Transcript
00:00:00You've authored more than 400 peer-reviewed scientific papers and literally created polyvagal
00:00:05theory. It's sort of rare that you get to ask Mike Tyson about how to throw a jab or the founder of
00:00:12a really impactful theory about what it means. So I guess, how do you describe polyvagal theory to
00:00:16someone who isn't familiar with it? It's really quite simple. It's that our underlying physiological
00:00:22state affects how we perceive the world, how we interact with others, and how receptacle we are
00:00:28to others engaging us. So in a sense, we kind of got dropped into a world where we think that all
00:00:34our behaviors are intentional, but we don't acknowledge that some days we feel basically
00:00:42quite constrained and some days we feel very energetic and engaging. The bottom line is that
00:00:47we have to start paying attention to our own underlying physiological state because it will
00:00:53help us navigate through a very complex world.
00:00:57So we're responsive in that way to the local ecology, kind of like a plant.
00:01:01We are a plant in a way, exactly. We're detecting signals just like plants. We're responding. The
00:01:08difference is that with our great intelligence, we think it's all our, we caused it all. We create
00:01:14narratives of control when in reality we're being swept away by the challenges of the environment in
00:01:23which we are in. And when we feel swept away and overwhelmed, at that point, we start acknowledging
00:01:29things. But we don't acknowledge it until it really gets over a certain threshold.
00:01:35Why is that adaptive? Why have we evolved to have that dynamic?
00:01:40Because the world was a dynamically changing place. That's as simple as that. But we've lost
00:01:47some of the, I would say, innate and intuitive skill sets. And that's being aware of when our
00:01:52body loses that resilience. And instead, we're trained by our culture to say, you can do it.
00:02:00You know, it's like, it's like, I mean, that's a quote from the water boy. If you don't remember
00:02:06that movie, it's, but the issue is we live in a world in which everyone thinks we can suppress our
00:02:12feelings or we can get over something when in reality, our body is just percolating and broadcasting
00:02:19signals to our awareness. And now we're being told, don't pay attention.
00:02:25I understand why. And this is a pivot in the world of nonfiction communication, personal
00:02:33development, self-growth that I've been really fascinated by the forget your feelings, just
00:02:40work harder approach. I understand why, because maybe for a lot of people, they're too at the
00:02:47mercy of their feelings. They actually could do with a little bit more agency. They could do
00:02:51with, I can do it. We're in a meritocracy and we want to uphold people. But as you say,
00:02:57it's denying the real dynamic that we are a system that is interacting with our environment.
00:03:03There are certain things that you're like skimming across the top of because implicit in what you're
00:03:09saying is you have some idea of what being a successful human being is. And what I'm saying is our
00:03:16markers of success may be somewhat confounded because part of being a successful person is feeling good about
00:03:24being a person. And part of the motivation for working is to, in a sense, get over those feelings of
00:03:31inadequacy. So we get kind of twisted and tricked by all this. And the other part is that we don't truly
00:03:38acknowledge that as we numb our body out or don't listen to it, we're literally turning off neurophysiological
00:03:45feedback loops. A feedback loop is part of us that monitors our functioning and a part of us that
00:03:52now creates the motor actions. And so in a way, we are destroying our own bodies. And those who work
00:03:59hard acknowledge that. They said, I'm stressed out, I burn out. But there's a physiology to that. And
00:04:06that is in part, we're not listening to our body.
00:04:09That's so wonderful. You're so right. How many people are chasing success to give themselves the
00:04:17sensation of feeling good, but in the pursuit of achieving the success, they have denied themselves
00:04:22the feeling of being good. Yeah. Now, as you say that, listen to what you said. And there's a
00:04:30circularity there. And then you accumulate. And listen, you're in Austin. So you're in the midst of a lot of
00:04:38what is now the success track. And patient zero. Yeah, yeah, yeah. This is ground zero right here.
00:04:43Yeah. And the issue is, yeah, acquisition, wealth, influence. These are wonderful things,
00:04:50but wonderful things for what? So how do you leverage that successes of acquisition,
00:04:56of respect and accumulation to become more, to do more, to be, you know, in a sense, what are our
00:05:05goals in life? And this is kind of a complicated and very personal question. So are our goals
00:05:11acquisition or goals, curiosity, learning, or our goals, benevolent and compassionate? No,
00:05:18we can set our goals, but they're not merely the here and now. We, we as a species like to do
00:05:26things that are different. We'd like exploration. We like curiosity. We like humor. And, you know,
00:05:32we like to meet people as well, which is part of that whole bit. So you could accumulate resources
00:05:37without having, in a sense, a type of curiosity that enables our nervous systems to thrive. So in a
00:05:45way, the manual for living a good life has been mistranslated. Can we use that term?
00:05:53So brilliant. So great. Okay. What was the actual problem that you were trying to solve in 1994?
00:05:59What didn't fight or flight, rest and digest? What didn't that explain?
00:06:04Well, it gets, okay, there are different levels. So you're sitting across from me, at least
00:06:10metaphorically, and you're asking me those questions, but there is really decades before that as well.
00:06:17Like, who was I? What were the types of questions that I personally was asking? I was asking what was
00:06:23going on basically behind the smiles of people? What was going on in their mind? What was going on?
00:06:29What were they feeling? I was asking different level questions, not levels of what were your scores on
00:06:35your tests or how fast was your reaction time? I was kind of more interested in what was going on
00:06:40inside of them. And what didn't have really an area of science. Science was really very mechanistic.
00:06:48So behaviorism was big. And then you don't, so behaviors was to explain everything. Certain types
00:06:56of physiological conditioning was to explain everything. And then the other part, what was
00:07:01going on in the mind, like psychoanalysis, mental health, that was something else totally independent
00:07:07of the body. So the issue then was, if something's bothering you, just sit on it. Don't, don't let it
00:07:14percolate. There was no understanding that the way we feel, which was a kind of like, was, was anything
00:07:21other than optional. Until something catastrophic happens in people's lives, like loss of a loved one,
00:07:28or a severe injury, or let's say a traumatic event where, uh, someone is raped or mugged on the street.
00:07:37And suddenly everything is different in the world. And what used to be comforting and interact,
00:07:42uh, engaging is no longer there. Or what happened to me was I got pneumonia and, uh, I had been
00:07:51extremely a social individual. And I, this was when I was, uh, a tenured, uh, actually, I was probably a
00:07:59full professor at that time. And, uh, the issue was I, I basically no longer could be around crowds of
00:08:06people that start to bother me, my threshold. And you see this after COVID for many people,
00:08:12they had chronic illness and they have words for like chronic fatigue syndrome. And people are literally
00:08:18marginalized when they say they have that, come on, get back into the flow.
00:08:22Everybody gets tired as they get older. Everyone's a little bit under slept.
00:08:27Yeah. Or fatigue. But those who suffer really get very upset because they're being dismissed.
00:08:33And they're trying to explain to you that they had a body that listened to them and now their body does it.
00:08:39And that's the interesting part that I started to ask. Why doesn't your body respond? What was going on?
