The Root Cause Of Burnout Anxiety And Chronic Stress with Dr. Dave Rabin

What's one thing that people do every morning that immediately tanks their nervous system?

Looking at your phone. We take in as much information in the first half an hour of looking at our phones in the morning that we used to in one week of being alive in the 1950s. Think about talking about like overstimulation uprooting us or dysregulating us. It starts right then and then multiply that times how many half hours of screen time we have during the day. We are completely, utterly overstimulated. And that's a huge part of what dysregulates us, starting with right when we wake— choose to do right when we wake up.

Dr. Dave Rabin, welcome to Rooted in Wellness.

Thanks so much for having me, Mona. It's a pleasure to be here with you.

So as I was describing a bit about the intention behind this podcast, I'm hoping our listeners are understanding it's ultimately about becoming more rooted. This is rooted in yourself and your health and your happiness and what I believe we all have, which is our inner wisdom to be able to heal ourselves. So as a doctor, as a practitioner, what are 2 or 3 practices that help you feel more rooted in who you are every day?

I mean, I think the most important practices are the practices that remind us that we have a say in our lives and put us— do something that's called restoring agency, which is remembering that we are actually in control of a lot more of our experience than we might have been taught. So, you know, some of those practices are For instance, like a practice that I call the Four Pillars of Self-Trust, which comes from the Shipibo tribal culture in South America that talks about trauma, regardless of whether you consider it to be like huge significant trauma or things that happened that were like what we might call lower level of trauma, like being picked on in school. Regardless, anything that changes the way we see ourselves to to look at ourselves like victims of circumstance needs to be corrected. And it's correct— restoring a sense of agency and control. So the 4 pillars that I use myself and with all of my clients are self-gratitude, self-forgiveness, self-compassion, self-love. And it starts by, more than anything, just writing those words down each morning in the first thing in the morning and then last thing before you go to bed at night. And it just keeps them fresh in your awareness that these are important emotional skills that can be honed and trained. Another one is choosing to breathe by choice, right? So if we don't breathe by choice, then our bodies breathe in response to the environment. And when we breathe in response to the environment, then we're breathing at around 12 to 24 breaths per minute, as we see in the clinical data. And that's actually stress breathing. It's not— it's not breathing the way we're supposed to breathe at rest. And when you breathe that fast, your heart rate goes up, your blood pressure goes up, your— to the point of what you were talking about earlier with your own experience, and your thoughts start to race. And what we're actually— science and Eastern and tribal medicine have shown that we're actually supposed to breathe at 5 to 7 breaths per minute at rest. And so that's 25 to 50% of our breathing rate. And simply by saying, I'm going to breathe by choice right now, and then actually taking a slow, deep breath in and a slow, deep breath out and paying attention to the feeling of the air, coming in and out, just doing that one thing sends an instant safety signal to the brain that starts to boost vagus nerve activity and remind the body that it's safe enough to start to allow healing and recovery to happen, which gets shut down by chronic stress. And of course, it also makes us— reminds us that we're in control because we just stopped everything and took a breath by choice. So those are the two easiest ones that I like. And then you could extend that into others. Like, Moving by choice, right? Wiggling your fingers, your toes, your arms, going for a 15-minute walk or a 5-minute walk. Like those kinds of things seem so small and minimal, but they're actually fundamental to health. And we just kind of forget about them because they don't get prioritized in the view of productivity in the modern world.

Are you not so perfectly aligned for this podcast or what? I'm so excited to dive in and I love that. And I'm noticing myself do what I notice other people do when I remind them to breathe. I just say the word, "Take a breath," and everyone's like, "Oh yeah, I have the capacity to really focus in on that." And I love that as a practice. So the 4 pillars: self-gratitude, self-forgiveness, self-compassion, and self-love. What a beautiful way to start the day and end the day, right?

Mm-hmm.

On the flip side, and ultimately I can imagine how much of this is driving the work that you do, do you notice the practices in this modern life, you know, do you notice when you get uprooted and what causes you to feel uprooted? Or dysregulated, I guess you could say.

Yeah. It's, I mean, I think as you, as we start to become more aware of our bodies and how our bodies feel when they're actually resting, not just like theoretically resting, but actually in a state of calm rest and recovery where vagus nerve activity is increased, it starts to feel really calm and pleasant and nice to be here in our bodies right now. And that requires a little bit of practice to learn to listen to our bodies. But the good news is there's a part of our brains called the insula that evolved over the last, you know, at least 25 million years, maybe longer, that is in all higher-order animals that live in community. So think like greater— great apes, elephants, dolphins, whales, us. and that part of the brain evolved for 3 things, one of which is interoception, body awareness. The second part is introspection, which is like self-reflection, looking in, looking inside yourself and thinking about yourself. And the third is empathy. And it all starts with interoception, which is like the skill of listening to our bodies again, which is hardwired into every single human being to have the ability to do that. And we can strengthen those neural networks like an emotional skill. So starting to take a breath by choice and listen to the breath and listen to how our bodies feel when we're doing that practice and not listening to anything else, uh, and if you get distracted, just redirecting yourself back, that is a practice of listening to your body or interoception. And as you start to feel what it feels like to feel calm and safe and nice in your own body, then what we start to notice is that anything that overstimulates or overwhelms us, which is too fast, too much, too loud, the news, too many responsibilities, too much noise around us in our environment, anything of that nature, um, blue light from smartphones and screens too often, right? All of those things just start to feed too much input into the body and it overstimulates the amygdala, which is that other core part of the nervous system that's governing the fear response. And that is what uproots us. That's what pulls us into our heads to say, I need to now start thinking about the future and start doing things to prep, to protect myself rather than being present in the moment. And so anytime we notice, like for me, the, the things that I notice first are when I start to get uprooted or dysregulated are irritability and like being like overly reactive or impulsive with, with people or interactions and then have noticing that my thoughts rather rather than being here on what I'm doing right now, start to venture off into the past or the future more often. And at that point, I know this is a moment to start to ground myself back in my body and come back to what's happening right now because the right now is where everything exists. Mm-hmm.

And we've normalized so much of that, right, in society. And what I'm excited to dive deeper into is really the understanding of how many of us actually recognize that feeling of feeling happy, good, and peaceful. In our bodies, right? We think about it quite often. We get taken away with our thoughts and how we want to feel. And what I talk about with my clients all the time is they're so overconsumed with getting somewhere, achieving numbers, getting better, getting to a certain number on the scale or whatever it is, instead of the actual remembering, which is a word that I loved, and taking agency that way. So let's dive into all of this. We're going to first start off with some rapid-fire questions. So—

Okay.

Whatever pops into your mind, and then we'll go deeper on all of it. All right. So what's the biggest myth about stress that keeps people stuck?

I think the single biggest myth is about stress is that the mind and the body are not connected or disconnected. And we still teach in school and in science, we teach like the Cartesian principle from René Descartes, like the 1600s, that the mind and the body are separate.

Exactly.

And that's quite pervasive in medicine as well, where we separate mental illness and physical illness. And that's not true. And, you know, if we are physically ill, our bodies are sick for an extended period of time, we don't do anything about it to fix it, we become mentally and emotionally ill. And if we are mentally and emotionally ill and we don't do anything about it or address it correctly, properly, then our bodies become sick. Right. And stress increases your heart rate and your breathing rate. So, so that's the biggest myth that we need to, you know, set aside.

What's one thing that people do every morning that immediately tanks their nervous system?

Looking at your phone.

That was intentional.

We take in as much information in the first half an hour of looking at our phones in the morning that we do, that we used to in one week of being alive in the 1950s. Think about talking about like overstimulation uprooting us or dysregulating us. It starts right then and then multiply that times how many half hours of screen time we have during the day. Like we are completely, utterly overstimulated. And that's a huge part of what dysregulates us, starting with right when we wake— choose to do right when we wake up.

You and I are part of that generation that remembers what it was like without cell phones.

Yeah. And without the internet.

And without the internet. Yeah. All right. Next, what's the fastest way to signal safety to your body when you're spiraling?

