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

26:16We all have our Achilles heel of something that is the tell. So when if you have a medical condition like, say, peptic ulcer disease, that's easy to understand. You feel like, oh, I have stomach pain. And so I can eat certain foods and I need to take care of myself and there'll be a flare and then you manage that symptom and it goes away and you know, you know what that tell is of peptic ulcer disease, stomach pain. But for stress, often things are happening to your body and you're not even aware of what that physical manifestation is. That's not to say that it's, you know, your headaches are caused by stress, but they're certainly worsened by stress.

26:49So when you have a certain symptom happening to your body, understanding that, hey, that could be my canary song. I think everybody intuitively knows what that canary is. I think everybody knows what that is. I've got a bunch of different ones. Whenever I'm stressed and I don't even know when I'm stressed, but I don't know why, but I don't know consciously that I'm stressed. But certain things start to happen. I have this really weird one where on my tongue, I'll get a little bit of like a, not like an ulcer, it kind of feels like I've got a spot on my tongue. I get that whenever I'm stressed, my skin gets worse.

27:22So I get like spots on my face when I'm stressed. There's a few of them. I'll get a cold pretty much exclusively when I'm stressed, which happens about once every six months or so. I think generally I manage stress well, generally, but I'm not immune. I once upon a time thought I was immune. I thought stress and all these other things and mental health all happened to other people. Turns out happens to me too. That's right. You know, and I think I really pushed myself for a good 5, 6, 7, 10, you know, I was a CEO of a company that had hundreds and hundreds of employees. And I was 25, 23, 24, 25, 26, 27.

27:58So I pushed myself very hard. And I think for the first couple of years I withstood it, but then as time went on, you know, I was not able to outrun the inevitable. And that's that resilience myth, you know, that like resilient people don't get burned out. It can't be me. Of course, I, of course I'm not stressed. I, someone like me, couldn't even fathom being stressed. And I have seen thousands of people who have said that very thing. I said the exact same thing during my stress struggle. Stress doesn't happen to people like me. You don't want to admit it either because there's an element of it where you go, I don't want to be fucking weak.

28:31I don't want to be the weak person. If I'm experiencing stress or I'm burnt out, then that makes me inadequate in some way. So I don't want to talk about that, you know. But I think I've been a victim of that. Like that pride that you go, especially as like a man and like a CEO and all of those things that are stereotypically, toxically associated with strength. I've never wanted to admit that I was stressed ever. I don't think I've ever actually said the word to anybody. But I've definitely been stressed. And I know because my body told me, and it tells me in a very predictable way, that canary stops singing.

29:04So I just think that's important because... It's your mind -body connection. And once you see it, you cannot unsee it. It's like gravity. It's all around you. It's working in the background all the time. And then suddenly you start paying attention. And it's like, oh my god. And on that point of it, feeling like evidence of your inadequacy, it's actually evidence that you're a human. That you're perfectly normal. That you're not broken versus this idea that it's evidence that you're broken. Beautifully said. Thank you. Really? Just... Have you listened to this post before? I'm joking. I am joking.

29:37For the record, testing, testing, 1, 2, 3, I am a avid fan of this podcast. And I have listened countless times. And I... This is the one podcast I regularly listen to on my morning walks. And I have shared on Instagram. Probably hundreds of lessons in my stories about what I've learned on this podcast. Thank you. So, stress on the brain. You read about that in your book as well. I know that stress causes cortisol. This is my very limited understanding of stress. It causes cortisol. Talk me through that. And then I have this other question that I wanted to ask you about the contagion of stress.

30:20If I am stressed and Jack is that over there, will Jack feel my stress? So, let's talk about stress and the main highway of stress in the brain and the body. It is the HPA axis. H stands for hypothalamus. P stands for pituitary gland. A stands for the adrenal glands. The hypothalamic pituitary adrenal axis. Mouthful. But the H and P part of the axis is in your brain. And the A part of the axis is above your kidneys, the adrenal glands. And that is the information highway that is responsible for our stress response. It's all of the things that we talked about. The fight or flight response, it makes our heartbeat.

31:05It makes, you know, it does all sorts of stuff. The amygdala works in that HPA axis as well. And other parts of the brain, the prefrontal cortex, etc. So, when you have that experience of stress, and this we're talking about acute stress, this is what is happening to you. Your brain and your body are sinking up and reacting. There's a cascade of hormones that happens in the body. And that is what you feel as, wow, I'm stressed. Or like you described, this discomfort or familiar feeling of like, wait a second, I know what this is. It's that thing that I have when I'm under pressure or under situations that are tense.

31:47And that is the stress response. And that is essentially what is happening to our bodies when we are feeling that fight or flight syndrome. Unfortunately, what often happens with the amygdala is that while it is helping with this fight or flight syndrome and the HPA axis, it with chronic stress does not shut off. And that is the problem. So those hormones are just flowing through that highway all the time? And cortisol is our stress hormone and it's all part of that as well. Because cortisol surges during adrenaline, nor adrenaline, all of these hormones are working through our bodies and surging through our bloodstream.

32:28Cortisol is also a stress hormone. And so when we have chronically elevated levels of cortisol, all sorts of badness can happen. It's stress contagious because I was on Google and I typed in it's stress contagious. And it says that in a workplace, stress is contagious. Stress is not contagious in the way that you think of a virus or microbes are contagious. As far as I am aware, now there might be emerging data to suggest otherwise. But it is not like a microbe where it's going to spread like the virus that it's going to spread from me to you, for example. But there are hormones, aren't there that spread like pharomones?

33:06Pharomones, but that's different. That's more for attraction, sex, and other things like charisma, etc. What is kind of contagious, and I want to use that word loosely, is emotion. So yes, creating a toxic environment. We call it in pop culture a vibe. Like that person just didn't have a good vibe. What's really interesting, and it's anecdotal, there isn't a ton of research to support this, but I find this fascinating, that the heart has an electromagnetic field that extends 15 feet. That's something that one of my early mentors had told me. So that is that vibe that you sense from people. Like you feel that goodness, right?

33:53Like when you meet someone that you just really like their heart, it's like heart expansiveness. And other people. With five feet away from each other. So your heart, it's electromagnetic field, is overlapping with my heart's electromagnetic field right now. So they say, now I've heard this in lots of people say this, but I have also dug deep into the science of like does this even exist? Is this even a real thing? And I'm not sure if it's a real thing, because I haven't found like multiple scientific studies that show robust data that yes, this is a real thing. But it is a fascinating thing to think about as a mind exercise, not so much from the scientific perspective, but like from a human lived experience perspective of, you know, when I try to think about that when I enter a room, certainly when I'm with a patient, we call it the therapeutic presence or the therapeutic encounter.

34:50And it's this idea that when you are with a patient, or right now I'm talking to you, and I am the doctor talking to you, right? Not your doctor, of course, but it's this idea that you have, that you can have a therapeutic experience. I try to engage in the therapeutic encounter at every talk anytime I'm speaking to an audience. I want people to leave feeling a sense of healing, healing and cure are two different things, by the way. So I'm not saying like, I'm, you know, we're going to talk and then it's like you're going to be cured of whatever illness you might this idea of like feeling that sense of healing and it's the therapeutic encounter.

35:29There is science behind the therapeutic encounter. And what that simply means is that doctors who have that sense of therapeutic presence, you know exactly what I mean. You might not call it that. And then you also have had lots of doctors who've had no therapeutic presence and you know what that feels like too. How does one get a therapeutic presence? It's something that needs to be cultivated. Of course, it's something that you know, you can have, but then you cultivate it with training and practice, etc. But the therapeutic presence that therapeutic encounter has been shown to actually have health outcomes.

36:02So greater adherence, you know, to medication, tighter glucose control, decreased asthma flares, like real concrete health outcomes when you have a therapeutic encounter with in that doctor -patient relationship. So there is some magic secret sauce happening in that encounter. And what is it? How do I cultivate it? Are there any tricks? Any tips, tricks? Is there like a body language thing? Maybe. Yes. So as a doctor, I can tell you that there is lots of studies. There are lots of studies which show that it's not really the amount of time you spend with someone. It's your body. And so for example, they've been, they've done studies on doctors who stand for let's say seven minutes and talk to the patient versus a doctor who sits down, makes eye contact.

