Speaker 1: How can we get into parasympathetic? What can you do
Speaker 1: to get out of fight or flight and get into parasympathetic?
Speaker 1: And you know, for some people it's put your phone down.
Speaker 1: Your phone is making you sickow.
Speaker 2: Welcome to the one you feed Throughout time, great thinkers
Speaker 2: have recognized the importance of the thoughts we have, quotes
Speaker 2: like garbage in, garbage out, or you are what you think,
Speaker 2: ring true. And yet for many of us, our thoughts
Speaker 2: don't strengthen or empower us. We tend toward negativity, self pity, jealousy,
Speaker 2: or fear. We see what we don't have instead of
Speaker 2: what we do. We think things that hold us back
Speaker 2: and dampen our spirit. But it's not just about thinking.
Speaker 2: Our actions matter. It takes conscious, consistent, and creative effort
Speaker 2: to make a life worth living. This podcast is about
Speaker 2: how other people keep themselves moving in the right direction,
Speaker 2: how they feed their good Thanks for joining us. Our
Speaker 2: guest on this episode is doctor Julie Holland, a psychiatrist
Speaker 2: specializing in psychopharmacology. As an assistant Professor of Psychiatry at
Speaker 2: NYU School of Medicine, she spent her weekends running the
Speaker 2: psychiatric Emergency room at Bellevue Hospital for nine years, and
Speaker 2: published her memoir Weekends at Bellevue in two thousand and nine.
Speaker 2: Doctor Holland is the author of many other books, including
Speaker 2: her newest one discussed here, Good Chemistry, The Science of
Speaker 2: Connection from Soul to Psychedelics.
Speaker 3: Hi, Julie, welcome to the show.
Speaker 4: Thanks for having me.
Speaker 5: I'm excited to have you on. We're going to be
Speaker 5: primarily discussing your book called Good Chemistry, The Science of
Speaker 5: Connection from Soul to Psychedelics. But before we get into that,
Speaker 5: will start like we always do with the parable. In
Speaker 5: the parable, there's a grandparent who's talking with their grandchild
Speaker 5: and they say, in life, there are two wolves inside
Speaker 5: of us that are always at battle. One is a
Speaker 5: good wolf, which represents things like kindness and bravery and love,
Speaker 5: and the other's a bad wolf, which represents things like
Speaker 5: greed and hatred and fear. And the grandchild stops. They
Speaker 5: think about it for a second. They look up at
Speaker 5: their grandparent and they say, well, which one wins, And
Speaker 5: the grandparent says, the one you feed. So I'd like
Speaker 5: to start off by asking you what that parable means
Speaker 5: to you in your life and in the work.
Speaker 3: That you do well.
Speaker 1: I guess the first thing it means to me is
Speaker 1: just where you place your attention, where you place your energy,
Speaker 1: and what you're trying to accomplish. You know. One of
Speaker 1: the metaphors I use is like, first you have to
Speaker 1: decide what a garden is, to coordinate off and get
Speaker 1: rid of the rocks and change the dirt around and
Speaker 1: add the plants, Like, the first thing you have to
Speaker 1: do is say this is going to be a garden.
Speaker 1: So some of the energy that I think I put
Speaker 1: toward things is figuring out what to build, where to
Speaker 1: build it, what it's going to look like, so that
Speaker 1: you can kind of defend your space with other people.
Speaker 1: But from a personal perspective, my two wolves are sort
Speaker 1: of like the Yin and Yang energies that I am
Speaker 1: constantly trying to balance. I am very naturally sort of
Speaker 1: Yang testosterone heavy.
Speaker 4: I have things to do, I've get a vector, I
Speaker 4: have places.
Speaker 1: To go, get out of my way, whereas the Yin
Speaker 1: energy is more receptive and hanging back and seeing what
Speaker 1: people say and taking it all in before you make
Speaker 1: a decision. So it's very easy for me to be
Speaker 1: sort of all in and aggressive and barreling forward, and
Speaker 1: where I really need to put my energy is to
Speaker 1: having more of a balance of yin receptivity, openness. That's
Speaker 1: my own sort of personal battle. I think I have
Speaker 1: issues with, like impulse control, for instance, which I feel
Speaker 1: like is a very yang thing to just kind of
Speaker 1: shoot first, ask questions later, you know, shoot from the hip.
Speaker 1: So luckily I'm married to someone who's very introspective and
Speaker 1: receptive and takes a lot of time before making a
Speaker 1: decision and is like sort of what I call a
Speaker 1: slow metabolizer. I'm a very fast patibilizer. I'm like, if
Speaker 1: this has changed, then we have to accommodate the new
Speaker 1: thing and pivot, you know, Whereas the person that I
Speaker 1: am emotionally yoked with is like, well, let's think about
Speaker 1: this and see where it's all going. So that's my
Speaker 1: real battle is to put the brakes on, not be
Speaker 1: all gas, to have some impulse control, to stop and
Speaker 1: listen and take things in, which is why I should
Speaker 1: stop talking now, right, Eric, Well.
Speaker 3: I'm not going to touch that.
Speaker 5: It's interesting though, as you were talking about your partner
Speaker 5: that you're yoked to, it made me think about a
Speaker 5: section in the book where you are talking about when
Speaker 5: we fall in love, there's this limerence period. There's sort
Speaker 5: of a high or not sort of, there actually is
Speaker 5: a high that comes from that, and then we settle
Speaker 5: into the harder work of building a relationship. And you
Speaker 5: have a line there where you say the optimal outcome
Speaker 5: the way out of the dead end, the dead end
Speaker 5: being the tendency to just kind of like keep looking
Speaker 5: for something else. You accept and embrace all the disowned
Speaker 5: traits in your partner, and that helps you accept them
Speaker 5: in yourself. And I was thinking about how it sounds
Speaker 5: like you found the way to do that, You found
Speaker 5: the way to appreciate the way in which your partner
Speaker 5: is different than you, and how that is helpful. I'm
Speaker 5: not saying all the time you feel that way, but
Speaker 5: that in general you do. And how did you get
Speaker 5: to a place where you were able to see that
Speaker 5: as different but a positive compliment to you versus this
Speaker 5: person is wrong about the way they see things or
Speaker 5: do things.
Speaker 1: Yeah, I would say it's constantly in flux. Those things
Speaker 1: like Jeremy through basically sheer will and brute strength has
Speaker 1: you know, consistently reminded me that my way is not
Speaker 1: always the best way, and that he is not.
Speaker 4: The enemy, you know.
Speaker 1: So and the truth is, you know, it's funny because
Speaker 1: like if we played opposite each other, like a game
Speaker 1: of scrabble, it would be a very close game, and
Speaker 1: he would drive me crazy because he took forever. But
Speaker 1: if we're on the same scrabble team and we're playing
Speaker 1: against our friends, we are unstoppable, you know. And so
Speaker 1: I just I kind of remember that, like we work
Speaker 1: better as a team, and it's sort of like buckshot,
Speaker 1: you know, if I'm all white and he's all black,
Speaker 1: and you put us together, we're covering a lot more ground.
Speaker 1: But because of the way I was raised to be
Speaker 1: self reliant and trust no one and take care of myself,
Speaker 1: and also, you know, those sort of very yang and
Speaker 1: I would say even maybe kind of misogynists sort of traits,
Speaker 1: like I think I had internalized misogyny growing up. I
Speaker 1: was the youngest of three girls. My parents both wanted boys.
Speaker 1: They told us they wanted boys. I heard so many
Speaker 1: times growing up, Julie, you were our last chance for
Speaker 1: a boy. So there was some way where I was
Speaker 1: operating of like how tom boyish can I be?
Speaker 4: Can I be a bully. Can I be a brute
Speaker 4: and a.
Speaker 1: Bruiser, and those traits honestly served me really, like being
Speaker 1: a pre med, being a med student, being a psych resinence.
Speaker 1: You know, I kicked ass because I did it all
Speaker 1: myself and I didn't trust anybody to do it. But
Speaker 1: when you're a white and a mother, and you know,
Speaker 1: like a parent and a spouse, like, you can't act
Speaker 1: like a surgeon, you know, like it just it doesn't work.