00:08:45But let's get back to your question. Going back to 1995, I was starting to do work in intensive care
00:08:53units with preterm babies. And I was building this in a sense of vagal or related theory about
00:09:01parasympathetic nervous system was very important. I was basically trying to describe the other side
00:09:07of the world, the other side of stress. What are the systems that calm you down? Where does,
00:09:13you know, let's say, in a sense, even meditative aspects, where do these insights, what state
00:09:18supports that? And so you had fight and flight and stress. And then you had this parasympathetic,
00:09:25this wonderful system that was a rest and restore system. And that was kind of an interesting model
00:09:32until I worked in the neonatal intensive care unit where you have these preterm babies. And of course,
00:09:40they have a fight flight response, frequently the high heart rates and tachycardia. But you know what
00:09:46their defensive systems were? Shutting down a lot of this vagal slowing heart rate, but slow, so slow
00:09:53that it could actually compromise their ability to get oxygen to the brain. And I couldn't quite understand
00:10:00what I later called the vagal paradox. How could this same nerve, which was really associated with
00:10:07basically good states, health growth and restoration, how could it kill you? In a sense, how could a good,
00:10:14in fact, a neonatologist wrote to me after I wrote a paper in a journal and said,
00:10:20maybe too much of a good thing is bad? And that, you know, that was the way most people think, you
00:10:27know, too much of a good, it shuts down. And I said, that doesn't make any sense. That's not how systems
00:10:33are, in a sense, all evolved or wired. And I started to get deep into the anatomy and then into the
00:10:40evolution. Basically, it was called phylogeny, where you look at species changes in autonomic regulation.
00:10:47And then there was something that became very mammalian, something of which we are mammals. And we start
00:10:54to have a very different type of autonomic nervous system, a nervous system that enabled us to be safe
00:11:00in proximity of another. So it was breeding cues, you know, when mothers talk to their babies, or if you
00:11:07have pets, do you have a pet, a dog, or a cat? No, I am on the cusp of getting a dog, but not yet.
00:11:13Okay. Well, you have friends, at least. Yeah. And I treat them like dogs sometimes, actually. So that
00:11:20probably works. True. But when you don't, you probably don't. This is the secret of it. The way people
00:11:25treat their dogs, they use very melodic, prosodic voices. It's the way that mothers talk to their
00:11:32babies. And that's when I started to realize that we, as mammals, have a whole collection of, let's
00:11:39call it a behavioral repertoire, of broadcasting signals of safety to others. And those seem to
00:11:45affect their physiology. And so that's where this whole story started, was trying to identify what was
00:11:52uniquely mammalian, and using the preterm baby as this window of an opportunity to see a system that
00:11:59was not fully developed. And I could see it coming on board.
00:12:05Can you just give me the adaptive explanation for those three states as you conceived them?
00:12:09Sure. Everything is adaptive in the model. Nothing is wrong, nothing is bad, nothing is pathological.
00:12:17They're adaptive in certain contexts. So in a sense, we have, because the system basically for vertebrates,
00:12:27and those are all the species of backbones, as they evolved into amphibia, and then basically mammals
00:12:35and reptiles broke off at the same time, and had basically parallel evolutionary pathways.
00:12:41The mammal had a very unique pathway because it needed to nurse. It needed the parent to take care of it.
00:12:50And it also, when it matured, when it was born, it needed to be taken care of. Now, the other species
00:12:57laid their eggs and walked away. So what happened was that you had a very special need to survive for this
00:13:06type of vertebrate, which we became, which we are part of mammals. And they needed to broadcast their
00:13:13underlying physiological state. In their vocalizations, in their facial expressivity, they needed to
00:13:21broadcast to signal. Everything's about now signaling. And other species didn't need that because they could
00:13:27just survive. They could scamper off and survive. So you needed this new signaling system. And ironically,
00:13:35what that signaling system did was enabled social behavior to act positively on our physiology.
00:13:44So that's why I asked if you had a dog. And when you have a dog, you realize that the dog's
00:13:50engagement to you and the way you vocalize with the dog is going to be a great regulator of both your
00:13:57physiological states. And that made us uniquely mammalian. And that's why dogs and humans, or if you look
00:14:03and see, can you see my cat? Yes. Yeah, we will be able to. Yeah. So the cat back there loves for me to talk
00:14:11to her. And if I don't talk to her, she will talk to me. And that's her broadcasting that she is there
00:14:18and she wants this comforting back. So let's go through the three. The old vertebrates had a very
00:14:25primitive autonomic nervous system, the system that regulated your organs. And that's fine. It had
00:14:31basically a primitive vagal system. And it had a bunch of chemicals like adrenaline or chemicals like
00:14:38that in the body. So it can mobilize and had a neural system of calming. That neural system was not merely
00:14:46acting on the organs. It was also reflecting what the organs were doing. And this becomes really critical
00:14:53here is that we tend to focus on the brain neural regulation of the organs when most of the neural
00:15:00traffic is the body sending signals to the brain. And that's what our culture said, forget it.
00:15:09Yeah. Just don't attend to it. So the vagus initially was fine when we were in, we could rest and restore
00:15:18with it in peaceful comfort. But when we had a fight flight mobilization, we interfered with that
00:15:24rest and restore. But what happened now with mammals, they had a very, let's say nuanced vagal system that
00:15:33became a vagal system that enabled social engagement, enabled even mobilization without fear. And we call
00:15:41that play and dance. And we didn't merely have to be immobilized and intimate to, in a sense, have this
00:15:48physiological calming. We could be interactive. So the mammal basically had not only a fight flight system and
00:15:56not only a older dorsal, the back of the brain cell, vagal system that regulate your organs, but also had
00:16:04this newer ventral vagal that was locked to our voice and the muscles of our face and head. Basically,
00:16:10we were broadcasting that visceral state and we were, in a sense, encouraging others to co-regulate with
00:16:17us to come closer. So the whole, in a sense, in Austin, where you're seeing, you know, startup businesses and all
00:16:25this, the question always will become the degree of cooperation within a workplace. And as we become
00:16:33more and more remote, that type of the social cues become more and more, uh, separate from the actual
00:16:41interaction. So the mammal had this remarkable system that enabled it or us to control our fight flight
00:16:50and actually co-op it as play and to control our immobilization to support our health growth and
00:16:56restoration by being safe in the arms of another. And to also signal, uh, that we needed help, that we
00:17:03needed care, that we needed support. Yeah. Signal is the magic word here. We are a nervous system that is
00:17:11looking for signals, signals literally of safety and connection. And what you really were saying is,
00:17:17so if you go and meet someone and you engage them and have a drink with them, you make face-to-face
00:17:24contact, you smile with them and you start now creating a, almost a template of what that person is like.
00:17:32You start inferring, or is that a person you would like to spend more time with or do you look at your
00:17:38watch or your phone and say, I gotta go. And you're picking up all those signals and those things are
00:17:44really signals of whether that person is accessible to you and are you accessible to that person or are you
00:17:51defensive? Does that person in a sense make you feel uneasy? You want to get out of there. And you may have
00:17:58those same feelings doing podcasts and say, wow, is the hour almost up or, you know, what am I going to
00:18:05talk about or can I move on? Yeah. Yeah. You say that we come into this world with a quest to be safe.
00:18:12Yeah. Why? Because we can't survive by ourselves. So, I mean, there's a function to all this. So,
00:18:21it's not like it makes it unimportant because it's pragmatic. It's just how we evolve. We,
00:18:27not, we didn't evolve as an independent self-controlled or self-contained system. We needed
00:18:34others in our world. And for many, especially those who survived trauma, people have great difficulty
00:18:42moving into their worlds or they have difficulty moving to others. So, they often gravitate to horses
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00:19:56and MODERNWISDOM at checkout. What does feeling safe actually mean neurologically?
00:20:03Okay. It means, basically, we can... Okay, so let me flip it on you. What does feeling stress mean to you?
00:20:11Um, high heart rate, sweating, um, tightness in the body, ruminating thoughts, intrusive thoughts,
00:20:19concern, um, lack of creativity. Lack of ability to access your capacities.
00:20:27Yes, yes. Constrained capacity. Yep. Right. So, now let's flip it and say,
00:20:32when do I feel I have options to access my capacities? When do I feel exploratory? When do I feel expansive?
