The Mental Health Doctor: “Sitting Is Increasing Your Anxiety!”, Your Phone Is Destroying Your Brain, You May Have ‘Popcorn Brain’!

[0] You need to hear about this.

[1] 72 % of people are struggling with stress.

[2] 70 % have at least one feature of burnout, and we are seeing a rise in mental health problems like we've never seen before.

[3] What's happening?

[4] So as a doctor, I can tell you that...

[5] Dr. Aditi Norcah is a Harvard physician nationally recognized stress expert who is understanding and combating modern day burnout.

[6] When I was a medical student, working 80 hours a week, I was in my own stress struggle.

[7] And it was terrifying, but I couldn't feel.

[8] finding a doctor who could help.

[9] So I became the doctor I needed.

[10] I uncovered all of these studies and found a solution that wasn't just tried to relax.

[11] We are seeing increased rates of depression, sleep disorders, fatigue or burnout because stress is higher than ever.

[12] Studies have shown at least 60 to 80 % of patient visits have a stress -related component.

[13] Jesus.

[14] It's crazy.

[15] And 60 % of people with burnout had an inability to disconnect from work and being addicted to work can't shut off and checking your phone 2 ,600 times a day.

[16] Yes, that is a statistic.

[17] So you might be experiencing a typical burnout.

[18] Even two -thirds of parents have burnout.

[19] That's crazy.

[20] And yet, even though we are all collectively experiencing it, it's so isolating.

[21] The now 330 million people go two weeks before speaking with anyone.

[22] So what can we do?

[23] Well, These are the five resets that are going to help you survive and thrive.

[24] The first technique is...

[25] Dr. Aditi, Naruka.

[26] Where does your story begin?

[27] And when I say that, I'm talking about the story that inspired the work you do on stress, burnout.

[28] There tends to be a catalyst moment in the experts that I speak to's lives where something happened, which started a chain of events, the first domino that fell, which led them to be sat here.

[29] Where does that story begin for you?

[30] My origin story as a doctor with an expertise on stress started as a stressed patient who couldn't find a doctor with an expertise in stress.

[31] And I became the doctor I needed at a time when I was in my own stress struggle.

[32] What is the backdrop?

[33] What is the situation of stress, the state of stress in the world at the moment?

[34] Are we getting more stressed as a people?

[35] We are seeing unprecedented levels of stress in the world.

[36] It is affecting every single industry and no country or group including, you know, all ages, all industries, all races.

[37] It is the great equalizer.

[38] More now than ever.

[39] So as a physician and clinician, those of us who work in the medical field, stress has always been a major problem.

[40] We see it with our patients.

[41] But now, if there is what silver lining from the recent several years is that now mental health, stress, burnout.

[42] The lexicon has grown and it is something that people are talking about finally in the C -suite, in other areas where before it was, you know, there was so much taboo.

[43] There still is.

[44] But it is finally getting the recognition it deserves.

[45] And stress right now is higher at greater rates than ever.

[46] what are those rates so typically 70 % of people have at least one feature of burnout 72 % of people are struggling with stress and approximately that same number have said that the past several years have been the most stressful their entire professional careers what's happening a couple of things are happening so going back to my own personal stress story why did I have those palpitations at night as I was going to bed, I was developing something called a delayed stress reaction.

[47] And what happens is under periods of acute stress, like the recent events that we've all endured collectively as a global whole, during acute periods of stress, we shore up our internal reserves.

[48] As a human being, you often do not crack in that moment.

[49] You keep it together at all costs.

[50] I've seen this with my cancer patients.

[51] They have a cancer diagnosis, and they They go through the treatment, radiation, chemotherapy, all of it, and they are fine.

[52] They do not shed a tear.

[53] Then when they get that first clean bill of health from their doctors, they are in my office sobbing and everyone is confused.

[54] Why now?

[55] What's going on now?

[56] Same thing with all of us.

[57] You may be feeling this way.

[58] I may be too.

[59] Right now, it's that feeling of like, okay, we've just lived through the pandemic.

[60] We should be celebrating.

[61] I'm sure you've seen every headline over the past several years, at least I did.

[62] The roaring 20s are coming, the post -pandemic era.

[63] The Guardian had a great piece on this, and I remember seeing headline upon headline, and I would just laugh because I would think that is not how the brain works.

[64] The reason we are all feeling very much not the roaring 20s is because our brains are built like dams.

[65] So what happens is when you are going through a period of stress, you shore up your internal reserves and you keep it together at all costs.

[66] That is just how the brain is built.

[67] When that acute period of stress is over, So in a cancer patient, the actual cancer treatment, for me as a medical resident, going through, you know, the difficult 30 -hour work shift and going to bed, and for all of us collectively, going through the pandemic experience and the various things that have happened since, we keep it together.

[68] But when we have that moment of respite, when that acute stressor is over, then our psychological defenses come down and our true emotions can emerge.

[69] And it's often a deluge.

[70] and it comes out in different ways.

[71] The manifestations of stress are different.

[72] But it's this delayed stress response.

[73] We are all feeling it, which is why none of us feel like it's the roaring 20s.

[74] We are seeing increased rates of mental health issues, anxiety, depression, sleep disorders, stress -related disorders, and a general feeling of malaise or fatigue or burnout now even more than we were back in 2020 or 2021.

[75] It's the delayed stress reaction.

[76] What is stress?

[77] we should probably define that word.

[78] And I'd also like to try and define it against the word burnout.

[79] Are they different things?

[80] Are they the same thing?

[81] Do either of them exist?

[82] Great question.

[83] There is a difference between acute stress and chronic stress.

[84] Under normal circumstances, we function in resilient mode.

[85] And we're governed by the prefrontal cortex.

[86] The prefrontal cortex is the part of our brain, if you put your hand here, right behind the forehead.

[87] And it is the part of the part of the brain.

[88] of your brain that is responsible for, in scientific terms, we call it general executive function or, you know, layman's terms, adulting.

[89] God, mine's huge.

[90] Behind the skull.

[91] Memory, planning, organization.

[92] This is what our strategic thinking, you're really good at these things, Stephen.

[93] Thank you.

[94] Thank you so much.

[95] The prefrontal cortex is what governs all of that.

[96] Under stress, we are governed not by the prefrontal cortex, but by the amygdala.

[97] And the amygdala is a time.

[98] tiny almond shaped structure deep in our brains.

[99] You can't touch it.

[100] It's not like the prefrontal cortex right behind here.

[101] It's like between your ears deep down.

[102] And that is our emotional center.

[103] It's the limbic system.

[104] And we often call it the reptilian brain because that part of our brain has not evolved the way other parts of our brain have.

[105] So it's that and the response that that amygdala creates is the fight or flight response, that stress response in our bodies.

[106] So under acute stress, we are not governed by the prefrontal cortex up here.

[107] We are governed by our amygdala.

[108] Our brains and our bodies are expertly designed to manage acute stress.

[109] We are built for managing stress.

[110] However, nowadays, so for example, let's talk a little bit about the fight or flight response that the amygdala governs, right?

[111] Back when we were all cave people, we were in the forest, we saw a tiger.

[112] You would either flee or fight.

[113] And there's all of these bodily mechanisms, that happen when you are engaged in the fight or flight response.

[114] Your heart beats faster.

[115] Your lungs start taking in more oxygen.

[116] Blood is shunted away from your vital organs and it goes to your muscles so you can either fight or you can run.

[117] Your pupils dilate.

[118] There's so many biological physiological mechanisms that happen with the fight or flight response.

[119] Then when that acute threat is over, so you either have fought or you have flown away from the tiger, you have a moment to recalibrate.

[120] modern day times there are no acute threats anymore that all of our tigers are chronic bills financial troubles marital conflicts or relationship problems health issues so there's this constant low hum of that fight or flight response in the distance and that is the problem so acute stress we are good at our brains and bodies are great at managing and it serves a role right of course it serves a role it's evolutionarily healthy and we can talk about the difference between healthy stress and unhealthy stress.

[121] But when it starts becoming chronic, that is when burnout sets in.

[122] Your brain doesn't get time to rest or recharge.

[123] It's not like a tiger in the forest where you fight, flee, and then there's like a respite time.

[124] So it's just ongoing in the background at a low hum at all times.

[125] What are the symptoms of burnout then?

[126] How do I know if I'm burnt out?

[127] The interesting thing about burnout is that the definition is changing.

[128] So earlier, when you think about burnout, You know what someone with burnout has or yourself might think like, oh, I know what burnout is.

[129] I don't have it.

[130] That's a lot of people feel this way.

[131] Classic typical symptoms of burnout.

[132] Apathy, lethargy, feeling unproductive, not very motivated.

[133] And the WHO in 2019 designated burnout as an occupational phenomenon, any clinical syndrome, which was really validating from many people who are feeling that way.

[134] This is 2019, way before the pandemic.

[135] In 2020, 2021, and 2022, what burnout is looking like has changed.

[136] So it is no longer these classic typical symptoms.

[137] Now we are seeing increasingly atypical features of burnout.

[138] In one study, 60 % of people with burnout had an inability to disconnect from work as their main feature of burnout.

[139] So it's not what you think, when you're thinking about the face of burnout of someone who's really not interested in work, you could be that person who is engaged in work and can't shut off and you're thinking yourself, this can't be burnout.

[140] I'm totally, you know, engaged in work.

[141] In fact, I can't shut off my brain.

[142] You might be experiencing atypical burnout.

[143] Atypical burnout.

[144] Because yeah, when I think a burnout, I think of like, oh, like not getting out of bed and losing motivation.

[145] But you're telling me that my addiction to work might be a symptom and a sign of being burnt out.

[146] That's right.

[147] So how do I know?

[148] Because I'm addicted to my work.

[149] I love my work.

[150] You know when it is different from your baseline.

[151] Being addicted to work, you love your work, yes.

[152] But you also make time for sleep, relationships and connections with loved ones.

[153] You feel a sense of engagement in the world.

[154] It is not interfering with your day -to -day life, so to speak.

[155] Okay.

[156] So when you are feeling that sense of inability to unplug, that means you're checking your phone multiple times per night.

[157] because you feel like you have to keep up, you are trying to keep up in the hamster wheel situation where you just can't.

[158] And so there are many manifestations of this atypical burnout, but that is one.

[159] And so often what's happening now is that people are feeling burnt out.

[160] Again, unprecedented rise, right, in stress, chronic stress, and burnout.

[161] And often people don't recognize that it's happening to them simply because the face and definition of burnout is changing.

[162] How many people are burnt out do they know?

[163] Have they done?

[164] any studies on that to figure out what that number is?

[165] We don't know.

[166] I mean, it depends on the sector.

[167] So there are lots of studies on burnout.

[168] And so one big study, it was done on parental burnout and found that two -thirds of parents have burnout.

[169] Two -thirds.

[170] Jesus, 66%.

[171] Yeah.

[172] And that is probably underestimated and certainly underreported.

[173] So typically we're seeing anywhere rates from 60 to 70 % of people note burnout.

[174] But again, think about, you know, if you're, if based on what we've talked about, if you are feeling like, I'm not burnt out.

[175] So if you're self -reporting burnout and you're saying, I don't really feel burnt out.

[176] I'm very engaged in my work.

[177] In fact, I check my email 10 times a night.

[178] You could actually be having burnout.

[179] There's also a lot of stigma and shame around burnout.

[180] So people don't want to come forward and say, hey, I might be stressed or I might have burnout.

[181] If I have that atypical burnout, why does it matter it matters because your brain and your body deserve a rest and to function optimally you need to have spaciousness you need you know to function optimally you need to have rest and when you feel that sense of burnout you are not thriving what if i don't feel it what if i'm one of those people that you just have said that's you know checking my emails 15 times a night i seem to be successful in my work.

[182] I'm kind of out of balance in my life.

[183] I don't really have anything else going on in my life.

[184] I'm just work, work, work, work, work, work, work.

[185] But I don't necessarily feel like there's anything wrong.

[186] So if I don't feel like there's anything wrong, if I'm successful in my work, then what is the case for making a change?

[187] So I've had lots of patients.

[188] I had a clinical practice in Boston.

[189] And what you're describing is the, you know, young entrepreneur.

[190] So many patients who are young entrepreneurs.

[191] And the question I would always ask them is, what's your end game?

[192] So is it a sprint or a marathon.

[193] Are you looking to do this for two years and you love it and then that's it, you're going to cash out?

[194] Or do you want to think about what your life is going to look like 10, 20, 30 years from now?

[195] And so they would think about it, ponder and then say, yeah, I want to spend time.