Fastest way to signal safety is soothing touch, whether you apply it to yourself directly, like a hug or rubbing your hands or rubbing or putting your hands on your chest or rubbing the inside of the outside of the ear where the vagus nerve comes to the surface. You can nearly instantly or getting a hug or, or from someone else or holding someone's hand, you can nearly instantly regulate the nervous system because it's a pre-verbal cue. So it doesn't require any words or understanding to get access to safety through touch. And it's evolved for hundreds of millions of years since the first mammals came on the earth. The second fastest is doing what we talked about earlier, which is choosing to take a deep breath. Mm-hmm.

Right. Aren't pets so great for that as well? You and I talked about our puppies.

Yeah.

It's magic. Instantly. What wisdom animals have for us. All right. Overrated or underrated meditation for the— say that again. Overrated or underrated meditation for nervous system recovery?

Meditation works great for nervous system recovery. The issue is when we choose to teach people how to do it. And I was just, you know, I teach courses about this all the time. And one of the challenges that patients face, that individuals face when they're struggling is everybody's like, we're always activated. It's like activation, activation, activation. Have you tried meditation activation of your nervous system? Right? And what we actually need is activation feeling process. Resolution, rest, right? Then we can be reactivated again. Then we can— or we can start to try learning a new technique like meditation. So if the body— when the body's in a state physiologically where safety has not been established because it's overwhelmed, overstimulated, when we try to teach meditation to people like my patients with PTSD or depression, the first thing that happens when they quiet their mind is it's flooded with noisy, negative, intrusive thoughts, and then they feel like they're failing even though they're actually trying. to do something right. And so that sets people up for failure and more hopelessness in the treatment process. So we need to make sure that with meditation, which is actually more of an advanced technique, more advanced than mindfulness even, which is just—

Right.

Noticing what's going on around you without doing anything about it. Then once we get people into a state where they're feeling safe and ready to learn new things and they start to feel a little bit more in control of their thoughts, and their attention, that's when is the right time to start to bring meditation into the picture.

That is brilliant. And it probably keeps them back, coming back to the practice as well, right?

Exactly.

Yeah. All right. What's one thing that the psychiatric system gets completely wrong about anxiety?

I mean, the first, so much, but the first thing is that, the first thing is that we treat anxiety like an illness, right? Like we call, we treat anxiety like it's a symptom. Of an illness, of a mental illness, or like it's a disorder itself. And anxiety is neither of those things. It is a signal that is not good or bad. It's a signal from our nervous system that's saying, hey, there's something in your environment, in your environment that needs your attention right now. And that is not a good or bad thing. It's just a, it's just a signal. If we judge the signal, before we feel it and understand what it's trying to tell us, then we miss the entire message because we're shutting down. So the only way to interpret the meaning of a message, of a message, like if a messenger is delivering you something, a telegram like back in the day, and that, and before he even delivers a telegram, we're like, this is bad, I don't want to hear it. You're gonna, we're gonna miss the message, right? We won't even get any of the, any of the good stuff somebody's trying to send us. Sometimes anxiety leads to good things. If you look at it as not good or bad, but just as a signal of communication, it actually is trying to tell us, hey, this, this thing needs your attention. This feeling needs your attention because it wants to get out of your body. And like emotion, emotion is like energy in motion. It needs to move to get out. It needs to be felt and then it needs to be moved. And if emotion isn't allowed to move, it gets stuck and then it turns inward. So it becomes self-destructive and causes restlessness and even worse, more significant anxiety because it's still trying to get our attention, but we're not listening. So that's, I would say, the number one thing that psychiatry gets wrong is we treat anxiety like it's bad, and then everyone internalizes that idea, and it prevents people from just feeling their feelings.

Oh, God. I have so much to say on that. All right. We'll keep going. Hot take, last one. Is burnout a mental health crisis or a biological one?

Both.

That's—

You know, we see that, again, with the mind and the body being connected, a mental health crisis is a biological crisis, right? People who have more— people who burn out first generally experience the psychological symptoms of burnout, which is like loss of passion, frustration, loss of engagement in their activities. Loss of reward from activities that used to be rewarding. And that's the psychological piece. Irritability is another part of that, right? Psychological. But the, the impact on the body is happening at the same time, which is that sleep gets impaired and emotion regulation through the body gets impaired. Vagus nerve activity goes down and the body is diverting more blood and resources to stress response systems like the heart, lungs, and skeletal muscles. Rather than sending that blood and those nutrients to the organ systems we want to be functioning when we're at rest, which are like reproduction, immunity, digestion, empathy, creativity, all the stuff that makes our lives great. So it's definitely— burnout is absolutely both biological and psychological at the same time.

What's so fascinating about this And, you know, thinking about the listeners right now who might be feeling foggy, disconnected, tired, overwhelmed, like a lot of these symptoms that didn't just happen overnight, but they've been accumulating over time because we were never taught how to listen to anxiety as a signal. We're never taught that emotions needed potentially some movement within our bodies, and it was just a calling to tune in. And so here we are living in this world of health and wellness with more information than ever before, and yet so many people are doing all the right things things, but they're still not feeling well. And when I was doing my research on, on your work, I came across a stat that said 75% of adults report experiencing physical or emotional symptoms of stress, yet most people don't take action. So their biology is speaking, but they don't actually know what state they're in. So can you shine light on this chronic stress epidemic and like what's actually happening within the bodies and why for someone who might be listening, for some it probably felt like it was overnight. For others, maybe it was a gradual climb that they weren't attuned to.

Yeah, absolutely. And it's a really, it's a really important topic because as you mentioned, right, most of us, myself included, were not taught properly about the stress response in the body and how the body, how, how, how the body responds to stress from the environment. And then like and then what happens downstream and how that can result in disease if it's not addressed over time. Basically, the short of it, continuing on from what we were just talking about, is that when we experience stress of any kind, our nervous system evolved to treat that stress as survival threat by default.

Mm-hmm.

So because back in the jungle, you know, in the 15th, 5,000, 10,000, 50,000 years ago when we didn't have any modern technology, we're just living as humans with each other in community, in the prairies or the jungle, in nature. We had to respond to uncertainty quickly. And uncertainty, not just in humans, but in all animals going back to ancient reptiles, have an amygdala. And that's why we call it the reptilian brain.

Right.

And the amygdala is detecting newness and contrast in the environment, not just fear. Fear comes after. Contrast and newness and uncertainty are the signals that tell the amygdala, hey, you should fire off, there's something different going on around us. And sudden changes, sudden differences that make us feel uncertain are potentially life-threatening. Right? So that, that system evolved for tens of thousands of years, millions of years from ancient animals to get to where we are today. And our bodies are functioning the same way. So a big part of my work is like, how do we understand the history of how our nervous system evolved and what's still the same? What is hardwiring that ancient animals have that we have today? And how is modern life accidentally hijacking that system to make it not function properly because we didn't evolve for the world we created, right? The world that we created is significantly different than the way it was when we— our nervous system evolved back in the jungles and the prairies tens of thousands of years ago.

Yeah.

So what happens when we experience stress, though, is the same. Uncertainty, unfamiliarity, newness, gets default detected as potential threat until it— until we, uh, understand otherwise and confirm otherwise that we're actually safe. Meaning we have to like check the signal, right? We have to make sure that if I'm feeling uneasy right now, is it actually because there's a real survival threat around me? That could be loss— loss of air, loss of water, food, shelter, physical safety.

Mm-hmm.

Or is it that my body is overstimulated, right? My, my brain's overstimulated. And if we don't check it, then the same survival response that happens when we're being chased by a predator 10,000 years ago happens now in response to emails, news, too many responsibilities, our phones, which means that 80%, up to 80% of our blood flow, sometimes more, is leaving all of our recovery organ systems that are governed by the vagus nerve. Mm-hmm. And getting sent to skeletal muscle, which means there's only about 20% of our total blood flow left to feed the rest of the body. In the moment, that's not a problem because in the moment that just gets us to safety. That's the whole purpose of that system. But when you multiply that times time, now you have only 20% left of your blood flow at any given time. Mm-hmm. That's being split between the entire body and the other 80% is going to skeletal muscles. And yet we're still expecting the rest of the body's systems, like reproduction, digestion, immunity, to function as normal. But they're resource deprived and they don't have waste pickup, which is the other feature that blood offers our cells.