00:20:41That's a... They're basically two different physiological states. One supports our physiology
00:20:47of health growth and restoration, and one is very constrained and is costly to us. And we know that.
00:20:53We call it burnout or exhaustion. And we also know that there are benefits. So, safety really is the child
00:21:02of a physiology that is homeostatic. It's taking care of itself. That's why, when we start to block the
00:21:09feedback loops. Of course, when we talk about homeostatic or the body regulating itself,
00:21:15it has to assess itself and act on itself. So, it's a feedback loop. But if we numb our own feelings,
00:21:23those feedback loops become less effective. Mm-hmm. What's the most powerful force of safety
00:21:31in the human world? Let's reframe it. What are the most powerful signals?
00:21:35Mm-hmm. Mm-hmm.
00:21:37And they would... You know, you could identify them. That would be maybe a smiling face,
00:21:44a voice that's prosodic. Prosodic voices, melodic voices are powerful. And just ask that crying baby
00:21:53who feels isolated, out of control, and how rapidly that baby will calm down when the mother's, if the
00:22:02mother has a good engagement, good voice. In fact, we actually did research on this where you kind of
00:22:09like disrupt the baby. And then you talk to the baby and see what happens. And if the mother's voices were
00:22:15more melodic, the baby's heart rates dropped almost immediately. The mother engaged without a melodic voice.
00:22:24No way.
00:22:25Yeah. So, when you get your dog, you can try this all out.
00:22:30Yeah, I will do. I'll sing this.
00:22:32I would say if you had a child or if you had a spouse or a partner, you can try it out as well.
00:22:37Yeah. Child soon cometh. Just give me... I need a little bit more time on that one. Okay. So, to sort
00:22:42of recap, to recap where we're at, is it right to say that your position is our ability to connect with
00:22:50others is fundamentally a biological state and not just a psychological choice? Feeling safe enables
00:22:58curiosity and empathy and social engagement. Yeah, I think that's quite accurate. I would kind of
00:23:03reframe one word. I would say our capacity to, which is not necessarily our ability. So, our capacity...
00:23:11To connect with others. Yeah. And so, part of... I view my goal in life is to navigate in a,
00:23:17let's say, a complex world that has lots of signals so that my capacities can be expressed.
00:23:23So, if I'm in a world that is too aggressive, too noisy, too overwhelming, I can't access my capacities.
00:23:31Why do some people never truly feel safe even when objectively everything's fine?
00:23:36I think that's the greatest... That was the question that got me going. Because I said, you know,
00:23:41we use this word safety. And it's not like there's a metal detector. That's not going to make me feel safe. It's something different. And it's because our culture sees threat and the removal of threat as obviously being safety. It's not. Safety requires signals, just like threat. So, it's not like take away the signals of threat and everything's fine. No. You can take them away.
00:23:41Yeah. But we really, really want signals of safety.
00:23:47Mm-hmm.
00:23:53And they will be, you know, watch children playing. And actually, you think that, like, when we mobilize this fight flight, when you watch children running in play, there's still something that we don't need to do.
00:23:58And so, we don't need to do that. So, we don't need to do that.
00:24:00So, we don't need to do that. So, we don't need to do that.
00:24:02We don't need to do that. We don't need to do that.
00:24:04But we don't need to do that. We don't need to do that.
00:24:06But we don't need to do that. We don't need to do that.
00:24:08And we don't need to do that. We don't need to do that.
00:24:10And they will be, you know, watch children playing. And actually, you think that, like, when we mobilize this fight flight, when you watch children running in play, they're still smiling.
00:24:24And when you look at them, you feel good. But if you see children running from a school or something else, your body gets a totally different response to that signal because the faces are telling you everything.
00:24:36So, that was the part that really got me going. This is now we're in the 1990s because the nerves that control the face, the smile, nerves that control the intonation of her voice were linked to how that mammalian vagus was working.
00:24:53So, as the mammalian vagus was really sending signals of calming, it was triggering social engagement.
00:25:02So, it was like, this is the broadcasting part of what we can see physiologically. And the mammal, social mammal, when it evolved, it literally gave a window to that underlying physiology.
00:25:16So, we know by people's voices and faces whether they're safe to come to.
00:25:20Do some people just naturally, in terms of disposition, before conditioning, do some people require a different dose of signaling in order to feel safe?
00:25:38I've read a little about HSPs, highly sensitive people. I'm trying to think about how much of personality and how much of safety is really nervous system state, and how much do people differ in terms of what it is that they need?
00:25:53So, we could actually kind of build a model and say, before we think that it's a locked-in temperament or a personality, maybe it's a physiological state that got retuned and got locked into this more defensive mode.
00:26:08So, let's kind of look at things optimistically. The interesting thing, or one of the interesting things you're bringing up, is that if a person has a history of not having safe individuals in that person's history,
00:26:23when someone tries to engage them, even with prosodic voices and those signals, they may actually react adversely to it, especially if there's a real abusive trauma history.
00:26:37And you can actually read what's going on in their nervous system. The nervous system is getting triggered, and they hear that voice and that face, and it goes, "Wow."
00:26:47Then the body starts feeling, those feelings inside the body, those feelings for healthy, or say healthy is not the right word, for atypical nervous system, are feelings you feel good.
00:26:59But if those feelings of feeling good are associated with being abused, what happens?
00:27:05So, you get the feeling, and then the brain remembers, says, "Been there. This is what happened to me. I'm out of the room."
00:27:13Sorry for interjecting. That feels a little bit Skinnerian. That feels a little behavioristy, that we have this stimulus response. What is it that we have associated?
00:27:23Is that fair? Is that fair for me to sort of add that little bit of a twist into how the conditionings occur?
00:27:28Yeah. So, we have in the sense of reflex, which is no cognition is necessary. And you talk to me, or I talk to you, or you talk to your dog, and the dog just kind of relaxes.
00:27:40That's a reflex. It's not an awareness. Now, the body responds. And so, you have that feeling. That's an awareness. Now, that awareness becomes conscious. And then you can associate that with good and bad things.
00:27:56Yes. Yes.
00:27:57So, there are two different parts of this sequence. One, my nervous system has a propensity to react. I can't change it. That's who we are.
00:28:06Okay.
00:28:07You know, we can get triggered. It's like, this reason I have a smile is that my wife used to say to me, you should be above it. You know? And I say, I'm human. I can get triggered. We all get triggered.
00:28:19Yes.
00:28:20And so, the real issue is being triggered is not the real issue. The issue is what happens when you get triggered. And when you get triggered, your body shifts state. And what is your awareness of that state? So, when you get aware that your body shifted state, what do you do?
00:28:37Do you scream at the other person across the table from you? Or do you say, wow, I got triggered. People are going to say, you think you're weird. But you say, oh, wow, it must have been triggered. Where did that come from?
00:28:50Very few people have the patience to stop getting in the way of that physiological shift. They want to create the narrative to get out of there.
00:28:58What's interesting, you used the example of when you got pneumonia and preferred to be around smaller groups of people, didn't want as much social stimulus. That shows just how adaptive, not only across time, human evolution, adapting to the environment, creating these different capacities and signaling that means that it's more likely that you'll survive.
00:29:22But even within a single organism's lifespan, your system had adapted to see an old stimulus in a new light.
00:29:35Yeah, that's who we are. We're a flexible species. And the problem is that when we have things like pneumonia or chronic fatigue or long COVID, that flexibility gets reduced.
00:29:49And that tends to be a shock to many of us when it happens. And the up part of it is that there's pathways of rehabilitation. There are ways in which you can seal the system to slowly gain confidence in itself again.
