using are the vagus nerve techniques, the breathing, the grounding, all very important. But in my view, what this does is it prepares the ground for neuroplasticity. So when we're stressed, our brain isn't particularly neuroplastic, so it can't shift the predictive processing, the learned responses. But when we calm the nervous system, the brain becomes more flexible. And interestingly, we know that psychedelics may work in a similar way where psychedelics may increase neuroplasticity by increasing connectivity between different parts of the brain and opening up the brain to new predictive processing sets. And if that's the case, it'd be very interesting to see, in a controlled way, of course, could psychedelics support people with these types of chronic conditions? And retraining is actually identifying the underlying conditioned threat responses, the learned loops, the predictions and retraining those underlying patterns that are keeping the system in a dysregulated state. And that's why the 2 work hand in hand, but one by itself is not enough. And that's why in the program, we talk about the 3 Rs of recovery. Firstly, on the right-hand side, relaxing and regulating the nervous system, which prepares the ground, loosens up the soil for neuroplasticity. Then brain retraining, which is retraining Physiological patterns, but also emotional patterns, and sometimes the underlying reasons for the condition. So in our view, healing doesn't just happen at the physiological level. That's one level of healing. It happens at the emotional level, the mental level, the energetic level, and the spiritual level. And so for long-term health and healing, addressing it at various levels is incredibly important. And that's where the re-engaging with joy, that deeper spiritual healing, we find helps people with longer-term better outcomes. So in terms of our evidence, I think many of you have already seen a lot of our evidence here. So I always talk about this idea of conditioning in the amygdala and insula. So we know that when we experience a physiological threat, viral, bacterial, our responses are encoded in the insula ready for the next time that we experience that threat. So sometimes, because the insula is also involved in emotional responses, the insula can get stuck and continue to create reactivity. So this was a study where they took mice and they created inflammatory bowel disease in the guts of these mice using an irritant. Then they measured the electrical signature in the insula, brought these rats back to baseline, And then they retriggered just that set of neurons in the insular cortex, and that created inflammatory bowel disease. And it's the first time on our planet that we've been able to show that peripheral immune responses, whether they be in the guts, the body, the muscles, they get encoded in the insula. And if we retrigger the insula, we can cause physiological responses, inflammatory responses, even when the original threat has gone. So this tends to back up our neuroimmune hypothesis, and this research only came out a few years ago. All right, so in terms of our research, we've done various studies. We've done 7 clinical studies, 5 randomized controlled trials. So you can read all of this on our website, but I'd like to highlight a couple of recent studies. So firstly, we did an independent clinical audit of our patients, and these were the Percentage improvements in health and functioning after 12 weeks. And what's interesting is these illnesses may seem very different, but it shows us that like branches of a tree, the cluster of symptoms may be different branches of a tree, but the core trunk is the same, the core mediating processes. And then the roots of the tree may be exactly the same, which is conditioning effects in the amygdala and insula. So we see these percentage improvements in health and functioning after 3 months of the program. The circles in red are the ones which were close to significant but weren't significant. The other 14 conditions were highly significant. And we did a recent study on fibromyalgia comparing Gupta's program to pregabalin, pregabalin being Lyrica, a common agent applied to fibromyalgia patients. And we saw a 54% reduction in fibro scores after 12 weeks of using the Gupta program and only 9% in the control group. And you can see very large effect sizes in sleep disturbances, pain catastrophizing, and depression and cognitive function. So this is an independent RCT. You can read this on our website. And then in terms of the new studies, we have a new study on long COVID, 66 patients randomized. And this study is very interesting because normally our studies look at subjective questionnaires, but here we also looked at objective measures. And we found big improvements in heart rate variability as a representation of how much the nervous system is regulated. And it actually lowered in the control group but increased in the treatment group. So this was highly significant. And we saw objective drops in CRP. So CRP being a measure of overall inflammation. So we saw a halving of inflammation in the treatment group and actually an increase in the control group. And of course, with the questionnaires, we saw lots of other changes as well. All right, and this is what I'm excited to share with you. So preliminary studies— preliminary results, sorry— on our latest trial RCT on mold. And this was quite a large trial, so 130 participants randomized to treatment as usual or treatment as usual combined with brain retraining. And we found that after 3 months— and this study was conducted by Dr. Neil Nathan and Dr. Jill Christer as the people who will be the authors on this manuscript. And they found that after 3 months, in terms of mold IQ symptoms as a measure of mold, there was a 30% drop in mold IQ scores and 22% mold risk score. But what was really interesting that this continued improving after 6 months. So after 6 months, we were close to halving symptomatology, mold symptomatology, which is very exciting to have this in a randomized controlled trial. And we're very excited to see this published and show this to the medical profession that these types of conditions can be improved. And in terms of others, depression, anxiety, fatigue, there were also big shifts and changes compared to the control group as well. So after 6 months, seeing an overall rough halving of mold risk scores, And big shifts, 35% reduction in depression, anxiety, and 32% improvement in EQ-5D. Okay. So I think the interesting thing is when do we integrate this? And there may be different times we integrate brain retraining, but something that Neil Nathan, Dr. Neil Nathan really surprises