36:53And as at the same level or a lower level than the patient, the patient has a perceived sense that this doctor cares more and is more engaged and has a therapeutic presence. No difference in time. I think that's the great myth that people say, you know, oh, I need to spend more time to create a therapeutic presence. It's not about the time spent. It's about how you are spending the time and the quality of time. So that's like one trick that you could try. I level. You mentioned the eye level back. Being at the same eye level or lower because it's a power dynamic. Think about when you're seeing, if you were in the hospital and you're lying in a hospital bed and your doctor came in and you're lying there, and the doctor is speaking above you, does that feel therapeutic in any way?

37:33Not really. But if the doctor came, pulled up a chair, sat next to you and looked at you eye level. That's why when you're talking to a child, it's better to bend down and make, you know, get on their level and talk to them. And if I'm in a meeting and my chair is maybe a little bit higher and I'm speaking to a client and I want the client to do a deal with me, it's best for me to get down to their eye level. It depends because in that situation, you know, again, this is like what you were talking about earlier. There's times when you want to show a sense of power and therapeutic presence is not a sense of power.

38:06It's a sense of equality, compassion, empathy. Are these the qualities that you're trying to create in a business interaction? I don't know, maybe. We've learned from, I don't know, been making content for about 10, 15 years now for a long time, making lots of videos. One of the things we've learned is that the engagement goes significantly up if you are on the island of the camera. So you'll notice in the diary for CEO, we don't shoot from above, we don't shoot from below, we go to great lengths to make sure that the camera is on the island and we just see that the engagement numbers are higher and actually the more down the barrel it is, especially if I'm looking into this camera here, the more down the barrel and the more on island I am, the better engagement with the video.

38:46We've just seen that over thousands and thousands of videos we've made. So that's why the podcast is set up like this where there's, we're on your island and we're on down the barrel as much as we possibly can be without you seeing too much of the back of my head there and the same applies for this one because it just makes, for some reason, the engagement with the audience is better, we see it in the numbers. There's so many tricks that you could use, I mean, like sitting down, eye level is one mirroring, also something else. This is not related to stress, but it's like mirroring. So for example, as I'm talking to you, as you're talking, if I do this, if I do this and then you're like, oh, this person is like totally following me.

39:25No, I'll be yeah. But it's like if I start doing this, you just did this and so I did that. So there's like mirroring is something that you, you know, there's lots of ways to try that. But again, it has to feel. Yes, the key is authenticity though, right? Like you can do all of these things, but ultimately authenticity and the human, the really fascinating thing about podcasting, by the way, and any sort of connection with another human being is the voice. So we as children as infants, we are highly attuned to voice. It's one of our first primal instincts, right? Like hearing our mother's voice or our caregivers voice or our parents voice.

40:07And we can, our BS meter with voice is high. So if someone isn't authentic, and that is why the audio version, like so listening to podcasts, the reason, like you can always suss out, like who is, for example, I don't know, like who's telling the truth and who's not. And it's not like something that you can explain. You just like, you're like, oh, I don't really like this person or I really like this person. It's because they lead with authenticity, vulnerability, all of these things that, you know, the likeability factor is high. It's because our brains are primed to recognize and register the human voice in a way that's very different from the physical.

40:52So yes, we, of course, like we see someone and you get the whole picture. Yes, but when you hear them in your ear, there's like something that is deeply intimate about that experience and that, you know, evolutionarily and even like in our own life, it's very poignant. And it's an intuitive thing. We don't necessarily know what it is about a voice that's authentic. It's just a feeling. You feel it. And you know it because when you hear someone on a podcast, you immediately are like, oh, yeah, I like this. And you don't know why you like it or, you know, you feel that connection. And it's like the voices of very primitive thing.

41:25And it's also like it's, it was because we formed those connections and synapses in our brain, preverbal, right? Like when we were infants, same thing with smell. You know, you smell something and it takes you right back to that moment. Well, I was so fascinated. I remember where I was when someone told me about pheromones that there's these chemicals that like leave our bodies and then into my chemicals will interfere with your chemicals. I just thought that was absolute witchcraft. And I'm a very logical science -based person. So I need science and evidence to believe anything. And then when I heard this rumor that like, you know, if you put a, my mother and my sister in the same house, their menstrual cycles would sink up.

42:06That's right. I googled it to check if it was true. Google told me it was true. And then I thought, if I can now believe in witchcraft. Well, I read the book, The Red Tent. I mean, it's like very much along those lines of like biblical times they had a red, red tent for women, menstruating women. And then it would just like the whole tribe would like sink up. And they'd be in the red tent during menstruating times. They've done studies with t -shirts and attractiveness. So you will smell a t -shirt that, you know, they've done studies with women and men have worn the t -shirts. And then you smell the t -shirt and you say, like, I like the center I don't.

42:43And it's not body odor. It's pheromones. And they've matched it with like the pheromones that you like. And then you see the visual and there's a match. Like, this person is attractive. And then you smell the pheromone and there's like a match. It's that person's pheromones. Often they say like you describe your mother and your sister. For example, they say that like genetically the more different, the more attractive, right? Because we're always trying to... So if you... Of course, there's like a comfort thing of like, you know, your mother and like, that's different. Because pheromones are mostly for attractiveness and meeting.

43:21So it's not about comfort, you know, I guess there might be some studies about comfort and maternal comfort and self -suiting or soothing with your parent or caregiver. But most of the pheromone research that I'm aware of is like sexuality, attractiveness, charisma, but mostly due to mating behavior. So going back to this subject of stress, I get stress now. I kind of understand the difference between acute stress and sort of chronic stress, which is a very bad thing. In your book, you talk about the resilience rule of two. Yes. The resilience rule of two is how our brains make change possible.

44:03So when we are undergoing a change, even a positive change in our life, like let's say, you know, I've had a patient who came to see me and had a binder filled of things that he was trying. And it was like the kitchen, everything but the kitchen sink approach. And so he came to see me and was like, Doc, I've been doing a great job. It's been a month and now I'm in month two and I don't want to do any of it. And I'm done. And he was under a lot of stress and he was trying all sorts of things. We've all been there. We've tried lots of different things. And then you just say, okay, I'm done. Can't do any of it.

44:43Why? Our brains, even when we're making positive changes, like let's say you recognize, like, yeah, I think stress is a problem in my life. I'm going to make a change. I'm going to start eating better and I'm going to start exercising and sleeping better. And I'm going to spend time with friends. And I'm going to do less work. And I'm going to do all of these things to help my life and, you know, make a big lifestyle overhaul. And I'm really stressed. It will not last because our brains have the ability to make two new changes at a time because even positive change, like all of these things that we're describing right now, are a stressor to your brain.

45:13How do we know that? How do we know we can only make two changes at the basis of the rule of two is based on a seminal landmark study in the 1960s. By two psychiatrists, doctors, homes and Rahe, they looked at 5 ,000 people and looked at 43 common conditions, like life events that happen in people's lives, the most common ones. Graduation, getting a new job, buying your first home, a outstanding personal achievement, getting married, having a child, getting a divorce, death of a loved one, 43 of the most common conditions. And when in every single condition, good and bad, got a score. They studied 5 ,000 people and found that the more life events someone accrued, and it's not about like age or, you know, chronology of age, it's just the more life events a person accrued, the greater their stress, the greater the likelihood also that they would develop an illness later in life.

46:12And that, homes and Rahe's study, is the basis of this rule of two because what they discovered is that positive life changes are also a stress to your brain and your body. And that is because there is a certain level of adapting, you know, there's a certain level of human adaptation that needs to happen with something positive and fantastic that happens in your life to regain the stability that you had before. Think about your own life. There are probably so many examples. I recently moved into a new home. Everyone was like, congratulations, this is amazing, a new home. And it was wonderful for a few months.

46:53And then like also incredibly stressful. And then of course, I had the delayed stress reaction three months later, right? Like where you're running on adrenaline initially and everything is great. And then that stops and then you're, you know, having sleepless nights about all the various stressors. So the rule of two is based on this idea that positive life events, things that you think might be really helpful to you to manage your stress. If you do them all at once, chances are it's not going to stick. So instead, aim to do two new things at a time, build them into your life over time in the five resets I offer, five mindset shifts, 15 science back strategies.

