Speaker 1: You know, t T. I think we can really convince
Speaker 1: ourselves of a lot of things.
Speaker 2: Yes, I've convinced myself of a lot of things, Like
Speaker 2: I'm six foot tall. I am also four foot eleven.
Speaker 1: Listen, different circumstances require different heights exactly.
Speaker 2: Sometimes I'm like, how did I have my head on
Speaker 2: this doorframe? Right? I'm six foot I'm not six foot.
Speaker 1: But you know, I think if the past year has
Speaker 1: taught me anything. My friends used to tell me that
Speaker 1: I was a hypochondriac, and I said, Oh, they're just
Speaker 1: throwing that word around. They don't really mean that. But
Speaker 1: the mind body connection, when I get it in my mind,
Speaker 1: they're like, oh I might be sick. It's like, oh,
Speaker 1: I'm failing. I'm not well, even if I was having
Speaker 1: those symptoms before. As soon as I decided in my brain,
Speaker 1: I've fallen into a dcline like it's a rap. And
Speaker 1: I think we really need to explore that a little
Speaker 1: bit more. That mind body connection underrated. I'm TT and
Speaker 1: I'm Zakiyah and from Spotify. This is Dope Labs. Welcome
Speaker 1: to Dope Labs. We're a weekly podcast that mixes hardcore science,
Speaker 1: pop culture, and a healthy dose of friendship.
Speaker 2: This week, we're talking about how the mind and the
Speaker 2: body intersect. Specifically, we really wanted to know more about
Speaker 2: the mind's ability to affect how we feel, whether that's
Speaker 2: better or worse.
Speaker 1: You may have heard the term psychosomatic before.
Speaker 2: I've heard it on TV, you know, like on medical dramas,
Speaker 2: but I've never really been sure about the actual definition.
Speaker 1: Well, it means something that involves both the mind and
Speaker 1: the body. So literally the word pairs the Greek words,
Speaker 1: which means of the mind, with soma, which means of
Speaker 1: the body.
Speaker 2: And today we're going to talk about just how connected
Speaker 2: those two things really are, all right, T T. I
Speaker 2: think I know what you're gonna say. I'm very excited.
Speaker 1: Let's kick off the recitation. I think the thing that
Speaker 1: we all know is that our minds are very strong.
Speaker 1: Our minds are like the central hub for our bodies.
Speaker 1: But sometimes we can't trust these minds absolutely.
Speaker 2: I know my mind has definitely played tricks on me,
Speaker 2: and I can think of a few times your mind
Speaker 2: has played tricks on you. There have been a few
Speaker 2: bugs that I've been asked to dispose of, and they
Speaker 2: were a lot smaller than what you had originally said
Speaker 2: that they were.
Speaker 1: I have a mind of scale, you know, it was
Speaker 1: able to easily scale. Now, some people might think that's positive, okay.
Speaker 2: And so one of the ways that our mind can
Speaker 2: positively affect us is the placebo effect, right. So I
Speaker 2: think a lot of people have heard of the placebo effect,
Speaker 2: and it's usually associated with drug trials where they might
Speaker 2: be testing out a drug and then they give a
Speaker 2: certain group of people a placebo, so just a sugar
Speaker 2: pill instead of the actual drug. And if the people
Speaker 2: are aware of what the effects of the drug should be,
Speaker 2: their mind might trick them into saying that they do
Speaker 2: feel those effects. Yeah, And I've also heard of hypochondria,
Speaker 2: So I think that's a term that people use a lot,
Speaker 2: but I don't really know the difference between yes, being
Speaker 2: a hypochondriac or you know, other things.
Speaker 1: And then I think the other question I have is
Speaker 1: around psychosomatic disorders and symptoms. When we say what do
Speaker 1: all these things have in common? I think for me,
Speaker 1: it's the connection of the mind and the body absolutely,
Speaker 1: And then that leads us to our overarching question for
Speaker 1: this episode, which is, how does the mind have control
Speaker 1: over the matter? You know, the body those are some
Speaker 1: very good questions and I cannot wait to hear the
Speaker 1: answers for today's dissection. Our guest expert is doctor Susanne O'Sullivan.
Speaker 3: My name is Susan O. Sullivan. I am a consultant
Speaker 3: neurologist and clinical neurophysiologist based at the National Hospital for
Speaker 3: Neurology in London.
Speaker 2: We just want to have a greater understanding of what's
Speaker 2: happening in this mind body connection.
Speaker 1: We've reached out to doctor O'Sullivan on our quests to
Speaker 1: really understand how aware is too aware. So when you're
Speaker 1: paying attention to your body, is that good? Or can
Speaker 1: you venture into this area where you're paying too much
Speaker 1: attention and then your mind is playing tricks on you?
Speaker 1: And I think that was our starting point. The mind.
Speaker 3: The first thing to say is that our mind is
Speaker 3: constantly altering our physical sort of experience of the world
Speaker 3: and our experience of our own bodies. So the mind
Speaker 3: body interaction is much greater, I think than most people realize.