me with is when he does his presentations at various conferences, we presented at a few conferences together. His very first slide is, They need to do limbic retraining, right? And I find that so powerful that someone in his position who's got decades of experience working with complex clients of mold and Lyme, his very first thing is do brain retraining. And so I would encourage us to bring brain retraining earlier in the treatment cycle, to actually do this right at the start of the intervention, because what this does is it calms down the nervous system and then enables a client to be more open or their bodies to be more open and receptive to medications and supplements. And certainly that's something that we see in clinical practice. Yeah. Okay. And in terms of how clients can take advantage of the program, so the program, as many of you know, is an app or a member website, and there are videos and audios that they can go through on their own. So it's self-directed. But of course, we now try to make ourselves a whole ecosystem of support. So what we're finding is really helping patients are weekly webinars with myself and daily Zoom calls for nervous system regulation and brain retraining, right? So our lovely coaches, our trained coaches, have these daily Zoom calls where they take clients through the techniques they need to do. And this encourages compliance, motivation, and really makes people feel part of a community. So I love the fact that we're doing a lot of these events live now, and it really helps support people. And we have 30 or 40 trained coaches around the world who can work one-on-one with people. We have 24-hour AI support and forum support as well. And the AI has been trained on everything I've ever said over the last 10 to 20 years, so it's very comprehensive. Okay, so first of all, if you haven't claimed your free access to the Gupta Program— I think most of you have— you can get free access to the program. So that's the QR code there. If some of you don't have access yet, if you scan that QR code, that should then open up a page that enables you to get free access to our program because we want you to experience it and get a feel for it and see if it's right for your clients as a complementary adjunct. And something else I want to share with you before we go into questions, we've just developed a new practitioner hub. So in the app itself, so if you already have access to the app, on the left-hand side of your menu, you should be able to see something called Gupta Practitioner Hub. And in this Practitioner Hub, first, and if you can't see it, please email into the clinic and we'll make sure that you can see this at the top of your app area. You'll see that there's a welcome by myself and by Dr. Joe Mather, how you can become an affiliate, and the resources for your patients. So if your patients are a bit reticent, they don't understand, you can print off a leaflet here or email them a leaflet. There's also a longer webinar, and we'll put the recording of today's webinar in here as well. So a 60-minute educational webinar on the Gupta program, and then also videos from other practitioners in terms of how they are integrating it to clinical practice. Then there's a 2-page summary of our clinical research. So if you want to have a browse through or share with colleagues, it's a very easy-to-use kind of 2-page summary. And our live webinars— we'll be holding regular live webinars on different topics, and we'll be posting them here in this practitioner hub. But this is the one I wanted to show you, which I think is quite funny. So our AI version— you can now ask AI, or a version of me, about your clients. So why don't we just call the AI live on here, and you can do it in any language as well, and ask it a question. Welcome. How can I help you support your patients? Hi there, Ashok. So I'm on a Zoom call with lots of lovely practitioners, functional medicine doctors, naturopaths, and we're just introducing them to your service here where you can tell them more about how the Gupta program can support their clients. So I just wanted to ask you as a typical question, let's say someone is suffering from Lyme disease and we have a patient with Lyme disease and they're pretty reticent of using any of the— oops, hang on. Hi there, lovely to have you and your colleagues here. With Lyme, I see it as a layered picture. There is the infection itself, And then there is the nervous system response that can keep symptoms firing long after the initial trigger. In my experience, the limbic system and the immune system are deeply intertwined. When the brain tags Lyme or the toxins and inflammation associated with it as a threat, it can keep the body in a heightened state of alert. That is where the Gupta program comes in. We don't replace antibiotics or other medical treatment. We work alongside it by retraining the brain's threat response. For many people, symptoms such as fatigue, pain, brain fog, and sensitivities persist because the nervous system has learned to stay switched on. The techniques we use— softening, the breath, the incremental approach— help the brain feel safe again, which then allows the immune and autonomic systems to settle. Okay, I'm gonna cut my friend off there. Um, so what's really interesting is you can actually use specific client cases. So as long as it's anonymized, you can ask the AI about a specific use case or a specific client and what they're experiencing. And then the AI can give you a good understanding of how you can support the client or indeed how you can communicate some of the benefits to that client. Okay. So overall, I think that hopefully this has given you a good picture as to when we're talking to our clients, how we can help them understand why sometimes these symptoms and these processes can become chronic. You know, how does an illness go from being acute to chronic? How does anxiety turn into— or rather, how does fear turn into anxiety? Or how does a mold exposure turn into mold illness? How does COVID turn into long COVID? That's a really interesting question for me. And I— our hypothesis here is that this is the effect of conditioning in the amygdala and insula. that when we experience a short-term threat, it turns into a chronic threat as far as the brain is concerned because of predictive processing. It gets stuck. And through brain retraining, we can unstuck it and essentially get people back to health and wellbeing, obviously with all the support of the good work that you do in the other spheres of medicine. And when it's working together in an integrated fashion, we can actually accelerate the healing and have better long-term outcomes.