47:30And every step of the way, it's about two small changes at a time. You work with your biology of stress rather than against it and competing against it. That is how you make change possible. In clinical practice, when I was a medical resident learning how to take care of patients, my mentors would do the same thing. So this is 50 years later after that study. They taught me that when I'm seeing a patient, you know, a patient will come in with a laundry list of symptoms or they will have six, seven, eight medical conditions. You always focus on two things because if you say to the patient, I really think you should stop smoking.

48:08Here's some suggestions. Let's work on your weight and get your weight better. Let's work on your cholesterol. How about your blood pressure? How about minimizing chances of cancer? Two overwhelming for the brain to sustain. Instead, let's focus on getting you to stop smoking and let's focus on lowering your cholesterol. These are two tangible things that you can work on. It takes about eight weeks to build a habit. Once you are engaged and that has become a habit for you, then you add two new things. Let eight weeks go by, then two new things. So over time, you do address that laundry list of symptoms or in this patient's case, you know, all eight medical diagnosis and the other patient's case who came in with everything but the kitchen sink approach to managing his stress.

48:54We eventually did get all the way to the finish line of fixing his stress and addressing all of the issues, but it only happens two small incremental steps at a time. The five resets, the first of those resets is to get clear on what matters the most. When you are feeling a sense of stress, you are living in survival mode. You are governed by your amygdala. Its focus is self -preservation. You are literally living in the moment. Your prefrontal cortex is the area of your brain that, like we said, behind the forehead that governs forward thinking, planning, organization. When you tell someone who is deeply stressed and in a crisis or fight or flight mode, oh, just figure it out.

49:44You know, make a plan, figure out what's going to help you and just do it. Mind of a matter. None of that helps. It is also biologically impossible to think five, ten steps ahead when you are living in fight or flight mode governed by your amygdala. The first reset, get clear on what matters most, offers three concrete science -back strategies that can help you when you are feeling a sense of stress and you're in fight or flight mode to help get out of your own way, create a roadmap and a plan forward. So it actively, by going through these strategies, you slowly get out of that amygdala mode and back to letting your prefrontal cortex take over.

50:30So how do I figure out what matters to me most? Is most is an acronym, M -O -S -T, and the book has a whole strategy of how to figure out what matters to you most because it's not so much what's the matter with me. It's what matters to me most. So when you shift that framework and stop blaming yourself and criticizing yourself of like this, you know, what's the matter with me? Why do I feel like this? Instead, have an external why? We know that when you have a why, you can get through things, right? Like you have a North Star of like how do you want to get to that place. And so my job is to hold up a mirror and say, this is your why because you figured it out using the strategies.

51:17The first reset will get you a clear plan and roadmap to that destination. So I'm going to do the first reset. So you have a stress score that you sort of initially do with your patients, right? So you figure out how stressed they are. That's right. There's some questions I think in the book, which I'll put up on the screen for anyone that's watching the video. These are questions you ask your patient to help them figure out their stress score. Yes. And then the first reset is really figuring out what matters to them, which is the acronym you're talking about most motivating objectives, small and timely.

51:49That's like a, what am I doing with that? So I'm setting myself a goal or understanding what matters, what goals matter to me. And I want those goals to be motivating objective, which means can you objectively and easily monitor this goal's progress? Small is the goal small enough to guarantee success and timely is the goal time sensitive? Can you achieve it in the next three months? I've had so many patients, when I was seeing patients in Boston, I have had so many patients who have been stressed and they want to feel better, but they don't know why, because they are consumed with what's matter, what's the matter with me?

52:28What's the matter with me, rather than what matters most to me? And so this is a way to reframe that internal dialogue and the conversation to what matters most to you. And so you figure out what your most goal is and there are many examples throughout the book. The book is filled with patient stories, real life, people who've had lots of different experiences, and there are examples of most goals. Some most goals have been, I want to teach my grandson how to throw a baseball. I want to go this summer on a hike and my knees not hurt. How does that help me with my stress? Because you have something to look forward to.

53:05It takes me out of the present moment. And it also gives you something measurable. When we stress can often feel like this vague, nebulous thing that's happening to us, right? But we need a metric to measure our progress, and the book is filled with metrics. And so the most goal is your first sort of like, north star of this is where you want to go. And then there are various other strategies throughout the book of like how to get there and what to measure. We do this with, I don't know, we do this with every single, we do this with blood pressure. We check to see like if you have high blood pressure, we check like, oh, your blood pressure is getting better with these interventions.

53:43But we don't do anything when it comes to stress. We just say like, are you feeling better? Yes or no. And stress is not a yes or no question. There are degrees and shades of stress in there. So you need a quantifiable metric to say, yes, my stress is getting better. Why? Because I wanted to walk 20 blocks and guess what? I could walk zero blocks when I started with you. But now I can walk five blocks. And that is good. So whatever that goal is for you of like, you're feeling a lot of stress because you've had a medical issue or whatever that most goal to you is finding that goal post to say like, okay, that's my destination.

54:21And this is where I am today. And then finding a way to get there. In this team here, there's about 30 of us at the Dario Vizio and we have a group inside the company, which is about exercise and fitness. And we do that because so many members of the team love to exercise. I mean, even the team here in New York City, they went out for a long run, all of them together in the morning. And I think, you know, we do that because we have goals for fitness and we like exercise, whatever else. What is the evidence that shows exercise helps with stress management? What is the research? Reams of research on exercise helping with stress.

54:56And the real misconception is that you have to do a lot of exercise to manage stress. And that is unequivocally false. Even a little bit of exercise can help because it gets you out of your head and into your body. A few minutes here and there can make all the difference. Park far away when you're driving someplace and you're going to a restaurant or you're going into a mall, a shopping center, park far and walk if you can. Build it into your day throughout the day. Take the stairs if you can. It is just small incremental changes over the course of a day. Aim for 20 minute walk. It has lots of health benefits.

55:33It gets you out of your head and into your body. It gets you into that daily habit of movement. Initially, when you are a sedentary person and a lifelong non -exerciser, going into the gym to exercise is like a complete deterrent. I remember as a medical resident, when I was going through my stress struggle, I had a state of the art gym in my building. I remember being incredibly stressed. And, you know, I'm a doctor. I was like, oh yeah, exercise is good for me. I walked into the gym. I saw the mirrors. I saw all of the fancy equipment, the techno music blasting. I walked right out. I then started a walking regimen simply because it was nice out one day and I walked around the block.

56:14And then I was like, oh, that felt really nice. Next day, I walked around the block and then some did a five, 10 minute extra walk. And then the next day, it was manageable. It was a low lift. It was easy for me to do. It wasn't like all this complicated equipment. So I walked a little bit more and I just gradually moved up over the course of a week or two to 20 minutes. And then I committed to a 20 minute walk. Over time, myself efficacy, which is that ability of you to know like, oh, I can do this. It increased. And that's what happens when you exercise. And you do something like this, something small a little bit every day.

56:47Your sense of self -efficacy increases. So you feel like, oh, I can do this. And your inner critics start silencing. And then I started walking. Just the walkers, you know, not the extreme exercises, just the walkers. You're telling me there's research that shows those people have a less stress in their lives and more resilient, Pussy. It's not so much that walkers are less stressed. It's that movement when you go from being sedentary to moving that this daily physical activity, even at low levels can help decrease your stress. So it's not like at why and how? So many reasons. So the first reason is because something like walking is something that's a very natural phenomenon that all of us do.

57:29We don't really feel like walking. When we are feeling a sense of stress, you just want to be still. But science shows that, you know, you've heard of the expression sitting as a new smoking. You've heard of that expression. But a research study found that sitting can also increase your sense of anxiety. So it's not so much that sitting is the new smoking per se. Yes, but it also has a tremendous impact on your actual mental health. And that movement is a antidote to that. So it's not necessary that you have to do excessive exercise, but even just a simple walk getting out low grade exercise has been shown to help with longevity.

58:12It's been it's been shown to help with so many markers of health, just a simple walk. And yes, your team, you know, people like to run. I'm not saying that you don't have you can you can continue running. But that's someone who is like a avid exerciseer. And so they run some people walk. It doesn't really matter what you do. It's that you do something you enjoy a little bit every day. I want to talk about social media. And in your book, you use this term, popcorn brain, which I for a second, I want to read what popcorn brain men started to think maybe I now have a popcorn brain. What is a popcorn brain?