Speaker 1: So when I was at Bellevue, you know, I spent
Speaker 1: nine years running a psychiatric emergency from a Bellevue hospital,
Speaker 1: and I was a cowboy. You know, I was a
Speaker 1: tough guy, and that's how I survived in like a
Speaker 1: very challenging environment. I lasted longer than any psychiatrist at
Speaker 1: that psycheer had. I had the same job for nine
Speaker 1: years and I didn't get burnt out, mostly because I
Speaker 1: worked weekends and I had all week.
Speaker 4: Off to recover.
Speaker 1: But over those nine years, I got pregnant twice. I
Speaker 1: nursed babies twice. By the end of it, there was
Speaker 1: so much oxytocin, like drowning out the testosterone. I couldn't
Speaker 1: really work there anymore. You know, I got too soft.
Speaker 4: I became a.
Speaker 1: Softie and maybe you can be a softy there, but
Speaker 1: I couldn't, you know, I had to really be a
Speaker 1: tough guy to make it through. And I got punched
Speaker 1: in the face, you know, because I was kind of
Speaker 1: being a bitch pardon me to a patient. And when
Speaker 1: I look back at my notes from Bellevue, now I
Speaker 1: wrote a memoir about my nine years in the psyche are,
Speaker 1: But when I look back at my notes, all my
Speaker 1: notes stopped after I got punched in the face, like
Speaker 1: it really did something to me and how I went
Speaker 1: about my job there. But I ended up writing about
Speaker 1: this sort of transformation from you know, a butch, tomboy,
Speaker 1: manly woman to somebody who had gone through having two kids.
Speaker 1: And I couldn't be a cowboy in there anymore.
Speaker 5: What does being a tough guy mean in that sort
Speaker 5: of circumstance or that sort of situation, you know at Bellevue.
Speaker 1: Yeah, yeah, Now, looking back, I would say, tough guy
Speaker 1: at Bellevue means that I was like kind of an asshole,
Speaker 1: like nothing got to me. I didn't care how sad
Speaker 1: the story was. I'd heard it all before. It didn't matter,
Speaker 1: you know, I would say things like all of it
Speaker 1: is sad, so none of it is sad. Like I
Speaker 1: had a threshold that I got very hardened, and I
Speaker 1: wrote about this in my book Weekends of Bellevue. I
Speaker 1: really wrote a lot about how hard I was when
Speaker 1: I came in and how softened up I was by
Speaker 1: the end, and that because I was soft, I couldn't
Speaker 1: really do the job. Because there's a lot of sad stories.
Speaker 1: And you know, there's terrible things that happen to people,
Speaker 1: and the people who end up with significant psychiatric issues
Speaker 1: and addiction issues almost inevitably, they have had horrible childhoods.
Speaker 1: They've been sexually abused, they've been physically and emotionally abused,
Speaker 1: They've had childhoods where they've had to be in fight
Speaker 1: or flight the whole time, and they end up as
Speaker 1: psychiatric patients and addicted to all sorts of drugs. So,
Speaker 1: you know, in a perfect world, you would have people
Speaker 1: coming in and you would do intense psychotherapy. God, what
Speaker 1: happened to you in your childhood, let's process it. But
Speaker 1: like the reality is, you don't have time for intensive
Speaker 1: psychotherapy and a psycher, and every single patient would require
Speaker 1: that or a childhood transplant. So we end up using
Speaker 1: humor a lot as a defense and as a shield,
Speaker 1: you know, in the yard, to sort of deal with
Speaker 1: the atrocities that we're seeing and sort of laughing it off.
Speaker 1: Maybe it's not what the patients want, but it was
Speaker 1: a way for the staff to stay connected, to enjoy
Speaker 1: being at work, and to get the job done. So,
Speaker 1: you know, a little bit of a callousness and a
Speaker 1: humor and a sort of gallows humor.
Speaker 4: Maybe there where it's.
Speaker 1: Not appropriate, but that's what it took to, you know,
Speaker 1: show up every week and work, you know, these sixteen
Speaker 1: hour shifts.
Speaker 3: Yeap.
Speaker 5: Do you find that you're able as you've become softer
Speaker 5: to use your words or less hardened? I might say
Speaker 5: more compassionate. Maybe you won't agree with that phrase, but
Speaker 5: I'll use it.
Speaker 1: You know. I feel like even when I was a
Speaker 1: hard ass, I was compassionate with the people who really
Speaker 1: deserved it. The thing about Bellevue is there's a certain
Speaker 1: percentage of people who are gaming the system, who are
Speaker 1: pretending to be mentally ill to get off the streets.
Speaker 1: They're hiding out from somebody, or they just don't have
Speaker 1: any money, They've run out of money, they come in.
Speaker 1: They say they're hearing voices to kill themselves and others,
Speaker 1: and they think that that will be enough to get
Speaker 1: them admitted to the hospital so that they can have
Speaker 1: you know, three warm beds and a place to sleep
Speaker 1: for a week or two. And you know, I appreciate
Speaker 1: that they're looking for respite, but one of my main
Speaker 1: jobs was to basically keep the sharks out. You know,
Speaker 1: people who are chronically persistently mentally ill are really vulnerable.
Speaker 1: And if you've got any social people who aren't really
Speaker 1: sick but they're pretending to be sick, the real patients
Speaker 1: are at risk and are vulnerable. So it's my job
Speaker 1: to keep the sharks out. On the other hand, as
Speaker 1: I grew more compassionate, and I was always giving lectures
Speaker 1: at the psycheer about psychosis or about malingering, people faking
Speaker 1: what to look out for. But the way I would
Speaker 1: start my malingering lecture after a while was like, look,
Speaker 1: even if they're faking symptoms, they are coming to the
Speaker 1: hospital for help, and we're here to help them, and
Speaker 1: we've got to figure out.
Speaker 4: Look, you don't.
Speaker 1: Really look like you're hallucinating to me, but you do
Speaker 1: look like you're having a hard time, and you run
Speaker 1: out of money and you're homeless, and let's figure out
Speaker 1: why that's happening. And you know, might it be because
Speaker 1: of this, that and the other thing, and not that
Speaker 1: you're actually psychotic. But at least you're still saying, I
Speaker 1: know you're coming to us for help. Figure out how
Speaker 1: we can really help you instead of just give you
Speaker 1: this band aid of a week off the streets.
Speaker 5: Right, And it speaks to the fact that somebody's in
Speaker 5: some degree of dire straits that they think a psych
Speaker 5: word is an improvement over, right, So.
Speaker 1: Let's, you know, start with the reality and sort of
Speaker 1: present them with the reality, like why is your life
Speaker 1: so chaotic that a week at Bellevue Hospital is a vacation? Right,
Speaker 1: Like what's going on to get you to this point?
Speaker 1: But you know, it was a bit of a revolving
Speaker 1: door Bellevue, people coming in and out, and sometimes the
Speaker 1: staff gets very frustrated that, you know, the same people
Speaker 1: aren't getting better and the same things that we're trying
Speaker 1: aren't working. It's because you know, they need a new childhood,
Speaker 1: They need a childhood transplant. We need to be focusing
Speaker 1: on early education and head start programs and things like
Speaker 1: that to prevent addiction and violence and things like that
Speaker 1: from taking root in childhood.
Speaker 5: You're very interested in involved in psychedelics as mental health treatments. True,
Speaker 5: was that driven by a frustration with the fact that
Speaker 5: the system that you were embedded into you didn't seem
Speaker 5: to be working.
Speaker 1: No, because it came before Bellevue. I got frustrated with
Speaker 1: the system by the time I get to Bellevue. But
Speaker 1: my interest in MPD as an adjunct to psychotherapy, for instance.
Speaker 1: I mean, some people may know MDMA better as molly
Speaker 1: or ecstasy, but this idea that there was a substance
Speaker 1: that could help psychotherapy go deeper and act as a
Speaker 1: catalyst to therapy where you're really getting to the stuff
Speaker 1: that matters quicker. I mean, I guess that's a very
Speaker 1: Yang way of talking about it, right, but like more efficacious,
Speaker 1: you know, more effective, faster, deeper, better. So that appealed
Speaker 1: to me even before I went to medical school. I
Speaker 1: got very interested in MDMA in the context of psychotherapy
Speaker 1: when I was an undergrad. You know, this is like
Speaker 1: the mid eighties. I'm a prima at Penn. The summer
Speaker 1: of eighty five, I was actually living in a castle.