Speaker 2: Our brain is constantly making assessments. Our brains are never resting.
Speaker 2: It's not just as simple as oh I touched this
Speaker 2: hot stove out, let me pull my hand away. It's
Speaker 2: also taking memories from the past stored in your mind
Speaker 2: to inform your body's reaction.
Speaker 1: A good example of this is how we sometimes react
Speaker 1: in anticipation of something. So if you've ever said our
Speaker 1: winced before you even got hurt, or like you know,
Speaker 1: you always stub your toe on that side of the bed,
Speaker 1: it's because our brains are working so fast and processing
Speaker 1: so many things that it's just automatically giving you that
Speaker 1: signal you're about to get hurt or you are hurt. Actually,
Speaker 1: and if you took the time to acknowledge every single
Speaker 1: thing your brain is processing, we probably wouldn't even make
Speaker 1: it out a bit.
Speaker 2: So, now that we have a baseline for understanding how
Speaker 2: the mind operates under typical circumstances, let's talk about what's
Speaker 2: happening when certain processes in the mind are stronger, louder,
Speaker 2: and more prominent.
Speaker 1: I think that's a good point what you said about
Speaker 1: understand the typical circumstance, because I think we take for
Speaker 1: granted that in all physical disease there's a mental component. Absolutely,
Speaker 1: if I break my ankle and it inhibits my mobility,
Speaker 1: depending on how it feels to me that my subjective
Speaker 1: experience that could be really devastating, that could lead to
Speaker 1: depression other things. There's a mental component to every physical disease.
Speaker 1: I think would you agree with.
Speaker 2: That absolutely, because I mean, using the same like break
Speaker 2: your ankle situation, your brain starts to tell your body, Okay,
Speaker 2: you need to lean more on if it's your right angle,
Speaker 2: lean more on your left hand. Yes, So you start
Speaker 2: to compensate for whatever that injury is. Like we've all
Speaker 2: been there with different things. Your brain is making all
Speaker 2: of these corrections in the presence of these injuries.
Speaker 1: And I think over the past couple of years, this
Speaker 1: is something that we've really come to understand more and
Speaker 1: accept more, both in the medical field and in the
Speaker 1: general population. People see how stress can exist to ascerbate
Speaker 1: other physical factors.
Speaker 2: Oh my gosh. Yes, when we all started working from home,
Speaker 2: like when the lockdown was really in place, I think
Speaker 2: we all started to feel that stress.
Speaker 1: And I think something we've been interested in and what
Speaker 1: we want to explore with doctor O'Sullivan is what are
Speaker 1: some of the other ways that the mind can control
Speaker 1: the body. And we see something that is a new
Speaker 1: physical symptom that is completely controlled by the mind or
Speaker 1: completely driven by the mind, and I think that's what
Speaker 1: basically psychosomatic disorders are.
Speaker 2: It really makes me start to think a lot more so,
Speaker 2: what are some other ways that the brain can produce
Speaker 2: or manifest a physical symptom or something that isn't necessarily
Speaker 2: linked to it. I really want to know the actual definition,
Speaker 2: like what falls under the umbrella of psychosomatic disorder?
Speaker 1: Yeah, what does it mean?
Speaker 3: So that means real physical symptoms. And I'm really emphasizing
Speaker 3: the word real because I think people when they hear
Speaker 3: psychosomatic they start thinking imaginary. But these are real physical
Speaker 3: symptoms that are for psychological reasons. I'm going to qualify
Speaker 3: the word psychological a little bit there, because again people
Speaker 3: think psychological means madness, insanity of some sort. You know,
Speaker 3: when I'm using the term psychological, I'm really talking about
Speaker 3: all the different functions of the mind, not necessarily pertaining
Speaker 3: to a psychiatric illness, for example.
Speaker 1: So there are psychosomatic symptoms, and you get these different
Speaker 1: symptoms within a psychosomatic disorder, But what about hypochondria. How
Speaker 1: is that related to psychosomatic disorders.
Speaker 3: It's not to say they're not related at all, but
Speaker 3: they are different phenomenon psychosomatic symptoms are physical symptoms with
Speaker 3: or without psychological distress. Hypochondria is psychological distress, probably without
Speaker 3: any actual physical symptoms. So their predominant experience really is
Speaker 3: the anxiety, and the thing that's disabling them is anxiety
Speaker 3: about illness.
Speaker 1: So these almost feel like opposites, right, because hypochondria is
Speaker 1: sheer psychological distress but no actual physical manifestation. It may
Speaker 1: be anxiety or anxiety about illness, but with no physical symptoms.
Speaker 1: But on the other hand, it seems like psychosomatic disorders
Speaker 1: present with these physical symptoms.
Speaker 2: What kind of symptoms do they have? Do psychosomatic disorders
Speaker 2: always present themselves in the same way.
Speaker 3: Every physical symptom you can imagine can be produced through
Speaker 3: psychological mechanisms, so the symptom can be anything, And I
Speaker 3: find the symptom is often determined either from their personal
Speaker 3: experience or their knowledge base, or as a result of
Speaker 3: a specific thing that's happened to them. And therefore all
Speaker 3: of these sort of psychosomatic symptoms are drawn usually from
Speaker 3: our environments.
