Why You Can’t “Think” Your Way Out of Anxiety (It’s Your Nervous System) | Dr. Nicole LePera

21:53Dr. Nicole LePera:Yeah. I mean, my model, I think really integrates like from Jungian to Freudian to the medical and model. And I think that's...

22:01Dr. Mark Hyman:I don't mean to pigeonhole you, but I just, I was like, oh, these, these seems like you're... Absolutely.

22:04Dr. Nicole LePera:I mean, I, I, inner child, I believe he was, Jung was maybe the first person who like worded that, that concept. And then of course, John Bradshaw made a career on speaking about it. So by, by no stretch of the imagination, am I the first one to speak of anything of, these are not new concepts, but the model that I'm presenting is now an integrated one because there's been a million different kind of developmental models. But in my opinion, they've really only focused on one aspect of development, right? Cognitive development, how we go through these different stages and we learn to think differently or kind of socio-emotional development, how this is, I think, the closest one to my model, simply, right?

22:40Dr. Nicole LePera:How my emotional relationships impact my development as a person. But all of these models left out the physical body. And universally, I mean, we all are wired, right? We have the same foundation, put it that way. We're not wired in the same way.

22:58Dr. Mark Hyman:We have the same wiring.

23:00Dr. Nicole LePera:Wiring, right, is influenced and tailored to our environment. So if I were to want to get really simplified of what inner child is, it's all of those habits that we learned in our earliest environments to create safety for ourselves, to express ourselves, to learn how to be in relationship with other people because in childhood that's what's most important and most of that learning is happening unconsciously without words which is why even the way you described it right i i had this experience and my heart got i felt this tension this clenching the sinking stomach that is the living then memory of what happened right and then you have the awareness to say oh well because it traces back to this moment in childhood where i was you know being bullied and I had a need and I understand this now narrative I've developed, right?

23:48Dr. Nicole LePera:But the body spoke first and so few of us, and I will be the first to share, of course, being a clinical psychologist, I spent the large majority of my life living in my mind, thinking I was, you know, being psychologically aware and insightful and right. So very few of us of humans, I don't think we're practiced in living in a body and we're definitely did not have the modeling that we need it to develop emotional maturity or simply the ability to be with emotions and to regulate greater and greater emotions over time. Again, because we were raised by parents who lacked resources, who lacked information.

24:24Dr. Nicole LePera:I mean, it's mind-blowing to me that only, I think it was in the 70s maybe, where the cry it out method.

24:30Dr. Mark Hyman:I mean, if you read - Oh my God, the fervorizing.

24:33Dr. Nicole LePera:Parenting books, fervorizing. Psychologists even would have told a parent to put your child in a room and if it cries enough it'll eventually calm a little bit of that here to my dad to my daughter

24:43Dr. Mark Hyman:she was like we put in the room and let her cry i'm like oh and that's only because i mean no shame

24:47Dr. Nicole LePera:not in meant to shame parents you were doing the advice at the time that was not grounded in awareness of the nervous system so very few of us again had the parents that not only knew what to do but could do it right because it's and i think now we have a lot of parents that are really aware and have more aligned parenting practices. But if in their own bodies, they don't feel safe, they don't feel at ease, they can't tolerate disappointment or uncomfortable emotions, then what their child, even if they're saying the right things, unfortunately, the child is going to feel the energy of their body and of their nervous system, which is why, in my opinion, this work is more important than ever so that we can align insight with action and actually begin to break the cycles.

25:35Dr. Mark Hyman:Yeah, it's such an important frame of the whole problem of mental health because you're right, you could talk forever about it. I had these insights forever about it. But unless I reset my nervous system, when I get that email, I can't stop that automatic response. I don't know how to regulate it. And I think that's kind of what you mean by nervous system regulation. The model that you've sort of developed is really about sort of reestablishing. And it's kind of, it's a little bit of attachment theory where part of the therapy for that is reparenting yourself. Is the idealized parent. What would your, like when I was sharing earlier about that journey where I went in as my adult, you know, 65-year-old grown-up Mark into that room to comfort the little Mark.

26:17Dr. Mark Hyman:That, in a sense, a little bit of reparenting. I don't know if that's what it is. I'm just guessing, but I'm kind of, and it really helps. And I do that every single day. When I wake up, I meditate, I do breath work, and I go back to those scenes and I re-experience that physiologically. And it's really helped me, you know, since I did it to kind of anchor that experience. And so now when I get to those emails, I'm like, no, it's okay. I'm going to say no without the physiological response.