Speaker 1: There's a castle on campus that was like a for
Speaker 1: fraternity house, so I was living in a castle. All
Speaker 1: of a sudden, I started hearing about this drug that
Speaker 1: they were calling Adam, that they were using in therapy,
Speaker 1: that you know, therapists were giving to their patients, and
Speaker 1: I got very interested. First of all, it was a
Speaker 1: new drug, and I was an undergrad studying psychopharm so
Speaker 1: the fact that there was a new drug, I didn't
Speaker 1: even care if it was in therapy or art, just
Speaker 1: the fact there was a new drug. Like I knew
Speaker 1: all about all the other ones so far, and I'd
Speaker 1: tried most of them, and this was the new one,
Speaker 1: so that was exciting. But the fact that it was
Speaker 1: actually being used as a catalyst during therapy. It's one
Speaker 1: of the reasons that I ended up really committing to
Speaker 1: psychiatry and not neurosurgery. When I went to medical school,
Speaker 1: I knew I was going to do something with the brain.
Speaker 1: I was always very interested in the brain and drugs.
Speaker 1: But the reality of what neurosurgery is and what neurology
Speaker 1: is versus the reality of what life as a psychiatrist was,
Speaker 1: it was really no contest for me. I got very
Speaker 1: interested in psychosis, you know, schizophrenia and bipolar and I
Speaker 1: mean it's also fascinating, you know, the things that go
Speaker 1: wrong and right with the brain. So I got interested
Speaker 1: in psychedelics as a treatment modality before I even went
Speaker 1: to med school. And honestly, it was one of the
Speaker 1: things that kind of fed me and kept me going
Speaker 1: when med school was impossible and ridiculous. Was you know,
Speaker 1: this sort of carrot. But I wrote a little haiku
Speaker 1: or something once and it was like, it takes a
Speaker 1: mighty lure to nurse the hardships we endure, Like med
Speaker 1: school is hard and you're not treated very nicely, and
Speaker 1: residency is sometimes more the same, and it's a real slog,
Speaker 1: you know, and you got to have a reason to
Speaker 1: go through all of this. And for some people it's
Speaker 1: like my dad's a doctor or I'm going to be
Speaker 1: a doctor is very familial. I didn't have that, but
Speaker 1: I did have this idea of MDMA assisted therapy sort
Speaker 1: of pushing me to go to med school, get my residency,
Speaker 1: be a psychiatrist. You know, it's an exciting time to
Speaker 1: be a psychiatrist because we've got a few more tools
Speaker 1: at our disposal and we need every tool you can imagine.
Speaker 5: I would assume then that the recent and I don't
Speaker 5: know the exact timeframe, but I believe in the last
Speaker 5: six months ruling by advisors to the FDA that MDMA
Speaker 5: treatment posed more risks than benefits was a bitter pill.
Speaker 1: So I would love to break this down. And I
Speaker 1: was really tempted to do the wolf thing and talk
Speaker 1: about this, but I decided it wasn't appropriate. So the
Speaker 1: way to get FDA approved is that you do phase one,
Speaker 1: Phase two f three clinical trials. And there were a
Speaker 1: multiple centers that did this kind of work. It wasn't
Speaker 1: just one place. There were a lot of different groups
Speaker 1: that were running people through an MDMA assisted therapy protocol
Speaker 1: during phase two, which is not the data that FDA
Speaker 1: needs to approve. They really look at Phase three data.
Speaker 1: But during the Phase two multi center trials, there was
Speaker 1: one cell, one center that ran four subjects. One of
Speaker 1: those subjects, there were egregious boundary violations and grossly inappropriate
Speaker 1: things that happened between a researcher and a research subject
Speaker 1: at this one cell that ran four subjects during phase two.
Speaker 1: There were no other improprieties. Phase three there's no problem
Speaker 1: with the data phase three, but people got very fixated
Speaker 1: on this terrible, egregious boundary violation. But I would argue
Speaker 1: that one terrible thing that happened from one cell of
Speaker 1: a site that ran four people should not discount the
Speaker 1: hundreds of other people who were run through the studies,
Speaker 1: who had a benefit and who did well, and who
Speaker 1: didn't have egregious boundary violations. And this is really a
Speaker 1: situation of like when bad apple should not spoil the
Speaker 1: whole bunch, and particularly the data should not be impugned
Speaker 1: by one boundary violation. The data is powerful and strong,
Speaker 1: and the bottom line is that a lot of people
Speaker 1: who had PTSD, once they made it through the MDMA
Speaker 1: assisted therapy protocol, they did not meet criteria for PTSD anymore.
Speaker 4: They did not have their symptoms.
Speaker 1: So you know, we don't say cured in psychiatry, but
Speaker 1: you could at least say that the end of the
Speaker 1: study those people wouldn't have made it into the beginning
Speaker 1: of the study because they weren't appropriate, because they didn't
Speaker 1: have the symptoms needed for the study. As many as
Speaker 1: two thirds of people responded robustly, and you don't see
Speaker 1: those numbers in any other treatment. So we've got more
Speaker 1: and more people with PTSD, we have more and more
Speaker 1: veterans committing suicide, and we have a medicine that, if
Speaker 1: used appropriately in the context of ongoing therapy, will markedly
Speaker 1: decrease PTSD symptoms and the desire to be dead. So
Speaker 1: I'm still very committed to FDA approval. You know, I
Speaker 1: listened to the talks that whole day June fourth, from
Speaker 1: eight thirty to six pm, and FDA spoke first, and
Speaker 1: I was very heartened by everything that FDA had to say.
Speaker 1: They seem to really understand the situation and the fact
Speaker 1: that it is nearly impossible or purely impossible to have
Speaker 1: a blinded study because everybody knows pretty much who took
Speaker 1: mdmain and who didn't, you know, so that's called functional unblinding.
Speaker 1: But still the study was blinded and the data is powerful,
Speaker 1: and you know, we're gonna have to see what FDA decides,
Speaker 1: because the Advisory Committee does not know as much as
Speaker 1: FDA about this. And there's a handful of about five
Speaker 1: or six people who are really committed to supporting the
Speaker 1: victim from the Phase three trial, and well they should
Speaker 1: be supporting this victim. But to stop MDMA from getting
Speaker 1: approved means that you're enabling the PTSD to continue in
Speaker 1: millions and millions of people because you are protecting one
Speaker 1: person who had a terrible experience. And I don't agree
Speaker 1: with that calculus at all.
Speaker 5: Right, Right, it seems that the committee was extrapolating from
Speaker 5: there to the fact that MDMA itself was the reason
Speaker 5: that people acted inappropriately, which I think is an extrapolation.
Speaker 1: Yeah, it's really easy to sort of name names and
Speaker 1: call names, and I'm tempted to, you know, out the
Speaker 1: boundary violator and say how terrible he is. I don't
Speaker 1: fully understand the situation. I mean, this was a married
Speaker 1: couple who was doing this work. As far as I know,
Speaker 1: they stayed married after this boundary violation and everything that
Speaker 1: happened with this third person. I don't pretend to understand,
Speaker 1: you know, what happens with couples and taking in somebody
Speaker 1: to live with them, or another lover or you know
Speaker 1: how that works. I understand it's very fraught. I will
Speaker 1: also say that, you know, in the underground scene, we
Speaker 1: had situations where married couples one or both members of
Speaker 1: the party ended up you know, being involved in boundary
Speaker 1: violations also, so you know, we all sort of had
Speaker 1: this idea that like a male female therapist couple would
Speaker 1: keep everybody safe, and it turns out not always right.
Speaker 1: Whether in research or underground, or in regular psychotherapy or
Speaker 1: with a dentist, there are often boundary violations and weird
Speaker 1: shit happens, you know, in regular therapy without the METS.
Speaker 1: But yes, MDMA is going to make you more vulnerable,
Speaker 1: more trusting, more open, And that's why what's been proposed
Speaker 1: to FDA is that it's in the context of ongoing therapy,
Speaker 1: that it is not just a one off with somebody
Speaker 1: that you don't know and don't have any therapeutic alliance with.
Speaker 5: Right, Right, let's move on from psychedelics at least for now.
Speaker 5: We may find our way back there. But I'd like
Speaker 5: to focus on the heart of your book, Good Chemistry,
Speaker 5: which is about the science of connection. You say our
Speaker 5: species is categorized, and I love this is obligatorially gregarious.
Speaker 3: What does that mean?
Speaker 4: Yeah?
Speaker 1: I like saying obligatorily gregarious too. It feels good in
Speaker 1: my mouth.