Right.

So imagine, like, how long would we live with one meal a day of 100 to 200 calories and garbage pickup only once a month or two.

Yeah, exactly. Yeah.

So that's what's happening to our bodies. And over time, then resource deprivation results in organ system dysfunction, cell dysfunction. Then if that lasts long enough, organ system dysfunction. And then if that lasts long enough, disease.

Well, yeah. And it's really unfortunate. We've essentially brushed off stress as just being common. Right? It's normal in our society. And I noticed that if I'm speaking to a group of people or at a conference and I ask about stress, I ask who's suffering from stress, everyone's hand will go up and there's laughter that's followed. Like, "Ah, we all have stress, of course, obviously, what a silly question." And, you know, we have to take that to our heart. Like, look at the state that we're all living in and we wonder why we're not waking up and feeling our best. Another question that I often ask people, because I wonder, and you can maybe shed some light on this, do people have a concept, do they even understand how many years that perhaps they've been living in more of a dysregulated state? So a question that I ask is, you know, on a scale of 1 to 10, what's the number of stress that you feel on a consistent basis? More often than not, I'm met with a 7, 8, 9, or 10.

Mm-hmm.

And then I take it a step further and I say, well, if I were to step into your body, if I were to feel the level stress that you're experiencing every day? Would it feel higher because you have become accustomed to living with a level 7 stress every day? Is that your baseline? Is that your normal? And sometimes I'm met with tears by people who are just like, you're absolutely right. I don't remember the last time I felt peace or relaxation. So I guess the question that can stem from this is you'd mentioned trauma before. Do many of us have a nervous system that's been trained in a certain stress response? So although we're experiencing something that might not be severe or life-threatening, our nervous system experiences the stress at the same level.

Yeah, that's exactly it. And you don't have to have a, like, history of violent trauma to have your nervous system still be trained into a fear-learned state. Trauma is— what we call trauma is the impact on the body of unsupported hardship. So when you— everybody's going to face challenges. Challenges are the— are part of life. Like, if we— if we are not challenged by life, then we— we stagnate and we don't grow. So it's, you know, we know that we require overcoming challenge to grow as human beings and become better, stronger versions of ourselves with an unknown potential. Right. But that those challenges are not— they can be stressful, but stress is not all bad. Stress is actually— this is also very poorly taught. There's two kinds of stress. There's eustress, which we call— which is eustress, Latin root word for good. And eustress is stress that promotes growth. So when eustress— when we face a stressor, a challenge, the thing that dictates whether or not that stress becomes eustress that promotes growth or the opposite distress that promotes stagnation and disease is how— what is our internal narrative about how we approach that stress? So in the eustress case, We say, what can I learn from this challenge— challenging experience, right? How can I grow from this? We don't judge it right out the gate. We don't, we don't, uh, attach any good or bad to it because we don't know what we're going to learn from it. We're just trying to figure out what— how can I grow from this, right? And that's called growth mindset. And the alternative, distress, is the opposite also. So it's like when stress— when a challenge comes, it could be exact same challenge we ask, why me? Or what's wrong with me that I have to deal with this right now? Right? And if you ask— well, I love to tell my patients this— if you ask the wrong questions, you get the wrong answers.

Right. Right.

Yeah. Question of what's wrong with me? Guess what? Our minds are going to fabricate information to answer that question, to try to make us feel— not on purpose, just because they're trying to answer the question about what's— what could be wrong with me that I deserve this? Right? And that's not going to lead us to, to growth. That leads us to victim mindset, that there's something wrong with me, that I am having this experience right now, right?

Yeah, yeah.

So that's a— so that's a huge part of stress that is very poorly taught. And our pers— that's where we have control, which is so amazing about the human mind, is we have control when a stress comes, generally speaking, of in modern day, of whether— of the mindset with which we approach it at.

Absolutely.

And we choose our words and our language to help shape and create the reality and what— and, and determine where stress fits in to either a category of eustress that promotes growth, which ideally is where most of our stress is, and distress that promotes disease. And we want to— the goal is eliminate as much distress as possible by changing our lifestyle in whatever way we can to just not have as much of that coming in. And then also try to change our mindset so that we can— when stress comes, we're more likely to categorize it as eustress than distress by default, which just takes a little practice. And then that has a downstream effect of shifting our nervous system in response. A growth mindset nervous system has higher vagal tone, higher parasympathetic rest and recovery nervous system activity that puts us in a state that's primed for learning, primed for, for, for cognitive, emotional ability, creativity, empathy. All those systems are still online. Distress sends 80% of your blood to your skeletal muscles and resource deprives the rest of your body.

Yeah, I really do feel that the essence of health, how we function in this world, how we can show up for ourselves, for others, and even our happiness is rooted in our nervous system. More than anything else. And I love that it's starting to trend a little bit, but we're still at such surface level, which is why your work is so important. And I really want listeners to tune in to not dismiss whatever number level of— I'll say that again. I really want listeners to really attune to the level of stress that they're feeling every single day and what the impact could be. You've now mentioned, you know, over a dozen biological symptoms that would manifest from experiencing chronic stress or eustress versus distress, right? Now, when we think about the fact that stress just doesn't live in your mind, right? It's not just psychological, but can we talk about some of the ways in which stress might be impacting you that you might not recognize? So in my experience and understanding the power of, like you said, one's thoughts or their belief systems about themselves. Or when we think about this concept of safety, from what age did we all try to fit in or to be seen as the good girl or the good boy or to try for, you know, my hand is up as a perfectionist. If I get this perfect, then I won't be judged, right? Then I'll fit in even more. There's so many layers of this, but can you talk a little bit about the psychological aspect that happens?

Yeah, I mean, with perfectionism, it's very interesting, right? Because Again, our words create our reality and feeling good and feeling safe and achieving joy in our lives requires to a large extent reminding ourselves of what we have control over and what we have control over are only things. There's only a few things that we actually have regular, reliable control over. They are basically our breath, our movement, where our attention is at any given moment, our vocalization, being able to hum or sing or create sound, to listen by choice, right? Which goes back to attention. And then like food, what we put into our body and when we rest. Pretty much everything else is outside of our control.

Yeah.

And so we can learn to adapt to stress better because we are— one of our big major strengths as humans is adaptation. We've looked at how far we've made it as human beings, right? Despite all odds and collaborative adaptation, working together to achieve goals like building cities, right? And bridges and all these things that you know, no single person can do on their own. So the— I think the— there's an opportunity of recognizing the things we have control over as a major point of focus and priority rather than productivity or things that we don't have control over, like perfection, because perfection doesn't actually exist by the creation of our own. Perfection exists if you believe in a higher power or whatever you want to call— people call God or divinity or, or whatever, whatever that source of our creation is, that is perfection. Nature is perfection, right? But we— what we make is experience translated through us, and therefore it was designed to be flawed, because if it's not a little bit flawed, then we can't grow. Mistakes are our number one way that we learn. And, and then we, we do something, we don't get it quite right, we are good enough to be satisfactory, then we iterate, right? We do it again and we try to do it a little better, a little differently. And there's a certain amount of, of error that's built into all of that, basically on purpose. So to try to— So one of the most fatal flaws that we mistake as a human being is we define success as perfection. Of our— by our own hand. But perfection is a psychotic delusion. It's not real.

Yeah.

So if you strive for something that's not real, you don't have control over achieving it, you will live your life in a state of constant disappointment. And that creates a fear response in the body also because it makes you feel like there's something wrong with you because you can't achieve your goals, but you perceive other people to be able to achieve those goals. That being said, perfection doesn't exist. So it's how do we understand To like, perfect is literally the enemy of the good, right? It's not perfect we're aiming for, it's good. And when we achieve good, then we can like, every time, no matter what it is we achieve good for, it could be getting out of bed, brushing your teeth really well, preparing a nice meal, having a nice social engagement with friends and family, like whatever it is, good deserves a round of applause from yourself.

Hell yeah.

And acknowledgement and celebration. And that's also part of the cycle that we often forget about.