[196] You know, my end game is that I want to lead a great life and I want to live until I'm 75 or until I'm 100.

[197] And so if you are on this fast track that you're describing, you know, burnout is not conducive with this idea of longevity and having that long life.

[198] That's what I was thinking.

[199] I was thinking of case studies that I know of of people that I think probably check their email 15 times a night and I like that.

[200] And those that are out of balance, I think, as you say, you can do that intensity, but you can't do it consistently.

[201] Like it's possible to be that intense, but it's not sustainable and it doesn't allow you to achieve the other things that life can offer you that will make you happy.

[202] There's no way of being like, like that and having like a healthy relationship with your family, building a family, staying in shape and all those are other things.

[203] And that for me is the really clear cost to that is you just play it out, zoom out on your life in 10 years time, something's going to be broken.

[204] Something's got a gift.

[205] You know, we don't have, I mean, I think that's a good segue into this idea of toxic resilience.

[206] It's like we don't all have human beings.

[207] We don't have an unlimited amount of bandwidth.

[208] There is a discrete amount of bandwidth that we all have.

[209] mental and physical.

[210] And so if you are not getting the proper rest that you need and you're not sleeping as much as you, you know, your body and brain need.

[211] And it's not about you as in personal, I don't need sleep.

[212] I only need four hours.

[213] I've also had many patients who've said that to me. But your brain and your body do physiologically and biologically need a certain amount of rest simply for the cellular function to continue.

[214] But we've got those posters up in our kitchens, you know, not my kitchen, obviously, but some people have their posters up in the house.

[215] They the keep calm, carry on.

[216] That's like a hallmark of society today is to just tough it out and carry on.

[217] And we're praised for that.

[218] We're praised for our resiliency.

[219] Resilience is a good thing, right?

[220] Beautifully said, keep calm and carry on.

[221] Resilience, the true scientific definition of resilience, is our innate biological ability to adapt, recover, and grow in the face of life's challenges.

[222] But resilience doesn't function in a vacuum.

[223] You need stress for resilience to show itself.

[224] Without stress, there can be no resilience.

[225] So think of swimming.

[226] The swim instructor is the stress saying, like, you can make it to the other side.

[227] And your resilience is what keeps your head up as you're swimming while your arms are flailing.

[228] And then with time and practice, it gets better.

[229] What you're describing, keep calm and carry on, is a manifestation of hustle culture.

[230] and our entire modern society is built on this idea of toxic resilience.

[231] And so what is toxic resilience?

[232] You have heard the word resilience over your lifetime, and you had no real, you know, no real, it had no real charge, right?

[233] Like you would listen to that word and it would be like, okay, fine.

[234] And over the past several years specifically, 2020, 2021, it was used.

[235] It was like a real buzzword at the start of our quarantine.

[236] We're resilient.

[237] We're going to get through this.

[238] And it has been.

[239] misused.

[240] And this is because of corporations and large companies said, you can work more.

[241] You're working from home now.

[242] Take on an extra project.

[243] You're resilient.

[244] It doesn't matter that you're doing child care and working.

[245] You're resilient.

[246] And so you hear these toxic messages all of the time.

[247] Resilience went from being something that's true, which is honoring your boundaries, making space and time for rest and to recharge, focusing on a sense of self -compassion and understanding that you are a human being with limitations.

[248] That is true resilience.

[249] Toxic resilience is productivity at all costs, a mind over matter mindset, and what many of us think of as true resilience is in fact toxic resilience.

[250] We are taught from a very young age that dealing with discomfort and being okay with discomfort is what resilience is all about.

[251] And I am here to debunk that because absolutely not.

[252] Resilience is our innate biological ability, but it also needs rest and recovery.

[253] It is not meant to be toxic.

[254] But being resilient, is that a good thing in your view?

[255] Being a resilient person?

[256] Not in the biological context.

[257] I mean, being psychologically resilient.

[258] Being resilient is an excellent thing to be.

[259] It is something that we can learn how to be better at.

[260] And yes, true resilience is wonderful.

[261] the challenge right now is that many of us hear the word resilience and we bristle at it.

[262] I do.

[263] When I hear, you know, the messaging of toxic resilience, no one calls it toxic resilience when they're giving you that messaging.

[264] They just say, hey, it's resilience.

[265] It's cringeworthy, right?

[266] Like you hear it like, oh, be more resilient.

[267] And so, yes, true resilience is a gift.

[268] It is our innate biological ability.

[269] We all have the power and the aptitude for true resilience.

[270] But toxic resilience is what we often do.

[271] see and what is often promoted.

[272] And that is something that needs to stop.

[273] Do you think people are getting more or less resilient with the nature of the way that the world is?

[274] I often have the conversation about whether, you know, the boomer generation are more or less resilient than the Gen Z or whatever's coming next, what's next.

[275] Is it like alpha?

[276] I think it's Generation Alpha, these new generations.

[277] And the argument, the stereotypical argument is that because the boomer generation were working in factories and mines and they were doing harder labor and they had less comparison because they didn't have social media and they didn't see, you know, the mate down the road having a chocker -frockal latte yata during their lunch break and doing yoga sessions or whatever, then they are more resilient.

[278] And the Gen Zs, they've got it easy.

[279] They're all doing like, you know, breathwork and yoga for six hours a day.

[280] Is that true?

[281] I would say no, because we know that with Gen Z and other younger populations we're seeing a rise in mental health, burnout, stress like we've never seen before.

[282] And I don't think it's because they're, quote, unquote, less resilient.

[283] They are managing lots and lots of onslaughts.

[284] You know, they've lived through something really awful.

[285] They've had a sense of collective trauma.

[286] Their minds are still young.

[287] They haven't had that lived experience of, you know, decades of going through stuff.

[288] So, no, I don't think so.

[289] And of course, the older generation is going to say that.

[290] I remember When I was in my medical training, you know, people would say, oh, 80 hours, it's all you're working, because we worked 120 hours because there were some reform in terms of like how many hours we could work as medical residents.

[291] And 80 hours felt awful to me. And so I think it's important to validate and normalize people's difficult experience.

[292] And it's not about what happened to you, you know, like, so in this example about prior generations, it's about helping people feel a sense of validation because if you need to name it to tame it.

[293] And so, for example, when you are going through a difficult experience, like a young person, there's such a rise of anxiety, depression, stress -related conditions, sleep disorders, mental health challenges, physical health challenges in the younger population.

[294] It's not because they're not resilient.

[295] It's because they're living in a hyper -connected world, and that is causing all sorts of issues down the road for them, both mental health and physical health.

[296] So I reject this idea that the older generation was more resilient.

[297] They had less stimulation and they had, you know, different, they had different challenges.

[298] But I think it's important to normalize and validate the difficult experience that people are having.

[299] I want to go through your book now, which is called The Five Resets, which is released January 2024, very exciting, which really aims to take on how we deal with stress, how we manage stress.

[300] there's sort of shades of neuroplasticity and how we can change our responses to stress.

[301] But I guess the first question about the canary in the coal mine, why did you write about that?

[302] What's that got to do with stress?

[303] It has everything to do with stress because stress is something that is so individualized and that's something that we were talking about earlier, right?

[304] Like some people who feel a sense of stress have physical manifestations, like I had palpitations, you had palpitations, someone else might have headaches, neck pain, shoulder pain, back pain, GI upset gastrointestinal issues, dizziness, fatigue, sleep problems, irritability, anger.

[305] The list goes on and on.

[306] It's like never -ending list.

[307] And the canary in the coal mine is my way of, personally, it's my way of really explaining this idea of the physical manifestations of stress.

[308] So my canary in the coal mine was palpitations.

[309] What is that phrase?

[310] I've never heard the phrase, the canary in the coal mine.

[311] Well, I've heard the phrase before, but I've just kind of been one of those people that pretends they know what it means.

[312] The canary in the coal mine is a historical reference.

[313] Back when there were coal miners, they would bring a canary, a bird, down into the mines with them.

[314] The bird would sing its canary song.

[315] When the air got bad, the workers were just working, right?

[316] Like 12 hour days and continued to work.

[317] when the air got bad, the canary would stop singing.

[318] They were in their mode.

[319] They didn't understand, you know, they weren't paying attention.

[320] And when the canary stopped singing, that was the first tell that the air is bad before any physical or mental health ramifications for the workers.

[321] And so the coal miners, when they stopped hearing the canary song, they would leave the mine with the canary.

[322] And it was the first tell of something going awry.

[323] And so everyone has a canary within them that tells them a signal, a song that is telling them that there is something happening with their stress.

[324] I didn't pay attention to it.

[325] It took the palpitations to occur every single night for two weeks before I sat up and took notice.

[326] All of the physical manifestations of stress that I've mentioned, of course you need to see a doctor like you and I did, got the full work up and been told stress is all.

[327] often what we call a diagnosis of exclusion, meaning you rule out any organic problems, and then you say, okay, this is because of stress.

[328] So seeing your doctor and getting that full work up is important.

[329] I have to say that as a medical professional because I believe in the medical system, and I'm part of the medical system.

[330] And so the canary in the coal mine is this idea that we all have a song, a stress song, and our body is trying to tell us something.

[331] And understanding that canary symptom for you, you know, it takes a little time to dig through, but once you kind of figure it out, then you can use that.

[332] We all have our Achilles heel of something that is the tell.

[333] So when if you have a medical condition like, say, peptic ulcer disease, that's easy to understand.

[334] You know, you feel like, oh, I have stomach pain.

[335] And so I can't eat certain foods and I need to take care of myself and there'll be a flare and then you manage that symptom and it goes away.

[336] and, you know, you know what that tell is of peptic ulcer disease, stomach pain.

[337] But for stress, often things are happening to your body and you're not even aware of what that physical manifestation is.

[338] That's not to say that it's, you know, your headaches are caused by stress, but they're certainly worsened by stress.

[339] So when you have a certain symptom happening to your body, understanding that, hey, that could be my canary song.

[340] I think everybody intuitively knows what their canary is.

[341] I think everybody knows what there's.

[342] I've got a bunch of different ones.

[343] whenever I'm stressed and I don't even know when I'm stressed but I don't know why but I don't know consciously that I'm stressed but certain things start to happen I have this really weird one where on my tongue I'll get a little bit of like a not like an ulcer it kind of feels like I've got a spot on my tongue I get that whenever I'm stressed my skin gets worse so I get like spots on my face when I'm stressed there's a few of them I'll get a cold pretty much exclusively when I'm stressed which happens about one time once every six months or so.

[344] I think generally I manage stress well, generally, but I'm not immune.

[345] I once upon a time thought I was immune.

[346] I thought stress and all these other things and mental health all happened to other people.

[347] Turns out happens to me too.

[348] That's right.

[349] You know, and I think I really pushed myself for a good five, six, seven, ten years.

[350] You know, I was a CEO of a company that had hundreds and hundreds and hundreds of employees and I was 25, 23, 24, 25, 26, 27.

[351] So I pushed myself very hard and I think for the first couple of years, years I withstood it, but then as time went on, you know, I was not able to outrun the inevitable.

[352] And that's that resilience myth, you know, that like resilient people don't get burned out.

[353] It can't be me. Of course I, of course I'm not stressed.

[354] Someone like me couldn't even fathom being stressed.

[355] And I have seen thousands of people who have said that very thing.

[356] I said the exact same thing during my stress struggle.

[357] Stress doesn't happen to people like me. You don't want to admit it either because there's a, there's an element of it where you go, I don't want to be fucking weak.

[358] I don't want to be the weak person.

[359] If I'm experiencing stress or I'm burnt out, then that makes me inadequate in some way.

[360] So I don't want to talk about that.

[361] You know, but I think I've been a victim of that, like that pride, that ego, especially as like a man and like a CEO and all of those things that are stereotypically, toxically associated with strength.

[362] I've never wanted to admit that I was stressed, ever.

[363] I don't think I've ever actually said the word to anybody, but I've definitely been stressed.

[364] And I know because my body told, me and it tells me in a very predictable way, that canary stops singing.

[365] So I just think that's important because it's your mind -body connection.

[366] And once you see it, you cannot unsee it.

[367] It's like gravity.

[368] It's all around you.

[369] It's working in the background all the time.

[370] And then suddenly you start paying attention and it's like, oh my God.

[371] And on that point of it feeling like evidence of your inadequacy, it's actually evidence that you're a human, that you're perfectly normal, that you're not broken versus this idea that it's evidence that you're broken.

[372] Beautifully said.

[373] Thank you.

[374] Really, just beautifully said.

[375] Have you listened to this podcast before?