00:30:06It feels...
00:30:07I need to break the fourth wall a little bit for a second, so bear with me.
00:30:13It feels very timely to be speaking to you, so you probably won't be aware of this, but a lot of the audience will.
00:30:21So I released a health vlog about nine months ago or so, tracking a journey that I'd been on from long COVID, chronic fatigue, Lyme, CMV, EBV.
00:30:36I lived in a house that had mold with every different polymorphism that you don't want in order to have mold toxicity, heavy metal, like just this laundry list of challenges.
00:30:47It had meant that I was tired at seven o'clock at night every night. It meant that no matter how much I slept, I never felt recovered.
00:30:56I hated the smell of standing water. I couldn't stand silence, but I also couldn't stand music.
00:31:02It's this real sort of big mess. We get to the back end of last year and I'd made some good progress.
00:31:10I'd improved all while doing this, right? Bits of the brain that are associated with word recall, working memory, being in a good mood.
00:31:18All of those were the ones that were being slammed while I was trying to put on a good show and be a professional for a few million people a week and to try and do this well.
00:31:27So that felt like a big tension. I go and do a tilt table test in February.
00:31:34I failed my tilt table test or succeeded depending on how you looked at it.
00:31:3811 minutes, full vasovagal syncope, fainted, heart stopped for five seconds.
00:31:44So for the people that don't know, this is a test for autonomic flexibility, autonomic response.
00:31:49They strap you onto a table. You've got blood pressure cuffs everywhere, heart rate sensors on your feet, on your hands.
00:31:54There's an IV in case you faint and need to come back around.
00:31:58And after you've laid down and done some breathing exercises, they raise you up to sort of 70 degrees and they see how your body responds.
00:32:05There's something about that 70 degree angle that your body doesn't like it.
00:32:11And after five minutes, I felt a little sweaty. I felt a little uncomfortable. I started to feel a little bit sick, but I've done a lot of meditation, a lot of breath work.
00:32:22And I was like, right. Okay. Well, this is the time to apply some of your meditation and breath work.
00:32:26You're not allowed to move at all. You can't wiggle your toes even a bit. You can't move your calves. You're on this special bed.
00:32:31You're all strapped in, not moving because you don't, they don't want you to help your circulation to get a full, a fully valid test.
00:32:37So I stopped breathing through it and it gets a little better and then it gets quite a bit worse.
00:32:42And then my vision starts to go blurry. It's nine minutes in. And then I start to sweat and it's 10 minutes in. And then the next thing that I knew I was flat on the bed and the nurse had come over me.
00:32:54This small Filipino nurse. There was a really lovely guy. He came over me in the first sentence that came out of his, out of his mouth after I sort of came back around was okay. So your heart's stop your hearts. No worries, buddy. Your heart's that was like, Hey dude, if I've just, if I've just passed out. Okay.
00:33:12I don't want the first words out of your mouth. When I come back around to be your heart. Stop.
00:33:16Um, anyway, all of this together, I've got about as strong of a personal investment in your work and in the world of nervous system regulation as, as, as I think I could, this has been unbelievably personal to me over the last two years and specifically the last nine months.
00:33:36You're catching me today. This week coming up, I'm going away in my first ever meditation retreat for seven days. And a big part of the motivation for that has been to try and get my, uh, autonomic system back in check to be gentle with myself. So anyway, I just appreciated you opening up about your, about your case with the pneumonia thing, because it, it, it felt like it gave me a license to talk about.
00:33:57You have license to talk to me about anything. So the, the interesting part is, first of all, it's a slow journey back. Don't I, I thought we could just throw a switch. I had optimism about these things as well. Basically listen to your body. It is telling you things. I will, I will tell you a similar story. When I was getting, uh, a heart checkup, they, they were, uh, basically put a IV in me and the IV started to get loose.
00:34:26And so I started to, uh, told them that I'd say twiddle it. And I wanted to vasovagal syncope as well. And they, they then looked at me and they said, what are you scared of? I said, not scared. You're basically tweaking with my bowel receptors.
00:34:40Yes. Yes.
00:34:41Basically they're playing with the blood pressure receptors, but they don't think of it in that way. So they see like this, this autonomia, which is what they're looking for.
00:34:49Yeah.
00:34:50Uh, with that. And they, uh, actually for many of the people who fail those tests, they start, they have a broad, uh, let's say array of symptoms and they tend to be treated by the medical community.
00:35:03As if there's nothing wrong with them. And yet these symptoms keep coming out. What I'm saying to you is be patient. Your nervous system is on a recovery track and long COVID is the story that I want to tell you is a metaphor for you to think about.
00:35:18You survived the pathogen. You had COVID and your COVID is for some people lethal, as you know. And the other part is that when our body wins the war, kills the pathogen, it doesn't always inform the entire nervous system.
00:35:34Hmm. You know what, you know what my Filipino friend said to me, he said, um, this is what I do. I'm a technician for the tilt table test. And prior to COVID, I would maybe do between three and five of these a month.
00:35:50Yeah. And now I do between three and five of these a day. Wow. I think long COVID or the consequence of the pandemic have been so underestimated. I've just completed a study on long COVID. I was part of a interesting, uh, government funded project, uh, basically doing it remotely.
00:36:11And we, uh, basically the intervention was vagal nerve stimulator, um, which was developed by a colleague of mine and another intervention, a sound intervention that I had developed with the, with, uh, uh, basically it's called sonacea or saw sonic augmentation technology.
00:36:29It's a new stuff that I've developed with a colleague called Anthony Gori and what it does.
00:36:35First of the vagal nerve stimulator, you know, what it does, it's sending a signal to the vagus and it's basically trying to tell the vagus that everything is okay in your body.
00:36:46And if it tells you that, then it may start connecting to the organs of the body and you feel better.
00:36:51So it's a signaling system.
00:36:53It's not regulating the motor part of the vagus.
00:36:56It's sending a signal in the sound does the same type thing.
00:36:59It basically sends signals of literally that you're floating in a rhythmic sea.
00:37:06So it's just like, think of the tilt table, but not like that.
00:37:10Think of it as rocking slow.
00:37:13More like a cradle than a tilt table.
00:37:15Yes.
00:37:16Yes.
00:37:17And we all have that visual image, like babies kind of like coming away and floating in space, but no fear of falling off.
00:37:25And basically the sounds had the same effectiveness as the vagal nerve stimulator was very profound in terms of what it did over a four week period.
00:37:36And so basically we had massive effects on all, basically all the parameters we had were measuring on, they were all questionnaires and symptom arrays.
00:37:48There were no blood samples, but symptom arrays of how people felt and whether they had fatigue and whether they were anxious or depressed.
00:37:59And basically all the indicators improved in a very, let's say powerful way, which provided the whole model, whether it's a vagal nerve stimulator or the sound, is that if you know what the signal profile is that your nervous system is looking for, you can get at that.
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00:39:20Why would it be the case that a dysregulated nervous system would cause people to feel more anxious, people to feel more depressed, them to have lower energy?
00:39:31Why would this huge suite of things occur?
00:39:34First of all, let's tap you on the back and give you a congratulation for observing and calling out that it is a suite of systems that are effective.
00:39:45It's not one.
00:39:46It's not really is.
00:39:47You're just tired.
00:39:48Not just sad.
00:39:49You're not just distracted.
00:39:50No.
00:39:51It's not just you have poor sleep.
00:39:52It's not that your gut isn't working.
00:39:54It's not that you have tachycardia.
00:39:56It's everything about your autonomic nervous system's regulation.
00:40:03So it's a regulatory disorder.