What a beautiful reframe. Thank you. And it really just offers an invitation to, you know, with some of the behaviors that might be leading to the chronic stress that we feel or some of the actions that we have or just the, the languaging that we're using for ourselves or even how we think we, we, we need to live. If you pull back and just ask yourself, well, where did I learn that? Who am I trying to achieve that for? Who's that going to make happy? And really reassessing. And I think that, you know, this is one of the amazing things as we get older is just the awareness of being able to pull back and ask those types of questions. Sometimes it opens up Pandora's box. You know, in NLP, we do a lot of timeline therapy. And I just— I noticed that all of us, all of us listening, we all had stuff that happened to us and it shaped and formed the way that we think, the way that we believe, the way that we go out into the world. But if there's certain behaviors that aren't serving us anymore, we need to ask, are they doing more harm than good? And I know in your work, you talk a lot about trauma and epigenetics too. This is a really fascinating study to just understand that now trauma can be passed on through our genes, right? In the way that we, I guess, process, or it leaves an imprint on the body, right? So can you talk to us a little bit about gene expression there? You know, obviously, this is a really big topic. And if all of us look at where we come from, we might recognize some major trauma, we might not. But what does it actually mean? And how does this give us some hopeful insight to how we look at healing in the future?

Yeah, so this is one of the most— to me, one of the most fascinating discoveries of the 20th century, where, you know, it started with you know, Pavlov's dogs and B.F. Skinner's rats, and then progressed into Eric Kandel's Nobel Prize-winning discovery of how we learn and remember in human beings about meaningful experiences that are governed by either fear, safety, and reward, or neutral experiences.

Mm-hmm.

Neutral experiences like what you ate for breakfast, we don't tend to remember that well because they're not particularly meaningful and they're often mundane and routine. The experiences that store the most intricately in our minds and our bodies are experiences that are meaningful. And what meaning is dictated in the nervous system is, is this— how, how, how far along the spectrum is this towards safety and reward?— and feeling good, because feeling safe and rewarded activates the vagus nerve and says healing and recovery can turn back on. Right? So that's a key trigger for the recovery nervous system. And fear on the other side says, I am not safe right now. My line could end at any moment. I need to focus just on that to get back to safety so everything else can then happen.

Hmm.

So Eric Kandel discovered that when we learn something new, that we, we knew before Eric Kandel that when we learn something new, neurons form connections between each other that increase how much they're talking to each other. So every time I think about myself as, as like a, uh, being bad at, at art, for instance, my brain starts to associate tighter neural connections between art and fear.

Right?

Right. And so those two parts of my brain get tighter together, tighter wired, more tightly wired together. What fires together wires together. Right? Right. So from that perspective, what— there's something that has to happen in the cells for them to allow them to grow. They don't just grow magically. They create protein. And the protein is like the scaffolding of the cell that says, hey, grow in this direction versus that direction, right? And, uh, it's like the building blocks of the cell structure. So what Eric Kandel won the Nobel Prize for, in large part, was understanding that these same principles that govern the direction that cells grow is not just the neurons talking to each other on their own, it's that repeated or intense, either fear or safe stimulation activates parts of the, of the cell, the neuron that go deep down into the nucleus that change the epigenetic code.

Hmm.

And when they change the epigenetic code, this is the layer of code that's on top of the DNA that says, hey, turn up the making of proteins to make the cell grow, to make the cells that think about art grow towards the cells that think about fear. Does that make sense?

Yeah.

Yeah. So you could see then from that concept that trauma, intense, meaningful, fearful, frightening experiences have a change to the body, not just on the way that the cells are individually talking to each other and the strength of those connections, but it changes the epigenetic layer of code that tells the cell and it's stored over time. To tell that cell how to behave in response to stress. And what's interesting about that is that proteins that are being made to change the direction of the cell growth don't get passed on to our offspring, but epigenetics and genetics do get passed on to our offspring, which is why if we've experienced severe trauma in our generation, then there's a very strong chance that if we don't deal with it before we have children, we can actually pass a predisposition to mental illness to our children through the epigenetic code that got changed around like cortisol receptor genes, for instance. And so Rachel Yehuda from Mount Sinai at Yale, um, made this incredible discovery that showed that when she studied Holocaust survivors, that there were changes to the epigenetic code of the cortisol receptor genes in these people. And those cortisol receptor epigenetic changes got passed down to their children and their children's children.

Yeah.

That increased their likelihood of mental illness, even though their children and their children's children grew up safe.

Right.

Yeah.

Yeah.

Go ahead. Sorry.

So, no, I think it's all fascinating. And I say this, one is education to understand, you know, we know, so what you're talking about is trauma can influence our gene expression as we age. However, with the studies emerging from epigenetics, really understanding that just because that happened, if we're changing the environment of the cell, that you can actually downregulate the expression that would cause you to get the illness to begin with. Right. And this is such a big piece that needs to be talked about in the world of health and wellness, because how many people do we know, a loved one, a family member, a friend who's walked into a doctor's office and being given a diagnosis and automatically they believe that that is fixed when healing is not fixed. And this is science that's proving that we are not fixed. Yeah. It's also this intelligence of the body that's rooted in the nervous system, right? And yet we still are stuck in a society where we're going to symptomatic symptom, like a symptomatic approach to healing, which, you know, the system is really just getting it, getting it all wrong. How do you challenge—

We haven't updated it yet, right?

Right.

Like, we're— systems often get fixed in a certain state of what we call dogma, right? Where we forget that the rules that we came up with, similar to what you talked about earlier, that's so— it was so well said where you're like, we develop these coping strategies about how to live and think growing up that is all learned behavior. But then down the road, as we get older and things in our lives change, we often find that many of those things we were taught as children about ourselves and the world are no— might have served us in the past, but they're no longer serving us now. Right. And it's the same with science in that a lot of the understanding about how the nervous system works was really helpful back in the day because that's the best we had. Now we know so much more and we need to update our understanding of how things work based on the current evidence base.

Right. Yeah.

If I grew up thinking that I am not good at learning, but then, or studying or focusing my attention, but then I went like I did, and then I went to medical school and graduate school and, you know, became one of the most highly educated doctors in the world, then I— it is incongruous for me to think about myself as somebody who's not good at focusing because clearly I know how to do it. I taught myself how to do it, but I still have these internal thought loops about, hey, maybe I— maybe there's something wrong with me that I'm not good at focusing. So that's the opportunity to— when I notice those loops, I can go in and just say, oh, I'm noticing that I'm thinking about myself in that old learned way, but that's no longer serving me or true to me right now. So I can literally just allow it to be let go. And then I can rewrite the story that I was telling myself by reminding myself, hey, look at all the things I've accomplished, right? That's not gloating. It's not bragging. It's just like acknowledging, look what I've accomplished. Look what I've done. That is— prove to myself that I do— there's nothing wrong with me that I can't focus. I just needed to try and practice a little more.

Yeah.

Right?

Look for more opportunities to seek evidence that disproves your story about yourself, right? That's a mindfulness act in and of itself that's really challenging to do. And I think there's a lot of shame too that comes up, right? A lot of people will experience shame around anxiety, shame around how they've been, or even today, shame around hyperfocus. Hypervigilance, right? When we think about this and something else I would love to hear your thoughts on. In a world where right now social media, they're talking about, you know, a sympathetic response being bad and a parasympathetic response being good, right? Instead of the flexibility that needs to happen in those two worlds. And as somebody, and maybe it was a coping mechanism for someone like myself, or I work with so many high performers and CEOs who, it's almost like an addiction to constantly be going and be doing. Now society's saying, well, that's a terrible way to live. That's terrible. But what if they have an incredible resilient nervous system where they actually are adaptable and they have the capacity of a nervous system to be able to hold them in that space? Do you want to shed light on that maybe for my hypervigilant listeners who just want some, some guidance on that?

Yeah, you know, nothing about our bodies, like your— our bodies from the studies of, of genetics. So going again, there's now below the epigenetics. So this is what we were all born with, show that you and me and every single other human being on the earth are, um, generally speaking, 99.9% the same.

Mm-hmm. Right.

Right. And we have like 40% of the same DNA as a banana.

Right.