26:46Dr. Nicole LePera:And that, I mean, so if I want to simplify, right? Reparenting is, A, becoming aware that we have these parts of us that are speaking through our body, not to shame them, not to write distinct, rationalize, oh, childhood was so far back there. I don't want to think about it. It was too painful or it's unnecessary. And to see in real time, again, through the spoken language of our body, how alive childhood really is. I mean, we don't have to in a woo-woo way or like, you know, cradle our inner child. It's as simple as, yes, my body, when Mark, right, is opening an email, I can say the same for me.

27:19Dr. Nicole LePera:I can't say no. I hate to say no, right? Boundaries, limitations, not something I learned. I love to be a people pleaser and be presented, right, in a certain way. I don't like to disappoint others. I struggle to tolerate disappointment myself.

27:30Dr. Mark Hyman:There you go.

27:30Dr. Nicole LePera:So here we go.

27:31Dr. Mark Hyman:We're in the same club.

27:32Dr. Nicole LePera:I've opened up the email and my body is speaking. So whether or not I want to say, oh, this is my inner child, right, worried to say no in this moment, afraid of disappointing mom or dad or whomever, what is most important is to just honor that my body is having a reaction. It's real. And then right, getting curious because the reality of it is, I think this is sometimes embarrassing. So I'll be the first to say it. I'm a 43 year old adult who still doesn't fully know what I need in most moments of the day.

28:00Dr. Mark Hyman:Right.

28:00Dr. Nicole LePera:So especially when I'm having a big emotion.

28:04Dr. Mark Hyman:Don't feel so bad. I'm 66 and I still.

28:07Dr. Nicole LePera:No idea. Right. I'm still learning, but I can sit here and talk about it. But when it's the lived experience, like I don't know fully how to take care of myself. I don't know, especially emotionally, how to take care of myself. I still struggle to share when I'm in an emotionally invulnerable place. And I need support because this is not something that I've practiced. So I'm sharing that because I think the journey for a lot of us begins again when we tune into our body is having a reaction. Often it is the past alive in the present. if we do have the awareness of all these stories and identities and roles and dynamics that we play in a relationship great though the real action and change happens when we get curious first and begin to explore well maybe i don't know exactly how to make myself feel better right now but you know i could try i could experiment with different things and and and so that i want to

29:00Dr. Mark Hyman:get into more around how how the practices work because you talked about a lot in your book how to actually implement a model of a nervous system re-regulation, you know, but, but what I find really interesting is you're, you're sort of widening the aperture around mental health to talk about not just your own mental health, not just your childhood trauma, but also the ancestral trauma we talked about already, and even the cultural trauma and your own life stresses. So you've got so many layers. You've got your childhood environment, you've got your ancestral trauma you've got the culture you've got your actual life stresses it's a lot to deal with and that all kind of yeah in some ways works to um dysregulate us i mean i think generally

29:46Dr. Nicole LePera:speaking before we even think about our individual cultural belief systems which absolutely you know cause cause stress tell us what roles or things are appropriate or not appropriate i if i want to speak as generally as possible societally i mean society has has shifted we We have information available at any given moment of any day. We live under blue lights. Very few of us even have earth or grass to go touch at any given time. I mean, we quite literally are living so disconnected from how we're wired to live, you know, in small villages, not in huge cities, not living on top of each other with all of the noise and the sirens being connected to the earth's rhythms, waking up with the sun, sleeping with the moon.

30:29Dr. Nicole LePera:I mean, this sounds like a great vacation for some of us that we wish we could sign up for, but it's not the life we're living.

30:35Dr. Mark Hyman:It sounded like during COVID when I was in Maui and I just lived outside and woke up with the sun and went to bed with the sun.

30:40Dr. Nicole LePera:Right, but that's, and then we have pressures and financial obligations and very few of us are living geographically near family or support where, you know, have migrated to other, you know, countries or what have you. So we are living in a very stressful, urgent, you know, inducing culture societally. Then again, you begin to think about the different cultural systems that we were born up in. Not all of them are aligned with what is healthy and or with what we need individually. Yet when we're born into these systems, right, we're assumed that we're just going to adopt all of those cultural aspects.

31:17Dr. Nicole LePera:And again, not always is that healthy for us or appropriate.

31:20Dr. Mark Hyman:The other thing that's really refreshing about your work is that a lot of people feel shame and feel bad about themselves for having anxiety or depression or having any mental health issue. And there's such a stigma about it, but you kind of reframe it as not that there's something wrong with you. I'd love to sort of maybe have you share how you have reframed this from the traditional model of like you've got a condition that's bad and you're mentally ill to this is just your best adaptation to a bad set of circumstances. circumstances.