Speaker 1: I feel like this makes a lot of sense, especially
Speaker 1: when we think about COVID nineteen. When you think back
Speaker 1: to the early days, I'm talking March and April of
Speaker 1: twenty twenty. We didn't know what was going on.
Speaker 2: Those were crazy times, yes, and people were just saying,
Speaker 2: are you experiencing shortness of breath?
Speaker 1: Are you having chest pain? I was like, maybe I
Speaker 1: was double checking everything.
Speaker 2: I would run up the steps and be like, am
Speaker 2: I usually this winded? I don't think so. And so
Speaker 2: then I was making myself nervous.
Speaker 1: And I was checking my temperature with the back of
Speaker 1: my hand, and I would say to myself, boiling hot,
Speaker 1: you definitely have a fever.
Speaker 2: But you had just gotten off the bike.
Speaker 1: But then I would get my thermometer and it wouldn't
Speaker 1: even say ninety eight point six. So clearly my mind
Speaker 1: was telling me something different than what was really going on.
Speaker 2: Similar things were happening with me because it was allergy season,
Speaker 2: and so I'm coughing because I have allergies and sneezing
Speaker 2: and I'm having issues because I also have asthma and
Speaker 2: using inhaler, and so I was just like, I don't
Speaker 2: know what's linked to what. I couldn't focus and figure
Speaker 2: out if this was just my mind playing tricks on
Speaker 2: me and these are just my allergy symptoms, or if
Speaker 2: you know COVID had got me.
Speaker 1: Did your allergies always feel like that?
Speaker 2: Exactly? I was like calling in the question. Literally, everything are.
Speaker 1: Usually based in something that you've experienced. So we were
Speaker 1: all aware and experiencing a respiratory virus that was sweeping
Speaker 1: across the globe. So everybody's thinking about their breathing. Yeah,
Speaker 1: but you can imagine if it wasn't confined to the
Speaker 1: respiratory system and it was related to something else, like.
Speaker 2: A hair loss pandemic, I would be counting all of
Speaker 2: the hairs in my white tooth comb a little bit closer.
Speaker 1: Yes, every straight hair would be a cause for panic.
Speaker 2: Every hair matters.
Speaker 1: The interesting part that doctor os Sullivan was saying is
Speaker 1: that it usually starts with an actual disease. So if
Speaker 1: you've had some bad bout of like gastro enteritis. What
Speaker 1: is gastro enteritis? I've never heard of that. You might
Speaker 1: not have heard of it, but you might have experienced
Speaker 1: it if you drink contaminated food or water. Some people
Speaker 1: call it the stomach flu.
Speaker 2: Oh, yes, it is awful.
Speaker 1: Upset stomach okay.
Speaker 2: Upset stomach diarrhea, yeahpops.
Speaker 1: No commercial. But I've always been more of a fan
Speaker 1: of Kopec tape.
Speaker 2: My friend is choosing Okay, I think we've all been there.
Speaker 1: So if you had a bad about of gastro enteritis,
Speaker 1: you're already focused on your stomach, so your psychosomatic symptoms
Speaker 1: could manifest around the gut. But interestingly, that's not where
Speaker 1: they always manifest. Doctor O'suliva says, you know, you could
Speaker 1: start with the gut because that's what you're familiar with,
Speaker 1: But there's also a possibility that you have symptoms that
Speaker 1: kind of move around the body too.
Speaker 3: But then once a person is prone to these disorders,
Speaker 3: one characteristic of them is that they tend to move around.
Speaker 3: So people are particularly badly affected by this will often
Speaker 3: have come to me with a list of diagnoses, you know,
Speaker 3: and these will be young people because it's often to
Speaker 3: sort of young people. You might see someone who's twenty
Speaker 3: years old and they walk in the door and they've
Speaker 3: got ten separate diagnoses because they are someone who has
Speaker 3: a tendency to express themselves through physical symptoms and that
Speaker 3: moves around their body of putting to what's happening in
Speaker 3: their lives.
Speaker 2: What I want to understand is, like, how how does
Speaker 2: the mind create physical symptoms without a specific biological trigger.
Speaker 1: We ask doctor O Sullivan to walk us through how
Speaker 1: this really works, this circuitry of stimulus and response and risk.
Speaker 3: Even so, I think the most important thing to know
Speaker 3: in this question is about a thing called top down processing.
Speaker 3: So I think a lot of people sort of have
Speaker 3: the kind of concept that you're you're looking at something
Speaker 3: and you're almost recording it, like a camera or a
Speaker 3: video recorder or something that you're just soaking up information.