58:51Many people, most people have popcorn brain. Popcorn brain is a biological phenomenon, a real biological phenomenon coined by a man named Dr. Levy, a psychologist. And it is essentially your brain circuitry starting to pop based on over stimulation. So it's not like your brain is actually popping, but it's that sensation of popcorning because of spending too much time online. It is hard to disengage from what's happening online because there's a constant information stream. And it is difficult to live fully offline where life moves at a decidedly slower pace. Popcorn brain is an affliction that nearly every single person has right now.

59:36Think about what you do when you're waiting in line at the grocery store. You're not just like letting your brain wander, pondering things, you are on your phone. What are you doing at the bank on your phone? At a car wash, at a traffic light, pedestrians walking across the street. They're not looking up at the light. In fact, it's like one of the hazards, a public health hazard of pedestrians having near misaccidents because they're looking down on your phone. I see it in Boston all the time. A busy street, people are looking at their phone. Most people listening now will be like on a tube somewhere on a train, on a plane, looking at their phone.

1:00:08Well, they're listening to this, but we rarely give our brains a moment of rest. So popcorn brain is different. A lot of people will ask me, is popcorn brain internet addiction? No. Internation addiction is a real, it's called internet addiction disorder. It's a DSM4 criteria. And it means that's our diagnostic criteria in medicine. And it's a real disorder, but what really defines internet addiction and popcorn brain is that internet addiction interferes with your life where you're unable to do certain things. Popcorn brain on the other hand is ubiquitous. It's everywhere. It is what defines modern life.

1:00:51Those two are very different things. And when we are feeling a sense of stress, we are especially prone to popcorn brain. Why? Because when we feel stress, we talked about the amygdala, right? Like that part of our brain that is focused on survival and self preservation. Back evolutionarily, when we were all cave people, there was a night watch person. And that person would sit by the fire, the tribe would sleep, and that person would scan for danger to keep the tribe safe. In modern times, we have all become that night watch person. And we scroll incessantly when we feel a sense of stress, because it is our primal urge.

1:01:36It is the way our amygdala feels a sense of safety, because we are scanning for danger. We are no longer in a tribe or not cave people anymore. So what do we do? We scroll. That is how we are scanning for danger, especially when we are feeling stressed. In recent times, there has been a lot of bad news. In fact, it feels like the onslaught of bad news, one thing after another way, whether it's a climate disaster or a conflict in a certain part of the world, something or the other is always happening now. The information stream is rapid and unprecedented. And so we are constantly scrolling and scanning for danger.

1:02:10And it's that primal urge to scroll. So how do we, the goal is really not to limit our social media use or media use, because we know studies have shown that it is not about abstinence, because that actually doesn't have an impact, positive impact on our mental health or our well -being. But what does have an impact on our mental health and well -being is decreasing our reliance to our phones. You know, most of us check our phones 2 ,600 times a day. That is a statistic. 2 ,617 times a day is the average number of times a person looks at their phone. Think about that, right? The other thing you want to think about is when you're thinking about like, huh, do I have a reliance on my phone?

1:02:57It's like the goal here is to reconsider your relationship with your phone. It is not about abstinence. We're not trying to become digital monks here. It's about creating digital boundaries. In every relationship in your life, you have boundaries. You have a boundary with your partner, with your children, with your colleagues, because relationships need boundaries, right? To thrive. Why don't we have a boundary when it comes to the relationship we have with our phone? There is no boundary. It is simply porous. We check in the morning, we check at night. What's the first thing you do when you wake up before your second eye is even open?

1:03:36You are scrolling. Studies show that 62 % of people check their phones within 15 minutes of waking up at about 50 % check them in the middle of the night. I'm guilty of this. I'm not going to pretend I'm put some st here. I'm that person. I'm on the upper end of that scale. I'm glued to my phone. Glue to my phone. Do you know what? When I'm stressed, I'm even more glued to it. That is facts. I tell you, when I'm stressed, I've got some bad habits. It's your primal orchus girl. It's a feedback loop. Do you want to feel safe? Out the window. You know, all kinds of bad habits that are... We can talk about the diet.

1:04:14We can talk about the diet piece. For some reason, if there's ever a time in my life where my diet slips, it's when work is hard. Or when something's difficult in my life, that's when I just can't get out of that bad diet or up for just a moment. We can do a small caveat because I think the social media piece is really interesting and what people like everyone loves hearing about that. The reason that you crave... So emotional eating is what you're describing when you're saying that your diet goes out the window when you're feeling a sense of stress. And that is because you're a Magdala. Went your Magdala, like I said, it's like a broken record when I say your Magdala is focused on survival and self -preservation.

1:04:56Your Magdala doesn't recognize a famine coming or bills or work stress, right? It's the reptilian part of your brain. And so it is focused on survival and calories equals survival. So when you are stress eating or emotional eating, your body craves high fat, high sugar foods. That's just biologically what your body craves. And that is why instead of berating yourself and loving that inner critic really, instead of berating yourself and letting that inner critic really take off, like when you're craving chocolate cake or my guilty pleasure is tortilla chips. I just can't get enough when I'm under stress.

1:05:37What's your stress food? Your business. Carrot cake. Oh my god, I didn't. Listen, I can't get carrot. So you know, carrot cake is not easy to get. You can't bake it yourself very easily. But I'd say like just things like that, like sweet foods, my probably my thing when I'm really stressed. And sometimes I go through these periods, maybe once every like three to four, I'm like really, I think generally, if you see what I think I'm really healthy, I think I do what I say, but there are moments, you know, and it should be that way because you're a human being and it ebbs and flows. And so you're not a robot, you're a mere mortal as am I.

1:06:14And so even though I know all of the science, like put a chocolate cake in front of me when I'm stressed and I will, of course, it's my biology. Anyway, so we can talk about social media if you wish, but that is an important caveat because I think people often when you're stress eating and you're feeling a lot of stress, like you even said, right, like I hate myself when I'm diet as well. I'll be a sub -eating myself up. I'm like, Steve, listen, you got plenty of podcasts of people that follow you that like, you know, I think you've got you got to live what you say. And then I'll just go through that moment of it's like it feels like most of the time I've got my hands on the steering wheel and I'm in charge.

1:06:46And then once in a while, I'm in the back seat and this car is on a water pilot and and we're just flying down the motorway and I'm like Jesus, I'm trying to get back into the front seat and I'm struggling against, I don't know, the wind, the windows are open, the shit's flying everywhere. And then eventually I get a hold of the steering wheel again with one hand and then I can kind of pull myself back onto the steering wheel and we have another good couple of months, you know, distance, that's right. And that ability that you have that where you are able to get out of the back seat, get your wear about and get back into the front seat and the driver seat, that time for you is likely maybe a week, maybe two weeks max.

1:07:24And because you have all of this knowledge and you've done this before, it's a muscle, right? It like grows that sense of agency and like I can do this. I know how to get this back on track. For others who may not have the practice that you have or the knowledge it takes a longer time. And that is what I am trying to work on is like closing the gap between knowledge and action. Understanding by the way that your brain, it takes eight weeks to build a habit and falling off the wagon is part of habit building. So how, how do we close that gap? Some, there's going to be people listening to this now that have had everything you've said.

1:08:01They want to implement better habits in their life to counteract the stress they're experiencing. They want to get away from that red velvet carrot cake, whatever. But they don't have that sense of agency or they struggle to a more extreme extent. You don't have to have a sense of agency. In fact, my favorite patients have been the skeptical patients and people who are like, I don't believe any of the stuff. When you follow the five resets and the 15 science back strategies, your body, it's all based on the biology of stress. So when you start the process and you go through the first technique and the second technique, your brain and your body will just know what to do because you will be doing the work.

1:08:34It's all about the work of doing. And when you do better, you feel better. That's the mind body connection. Your brain and your body are constantly speaking to each other. They're inextricably linked. What's good for your body is good for your brain. And when you do better, you feel better. But it's all in the doing and getting yourself into that moment of action when you have the information, but you need to act. It's all about small, keeping it smaller than you think it is. So it's not about going to the gym for an hour every day when you're stressed. Forget it. You're a mix of that and prefrontal cortex will be duking it out for that one.

1:09:06No way. You're not going to go. It's like you're waiting through molasses to put your sneakers on. But if you start small and say, I'm going to go for a five -minute walk today, you'll do it. But sometimes it's so small that it's almost humiliating. It's so small that it seems trivial. That's how it feels, right? For two minutes, what's that going to do? Two -minute walk? There's no birth. It's going to do enough. Trust the process. I'm not going to lose any belly fat with two minutes. It's not about losing belly fat. So the cosmetic promise of fitness has never propelled any of my patients from going from lifelong non -exercisers to exercisers.