31:51Dr. Nicole LePera:So two things I want to say about shame. The first is, again, when we have awareness of the different underlying learnings, the lack of safety that manifested again, whether it's the depression that we feel shameful about because we can't get off the couch or, right, we want to be productive, but we're just too anxious. So I think when we have that awareness, we can relieve some of the shame, understanding that these were normal adaptations to a stressful life experience. Something else I want to say about shame, because shame is actually quite a natural human emotion. It's a necessary one. It helps us to understand that our social connections are important because shame happens when we step out of boundaries socially, right?

32:31Dr. Nicole LePera:We get embarrassed. So it is a way to kind of keep us within the guardrails to stay connected because we are much safer and stronger as a human when we are in a community. So we have to think about shame being natural, normal, healthy. But of course, the shame many of us are living with is foundational, is toxic, is grown out of a childhood. Because in childhood, when we are dependent, we need someone to take care of us. We literally can't physically care for ourselves. Again, our nervous systems can't regulate on their own. So when mom or dad or whomever isn't physically present or emotionally present, the only way our mind kind of brought up this idea of interpretation and a meaning a lot.

33:14Dr. Nicole LePera:The only way our mind can make sense of what's happening is it will assign us as the cause of their behavior because we don't have the maturity to zoom out and see all the different reasons why mom or dad might not be able to show up the way we wanted or needed to. So something you're doing wrong. That have nothing to do with us. And the second aspect is it's safer because it puts us back in control because we are very attuned as children. So if I can get the sense of what makes mom or dad go away, right, I'm simplifying it. I can then modify how I am to try to get them to come back quicker or to stay.

33:51Dr. Nicole LePera:Right. So what happens then is if I'm to simplify it, for whatever reason, mom or dad couldn't meet my needs. The immature just developmentally, I mean, meaning that my mind or story my mind will tell is I have done something wrong. Right. I am at fault. And there is the kind of like seed of shame. And then, of course, we have individualized. We tailor right why I'm at fault. So for me, I think it might be similar, right? I'm at fault because I am not performing. I'm not showing up as an easy child, as successful in this way. So I will be more of that. And then all of those parts of me that aren't performative, easy, successful, I can continue to shame because that was the messages that I got.

34:39Dr. Nicole LePera:So when we have this understanding, not only of why we're struggling or stuck in the way that we are, but also when we understand why so many of us feel so deeply unworthy, it's because we assigned that meaning. We weren't worthy of care in childhood. And that's real. We don't want to invalidate that. We want to leave space for how sad that is, how angry you might feel. And then through action, we want to show our self-worthiness by learning how to care and nurture for ourselves.

35:04Dr. Mark Hyman:And we both went to Cornell, so I'm wondering in my mind, like, what's in the water up there? No, no. How many kids that go to Ivy League colleges have this story about performance? You know, like.

35:13Dr. Nicole LePera:And I think where it's confusing, because I think I much like you, right, I saw the world celebrating me. I had everything. I had a successful practice. I had all these accolades. Right. I I had partners. So shame. When I when I talk about shame, shame was something I wouldn't even speak about, because who was I to be not fulfilled or not happy in life? Right. Because I had it all. And it felt very shameful for me in the beginning to start to admit, like, I actually don't, I don't feel fulfilled. I fantasize about running away from this life that I've created for myself. And that was very real, that disconnection, that lack of fulfillment.

35:49Dr. Nicole LePera:But I was kind of inadvertently shaming myself for feeling that way because I didn't have the reason or the story that I was taught would lead to those behaviors.

35:59Dr. Mark Hyman:so maybe people have heard about and i want to sort of loop back to we were getting to how to reparent because this is the whole thesis of your book right we're just talking about the why we need to reparent now like and how we're we kind of misinterpret a lot of information that came to us as children as our best adaptation to a shitty environment you know the idea of like the attachment frameworks is something that most people know about but i only learned about it fairly recently there's like the anxious attachment where you where you respond to a shitty environment by getting more anxious about things and being more needy or the avoidant attachment style which is where you kind of are self-reliant and independent and don't need anybody or anything and you know you kind of push away intimacy or connection and then there's the disorganized which is even i don't know how to describe that but it's more like messy and chaotic and ptsd level and then there's the secure which is like where you kind of actually are emotionally regulated which is what you're sort of talking about but i think your individual developmental model goes beyond that.

36:54So can you talk a little bit about the attachment framework and how your

36:58Dr. Mark Hyman:model goes beyond that and why it's different?

37:00Dr. Nicole LePera:If I were to generalize what we're talking about, when we're talking about attachment, we're talking about, right, how I show up in a relationship, right? What do I typically do? Like beautifully described, right? Do I pursue in the anxious model? Do I struggle with distance and pursue and try to close the gap or other end of the spectrum very loosely, right? Avoid it.