[376] I'm joking.

[377] I'm joking.

[378] For the record, testing, testing, one, two, three.

[379] I am a avid fan of this podcast and I have listened countless times.

[380] And this is the one podcast I regularly listen to on my morning walks.

[381] And I have shared on Instagram probably hundreds of lessons in my stories about what I've learned on this podcast.

[382] podcast.

[383] So stress on the brain.

[384] You write about that in your book as well.

[385] I know that stress causes cortisol.

[386] This is my very limited understanding of stress.

[387] It causes cortisol.

[388] Talk me through that.

[389] And then I have this other question that I wanted to ask you about the contagion of stress.

[390] If I am stressed and Jack is sat over there, will Jack feel my stress?

[391] So let's talk about stress and the main highway of stress in the brain and the body.

[392] It is the HPA axis.

[393] H stands for hypothalamus.

[394] P stands for pituitary gland.

[395] A stands for the adrenal glands.

[396] The hypothalamic pituitary adrenal axis, mouthful.

[397] But the H and P part of the axis is in your brain and the A part of the axis is above your kidneys, the adrenal glands.

[398] And that is the information highway that is responsible for our stress response.

[399] It's all of the things that we talked about, the fighter flight response, it makes our heartbeat, it makes, you know, it does all sorts of stuff.

[400] The amygdala works in that HPA axis as well and other parts of the brain, the prefrontal cortex, etc. So when you have that experience of stress, and this, we're talking about acute stress, this is what is happening to you.

[401] Your brain and your body are sinking up and reacting.

[402] There's a cascade of hormones that happens in the body.

[403] And that is what you feel as, wow, I'm stressed.

[404] Or like you describe, this discomfort or familiar feeling of like, wait a second, I know what this is.

[405] It's that thing that I have when I'm under pressure or under situations that are tense.

[406] And that is the stress response.

[407] And that is essentially what is happening to our bodies when we are feeling that fight or flight syndrome.

[408] Unfortunately, what often happens with the amygdala is that while it is helping with this fight or flight syndrome and the hpa axis it with chronic stress does not shut off and that is the problem so those hormones are just flowing through that highway all the time and cortisol is our stress hormone and it's all part of that as well because cortisol surges during you know adrenaline noradrenaline all of these hormones are working through our bodies and surging through our bloodstream cortisol is also a stress hormone.

[409] And so when we have chronically elevated levels of cortisol, all sorts of badness can happen.

[410] Is stress contagious?

[411] Because I was on Google and I typed in, Is stress contagious?

[412] And it says that in a workplace, stress is contagious.

[413] Stress is not contagious in the way that you think of a virus or microbes are contagious as far as I am aware.

[414] Now, there might be emerging data to suggest otherwise, but it is not like a microbe where like it's going to spread like a virus that it's going to spread from me to you for example but there are hormones aren't they that spread like pheromones is it pheromones but that's different that's like you know that's more for like like attraction sex and other things like charisma etc what is kind of contagious and i want to use that word loosely is like emotion so yes creating a toxic environment right like we call it in pop culture like a vibe like that person just didn't have a good vibe.

[415] What's really interesting, and it's anecdotal, there isn't a ton of research to support this, but I find this fascinating, that the heart has a electromagnetic field that extends 15 feet.

[416] That's something that one of my early mentors had told me. And so that is that vibe that you sense from people.

[417] Like you feel that goodness, right?

[418] like when you meet someone that you just really like their heart, you know, it's like heart expansiveness.

[419] So we're...

[420] We're five feet away from each other.

[421] So your heart, it's electromagnetic field, is overlapping with my heart's electromagnetic field right now.

[422] So they say.

[423] Now, I've heard this in lots of, you know, lots of people say this, but I have also dug deep into the science of like, does this even exist?

[424] is that is this even a real thing?

[425] And I'm not sure if it's a real thing.

[426] Because I haven't found like multiple scientific studies that show robust data that, yes, this is a real thing.

[427] But it is a fascinating thing to think about as a mind exercise, not so much from the scientific perspective, but like from a human lived experience perspective of, you know, and I try to think about that when I enter a room, certainly when I'm with a patient.

[428] We call it the therapeutic presence or the therapeutic encounter.

[429] And it's this idea that when you are with a patient or right now I'm talking to you and I am the doctor talking to you, right?

[430] Not your doctor, of course, but it's this idea that you have, that you can have a therapeutic experience.

[431] I try to engage in the therapeutic encounter at every talk anytime I'm speaking to an audience.

[432] I want people to leave feeling a sense of healing.

[433] Healing and cure are two different things by the way.

[434] So I'm not saying like, you know, we're going to talk and then it's like you're going to be cured of whatever illness you have.

[435] I can't wait.

[436] I can't wait.

[437] What are some of those tongue spots?

[438] But it's like it's this idea of like feeling that sense of healing and it's the therapeutic encounter.

[439] There is science behind the therapeutic encounter.

[440] And what that simply means is that doctors who have that sense of therapeutic presence, you know exactly what I mean.

[441] You might not call it that.

[442] And then you also have had lots of doctors who've had no therapeutic presence and you know what that feels like too.

[443] How does one get a therapeutic presence?

[444] it's something that needs to be cultivated.

[445] Of course, it's something that, you know, you can have, but then you cultivate it with training and practice, et cetera.

[446] But the therapeutic presence, that therapeutic encounter has been shown to actually have health outcomes.

[447] So greater adherence, you know, to medication, tighter glucose control, decreased asthma flares, like real concrete health outcomes when you have a therapeutic encounter with, in that doctor -patient relationship.

[448] So there is some magic secret sauce happening in that encounter.

[449] What is it?

[450] How do I cultivate it?

[451] Are there any tricks?

[452] Any tips, tricks?

[453] Is there like a body language thing?

[454] Maybe I don't know.

[455] Yes.

[456] So as a doctor, I can tell you that there is lots of studies.

[457] There are lots of studies which show that it's not really the amount of time you spend with someone.

[458] It's your body.

[459] And so, for example, they've done studies on doctors who stand for, let's say, seven minutes and talk to the patient versus a doctor who sits down, makes eye contact, and is at the same level or a lower level than the patient, the patient has a perceived sense that this doctor cares more and is more engaged and has a therapeutic presence.

[460] No difference in time.

[461] I think that's the great myth that people say, you know, oh, I need to spend more time to create a therapeutic presence.

[462] It's not about the time spent.

[463] it's about how you are spending the time and the quality of time.

[464] So that's like one trick that you could try.

[465] Eye level.

[466] You mentioned eye level there.

[467] Being at the same eye level or lower because it's a power dynamic.

[468] Think about when you're seeing, if you were in the hospital and you were lying in a hospital bed and your doctor came in and you're lying there and the doctor is speaking above you, does that feel therapeutic in any way?

[469] Not really.

[470] But if the doctor came, pulled up a chair, sat next to you and looked at you, eye level.

[471] That's why when you're talking to a child, it's better to bend down and make, you know, get on their level and talk to them.

[472] And if I'm in a meeting and my chair is maybe a little bit higher and I'm speaking to a client and I want the client to do a deal with me, it's best for me to get down to their eye level.

[473] It depends because in that situation, you know, again, this is like what you were talking about earlier.

[474] Like there's times when you want to show a sense of like power and therapeutic presence is not a sense of power, right?

[475] It's a sense of equality, compassion, empathy.

[476] Are these the qualities that you're trying to create in a business interaction, I don't know, maybe.

[477] Well, one of the things we've learned from, I don't know, I've been making content for about 10, 15 years now for a long time, making lots of videos.

[478] One of the things we've learned is that the engagement goes significantly up if you are on the eye line of the camera.

[479] So you'll notice in the diary of a CEO, we don't shoot from above, we don't shoot from below.

[480] We go to great lengths to make sure that the camera is on the eye line.

[481] And we just see that the engagement numbers are higher.

[482] And actually the more down the barrel it is, especially if I'm looking into this camera here, the more down the barrel and the more on eye line I am, the better than engagement with the video.

[483] We've just seen that over thousands and thousands of videos we've made.

[484] So that's why the podcast is set up like this, where there's, we're on your eye line and we're on down the barrel as much as we possibly can be without you seeing too much of the back of my head there.

[485] And the same applies for this one.

[486] Because it just makes, for some reason, the engagement with the audience is better.

[487] We see it in the numbers.

[488] And there's so many tricks that you could use.

[489] I mean, like, sitting down eye level is one, mirroring, also something else.

[490] This is not related to stress, but it's like mirroring.

[491] So, for example, as I'm talking to you, as you're talking, if I do this, if I do this, and then you're like, oh, this person is like totally following me. No, I don't think you'd lost your mind.

[492] Yeah.

[493] But it's like, if I start doing this, you just did this and so I did that.

[494] So there's like mirroring is something that you, you know, there's lots of ways to try that.

[495] But again, it has to feel.

[496] Is that supported by science?

[497] Yes.

[498] The key is authenticity, though, right?

[499] Like, you can do all of these things, but ultimately authenticity and the human, the really fascinating thing about podcasting, by the way, and any sort of connection with another human being is the voice.

[500] So we as children, as infants, we are highly attuned to voice.

[501] It's one of our first primal instincts, right?

[502] Like hearing our mother's voice or our caregiver's voice or our parents' voice.

[503] and we can our BS meter with voice is high so if someone isn't authentic and that is why the audio version like so listening to a podcast the reason like you can always suss out like who is uh for example i don't know like who's telling the truth and who's not and it's not like something that you can explain you just like you're like oh i don't really like this person or I really like this person.

[504] It's because they lead with authenticity, vulnerability, all of these things that, you know, the likability factor is high.

[505] It's because our brains are primed to recognize and register the human voice in a way that's very different from the physical.

[506] So, yes, we, of course, like we see someone and you get the whole picture, yes.

[507] But when you hear them in your ear, there's like something that is deeply intimate about that experience and that, you know, evolutionarily.

[508] and even like in our own life, it's very poignant.

[509] And it's an intuitive thing.

[510] We don't necessarily know what it is about a voice that's authentic.

[511] It's just a feeling.

[512] You feel it and you know it because when you hear someone on a podcast, you immediately are like, oh, yeah, I like this.

[513] And you don't know why you like it or, you know, you feel that connection.

[514] It's like the voice is a very primitive thing.

[515] And it's also like it was because we formed those connections and synapses in our brain preverbal, right?

[516] Like when we were infants.

[517] Same thing with smell.

[518] You know, you smell something and it takes you right back to that moment.

[519] I was so fascinated.

[520] I remember where I was when someone told me about pheromones that there's these chemicals that leave our bodies and then my chemicals will interfere with your chemicals.

[521] I just thought that was absolute witchcraft.

[522] And I'm a very logical science -based person so I need science and evidence to believe anything.

[523] And then when I heard this rumor that like, you know, if you put my mother and my sister in the same house, their menstrual cycles would sink up.

[524] That's right.

[525] I Googled it to check if it was true.

[526] Google told me it was true.

[527] And then I thought, fuck, I now believe in witchcraft.

[528] Do you know what I mean?

[529] Well, have you read the book, The Red Tent?

[530] I mean, it's like very much along those lines of like biblical times they had a red tent for women, menstruating women, and then it would just like the whole tribe would like sink up and they'd be in the red tent during menstruating.

[531] times.

[532] They've done studies with t -shirts and attractiveness.

[533] So you will smell a t -shirt that, you know, they've done studies with women and men have worn the t -shirts and then you smell the t -shirt and you say, like, I like the scent or I don't.

[534] And it's not body odor.

[535] It's pheromones.

[536] And they've matched it with like the pheromones that you like and then you see the visual and there's a match.

[537] Like, this person is attractive and then you smell the pheromone and there's like a match.

[538] It's that person's pheromones.

[539] Often they say, like, you described your mother and your sister.

[540] For example, they say that, like, genetically, the more different, the more attractive, right?

[541] Because we're always trying to, so if you, of course, there's like a comfort thing of like, you know, your mother and like, that's different.

[542] Because pheromones are mostly for attractiveness and mating.

[543] So it's not about comfort, you know, I guess there might be some studies about comfort and maternal comfort and self -soothing or soothing with your parent or caregiver, but most of the fairmoan research that I am aware of is like sexuality, attractiveness, charisma, but mostly due to mating behavior.

[544] So going back to this subjective stress, I get stress now.

[545] I kind of understand the difference between acute stress and sort of chronic stress, which is a very bad thing.

[546] In your book, you talk about the resilience rule of two.

[547] Yes.

[548] The resilience rule of two is how our brains make change possible.