So just to put it in perspective, we're all, we're all relatives of the same family. We're just that 0.1% is what makes— that's different, is what makes us all special and unique in our own ways. It's pretty humbling to think about. And so, right. So hypervigilance is— and I think, I think the, the other part that we can learn from that when we look at evolutionary biology and the discovery of DNA, which also won a Nobel Prize in the 19th— in the 20th century as one of the greatest discoveries of humankind, is that when we understand that we're 99.9% the same as every single other human being and that we are all genetic relatives of the same family, it helps to remind us that We are safe because more often than the time, because things around us are act— we have infinitely more in common with each other than we do different, even with the animals, right? Like we all need food, water, and air and, and physical safety, right? Our core fundamental needs, what we call like Maslow's hierarchy of needs is what lives on the bottom, physical safety, air, water, food, right? We all need it. So everything else, like whether you like chocolate ice cream or I like vanilla, or like whether you like driving certain kinds of I like cars and I like biking. Like all of that's just what enriches our lives. Like that's the good stuff that makes life diverse and exciting and different. But at the core, we all have the same wants, needs, and desires at core baseline. And so that means that there's more commonality and sameness than there is difference, which is a signal to the nervous system. And we take time to acknowledge it, that we don't have to fear each other so much. Right? We don't need to worry so much about, about this other person having such different needs than I do. We actually, at the, at the core, have the same needs. And hypervigilance to that extent gets increased because we perceive ourselves as different before we perceive ourselves as the same. It's just an order of operations. Sameness, recognition of sameness must come before recognition of difference for us to feel safe enough to appreciate each other's differences. differences and variety. If we focus on the differences first, then we ignore the sameness. And when we're already stressed, difference is interpreted as fear by default.

Mm-hmm.

Newness, uncertainty, right? It's determined as fear. And so the reason why I'm explaining it this way is because hypervigilance is an adaptive response. It's not bad. It is designed to exist to protect us. But we haven't been taught how to harness it for our benefit, except in like high-energy, super productive work environments, right? Like we haven't been taught to harness that in other parts of our lives to regulate it and let it know, hey, like I'm safe right now. You could take a— hey, hypervigilant part of myself, you can go take a break in the backseat, take a rest. I'm going to drive.

Right?

Right.

So we can— I think what I'm—

When we harness that, we actually gain its power rather than giving our power to it and then letting it control our reactions to the environment from fear first rather than from common ground first.

What I'm hearing, and I think what I remember experiencing, there's a difference to be in that hypervigilant state when you're not present. You know, your mind is literally decapitated from your body, you're thinking, you're doing, you're going, you're achieving.

Preparing.

Versus being present. Present and you're present to the busyness and it feels a little bit more like flow state. And I think that that's the retraining that often needs to happen so that you can understand the difference when it becomes a little bit more depleting versus something that actually could be energizing you and giving you money, more momentum and fuel and inspiration and all those beautiful things that we want to feel. Yeah.

Exactly.

Do you notice that, do you have a lot of male patients This word safety is coming up a lot. And in today's world, you know, we are so blessed to live where we do in this side of the planet and have access to clean water, food, resources, and all of those things that they say, of course I'm safe. But the safety of a nervous system, can you talk to us about, you know, for some people it's a little bit harder to connect to what that is and how you take a patient through that shift to feeling safe in their nervous system?

Yeah, it's a great question. A lot of people have a cognitive sense of what safety means, right? But real feeling, real feeling and safety in particular, is embodied. It's a feeling in the heart and the lungs and the brain and the body. And it's not just a thought. And The way that we do that, if we think about this from a— from— there's two ways to input into a human, and one of them is the body and one of them is the brain, and they're connected. Then what if we started teaching people safety from the body first rather than from explanations in books first, right?

Yeah.

Which is called top-down. That's called top-down learning. That's like most of the learning we do is top-down and brain to body. So if that's not working and people don't remember what it's like to feel safe, then there's two ways, two things we could do, one of which is— or three things, one of which is keep trying to explain it to them. The second thing is we can ask them to remember when they last felt safe. Right? And that's a great question for people because oftentimes it— or we can ask ourselves, when did I last feel safe? And just by remembering situations from our lives in the past, like great celebrations with friends or family, or, you know, great dinners or hugs or awe-inspiring experiences like sunsets and sunrises, like any of those kinds of things, you know, raising children, like lots of different things can bring back safety or feelings that we had when we were children before we learned how hard the world is, right? Those memories exist. They're always there. And everyone has at least one they could draw from.

Yeah.

And so that is a more effective top-down way to get people when you're just— the explanations don't work and the understanding isn't translating into embodiment. Remembering the feeling is one of the first and easiest ways that we could take with us anytime to, to basically bring flashback to, to safety and remind the body of what it feels like to be safe because we felt it before. Every single human being has felt safe at one time. When people forget that, and that is still a challenge, we go straight into the body. So we use soothing touch, we use soothing sensations like, like soothing smells. We use soothing, like things that taste really good or remind us of foods we used to love as children. Soothing music, your favorite song, right? Soothing ambiance, like soothing lighting, looking at a sunset, right? Things like that. When you soothe the body, That is a safety signal for the body. And so it doesn't require— the nice part about it is it's nonverbal and it bypasses cognition. You don't need to be aware of or do any mental processing to take in this, the soothing sensation that you get when somebody you like gives you a hug.

Yeah.

Or when you snuggle a pet, you do not need to evaluate whether are not that that's meaningful or rational in any way. It's pre-verbal, pre-cognitive, and it's instantaneous. So our nervous system is hardwired from every sense to tap directly into the safety response and the fear response. So if we decide, hey, I'm going to take a moment to just give myself a hug or, or take a few deep breaths or put on my favorite— one of my favorite songs, my favorite playlist. Anything like that, that falls into the category of soothing will rapidly restore a sense of safety that gives people more access to more frequent, more recent memories of what it feels like to feel safe in your own body without having to think about it. And then they can continue to tap into those. And we use psychedelic medicine to help with this too, because psychedelic medicines activate neural pathways when used properly in therapy. that are involved heavily in the safety, the safety part of the nervous system in the insulin. So yeah, so there's lots of ways to get there. The best ways involve the body first.

And I think everything that you just described is a mind-body experience, right? I often use the word imagine with my clients. You know, just imagine again a time when you felt happiness, love, peace, Sunlight, the sunrise, the sunset, being hugged, being held, being in nature. And I can always see the face relaxes. There's a cue for an exhale. Often people lean back or there's a smile on their face, right? But I think it's, you know, maybe a duty that we all have to ourselves every day to just remind ourselves of our own capacity to get into that state. We're so often looking for things outside of us. to get there when it's already built in within us. We just have to recall it every day. And this is making me think—

That's it.

Yeah, you got it. I've heard you speak about treatments for resistant patients, people who've tried everything. Can you tell us about some conventions, the approaches that people might be missing or things that might be keeping them stuck? I think this is the top-down versus bottom-up approach that you were mentioning.

Yeah, you know, I think it's not actually that different than what we were just talking about.

Mm-hmm.

What's different is the mindset of the person when they're coming to see me. And this is— most of my patients, by the way, are people who have tried everything, and they're coming to me because nothing's worked, and they're looking for hope. And they've often either lost hope already, or they have very little hope left, right? They're on, like, their last run, last go at it. And I think like that when we're approaching— and apologies, I have allergies.

My nose is very stuffy. It's OK. Take a break if you need to, please.

Oh, yeah.

Thank you.