37:17Dr. Mark Hyman:Do I text 40 times in a minute, right?

37:19Dr. Nicole LePera:Or do I typically run away and closeness feels scary. So I push away. And the important takeaway is I've learned to do one or two or both. I would argue the disorganized is kind of like a blend of the two where it's highs, lows, very chaotic, a desire to be close, but close feels very fearful. Again, the important thing is I learned this because in childhood, again, it would have made sense if something was unpredictable or chaotic to be very hypervigilant, right? The more anxious mode of being. If I scan and wait for the shoe to drop and notice every change in tone and brace myself, probably in childhood there was a benefit because the quicker I noticed the change in tone that might have led to either the explosion or the disconnection, the quicker I'm able to possibly close that gap and to deal with it.

38:12Dr. Nicole LePera:So we learn how to relate to other people based again in our earliest relationship. So what my model I hope does is it even expands it beyond how am I relating to others with whom I'm in a relationship, but how am I relating to myself? Do I know who I am? Am I able to separate myself from another person through boundaries so that I can discover and then begin to express myself? Do I have the ability? So to be clear, secure attachment doesn't mean lack of conflict, doesn't mean a lack of uncomfortable emotions. It means the ability to deal with those in a grounded way. So my model, I'm hoping kind of expands to gain and give readers the understanding of from kind of top to bottom, like who I am and how I've come to be.

38:59Dr. Nicole LePera:my argument would be it has been an adaptation to early environments that even predated you, beginning in your ancestors. And then the goal of the reparenting journey that I take readers on is how to begin to, first and foremost, create the safety and security in my body so that regardless of what's happening out there, and this even speaks to your work, you could have access to the healthiest foods, right? You could know what to eat. You could be eating the healthiest foods, But if you're doing so in a body that's on edge, that's bracing for that next shoe to drop, then that's not going to create the safety that your body needs to repair, to replenish, to actually grow, evolve and change.

39:40Dr. Nicole LePera:So the reparenting journey will take you through different kind of pillars, if you will, where all change begins in safety and security. Very few of us know how to feel safe and secure in our own bodies. Then it continues with creating space from other people, especially for those of us who had no boundaries or no space in childhood. we need to learn how to separate, learn how to give ourselves space to have different opinions, desires, learn then how to navigate emotions, not avoid them, not suppress them, not white knuckle them, not hope we never feel them, but learn how to make space for them, to communicate them because that's what creates the relationships that most of us are seeking and not in.

40:25Dr. Nicole LePera:We wanna feel deeply connected. We wanna feel understood. We wanna be able to take space from our loved ones and not worry that they're going to be gone when we come back to reconnect. And very few of us have had those experiences. So through small daily choices, practices, I have many in the book, most are grounded again in the body. We begin to develop that safety, that security. We begin to create space. We begin to learn our own emotions and then learn how to share them with someone else so that ultimately we can be ourselves in relationships and begin to feel that connection that so many of us are looking for.

41:00Dr. Mark Hyman:Well, this is great. You talk about five developmental spheres, you know, in the book, and you touched on the first, which is safety and security and freedom to, and the second, the freedom to explore and become, which is like, so how do you go out on your own like a toddler, right? You have to feel safe as a baby, but then you're like run off on your toddler all the way and then you come back. It's that same thing, but as an adult.

41:17Dr. Nicole LePera:Yeah. Yeah.

41:18Dr. Mark Hyman:So break it down for us with the first section, which I think is really important, the safety and security, because that seems like an anchor point. And you talk about how to, you know, that you have to be able to feel safe in your body and your nervous system. And we talk a lot about nervous system regulation. So talk about how that helps you heal from this either controlling behavior, hypervigilant behavior, shutting down behavior, panic, anxious behavior. What are the practices? What are the tools? Because I get the concept. I think people understand yeah i want to feel safe and secure but like how the hell do i do that you

41:50Dr. Nicole LePera:know like what do i do next yeah and it begins by first connecting with our body to be able to determine whether we're not feeling safe right so the major systems that shift and change when we're under stress or having an emotional reaction are our heart rate our breath and the tension in our muscles and i'm really emphasizing this first step because i i know for myself i spent little to no time in my body like i said i was always in my mind always zooming around and worrying about someone else's body and what they needed and not connect it to my own. So rebuilding, first noticing, well, even if I were to prompt listeners right now, like, do you feel, like, can you feel your muscles?

42:28Dr. Nicole LePera:Do you feel your heart rate? Like, how are you breathing? Are you breathing? Are you holding your breath? It's building in those checkpoints throughout the day. So simply creating the habit of checking in with our body so that then if we want to focus just on those three areas, we can begin to notice as our body shifts into or maybe is consistently in a stressed state with our tense muscles. I mean, I don't know how many of us walk around with tense jaws. I know I do. My shoulders might as well be up to my ears, like they're earrings, right? All of these moments where for some of us, it becomes so normal.