Speaker 5: I was afraid I was going to stumble over it,
Speaker 5: but it came out okay.
Speaker 4: So integreator yeah. So the idea is that we are obligated.
Speaker 1: It is part of our biological imperative that we are gregarious,
Speaker 1: which means friendly, so homo sapien sepiens. If we are
Speaker 1: not social, we do not survive. And if you think
Speaker 1: back to our time on the Savannah, we lived in
Speaker 1: multi generational homes. We were a part of a clan.
Speaker 1: There'd be several families that would be part of a
Speaker 1: clan together, and within the clan there was cooperation in
Speaker 1: building a shelter, hunting, sharing food, sharing resources, making sure
Speaker 1: everybody got a mate and was mating, and so within
Speaker 1: that clan, if you were ostracized, if the clan decided
Speaker 1: that you know, you're not on our team and you're
Speaker 1: not with us, and they ostracized you, you would die.
Speaker 1: Ostracism back on the Savannah meant very likely death because
Speaker 1: no one would help you build a shelter, no one
Speaker 1: would feed, you wouldn't share the kill with you, you
Speaker 1: would not mate. If you didn't die, at least your
Speaker 1: genetics aren't getting spread, which is part of our imperative
Speaker 1: is to clone ourselves, basically reproduce, so we still process
Speaker 1: ostracism and not being in the group and being in
Speaker 1: the in crowd as an existential threat that puts us
Speaker 1: into fight or flight. So when we are disconnected from
Speaker 1: our community, from our friends, from our family, and then
Speaker 1: I would also argue disconnected from ourselves and our own bodies,
Speaker 1: which happens every time we open up our phone, or
Speaker 1: disconnected from the planet and the earth, which happens every
Speaker 1: time we open up our phone. All of this severance
Speaker 1: and disconnection puts us in fight or flight. It puts
Speaker 1: us in the sympathetic nervous system, which is not where
Speaker 1: your body wants to be. Your body wants to be
Speaker 1: in the other side, which is called parasympathetic. That's where
Speaker 1: we can rest, digest, and repair, and not just repair
Speaker 1: our bodily functions. You know, the only time the body
Speaker 1: does any major repairs is when you are not in
Speaker 1: fight or flight. When you are in parasympathetic rest dies repair,
Speaker 1: not just bodily repair, social repair. Right, you get into
Speaker 1: a fight with somebody, you say something stupid because you're
Speaker 1: in fighter flight, Then you feel calm and you're in
Speaker 1: parasympathetic and then you can repair the social disconnect that happened.
Speaker 1: Your social skills suck. When you're in fight or flight,
Speaker 1: you know you're more likely to break and disconnect than
Speaker 1: you are to connect. So when you are in fighter flight,
Speaker 1: the main sort of juice that runs your sympathetic nervous
Speaker 1: system are things like cortisol and adrenaline, and adrenaline in
Speaker 1: the brain is known as epinephrine, but cortisol and adrenaline
Speaker 1: are sort of the main chemicals that enable you to
Speaker 1: be in fighter flight. And the longer you're in fighter
Speaker 1: flight and the more you're exposed to cortisol, the worse
Speaker 1: your body is. You get fat, you can't sleep, your
Speaker 1: immune system is a mess, your blood sugar is a mess,
Speaker 1: and your body can't repair itself when you are in parasympathetic,
Speaker 1: which is rest digest repair. That is primarily not adrenaline cortisol,
Speaker 1: but rather oxytocin and something called a setyle cooline, which
Speaker 1: is involved in memory. But the oxytocin is the hormone
Speaker 1: and neurotransmitter that allows you to open up trust connect.
Speaker 1: Oxytocin is very much involved in parent infant bonding with
Speaker 1: a nursing baby or just any baby who's dependent on you.
Speaker 1: It's also involved in like a post orgasmic bonding state,
Speaker 1: which is why I said in Moody Bitches that you
Speaker 1: should be careful. You think you're having casual sex with somebody,
Speaker 1: but if you have an orgasm, you're going to be
Speaker 1: in this post orgasmic state, which is a high oxytocin state,
Speaker 1: and you may find yourself emotionally bonding even though you
Speaker 1: didn't mean to so. Oxytocin is involved in wound healing,
Speaker 1: body repair, social repair, and it's involved in all the
Speaker 1: sort of trusting and bonding that happens between parents, between lovers,
Speaker 1: between teammates, even you know that little like pad on
Speaker 1: the butt, the football, or the pat on the shoulder,
Speaker 1: or the hug, all those things, eye contact, handholding, spooning,
Speaker 1: they all enable the release of oxytocin, and oxytocin feels good.
Speaker 3: Let me ask a question.
Speaker 5: I've never thought of this question before, even though we've
Speaker 5: had plenty of guests who talk about the para sympathetic
Speaker 5: and sympathetic nervous systems. That makes it sound like you
Speaker 5: just switch into one or the other. Is there a
Speaker 5: clean line between them? Is there a way that, like
Speaker 5: you could say, Eric, you are in parasympathetic or Eric
Speaker 5: you are in sympathetic or is it more like many things,
Speaker 5: there's a gradiation in there.
Speaker 1: I think it's okay to say it's a spectrum, And
Speaker 1: the truth is there's one specific situation where there's actually
Speaker 1: a couple of situations where they both come into play,
Speaker 1: where you're in both. But if you think of it
Speaker 1: on a spectrum, I'll get on my phone and I'll
Speaker 1: scroll and I'll scroll, and I'll start to notice that
Speaker 1: my heart rate's going up a little bit, and my
Speaker 1: hands are getting a little sweaty, and they're getting a
Speaker 1: little clenchy, and oh, maybe I'm blenching my jaw, and like,
Speaker 1: sure enough, you know, whatever I'm reading and responding to
Speaker 1: or not responding to is putting me in fight or flight.
Speaker 1: I can feel it in my body. So I would
Speaker 1: argue that even if it is a spectrum, you reach
Speaker 1: a point where you say I'm over the line. You know,
Speaker 1: I've gone from ash gray to charcoal gray. And it's
Speaker 1: not good for your body, you know, And the longer
Speaker 1: you're in fight or flight, the worse it is for
Speaker 1: your body. So one of the things that I talk
Speaker 1: about in good chemistry is how can we get into parasympathetic.
Speaker 1: What can you do to get out of fight or
Speaker 1: flight and get into parasympathetic? And you know, for some people,
Speaker 1: it's put your phone down. Your phone is making you sick,
Speaker 1: your phone is making you miserable. I mean, I have
Speaker 1: a private practice in psychiatry. I talk to my patients
Speaker 1: and it comes up quite a bit that they feel
Speaker 1: like their phones are making them depressed, their phone is
Speaker 1: making them anxious. They feel like they're addicted to their phones.
Speaker 1: And we talk about sort of having a media diet
Speaker 1: or a social media diet or a media fast. You know,
Speaker 1: sometimes you have to stop. You know, you're soaking in
Speaker 1: all this terrible news, and it's terrible news about things
Speaker 1: that are happening all over the world that you can't
Speaker 1: do anything about. You know, the way we make a
Speaker 1: laboratory animal depressed or anxious so we can study it
Speaker 1: is we put them in a situation where they feel
Speaker 1: bad and they can't do anything to stop it. You know,
Speaker 1: you shock them, and you shock them and they don't
Speaker 1: know where the shock is coming from and they can't
Speaker 1: stop it, and they get depressed and they get anxious,
Speaker 1: and it's like, I feel like this is what's happening
Speaker 1: with people on their phones is that they're getting into
Speaker 1: this learned helplessness situation where oh my god, so terrible.
Speaker 1: What's happening in Ukraine, It's so terrible, what's happening in Gaza.
Speaker 1: You know, the world is a mess. America is a mess.
Speaker 1: Even the psychedelic community now we're fighting, and it's a mess.
Speaker 1: And like, you know, where do you turn for peace?
Speaker 1: And so soaking in all that unrest and unease is
Speaker 1: going to put you in a sympathetic place. It's not
Speaker 1: good for your body. So sometimes just like you have
Speaker 1: to watch what you eat, and maybe flour and sugar
Speaker 1: is not that great for you, and so you learn
Speaker 1: to limit or cut out.
Speaker 4: Flour and sugar.