00:40:05And we have difficulty in, I would say we, I'm talking about modern medicine, in seeing a system and seeing the system and its function.
00:40:15The system is dysregulated.
00:40:17It doesn't, it's not coordinated in a way that it should.
00:40:21And the, and we were picking up on it.
00:40:23And so the issue is yes.
00:40:25And I'll give you a word that fits in with all this.
00:40:28Your body's in a chronic state of defense.
00:40:32It's as simple as that.
00:40:33It's like the, you killed the pathogen, but that information, the success of that war didn't retune how your nervous system worked.
00:40:44So it's still prepared for war.
00:40:47Oh, you're locked into this price.
00:40:50Oh, that's interesting.
00:40:51So in the same way as a traumatic emotional event or physical event, a traumatic pathogenic event.
00:40:58Yeah.
00:40:59Does something similar.
00:41:00It's all the same.
00:41:01It's all the same.
00:41:02But the difference is when something has occurred consciously, you know, people can talk back to while I go into that car crash.
00:41:09So getting into cars, it makes sense that that would make me feel nervous.
00:41:12Yeah.
00:41:13The same thing we don't draw because it's, it's below the conscious threshold.
00:41:17We don't draw the same analogy to pathogens.
00:41:19We need to be close.
00:41:20We're numb to our body.
00:41:21We don't have the language.
00:41:22So our narrative isn't saying, look, it doesn't matter whether it was a car wreck or a pathogen or whether someone humiliated me in public.
00:41:30It doesn't matter.
00:41:31My body reacted to it as if I was going to die.
00:41:34Uh-huh.
00:41:35And this is what bodies do when they think they're going, they don't think.
00:41:39When all the signals are that, that death is eminent, imminent.
00:41:44So I actually, uh, uh, gave a couple of recent talks that I call sentinel trauma.
00:41:50And that is what the, how does the body react to the single events of mortal threat?
00:41:56And I'm actually saying that COVID can be a mortal threat to the nervous system.
00:42:01And that's the consequence.
00:42:03It gets hardened as a response pattern and you're, you're living through it.
00:42:09Uh, I, I would say optimistically, uh, these you're doing well and even your curiosity.
00:42:17So where you're going with it is, and you're going to end up on that journey about understanding about the body's own feedback loops and how they got challenged.
00:42:26Uh-huh.
00:42:27And that's exactly what they're assessing in the, uh, tilt table test.
00:42:31They're assessing whether the feedback loop is working on your blood pressure.
00:42:36Yeah.
00:42:37Meaning your vascular bed, the vagus, the sympathetics, you know, blood flow.
00:42:42Now I will tell you what are my exercises every morning.
00:42:45Yes.
00:42:46I have a backswing, basically a tilt table in the basement.
00:42:50Yeah.
00:42:51Ever see when the back swings?
00:42:53Yes.
00:42:54So it tilts down like that and you can go upwards like that.
00:42:58To in like an inversion table?
00:42:59Yeah.
00:43:00Yeah.
00:43:01It doesn't go on.
00:43:02I can't rotate, but I can go like 70 degrees down, 70 degrees up.
00:43:06Yep.
00:43:07Yep.
00:43:08Yep.
00:43:09I have seen that.
00:43:10Why?
00:43:11I'm challenging my down receptors.
00:43:12I'm doing a neural exercise on them every morning.
00:43:15How long are you doing that for?
00:43:17I'm doing, first of all, I tilt downward and do basically sit ups and basically about 10,
00:43:24five minutes or so of exercises in the inverted position.
00:43:28Uh huh.
00:43:29Then I do tilts on each breath, 30 of them.
00:43:34They're quite rapid.
00:43:35You would pass out.
00:43:36Yeah.
00:43:37I bet I would.
00:43:38Yeah.
00:43:39And, but I'm not passing out and look, I'm 81.
00:43:43So it's not like I, what I'm saying is I'm trying to stay here for a while.
00:43:48And if I were totally sedentary, my body might think it's up.
00:43:53You're too old to do those things.
00:43:55Hmm.
00:43:56How fascinating.
00:43:57Okay.
00:43:58I think it's important to get into across all of your research.
00:44:02What interventions have you found to be most impactful for improving autonomic function?
00:44:06Okay.
00:44:07So first of all, if we go back, we're going to go back into the nineties.
00:44:11I actually was playing around with a tilt table.
00:44:14I had a motor on it where I rocked people up 21 degrees and then back down to horizontal.
00:44:20It took seven seconds up.
00:44:22So one, two, three, four, five, six.
00:44:25So you can start feeling that it's kind of like a very nice rocking, even slower than
00:44:32what you're doing much slower.
00:44:33Yep.
00:44:34Yep.
00:44:35Yep.
00:44:36And suddenly no one wanted to get off the table.
00:44:37That was the first.
00:44:38So the research showed that I could entrain rhythms associated with literally vascular bed
00:44:45activity.
00:44:46I could actually get into that system and exercise those.
00:44:49But the subjective response, how people felt was to me, the most interesting part of it.
00:44:55No one wanted to get off the table.
00:44:57Hmm.
00:44:58And I never forgot that.
00:45:00And that's when I started to develop the acoustic one.
00:45:03I was mimicking what the tilting was doing.
00:45:06And so the, the issue is that the acoustic interventions that I've developed two of them.
00:45:14One has been used by a few hundred thousand people.
00:45:17Now it's called the safe and sound protocol.
00:45:20And what it does is basically mimic the acoustic features of a mother's voice.
00:45:25So it's broadcasting calmness and engagement.
00:45:30And they're finding that it works quite well with, you know, pediatric populations.
00:45:35But the trauma population, people have used it with other therapies.
00:45:39And it's been intertwined with EMDR and with various cognitive behavioral therapy and all forms
00:45:48of it, in a sense, to make the client more accessible to the therapy.
00:45:53So what it's doing is priming a system to be more connected with the therapist.
00:45:58Uh-huh.
00:45:59So what I'm doing, so both of the, and then on the new one I developed, which is called, uh,
00:46:05sonic augmentation technology.
00:46:06And the intervention was called rest and restore protocol.
00:46:10And that was feeling really with visualized, basically floating in a wonderful sea without
00:46:17not having any need to connect.
00:46:20You feel so safe.
00:46:21You don't have to look for someone.
00:46:22You don't have to listen.
00:46:23You're just there.
00:46:25Basically, I called it stealth meditation.
00:46:28And when you deal with, when you deal with it, meditation is too hard.
00:46:32Okay.
00:46:33And, and the issue is if you deal with meditation for traumatized individuals, they run out of
00:46:39the room.
00:46:40Yeah.
00:46:41Because that immobilization now is a signal to the nervous system of vulnerability.
00:46:46Fascinating.
00:46:47So, okay.
00:46:48You've managed to isolate frequencies of a mother's voice.
00:46:51I think it's like 1500 to 3500 Hertz.
00:46:53Is that right?
00:46:54You read real well.
00:46:55Yes.
00:46:55What can I say?
00:46:56I do my research also, obviously like unbelievably personally invested in getting this right.
00:47:01Um, and that's why, uh, layering into music, making the connection that that's enough to signal
00:47:07safety cues to the nervous system.
00:47:08Yeah.
00:47:09But it's actually even broader.
00:47:10So anything it's like 500 to 3000 will be fine.
00:47:13Or.
00:47:14Yep.
00:47:15It's actually, it enables the frequent, actually all mammals, even little mice like animals.
00:47:21They vocalize in a certain area of the auditory spectrum.
00:47:25That is very similar.
00:47:26If you looked at their full spectrum.
00:47:28So dogs, cats, and horses overlap with our, uh, band of social communication.