Speaker 3: And when you learn about neurology as a neurologist or
Speaker 3: as a biologist, you learn about you know, this is
Speaker 3: where the nerves begin and they travel up through the body,
Speaker 3: and it makes it sound very electrical. It makes it
Speaker 3: sound like a light switch or something, but it's not
Speaker 3: like that. What's actually happening is that as a sensory
Speaker 3: stimulus is entering, be it a visual stimulus or a
Speaker 3: sensation or a sound, it is being compared by top
Speaker 3: down processing to priors and expectations that you have stored
Speaker 3: in your brain. So we have all these expectations stored
Speaker 3: in our brains, and when we look at something, as
Speaker 3: the information is entering from below, it's also being processed
Speaker 3: from above and compared with our expectations.
Speaker 1: Are you thinking what I'm thinking?
Speaker 2: Absolutely, I think we're about to say the same thing.
Speaker 2: Doctor rober Wiley here from Lab thirty. Yes, yes, doctor Wiley,
Speaker 2: that's right. Doctor Wiley talked about this type of dual
Speaker 2: processing in Lab thirty. We call it science sale delivered.
Speaker 2: Our brain creates shortcuts while we're reading this.
Speaker 1: Is while you know. It really is all about our
Speaker 1: brains and their previous experiences and expectations.
Speaker 3: You know, there are lots of kind of thought experiments
Speaker 3: you can use that will show to people how easy
Speaker 3: it is to derail your body. So you know, if
Speaker 3: I ask somebody to walk on a narrow line on
Speaker 3: the road, you know most of us could do it
Speaker 3: with no difficulty. If I asked you to walk exactly
Speaker 3: the same line on the edge of the cliff or
Speaker 3: the top of a high wall or something, it changes
Speaker 3: the way you think about your body, and your entire
Speaker 3: coordination has now been changed. And I've done nothing but
Speaker 3: changed your position.
Speaker 2: I actually had this happen to me, So me and
Speaker 2: my husband went on a really long hike for our honeymoon,
Speaker 2: don't ask about it, and I fell pretty far at
Speaker 2: one point, it was very traumatizing because I was very scared.
Speaker 2: I thought I was going to die. So I went
Speaker 2: from being surefooted so like not even really paying attention
Speaker 2: to how I walk or what I was doing, so
Speaker 2: feeling like every step that I took could be the
Speaker 2: end of my life. So now even if I'm walking
Speaker 2: on like a tall curb, I'm shaking. I don't know
Speaker 2: what's going on. I'm like, this is a little bit
Speaker 2: high up off the ground, and I'm not sure if
Speaker 2: I can make it. Yeah, So I'm not injured and
Speaker 2: I'm not hurt. You know, I was a little banked
Speaker 2: up at the time, but I'm doing fine now. But
Speaker 2: it's simply my lived experience that causes a new physical
Speaker 2: manifestation or a new reaction to this environment or a
Speaker 2: set of circumstances. But that makes sense, you know, I
Speaker 2: don't have that same experience of what it's like to
Speaker 2: be walking in to be so close, you know, to death, right,
Speaker 2: and so there's no objective experience of what it's like
Speaker 2: to be alive. So what's happening in the brain neurologically
Speaker 2: when people experience psychosomatic symptoms.
Speaker 3: So it's quite difficult with psychosomatic symptoms to know exactly
Speaker 3: what's happening in the brain. When you consider how many
Speaker 3: different kinds of psychosmatic symptoms there are and how many
Speaker 3: different things can cause them, trying to, you know, compare
Speaker 3: different brain scans and compare to people who've got wildly
Speaker 3: different symptoms for wildly different reasons is never going to
Speaker 3: get you very far. So there's actually very limited information
Speaker 3: available about what's actually happening in the brain with the psychosomatic.
Speaker 1: Disorder MRIs or brain scans, they've only really been in
Speaker 1: regular clinical use for about thirty years or so. That's
Speaker 1: really young technology wise, and so scientists and doctors are
Speaker 1: still trying to use them to understand what a typical
Speaker 1: brain looks like. And so then you have to use
Speaker 1: that to compare to what's happening in the brains of
Speaker 1: folks who are experiencing psychosomatic symptoms. Doctor Sullivan explained that
Speaker 1: functional MRIs can help our understanding of functional paralysis, so
Speaker 1: paralysis caused by an injury or psychosomatic paralysis. She told
Speaker 1: us about a study where they use functional MRI to
Speaker 1: take images of two groups of people, one group who
Speaker 1: had psychosomatic paralysis and another group who was asked to
Speaker 1: pretend to be paralyzed. The functional MRIs showed that there
Speaker 1: were completely different brain activations in the two groups.
Speaker 2: So that tells you right away that whatever is happening
Speaker 2: in the brain of someone with psychosomatic disorder is not
Speaker 2: the same as pretending.
Speaker 3: And the other thing that study showed us is that
Speaker 3: there seems to be a kind of an increased connectivity
Speaker 3: between the emotional parts of brain and the motor parts
Speaker 3: of the brain in people who have psychosomatic paralysis. So
Speaker 3: people are somehow rewiring the way their nervous system works
Speaker 3: to become less efficient. And I think of it like learning.