When we approach folks like that, it's really about meeting them where they're at and not jumping in and saying, well, if you just do all of these new behaviors and new things, things, your life is going to change, everything's going to be different. And they don't want to hear that. Most people aren't ready to hear that. What they need is a teammate, right? What they need is trust and, and repairing trust as a foundation. Like we talked about earlier, the Four Pillars of Self-Trust is one of those first things I start with that, and, and small body-focused interventions that remind people what that feeling of safety feels like so that they can start to have a target to aim for when they're throwing the darts of health, right? They're like, like right now in medicine, like when you're asking somebody to meditate and they don't know what it feels like to access a meditative state, it's like throwing, asking them to throw darts at a board with a blindfold on. They don't know where the bullseye is, right? So what are the chances they're gonna hit it? It's almost zero. But if you give them a feeling to— as a target, I'd say, this is the— do you remember what it feels like when you felt safe? Okay, that's a good start. They pick out one thing, right? Uh, then you say, okay, well, let's get you back. Let's get you back there. What kinds of things help you get there now? Let's do some— you know, are there any soothing body techniques that you could do? Pets, music, sound, anything. Sound, touch. Uh, Apollo is a great tool. What wearing on my chest that helps deliver soothing vibrations to the sense of touch that when people haven't— have struggled with a lot of these techniques and putting them into practice regularly, they can wear Apollo and it gives them enough of a vagal nerve improvement that helps them to feel a difference. And when they feel the difference of what it feels like to have their noise— like noise canceling in their brain versus constant noisy brain, that is a key component of of showing them where that safety target is. Safety is quiet mind, observing, but without attaching to our thoughts because we're not our thoughts, right? Our thoughts are like clouds passing by on a glorious sunny day. They are not us. We're there for the sun, right? So we don't attach to every cloud. We let the clouds go. We focus on the sun.— that is safety. That's the sunlight is what we need to grow and thrive as human beings. Safety is what we need to grow and thrive as human beings. So a lot of it is just really focusing on slowing the process down, identifying what somebody's needs are, and just meeting them exactly where they are so that they get some benefit of feeling different with as little effort as possible through some of these basic somatic practices.

I think that one of the most powerful things for my healing is actually going to the ashram because the stage was set, right? The sensorial aspect, everything that I was digesting from what I was eating and smelling and listening to and feeling, the stage is set. And that caused me to— I built a course called Build Your Ashram because I think we all have the capacity to build it wherever we are. But there needs to be a level of intention that's there. And it's almost like What do you call it? Like a, it's the cycle interruption. Unless you're working with a practitioner or have a care team, often you don't know, you don't recognize that you need to interrupt the pattern that you're in, like identifying with the thoughts and how you need to become. And this is the one conversation I wish we were all having. We talk about longevity. No one's thinking about how you want to feel when you are 100 or 120 or God knows what age, you're seeking, right? No one's focusing on that. It's always, it's always about, you know, physical appearance or making it that long, which let's just say it's going to be quite a lonely place if we're not there feeling well together. And let's transition this into psychedelics, which I think have to be part of our future. A lot of people, a lot of the clients that I've worked with have had such profound shifts neurological benefits of shifting a belief pattern that they had about themselves that they could finally let go or forgive about themselves, themselves through psychedelics. So what do you think is the most powerful approach to this process and how does it fit into your practice?

So I'm, I'm trained in— I'm one of the few psychiatrists nationwide who's trained in both ketamine and MDMA-assisted therapy. I use it with a lot of my patients because they fit into this category of what we, what Western medicine has labeled them as like treatment-resistant mental illness. And I think that piggybacking off the last question you asked me, there's one key piece that I tell every single patient at the first visit that kind of sets the stage for what kind of treatment we're going to do together. and the work we're going to do together as a, as a team. And it is a core understanding that most people don't have before they come to me. And that understanding is something that stems back to ancient Western medicine, back to Hippocrates, back to ancient Eastern and tribal medicine. They all agree on this one thing, which is that the source of healing comes from within the person seeking to be healed.

Mm-hmm.

Yeah. So the challenge is that our medical system, by way of how we deliver care in the Western world, generally speaking, externalizes the healer to medicine, tools and techniques, and the care providers themselves, where patients are often feeling like they require these things to heal.

Right.

These are tools.

I couldn't agree more.

Yeah, not these are tools to help me augment my own natural healing process. And so that's where I start with everyone, especially folks who are considered treatment resistant because they have often taught themselves through the system and through the way they use their words, I have a disorder, therefore I need XYZ outside of me, medication, therapists, doctors, surgery, whatever it is to heal. And so I just put them back and I'm like, you do— those are all tools that can potentially help you. Some of those side effects, let's talk about that before you do any of them. But let's bring it, bring it back to the source of healing comes from within you, right? If the source of healing comes from within you, then that's something that you have control over. So that is at the foundation of all psychedelic care.

Yeah.

And it's really, really important for people to have that understanding. Because if somebody accidentally externalizes the profound healing experience they have with a psychedelic medicine to the psychedelic, then they've just given up their power to heal.

You got it.

And then, and then what extends, what, what takes 1 to 12 doses of a psychedelic, like from MDMA to ketamine to psilocybin, and turns that into symptom, full symptom remission at 1 year to 5 years out where you know, people aren't requiring medication for life, is like we are doing now, is the fact that they are learning through the practice of medicine by starting to retrain their brain around this concept of we are the healers of our own selves coming in. That reminds us, that helps reinforce safety, right? It's sense of control, a sense of agency. Then they take the medicine with the, with the proper guidance, and the medicine amplifies like pouring fuel on the, on the the neuronal network fire that governs safety in the brain.

Yeah.

That amplifies safety firing in the emotional brain, the limbic system. And that helps rapidly retrain the brain quicker to be in a state that's more primed for learning, feels even more safe to learn, and is able to start to realize the next step of if I accept in this moment that the source of healing comes from within me, that I have the ability to heal myself by changing my actions in my environment, by curation. Right. And if— when people start to realize that through the experiences with these medicines, they actually start to, to do what the integration process is called, what happens after the medicine's administered. which is they start to make changes in their lives that result in their continuous healing of themselves, which doesn't make them reliant on us. So that's kind of the way that I think about as a 10,000-foot view of how I take people through this.

Well, it's really powerful because what I pray isn't happening, and you know, you're probably seeing this, psychedelics, MDMA therapy, ketamine therapy, this cannot be the next pharmaceutical where people are outsourcing their health to a practitioner to go and be fixed is what I'm hearing from you. And yet I think that that's a tendency. A lot of people are starting to hear about these modalities as being supportive, and they jump right into it without actually understanding that concept that your body actually does have the capacity to heal. And then they're outsourcing. And I'm finding— I'm hearing a lot of people who will just constantly want to jump back in, whether it's plant medicine or psychedelics. They want to go back and they want to go back in because of the feeling that they have. However, there's no integration with a trained practitioner that's happening afterwards to help them understand what that is, right? It's not a Band-Aid solution for you to get to where you have to go. It's instead, it's, it's a modality that has the capacity to reshape the way that your brain is working to help you understand different parts about yourself. Can you share some stories around whether it's depression or trauma or relationships even that you're seeing these types of therapies benefit?

Oh yeah, there's countless stories.

I am sure there's countless, yeah.

I mean, I think some of my favorite ones, I saw a woman who for a bit, this is probably 5 or 6 years ago, that ended up escaping from a cult that she was raised in. So she had no understanding of the world or how it worked outside. And she lived in that cult for 20 or 30 years growing up there. And they told her, when you leave, you're cut off from all of your friends and family for good, and you're going to be on your own. The world is a harsh, cruel place, right? And she and her husband decided, you know what, this doesn't— this isn't right. Like, we're going to take our chances. And they left. And it was very hard. And she struggled with PTSD and depression. ever since and without any relief from standard Western medicine. And, uh, so we started— I started working with her doing some regular old psycho talk therapy, uh, and then we went into ketamine therapy together. And she, in the first— very first session, the very first session, she not only re-internalized her own ability to heal herself she internalized her connection to God because she was told when she grew up that God came from the members of the cult that were the gatekeepers to spirituality, like many Western religions teach, you know, not, not accurately, right? The truth of the matter is that our source of divinity and access to divinity comes from within ourselves, just like our source of healing comes from within ourselves. It's a personal And when she had this experience of actually having ketamine quiet her mind for an hour, because that's how long the experience was in the first session, she had these 3 powerful insights that I still remember because it was so impactful. She's like— she realized that she has the ability to heal herself. She realized that she has the ability to connect with God anytime that she wants without anybody in the way. and was able to start nurturing that relationship. And my favorite part was she said, "Now I know how they do it." And I was like, "What do you mean? How? Who does it?" She's like, "The Beatles. I know how the Beatles finally came up with all of those songs." Oh, that's special.