00:47:35So you can calm a dog or a horse or a cat by talking to them.
00:47:39Is that part of the reason that we have.
00:47:41Yes.
00:47:42Collaborated and partnered with those animals.
00:47:44So, oh, that's so fucking cool.
00:47:46Okay.
00:47:47So part of the reason that humans, cats and dogs, cats, dogs, and horses.
00:47:53Yeah.
00:47:54Have bonded so well.
00:47:56Is that our frequency.
00:47:59Of calm.
00:48:01When vocalized.
00:48:02Yeah.
00:48:03Is in a similar range to the one that they use.
00:48:05Absolutely.
00:48:06That is so cool.
00:48:08It's totally amazing.
00:48:10And it's so interesting to watch how people talk to their cats.
00:48:14It's like they have a manual.
00:48:16Yeah.
00:48:17Have you ever seen a video, a short video of a golden retriever.
00:48:22And there's two hands down in front of it.
00:48:25It's on a couch somewhere.
00:48:26And the golden retriever is going from dad to mom.
00:48:29And with dad, the golden retriever is used to play fighting.
00:48:32So he bears his teeth and sort of pretend bites at the hand as he's putting the hand down.
00:48:37And then when he goes to mom, he just rests his chin on the top of a hand.
00:48:41But the dog does it two seconds, two seconds, two seconds, two seconds.
00:48:45Bite, rest, bite, rest, bite, rest.
00:48:47And I just thought that was, it's so funny.
00:48:50It's so funny how quickly adaptive that is to be able to have.
00:48:56Yeah.
00:48:57No.
00:48:58Listen, my cat does something similar.
00:49:00My cat likes to mouth me, my hands, not my wife's.
00:49:04It's the same time.
00:49:05Very interesting.
00:49:06Okay.
00:49:07So if that, if this is the case, right.
00:49:08And safety cues can be cued through, uh, auditory, um, input.
00:49:14Why not just play this music all the time?
00:49:16If it's that simple, why not just play the music permanently?
00:49:19Okay.
00:49:20Interesting.
00:49:21And so I had that idea and I decided to play it in a preschool to see what would happen.
00:49:27And I was playing it in the preschool and guess what?
00:49:31The kids were talking to each other.
00:49:33They were gravitating near the speakers and they were very socialized.
00:49:37I played the same music without the algorithm, uh, modulating it the way I wanted.
00:49:42And they were, they were solitary, this very solitary.
00:49:46And I played other music and nothing happened.
00:49:48So the, the part was that our nervous system recognizes it, but here is the problem.
00:49:54And this is a massive problem.
00:49:56And I thought that we're just there sitting there waiting for love sounds and sounds of
00:50:03connection to occur and wouldn't the world be so much nicer.
00:50:07I forgot that if you come out of a traumatized environment, someone who is broadcasting those
00:50:16same frequencies is a predator to their nervous system.
00:50:19Huh?
00:50:20So the history, their own history retunes them and keeps them out of social settings.
00:50:26And again, in the world that we both live in, we know people who have had very bad relationships.
00:50:33And we also know that they talk about finding the right person, but you know, after meeting
00:50:39them, there will never be a right person because their nervous system is not broadcasting signals
00:50:47of accessibility.
00:50:48That's interesting.
00:50:49Okay.
00:50:50So what about, um, vagus nerve stimulators?
00:50:54That's something else that you mentioned earlier on, how much is real and how much is bunk
00:50:58with regards to that?
00:50:59Oh, I mean, number one, it's real.
00:51:02Uh, the question is for what and what reason are you, do you want to use it?
00:51:07A lot of people want to use these things because they think it's a simple way out that they can
00:51:13change the context of their life by stimulating a nerve.
00:51:17And the answer is the nervous system is smart.
00:51:20If you stimulate the system to be calm and accessible and you abuse it, the nervous system will cut
00:51:26off that feedback.
00:51:27It will just adjust.
00:51:29So terms like hacking the nervous system is not the right concept.
00:51:34You want to make the nervous system available and then you want to exercise it to expand its
00:51:40range and increase its flexibility.
00:51:43What does exercise it, expand its range, increase its flexibility look like?
00:51:47For me, it's like challenge it and let it, let it calm down, challenge it again.
00:51:52It's like my oscillating tilt in the morning.
00:51:55I'm challenging the system.
00:51:57So one might say this is stressing the system, but it's exercise if I allow it to recover.
00:52:03So the issue is I'm aware that if I stress the system, it's going to change.
00:52:08It's going to pull off its inhibitory or slowing up aspect.
00:52:12So the heart rate will go up, but then my heart rate will come back down.
00:52:16And now I can do it again.
00:52:18It's like saying to people who have high heart rate and they're concerned about exercising,
00:52:24their system has been retuned and they're locked into a fight flight.
00:52:28And if they now try to exercise, they can get into a syncope situation where the body just
00:52:35can't adjust.
00:52:36It can't give anything else more out and just will shut down.
00:52:40So we have a real problem in how we conceptualize even our own physiology.
00:52:46So it's not only our heart rate level, it's the neural regulation of our heart rate.
00:52:53And that's where heart rate variability.
00:52:56Actually, what you don't know is that in the 60s, I was the first person to quantify heart rate variability.
00:53:02That's something that I do know because I did my reading.
00:53:05Ah.
00:53:06That was your first paper, right?
00:53:081969?
00:53:09Right.
00:53:10Seriously.
00:53:11You're on my good list.
00:53:14So the real issue is I'm extraordinarily disappointed in the area of heart rate variability.
00:53:21Because what I was working on was once I observed the phenomenon, the question was what is causing,
00:53:28what were the underlying mechanisms?
00:53:30What was I really measuring?
00:53:32And if I can measure it better, in a sense, get closer to the neural innervation, then the measurement
00:53:38would have much greater and better generalization, more useful.
00:53:42Ah.
00:53:43And what happened is that it went back to very descriptive.
00:53:46So like I have a Fitbit and the Fitbit is just giving me measures of variance, which is a descriptive statistic.
00:53:54I've worked on this for decades to develop technologies to, in instance, pull out the specific vagal influence in the heart rate activity.
00:54:03And that's basically swept under the carpet.
00:54:05Speaking of that, what do you make of resonance breathing?
00:54:08Well, there's something very interesting there.
00:54:11Well, first of all, there is a, when we start understanding that the brainstem's respiratory rhythm is not just affecting heart rate, but affects other things.
00:54:23We start getting into this notion of what would be called resonance.
00:54:27I have a very simplistic view of it.
00:54:30I think a lot of people think that a lot.
00:54:33So the theory is really that there's individual differences in what your resonant frequency is.
00:54:40I don't think it's that tailored that neatly.
00:54:43I think our bodies like certain slower rhythmicities.
00:54:46And that's even like with the music I was really working on.
00:54:51I don't think it has to be, it says that's specifically designed.
00:54:55And with resonant frequency, they were going at 0.1 Hertz or 10 seconds.
00:55:00Yeah.
00:55:01I think the body wants to gravitate slower.
00:55:04Yeah.
00:55:05It wants to go to like 0.12, which is really what I was tilting people at.
00:55:09Actually, I think it wanted to be moved out of our normal breathing frequency.
00:55:14Correct.
00:55:15It wants a different experience.
00:55:17It wants a frequency that is closer to our normal vascular oscillation.
00:55:23And breathing tends to be quite a bit faster than a vascular oscillation.
00:55:27I did a bunch of assessments.
00:55:29I love this product.
00:55:30It's called Ohm, ohm.health.
00:55:32And it's a HRV resonance breathing lamp.
00:55:36And you grab this thing.