Speaker 1: And I would argue that TikTok and Instagram and all
Speaker 1: these things and Twitter, Facebook, whatever you're doing, pay attention
Speaker 1: to how your body feels. You know, they don't call
Speaker 1: it doom scrolling for nothing. And it's not just that
Speaker 1: you start thinking bad thoughts, but your body, on some
Speaker 1: very basic level, does not know the difference between reading
Speaker 1: about a woman whose kid has just died in an
Speaker 1: earthquake and being the woman whose kid has just died
Speaker 1: an earthquake. You see that picture of a woman holding
Speaker 1: a dead baby in front of a pile of rubble.
Speaker 1: I don't know about you, Eric, but like I feel
Speaker 1: it in my chest, in my torso I see something
Speaker 1: like that and I'm like, ugh, as if this terrible
Speaker 1: sad thing is also happening to me. And that's like,
Speaker 1: I have a lot of empathy. I have a lot
Speaker 1: of compassion. And that's good unless I'm scrolling past image
Speaker 1: and image and you know, there's famine, there's genocide, there's war,
Speaker 1: and what.
Speaker 4: Can you do about any of it?
Speaker 1: So it's really not good for your physical and mental health.
Speaker 1: Sorry to be a downer.
Speaker 5: Well, I agree with you, and I think that any
Speaker 5: thinking person in today's world is wrestling with these questions
Speaker 5: of to what extent do I remain informed? As if
Speaker 5: informed is a virtue on its own, which I'm not
Speaker 5: entirely sure it is, But to what extent do I
Speaker 5: remain informed?
Speaker 3: Versus do I go too far into it?
Speaker 4: Yeah?
Speaker 3: I think everybody wrestles with these things.
Speaker 4: I have a few ideas.
Speaker 1: Malcolm mcglewin, i think, is the one who said that
Speaker 1: when you act as if your nervous system is on
Speaker 1: the outside of your body. You're going to be in
Speaker 1: a very unnatural situation, and the media is making us
Speaker 1: have eyes and ears all over the world. Right, so
Speaker 1: we're experiencing trauma like okay, a thousand years ago. You
Speaker 1: might experience trauma once or twice. Maybe there's an earthquake
Speaker 1: in your town, maybe there's a fire in your town,
Speaker 1: but not every single day whenever you want. Can you
Speaker 1: see that there are earthquakes and fires happening and you're
Speaker 1: experiencing them to some degree, obviously not as if you're burning,
Speaker 1: but your brain is still having that panic response.
Speaker 4: What I would argue is that what's.
Speaker 1: Better for you and your community is that you focus
Speaker 1: on what is actually around you. That you can't fix
Speaker 1: the Middle East, right, but you could volunteer at your
Speaker 1: community resource center in your town and drive somebody to
Speaker 1: their doctor's appointment. You're going to feel good giving back
Speaker 1: to your community, and you are actually doing something that
Speaker 1: makes a difference instead of scrolling and not being able
Speaker 1: to make a difference with all these terrible things that
Speaker 1: are happening somewhere. So the other thing I want to
Speaker 1: say is, you know the hunter gatherer brain that we've inherited.
Speaker 1: We don't need to hunt for food anymore because God
Speaker 1: knows the food is everywhere, and there's calories available everywhere
Speaker 1: as soon as you open your hand, and there's cheap,
Speaker 1: plentiful calories everywhere. So now that we don't forage for food,
Speaker 1: we forage for information. We think that the more we have,
Speaker 1: the safer we're going to be. And that may be true,
Speaker 1: but mostly what's happening is that we're getting terribly depressed
Speaker 1: and feeling hopeless and demoralized and helpless. We can't do
Speaker 1: anything to change it. So good chemistry was all about,
Speaker 1: like close your laptops and go outside, go be in nature.
Speaker 1: You know, sit next to a tree. The tree will
Speaker 1: help to calm you. You know, you can go on
Speaker 1: earth time instead of social media time, and you know,
Speaker 1: have a very different experience of what's really going on
Speaker 1: around you, what's really going on in the environment that
Speaker 1: actually will have an impact on you, and get involved locally.
Speaker 5: Greek philosophers were talking about this doctrine of control what
Speaker 5: you can control versus what you can't, And I think
Speaker 5: Stephen Covey, in his book Seven Habits of Highly Effective
Speaker 5: People gave to me the best example of this, and
Speaker 5: he talked about imagine two circles. Right, There's a big
Speaker 5: circle and within it there's a small circle. And the
Speaker 5: big circle is your circle of concern, everything that you
Speaker 5: possibly are concerned about or care about. The small circle
Speaker 5: is your circle of influence. And the idea is you
Speaker 5: would want to spend more time in your life circle
Speaker 5: of influence. Obvious, right, But the thing that he said
Speaker 5: that really opened this for me was he said, the
Speaker 5: more time you spend in your circle of concern, but
Speaker 5: not your circle of influence, your circle of influence shrinks, right.
Speaker 5: And the more time that you spend in your circle
Speaker 5: of influence, the more it grows. And that to me
Speaker 5: really put all this into really clear state that like this,
Speaker 5: concerning myself with all the problems of the world wears.
Speaker 3: Me out and I don't do anything right.
Speaker 5: Whereas if I'm taking clear, targeted positive actions, it feeds
Speaker 5: you and I'm going to be more effective. If my
Speaker 5: true concern is less suffering in the world, you.
Speaker 1: Will have an impact locally, and it will give you
Speaker 1: the energy to continue to have an impact and maybe
Speaker 1: it scales up, who knows. But you can't start with
Speaker 1: fixing the world so I think what happens is people
Speaker 1: get kind of paralyzed by how terrible everything is and
Speaker 1: they do nothing. And the other thing, I'll tell you,
Speaker 1: my patients do this all time. We'll talk like, I
Speaker 1: know I should exercise, I know I should do this,
Speaker 1: but I'm not motivated, And as soon as I figure
Speaker 1: ot how to get motivated, I'll do it. And I'm
Speaker 1: always like, just doesn't work that way. If you start
Speaker 1: up saying anything, just start it. Then you'll get motivated
Speaker 1: to continue it. And that's about the best you're going
Speaker 1: to get. But waiting around to feel motivated to go exercise,
Speaker 1: that may never happen. Put your sneakers on, go out
Speaker 1: the door and start walking. You'll be motivated to continue.
Speaker 5: Yeah, it's such common sense, but not common practice. You know.
Speaker 5: When I was in recovery, we used a phrase and
Speaker 5: listeners of the show are probably tired of it by
Speaker 5: this point, but it illustrates exactly what you said, which is,
Speaker 5: sometimes you can't think your way into right action. You
Speaker 5: have to act your way into right thinking.
Speaker 1: Yeah, and also that sort of act as if and
Speaker 1: your body will follow. You know, if your body starts,
Speaker 1: your mind will follow. But yeah, I agree that right
Speaker 1: action can proceed right thinking absolutely. You know, It's funny
Speaker 1: because chemistry was written before COVID, right, so a lot
Speaker 1: of the suggestions in there are a little timed out unfortunately.
Speaker 1: Like you know, there was this whole idea of like
Speaker 1: not only do you like put your phone down, put
Speaker 1: your laptops down, but go be with people, face to face,
Speaker 1: skin to skin, the hug, kiss, have sex, you know,
Speaker 1: like just just connect, go connect. And then like COVID
Speaker 1: came and it was really pardon me for saying, but
Speaker 1: it was just like a huge kind of cock blocker,
Speaker 1: you know, that people couldn't do these things that.
Speaker 4: Would really help them feel better, right.
Speaker 1: I mean I literally had a patient who was trying
Speaker 1: to get pregnant during COVID and she's like, what am
Speaker 1: I going to have? Like spurm mailed to me, Like,
Speaker 1: you know, COVID really was a cock blocker for her.
Speaker 1: A lot of the advice in good chemistry temporarily could
Speaker 1: not be acted upon, and now it can be.
Speaker 3: Yep.
Speaker 5: Yeah, you talk about this idea of staying glued to
Speaker 5: our phones and it feeling good and us maybe getting
Speaker 5: a little bit of connection from it, right, synthetic, right,
Speaker 5: And you say, there's a great saying in an addiction medicine,
Speaker 5: which is you can never get enough of something that
Speaker 5: almost works. And I mean, I think that's so true.
Speaker 4: I love that quote.
Speaker 1: Maybe that it was Gubb or Mante that said it,
Speaker 1: but I'm not sure, but that is one of my
Speaker 1: favorite quotes that I use a lot, and it is
Speaker 1: really true. You know, if you're scratching around the itch,
Speaker 1: you're never really going to get any relief.
