Stress, Health, and Recovery: A Conversation with Dr. Nick Hall | Izzy Kiver | COE

Thank you readers for joining me Today we have Dr. Nick Hall. Dr. Nick hall is a distinguished psychoneuroimmunologist whose groundbreaking work has significantly advanced our understanding of the intricate relationship between the brain and the immune system. Dr. Hall is considered a pioneer in the field of psychoneuroimmunology by being amongst the first to explore the biochemical wings between the brain and the immune system. Dr. Hall, thank you for being with us here today.

Thank you for having me on.

Of course. Can you tell us a little bit about your background and how you became interested in psychoneuroimmunology?

It was really an evolving process. I grew up my first decade in England after World War II and my playground of the buildings that had been bombed, the rubble that remained, burnt out, airplanes that had been shot down. And so I suppose the seed was planted. There is often no way that you can really predict what's going to happen, but sometimes circumstances occur that are outside of your control. I heard stories of the various cousins, uncles who never came back from the battlefield. And her mother was a big influence as well. Her job during the war was to provide entertainment in a bomb shelters. She was a pianist, son and dance routines, that sort of thing. And she spoke at length about the days she wake up wondering how many of her neighbors have made it through the night. So at a very early age I came to realize that life can be short and you have to basically live each day to help. There may be no tomorrow, but at the same time be responsible about it. My jobs entailed stress. Summer job rescing alligators and milking rattlesnakes. Went to work for the Office of Naval Research training whales and dolphins as part of a stress related communication study, and eventually went on to university to get formal training. So the jobs I had were exposing me to stress as well as enabling me to observe how animals responded. And I suppose that's what whetted my appetite to go on to university where I received an undergraduate degree in psychology, a doctorate in neuroendocrinology, and then finally postdoctoral training in tumor immunology. Conveniently, I found that I had all the syllables to do research in psychoneuroimmunology. And that's what I did for many, many years. Studying the ways that the brain communicates with the entire body and the feedback signals that come back, including from the immune system.

It's incredible how the whales were the ones who inspired you at the beginning of your journey, but of course also your personal life experiences that have pushed you along this path.

I must say, Izzy, I Didn't set out to do this. I had opportunities that arose, I took advantage of them, and at some point the door yelled and off I went.

So the concept of stress recovery has garnered a lot of attention from the medical community. Can you tell us a little bit more about how this concept relates to your overall health well being?

I firmly believe that stress is not necessarily detrimental. Stress, in fact, is a survival response. It's how the body reacts to adversity, enabling us to survive. Heart rate goes up to provide more red blood cells to the brain, to provide oxygen wherever it might be needed in the body. Other changes mobilize the muscles, provide us with energy. The problem is when that stress interferes with our sleep, our productivity, our health. And so it's not the stress per se. It's when the stress goes on for an extended period of time and we don't have the opportunity for recovery. Stress is basically a stimulus for growth. Ask any athletes who sustained an injury, had to immobilize an arm or a leg, and they'll talk about how within 24 to 48 hours they started losing strength. So stress is the stimulus to grow and to maintain that growth where it is. But it's during periods of recovery when that growth actually takes place. So the problem is when a person is exposed to a large amount of stress without having opportunities for recovery. Now, in my opinion, the recovery has to be equal and opposite to the stress. And that is not the original idea. Isaac Newton observed that for every action there has to be an equal and opposite reaction. So it's very important to build recovery into our lives so that we have the opportunity to grow from the stresses that they're actually inevitable.

Interesting. So this is a concept which accents the idea that stress is not all bad. It's stress without recovery that is failing us.

Make a certain amount of stress to keep from getting bored. People who have monotonous jobs, they get very little feedback about how they're doing. Of course they're going to suffer from boredom. You need a certain amount of stress to be in that ideal performance state. You need to be vigilant, alert. But at the same time, if you have too much stress, you'll experience anxiety, too little stress, boredom. So each person has to find that sweet spot for them in order to perform optimally.

Excellent. As a leading authority on stress, what do you believe are some of the misconceptions society has about stress today?