Speaker 3: So if I can learn to play tennis well, probably
Speaker 3: there is someone who could give me bad instructions that
Speaker 3: can teach me to play tennis badly. We learn motor
Speaker 3: coordination and we learn muscle movements by repetitive actions. We
Speaker 3: know we can learn to do things efficiently. I think
Speaker 3: we kind of tend to forget that one little change
Speaker 3: to the way we do things could make us less
Speaker 3: efficient in a motor sense. So I think that changes
Speaker 3: we're seeing in these functional MRI scans probably represent normal movements,
Speaker 3: sort of unlearned so we've learned to do something badly
Speaker 3: instead of something Well.
Speaker 1: That's really interesting because I think in the past people
Speaker 1: have dismissed psychosymatic disorders and saying like, well, your brain's
Speaker 1: not connected, and actually, exactly, it seems like there are
Speaker 1: some stronger connections or increased connectivity based on what T.
Speaker 1: Sullivan is saying.
Speaker 2: It's not a malfunction of your brain. It's not your
Speaker 2: brain like not working right.
Speaker 1: It is a rewiring. And it's really interesting that this
Speaker 1: requires even more connectivity than what you would typically expect.
Speaker 1: And so one of the things that doctor O Sullivan
Speaker 1: was saying is every connection is basically learning, you know,
Speaker 1: and we talked about this in some of the earlier episodes.
Speaker 2: I think that's a good point though, because there are
Speaker 2: some functions of our bodies that we don't have to
Speaker 2: think about because of those strong connections, like how our
Speaker 2: body regulates this temperature, blinking, breathing, our heart rate. Yes,
Speaker 2: these are all really strong connections that our mind has
Speaker 2: made over time, like since you know, we had a brain.
Speaker 1: And there are also these connections to emotions as well.
Speaker 1: When you're upset, there's a physiological process that happens your
Speaker 1: body responds and tears come out of your eyes right
Speaker 1: every sack time. Another type of connection, and so you
Speaker 1: see these emotional parts of the brain connected to the
Speaker 1: physical part.
Speaker 2: I heard that there was some study that when you
Speaker 2: look at folks pupils, if you say somebody that they love,
Speaker 2: their pupils will get bigger.
Speaker 1: We have to try that. And let me tell you something.
Speaker 1: When I say my name, I'm expecting full dilation. They
Speaker 1: better look like saucers.
Speaker 2: The whites of my eyes will turn black.
Speaker 1: The whole thing is irin oh man, why do we
Speaker 1: have to act like this.
Speaker 2: We're gonna take a quick break and then we'll talk
Speaker 2: more about pain, diagnosis and treatment of psychosomatic disorders and
Speaker 2: who's affected the most. We're back and we're talking more
Speaker 2: about what it means to have a psychosomatic disorder. We're
Speaker 2: trying to understand how the brain processes pain and other stimuli,
Speaker 2: the route to diagnosis and why it takes so long,
Speaker 2: and how the framing of psychosomatic symptoms and disorders can
Speaker 2: affect how people perceive the diagnosis once they get it.
Speaker 2: We really wanted to talk about pain with doctor O'Sullivan
Speaker 2: since that's a symptom that many people experience, and it
Speaker 2: can be really hard to diagnose.
Speaker 3: I think pain is the hardest question you could ask.
Speaker 3: I almost wish you'd ask any other question, because the
Speaker 3: problem with pain is there, it's subjective, so it is
Speaker 3: unbelievably hard to study, and it's unbelievably hard to sort
Speaker 3: of understand how exactly you know. One person can feel
Speaker 3: a completely different level of pain to another person. So
Speaker 3: I don't think that I know the absolute answer to
Speaker 3: how we can feel pain in the absence of a
Speaker 3: truly painful stimulus. It may be that we're feeling the memory,
Speaker 3: the expectation, the prior of of a pain we've felt before,
Speaker 3: or it may just be that we are stimulating some
Speaker 3: sort of sensory response to something that doesn't exist based
Speaker 3: on our expectations. Clearly, something slightly different is happening in
Speaker 3: the brain. But what's more important to say is that
Speaker 3: there's no difference. Is that if you have pain, you
Speaker 3: have pain. Pain is a subjective experience, and if you
Speaker 3: have it, you have it.
Speaker 2: Are there certain people who are more likely to have
Speaker 2: psychosomatic disorders.
Speaker 3: Anyone can have a psychosomatic disorder, and it really just
Speaker 3: requires the correct set of sort of triggers to be
Speaker 3: present for that person. But that's not to say that
Speaker 3: there aren't people who are more vulnerable than other people.
Speaker 3: If you are a tendency to be a worrier, if
Speaker 3: you have a tendency to be anxious, you are a
Speaker 3: bit more likely to get a psychosomatic disorder. If you've
Speaker 3: been exposed to serious illness, not necessarily personally yourself, but
Speaker 3: within your family or people close to you when you
Speaker 3: were a child, you're more likely to get psychosomatic disorders.
Speaker 3: So you see it in sports people. You know, in
Speaker 3: sports people who are functioning at a really high level,
Speaker 3: and they're expected to perform at a high level all
Speaker 3: the time, and sometimes that pressure can alter their coordination
Speaker 3: or how they perceive their bodies and affect their sports performance.