[549] So when we are undergoing a change, even a positive change in our life, like let's say, you know, I've had a patient who came to see me and had a binder filled of things that he was trying.

[550] And it was like everything but the kitchen sink approach.

[551] And so he came to see me and was like, Doc, I've been doing a great job.

[552] been a month and now I'm in month two and I don't want to do any of it.

[553] And I'm done.

[554] And he was under a lot of stress and he was trying all sorts of things.

[555] We've all been there.

[556] We've tried lots of different things.

[557] And then you just say, okay, I'm done.

[558] Can't do any of it.

[559] Why?

[560] Our brains, even when we're making positive changes, like let's say you recognize like, yeah, I think stress is a problem in my life.

[561] I'm going to make a change.

[562] I'm going to start eating better and I'm going to exercising and sleeping better and I'm going to spend time with friends and I'm going to do less work and I'm going to do all of these things to help my life and you know make a big lifestyle overhaul and I'm really stressed it will not last because our brains have the ability to make two new changes at a time because even positive change like all of these things that we're describing right now are a stressor to your brain how do we know that how do we know we can only make two changes at once the basis of the rule of two is based on a seminal landmark study in the 1960s by two psychiatrists, doctors, Holmes, and Rehi.

[563] They looked at 5 ,000 people and looked at 43 common conditions like life events that happen in people's lives, the most common ones.

[564] Graduation, getting a new job, buying your first home, a outstanding personal achievement, getting married, having a child, getting a divorce, death of a loved one, 43 of the most common conditions.

[565] And when in every single condition, good and bad, got a score.

[566] They studied 5 ,000 people and found that the more life events someone accrued, and it's not about like age or, you know, chronology of age.

[567] It's just the more life events a person accrued, the greater their stress.

[568] The greater the likelihood also that they would develop an illness later in life.

[569] And that Holmes and Rahi study is the basis of this rule of two because what they discovered is that positive life changes are also a stress to your brain and your body.

[570] And that is because there is a certain level of adapting.

[571] You know, there's a certain level of human adaptation that needs to happen with something positive and fantastic that happens in your life to regain the stability that you had before.

[572] Think about your own life.

[573] There are probably so many examples.

[574] I recently moved into a new home.

[575] Everyone was like, congratulations.

[576] This is amazing.

[577] A new home.

[578] And, And it was wonderful for a few months and then, like, also incredibly stressful.

[579] And then, of course, I had the delayed stress reaction three months later, right?

[580] Like where you're running on adrenaline initially and everything is great.

[581] And then that stops.

[582] And then you're, you know, having sleepless nights about all the various stressors.

[583] So the rule of two is based on this idea that positive life events, things that you think might be really helpful to you to manage your stress.

[584] If you do them all at once, chances are it's not going to stick.

[585] So instead, aim to do two new things at a time, build them into your life over time.

[586] In the five resets, I offer five mindset shifts, 15 science -back strategies, and every step of the way, it's about two small changes at a time.

[587] You work with your biology of stress rather than against it and competing against it.

[588] That is how you make change possible.

[589] In clinical practice, when I was a medical resident learning how to take care of patients, my mentors would do the same thing.

[590] So this is 50 years later after that study.

[591] They taught me that when I'm seeing a patient, you know, a patient will come in with a laundry list of symptoms or they will have six, seven, eight medical conditions.

[592] You always focus on two things.

[593] Because if you say to the patient, I really think you should stop smoking.

[594] Here's some suggestions.

[595] Let's work on your weight and get your weight better.

[596] Let's work on your cholesterol.

[597] How about your blood pressure?

[598] How about minimizing chances of cancer?

[599] Too overwhelming.

[600] for the brain to sustain.

[601] Instead, let's focus on getting you to stop smoking and let's focus on lowering your cholesterol.

[602] These are two tangible things that you can work on.

[603] It takes about eight weeks to build a habit.

[604] Once you are engaged and that has become a habit for you, then you add two new things.

[605] Let eight weeks go by, then two new things.

[606] So over time, you do address that laundry list of symptoms, or in this patient's case, you know, all eight medical diagnosis, in the other patient's case who came in with everything but the kitchen sink approach to managing his stress, we eventually did get all the way to the finish line of fixing his stress and addressing all of the issues, but it only happens two small incremental steps at a time.

[607] The five resets.

[608] The first of those resets is to get clear on what matters the most.

[609] When you are feeling a sense of stress, you are living in.

[610] survival mode.

[611] You are governed by your amygdala.

[612] Its focus is self -preservation.

[613] You are literally living in the moment.

[614] Your prefrontal cortex is the area of your brain that, like we said, behind the forehead that governs forward thinking, planning organization.

[615] When you tell someone who is deeply stressed in a crisis or fight or flight mode, oh, just figure it out.

[616] you know, make a plan, figure out what's going to help you, and just do it.

[617] Mind over matter.

[618] None of that helps.

[619] It is also biologically impossible to think five, ten steps ahead when you are living in fight or flight mode governed by your amygdala.

[620] The first reset, get clear on what matters most, offers three concrete science back strategies that can help you when you are feeling a sense of stress and you're in fight or flight mode to help get out of your own way, create a roadmap and a plan forward.

[621] So it actively, by going through these strategies, you slowly get out of that amygdala mode and back to letting your prefrontal cortex take over.

[622] So how do I figure out what matters to me most?

[623] Is there a system?

[624] Yes.

[625] Most is an acronym, M -O -S -T.

[626] And the book has a whole structure, strategy of how to figure out what matters to you most.

[627] Because it's not so much what's the matter with me. It's what matters to me most.

[628] So when you shift that framework and stop blaming yourself and criticizing yourself of like this, you know, what's the matter with me?

[629] Why do I feel like this?

[630] Instead, have an external why.

[631] We know that when you have a why, you can get through things, right?

[632] Like you have a north star of like how do you want to get to that place.

[633] And so my job is to hold up a mirror and say, this is your why, because you figured it out using the strategies, the first reset will get you a clear plan and roadmap to that destination.

[634] So I'm going to do the first reset.

[635] So you have a stress score that you sort of initially do with your patients, right?

[636] So you figure out how stress they are.

[637] That's right.

[638] There's some questions, I think, in the book, which I'll put up on the screen for anyone that's watching the video.

[639] These are questions you ask your patient to help them figure out their stress score.

[640] Yes.

[641] And then the first reset is really figuring.

[642] out what matters to them, which is the acronym you're talking about most.

[643] Motivating, objective, small, and timely.

[644] That's like a, what am I doing with that?

[645] So I'm setting myself a goal or understanding what matters, what goals matter to me. And I want those goals to be motivating, objective, which means can you objectively and easily monitor this goal's progress?

[646] Small is the goal small enough to guarantee success?

[647] And timely is the goal time sensitive?

[648] Can you achieve it in the next three months?

[649] I've had so many patients, when I was seeing patients in Boston, I have had so many patients who have been stressed and they want to feel better, but they don't know why, because they are consumed with what's the matter with me, what's the matter with me, rather than what matters most to me. And so this is a way to reframe that internal dialogue and the conversation to what matters most to you.

[650] And so you figure out what your most goal is, and there are many examples throughout the book.

[651] The book is filled with patient stories, real life people who've had lots of different experiences.

[652] And there are examples of most goals.

[653] You know, some most goals have been, I want to throw, I want to teach my grandson how to throw a baseball.

[654] I want to go this summer on a hike and my knee's not hurt.

[655] How does that help me with my stress?

[656] Because you have something to look forward to.

[657] Okay.

[658] It takes me out of the present moment.

[659] And it also gives you something measurable.

[660] You know, when we, stress can often feel like this vague, nebulous thing that's happening to us, right?

[661] But we need a metric to measure our progress and the book is filled with metrics.

[662] And so the most goal is your first sort of like north star of this is where you want to go.

[663] And then there are various other strategies throughout the book of like how to get there and what to measure.

[664] We do this with, I don't know, we do this with every single, we do this with blood pressure.

[665] We check to see like if you have high blood pressure.

[666] We check, like, oh, your blood pressure is getting better with these interventions.

[667] But we don't do anything when it comes to stress.

[668] We just say, like, are you feeling better?

[669] Yes or no. And stress is not a yes or no question.

[670] There are degrees and shades of stress in there.

[671] So you need a quantifiable metric to say, yes, my stress is getting better.

[672] Why?

[673] Because I wanted to walk 20 blocks and guess what?

[674] I could walk zero blocks when I started with you.

[675] But now I can walk five blocks.

[676] And that is good.

[677] So whatever that goal is for you of like you're feeling a lot of stress because you've had a medical issue or, you know, whatever that most goal to you is, finding that goalpost to say like, okay, that's my destination and this is where I am today and then finding a way to get there.

[678] In this team here, there's about 30 of us at the Dyer of a CEO and we have a group inside the company which is about exercise and fitness.

[679] And we do that because so many members of the team love to exercise.

[680] I mean, even the team here in New York City, they went out for a long run.

[681] all of them together in the morning.

[682] And I think, you know, we do that because we have goals for fitness and we like exercise, whatever else.

[683] What is the evidence that shows exercise helps with stress management?

[684] What is the research?

[685] Reams of research on exercise helping with stress.

[686] And the real misconception is that you have to do a lot of exercise to manage stress.

[687] And that is unequivocally false.

[688] Even a little bit of exercise can help because it gets.

[689] you out of your head and into your body.

[690] A few minutes here and there can make all the difference.

[691] Park far away when you're driving someplace and you're going to a restaurant or you're going into a mall, a shopping center.

[692] Park far and walk if you can.

[693] Build it into your day throughout the day.

[694] Take the stairs if you can.

[695] It is just small incremental changes over the course of a day.

[696] Aim for 20 minute walk.

[697] It has lots of health benefits.

[698] It gets you out of your head into your body.

[699] It gets you into that daily habit of movement.

[700] Initially, when you are a sedentary person and a lifelong non -exerciser, going into the gym to exercise is like a complete deterrent.

[701] I remember as a medical resident when I was going through my stress struggle, I had a state -of -the -art gym in my building.

[702] I remember being incredibly stressed and, you know, I'm a doctor.

[703] I was like, oh, yeah, exercise is good for me. I walked into the gym.

[704] I saw the mirrors.

[705] I saw all of the fancy equipment.

[706] techno music blasting, I walked right out.

[707] Walked right out.

[708] I then started a walking regimen simply because it was nice out one day and I walked around the block.

[709] And then I was like, oh, that felt really nice.

[710] Next day, I walked around the block and then some.

[711] Did a five, 10 minute extra walk.

[712] And then the next day, it was manageable.

[713] It was a low lift.

[714] It was easy for me to do.

[715] It wasn't like all this complicated equipment.

[716] So I walked a little bit more and I just gradually moved up over the course of a week or two to 20 minutes.

[717] And then I committed to a 20 -minute walk.

[718] Over time, my self -efficacy, which is that ability of you to know, like, oh, I can do this.

[719] It increased, and that's what happens when you exercise and you do something like this, something small, a little bit every day.

[720] Your sense of self -efficacy increases.

[721] So you feel like, oh, I can do this.

[722] And your inner critic starts silencing.

[723] And then I started walking.

[724] Just the walkers, you know, not the extreme exercises, just the walkers.

[725] You're telling me there's research that shows those people that are less stressed in their lives and more resilient, per se.

[726] It's not so much that walkers are less stressed.

[727] It's that movement when you go from being sedentary to moving that this daily physical activity, even at low levels, can help decrease your stress.

[728] So it's not like at - And how?

[729] So many reasons.

[730] So the first reason is because something like walking is something that's a very natural phenomenon that all of us do.

[731] We don't really feel like walking.

[732] When we are feeling a sense of stress, you just want to be still.

[733] But science shows that, you know, you've heard of the expression, sitting is a new smoking.

[734] You've heard of that expression.

[735] But as research study found, that sitting can also increase your sense of anxiety.

[736] So it's not so much that sitting is the new smoking per se.

[737] yes, but it also has a tremendous impact on your actual mental health.

[738] And that movement is a antidote to that.

[739] So it's not necessary that you have to do excessive exercise, but even just a simple walk getting out low grade exercise has been shown to help with longevity.

[740] It's been shown to help with so many markers of health, just a simple walk.

[741] And yes, your team, you know, people like to run.

[742] I'm not saying that like you don't, you can continue running.

[743] But that's someone who is like a avid exerciser.

[744] And so they run.

[745] Some people walk.

[746] It doesn't really matter what you do.

[747] It's that you do something you enjoy a little bit every day.