43:02Dr. Nicole LePera:We don't notice until someone says, put your shoulders back. And like, oh, wow, it's relieving some tension or drop your jaw, right? Oh, wow, I didn't realize how much tension I was holding.

43:12Dr. Mark Hyman:Yeah, most of us don't realize how stressed we are until we don't feel the stress. We don't realize it.

43:16Dr. Nicole LePera:And that's the thing too about stress. We become so familiar. We develop such a baseline for stress that I referenced this study where individuals who have a higher, just general consistent level of stress actually will be less likely to rate things that are objectively being rated as stressful by someone else who has a lower baseline of stress as stressful. So simply, they're not registering stress unless it crosses a higher threshold. So we become so used to it. We're ignoring the fact that we are living in it chronically for a long period of time because it's just what's there. And we become addicted to it to some extent.

43:56Dr. Nicole LePera:So especially if we're so depleted, this happens a lot, if we're so depleted, we're exhausted, some of us only feel inspired to act when there's a deadline, when we have to, right? When something is causing us stress to compel us into action. So then we start to say, oh, I work good under pressure, right? I juggle all this so well, right? And that is to some extent the case because the nervous system became activated by the stress enough to, inspire action. So for all of these crazy reasons, we become so familiar with our body being in a stressed state that you're right. We wake up and we don't even realize how stressed we are, let alone the impact that is having.

44:40Dr. Mark Hyman:So the first thing is really just like tune into it and be aware of your like simple body sensations. And then when you notice you might be feeling stressed, then what?

44:49Dr. Nicole LePera:So when you notice, I mean, the first thing that happens, right, is we begin to move really quickly. We talk really quickly, right? So some things we can do is notice we can slow our pace of movement down, our pace of speaking down. We can begin to slow our breathing down if we're noticing that we're starting, like our chest is heaving or maybe we're holding our breath, right? We can maybe relax a bit to allow some breathing to happen. We can begin to even just tune into, and these practices seem really simple, which is why I think a lot of us like, what's this really going to do? And I'll be the first to say, if you do it once, nothing at all.

45:25Dr. Nicole LePera:If you consistently practice, though, reconnecting with my body, right, elongating my exhale, moving a little slower, tuning into the present environment. What can I see, smell, right? Simple practices, but they go a long way because they bring my attention to the present moment, right? They help maybe shift my physiology into a calmer state. and then over time they're beginning to allow my body because my body naturally wants to come back down my parasympathetic nervous system wants to come back online and calm my body down it wants to go back to homeostasis so sometimes we just have to get out of our own way and notice when we're doing things that are preventing our body from fully and the most thing that prevents our human body is our mind.

46:15Dr. Nicole LePera:Because these are the moments now, because our body is communicating with our mind, a stressed body will naturally result in stressed thoughts, racing thoughts, ruminative thoughts, where now I'm only thinking about all the things in my life that are causing me stress, right? So the more I'm continuing down that cyclone of thinking about stressful things, now I've created this perfect storm where the stress in my tense muscles are communicating to my mind resulting in stressful thoughts the more i allow my attention to focus on those stressful thoughts the more i keep my body in that stress response and some of us have been

46:50Dr. Mark Hyman:living this cycle yeah i saw i saw that when i was in in the journey and i began i like how much i've been in a sympathetic state my whole life like i just it's just a normal you know it was maybe a month when i was a yoga teacher i was just doing yoga seven hours a day and and i probably didn't feel that but i slept like a baby and it was i felt the best i'd ever felt Yeah. But, you know, who has time to do seven hours of yoga a day?

47:13Dr. Nicole LePera:I mean, I woke up to being to the extent of my just exhaustion, the depletion that ended because of decades of me living in that sympathetic overdrive when I fainted out of nowhere. And I wrote about this mainly in my first book because it scared the crap out of me. I thought coming from a family of health related issues, I thought, oh, this is for sure that brain tumor that was just a brewing. And so I got really scared until thankfully that timeline, that time period of my life really coincided with this learning. And I now have a reframe of, oh, no, you actually lost consciousness because you kind of reached the final stage of the nervous system journey of fainting when your body was so depleted, decades of exhausting yourself, never being able to calm down and rest and replenish that my body literally just shut me down entirely.

48:02Dr. Mark Hyman:It reminds me of my mother who used to faint a lot. And I would have to save her when I was a little kid. But she would faint because she was so stressed because she was never allowed to be a kid. She was the parent to her parents because they were deaf. And then when my parents split, it was very stressful. And she just, she kind of couldn't function.