00:55:37Anyway, my frequency is 4.5 breaths a minute.
00:55:40Hmm.
00:55:41It's 4.5.
00:55:42That's good.
00:55:43And that's where I get the highest oscillation between top and bottom.
00:55:49That's where mine is.
00:55:50Okay.
00:55:51So vagal nerve stimulators, good, but being used in the right context.
00:55:55Resonance breathing, interesting and may also play a good role.
00:55:58Also good.
00:55:59But remember what you were doing, you were doing a lot of interoception with your resonant breathing.
00:56:04Yep.
00:56:05You were not only looking at what the numbers are, you were assessing what was optimal, how you felt.
00:56:10How I felt.
00:56:11So you're really closing the loop of the sensory part with the motorized.
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00:57:15I guess that's a really good question.
00:57:17So there's a ton of different interventions, humming, chanting, a variety of other interventions that we could use.
00:57:27But how much of what we're trying to do requires some relational aspect between us and another person?
00:57:35Because there's the physiological intervention, vagus nerve stimulator, using a tilt table up and down, breathing at a particular rate.
00:57:46But then that perhaps stresses and then relaxes or relaxes and opens up tolerance for your nervous system.
00:57:55In that window, is that important beyond just the interoception thing to say, "Hey, and now I'm going to start to relate to the world around me," like a social exposure therapy or nervous system exposure therapy within that newly calmed window?
00:58:10Yeah, well, that's exactly how the Safe and Sound Protocol is being used in clinical interventions.
00:58:16It's not being used by itself.
00:58:18It's being used to make the client more accessible to the intervention, which may be the therapist herself or himself is maybe what the actual therapist may make the therapist more effective.
00:58:32So you're engendering a state which is one of calm.
00:58:39Would it be fair to say sort of a broader flexibility within the nervous system for a little while?
00:58:46Absolutely.
00:58:47You're creating a window of flexibility.
00:58:50Of tolerance.
00:58:51And then in that newly expanded window that's going to exist for a little time, you're going to expose yourself to some interventions.
00:58:59And then once that's closed off, the goal is to increase that window of tolerance from state to trait.
00:59:06Yeah, well, this is exactly what several therapists are using the Safe and Sound Protocol with, with extraordinarily sensitive people.
00:59:15So go back to your initial interest, which is on hypersensitive people, which is something you brought up.
00:59:21They found, or some of them found that just listening for, let's say, a few seconds or a minute has had effect, but they tend to react.
00:59:31They found that if they start to expand over days, how much they listen to, they're creating, in a sense, with a tool, they're opening up the window for longer and longer periods.
00:59:42Yep, yep.
00:59:43Okay.
00:59:44Uh, why do singing and humming and chanting calm us so much?
00:59:48It's a very easy answer.
00:59:50Uh, it's because they're, they're recruiting.
00:59:53I could actually say, why does eating or ingestion calm us?
00:59:58Uh, you have enough resources to, uh, sit down and have this food that suggests that there's not a threat.
01:00:07Also, it's a reinforcement that there's calories.
01:00:09So you're not in starvation mode.
01:00:11No.
01:00:12Too smart.
01:00:13You have to go back there.
01:00:14That's a problem I have all the time.
01:00:16Yeah.
01:00:17It really is.
01:00:18Well, yeah, no, you're trying to, you're building your narrative when all you need to be was a simple observer.
01:00:24And that is you watch a baby suckling.
01:00:27Okay.
01:00:28Okay.
01:00:29And what you realize is that the nerves and the neuromuscular control of suck, swallow and breathing, that coordination are the same of social expressivity.
01:00:39It's the same thing.
01:00:41So we're essentially using the same neural system when we ingest than when we are interacting with others.
01:00:49And this becomes really, I, in some of my talks, I say, we, we try to share ingestion, but not digestion.
01:00:57And digestion is a private matter.
01:00:59It's a dorsal vagus ingestion is the ventral vagus, which is our social engagement system.
01:01:05So we say, let's get together and have something to eat.
01:01:08That's a social act.
01:01:10And in fact, if we start tracking the history of society, ingestive practices or rituals literally are part of the history of community.
01:01:21You know, what's, uh, interesting.
01:01:23I had a communication expert, a guy called, uh, uh, Chase Hughes on the show a couple of weeks ago, and he deals in micro expressions and body language and, and, and some interesting things.
01:01:34And he had one insight around, uh, people who are feeling, uh, anxious and, uh, unsafe.
01:01:41He says that they tend to keep the inside of their arms in close.
01:01:46They don't want that brachial vein to be exposed.
01:01:49But one of the other things as I was, um, got him to break down a killer who was being sentenced, this guy, this guy that had done some pretty heinous crimes.
01:01:59And he highlighted that as the, uh, sentence was being given to him and the judge was reading out what he'd done and sort of giving him his, his, his dressing down.
01:02:12He was there and he, his tongue came out just a tiny little bit, licked his lips and then pushed back in.
01:02:18And I said, well, what's, what's going on there?
01:02:20He said, well, it's a vanity thing, uh, uh, moistening the lips makes you look better, but also as a baby who is pre-verbal, the first no that you have is because it's pushing whatever is in your mouth, maybe a nipple out of your mouth.
01:02:37And he, he had that as the, the, uh, a human's first no.
01:02:41And, uh, I have no idea if it's true, but I thought it was really cool.
01:02:44All these things can be true, but there are other parsimonious strategies.
01:02:48Uh, if you're getting a sentence, are, do you think your mouth will be drier than if you're getting an award?
01:02:56So it can be really the body's, uh, dehydration at that.
01:03:01The, the adaptive reaction is to kind of re-lubricate your, your orifice.
01:03:06Yeah.
01:03:07Um, I think re-lubricate your orifice indeed.
01:03:09Yeah.
01:03:10Yeah.
01:03:10Okay.
01:03:11That's another point because they, they, anyway, not another, but let's, let's go to this, this bit.
01:03:18This is for me, I basically talk about this is accessibility when the arms pull out.
01:03:25Okay.
01:03:26That's showing the ventral side.
01:03:28And like when my cat, my cat loves to do that.
01:03:31That's not a normal posture for a cat, but she loves because she likes her belly to be round.
01:03:37She wouldn't be doing that if she was underneath a foreign parked car out on the street.
01:03:42Or a stranger.
01:03:45But this is really, we hold in, we protect, we protect the ventral side.
01:03:51Right.
01:03:52So the issue of the evolutionary history is the ventral side is a side of vulnerability to injury.
01:03:58And, and it becomes how we protect ourselves versus not.
01:04:02So part of the bracing is symbolic.
01:04:05Yeah.
01:04:06If I were to sit like this, you'd have a different interpretation than if I were like this.
01:04:11What's the biggest myth about anxiety from your perspective?
01:04:15Anxiety is the body being in a defensive state.
01:04:21Simple as that.
01:04:23We don't need the word anxiety.
01:04:25We don't even need many of the words that we associate as emotion.
01:04:28The characteristics of anxiety are we're mobilized.
01:04:33Why are we mobilized?
01:04:35Now, what people like to say, I'm mobilized because I have to get something done.
01:04:40But what we notice is that, quote, anxious people, it doesn't matter if they get it done.
01:04:45If they get it done, they're still anxious.
01:04:47So that's just the narrative of how they are explaining their feelings.
01:04:53So the myth about anxiety is that it's outside of us when it really is.
01:05:01We're really broadcasting our physiological state.
01:05:05I guess a lot of people may feel, and obviously very self-serving.