[748] I want to talk about social media.

[749] And in your book, you use this term popcorn brain, which I for a second, when I read what popcorn brain meant, started to think maybe I now have a popcorn brain.

[750] What is a popcorn brain?

[751] Many people, most people, have popcorn brain.

[752] Popcorn brain is a biological phenomenon, a real biological phenomenon coined by a man named Dr. Levy, a psychologist.

[753] And it is essentially your brain circuitry starting to pop based on overstimulation.

[754] So it's not like your brain is actually popping, but it's that sensation of popcorning because of spending too much time online.

[755] It is hard to disengage from what's happening online because there's a constant information stream, and it is difficult to live fully offline where life moves at a decidedly slower pace.

[756] Popcorn brain is an affliction that nearly every single person has right now.

[757] Think about what you do when you're waiting in line at the grocery store.

[758] You're not just like letting your brain wander, pondering things, you are on your phone.

[759] What are you doing at the bank on your phone?

[760] At a car wash, at a traffic light.

[761] Pedestrians walking across the street, they're not looking up at the light.

[762] In fact, it's like one of the hazards, a public health hazard of pedestrians having near -miss accidents because they're looking down on your phone.

[763] I see it in Boston all the time.

[764] A busy street and people are looking at their phone.

[765] Most people listening now will be like on a tube somewhere on a train, on a plane, looking at their phone while they're listening to this, but...

[766] We rarely give our brains a moment of rest.

[767] So popcorn brain is different.

[768] A lot of people will ask me, is popcorn brain internet addiction?

[769] No. Internet addiction is a real, it's called internet addiction disorder.

[770] It's a DSM4 criteria.

[771] And it means that's our diagnostic criteria in medicine.

[772] And it's a real disorder.

[773] But what really defines internet addiction and popcorn brain is that internet addiction interferes with your life where you're unable to do certain things.

[774] Popcorn brain, on the other hand, is ubiquitous.

[775] It's everywhere.

[776] It is what defines modern life.

[777] Those two are very different things.

[778] And when we are feeling a sense of stress, we are especially prone to popcorn brain.

[779] Why?

[780] Because when we feel stress, we talked about the amygdala, right?

[781] Like that part of our brain that is focused on survival and self -preservation.

[782] Back evolutionarily when we were all cave people, there was a night watch person and that person would sit by the fire, the tribe would sleep, and that person would scan for danger to keep the tribe safe.

[783] In modern times, we have all become that night watch person.

[784] And we scroll incessantly when we feel a sense of stress because it is our primal urge.

[785] It is the way our amygdala feels a sense of safety because we are scanning for danger.

[786] We are no longer in a tribe.

[787] We're not cave people anymore.

[788] So what do we do?

[789] We scroll.

[790] That is how we are scanning for danger, especially when we are feeling stressed.

[791] In recent times, there has been a lot of bad news.

[792] In fact, it feels like the onslaught of bad news, one thing after another, whether it's a climate disaster or a conflict in a certain part of the world or something or the other is always happening now.

[793] The information stream, it is rapid and unprecedented.

[794] And so we are constantly scrolling and scanning for danger.

[795] And it's that primal urge to scroll.

[796] So how do we, the goal is really not to limit our social media use or media use because we know studies have shown that it is not about abstinence because that actually doesn't have an positive impact on our mental health or our well -being.

[797] But what does have an impact on our mental health and well -being is decreasing our reliance to our phones.

[798] You know, most of us check our phones 2 ,600 times a day.

[799] That is a statistic.

[800] 2 ,617 times a day is the average number of times a person looks at their phone.

[801] Think about that, right?

[802] The other thing you want to think about is when you're thinking about like, huh, do I have a reliance on my phone?

[803] It's like the goal here is to reconsider your relationship with your phone.

[804] It is not about abstinence.

[805] We're not trying to become digital monks here.

[806] It's about creating digital boundaries.

[807] In every relationship in your life, you have boundaries.

[808] You have a boundary with your partner, with your children, with your colleagues, because relationships need boundaries, right, to thrive.

[809] Why don't we have a boundary when it comes to the relationship we have with our phone?

[810] There is no boundary.

[811] It is simply porous.

[812] We check in morning, we check at night.

[813] What's the first thing you do when you wake up before your second eye is even open?

[814] You are scrolling.

[815] Studies show that 62 % of people check their phones within 15 minutes of waking up and about 50 % check them in the middle of the night.

[816] I'm guilty of this.

[817] I'm not going to pretend I'm some saint here.

[818] I'm that person.

[819] I'm on the upper end of that scale.

[820] I'm glued to my phone.

[821] glued to my phone.

[822] And you know what?

[823] When I'm stressed, I'm even more glued to it.

[824] That is facts.

[825] I tell you, when I'm stressed, I've got some bad habits.

[826] It's your primal urge to scroll.

[827] It's a feedback loop.

[828] You want to feel safe?

[829] Out the window.

[830] You know, all kinds of bad habits that are...

[831] And we can talk about the diet piece too.

[832] Some of them we can't talk about, but we can talk about the diet piece.

[833] For some reason, if there's ever a time in my life where my diet slips, it's when work is hard or when I'm, you know, when something's difficult in my life.

[834] That's when I just can't get out of that bad diet we're up for just, you know, just a moment.

[835] So we can do a small caveat because I think the social media piece is really interesting and what people, like everyone loves hearing about that.

[836] The reason that you crave high, so emotional eating is what you're describing when you're saying that your diet goes out the window when you're feeling a sense of stress.

[837] And that is because you're amygdala.

[838] When your amygdala, like I said, it's like I'm like a broken record when I say, your amygdala is focused on survival and self -preservation.

[839] your amygdala doesn't recognize a famine coming or bills or work stress right it's the reptilian part of your brain and so it is focused on survival and calories equals survival so when you are stress eating or emotional eating your body craves high fat high sugar foods that's just biologically what your body craves and that is why instead of berating yourself and letting that inner critic really instead of berating yourself and letting that inner critic really take off, like when you're craving, you know, chocolate cake or my guilty pleasure is tortilla chips.

[840] I just can't get enough when I'm under stress.

[841] What's your stress food?

[842] Not in your business.

[843] Carrot cake.

[844] Oh my God, I didn't.

[845] Listen, I can't get carrot.

[846] You know, carrot cake's not easy to get.

[847] You can't bake it yourself very easily.

[848] But I'd say like just things like that.

[849] Like sweet foods are probably my thing.

[850] when I'm really stressed.

[851] And sometimes I go through these periods.

[852] Maybe once every like three to four, I'm like really, I think generally, if you see what I eat, I think I'm really healthy.

[853] I think I do what I say.

[854] But there are moments, you know.

[855] And it should be that way because you're a human being and it ebbs and flows.

[856] And so you're not a robot, you're a mere mortal, as am I. And so even though I know all of the science, like put a chocolate cake in front of me when I'm stressed and I will, of course, it's my biology.

[857] Anyway, so we can talk about social media if you wish, but that is an important caveat because I think people often when you're stress eating and you're feeling a lot of stress like you even said right like I hate myself when I my diet is off and I start beating myself up I'm like Steve listen you got bloody podcasts of people that follow you that like you know I think you got you got to live what you say and then I'll just go through that moment of it's like it feels like most of the time I've got my hands on the steering wheel and I'm in charge and then once in a while I'm in the back seat and this car is on autopilot and we're just flying down the motorway and I'm like Jesus I'm trying to get back into the front seat and I'm struggling against suddenly the wind the windows are open shit's flying everywhere and then eventually I get a hold of the steering wheel again with one hand and then I can kind of pull myself back onto the steering wheel and we have another good couple of months you know discipline's returns and that ability that you have that where you are able to get out of the back seat get your whereabouts and get back into the front seat and the driver's seat that time for for you is likely maybe a week, maybe two weeks, max.

[858] Yeah.

[859] And because you have all of this knowledge and you've done this before, it's a muscle, right?

[860] It, like, grows that sense of agency and, like, I can do this.

[861] I know how to get this back on track.

[862] For others who may not have the practice that you have or the knowledge, it takes a longer time.

[863] And that is what I am trying to work on is, like, closing the gap between knowledge and action.

[864] understanding, by the way, that your brain, it takes eight weeks to build a habit, and falling off the wagon is part of habit building.

[865] So how?

[866] How do we close that gap?

[867] There's going to be people listening to this now that I've had everything you've said.

[868] They want to implement better habits in their life to counteract the stress they're experiencing.

[869] They want to get away from that red velvet carrot cake, whatever.

[870] But they don't have that sense of agency.

[871] Or they struggle to a more extreme extent.

[872] You don't have to have a sense of agency.

[873] In fact, my favorite patients have been the skeptical patients.

[874] and people who are like, I don't believe any of the stuff.

[875] When you follow the five resets and the 15 signs back strategies, your body, it's all based on the biology of stress.

[876] So when you start the process and you go through the first technique and the second technique, your brain and your body will just know what to do because you will be doing the work.

[877] It's all about the work of doing.

[878] And when you do better, you feel better.

[879] That's the mind -body connection.

[880] Your brain and your body are constantly speaking to each other.

[881] They're inextricably linked.

[882] What's good for your body is good for your brain.

[883] And when you do better, you feel better.

[884] but it's all in the doing and getting yourself into that moment of action when you have the information but you need to act, it's all about small, keeping it smaller than you think it is.

[885] So it's not about going to the gym for an hour every day when you're stressed.

[886] Forget it.

[887] Your amygdala and prefrontal cortex will be duking it out for that one.

[888] No way.

[889] You're not going to go.

[890] It's like you're waiting through molasses to put your sneakers on.

[891] But if you start small and say I'm going to go for a five minute walk today, you'll do it.

[892] But sometimes, that it's so small that it's almost humiliating.

[893] It's so small that it seems trivial.

[894] That's how it feels, right?

[895] For two minutes, what's that going to do?

[896] Two minute walk?

[897] That's going to do nothing.

[898] Trust the process.

[899] I'm not going to lose any belly fat with two minutes.

[900] It's not about losing belly fat.

[901] So the cosmetic promise of fitness has never propelled any of my patients from going from lifelong non -exercisers to exercisers, taught bellies, muscular physiques, Never the reason people exercise.

[902] People start exercising because those are all aspirational things.

[903] It's like they're out of reach.

[904] Most people who exercise, at least in my experience, who I have been able to convince to exercise, they exercise because of the mental health promise, not the physical health promise.

[905] In turn, they might have some weight loss.

[906] You know, we know that even if you exercise on a regular basis and have no weight reduction.

[907] whatsoever.

[908] You are still improving your cardiovascular health, your metabolic health, all of the other profiles.

[909] You can still improve even without any weight change.

[910] What my thing is about stress, right, like so mental health.

[911] So that's just the physical health aspect of it.

[912] Even just a 15, 5, 2 minute walk can make a difference in your biology of stress.

[913] I read in, there was a study in your book about how just taking even a 10 second break from your work can have an impact on your stress levels.

[914] study was done by Microsoft Labs.

[915] You know how we say you'll often hear like, oh, just take a break and, you know, because we often, when we're feeling a sense of burnout, an atypical burnout, an inability to disconnect from work, right?

[916] And then it's like, how are you going to get yourself back on track?

[917] I call it the Goldilocks principle.

[918] I talk about it in the five resets.

[919] Human productivity functions on a curve.

[920] It's not linear.

[921] It's not like, okay, like I'm going to just keep being productive, there's actually a bell -shaped curve for stress as there is a bell -shaped curve for human productivity.

[922] And so if you think about one side, you know, the y -axis as human productivity and the x -axis as stress, it's a bell -shaped curve.

[923] So when we are to the left of the curve, we're not feeling very motivated, we're bored, we're apathetic, chances are you're not going to be very productive.

[924] When you are to the far right of the curve, you're highly stressed, you're anxious, many of us are feeling this way, you're not going to be very productive.

[925] There is a sweet spot of human productivity right in the middle of that bell -shaped curve and that is the Goldilocks principle, the just right part of stress and human productivity.

[926] Now, many of us are to the right of the curve.

[927] We are anxious and keyed up and stressed out and we're not very productive.

[928] So how do we bring the science into everyday life?

[929] and apply it to our life.

[930] We can't just, like, chill out and, like, go for a month to Bali for a surfing holiday.

[931] Wish I could.

[932] Can't do it.

[933] Can't, you know, spend six months eating my way through Italy or hanging out in the Himalayas and a retreat.

[934] All of these things are my dreams.

[935] You have financial constraints.

[936] You have constraints with your family, obligations, all of these things.