Speaker 5: Yeah.
Speaker 1: You know, we see this sometimes with like even like
Speaker 1: a food situation, right where like I really have a
Speaker 1: craving for pasta, but I shouldn't have pasta, so I
Speaker 1: will go eat this instead, and that didn't really work,
Speaker 1: so then I'll also eat this other thing. And like,
Speaker 1: by the time I'm done eating around the craving, if
Speaker 1: I had just had a couple forkfols of the pasta
Speaker 1: I wanted, I would have been done with it. I've
Speaker 1: actually ingested, you know, six hundred more calories than if
Speaker 1: I had just eaten the thing. So I think that
Speaker 1: that's true with our sort of hunger for connection. Also
Speaker 1: is that we do other things to sort of plug
Speaker 1: the hole, and you know, social media friendships are not
Speaker 1: going to give you what a real friend is going
Speaker 1: to give you, you know, and texting is great, but
Speaker 1: it's not going to give you the same thing that
Speaker 1: like eye contact and hugging or handholding is going to
Speaker 1: give you. Like, you know, we we are designed for
Speaker 1: physical connection and we are trying to fill that hole
Speaker 1: with technological synthetic virtual connection and it's not ever going
Speaker 1: to really scratch the edge.
Speaker 5: Yeah. I was thinking about texting recently because I'm general
Speaker 5: sense was like, well, you know, texting is not as
Speaker 5: good as a phone call, which is not as good
Speaker 5: as seeing a person in person and nothing.
Speaker 3: And I believe that to be true.
Speaker 5: What I realized though, is with certain people, I'm actually
Speaker 5: like in far more regular contact with them than I
Speaker 5: would be if it was a phone call or having
Speaker 5: to see them, right. And So I don't think it's
Speaker 5: that it doesn't have a place, but it's not shouldn't
Speaker 5: be a replacement for it's I think it can be
Speaker 5: a nice addition too.
Speaker 1: Yeah. To me, it's almost like vitamins versus food. You're
Speaker 1: always gonna have better nutrition if you eat colorful foods
Speaker 1: than if you take a supplement. Yeah, look, I get
Speaker 1: a lot of pleasure.
Speaker 4: We all do.
Speaker 1: I mean, I get a lot of pleasure from texting
Speaker 1: my kids. My kids don't want to talk on the phone.
Speaker 1: They want to text, so we text and it's great.
Speaker 1: You know, I end up because I'm like gen x,
Speaker 1: I'm like dictating long texts, you know, and then I
Speaker 1: get back likekky. But I still enjoy feeling in touch
Speaker 1: with them, There's no question. I mean, my daughter's in London,
Speaker 1: you know, I'm actually I'm gonna go see her next week.
Speaker 1: And it's this is the longest we've been separated. I
Speaker 1: feel it in my body that I been like physically
Speaker 1: separated from this person who came out of my body,
Speaker 1: like the longest ever. And like, yeah, we text them,
Speaker 1: it's great, but I can't wait to like have a
Speaker 1: real hug.
Speaker 4: You know. It's long overdue.
Speaker 1: So yeah, it's better than nothing, but it's definitely not
Speaker 1: as good as a real thing. And but I would
Speaker 1: also argue again, the brain doesn't completely fully differentiate you,
Speaker 1: like synthetic texting from talking or whatever. Like I don't know,
Speaker 1: I just know it's like good, better, best, and the
Speaker 1: best is rolling around naked with somebody that you really love.
Speaker 1: That's a high oxytocin state, and that's what's best for
Speaker 1: your body.
Speaker 5: As a member of gen X, you not only are
Speaker 5: dictating a long text message to your daughter, you're making
Speaker 5: sure it's grammatically correct and it has all the right punctuation.
Speaker 5: Me you.
Speaker 3: The comma Yeah, yeah, totally.
Speaker 1: Maybe not an Oxford comma, but plenty of common Yeah,
Speaker 1: I do.
Speaker 4: I am guilty.
Speaker 5: I keep asking myself. I'm like, I know this doesn't matter,
Speaker 5: and yet I can't stop doing it.
Speaker 1: Yeah, because it's for me. It's such a sign of
Speaker 1: intelligence that I know how to spell your and your
Speaker 1: apropos of nothing gen X. But I just saw a
Speaker 1: picture of Vice President Kamala Harris from back in the
Speaker 1: late eighties early nineties when all of us were wearing
Speaker 1: our hair particular way and wearing make up a certain way,
Speaker 1: and I was just like, oh my god, she is
Speaker 1: like absolutely my demographic, one hundred percent.
Speaker 4: Like that's how my hair looked that year.
Speaker 1: You know. It was just kind of really funny to see, like,
Speaker 1: you know, we all had this kind of like short
Speaker 1: on the sides and curly on the top thing for
Speaker 1: a while, and.
Speaker 4: So did she.
Speaker 5: We've talked about oxytocin, and I think many people have
Speaker 5: probably heard of oxytocin as sort of the bonding chemical.
Speaker 5: You brought up a chemical that I haven't heard about
Speaker 5: in years. I remember hearing about it and being fascinated
Speaker 5: by it. It's a brain chemical. Vascipressin.
Speaker 1: Yeah. So the first thing I will say about vasapressant
Speaker 1: is it's really complicated, and my publishers didn't want it
Speaker 1: included because it muddies up everything. As straightforward as oxytocin is,
Speaker 1: I feel like vaserpressin is much less straightforward. It's more commonplicated.
Speaker 1: One thing for sure is that it's more active in
Speaker 1: men than in women, and women oxytocin is more active
Speaker 1: than men. Like oxytocin works very well in an estrogen
Speaker 1: rich environment, Oxytocin is a little bit embattled in a
Speaker 1: testosterone rich environment. Vasopressin does not have those same sort
Speaker 1: of constraints on it, but it does a lot of
Speaker 1: the same things. But there's one thing we didn't mention,
Speaker 1: which is like, if you're in or out of the
Speaker 1: in group, you know everybody thinks like oxytocin and vasopressin
Speaker 1: is all this kind of touchy feely granola kumbaya. You're
Speaker 1: you know, bonding and trusting and openness, and it sounds
Speaker 1: lovely and like, you know, flowery. But the truth is
Speaker 1: that oxytocin and vasopressin are also involved in discerning who
Speaker 1: is on your team and who's not on your team,
Speaker 1: who is friend or foe. Basically are they in your
Speaker 1: clan or are they in the opposing clan? And so
Speaker 1: both oxytocin and vasopressint are involved in that sort of discernment.
Speaker 1: You know, nothing makes a group more cohesive, I think
Speaker 1: than if they have an enemy. You know, I don't
Speaker 1: want to talk too much about politics, but it's one
Speaker 1: of the things that really drives politics is that you
Speaker 1: come together in your distaste for the other group. And
Speaker 1: that is a heavily I would argue vasopressin and oxytocin
Speaker 1: fueled state to be in. But it feels good, right
Speaker 1: because you're all on one team and you feel the
Speaker 1: cohesion of being on a team, and you know, everybody
Speaker 1: wants to be on the winning team, and the more
Speaker 1: cohesion the team has, the better they are at winning.
Speaker 1: So xenophobia, for example, right is sort of about are
Speaker 1: you on my team or are you on the other team,
Speaker 1: you know, looking at immigrants as other and as them.
Speaker 1: There's a great ted talk called them as a four
Speaker 1: letter word. You know, this idea that you don't have compassion,
Speaker 1: that you've othered them into something different from yourself. And
Speaker 1: this actually gets back eric to what you were talking
Speaker 1: about with partners and being yoked and them having sort
Speaker 1: of disowned things about you that you project onto them.
Speaker 1: And people do this in groups too, in a diet
Speaker 1: or a partnership or marriage or something. Let's say for example,
Speaker 1: that I mean, these are real examples, but I feel
Speaker 1: like in my childhood, if I was sad or if
Speaker 1: I was scared, I was sort of rejected.
Speaker 4: You know, I had to be.
Speaker 1: Tough and happy, and so don't be sad and scared
Speaker 1: are bad things. I go out in the world and
Speaker 1: I fall in love with and marry somebody who, on
Speaker 1: some level, at least to me, presented as a sad,
Speaker 1: scared person. And because I embraced him and sort of
Speaker 1: you know, engulfed him and we became one entity, I
Speaker 1: was able to get those things that were rejected out
Speaker 1: of me and I had put away, and I was
Speaker 1: able to sort of accept them and accept the sad
Speaker 1: and scared parts of myself.