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50:11Dr. Nicole LePera:That happens so much in children for different reasons because of, you know, physical limitations. A lot of times we see this in immigrant households too, coming to a new country with the children being the only ones that speak the native language. And then they have to take on understandably so much of the burden with parents who two parents are working in the household and there's children and so then you have an older sibling taking care

50:30Dr. Mark Hyman:of the younger siblings and i mean this is i mean this guy last day i went to the comedy store which was a comedy club here in la and we're recording and uh this is a latino guy was talking about his you know growing up as an immigrant first generation had to how he had to like translate for his parents all the time and he says you know imagine being a five-year-old or six-year-old and trying to translate adjustable rate mortgage and equity and he doesn't know what that means and like he's like, I got my parents into a lot of bad deals, you know? So it was very funny, but it's not funny.

51:02Dr. Nicole LePera:Yeah, this is serious and very real for a lot of, just again, just the factors that have contributed to now where we're living, the lack of support. And it's often necessary that that happens. So I'm not shaming that dynamic for being what was needed at that time. But again, I just think that speaks to a whole array of extra support needed for families and individuals really in general.

51:25Dr. Mark Hyman:Part of this goes to some of the work that's sort of emerging around the trauma field, around somatic therapy. People throw that term around. What does that mean? And it's sort of, you're kind of hinting at a little bit, but can you kind of unpack that? What is somatic therapy? How is it different from talk therapy? Why is it the doorway to actually solving a lot of the suffering we're all in right now?

51:48Dr. Nicole LePera:So somatic soma, right, is based in body. So it's based, and again, there's different branches of somatic work out there, but it's based in the foundation of the body, creating change through body movement or body manipulation in a sense. Again, going back full circle. Why? Because our life really is dictated by our body, by our nervous system, our emotional world included, lives in our body. So I think the most commonly known, perhaps, or at least maybe by me, Dr. Peter Levine developed something called somatic experiencing. And I'm really aligned with that approach because, again, there's a ton of different somatic work we can do from yoga to movement.

52:31Dr. Nicole LePera:to his work though really focuses on the nervous system cycle. And the thought is, again, if we didn't have that safe, secure caregiver to help, again, if I'm simplifying the nervous system state to help go from an activated state, right? Back to calm, grounded, connected, open baseline state, which hypothetically we should spend most of our time in. The belief is if we didn't have that, right? Our nervous system will default to different states, like the sympathetic activation that you and I are describing, right? Always on edge, running a mile a minute, the perfectionist overachiever, or it could look like shut down where I have no energy.

53:07Dr. Nicole LePera:I'm disconnected. I'm more in that dorsal vagal state. But we kind of default and some of us then end up living predominantly, right, reverting back to these states. So somatic experiencing is really not only understanding the state that our body might most frequently kind of go into when we're activating, but to then help our body complete, so to speak, the cycle. So if we're shut down in that dorsal state where we have no motivation, right, helping our body safely, because this is, again, where I'm watching some of the field. The goal isn't to just dive into the cold plunge because we know we're shut down, because that could be completely overwhelming for a body that is shut down because it's shut down because it's already too overwhelmed.

53:51Dr. Nicole LePera:right so we want to gradually you're right offer movement and like a softening of tense muscles so that i can move so we don't literally physically or emotionally overwhelm ourself or again if we're in that sympathetic activation we want to help our body calm down right slow our breath slow our movement like i was talking about earlier because the belief then is right if i complete and if i help my body complete that cycle, then I'm discharging that emotional energy and I'm reducing the likelihood that I fall back on the dysfunctional habits, the things I usually do when I can't discharge that energy, right?

54:31Dr. Nicole LePera:The overeating, the being distracted, the, you know, mindlessly scrolling, the appeasing and worrying and caretaking the world around me instead. Because the number one thing I think that, and this is why I went into like the don't overwhelm yourself, we feel more shameful when we know better, when we have a plan of action, and when we try to white knuckle or very understandably like get better quicker, right? And then we end up falling right back into those old habits because that is going to be where we revert to as stress goes up slow. It takes the thing that we hate to do, which is the slow and steady and consistent practice of creating new habits.

55:09Dr. Mark Hyman:Is a longer time.

55:10Dr. Nicole LePera:Yeah. And that's why I will be the first to, and we were giggling about here when I was talking, I will be the first to say all of the ways my old habits still come back as frequently, as recently as this morning, because it's a journey. Right. And I think a lot of us have this expectation that once we become aware of these these habits, once we have some new practices that miraculously. Right. All the old habits are just like your health, too.