Speaker 2: You know what this reminded me of. This reminded me
Speaker 2: of someone bows pulling out of the Olympics. So she
Speaker 2: pulled out of the Olympics because she was saying that
Speaker 2: she wanted to check in with herself with her mental health,
Speaker 2: and knowing what doctor O'Sullivan has just told us, it
Speaker 2: completely makes sense if she's feeling unsure and the pressure
Speaker 2: is making her feel even more unsure. You know, so
Speaker 2: when she's running to do that vault and she's throwing
Speaker 2: her body in the air and doing three spins and
Speaker 2: having the land on her feet, she's putting herself in
Speaker 2: a real dangerous situation where she has to absolutely be confident.
Speaker 2: And so if the pressure is making her question her
Speaker 2: perception of her body and what it can do, the
Speaker 2: right thing to do was to pull herself out. And
Speaker 2: you know, the same is true for Naomi Osaka. She
Speaker 2: was having some issues. It was like a year ago,
Speaker 2: you know, the pandemic time warp. It's hard for me
Speaker 2: to know, but she was having some issues because she
Speaker 2: was really struggling with the press and the questions that
Speaker 2: they would ask her, and it was affecting her confidence
Speaker 2: level when she was going into matches. And we see
Speaker 2: it even recently at Indian Wells when she had a
Speaker 2: heckler that kind of threw her off while she was playing.
Speaker 1: Yes, you told me about that. Yes, all of these things.
Speaker 2: Totally affect the quality of the work that you're doing.
Speaker 2: And for them it's their sport.
Speaker 1: I know, my job.
Speaker 2: If I'm not feeling myself and I take a mental
Speaker 2: health day or if I decide not to, if I
Speaker 2: try and push through, no one's going to get hurt,
Speaker 2: no one's going to die. But for someone like Simone Biles,
Speaker 2: who is doing really strenuous and dangerous what are those
Speaker 2: things called stunts?
Speaker 1: Yeah, activities.
Speaker 2: Flying to the sky like a bird, there's way more
Speaker 2: that she has to consider. She's talking about her life here,
Speaker 2: you know what I mean. She said it, she said
Speaker 2: there's more to life than gymnastics. Her gymnasis career, God
Speaker 2: willing will be a small sliver of her life. This
Speaker 2: is just a small sliver of who she is, and
Speaker 2: we are so proud of her. But she still has
Speaker 2: very many years that she needs to live and we
Speaker 2: want her to be having the highest quality of life possible.
Speaker 2: And if it means taking a step back to make
Speaker 2: sure she's in the right brain space headspace to be
Speaker 2: able to perform at a high level, then that's just
Speaker 2: what she needs to do.
Speaker 1: And like you said, if we get lost in stuff
Speaker 1: and it's like, oh, what tab was I on? You
Speaker 1: know where was I in this paragraph?
Speaker 2: I'm not gonna fall on my neck right.
Speaker 1: Very different. So we understand that there are groups of
Speaker 1: folks who may be more vulnerable to experience in psychosomatic symptoms.
Speaker 1: But what does it take to get to diagnosis? How
Speaker 1: do you identify theo.
Speaker 3: There's a perception that neurologists diagnose psychosomatic conditions because the
Speaker 3: scans are normal, or because we can't find anything else there.
Speaker 3: When it's presented in that way, it becomes a diagnose
Speaker 3: of dismissal. It sounds a bit like, well, science hasn't
Speaker 3: cut up with it yet, or the scan isn't good
Speaker 3: enough to show it. Actually, that's not how we make
Speaker 3: the diagnosis. We make the diagnosis on positive findings in
Speaker 3: the examination that make this disorder biologically impossible. So our
Speaker 3: nervous systems are organized in a very intricate way. And
Speaker 3: when you get paralysis in leg due to a muscle problem,
Speaker 3: a brain problem, a spine problem, there's a really specific
Speaker 3: pattern of weakness that fits with biology. But when you
Speaker 3: get a psychosomatic disorder, you get patterns of symptoms that
Speaker 3: do not fit with biology, and you get a completely
Speaker 3: different set of clinical signs. There's no scans or tests involved,
Speaker 3: and that's often what psychosomatic disorders are like. There's a
Speaker 3: specific set of symptoms and patterns of discipl that don't
Speaker 3: fit with biology, and that's why we make the diagnosis.
Speaker 1: One of the things doctor O. Sullivan told us is
Speaker 1: that speed is the key to getting better. The sooner
Speaker 1: you know your symptoms are psychosomatic, the more likely you
Speaker 1: are to get better.
Speaker 3: There's lots of studies in seizures where a third of people,
Speaker 3: just by learning that those seizures are psychismatic, spontaneously improve.
Speaker 3: It's just something in that sort of fear anxiety sort
Speaker 3: of cycle has been broken and they inmediately get better.
Speaker 2: Unfortunately, our medical systems, both here in the US and
Speaker 2: in other countries too, don't lend themselves to speedy diagnosis.