Speaker 4: Blah blah blah.
Speaker 1: Same thing in groups, you know, there's a group cohesion
Speaker 1: and we're good and they're bad, and you know, you
Speaker 1: project all the things that you don't want to own.
Speaker 1: For instance, as an example, let's say that a Republican
Speaker 1: actually really likes having sex with men, but they feel
Speaker 1: like that's not part of the Republican image, and so
Speaker 1: they're going to say that they're all about family values
Speaker 1: and that being gay is wrong, and they're going to
Speaker 1: kind of double down, and so they're rejecting this part
Speaker 1: of themselves. They put it on the other and they say,
Speaker 1: those people that have those feelings about one af sex
Speaker 1: with men, they're bad and I'm against them, when really
Speaker 1: it's self hatred. It's projected self hatred taking that part
Speaker 1: of themselves they can't accept. They're putting it on the
Speaker 1: other people and they're saying they have that thing, and
Speaker 1: now I'm allowed to hate them because I was told
Speaker 1: that those things were bad and I shouldn't be those things. So,
Speaker 1: you know, the basic things that vasopressin does has nothing
Speaker 1: to do with what we're talking about. I mean, primarily
Speaker 1: it is an antidiuretic hormone that helps to control the
Speaker 1: balance of water and electrolytes so that you don't get
Speaker 1: too overhydrated. That's primarily what it does. It's also like
Speaker 1: a vasoconstrictor, which means it increases blood pressure.
Speaker 4: If you lose blood volume, it comes around so that
Speaker 4: it keeps your blood pressure up.
Speaker 1: Those are sort of the main things it does. But
Speaker 1: then also in males, it reinforces pair bonding, keeping you mate.
Speaker 1: It also reinforces aggression of like sort of territorial aggression,
Speaker 1: like what I sometimes refer to as territorial pissings. This
Speaker 1: is my territory. You can't cross over into this line.
Speaker 1: If you do, I'm going to attack you. That's very
Speaker 1: much a vasopressant thing.
Speaker 5: So let's talk a little bit about psychedelics and addiction,
Speaker 5: and I think it is a nuanced and complicated area.
Speaker 5: I am a recovering alcoholic heroin addict. I usually don't
Speaker 5: state this, but in addition to those two, I was
Speaker 5: a prodigious marijuana user. So I have watched this psychedelic
Speaker 5: unfurling over the last decade where it's really started to
Speaker 5: get traction in both mental health and spiritual circles very
Speaker 5: interestedly and also very cautiously, given my history and given
Speaker 5: I've had some really tremendously bad trips in my past.
Speaker 5: And so let's talk about first just that link between
Speaker 5: psychedelics and addiction, whether psychedelics are actually addictive, and then furthermore,
Speaker 5: what do we see that are some of the possibilities
Speaker 5: that psychedelics might give for healing addiction.
Speaker 1: Yeah, so, I mean you could tell by the length
Speaker 1: of your question how complicated it is, right, Like, psychedelics
Speaker 1: can potentially help people who are addicted, and psychedelics can
Speaker 1: potentially make things worse if you're addicted, And some of
Speaker 1: it depends on which medicine we're talking about. So there's
Speaker 1: one way of talking about psychedelics, which is a very umbrella.
Speaker 1: You know, anything that helps you see the way your
Speaker 1: mind works could be considered a psychedelic. And if you
Speaker 1: use that broad term, then things like ketamine and cannabis
Speaker 1: fall under the psychedelic umbrella n MDMA. If you're using
Speaker 1: a more narrow term where you're like, okay, let's just
Speaker 1: say the classical psychedelics are like LSD and mushrooms and mescaline.
Speaker 1: Those three the classical psychedelics, There really isn't any addiction
Speaker 1: in terms of tolerance, dependence, withdrawal, sort of the classic
Speaker 1: things physiologically that you would see an addiction. So I'm
Speaker 1: going to start with sort of the broad statement that
Speaker 1: in general, what has not been reported is tolerance dependence
Speaker 1: withdrawal with the classical psychedelics, LSD, mushrooms, mescaline. So put
Speaker 1: those aside because I do think they may be helpful
Speaker 1: in treating addiction. So we'll come back to them. Where
Speaker 1: we get into trouble with quote psychedelics and addiction. Ketamine,
Speaker 1: which is really not officially a psychedelic. It's definitely not
Speaker 1: a classical psychedelic. Ketamine is actually a dissociated anesthetic, and
Speaker 1: ketamine is the most addictive of the psychedelics full stop.
Speaker 1: If you are the kind of person who has addictive tendencies,
Speaker 1: you tend to get addicted to things. I do not
Speaker 1: recommend that you do any sort of self administration of ketamine.
Speaker 1: You very well may end up in trouble. MDMA rarely
Speaker 1: causes problems with addiction. It's not something that you can
Speaker 1: really take chronically. It feels worse and worse every time
Speaker 1: you take it. Basically, if it turns out that really
Speaker 1: you've got sort of something you think is MDMA but
Speaker 1: it's not, and it's methamphetamine, obviously you're going to get
Speaker 1: into trouble. Methamphetamine is much more addictive than MDMA, which
Speaker 1: is methylene dioxy methamphetamine. I've never seen a case of
Speaker 1: MDMA addiction, but I have heard about people who, you know,
Speaker 1: go clubbing and take ecstasy and or molly as the
Speaker 1: kids call it today, and you know, maybe they're taking
Speaker 1: it multiple nights in a row or multiple weekends in
Speaker 1: a row. Like, we know that's not good for you.
Speaker 1: No one is saying that's good for you. Cannabis has
Speaker 1: an addictive potential one hundred percent. We all know people
Speaker 1: who've gotten addicted to cannabis. The percentage is, you know,
Speaker 1: they put it at roughly nine percent. It might be
Speaker 1: higher now with a higher THHC percentages. It's still not
Speaker 1: nearly as addictive as I mean. I don't know that
Speaker 1: it matters to like put things in order, but I
Speaker 1: would argue that cigarettes, heroin, cocaine, alcohol, cannabis kind of
Speaker 1: in that order from top down of how addictive things are,
Speaker 1: how hard it is to quit it's harder to quit
Speaker 1: smoking cigarettes than it is to quit heroin. It may
Speaker 1: be harder to quit heroin than it is to quit cocaine.
Speaker 1: It's harder to quit cocaine than it is to quit cannabis.
Speaker 1: Then the other thing, I'll just have to say, it's
Speaker 1: sort of a cop out sounding, but you can get
Speaker 1: addicted to anything.
Speaker 4: Obviously.
Speaker 1: We know people who get addicted to masturbation, to shopping,
Speaker 1: to gambling, blah blah blah blah blah. So we have
Speaker 1: to cop to the fact that there's also something called
Speaker 1: a process addiction where you can get addicted to any behavior.
Speaker 5: Right, right, And some of these things that we might
Speaker 5: think of as less addictive, like cannabis is going.
Speaker 4: To I could think still a process addiction.
Speaker 5: I think it ends up co opting a little from both, right, Yeah, I.
Speaker 1: Agree, And the same with food, right, Like, you can
Speaker 1: have a process addiction around eating. You know, what's a
Speaker 1: drag about food addictions is that you have to eat
Speaker 1: or you'll die. You don't have to drink or have
Speaker 1: to smoke pots. So it's you know, it's really really
Speaker 1: tough when food is your of choice. As a psychiatrist
Speaker 1: who works with addiction quite a bit as a friend
Speaker 1: and colleague of Gabor Mate and also Elias Daquar just
Speaker 1: wrote an amazing book about addiction. You may want to
Speaker 1: talk to him. I will say that a lot of
Speaker 1: people who work in this field feel like part of
Speaker 1: addiction is sort of like a spiritual illness, where there
Speaker 1: is a lack of meaning and a demoralization and a
Speaker 1: sort of just trying to numb and existential angst. And
Speaker 1: so in those situations, cannabis or other psychedelics, classical psychedelics
Speaker 1: that may give you sort of a meaning making experience
Speaker 1: or fill you with some sort of hope or plans
Speaker 1: for the future that can be helpful in treating an addiction.