[937] And so we can't do all of those things to suddenly scale back into that sweet spot of human productivity.

[938] So what can we do?

[939] we can honor our breaks.

[940] And there was a study by Microsoft done not too long ago, which showed that even taking 10 minute breaks, like three to four, 10 minute breaks throughout the day, can have a cumulative impact on your stress and can help with your mood, productivity, sense of engagement.

[941] So it's not like, oh, breaks are nice to have.

[942] They should be an essential part of your workday because it helps manage your stress in the workday.

[943] It is a way to honor your breaks to get.

[944] back into that sweet spot of human productivity so that you can have just right stress.

[945] And with that idea of just right stress, I want to make a point that not all stress is bad, stress isn't the enemy, our cultural perception of it is.

[946] There is good stress and bad stress.

[947] Good stress is adaptive stress.

[948] That's the scientific term for healthy good stress.

[949] Bad stress is maladaptive stress, that is the scientific term.

[950] Everything good in your life was created because of a little bit of stress.

[951] Like, you started this podcast, something really positive.

[952] You met your girlfriend, also something positive.

[953] You may have made a new friend as an adult, wonderful and positive.

[954] Chearing for your favorite sports team, also a positive thing.

[955] Now, when we think of the word stress in modern culture, we think about bad stress.

[956] Bad stress are all of the things that we already know, right?

[957] Like the feelings that we've talked about.

[958] But the goal of life is not, to live a life without stress because that is biologically impossible.

[959] Our brains and our bodies need stress to survive.

[960] It is to live a life with healthy manageable stress.

[961] It's to move away from unhealthy stress back to healthy stress.

[962] My calendar, and people see my calendar a lot because we have this vlog channel, my calendar is full of just like back to back to back to back meetings.

[963] I actually had a conversation with my assistant the other day.

[964] I was like, when you look at my calendar, there's actually not a 60 second gap between meetings, which means I'm continually like late because meetings always run over.

[965] And also you have to travel between one meeting to the next, or at least you might have to load up Zoom or something, which takes like 30 seconds.

[966] So I'm going to be 30 seconds late because there's not a gap.

[967] And when I was reading in your book about this Microsoft study that compared brain scans of people who were in back -to -back meetings with those who took short breaks and they found that the group taking short breaks experienced significantly less stress, it made a lot of sense to me because when I'm back to back to back to back to back, it's kind of like your kettle example.

[968] You have the, I'll put it on the screen, the kettle analogy of stress.

[969] I just feel like it's filling up with steam, you know?

[970] And then in the kettle analogy, when the steam comes out of the nose of the kettle, that's kind of when you let some of the stress out.

[971] So taking those gaps.

[972] Opening the lever.

[973] Oh, you can open the level.

[974] That also lets the stress out.

[975] That's what I don't have in my day.

[976] I don't have.

[977] I don't have.

[978] breaks like when this podcast ends right people will come through this door over there one by one and they have and Jack's laughing because he knows he's one of them he's he's way he's because he's closer so he gets in first I have like 17 things that I need to do for these people I won't even be able to make it to the toilet because someone's gonna want me to review something and that's my day every day you have to build in breaks and even if that means so you're putting it in your calendar again the study was 10 minutes.

[979] You can do as little as 10 seconds that research has shown.

[980] Why?

[981] Because neural consolidation, again, a very fancy scientific term, but it simply means that when we are on the go and moving, moving, moving, we are not always learning.

[982] And so when do you want to learn?

[983] Neural consolidation means that there's information floating in our brains.

[984] And consolidation, your brain lays down cements the information into knowledge, right?

[985] So there's information and knowledge.

[986] And neural consolidation is the process of the cementing of new information.

[987] And taking a break helps to do that.

[988] Wait, so if I'm listening to a podcast and something profound just gets said, I should pause the podcast and just wait 10 seconds to help with the neural consolidation.

[989] That would be wonderful.

[990] Interesting.

[991] On this podcast, one of the things I came to learn about was this gut -brain connection.

[992] Yes.

[993] I think Tim Speck was one of the first people to talk about that.

[994] Many of the guests have built on that knowledge.

[995] And now, if it wasn't for this podcast, I wouldn't understand the importance of the gut.

[996] I thought the gut was just where the food goes in, chemicals attack the food, processes it, poop, comes out the other end.

[997] What I've come to learn, which is really surprising and amazing, was that much of my mental health can be attributed to my gut.

[998] That is incredible.

[999] Isn't it?

[1000] Isn't it?

[1001] It is newly emerging science.

[1002] Honestly, every month we learn more and more about the gut.

[1003] gut -brain connection, the microbiome, which is an ecosystem of healthy bacteria that govern the gut -brain connection, and what you're speaking about specifically, an even newer entity called the psychobiome, which are a dedicated group of healthy bacteria in your gut, whose sole function is to manage mood and other mental health.

[1004] What?

[1005] So the bacteria in my gut, first of all, I thought bacteria were bad.

[1006] you know people always say get that bacteria off your hands to have some of this but you're telling me there's bacteria in my gut trillions trillions trillions of healthy bacteria and microbes living in your gut and they are very active it's an ecosystem and they have many different roles besides digestion we are learning honestly every month a new finding what the microbiome can do it can help regulate blood glucose the microbiome and we say it for the microbiome because we're talking about it as a one large entity but what is actually the microbiome and what constitutes the microbiome is trillions and trillions of healthy bacteria right so but we when we use the word microbiome we're saying it just because it's easier to say in parlance like when we're talking in your book i learned about serotonin in the gut yes three to five times more serotonin receptors in our gut than our brain.

[1007] Now, when you think about serotonin, Stephen, like, of course, serotonin's a brain chemical, right?

[1008] And yet, what does it do?

[1009] Serotonin is like the happy hormone.

[1010] For like mood and stress.

[1011] Yeah, mood, stress.

[1012] Like, you know about this very popular class of drugs called SSRI's selective serotonin re -uptake inhibitors.

[1013] They are used for anxiety and depression and lots of other mental health, you know, conditions.

[1014] And we always think of serotonin.

[1015] We call it a neurotransmitter or a brain chemical, when in fact we have more serotonin three to five times more in our guts than our brains, which just goes to prove how important the gut is.

[1016] It's truly our second brain.

[1017] So we can reset our stress by resetting our gut brain connection.

[1018] Yes.

[1019] And how do I reset my gut brain connection?

[1020] something that I have to eat?

[1021] So a lot of your microbiome and the health of your gut and your microbiome is governed in the same way of many things that we've talked about.

[1022] So sleep, of course, yes, diet, exercise, stress reduction.

[1023] There are many, many ways to help your microbiome thrive.

[1024] But yes, food is also one way.

[1025] So focusing on prebiotic and probiotic foods, there's, you know, there's many different avenues to that.

[1026] Okay, so a question then.

[1027] If I wanted to be, this is flipping the coin, if I wanted to be really, really stressed and really, really anxious, right?

[1028] And I wanted maybe have thrown some depression.

[1029] If I wanted stress and anxiety, how should I live?

[1030] That's a great question.

[1031] Get on your phone.

[1032] Make sure it's on high brightness and scroll through every social media platform, every news platform, watch graphic content of videos of horrible, terrible things happening in the world at midnight.

[1033] Keep doing that off and on until 4, 5 a .m. Your cortisol spike usually happens around 6 a .m., you know, give or take for people.

[1034] That cortisol spike is a natural thing that happens.

[1035] It's part of your circadian rhythm.

[1036] It's what prompts you to get up out of bed.

[1037] of course make sure that you are you know you check your phone right away right when you get up out of bed and continue scrolling um this is a really fun exercise of what not to do rather than what to do um it doesn't always happen it like it won't be one day because you do have some reserves but if you did this for one month i would say instead of like one day let's do it for one month Yeah, 30 days.

[1038] 30 -day plan to maximize anxiety and stress.

[1039] No movement whatsoever.

[1040] Just stay in bed.

[1041] Stay in bed or sit, you know, as sedentary as you can.

[1042] Skimp on your sleep as much as you can.

[1043] Yeah.

[1044] In every possible way.

[1045] Sleep late.

[1046] Keep waking up throughout the night and make sure that you get as little sleep as possible for as long as possible.

[1047] Don't spend time with anyone.

[1048] spent, you know, don't stay on your phone, day and night, day and night, day and night, no movement.

[1049] What else?

[1050] Do I go outside?

[1051] I can't go outside.

[1052] No, you're just going to sit.

[1053] Window?

[1054] No, don't even be near natural light.

[1055] Just sit in a chair if you can.

[1056] Make sure that you have, if you're on your phone, great, but if you have a TV on, make sure it's on in your bedroom too, on full volume all night long.

[1057] Is that, that's going to make me stressed?

[1058] Yes, it will.

[1059] keep it on like a news channel all night long.

[1060] Okay.

[1061] So, you know, we're joking about this, of course, but what I have experienced in my clinical practice is, you know, we are of a younger generation where we engage on our phones.

[1062] But many of the older generation, people in their 60s and 70s, many of my patients, in fact, were using, we're getting their news from their TV.

[1063] And I've had so many patients over the years who have told me that, They used to just watch TV that one hour of news a day.

[1064] Then it morphed into two hours and three hours.

[1065] And I've had patients who sleep with the TV on all night long.

[1066] And they didn't start off that way, but it just happened that way.

[1067] Again, talk about, you know, it's not the primal urge to scroll, so to speak, because they're not scrolling on a phone, but it's that night watchman phenomenon.

[1068] And so they are watching the news all night long.

[1069] They're not sleeping.

[1070] They're, you know, really in bad shape.

[1071] And so moving the TV out of the bedroom is one of the first intervention that I suggest to patients like that.

[1072] I'm hungry.

[1073] What do I do?

[1074] Eat at all hours of the day and night.

[1075] Don't even think about it.

[1076] The more processed food, the better.

[1077] Don't even read anything about the Mediterranean diet.

[1078] No fruits and vegetables.

[1079] I wasn't planning reading.

[1080] No water.

[1081] Lots of other beverages besides water.

[1082] More additives, the better.

[1083] And no regular meal times.

[1084] Erratic food.

[1085] Lots of it.

[1086] What's that got to do?

[1087] stress, erratic mealtimes?

[1088] Well, just because our brains like compartmentalization and structure, and so when you have a sense of structure throughout your day, it helps you plan better, it helps get out of the fighter flight mode and, you know, creates a little bit more of a balance.

[1089] And that's, that's really the main reason.

[1090] What about multitasking?

[1091] You say in the book, multitasking is a myth.

[1092] I think that I multitask sometimes.

[1093] 98%.

[1094] 100 % of people think they are excellent multitaskers.

[1095] but in fact, the science shows that only 2 % of human brains can effectively multitask.

[1096] Multitasking is a scientific misnomer.

[1097] There is no such thing.

[1098] When we multitask, what we are actually doing is task switching, doing two different tasks in rapid secession.

[1099] The opposite of multitasking is monotasking.

[1100] And the reason we want to monotask is because multitask, task switching has been shown to decrease and weaken our prefrontal cortex.

[1101] It decreases our ability to solve complex problems.

[1102] It impacts our concentration, mood, engagement, and a whole host of other things.

[1103] At this time in our lives, in the world and the state of the world as it is, we cannot afford to multitask because the world is filled with complex problems that need to be solved.

[1104] Instead, monotask.

[1105] One common question I get when I suggest monotasking is, how am I going to get everything done?

[1106] I need to multitask.

[1107] You don't need to multitask.

[1108] It's a myth.

[1109] You're actually not multitasking.

[1110] You're doing task switching, which is detrimental to your brain and your prefrontal cortex.

[1111] So the antidote to multitasking is monotasking.

[1112] And the way you do monotasking is time blocking.

[1113] In fact, I wrote the five resets doing time blocking.

[1114] It's the technique that I use for everything that I work on.

[1115] I started doing it in medical school because I had to consume vast amounts of information.

[1116] And how did I do that?

[1117] So what I would do is what is time blocking?

[1118] It's the Pomodoro technique.

[1119] You may have heard of it.

[1120] It was developed in the 1980s.

[1121] Pomodoro means tomato.

[1122] And an Italian researcher developed this technique and used a tomato -shaped timer, which is why it's called the Pomodoro technique.

[1123] And it's essentially time blocking.

[1124] So you set a timer for, say, 30 minutes.

[1125] or initially when you first start off, 20 minutes, 25 minutes.

[1126] And then you do whatever task you're doing, one task, and then you take a five -minute break.