Well, the first one is the idea that stress is always bad for you. So many books have been written about techniques to eliminate the stress in your life. Reduce the stress in your life and everything will be fine. Nothing could be further from its truth. You need a certain amount of stress, as I said, to stimulate growth. The original concept put forward by Hans Solye, whose name is pretty much synonymous with stress research dating back to the first half of the last century. And he proposed the alarm phase, the resistance phase, and then the exhaustion phase. He argued that when you become stressed, it activates systems in the body which then run out, they become exhausted, and that's when the organism either gets sick or dies. He had it completely backwards. And this has been written about extensively by Robert Sapolsky in his book why Zebras Don't Get Ulcers. It's for chronic exposure to cortisol, to adrenaline. It's for chronic exposure to all the chemicals associated with stress that actually lead to a person's demise. Another big misconception is that stress is always harmful. Sometimes it is. Sometimes it depresses the immune system. On other occasions it actually stimulates your immune system. Those, I think, are the major misconceptions.

So you mentioned earlier that you need to have an equal amount of recovery after a stressful event or after subjecting your body to stress. What are some of the ways that you recommend going on about this?

I don't recommend the same thing for everybody because, as I said, it needs to be equal and opposite to what's causing you stress.

So what do you mean by that?

Working in the emergency room, healthcare workers, they're triaging patients after an incident. They don't have time to eat a sandwich, take my lunch break. They're on their feet constantly. And so for that person, recovery would be going home and listening to some relaxing music, mindfulness meditation, which has been found to be very effective for some people, doing some of the yoga exercises, which some people find beneficial. However, if your job is tedious, if it's boring, the last thing you want to do is listen to quiet music. It'll put you into a coma. And so engaging in community theater, signing up for a master's exercise program, any sort of outdoor sport activity. And again, if your stress is most people working indoors, in an office, their home, if they work remotely to go outside and have a different environment, none of the reminders of what's caused your stress. So that's what I mean by equal and opposite. Now, if a stress has been going on for a long time, then that interval needs to be longer. When I used to teach, I found that after a major exam, when students had been preparing, probably For a week beforehand. There was no point in introducing complicated new material for at least two or three days. They needed that time to recover. So I would basically firstly review the exam and then maybe give an overview of what was coming up before delving into the more complicated details.

So it seems that every stage you need to have a different type of recovery mechanism. And the length of recovery will also vary depending on the intensity of the stress that came before it.

Correct. In fact, some fairly recent research, recently, recent in the last five years, has revealed that when people go out into a wilderness environment, it takes about three days to clear the brain of all the clutter, the memories, the things that need to be done by a certain deadline, the things that didn't turn out the way they had been predicted. So when a person first arrives in that scene without their cell phone, without access to the Internet, it actually increases their anxiety. Then after the second day, they'd already processed the information associated with the workplace, and it's being replaced with trees, nature. What are we going to do tomorrow? Which hike are we going on by the third day? In fact, it's called the three day effect. You don't care less about what happened two days ago.

Sure.

Now you've replaced those memories that are being processed with things that don't associate with the unpredictable.

Right. Fascinating. So you've been speaking on stage for what is well over 30 years now?

Just about when I wrestled alligators, starting at the age of actually 16, I gave a show presented to people.

So you've been on stage your whole life? Pretty much you're public speaking, not just on stage. What were some of the key takeaways you wanted your audience to have? And still, what are really the key takeaways you want people to have and really understand of, you know, culmination of your work and your speeches?

Number one would be one size never has, never will fit all. In biology and especially medicine, there are differences in what triggers stress in a man versus a woman. Women find any change in your relationship as being more stressful than a man who will find something that affects achievement. His favorite sports team lost the game, big match. The he lost his job. Whereas for a woman, it's going for a divorce or losing a loved one. Now, I'm not saying that it's all black and white. There's tremendous overlay.

Is that social? Is that because of social effects or is that biological?

Probably biological, because young girls use language at a greater rate than comfortable age boys. They engage in facial gazing court. They learn to recognize from body Language, facial expressions, what a person's intent is. They, they associate a smile with love and warmth. Boys could care less. A little girl is for far more likely to be conciliatory. If there's an argument about what they're going to do, what game they're going to play, a girl is more likely to say, what do you say we do this? What do you think? Mary Linda? We're a little boy, she doesn't like the way the rules are going, grabs his bat and ball and goes home. A little girl will make eye contact with her mother or father before going on a slide or doing something for which permission might be granted. And we'll wait for a nod or some indication that it's okay. Little boy, just the opposite. Mother could be shaking her head, don't you dare jump off that diving board. And that's his cue to go ahead and do it again. We're all on a continuum. There are tall people, short people, wide people, narrow people, blue eyed, brown eyes, you name it, and we're all on that continuum somewhere. But in general, when you control for all the variables, a woman's brain is programmed after it's been marinated in estrogen and progesterone to develop in one direction, while a man's brain that's being blasted in testosterone is going to go another.