1:09:42Taught bellies, muscular physiques. Never the reason people exercise. People start exercising because those are all aspirational things. It's like they're out of reach. Most people who exercise, at least in my experience, who I have been able to convince to exercise, they exercise because of the mental health promise, not the physical health promise. In turn, they might have some weight loss. We know that even if you exercise on a regular basis and have no weight reduction, whatsoever, you are still improving your cardiovascular health, your metabolic health, all of the other profiles. You can still improve even without any weight change.

1:10:25What my thing is about stress, right? So mental health. So that's just the physical health aspect of it. Even just a 15 -5 -2 -minute walk can make a difference in your biology of stress. I read in, there was a study in your book about how just taking even a 10 -second break from your work and having an impact on your stress levels. That study was done by Microsoft Labs. You know how we say you'll often hear like, oh, just take a break and you know, because we often when we're feeling a sense of burnout and atypical burnout, an inability to disconnect from work, right? And then it's like, how are you going to get your self back on track?

1:11:05I call it the Goldilocks Principle. I talk about it in the five resets. Human productivity functions on a curve. It's not linear. It's not like, okay, like I'm going to just keep being productive. There's actually a bell -shaped curve for stress as there is a bell -shaped curve for human productivity. And so if you think about one side, you know, the y -axis as human productivity and the x -axis as stress, it's a bell -shaped curve. So when we are to the left of the curve, we're not feeling very motivated, we're bored, we're apathetic, chances are you're not going to be very productive. When you are to the far right of the curve, you're highly stressed, you're anxious, many of us are feeling this way.

1:11:48You're not going to be very productive. There is a sweet spot of human productivity right in the middle of that bell -shaped curve and that is the Goldilocks Principle, the just right part of stress and human productivity. Now, many of us are to the right of the curve. We are anxious and keyed up and stressed out and we're not very productive. So how do we bring the science into everyday life and apply it to our life? We can't just like chill out and like go for a month to Bali for a surfing holiday, wish I could, can't do it, can't, you know, spend six months eating my way through Italy or hanging out in the Himalayas and a retreat.

1:12:28All of these things are my dream you have financial constraints, you have constraints with your family, obligations, all of these things. And so we can't do all of those things to suddenly scale back into that sweet spot of human productivity. So what can we do? We can honor our breaks. And there was a study by Microsoft done not too long ago, which showed that even taking 10 minute breaks like three to four or 10 minute breaks throughout the day can have a cumulative impact on your stress and can help with your mood, productivity, sense of engagement. So it's not like, oh, breaks are nice to have.

1:13:05They should be an essential part of your work day because it helps manage your stress in the work day. It is a way to honor your breaks to get back into that sweet spot of human productivity so that you can have just right stress. And with that idea of just right stress, I want to make a point that not all stress is bad, stress isn't the enemy, our cultural perception of it is there is good stress and bad stress. Good stress is adaptive stress. That's the scientific term for healthy good stress. Bad stress is mal -adaptive stress. That is the scientific term. Everything good in your life was created because of a little bit of stress.

1:13:45Like you started this podcast, something really positive. You met your girlfriend, also something positive. You may have made a new friend as an adult, wonderful and positive. Cheering for your favorite sports team, also a positive thing. Now, when we think of the word stress in modern culture, we think about bad stress, bad stress are all of the things that we already know, right? Like the feelings that we've talked about. But the goal of life is not to live a life without stress because that is biologically impossible. Our brains and our bodies need stress to survive. It is to live a life with healthy, manageable stress.

1:14:18It's to move away from unhealthy stress back to healthy stress. My calendar and people see my calendar a lot because we have this vlog channel. My calendar is full of just like back to back to back to back meetings. Actually, a conversation with my assistant at the day, I was like, when you look at my calendar, there's actually not a 60 second gap between meetings, which means I'm continually late because meetings always run over. And also, you have to travel between one meeting to the next. Really, she might have to load up zoom or something, which takes like 30 seconds. So I'm going to be 30 seconds late because there's not a gap.

1:14:50And when I was reading in your book about this Microsoft study that compared brain scans of people who are in back to back meetings with those who took short breaks and they found that the group taking short breaks experienced significantly less stress. It made a lot of sense to me because when I'm back to back to back to back to back to back to back to back to back to back to back to back to back to back to back to back it's kind of like your kettle example you have the or put on the screen the kettle analogy of stress. I just feel like it's filling up with steam. You know, and then in the kettle analogy when the steam comes out of the nose of the kettle that's kind of when you like let some of the stress out.

1:15:24So taking those gaps opening the lever. Oh you can open the that also lets stress out. That's what I don't have on my day. I don't have breaks like when this podcast ends right. People will come through this door over there one by one and they have and Jack's laughing because he knows he's one of them he's he's he's because he's closer so he gets in first. I have like 17 things that I need to do for these people I wouldn't be able to make it to the toilet because someone's going to want me to review something. And that's my day every day. You have to build in breaks and even if that means that you're putting it in your calendar again the study was 10 minutes you can do as little as 10 seconds that research has shown why because neural consolidation again a very fancy scientific term but it simply means that when we are on the go and moving moving moving we are not always learning.

1:16:19And so when do you want to learn neural consolidation means that there's information floating in our brains. And it consolidation your brain lays down cements that information into knowledge right so there's information and knowledge and neural consolidation is the process of the cementing of new information and taking a break helps to do that. Wait, so a finalist things were podcast and something profound just get said. I should pause the podcast and just wait 10 seconds to help with the neural consolidation. That would be wonderful. Q one is often when businesses start implementing new systems and processes in hopes of creating efficiencies for the year ahead and over the course of my career.

1:17:00I've learnt just how crucial having the right systems in places. One which has helped me across many of my investments is net suite. They're also a sponsor of this podcast net suite is the number one cloud financial system through their streamlined platform you'll find all of your accounting financial management inventory and HR in one place. Their technology has been a real game changer, especially for my team at flight studio. As over the last year we've moved out of startup mode and into scale at mode. We no longer have to juggle multiple systems and having everything together has reduced the number of manual tasks and errors over 41 ,000 businesses have chosen to future proof their business with net suite.

1:17:37So if you'd like to learn how it can help your business head to net suite dot com slash Bartlett and free download the CFO's guide to AI and machine learning that's net suite dot com slash Bartlett. On this podcast one of the things I came to learn about was this gut brain connection. Yes, I think Tim's bad was one of the first people talked about that but many of the guests have built on that knowledge and now if it wasn't for this podcast. I wouldn't understand the importance of the gut. I thought the gut was just where the food goes in chemicals attack the food processes it poop comes at the other end.

1:18:09When I've come to learn, which is really surprising and amazing was that much of my mental health can be attributed to my gut. That is incredible. Isn't it isn't it is newly emerging science. Honestly every month we learn more and more about the gut brain connection. The microbiome, which is an ecosystem of healthy bacteria that govern the gut brain connection and what you're speaking about specifically an even newer entity called the psychobion, which are a dedicated group of healthy bacteria in your gut who solve function is to manage mood and other mental health. What so the bacteria in my gut first of all I thought bacteria or bad.

1:18:54You know people always get that bacteria of your hands to have some of this but you're telling me there's bacteria in my gut trillions trillions of healthy bacteria and microbes living in your gut. And they are very active. It's an ecosystem and they have many different roles besides digestion. We are learning honestly every month a new finding what the what the microbiome can do. It can help regulate blood glucose the microbiome and because we we say it for the microbiome because we're talking about it as a one large entity but what is actually the microbiome and what constitutes the microbiome is trillions and trillions of healthy bacteria right so but we use the word microbiome or saying it just because it's easier to say in parlance like when we're talking.

1:19:46In your book I learned about serotonin in the gut yes three to five times more serotonin receptors in our gut than our brain now when you think about serotonin Stephen like of course serotonin is a brain chemical right and yet what does it do. Serotonin is like the happy hormone for like mood and stress mood stress like you you know about this very popular class of drugs called SSRIs selective serotonin re uptake inhibitors they are used for anxiety and depression and lots of other mental health conditions. And we always think of serotonin it's we call it a neurotransmitter or a brain chemical when in fact we have more serotonin three to five times more in our guts than our brains which just goes to prove how important the gut is it's truly our second brain so we can reset our stress by resetting our gut brain connection.