That's very special.

It's really special. But yeah, then some, like, you know, some other cases that were really great were, people who are just—

Sorry. Yeah.

Like 10 to 20 years of depression, PTSD, who have just failed all other treatments. And then, you know, within somewhere between 4 and 12 weeks of ketamine work together, were hanging out with their families again. They were getting— going back to work and enjoying it. And they were just getting more fulfillment out of their lives without reliance on daily medicine that was causing them side effects and And that's just incredibly rewarding to see how quickly people can get those kinds of benefits just by learning these, these simple, relatively simple techniques and then also get long-lasting benefit as well.

Yeah, I'm really excited about the direction that this is going in, and I think that it opens up an entirely new pathway for where conventional or traditional modalities might not work. This is something that could be just so powerful. And to your point, after one session for a lot of my clients, not that I offer the— I work with trained practitioners, but after one session, there's a dramatic difference. And one thing that I hear very often is the feeling of connectedness. It's remembering like, ah, I'm connected to source, I'm connected to the earth, we're connected to each other. I have been living my life as an outsider disconnected from it all. And in that is the awareness of like just wanting to live life at a more present state or fulfilled state. And in fact, my entire foundation, I have an entire course called You Are the Healer. It came from a session, just kind of undoing some traumas from my past. And yeah, I'm a big believer in it and I'm really excited at the work. You have so many incredible, incredible resources online. So even YouTube videos and stuff like that where a lot of your speeches are recorded and given out to the audience. You're profound voice in this. So thank you for sharing some stories.

Yeah, it's my pleasure. I mean, I think, you know, one of the things that— this is one of the major areas that we have to update in medicine. Yeah, for sure. General, general education of the community because we're in a mental health epidemic right now. And that includes substance use disorder and suicide. That's dramatic. They're all dramatically on the rise. We don't have an end in sight. And yet psychedelic medicines, when delivered properly with appropriate pre-care and aftercare— my surgeon colleagues are so funny, they call what I do psychosurgery because they're the same protocol of pre-surgical care, post-surgical care, but then it's a psychiatric intervention rather than cutting someone open. But it's the same concept, right? You have to have the pre-surgical care, the pre-procedure care, and the post-care to make sure it goes well and that we heal. Without a terrible scar, an infection, or something— the emotional equivalent of an infection. And so I think just to put it out there, I think it's really important that people understand that, you know, there are proper known standards for how to deliver this care safely. We published a thorough review of those best practice gold standards in Journal of Affective Disorders in 2023. Anybody's welcome to check it out. Um, it's on our website, theboardofmedicine.org, for anyone who's curious about on how to deliver this care, access it safely. Also psychedelic.support is a great resource for that. But I think in terms of like the paradigm shift that we're coming up against in psychiatry, we were taught don't use the C word. And the C word is cure.

Mm.

But don't use the cure word with our patients. And yet we're now seeing that with 1 to 3 doses or 1 to 12 doses of psychedelic medicine delivered properly with safety at the forefront, people are no longer meeting diagnostic criteria for mental illness 1 to 5 years out. To me, that is as close to a cure as anything we've ever had in the history of psychiatry. And we need to be start— we need to start using that word not as aspirational, but as the goal of what we're doing, right? Infections before antibiotics were also considered to be terminal or life-threatening illnesses. And then— and they were not— we didn't use the cure word for those very often or at all. All of a sudden, Alexander Fleming in the 1920s and '30s discovers antibiotics by chance. And within 30 years, we've revolutionized humankind. And now we can cure infections in, guess what, 1 to 12 weeks with appropriate aftercare. Right. It's no different. And psychedelics are to mental illness what antibiotics are to infection, and they're shifting the entire paradigm. And people really need to understand that because I think there's so much that we can learn about how to dramatically improve quality of human life on Earth and quality of life for everyone on Earth, all the, all the, the Earth itself and all the creatures in it that that are our genetic relatives by understanding that we actually do have the capacity to cure these mental illnesses. And that by— I think I'm confident that if we, if we stick to the, to the course and the path, by 2030 we will have at least one cure for one mental illness using a combination of things like psychedelic-assisted therapy and what we've learned from it and technology-based tools.

It's so powerful. And I love that prediction. 2030 is right around the corner. I think it's a time of necessity. And a lot of us, not only if you've experienced mental health issues or if you come from a family like myself with mental health issues, then it's really profound work. And I think out of necessity, if we are to forecast the way, the trajectory right now for our kids and for youth, it's now's the time, right? And gosh, the realization— do we need more realization of the role of nature and our connection to nature for our well-being in the future? If this is how we get there, then I think it's how we get there. Can you share with us the inspiration behind A Simple Guide to Being Alive?

Yeah, I mean, it's basically what we're talking about, right? It's that I went through 12 years of post— over 12 years of post-college medical training. To learn how to properly, by the book, address mental illness and treat it. And what I found was not only— I mean, what I found is that, that not just me, but most of my psychiatry colleagues were treating patients by the book, and our patients are still sick and suffering, right? Not just a few of them, but like 80% of them are still struggling. And that is terrible. Not just for them, for our patients and their hope and morale, but it's terrible for the doctors and the clinicians. And guess what? That's a sign— that's a, that's a straight path to burnout, right? To just keep banging your head against the door over the wall over and over and over again and not making any, any progress. So, so that was the first, the first inspiration. And then as I started to become more of an independent adult and learn about the world and how the world works and how my patients' worlds work and learn about myself, I realized how much from pulling on these threads of why aren't our treatments working as we think, as well as we think they should. I started to learn how, you know, investigate other, other disciplines, right? Like other disciplines like Eastern and tribal medicine that are older than Western medicine by thousands of years and trying to see like, how did they think about mental illness? How did they think about trauma? Mona Sharma. And what I realized is that they have a lot of value to add. They're literally looking at the same thing that we're looking at in Western medicine, but they're looking at it through a totally different lens that is based on thousands of years of pre-technology interpretation of human experience.

Yeah.

Before smartphones, before internet, before television, before we could measure the body in any meaningful way. They built their philosophy from feeling the body and sensing the body.

Yeah.

Right. And that is not, uh, any worse of a way to look at the world or less valid of a way to work— look at the world and illness than what we're doing in Western medicine. If anything, it is superior to the way that we look at chronic illness than the way that we look at chronic illness in Western medicine. Western medicine is fantastic at treating acute, immediate, life-threatening illnesses. We are absolutely the worst at treating chronic illness. And Eastern and tribal practices are actually pretty great at treating chronic illness, but pretty bad at treating emergency life-threatening things. Mm-hmm.

Right?

So when we put the two together, all of a sudden we have a complete picture and all the puzzle pieces laid out right in front of us of how to put— how to solve this problem, right? We need to take the best of the best of Eastern and tribal traditions and the best of the best of Western medicine and, and bring them all together for a holistic approach to health. And we can solve both acute illness and chronic illness at the same time. And so that's what the book was about. Uh, it's called A Simple Guide to Being Alive because I realized how simple most of these concepts are when we think about them, the Eastern and tribal concepts through a Western scientific lens. I realized science proves that all this stuff works and it's real, you know, especially in the last 25 years. We've proven breathwork, yoga, mindfulness, meditation, movement, all of these soothing touch, all the sensation things we talked about, we've proven they all work to, to heal. And we know why, right? There's just no argument around it. Now we just need to update the education system. So rather than wait for anyone else to do it, I was like, I'm just gonna, I'm just gonna publish how to, how to do it in the simplest terms that I can possibly throw together, and we'll see how it goes.

I can't wait to read it. And I agree with you, it's time for a rebrand on what healthcare actually is, right? And I also know that I'm not alone on this. When I was initiated into a spiritual name, there's this process with the Swami where you're chanting for a couple of hours and you're saying the same thing over and over and over. And after that, I had a moment where I was walking down this, this lane outside in nature. And I had a similar, that was very, very, very similar. I had a feeling that was very similar to being on psychedelics after doing the breathwork and chanting. Ancient wisdom has known about this forever, right? Ways to activate the body and how to kind of tune into our pineal gland as well and connect us with source energy. Mm-hmm. On our own without getting there. But I think psychedelics is an incredible path to getting there. And I think that also when you look at these ancient tribes, they had their own form of psychedelics that were used with, you know, healers or shamans. And they were different amongst different cultures, which I think we need to finally recognize. Like, they were also healers that lived in the society with the people who would fix your bones and, you know, support with wound healing and stuff like that. it's all integration and it's time that we, that we make that connection as well. Would you say that this is an opportunity for people to recognize the biohacking trap? You know, the, the way that people feel like they need to optimize through a modality outside of themselves?