Speaker 1: More directly, I really want to let people know that
Speaker 1: they're there's a plant called ibogain that is from a
Speaker 1: shrub of the iboga tabernathy plant. I'm probably saying tabernan
Speaker 1: the wrong anyway.
Speaker 4: I begain, which you will.
Speaker 1: Be hearing more about, seems to specifically really help with
Speaker 1: opiate addiction. Seems to sort of reset the receptors so
Speaker 1: that you get rid of the whole tolerance withdrawal issue,
Speaker 1: and also gives people a very intense psychedelic experience where
Speaker 1: they do a bit of a life review and sort
Speaker 1: of come to the conclusion that the opioids have not
Speaker 1: been helpful and it becomes easier to quit physiologically and
Speaker 1: psychologically after I Begain experiences. So I think you're going
Speaker 1: to be hearing more about ibogain for drug addiction, and
Speaker 1: I really I think there's a lot there. The problem
Speaker 1: is that I begain is potentially toxic to the heart, cardiotoxic,
Speaker 1: and there are a few ways to get around this.
Speaker 1: You can do an EKG and an echo to make
Speaker 1: sure your heart's okay before I begin, or you could
Speaker 1: potentially take magnesium during the I begin to lessen the
Speaker 1: cardiac effects. But that that is one clear example of
Speaker 1: a psychedelic treating addiction with really impressive results. I would
Speaker 1: also argue, I have patients who have quit being addicted
Speaker 1: to pain meds by using mushrooms. I have had patients
Speaker 1: quit being addicted to pain meds by using ayahuasca. I
Speaker 1: do think that there is value in a guided psychedelic
Speaker 1: experience in tackling childhood trauma and just maybe kind of
Speaker 1: unraveling where things went wrong, where things went south. You know,
Speaker 1: you weren't an addict when you were eight, You weren't
Speaker 1: an addict when you were ten. What happened when you
Speaker 1: were twelve, because from thirteen onward there was an issue.
Speaker 1: You know, It's like you can kind of look back
Speaker 1: and see the narrative figure out where things went wrong.
Speaker 1: I think in the context of like supportive psychotherapy, the
Speaker 1: classical psychedelics ayahuasca, I begain could be very helpful in
Speaker 1: treating addiction. And then there's cannabis, which is complicated because
Speaker 1: you know, it's sort of like the people's psychedelic. Cannabis
Speaker 1: is a psychedelic if you use that big umbrella term
Speaker 1: where it's mind manifesting and it shows you how you think.
Speaker 1: And there are people who are using cannabis in high
Speaker 1: doses as a psychedelic the same way that you would
Speaker 1: use psychedelics as the therapy.
Speaker 4: Whether they're treating addiction or not. I could not say.
Speaker 5: Yeah, And obviously I feel like I always hear other
Speaker 5: podcasters do this, so I suppose I should do it.
Speaker 5: None of this is medical advice.
Speaker 1: No, I'm not your psychiatrist, I'm not your doctor. I'm
Speaker 1: speaking in generalities.
Speaker 3: Yeah, we're not encouraging or condoning.
Speaker 1: We're just discussing, Yeah, and there are a lot of risks,
Speaker 1: and it's important to talk about the risks. You know, Unfortunately,
Speaker 1: with our nation's drug policy, the number one risk is
Speaker 1: that you don't get the drug you thought you were buying,
Speaker 1: and it's more dangerous than what you were hoping to get.
Speaker 1: And you know, I often tell the story when I
Speaker 1: was a teenager, I'd heard a lot about mescaline. I
Speaker 1: was very interested mescal and I wanted to try it.
Speaker 1: I inadvertently ended up trying PCP. It wasn't what I wanted,
Speaker 1: and I got a very intense psychotic experience, which was
Speaker 1: not you know, the unifying, you know, peak mystical experience
Speaker 1: I was hoping for. Ye, but it got me very
Speaker 1: interested in psychosis and psychiatry, and it got me really
Speaker 1: interested in harm reduction and counterfeit drugs and drug substitution
Speaker 1: is one of the things that makes drug taking so dangerous,
Speaker 1: and as long as we have the drug policy in
Speaker 1: America we do, that's.
Speaker 4: The number one risk.
Speaker 1: The number two risk is just not getting good information.
Speaker 1: You know, it's hard to get reliable drug information. Our
Speaker 1: government isn't great at giving us all the information and
Speaker 1: then it's hard to figure out, you know, whether you
Speaker 1: should trust whoever's giving you this information. So that's also
Speaker 1: a real casualty of the drug war, is you know
Speaker 1: the truth?
Speaker 5: Right. I think that's a really good point, is it
Speaker 5: is really difficult to get good information on what are
Speaker 5: considered illegal substances, right because you're right, the governing bodies
Speaker 5: are just interested in demonizing them by and large, and
Speaker 5: then you get the people who are unabashed advocates of
Speaker 5: it right, right, And that's not what you want either. No,
Speaker 5: and I'm not saying it's perfect, but you want something
Speaker 5: a little bit closer to what we get with FDA
Speaker 5: approved drugs, where you have some sense of the truth
Speaker 5: being disseminated to some degree about the pros and the
Speaker 5: cons the side effects, the benefits.
Speaker 1: The other risk besides drug substitution or misinformation, is that
Speaker 1: when you are altered on a psychedelic you are in
Speaker 1: an exquisitely vulnerable, plastic impressionable state. It is a non
Speaker 1: specific amplifier. Everything comes in more and so it's really
Speaker 1: important that you are in a safe space, that you
Speaker 1: are around people who make you feel safe, that you're
Speaker 1: in a good headspace when you start the experience. I
Speaker 1: mean that's all set and setting and that you are
Speaker 1: not around bad actors, and it's you know, it's hard
Speaker 1: to tell, you know, I jokingly refer to something as
Speaker 1: like Shaman's behaving badly. You know, there there are there
Speaker 1: are people out there who say they're a shamans Shaman's gone,
Speaker 1: Shaman's yeah, but like, you know, it's not funny. I
Speaker 1: mean it's you know, sadly. You know, the phrase is funny,
Speaker 1: but the reality is really and terrifying that there's always
Speaker 1: going to be people who are going to take advantage
Speaker 1: of other people. You know, there are bad actors in
Speaker 1: the world. There are people who are going to take
Speaker 1: advantage of somebody who's trusting in an open state, and
Speaker 1: so you really have to do sort of the homework
Speaker 1: ahead of time that you are at a good retreat,
Speaker 1: that you're with a good guide, that you are actually
Speaker 1: taking the medicine you think you on and you know,
Speaker 1: like there are so many variables that need to be
Speaker 1: accounted for. And there's no question that in a medical
Speaker 1: model it's safer because there's no counterfeit drug substitution. You're
Speaker 1: not over hydrating or overheating or doing any of the
Speaker 1: crazy things that can get you into trouble with MDMA,
Speaker 1: where you know, you're like dancing for hours on end,
Speaker 1: you're not taking breaks, if you're sitting in your therapist
Speaker 1: office talking about childhood trauma. You're not overhydrating or overheating,
Speaker 1: and you haven't taken a counterfeit drugs. So already, like
Speaker 1: three major risks are mitigated in the medical model. The
Speaker 1: reality is that most people don't take psychedelics under a
Speaker 1: medical model. They use a recreational model. And sadly, the
Speaker 1: recreational model in our country is going to be less safe. Unfortunately,
Speaker 1: you know, you have to do more work to make
Speaker 1: sure you're going to be safe. The government, unfortunately in
Speaker 1: the situation, is not gonna at least for now, is
Speaker 1: not going to be guaranteeing your safety.
Speaker 5: Yep, Well, that is a wonderful place for Well, it's
Speaker 5: actually not a great place to wrap up because there's
Speaker 5: about one hundred other things we could discuss about it. However,
Speaker 5: what it is is time, Yeah, to wrap up. I
Speaker 5: segued into my usual habitual. Well, that's a great place
Speaker 5: for us to stop. It's not a great place, but
Speaker 5: but that's where we are. You and I are going
Speaker 5: to continue to discuss these issues and a little bit
Speaker 5: more in the post show conversation, which listeners, we would
Speaker 5: love to have you join our community where you get
Speaker 5: post show conversations, ad free episodes, and all sorts of
Speaker 5: other wonderful things by going to oneufeed dot net slash join.
Speaker 5: Thank you so much, Julie for coming on.
Speaker 4: Absolutely my pleasure.
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