1:20:48Yes. And how do I reset my gut brain connection is this something that I have to eat or so a lot of your microbiome and the health of your gut and your microbiome is governed in the same way that many things that we've talked about so sleep of course yes diet exercise stress reduction there are many many ways to help your microbiome thrive but yes food is also one way so focusing on prebiotic and probiotic foods there's you know there's many different avenues to that. Okay so question then if I wanted to be this is flipping the coin if I wanted to be really really stressed and really really anxious right and I want it maybe if it throw in some depression if I wanted stress and anxiety how should I live.

1:21:39That's a great question get on your phone make sure it's on high brightness and scroll through every social media platform every news platform watch graphic content of videos of horrible terrible things happening in the world at midnight keep doing that often on until four five a .m. your cortisol spike usually happens around six a .m. You know give or take for people that cortisol spike is a natural thing that happens it's part of your circadian rhythm it's what prompts you to get up out of bed. Of course make sure that you are you know you check your phone right away right when you get up out of bed and continue scrolling.

1:22:25This is a really fun exercise of what not to do rather than what to do. It doesn't always happen it like it won't be one day because you do have some reserves but if you did this for one month I would say instead of like one day for one month 30 days 30 day plan to maximize anxiety and stress. No movement whatsoever just staying bad staying bad or sit you know as sedentary as you can skimp on your sleep as much as you can yeah in every possible way sleep late. Keep waking up throughout the night and make sure that you get as little sleep as possible for as long as possible. Don't spend time with anyone spent you know don't stay on your phone day and night day and night day and night no movement.

1:23:18What else do I go out of the corner so you're just going to sit window no don't even be near natural light just sit in a chair if you can. Make sure that you have if you're on your phone great but if you have a TV on make sure it's on in your bedroom to on full volume all night long. Is that that's going to make me stressed yes it will keep it on like a news channel all night long. Okay so you know we're joking about this of course but what I have experienced in my clinical practice is you know we are of a younger generation where we engage on our phones but many of you. We have the older generation people in their 60s and 70s many of my patients in fact and we're using we're getting their news from their TV and I've had so many patients over the years who have told me that they used to just watch TV that one hour of news a day then it morphed into two hours and three hours and I've had patients who sleep with the TV on all night long and they didn't start off that way but it just happened that way again talk about you know it's not the primal urge to scroll so to speak because they're not scrolling.

1:24:27They're not going on a phone but it's that night watchman phenomenon and so they are watching the news all night long they're not sleeping they're you know really in bad shape and so moving the TV out of the bedroom is one of the first. Interventions that I suggest to patients like that hungry what do I do eat eat at all hours of the day and night don't even think about it the more process food the better don't even read anything about the Mediterranean diet. No fruits and vegetables no water lots of other beverages besides water more additives the better and no regular meal times erratic food lots of it what's like to do a stress erratic meal times well just because our brains like compartmentalization and structure and so when you have a sense of structure throughout your day it helps you plan better it helps get out of the spider flight mode and you know creates a little bit more.

1:25:23Of a balance and that's that's really the main reason what about multitasking you say in the book multitasking is a myth I think that I multitask sometimes 98 % 100 % of people think they are excellent multitaskers but in fact the science shows that only 2 % of human brains can effectively multitask multitasking is a scientific misnomer there is no such thing when we multitask what we are actually. So what we are actually doing is task switching doing 2 different tasks in rapid succession. The opposite of multitasking is mono tasking and the reason we want to mono task is because multitasking task switching has been shown to decrease and weaken our prefrontal cortex it decreases our ability to solve complex problems it impacts our concentration mood engage.

1:26:23Engagement and a whole host of other things at this time in our lives in the world and the state of the world as it is we cannot afford to multitask because the world is filled with complex problems that need to be solved instead mono task one common question I get when I suggest mono tasking is how am I going to get everything done I need to multitask you don't need to multitask it's a myth you're actually not multitasking you're doing task switching which is detrimental to your brain and your prefrontal cortex. So the antidote to multitasking is mono tasking and the way you do mono tasking is time blocking in fact I wrote the five resets doing time blocking it's the technique that I use for everything that I work on I started doing it in medical school because I had to consume vast amounts of information and how did I do that so what I would do is what is time blocking it's the Pomodoro technique you may have heard of it it was developed in the 1980s Pomodoro.

1:27:23So the role means tomato and an Italian researcher developed this technique and used a tomato shaped timer which is why it's called the Pomodoro technique and it's essentially time blocking so you set a timer for say 30 minutes or initially when you first start off 20 minutes 25 minutes and then you do whatever task you're doing one task and then you take a five minute break then you come back and you do another 25 minute section of work the next task and then you take a five minute break. 25 minute five minute break 25 minute five minute break so at the end of like an hour hour and a half you have completed all of your tasks but you have been mono tasking not task switching so you're protecting your prefrontal cortex strengthening your prefrontal cortex and not decreasing or making it difficult with attention memory concentration etc that multitasking does multitasking make you more stressed then multitasking makes you more stressed yes because it decreases your brain.

1:28:22So you're just a sense of self efficacy because most people aren't good at multitasking so then at the end you haven't really completed you've done a lot of different things your attention is all over the place you're on your slack channel you're trying to do five different tasks at once you're not doing any of them well so at the end of that hour and a half where you could have been mono tasking using the time blocking technique you feel you don't feel that sense of accomplishment or completion we know that when we feel that sense of accomplishment and completion we are just feeling less stressed because you have a greater sense of agency.

1:28:53So it's like that feeling of getting out of the back seat going into the driver seat what prompts that it's like yes I have the ability to get out of the back seat and go into the driver seat that takes some hoodspot that takes some agency and self efficacy. So many people listening to this and you talk about this in chapter five of your book where you're talking about the third reset so many people have that subtle you talked about it at the start as well subtle humming of stress and anxiety in their life it's just kind of like a background noise of their life I have that sometimes often I have that subtle angst one of the things that's really helped me which you talk about in the book is breathing and learning some practical breathing techniques because you don't need to go to I know a therapist or go to some yoga.

1:29:38So you're class to do breathing on your own especially sort of short breathing techniques what is the most effective breathing technique that anybody listening to this right now that has a little sense of angst could adopt instantly and repetitively as a habit in their lives that you've seen and that has been proven to be most effective in reducing that subtle angst. To first diaphragmatic breathing it's how we all breathe as babies and somewhere in our adulthood or young adulthood we lose our ability to innately do diaphragmatic breathing but if you watch babies diaphragmatic breathing is belly breathing or deep belly breathing.

1:30:15When people say belly breathing I need you to explain this to me how do I know if I'm doing it right put your hand on your belly. Yeah. One hand on your heart or one hand on your belly or both hands on your belly since we're doing diaphragmatic breathing and then you're going to take a deep breath in let your belly expand. Here you're expanding your chest but what I want you to do is expand your belly and then let it out with your lips. Purse your lips and get it out so you're always inhaling through your nose and exhaling through your mouth or your nose but you're doing it very slowly. So what you did initially is that you went with my chest and that's not diaphragmatic breathing per se what you're trying to do is just expand your belly and then let it fall and you want to get into somewhat of a natural breathing pattern you're forcing it right now because we're doing this like you know immersive instructional moment but you can then as you get better at it you can put your hand on your belly both hands and as you're hanging out talking to me just let your belly rise and fall.

1:31:24Is there a speed in which I need to exhale? Not necessarily you want to be as slow as possible some people you know in some yogic traditions say like the exhale should be double than the inhale. The reason the reason that breathing is truly a game changer when it comes to your stress response is because the breath is the only physiological mechanism in our body that is under voluntary and involuntary control. So as you're writing down right now you are breathing your body is breathing you're not even thinking about it and then suddenly if I say hey Steven want to try a diaphragmatic breathing again you can voluntarily start breathing again it is the only bodily mechanism that is under voluntary and involuntary control your heart can't do that your brain waves can't do that your digestion can't do that.

1:32:18It's all involuntary right it's just happening but the breath is the one thing that you can control and then let go and it does it on its own and the reason the breath is so powerful at mitigating the stress response and decreasing it is because when you are feeling a sense of stress and the fight or flight response your breath involuntarily is short in your chest and rapid it's like this. Right your stress your heart speeding and that's also physiological mechanism because your body is trying to get oxygen and you're anxious and your cataclysmines and your cortisol and your heartbeat is racing to your breathing quick and that is called fight or flight.