Yeah. And I might reframe it to call it like the, the optimization trap. Where everything constantly has to be made better by relying on tools outside of us. Again, the tools outside of us are not bad, but it's, it's how we think about them. Just like longevity is not bad. We all want to live longer, but if we're optimizing because— and, and doing everything we can to try to live longer, because the motivation is fear of mortality and death, right? We're going to spend all those extra years on the earth just fearing death more, right?

Yeah.

That is actually going to result in increased fight or flight nervous system activity, increased inflammation, because we're afraid of something that's inevitable. Everybody dies just like everybody poops. It's going to happen, right? So if we can't— it's completely worthless and useless to spend any amount of time fearing something that is going to happen eventually.

You got it.

What you were describing earlier is what if we shift the narrative, right? What if the story is, how do I optimize to improve access to joy? How do I optimize, improve access to awe, to connection, to living more fully for as long as I'm here? And what's interesting is if you look at the studies of blue zones where people live the longest, These people, I think these studies are so fascinating. They're not perfect, but they're really—

Yeah.

When you look at like, especially like the Italians who smoke and drink, who—

Exactly. It makes no sense.

Well, here's what makes sense about it. If you think about the relative impact on longevity and healthspan and our overall health from the perspective of What is having the biggest impact on making us sick? It's not tobacco and alcohol use, frequent use, especially abuse, do have a major impact and they will make us sick, especially if we abuse them or misuse them. However, you know, what's probably worse than both of those things when you really look at the data, chronic stress.

Stress.

Right. Number one worst possible thing that you could do. It causes increased rates of heart attack, cancer, autoimmune disease, digestive issues, chronic pain, you name it, illness, insomnia, you name it, illness, chronic stress makes it worse or causes it or both. Right.

Mm-hmm.

And faster. So if we think about it from that perspective, we're looking at a group of Italians that have a very high rate of living to over 100 years old. They smoke and drink sometimes, but maybe it's like once or twice a week. Maybe it's a little more than that, but they're not doing it because they're anxiously afraid of death. They're doing it in, in community, in relationship, in immersive social connection. That's authentic. It's not because they're putting— they're going through the motions because they feel like they're supposed to socialize. They genuinely love hanging out with each other and, and schedule their whole days. around prioritizing human connection. Right. And so that is one of the single biggest, best ways we can relieve stress. It brings us closer together. It like, like the psychedelic feelings you're talking about, right? It makes us feel more connected to something bigger than ourselves. It makes us feel held and seen and heard. And that brings down our chronic stress more than anything. So then if you want to have a cigarette or a drink once in a while, it's not that big a deal because it's not aggravating this existing milieu of crazy stress-induced inflammation that you have all the time. It's just a single event that you're doing. You're not— it's not— it doesn't become abusive as frequently. Right. So I think that is a really important lesson for us to learn is we could be enjoying life a whole lot more and living longer if we spent— Yeah. Or time prioritizing the things that we know naturally make us feel good and safe and healthy, like community and togetherness and connection as a top number one priority and recovery. And then if we wanted to drink or smoke once in a while, it would be fine. And it probably wouldn't have much of an impact on us. But if we can't get the core safety stuff and Maslow's hierarchy of needs and those core fundamental human needs met, first, including community connection, everything else we do is not going to have a very— like, any optimization or any obsession around that kind of, that kind of like optimization behavior is a trap. And it will actually shorten your lifespan to think— spend your time thinking about fearing death than it does to think about enjoying life.

Couldn't agree with you more. Honestly, for anyone who's feeling overwhelmed, I say this to my clients all the time. If anyone feels overwhelmed from a wellness protocol or what they knew need to do to be well, seek more awe, wonder, and joy with other people every day and schedule that as your wellness protocol. The second you feel those emotions, you don't even think about eating well for longevity. Don't think about things you have to do to feel better. You naturally do them. Healthy living becomes you. It's less a chore of— or a task. And, um— Yeah. I just, I love this conversation so much. For someone listening who's feeling dysregulated, who's inspired maybe to look into psychedelics, I want them to go and check you out. So are you most active on Instagram or how do you like to connect with your audience?

Yeah, Instagram's great. I'm Dr. David Raymond on Instagram. Please hit me up anytime. I love to hear from you. You can also check out my website, drdave.io. And specifically if you're interested in in psychedelics, I would highly recommend checking out the— my podcasts, which are all about consciousness and how psychedelics work. They really break it down across a whole host of different categories and ways that they can be used and safely. The one of them is called The Psychedelic Report. The other one's called Your Brain Explained. And then, of course, the upcoming book talks a lot about what we've learned from psychedelic medicines about how we learn and heal for long, happy, healthy lives. And it's called A Simple Guide to Being Alive.

So wonderful. Thank you for today. It's so great to meet you. To wrap things up, tell me what excites you most about psychiatry and neuroscience in the future.

I mean, I think You know, the most important— the most exciting thing is that we are alive during what I argue is the most exciting time in the history of psychiatry and mental health. We are starting to see evidence that's pretty significant now in terms of the amount of evidence that there is, and it's extremely compelling and convincing that cures for mental illness the first mental illnesses like depression and PTSD are right around the corner, right? Like 2023 is right around the corner. And those studies that I'm referencing have already been done. We know the techniques that have to be administered. We know the parts of the brain that are activated that make it possible to, to think about, for patients to be cured from some of these symptoms. And what's more is we know how to activate those pathways. Going back to something you said earlier, that's really important. We know how to activate those pathways that promote healing without drugs. Right. So doing the chanting, the breathing, sound, sound and sound as vibration, like Apollo emerged from psychedelic research into study, understanding the neural pathways of how we heal through safety. Then we said, well, how do we get there naturally? Soothing touch. Can we put that in a box? and put it on people's bodies, right?

Yeah.

And so between, like, this is one of the most— this is easily, I would say, one of the most— I would say this is easily hands down the most exciting time in the history of mental health to get everybody's hope networks going in their brains. That between technology that we have, like Apollo, which is giving people 30 to 60 minutes more sleep at night, and it's clinically proven to boost mood, reduce stress, improve cognition, and improve focus and productivity and quality of life during the day and psychedelics on psychedelic-assisted therapy on the medicine side that we are going to not only— I expect to see at least one mental illness that we can cure, probably PTSD or depression by 2030. We're going to start to see that in after 2030 rapidly fold into many mental illnesses being cured and starting to see that number that's going up exponentially every year of the number of people who are sick. Start to shift direction, go down.

Wow.

And then we can— and we'll start to also prevent these illnesses from happening in the first place by catching the signs early. And so again, I think there's just never been more excitement in the space around the way that we can facilitate better access and scale of access to healing for every human being on the earth, and especially it's at least for the start, everyone in America. And I'm just so proud to be a part of this work and to share it with everybody.

And you do such a great job at it. I've got to pull out my Apollo so you can also— you wrap it around your wrist, right? That's what I was doing.

You can wear it anywhere.

I— Okay.

I wear it on my chest during the day usually, and I wear it on my ankle at night. The ankle is the best spot for sleep. That's where people have the best— those 30 to 60 minutes more sleep back at night gains. But yeah, you can wear it anywhere in your body because it's, it's working to activate the vagus nerve indirectly through the touch receptor system. And we have touch receptors literally everywhere.

Everywhere. Yeah. All right. So chest, around your ankle at night, around your wrist, and it will work. We're going to link that out. Thank you for, for closing this off with so much hope. I think that's something that we all need. So thank you for that. And I'm excited to follow your work and to get your book. I'll meet you in person next time.

Sounds good.

Thanks, Mona Sharma. Sounds good. You too.