Speaker 1: For any psychosomatic disorder. The average time to diagnosis is
Speaker 1: one year. Now, i'm gonna tell you something that's gonna
Speaker 1: blaw your mind. For psychosomatic seizures, the average time to
Speaker 1: diagnosis is seven years.
Speaker 2: Oh my gosh. I can't imagine going through something like
Speaker 2: that that's so traumatic, not just emotionally but physically traumatic
Speaker 2: for seven years before getting a diagnosis, and to.
Speaker 1: Not know what is causing it or what's happening, and
Speaker 1: to just continue experiencing that. I would be sour on
Speaker 1: the whole medical system.
Speaker 2: Okay, absolutely, I would feel absolutely failed.
Speaker 3: So I think that doctors need to start elevating this
Speaker 3: diagnosis so that it's given the same level of priority
Speaker 3: as everything else. So it doesn't have to be the
Speaker 3: case that someone comes and sees you and says you've
Speaker 3: got a psychosomatic disorder from the outset. What would be
Speaker 3: better is if they did what they did with every
Speaker 3: other diagnosis. You know, you've got seizures, so they could
Speaker 3: be epilepsy, here's the reasons for and against epilepsy, it
Speaker 3: could be psychosomatic. Here's the reason for and against, and
Speaker 3: you investigate those things in parallel, and then you don't
Speaker 3: just blindside the patient a year later saying I've ruled
Speaker 3: out epilepsy. Now you have the Booby prize that I
Speaker 3: never mentioned at the start. So I think doctors need
Speaker 3: to just give it a make it a diagnos of
Speaker 3: equal standing, and raise it earlier with patients.
Speaker 1: It kind of makes Now, that doesn't make it right.
Speaker 1: But when we think about how our medical system is
Speaker 1: structured with a general physician and then you go see
Speaker 1: XYZ specialists over and over, I can see that taking
Speaker 1: a really long time. TC.
Speaker 2: Yeah, I mean you would hope that there's ways that
Speaker 2: we could streamline these processes so that everybody benefits from it.
Speaker 2: There's a lot of pitfalls because that's assuming everything goes right.
Speaker 2: That's assuming that you have access to great healthcare, access
Speaker 2: to doctors who care, access to a lot of things
Speaker 2: that you might not have access to depending on your
Speaker 2: level of income, and a lot of socioeconomic factors.
Speaker 1: And it's also assuming that the way your psychosomitic symptoms
Speaker 1: present stay the same. So I can imagine if you
Speaker 1: went to an ear nosen throat doctor and they checked
Speaker 1: you and everything was fine, and then you go to
Speaker 1: a neurologist and then you are starting to have symptoms
Speaker 1: that go back to the earos and throat doctor and
Speaker 1: they say, we already checked you, you were fine, And
Speaker 1: are those people even talking like exactly?
Speaker 2: That feels like a medical nightmare, Like doctor O'Sullivan said,
Speaker 2: these symptoms they move around, and so they might not
Speaker 2: even be able to catch some of these things when
Speaker 2: they're happening. And yes, it's just feel like a wild
Speaker 2: goose chase.
Speaker 1: Yeah, when we really look at the numbers, this is
Speaker 1: more common than folks probably think, right, Doctor Sullivan told
Speaker 1: us that one third of the people coming into neurology
Speaker 1: clinics have a psychosomatic disorder.
Speaker 3: If you can't walk, or you're having seizures, or you're
Speaker 3: unable to work, then you're seriously enough ill to require
Speaker 3: the same speed to treatment as diseases. But I don't
Speaker 3: think people take these disorders seriously enough yet to care
Speaker 3: about that.
Speaker 1: So it really makes you ask what can we do.
Speaker 1: How can we change this process where folks are having
Speaker 1: this long drawn out experience where they're going from provider
Speaker 1: to provider trying to figure out what's happening. How do
Speaker 1: we raise awareness about this.
Speaker 3: We're still waiting to see people running the marathons with
Speaker 3: t shirts that say psychosomatic disorders. Because people care about
Speaker 3: cancers and which they should and other diseases like that.
Speaker 3: We need to start opening our eyes to that and
Speaker 3: create treatment facilities.
Speaker 1: There's not a lot of public awareness around psychosomatic disorders,
Speaker 1: but they affect about one third of people going into
Speaker 1: neurology clinics.
Speaker 2: I think this is such a good point. We really
Speaker 2: need to dignify this disorder.
Speaker 1: It is real.
Speaker 2: People are really suffering, and I think a lot of
Speaker 2: folks when they hear something like this, they're just like, Oh,
Speaker 2: this person is just out of their mind. But there's
Speaker 2: a spectrum like it affect people in little ways, and
Speaker 2: then it can also affect you in really catastrophic ways.
Speaker 2: These are real physical symptoms that need treatment, and you.
Speaker 1: Really have to ask. Even if you're dismissing somebody and
Speaker 1: saying they're out of their mind, well, your mind tells
Speaker 1: you when you step on something sharp, it is your
Speaker 1: mind that tells you that. And so if their mind
Speaker 1: is telling them that they are feeling this physical pain,
Speaker 1: who's to say, well, I need to see what the
Speaker 1: stimulus is for you to have this.