55:32Dr. Mark Hyman:It's like, you know, if you have 100 pounds of those, you can't do it in a day. The somatic experience is interesting because it's really a different specific kind of modality. you can read about it but it's essentially it's a it's a methodology for helping you get back in your body to re-regulate your body to regulate your nervous system and to sort of break some of this and to sort of the reparenting process is part of that right yeah but there's other parts to it right so you know the the sort of dan brown from harvard psychologist was a buddhist talks about this sort of idealized parent how do you like look in that scene i talked about being the show where i was this little boy and i was 11 i went in as me grown-up mark who's more mature and grounded and and comfort him that was sort of an experience of me in some ways reparenting and i literally have to do that every day so that they live in your boy doesn't hijack my life you know and and so so you talk about sort of sort of in some ways it's marrying young about this individuation how do you sort of get back to your authentic self that's what he's really talking about is these people who go through life and they're kind of in midlife and they realize, gee, wait a minute, like I've succeeded, I've done all these things, but like I don't feel fulfilled.

56:42Dr. Mark Hyman:And he talks about how do you get back to this place of being whole and integrated, which I think is what you're referring to when you talk about your authentic self. So how do people get there?

56:52Dr. Nicole LePera:Yeah, once we have safety and security in our body, once we've learned that boundaries and limits are important to have, those no's are just as important as those yes's, right? That we can give to people to create space. once we then kind of begin to reconnect with our emotional systems and learn how to tolerate more uncomfortable emotions, right? Then the next really goal is to really see how I'm showing up, right? How am I expressing myself authentically when I have a perspective or want or a need or an emotion? Can I share that with someone or do I water it down? Do I suppress it? Do I ignore it?

57:28Dr. Nicole LePera:Do I project it outward and make someone else the cause of it? And the reality, again, going back to childhood, because we need it to belong, we learned how. We learned the role to play. We learned the identity to wrap around ourselves. And that's where we began being the people pleaser, the caretaker, the overachiever, the black sheep, right? We became a role or an identity in childhood. So, and a lot of us, it's not always necessarily negative. Some of us, again, we're giving messages culturally, societally about very well-meaning messages about who we have to be to be, right? To be secure and financially secure and emotionally secure in our adulthood.

58:12Dr. Nicole LePera:And so we need to get clear on two things. First and foremost is what are those roles that we're playing? Like seeing ourself kind of default into certain actions. And then we need to give ourselves the moment to pause and to now in adulthood determine if that action or that role is still serving us as it once did. And I think that's the area where, again, it needs to begin for a lot of us in curiosity because it mainly is like, I just don't feel good. You know, I might not know why or who I even want to be or need to be. And this is really, again, what started my journey. I wasn't feeling fulfilled for all of the different reasons.

58:51Dr. Nicole LePera:And some of it was because I really wasn't feeling fulfilled in the way that I was working, the career I picked. I much more resonate with what I'm doing now, with thinking, with teaching, with writing. And my dad's joke that I'm a forever student is really being, you know, enacted in reality because that's what lights me up the most. I, you know, therapists, clinicians, we need them in the room to support individuals. And that just really wasn't.

59:16Dr. Mark Hyman:You got 9 million patients on Instagram. Right.

59:18Dr. Nicole LePera:So that's where I was and what. And so it's, you know, I didn't know, know where I was going. I just what I knew first was I'm fantasizing about running away. So that's a marker that like something isn't, you know, connecting here. And so as I got then clear, this kind of leads into then the final goal of this whole journey. Once I became and understood what lights me up, what I get excited about, what I don't like doing, and then I became more of who I am in the world, then we can reconnect with our deeper purpose. like the I believe we all have a function and a role that's for a greater good right you might not do it as publicly as I'm doing it with right 9 million followers and you don't need to because we impact everyone that we interact with right so we all I think have a greater purpose and I think this is why many of us are feeling so unfulfilled and spiritually depleted and I'm not even talking about spiritual in like a religious sense I'm talking about spiritual and I connect it to the greater sense of the universe and natural order of things.

1:00:23Dr. Nicole LePera:And I think, again, this goes back to society where we're not, we're not connected. We're not even in communities. Very few of us are anymore. And that's again, why we feel so depleted.

1:00:34Dr. Mark Hyman:So it's so true. And I think, you know, what you're talking about through these practices and through all the exercises in your book, we don't have time to talk about all of them, but I encourage you to go get the book. And there's going to be a link in the show notes and I encourage you to get it where you can get books it's called reparenting the inner child the new science of our oldest wounds and how to heal them what what i think you kind of hit on which i think is really important is this idea of of relational neuroplasticity and and that's a big mouthful so unpack what that means and and i'm going to say why it's important because as a doctor you know we think in some ways when we have these emotional states we think we're fixed but the reality is that we can rewire our nervous system like literally change the neural connections uh you can literally change the the the the nerve cells and how they function it's it's it's documented through the science of neuroplasticity and and neuro neuro neurogenesis which is creating new brain cells so we know this is possible but what you're talking about is through these practices you're able to actually rewire it so So it's not, you're not like this automatic state.