1:32:59That is the sympathetic nervous system your sympathetic and parathetic system can't be on at the same time so when you start forcing yourself to take deep belly breaths you switch your mode into the power sympathetic system and that is called the rest and digest system. And then that is what starts calming down your stress response in the moment. And the second important breathing technique that I would really suggest people try is stop breathing be it's a way to tap into your mind body connection and it can be really helpful and the way you do that is and it was the first technique I learned and you essentially just stop whatever you're doing.

1:33:41Breathe and be it's three seconds typically it's done I did it when I was first starting in my in I busy as a busy medical resident I did it when I right before I would knock on the patient's door of the exam room and I would turn the knob so I would stop breathe and be I would knock and walk in you can do it right before your zoom meeting Monday repetitive tasks is when stop breathe and be works best you can do it throughout the day you tap into your mind body connection you get a sense of presence you take care of your body. And then you get that mental break and then you go on so for you Stephen with your crazy schedule of not having even a moment you could try stop breathe be after before or after every single meeting as a book as a book end and what that you to my brain that will immediately set off that it will go from sympathetic to parasympathetic so it will switch the it will flip the switch and it will decrease your stress response in the moment it will prime your brain and body for what's next it will also help you.

1:34:38In the moment because it will make you feel grounded and a sense of presence in the moment so you stop you breathe and you be and you can say that was for that to yourself as you're doing it and then as you get better you know you won't have to say that to yourself I do it constantly I did it right before I walked into this building right before I sat down as we were getting the mic fixed stop breathe be just keeps you grounded and in the present moment it helps with the runaway train of stress in the and it keeps you in right here right now and keeps your mind where your feet are we talked about speaking to people when you have you know your experiencing stress but one of the things I read about your book is the importance of writing therapeutic writing and how that plays a really wonderful role in limiting our stress.

1:35:27Is there any research that supports the fact that if I just go home and write that I'll experience less stress and if so what is the research and how what's going on there. Yes there's plenty of research a wonderful researcher psychologist named James Pennebaker from the University of Vanderbilt developed a technique called expressive writing also known as therapeutic writing and the instruction is essentially for four days right for 20 to 25 minutes at a time and just right no one's going to see it. Just write about a traumatic event that happened to you so whatever that trauma maybe I talk about it in the book it's like one of my patients who had a traumatic event or if something's gone on this week for you that you want to work out it doesn't have to be some deep seated trauma can be like you had a argument with your girlfriend you had something come up at work you were stressed about a project or you're getting into an argument with your parent or your child or whatever it may be.

1:36:22You just set a timer on your phone if you wish or a you know old fashioned alarm clock or your you know your oven if you don't have if you don't want to use your phone set a timer for 20 minutes or 25 minutes sit down with a piece of paper and a pen and just start writing about the event. And then when the timer ends you stop and then the next day you do it again for consecutive days you might notice an uptick in your distress on day two or day three and then it will just decrease that therapeutic writing has been shown to be effective for so many things it can be helpful for your mood and sleep and anxiety and irritability it's been shown to be helpful in studies to increase your GPA to decrease hospital admissions it's been a great thing to do.

1:37:11It's been it's wild what therapeutic writing has been shown to do it's called expressive writing and what's going on there in the brain what's going on in the body what's making the it's so therapeutic. I think one of the things that is happening is that there is you mentioned this earlier I think one of the things that's happening is likely cognitive reframing so first you are on day one and I've done this many many times I practice therapeutic writing on a regular basis on day one as you're writing it's your MIG to less speaking right it's like your self preservation and survival and your inner critic and you're like blasting whatever issues happening.

1:37:48And then as you go through day two three and four I think there you're creating a safe space you're processing a lot of your emotions it's very important to process a lot of your emotions and you're not keeping them stuck you're you expressing yourself. And then I think you're coming to your own conclusions so there's probably many many things active things that are happening in your brain you are moving away from amygdala to prefrontal cortex because you're thinking strategizing organizing your ideas you're expressing yourself we know that writing and it's just you know journaling is also very helpful why because it is a way to express yourself and let these nebulous ideas become concrete words and thoughts and feelings.

1:38:28And then I think there's an element of self efficacy in a sense of agency happening to because you are solving your own issue or figuring out a new angle and you perspective and you're looking at yourself hopefully by the end through a lens of self compassion which is also something that happens. It made me think that you know it explains why if I send a message or an email what I'm stressed it's never a good message I always regret it you know like when you have an argument with somebody or like you know you might be with your girlfriend or your boyfriend and they've triggered you in some way maybe.

1:38:58You're tired and then you start responding very bad time to send messages very bad time to send anything just stress stressed people are going to send the worst emails on they because the amygdala's right in the email that's right take a beat do it the next day so let's say sleep on it right sleep on it if it's a good idea today it'll be a better idea tomorrow. Interesting. I want to talk to you about this last thing which is live a lifetime in a day. I've never heard this before but you say this technique is the antidote to hustle culture. Often when you hear the term live a lifetime in a day it sounds like hustle culture it's like cram it all in in a day make it all count no it's the antidote.

1:39:41When we are going through life on autopilot and we are doing a million things we often go to bed at night and we're like what did we just do what was the point of all of that right like human beings are meaning seeking purpose driven creatures and live a lifetime in a day is my universal prescription to patients it is helpful when you have 70 years to live. And what it essentially means is that there are six areas of what make up the arc of a long and meaningful life and the prescription is to bring those six areas into one day even for a minute or two so when your head hits the pillow at night you have a sense of fulfillment of meaning of purpose.

1:40:29The six elements of live a lifetime in a day are childhood spend a few minutes every day in a sense of wonder and play whatever that may mean to you work for most of us it's hours so that's easy right like doing something whether it's paid or unpaid that gives you a sense of meaning and accomplishment. Solitude spend some time alone to reflect and really think about we know that spending time alone is helpful for our mental health and well being also for creativity. Vacation that's an easy one spend time even if it's a few minutes a day doing something you love and the example of that that is the most common that I've seen with patients is people love playing a musical instrument let's say the guitar and this is one particular patient I'm thinking about and she loved playing the guitar and asked her when was the last time you played the guitar and she said oh my god it's been like six months and I have three guitars at home and I said why.

1:41:20She said because I like have three kids and I have lots of stress and I have a job in my husband I said well what about just like two minutes every day. Like you know bring that into your life as you just do it for the joy of playing the guitar and so she did every single day and she played a song and then over time she played two songs and then she started playing 30 minutes a day but initially it's like that you know because we have that all or nothing fallacy so we don't do it at all. Vacation so build that in a little bit something that brings you joy then family doesn't mean you have to have a family but spend time with the family.

1:41:50You can spend time in community with loved ones engaging with some people whether it could even mean a quick phone call and then finally retirement spend a few minutes taking sake of your day figuring out what worked what didn't and then that is the prescription essentially to lead a wonderful fulfilling life so when your head hits the pillow at night you feel that deep sense of satisfaction you've hit all six areas even if it's a minute or two you're like oh yeah I spent some time in childhood I spent some time in the middle of the day. You know and that is the antidote to hustle culture because when we are feeling stressed and burned out and always on the go and living with our amygdala we often will be doing so much during the day and then we go to bed at night and we don't feel a sense of accomplishment at all and then you wake up and you do it again the next day and so how do you bring in that sense of joy and meaning and purpose into our life every day that's one way.

1:42:44What is the most important thing that we've missed.

1:42:50So we talked about popcorn brain and that's what happens when we spend too much time so too much time on our phone. There is also this concept of brain drain what happens to us in our brain power even when our phone is close by but not in use because of the sheer potential for distraction. So our phones are really powerful they are not benign devices one antidote to popcorn brain and to brain drain is a media diet and there are really three ways that you can instill this media diet into your life to help with your primal or to scroll the first is time limits 20 minutes a day and set a timer if you have to for engaging and consuming bad news.