Speaker 2: Right exactly, everybody deserves treatment.
Speaker 1: Sad is sad. Pain is pain, regardless of the sem
Speaker 1: me list that creates it, regardless of the origination. Treat
Speaker 1: the pain. If we can treat it, treat it.
Speaker 2: Treat the pain.
Speaker 1: All right, it's time for one thing, tet, what's your
Speaker 1: one thing this week?
Speaker 2: My one thing this week is an artist. Her name
Speaker 2: is Dominique Brown, and I stumbled upon her work while
Speaker 2: I was at home Goods. So home Goods it treats
Speaker 2: me like Target. I went in there looking for a
Speaker 2: coffee table, ended up buying three pieces of art to
Speaker 2: buy this woman. I caught it out the corner of
Speaker 2: my eye and I was like, there's no way I
Speaker 2: can leave here without this art. And I did not
Speaker 2: get a coffee table. Her name is Dominique Brown. Really
Speaker 2: beautiful art that is black woman centric. If you see
Speaker 2: any pictures of my office, you will see her work
Speaker 2: in the background of it. And I really love it.
Speaker 2: And you can also follow her on Instagram at Snoop
Speaker 2: Doggie Dom and check her artwork out at Home Goods.
Speaker 2: So that's Snoop Doggy Dom.
Speaker 1: Yes, and you have been very excited, and I must
Speaker 1: say it does look lovely back there. Thank you.
Speaker 2: What's your one thing?
Speaker 1: Well? You know, this weekend my Instagram stories, I was
Speaker 1: asking people to give me book recommendations and I got
Speaker 1: a lot of book recommendations. I put them all together
Speaker 1: on one list. But I got a book recommendation from
Speaker 1: one of our favorites tt This book I'm going to
Speaker 1: tell you about it is written by a movie critic
Speaker 1: that we both like, Brooke Obi Wow. Obie is a
Speaker 1: strong writer. Anyway. We love all of Obi's stuff and
Speaker 1: we've mentioned her before on the podcast, but one of
Speaker 1: my friends from Hampton said, Hey, did you know that
Speaker 1: Brooke wrote a book and it's called Book of Attists
Speaker 1: Cradled Embers. So I just started that and that's my
Speaker 1: one thing this week. I'm really enjoying it.
Speaker 2: Okay, once you finish, give it to me.
Speaker 1: I already know the deal. Put it in the mail.
Speaker 1: We love Brooke. That's it for this lab. Call us
Speaker 1: at two zero two five six seven seven zero two
Speaker 1: eight and tell us what you thought, or give us
Speaker 1: an idea for a different lab you think we should
Speaker 1: do this semester. We like hearing from you. That's two
Speaker 1: zero two five six seven seven zero two eight.
Speaker 2: And don't forget that there is so much more to
Speaker 2: dig into on our website. There'll be a cheat cheat
Speaker 2: for today's lab, additional links and resources in the show notes. Plus,
Speaker 2: you can sign up for our newsletter check it out
Speaker 2: at Dope labspodcast dot com. Special thanks to our guest expert,
Speaker 2: doctor Suzanne O'Sullivan.
Speaker 1: You can find her on Twitter at sus Underscore Osullivan.
Speaker 1: That's su Z Underscore o Sullivan and you can.
Speaker 2: Find us on Twitter and Instagram at Dope Labs Podcast.
Speaker 1: TT's on Twitter and Instagram at dr Underscore t Sho
Speaker 1: and you.
Speaker 2: Can find Zakia at z said. So Dope Labs is
Speaker 2: a Spotify original production from Mega Own Media Group.
Speaker 1: Our producers are Jenny ratlit Mass and Lydia Smith of
Speaker 1: Wave Runners Studios. Our associate producer from Mega Oh Media
Speaker 1: is Brianna Garrett.
Speaker 2: Editing in sound design by Rob Smerciak.
Speaker 1: Mixing by Hannes Brown.
Speaker 2: Original music composed and produced by Taka Yasuzawa and Alex
Speaker 2: Sugier from Spotify. Executive producer Corin Gilliard and creative producer
Speaker 2: Miguel Contreras.
Speaker 1: Special thanks to Shirley Ramos, Jess Borrison, Yasmine Afifi Kamu, Elolia,
Speaker 1: Till krat Key and Brian Marquis. Executive producers from Mega
Speaker 1: Oh Media Group are us T t show Dia and
Speaker 1: Zakiah Wattley.
Speaker 2: So like, if it wasn't COVID and it was like
Speaker 2: a hair loss pandemic, I might be counting the hairs
Speaker 2: of my waye tooth comb a little bit closer.
Speaker 1: Right, and you would say, did my edges always look
Speaker 1: like this?
Speaker 2: Is this? A wait?
Speaker 1: I'm just saying mind is strong. The mind is strong.
Speaker 2: Okay, let's leave my edges out of this conversation.
Speaker 1: Let's move on to something else.
Speaker 2: I'm sensitive