1:01:43Dr. Nicole LePera:Relational neuroplasticity again, kind of brings us so full circle. And learning that neuroplasticity existed in science is, in my opinion, is an absolute game changer because, and my dad is of the generation where that wasn't the predominant belief. I can't tell you how many times, even to this day, my dad was like, oh, that's just how I am. I can't change, you know? And so the reality, thankfully, we know in science that we can change. We just have to make consistent new choices to create that change. But in terms of our brain and our neurophysiology, it can happen beautifully, thankfully.

1:02:18Dr. Mark Hyman:Just after you go to the gym, you can build muscle at any age, right?

1:02:22Dr. Nicole LePera:The relational component kind of brings us again full circle. Our wiring, right, was built in a relationship, was impacted by those individuals that were either present and attuned to us and able to soothe us and comfort us or who weren't. so just as we were greatly impacted by our earliest relationships we can be equally greatly impacted by our relationships now and not to sound cliche but the predominant relationship again begins with me and learning when i don't feel safe right my own self learning how to create safety and security and then finding first and foremost what first of us become a lot of us more often become aware of is when relationships aren't healthy, when we are participating in dysfunctional dynamics and then making the changes that we can because a safe and secure relationship, whoever it's with, with the therapist, with the best friend, with the romantic partner, if you're lucky to be working toward creating that with them, then that can be so impactful again because our brain was wired in a relationship.

1:03:24Dr. Nicole LePera:So at any time into our future in a safe relationship or in a relationship that's moving towards safety, we can really create limitless change. And then that becomes then what's modeled in future relationships, especially for those of us who have children.

1:03:39Dr. Mark Hyman:Breaking the chain of trauma for generations, right? And I think, you know, you hit on the first bit, which I think is the most important, which is the first and most important relationship is the religion of yourself. Because that is what other relationships are predicated on. And whether you're going to be healthy or not, or whether you're going to be happy or not, is really dependent on that. And I just can't thank you enough for the work you do and the messages you get out there. Definitely helped me. I know it's taught my wife, helped obviously a lot of millions of people. And in some ways it's driven by our own stories.

1:04:11Dr. Mark Hyman:But thank God, you know, we had to figure this out for ourselves so we can teach the world, right?

1:04:16Dr. Nicole LePera:Well, again, I reflect that gratitude right back. Like I said, your work was so pivotal in my understanding. And I'm just so honored and gleeful and excited that we can come across the aisle and talk to each other. as doctors of different parts of the body and understand that it's the same experience that we're working to help humanity around. And it's so, I'm just, I get a kick out of the fact that 9 million people are interested in hearing these conversations and that I have a virtual community and people want to buy books on The Inner Child. So I'm here for it and we'll talk about it till whenever.

1:04:44Dr. Nicole LePera:So thank you for giving me the opportunity to share.

1:04:48Dr. Mark Hyman:Amazing, amazing. So where can people learn more about your work?

1:04:52Dr. Nicole LePera:Yeah, absolutely. So of course the book is available wherever books are sold. There's an audio book as well. I am really, I think it's very important to get this information out for free, accessible content. So I'm really across all of the social media platforms. However you consume content, the Holistic Psychologist, go give it a follow. I have a virtual Holistic Psychologist, some version of that name, whether it's X or TikTok or YouTube or Instagram, all of the things. And again, we really do focus on giving content resources that can help information that can help individuals change whether or not you purchase anything that obviously I do offer.

1:05:28Dr. Nicole LePera:The other thing being my virtual membership community, Self Healer Circle. You could check that out at selfhealercircle.com. We just actually released an app. So it's super exciting.

1:05:37Dr. Mark Hyman:Amazing. Well, everybody listening, we're going to dive deep in more of Nicole's work. I'm certainly going to dive deep. And we're doing an Ultra Mind Summit about mental health and the brain. and hopefully we'll have you on that and talk more about this. So look forward to it. Yeah, thanks, Nicole. Of course, thank you. What if the greatest threat to your health wasn't bad choices, but bad design? In America, chronic disease isn't accidental. It's the predictable outcome of a food system built for profit, not people. A web of corporations, lobbyists, and policymakers all feeding off your plate.

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1:07:01Dr. Mark Hyman:If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to The Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on The Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer.

1:07:32Dr. Mark Hyman:This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient.

1:08:05Dr. Mark Hyman:It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.