[1127] Then you come back and you do another 25 -minute section of work, the next task, and then you take a five -minute break, 25 -minute, five -minute break, 25 -minute, five -minute break.

[1128] So at the end of like an hour, hour and a half, you have completed all of your tasks, but you have been monotasking, not task switching.

[1129] So you're protecting your prefrontal cortex, strengthening your prefrontal cortex, and not.

[1130] decreasing or making it difficult with attention, memory, concentration, et cetera, that multitasking does.

[1131] Does multitasking make you more stressed then?

[1132] Multitasking makes you more stressed, yes, because it decreases your sense of self -efficacy because most people aren't good at multitasking.

[1133] So then at the end, you haven't really completed, you've done a lot of different things, your attention is all over the place, you're on your Slack channel, you're trying to do five different tasks at once, you're not doing any of them well.

[1134] So at the end of that, hour and a half where you could have been monotasking using the time blocking technique, you don't feel that sense of accomplishment or completion.

[1135] We know that when we feel that sense of accomplishment and completion, we are just feeling less stress because you have a greater sense of agency saying like, oh, I can do this.

[1136] You know, it's like that same feeling of getting out of the backseat, going into the driver's seat.

[1137] What prompts that, it's like, yes, I have the ability to get out of the back seat and go into the driver's seat.

[1138] That takes some hutzpah, and that takes some agency and self -efficacy.

[1139] So many people listening to this, and you talk about this in chapter five of your book, where you're talking about the third reset, so many people have that subtle, you talked about it at the start as well, that subtle humming of stress and anxiety in their life.

[1140] It's just kind of like a background noise of their life.

[1141] I have that sometimes, often.

[1142] I have that subtle angst.

[1143] One of the things that's really helped me, which you talk about in the book, is breathing and learning some practical breathing techniques.

[1144] because you don't need to go to, I don't know, a therapist or go to some yoga class to do breathing on your own, especially sort of short breathing techniques.

[1145] What is the most effective breathing technique that anybody listening to this right now that has a little sense of angst could adopt instantly and repetitively as a habit in their lives that you've seen and that has been proven to be most effective in reducing that subtle angst?

[1146] Two.

[1147] First, diaphragmatic breathing.

[1148] It's how we all breathe as babies and somewhere in our adult.

[1149] adulthood or young adulthood, we lose our ability to innately do diaphragmatic breathing.

[1150] But if you watch babies, diaphragmatic breathing is belly breathing or deep belly breathing.

[1151] When people say belly breathing, I need you to explain this to me. How do I know if I'm doing it right?

[1152] Put your hand on your belly.

[1153] Put your hand on your belly.

[1154] Or one hand on your belly or both hands on your belly since we're doing diaphragmatic breathing.

[1155] And then you're going to take a deep breath in, let your belly expand.

[1156] Here, you're expanding your chest.

[1157] But what I want you to do is expand your belly and then let it out with your lips, purse your lips and get it out.

[1158] So you're always inhaling through your nose and exhaling through your mouth or your nose, but you're doing it very slowly.

[1159] So what you did initially is that you went with your chest.

[1160] And that's not diaphragmatic breathing per se.

[1161] What you're trying to do is just expand your belly and then let it fall.

[1162] and you want to get into somewhat of a natural breathing pattern.

[1163] You're forcing it right now because we're doing this like, you know, immersive instructional moment.

[1164] But you can then, as you get better at it, you can put your hand on your belly, both hands.

[1165] And as you're hanging out, talking to me, just let your belly rise and fall.

[1166] Is there a speed in which I need to exhale?

[1167] Not necessarily.

[1168] You want to be as slow as possible.

[1169] Some people, you know, in some yogic traditions say like the exhale should be done.

[1170] than the inhale.

[1171] The reason that breathing is truly a game changer when it comes to your stress response is because the breath is the only physiological mechanism in our body that is under voluntary and involuntary control.

[1172] So as you're writing down right now, you are breathing.

[1173] Your body is breathing.

[1174] You're not even thinking about it.

[1175] And then suddenly, if I say, hey, Stephen, want to try diaphragmatic breathing again, you can voluntarily start breathing again.

[1176] It is the only bodily mechanism that is under voluntary and involuntary control.

[1177] Your heart can't do that.

[1178] Your brain waves can't do that.

[1179] Your digestion can't do that.

[1180] It's all involuntary, right?

[1181] It's just happening.

[1182] But the breath is the one thing that you can control and then let go and it does it on its own.

[1183] And the reason the breath is so power, at mitigating the stress response and decreasing it is because when you are feeling a sense of stress and the fight or flight response, your breath involuntarily is short in your chest and rapid.

[1184] It's like this, right?

[1185] You're stressed, your heart's beating.

[1186] And that's also a physiological mechanism because your body's trying to get oxygen and you're anxious and your catacolamines and your cortisol and your heartbeat is racing.

[1187] So you're breathing quick.

[1188] And that is called fight or flight.

[1189] That is the sympathetic nervous system.

[1190] Your sympathetic and paratist sympathetic system can't be on at the same time.

[1191] So when you start forcing yourself to take deep belly breaths, you switch your mode into the parasympathetic system.

[1192] And that is called the rest and digest system.

[1193] And then that is what starts calming down your stress response in the moment.

[1194] And the second important breathing technique that I would really suggest people try is stop breathe and be.

[1195] It's a way to tap into your mind -body connection.

[1196] and it can be really helpful.

[1197] And the way you do that is, and it was the first technique I learned, and you essentially just stop whatever you're doing, breathe, and be.

[1198] It's three seconds.

[1199] Typically, it's done.

[1200] I did it when I was first starting in my, in a busy medical resident.

[1201] I did it right before I would knock on the patient's door of the exam room and I would turn the knob.

[1202] So I would stop, breathe and be.

[1203] I would knock and walk in.

[1204] You can do it right before your Zoom meeting.

[1205] mundane repetitive tasks is when stop, breathe, and be works best.

[1206] You can do it throughout the day.

[1207] You tap into your mind -body connection.

[1208] You get a sense of presence.

[1209] You take that mental break and then you go on.

[1210] So for you, Stephen, with your crazy schedule of not having even a moment, you could try stop, breathe, be before or after every single meeting as a bookend.

[1211] And what would that do to my brain?

[1212] That will immediately set off that it will go from sympathetic to parasympathetic, so it will switch the, it will flip the switch, and it will decrease your stress response in the moment.

[1213] It will prime your brain and body for what's next.

[1214] It will also help you in the moment because it will make you feel grounded and a sense of presence in the moment.

[1215] So you stop, you breathe, and you beat.

[1216] And you can say that, whisper that to yourself as you're doing it, and then as you get better, you know, you won't have to say that to yourself.

[1217] I do it constantly.

[1218] I did it right before I walked into this building, right before I saw.

[1219] sat down as we were getting the mic fixed stop breathe be just keeps you grounded and in the present moment it helps with the runaway train of stress and it keeps you in right here right now and keeps your mind where your feet are we talked about speaking to people when you have you know you're experiencing stress but one of the things i read about in your book is the importance of writing therapeutic writing and how that plays a really wonderful role in limiting our stress um Is there any research that supports the fact that if I just go home and write, that I'll experience less stress?

[1220] And if so, what is the research and what's going on there?

[1221] Yes, there's plenty of research.

[1222] A wonderful researcher psychologist named James Pennebaker from the University of Vanderbilt developed a technique called expressive writing, also known as therapeutic writing.

[1223] And the instruction is essentially for four days, write for 20 to 25 minutes, set a timer, and just write.

[1224] no one's going to see it, just write about a traumatic event that happened to you.

[1225] So whatever that trauma may be, I talk about it in the book.

[1226] It's like one of my patients who had a traumatic event or if something's gone on this week for you that you want to work out.

[1227] It doesn't have to be some deep -seated trauma.

[1228] It can be like you had an argument with your girlfriend.

[1229] You had something come up at work.

[1230] You were stressed about a project or you're getting into an argument with your parent or your child or whatever it may be.

[1231] You just set a timer on.

[1232] on your phone if you wish or a old -fashioned alarm clock or your, you know, your oven if you don't have, if you don't want to use your phone.

[1233] Set a timer for 20 minutes or 25 minutes.

[1234] Sit down with a piece of paper and a pen and just start writing about the event.

[1235] And then when the timer ends, you stop.

[1236] And then the next day you do it again.

[1237] Four consecutive days, you might notice an uptick in your distress on day two or day three and then it will just decrease.

[1238] That therapeutic writing has been shown to be effective for so many things.

[1239] It can be helpful for your mood and sleep and anxiety and irritability.

[1240] It's been shown to be helpful in studies to increase your GPA, to decrease hospital admissions.

[1241] It's been, it's wild what therapeutic writing has been shown to do.

[1242] It's called expressive writing.

[1243] What's going on there in the brain?

[1244] What's going on in the body?

[1245] What's making the, it's so therapeutic?

[1246] I think one of the things that is happening, is that there is, you had mentioned this earlier.

[1247] I think one of the things that's happening is likely cognitive reframing.

[1248] So first, you are on day one, and I've done this many, many times.

[1249] I practice therapeutic writing on a regular basis.

[1250] On day one, as you're writing, it's your amygdala speaking, right?

[1251] It's like your self -preservation and survival and your inner critic, and you're like blasting whatever issue is happening.

[1252] And then as you go through day two, three, and four, I think you're creating a safe space, you're processing a lot of your emotions.

[1253] It's very important to process a lot of your emotions and you're not keeping them stuck.

[1254] You're, you know, expressing yourself.

[1255] And then I think you're coming to your own conclusion.

[1256] So there's probably many, many things, active things that are happening in your brain.

[1257] You are moving away from amygdala to prefrontal cortex because you're thinking, strategizing, organizing your ideas.

[1258] You're expressing yourself.

[1259] We know that writing and just, you know, journaling is also very helpful.

[1260] Why?

[1261] Because it is a way to express.

[1262] yourself and let these nebulous ideas become concrete words and thoughts and feelings.

[1263] And then I think there's an element of self -efficacy and a sense of agency happening too because you are solving your own issue or figuring out a new angle, a new perspective, and you're looking at yourself, hopefully by the end, through a lens of self -compassion, which is also something that happens.

[1264] It made me think that, you know, it explains why if I send a message or an email when I'm stressed, it's never a good message.

[1265] I always regret it.

[1266] You know, like when you're having an argument with somebody or, like, you know, you might be with your girlfriend or your boyfriend and they've triggered you in some way.

[1267] Maybe you're tired and then you start responding.

[1268] Very bad time to send messages.

[1269] Very bad time to send anything.

[1270] Just stressed people are going to send the worst emails, aren't they?

[1271] Because the amygdala is right in the email.

[1272] That's right.

[1273] Take a beat.

[1274] Do it the next day.

[1275] That's why they say, sleep on it, right?

[1276] Sleep on it.

[1277] If it's a good idea today, it'll be a better idea tomorrow.

[1278] Interesting.

[1279] I wanted to talk to you about this last thing, which is live a lifetime in a day.

[1280] I've never heard this before, but you say this technique is the antidote to hustle culture.

[1281] Often, when you hear the term, live a lifetime in a day, it sounds like hustle culture.

[1282] It's like, cram it all in in a day, make it all count.

[1283] No, it's the antidote.

[1284] When we are going through life on autopilot and we are doing a million things, we often go to bed at night and we're like, what did we just do?

[1285] What was the point of all of that, right?

[1286] like human beings are meaning -seeking purpose -driven creatures and live a lifetime in a day is my universal prescription to patients it is helpful when you have 70 years to live it's helpful when you have seven days to live and what it essentially means is that there are six areas of what make up the arc of a long and meaningful life and the prescription is to bring those six areas into one day even for a minute or two.

[1287] So when your head hits the pillow at night, you have a sense of fulfillment, of meaning, of purpose.

[1288] The six elements of live a lifetime in a day are childhood.

[1289] Spend a few minutes every day in a sense of wonder and play, whatever that may mean to you.

[1290] Work, for most of us, it's hours.

[1291] So that's easy, right?

[1292] Like doing something, whether it's paid or unpaid, that gives you a sense of meaning and accomplishment.

[1293] Solitude.

[1294] Spend some time alone to reflect and really think about, we know that spending time alone is helpful for our mental health and well -being, also for creativity.

[1295] Vacation, that's an easy one.

[1296] Spend time, even if it's a few minutes a day, doing something you love.

[1297] And the example of that that is the most common that I've seen with patience is people love playing a musical instrument, let's say the guitar.

[1298] And this is one particular patient I'm thinking about.