It's incredible. So the hormones play a big role in this.

Huge role, huge role.

How do you see the field of psychoneuroimmunology evolving in the coming years? And how do you see it affecting our understanding of our overall stress and health?

We've already shifted away from the notion that psychoimmunology has a role to play in curing disease. In the early days, it was thought that if you engaged in guided imagery, if you participated in the right types of activities, if you relaxed, if you engaged in positive thinking, you could make that cancer go away. You could make that disease melt like a slow ball in a hot stone. And so we've already made that transition. And the key role for psychoneurimmunology, and I think this is where the developments are going to be in medicine, is in the prevention of disease. Stress doesn't cause disease, it doesn't cause anything. What stress does is create a chemical environment in the body to make it easier for something else to do the dirty work. A virus causes infection, stress, but what stress will do is, in some cases especially chronic stress, will lower the immune system, enabling that virus to take hold. And a person may have a genetic disposition for a certain type of Heart abnormality. But as long as that gene is not activated, then everything's going to be all right. But stress could be an activator or a deactivator of other types of diseases. So I think there's going to be a lot more understanding, especially with the genetic testing that's going on now and the way that stress interferes with the expression of certain genes as opposed to another. The microbiota is huge. If I was starting over again in graduate students, I would focus on microbiology and the role of the bacteria that live within us. We've always known they were there, but we always thought the gut bacteria were involved in helping us to digest fiber and things that the human can't do. So I think that the understanding that certain types of bacteria can be correlated with the expression, depressive symptoms and other mood changes is huge. I read somewhere, I don't know how you would know this, but 90% of the genome of a human body is bacteria. Only 10% is human. So they're doing a lot more than in being involved in the digestion of food. I think that's going to become a new area of focus.

This is the big one. What advice do you have for the reader who is struggling with potential stress or burnout in their daily lives?

First of all, you have to do two things. There's the perception, the image that you have in your mind of what's happening, and the way that your beliefs, your past experience, or helping shape that image. So you've got to do something to get rid of that trigger. Something has happened in your personal life, in your professional endeavors that has caused this stress. So if you can change your perception, if you can look, maybe your expectations, maybe your interpretation is totally wrong, maybe it is correct, in which case, thinking about things that have happened in the past that might have been worse, and you know what? I survived that. I can survive this. At the same time, the brain is monitoring what's happening throughout the whole body and a lot more than we initially thought. It's now known that there are receptors lining the blood vessel that respond to heart rate, to blood pressure, transmitting these signals back to the brain and areas of the brain that are not just involved in regulating the hunt. So years ago, Walter Cannon, Claude Bernard, others would argue, where does stress come from? Are you running away because you're afraid? Or are you afraid because you're running away? And the answer is yes. And we now know the perception begins to process, but then your physiological response, the outpouring of hormones, the changes in heart rate, respiration rate contribute to. So you've got to do two things. One that changes the perception, one that addresses the physical symptoms for that relaxation exercises. Herb Benson's progressive muscle relaxation. For example, for me, going for a walk, I get bored of tears. Meditating. I've tried. It doesn't work for me. I experience the same changes that those who do research in the area experience. When I go out riding my bicycle, go out on the trails or go in the Gulf of Mexico. In my career, away from people, just, that's how I unwind. So I'm doing something physical, which a lot of people would think, well, that's not relaxing. Well, no, I don't need relaxing. That's how I get it. And so recognizing what works for another person is not necessarily what's going to work for you.

This actually comes back to where we started, where you mentioned that stress recovery is highly custom to each individual, each person. And for that reason, I recommend two things for the reader. The first is do not forget Nick's new book, the Stress Recovery Effect. It's available on which platforms now?

I think all of them. Dick Tibbets is my co author on this book. And well, so we, we cover the subject from just about all perspectives.

Fascinating. You heard it first, Dr. Nick Hall. If you want to hear more thought leadership, join us on the R3 platform where you can have direct access to Nick's teachings and answer your questions personally. Thank you, Nick.

Thank you, Izzy.

Fantastic. Okay, until next time.