1:43:35The second is geographical limits during the day keep your phone 10 feet away from your workstation if you can out of reach out of arms reach and at night off your nightstand keeping your phone off your nightstand could be the biggest game changer because in the morning when you wake up like most people checking their phone instead you aren't just scrolling you're getting up maybe brushing your teeth using the bathroom and then you can engage with technology but that one small shift could be key. And the third is to set some logistical limits so creating some sort of boundary in a digital boundary could make all of the difference in your relationship with your phone thereby improving your stress and mental health.

1:44:17There's a lot going on in the world right now there's a lot of bad news there is wars there is I mean in the whole sort of two decades that I've been on the internet social media I have never lived through a moment maybe the pandemic was somewhat similar but I think this is maybe even more extreme. Where I go on my Instagram and I see videos and photos of dead babies. Not that far away from where we are in Europe relatively and there's a sort of trauma involved in that so much so that the other day I walked into the into my kitchen and my partner was sat there and she's just crying and she's looking at her phone and she's crying and you know I put some things on her phone.

1:45:05Just to make sure that she wouldn't accidentally stumble across those things again and then the next day we had the same situation happened where she was in the kitchen and she was very very upset she was again tears coming down her face she's like struggling with it from multiple days in a row. And it just made me think that's an extreme example but yeah I mean like it's not an extreme example I had the same thing happened to me and you all that I know all the science and yet I was also weeping and I think many people are feeling exactly like your girlfriend. And the science supports this you know we're experiencing in many ways it's like the cycle of trauma and a researcher who I spoke to for my book Roxanne Silver who is a psychologist in California has shown through multiple studies that your risk of PTSD increases when you consume graphic images even if the thing that you're consuming is happening thousands of miles away.

1:46:02Like the world like any conflict any climate disaster anything if you start consuming graphic images and videos you increase your risk of PTSD your own personal risk even though you have not had any direct trauma because it's indirect trauma that you're seeing. And so it's a cycle the more videos you consume or the more graphic content you consume your amygdala gets fired your primal urge to scroll starts going haywire and then you scroll some more and then you also more because you don't feel safe you don't you know so this is a common occurrence it is not uncommon it is your biology working as it should because it is your biology of stress and clickbait and doom scrolling are both powered by the same biology that governs the fight or flight response.

1:46:49And there is actual data to show that it increases your risk of PTSD and increases your risk of getting mental health conditions later in life so years later what when I think about all the things that going on in the world. I'm conflicted right because you can't ignore those things but at the same time those things are giving you PTSD that's right well the key is an I work in journalism I'm a medical correspondent it's not a problem. I'm not about censorship being an informed citizen is critical at all times especially now you have to be an informed citizen but you have to create some digital boundaries so you're protecting your sanity and protecting your mental health there are also other ways that you can get involved by supporting various causes and donating and taking action we know that that is also very helpful but you want to limit your engagement with graphic content you can also limit your engagement with looking at videos and looking at the images and instead read about it right like follow certain accounts that you trust and read about what's happening in the world it is not about censorship because the news and journalism and I am speaking from the perspective of being a journalist or corresponded it's vital it's vital to democracy it's vital to functioning society but there has to be a line between being an informed citizen and protecting our mental health and our sanity.

1:48:18And understanding that if you are having difficulty sleeping if you notice any alarm signs like mood disorders if you're having an uptick in anxiety depressive thoughts thoughts of hurting yourself hurting others that you should seek counseling and seek medical attention because these are not benign thoughts like you you know it's very easy to say oh but it's happening far away I shouldn't be feeling like this don't should yourself right instead seek the help because this data shows that you are at risk if you are over consuming there is a fine line between consuming and over consuming the news at any time especially now but really at any time.

1:48:56You wanted to show me something on the paper you just said. I wanted to talk to you a little bit about this idea of we are all hyper connected we've already talked about all of the data about you know we look at we touch our screens our phones 2 ,617 times a day we you know think about like how many times we breathe in an hour it's 960 breaths that we take an hour and some people are touching their phones like that much and if you want to check your reliance on your phone it's very easy to check you just like keep your phone far away for 3 or 4 hours and take a piece of paper and do a tick mark every time like a tally every time you feel like you want to check your phone and see what that impulses and you'll you'll be shocked at how often you're checking your phone.

1:49:38I want to kind of talk a little bit about this idea of hyper connected and that we are all hyper connected but we are disconnected and I write about this in the 5 resets the loneliness epidemic it's really a pandemic globally loneliness levels are higher than they have been in years and one statistic 330 million people globally go 2 weeks before speaking with anyone family friends anyone loneliness is something that is a real concern because we know that when we are not spending time with people and we feel a sense of loneliness and that's different than being alone by the way when you are feeling a sense of loneliness it actually has a health outcome loneliness has been found to be equal to smoking 15 cigarettes a day it increases your it increases your risk of heart disease by 30 % it increases your risk of stroke by 30 % and it shortens your lifespan.

1:50:43So all to say that we are spending more time alone now than ever and you could be an introvert you could be an extrovert it's not about necessarily your personality type it's about feeling that sense of connection and community and that is really an antidote for stress. We have a closing tradition on this podcast the tradition is that the last guest leaves a question for the next guest not knowing who they're going to be leaving it for and the question that's been left for you is this is a great one for you I think what idea that you once held to be true turned out to be entirely false. I love this question and I've thought about it so often because I one idea that I used to think was true is that people's internal experience and external presentation match up.

1:51:46So if you see someone who's really confident and put together it's because inside they feel confident and put together and through my own lived experience as just a human in this world as a doctor treating patients as a speaker speaking to tens of thousands of people I so deeply know that that is not true that people will often look a certain way and look put together and confident happy and smiling but they are struggling inside and so I'm just going to do it. I try to do this and so you know corny cliche but be kinder than necessary because everyone is fighting a battle you know so little about.

1:52:27Thank you so much. Thank you so much for both the wonderful compliments you've given us on and off camera about what we do here but thank you for helping us build this show make even better the things that you talk about in your book is so timely. You know the subject matter of stress and burnout and resilience and all of these things are so timely and reading through the book has helped me to reframe both my perspective but maybe even more interestingly some of my terminology because there is certain loaded terminology that we all use and the certain ideas we have about stress and resilience and stereotypes that are completely unhealthy that I'm 100 % guilty of using and furthering.

1:53:08You're also a wonderful communicator I think the way that you approach this subject matter is through a very empathetic lens and you're able I think to bring both sides of the conversation and the argument per se with you and when I say both sides of the argument I mean the people on the the one side who think that all stress is great and that you know the hustle culture side but also the other side that I think we should never do anything that's stressful whatsoever there's a there's a nuance to middle ground which you approach so articulately and I think that is a very important thing to do.

1:53:37So the only thing that you do is to do the work and the work that you've done for the entirety of your life and it's such important work it's increasingly more important work and hopefully more of us can realize that chronic stress is not natural it's not to be glamourized per se and it is not a sign of success and really there's something else we should be aiming at in our lives which will get us closer to the happiness for film and connection that we're all seeking and that's what your book is doing does so well. So thank you for being here today and thank you for the wisdom and the gems that you've given me because I'm sure it'll change my life in a better direction.

1:54:10Thank you so much Stephen like I told you before I am a fan and you're such a great interviewer and this is testament like you're reading back the book to me and it just is you know it is so beautiful and you really get at the heart I think what you do so so well and I've noticed this when you are doing your interviews is that you really get to the heart of the person. You're not just a person's work that you're talking about but you also get to the heart of who the person is and I really admire that because ultimately while we all do our work we are humans doing this work we are mere mortals a flesh and blood and I think that's something that you do so well is that you really show the humanity in each person and their work but it's so much deeper and I think that's why your podcast is so successful you share your own humanity and you bring out the humanity.

1:55:03Thank you so much for being the people you speak to so thank you. Thank you. Honestly you know people say to me all the time they're like oh you must get sick of hearing this and all that stuff but every single time I get feedback it really does it there's not been a time someone's going to meet feedback on this podcast that I don't feel like I've learned something and in that what you just said there I learned something again you know and it's reinforced something that I believe so thank you so much for sharing that you didn't have to and thank you for being here and this is the start of our relationship and I'm looking forward to the rest of it.

1:55:32Thank you. It's really rare to be a fan of something and then do it and have a greater esteem for it afterwards and that is what has happened today my friend. Oh wow. Thank you. Come give me a hug.

1:55:54Do you need a podcast to listen to next we've discovered that people who liked this episode also tend absolutely love another recent episode we've done so I've linked that episode in the description below. I know you'll enjoy it.

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