[1299] And she loved playing the guitar and I asked her, when was the last time you played the guitar?

[1300] And she said, oh my God, it's been like six months.

[1301] And I have three guitars at home.

[1302] And I said, why?

[1303] She said, because I, like, have three kids and I have lots of stress.

[1304] And I have a job and my husband.

[1305] I said, well, what about just like two minutes every day?

[1306] Like, you know, bring that into your life.

[1307] You just do it for the joy of playing the guitar.

[1308] And so she did every single day.

[1309] And she played a song.

[1310] And then over time, she played two songs.

[1311] And then she started playing 30 minutes a day.

[1312] But initially, it's like that, you know, because we have that all or nothing fallacy.

[1313] So we don't do it at all.

[1314] Vacation.

[1315] So build that in a little bit.

[1316] Something that brings you joy.

[1317] Then family.

[1318] Doesn't mean you have to have a family, but spend time in community with loved ones engaging with some people, whether it could even mean a quick phone call.

[1319] And then finally, retirement.

[1320] Spend a few minutes, taking stock of your day, figuring out what worked, what didn't.

[1321] And then that is the prescription, essentially, to lead a wonderful, fulfilling life.

[1322] So when your head hits the pillow at night, you feel that deep sense of satisfaction.

[1323] You've hit all six areas, even if it's a minute or two, you're like, oh, yeah, I spent some time in childhood.

[1324] I spent some time, you know.

[1325] And that is the antidote to hustle culture, because when we are feeling stressed and burned out and always on the go and living with our amygdala, we often will be doing so much during the day and then we go to bed at night and we don't feel a sense of accomplishment at all.

[1326] And then you wake up and you do it again the next day.

[1327] And so how do you bring that sense of joy and meaning and purpose into our life every day?

[1328] that's one way.

[1329] What is the most important thing that we've missed?

[1330] So we talked about popcorn brain and that's what happens when we spend too much time on our phone.

[1331] There's also this concept of brain drain.

[1332] What happens to us and our brain power even when our phone is close by but not in use because of the sheer potential for distraction.

[1333] So our phones are really powerful.

[1334] They are not benign devices.

[1335] One antidote to popcorn brain and to brain drain is a media diet.

[1336] And there are really three ways that you can instill this media diet into your life to help with your primal arch to scroll.

[1337] The first is time limits, 20 minutes a day and set a timer if you have to for engaging and consuming bad news.

[1338] The second is geographical limits during the day.

[1339] Keep your phone 10 feet away from your workstation, if you can, out of reach, out of arms reach, and at night off your nightstand.

[1340] keeping your phone off your nightstand could be the biggest game changer because in the morning when you wake up like most people checking their phone instead you aren't just scrolling you're getting up maybe brushing your teeth using the bathroom and then you can engage with technology but that one small shift could be key and the third is to set some logistical limits so creating some sort of boundary in a digital boundary could make all of the difference in your relationship with your phone, thereby improving your stress and mental health.

[1341] There's a lot going on in the world right now.

[1342] There's a lot of bad news.

[1343] There is wars.

[1344] There is, I mean, in the whole sort of two decades that I've been on the internet, social media, I have never lived through a moment.

[1345] Maybe the pandemic was somewhat similar, but I think this is maybe even more extreme, where I go on my Instagram and I see videos and photos of dead babies.

[1346] not that far away from where we are in Europe relatively.

[1347] And there's a sort of trauma involved in that, so much so that the other day I walked into my kitchen and my partner was sat there and she's just crying.

[1348] And she's looking at her phone and she's crying.

[1349] And, you know, I put some things on her phone just to make sure that she wouldn't accidentally stumble across those things again.

[1350] And then the next day we had the same situation happen where she was in the kitchen and she was very, very upset.

[1351] She was, again, tears coming down her face.

[1352] She's, like, struggling with it for multiple days in a row.

[1353] And it just made me think that's an extreme example, but, yeah, I mean, like...

[1354] It's not an extreme example.

[1355] I had the same thing happen to me. I knew all the science, and yet I was also weeping, and I think many people are feeling exactly like your girlfriend.

[1356] And the science supports this.

[1357] You know, we're experiencing, in many ways, it's like the cycle of trauma, and a researcher who I spoke to for my book, Roxanne Silver, who is a psychologist.

[1358] in California, has shown through multiple studies that your risk of PTSD increases when you consume graphic images, even if the thing that you're consuming is happening thousands of miles away.

[1359] Like the war.

[1360] Like any conflict, any climate disaster, anything.

[1361] If you start consuming graphic images and videos, you increase your risk of PTSD, your own personal risk, even though you have not had any direct trauma because it's indirect trauma that you're seeing.

[1362] And so it's a cycle.

[1363] The more videos you consume or the more graphic content you consume, your amygdala gets fired, your primal urge to scroll starts going haywire, and then you scroll some more, and then you scroll some more because you don't feel safe.

[1364] You don't, you know, so this is a common occurrence.

[1365] It is not uncommon.

[1366] It is your biology working as it should because it is your biology of stress and clickbait and doom scrolling are both powered by the same biology that governs the fight or flight response.

[1367] And there is actual data to show that it increases your risk of PTSD and increases your risk of getting mental health conditions later in life.

[1368] So years later.

[1369] When I think about all the things that are going on in the world, I'm conflicted, right?

[1370] Because you can't ignore those things.

[1371] But at the same time, those things are giving you.

[1372] PTSD.

[1373] That's right.

[1374] Well, the key is, and I work in journalism.

[1375] I'm a medical correspondent.

[1376] It's not about censorship.

[1377] Being an informed citizen is critical at all times, especially now.

[1378] You have to be an informed citizen, but you have to create some digital boundaries.

[1379] So you're protecting your sanity and protecting your mental health.

[1380] There are also other ways that you can get involved by supporting various causes and donating and taking action.

[1381] We know that that is also very helpful.

[1382] But you want to limit your engagement with graphic content.

[1383] You can also limit your engagement with looking at videos and looking at images and instead read about it, right?

[1384] Like follow certain accounts that you trust and read about what's happening in the world.

[1385] It is not about censorship because the news and journalism, and I am speaking from the perspective of being a journalist or correspondent, it's vital.

[1386] It's vital to democracy.

[1387] It's vital to functioning society.

[1388] But there has to be a line between being an informed citizen and protecting our mental health and our sanity.

[1389] And understanding that if you are having difficulty sleeping, if you notice any alarm signs, like mood disorders, if you're having an uptick in anxiety, depressive thoughts, thoughts of hurting yourself, hurting others, that you should seek counseling and seek medical attention.

[1390] Because these are not benign thoughts.

[1391] Like you, you know, it's very easy to say, oh, but it's happening far away.

[1392] I shouldn't be feeling like this.

[1393] don't should yourself, right?

[1394] Instead, seek the help because this data shows that you are at risk if you are over -consuming.

[1395] There is a fine line between consuming and over -consuming the news at any time, especially now, but really at any time.

[1396] You wanted to show me something on the paper?

[1397] I wanted to talk to you a little bit about this idea of we are all hyper -connected.

[1398] We've already talked about all of the data about, you know, we look at, we touch our screens, our phones, 2 ,617 times a day.

[1399] we, you know, think about like how many times we breathe in an hour.

[1400] It's 960 breaths that we take an hour.

[1401] And some people are touching their phones like that much.

[1402] And if you want to check your reliance on your phone, it's very easy to check.

[1403] You just like keep your phone far away for three or four hours and take a piece of paper and do a tick mark every time, like a tally, every time you feel like you want to check your phone and see what that impulse is.

[1404] And you'll be shocked at how often you're checking your phone.

[1405] I want to kind of talk a little bit about this idea of hyper -connected and that we are all hyper -connected, but we are disconnected.

[1406] And I write about this in the five resets.

[1407] The loneliness epidemic, it's really a pandemic.

[1408] Globally, loneliness levels are higher than they have been in years.

[1409] And one statistic, 330 million people globally go two weeks before speaking with anyone, family, friends, anyone.

[1410] Loneliness, is something that is a real concern because we know that when we are not spending time with people and we feel a sense of loneliness, and that's different than being alone, by the way.

[1411] When you are feeling a sense of loneliness, it actually has a health outcome.

[1412] Loneliness has been found to be equal to smoking 15 cigarettes a day.

[1413] It increases your, it increases your risk of heart disease by 30%.

[1414] It increases your risk of stroke by 30 % and it shortens your lifespan.

[1415] So all to say that we are spending more time alone now than ever.

[1416] And you could be an introvert.

[1417] You could be an extrovert.

[1418] It's not about necessarily your personality type.

[1419] It's about feeling that sense of connection and community.

[1420] And that is really an antidote for stress.

[1421] We have a closing tradition on this podcast.

[1422] The tradition is that the last guest leaves a question for the next guest not knowing who they're going to be leaving it for.

[1423] and the question that's been left for you is this is a great one for you I think what idea that you once held to be true turned out to be entirely false I love this question and I've thought about it so often because I one idea that I used to think was true is that people's internal experience and external presentation match up So if you see someone who's really confident and put together, it's because inside they feel confident and put together.

[1424] And through my own lived experience as just a human in this world, as a doctor treating patients, as a speaker speaking to tens of thousands of people, I so deeply know that that is not true, that people will often look a certain way and look put together and confident and happy and smiling, but they are struggling inside.

[1425] And so I try, try to do this and so, you know, corny cliche, but be kinder than necessary because everyone is fighting a battle you know so little about.

[1426] Thank you so much.

[1427] Thank you so much for both the wonderful compliments you've given us on and off camera about what we do here.

[1428] But thank you for helping us build this show, make it even better.

[1429] The things that you talk about in your book are so timely.

[1430] You know, the subject matter of stress and burnout and resilience and all of these things are so timely.

[1431] And reading through the book has helped me to reframe.

[1432] both my perspective, but maybe even more interestingly, some of my terminology, because there is certain loaded terminology that we all use and there's certain ideas we have about stress and resilience and stereotypes that are completely unhealthy, that I'm 100 % guilty of using and furthering.

[1433] You're also a wonderful communicator.

[1434] I think the way that you approach this subject matter is through a very empathetic lens, and you're able, I think, to bring both sides of the conversation and the argument, per se, with you.

[1435] And when I say both sides of the argument, I mean the people on the one side who think that all stress is great and that, you know, the hustle culture side, but also the other side that I think we should never do anything that's stressful whatsoever.

[1436] There's a, there's a nuanced middle ground which you approach so articulately based on science and the work that you've done for the entirety of your life.

[1437] And it's such important work.

[1438] It's increasingly more important work.

[1439] And hopefully more of us can realize that chronic stress is not natural.

[1440] It's not to be glamorized per se.

[1441] And it is not a sign of success.

[1442] And really, there's something else we should be aiming at in our lives, which will get us closer to the happiness, fulfillment, connection that we're all seeking.

[1443] And that's what your book endeavors to do and does so well.

[1444] So thank you for being here today.

[1445] And thank you for the wisdom and the gems that you've given me, because I'm sure it'll change my life and nudge me in a better direction.

[1446] Thank you so much, Stephen.

[1447] Like I told you before I am a fan and you're such a great interviewer and this is testament like you're reading back the book to me and it just is you know it is so beautiful and you really get at the heart I think what you do so so well and I've noticed this when you are doing your interviews is that you really get to the heart of the person's work that you're talking about but you also get to the heart of who the person is and I really admire that because ultimately while we all do our work, we are humans doing this work.

[1448] We are mere mortals of flesh and blood.

[1449] And I think that's something that you do so well is that you really show the humanity in each person and their work, but it's so much deeper.

[1450] And I think that's why your podcast is so successful.

[1451] You share your own humanity and you bring out the humanity and the people you speak to.

[1452] So thank you.

[1453] Thank you.

[1454] Honestly, you know, people say to me all the time, they're like, oh, you must get sick of hearing this and all that stuff, but every single time I get feedback, it really does, there's not been a time as someone who's giving me feedback on this podcast that I don't feel like I've learned something.

[1455] And in that, what you just said there, I learned something again, you know, and it's reinforced something that I believe.

[1456] So thank you so much for showing that you didn't have to.

[1457] And thank you for being here.

[1458] And this is the start of our relationship.

[1459] I'm looking forward to the rest of it.

[1460] Thank you.

[1461] It's really rare to be a fan of something and then do it and have a greater esteem for it afterwards and that is what has happened today my friend oh wow thank you come give me a hug do you need a podcast to listen to next we've discovered that people who liked this episode also tend to absolutely love another recent episode we've done so i've linked that episode in the description below i know you'll enjoy it