01:05:12They go through periods of life where new lower tolerance periods, lower tolerance abilities with regards to how much stress they can put up with, how much energy they've got, their startle response, their level of ambient anxiety, their capacity to deal with stress and change and uncertainty and ambiguity and stuff, where that gets constrained.
01:05:36Yeah.
01:05:37What's the difference between somebody who gets locked in from that situation and somebody who ends up bouncing back?
01:05:44And how much resilience can be re-inherited after it's potentially being damaged?
01:05:50Okay.
01:05:51So you're living through a recovery phase of post-long COVID.
01:05:55So you know exactly that your range of resilience is different than what it was pre-COVID.
01:06:01Correct.
01:06:02Well, you also know that it's getting greater than it was immediately after COVID or during COVID.
01:06:06So you have a trajectory that you can assess.
01:06:10So the part of it is that we tend to think that if we're not flexible, we're not trying hard enough.
01:06:19And the issue is we have to understand what it is that is implementing the constraint on us.
01:06:28Our nervous system wants to blame something outside of us.
01:06:32It tries to blame, let's say, colleagues or bosses or spouses or, let's say, fiscal demands or political issues.
01:06:43It tries to create a whole set of other issues to externalize feelings that are really being generated inside our body.
01:06:51I'm not saying that the external ones aren't real.
01:06:54They are real.
01:06:55But the issue is it's not that they're not real or not that they are real.
01:07:01It's how we deal with them.
01:07:02So we can't solve the problems.
01:07:04We can't navigate into complex world if our body's in a state of defense.
01:07:10So what I've been working on is this whole idea of what optimizes our ability to utilize or gives us the access to our capacities.
01:07:21And that should be really the real question we should be asking.
01:07:25Not what is your capacity, but what gives us access to our capacities.
01:07:31So what you experience and are experiencing is that the capacities that you know that you have were being compromised.
01:07:41And that creates a conundrum.
01:07:43You don't understand why or how you want it to be fixed.
01:07:47And the answer is the nervous system is really broadcasting a message that those capacities are not accessible.
01:07:55It's not that they haven't been taken away.
01:07:57They're just not accessible.
01:07:59So the real question is what enables them to be accessible.
01:08:03And that's where we move into the concept that our physiological state, how we start the conversation.
01:08:09Our physiological state is really giving the boundary conditions of permission for these capacities to be expressed.
01:08:19But the problem is when it's giving us constraints, how do we reverse that?
01:08:24And that's part of our whole dialogue.
01:08:26And that is, it's all going to end up with signaling the nervous system that it's basically okay to come out and play again.
01:08:34It's almost like, is it safe enough to come outside?
01:08:40It's like a horror movie.
01:08:42Our nervous system wants to be reassured.
01:08:45And this is difficult because we do not know the signals.
01:08:49Our culture is horrible with signaling our nervous system.
01:08:53Just think about the traumatic events of schools with mass shootings.
01:08:59And the solution is to give guns to teachers and principals and put metal detectors.
01:09:04What is that doing to the nervous system of these children?
01:09:08Yeah.
01:09:09Yeah.
01:09:10I mean, it's not like metal detectors aren't useful and having someone with a gun may be very adaptive in complex situations.
01:09:18But those are profound signals to a developing nervous system.
01:09:22It's so interesting how because people's nervous system states aren't anywhere near as visible as pretty much anything else.
01:09:28If you had dirty drinking water and that impacted the way that a child's digestion worked, or if you had loud music and it was obvious how distracted they were, if you can see stimulus and response quite easily, the pushback against that intervention would be quite obvious.
01:09:45What we don't see, for instance, are humans built to see assassinations live streamed on X within minutes of it happening, posted around the world?
01:09:56Are we supposed to watch movies and car crashes?
01:10:02Well, you know the answers.
01:10:04You know the answers.
01:10:05Of course.
01:10:06But the question is, you start with a very interesting and very important question, and that is, if our nervous systems were visible, and I'm saying they are to much more of an extent than you think.
01:10:20Yep.
01:10:21Because people's faces broadcast, their voices broadcast, their muscle tension broadcast.
01:10:28Can you explain what a low-tolerance nervous system expressing person and a high-tolerance nervous system expressing person?
01:10:37A low-tolerance?
01:10:38They show up differently.
01:10:39Okay.
01:10:40First of all, the face would be flat, and you've seen flat faces, especially the upper part of the face.
01:10:45The lower part, you have much more control, and so you can make false smiles, but the upper part tells you really truthful emotions or feelings.
01:10:55The other one is intonation, and again, this is from your seat as a podcaster.
01:11:01When your interviewee has a monotone voice or a high-pitched voice, it doesn't show any flexibility.
01:11:15It's just broadcasting to your ear and to your body anxiety.
01:11:20So they're broadcasting to your physiological state.
01:11:23And I think when you brought up your question about anxiety, it's a rhetorical question.
01:11:31If you spend time with someone who's highly anxious, there's no doubt that your body is feeling their anxiety.
01:11:37Hmm.
01:11:38And what are you detecting?
01:11:40What are the things that you feel?
01:11:41You basically say, I don't want to be around this person.
01:11:43That is, you make a gullible statement, and you try to distance yourself.
01:11:47You haven't really, it says, gave the simple answer.
01:11:52The physiological state that that person is in is broadcasting that state to me, and it's bleeding all over me.
01:11:59Yep.
01:12:00Yep.
01:12:01Yep.
01:12:02And so what it does is it changes our responsibility in the world that we are in.
01:12:10We feel as a species that we can say whatever we want.
01:12:14It's all, I shouldn't say, it doesn't matter how we say things.
01:12:18It's what we say is important.
01:12:20And I'm saying it's how we say it becomes as important or more important.
01:12:25Mm.
01:12:26How we utilize this wonderful, uh, apparatus vocalization.
01:12:31Mm.
01:12:32Okay.
01:12:33How do you advise people to increase their window of tolerance and build safety practically?
01:12:38Then we talked about a variety of interventions.
01:12:41What's something that's, uh, high compliance, high impact?
01:12:45Well, you actually brought up things that people are doing.
01:12:49They're working on breath.
01:12:50I would say when they do breath, they start really working on their own internal feelings
01:12:55of the breath.
01:12:56So they're helping the feedback loops become more enhanced.
01:13:00I think, you know, like resonance breathing is, is powerful.
01:13:04Yoga breathing is powerful.
01:13:06I think part of what's missing again, even in the world of, let's say elite athletes and exercises,
01:13:13people are not saying as you exercise, go into the exercise and feel your body responding to it.
01:13:22Okay.
01:13:23You know, so we put on a television while we're on treadmills.
01:13:26We don't take the exercise as a moment of Zen.
01:13:30Why is that important?
01:13:31Why is it important to feel the thing that's happening?
01:13:34Why is it not enough to just do the thing?
01:13:36Ah, this is where the nervous system comes in.
01:13:39If we're not feeling it, we're, in a sense, down-regulating the feedback loop of the feelings
01:13:46of the sensory information coming in.
01:13:48We're dampening the sensory information.
01:13:51And I don't think we appreciate the, I would say, the power of what sensory information
01:13:57does to our brain.
01:13:59And so even like with the concept of the vagus, which has a lot of press, 80% of the fibers
01:14:06of the vagus are sending sensory information to the brain.
01:14:1180%.
01:14:12It's an internal surveillance system of our body.
01:14:16Our body craves that information.
01:14:18So are you suggesting that the, because 80% is going vagus up and only 20% is going brain
01:14:27through vagus down.
01:14:28Yeah.
01:14:29That by paying more attention to the breath as you're doing resonance breathing, to the
01:14:34sounds as you're doing safe and sound protocol, to your body as you're exercising, playing
01:14:38and dancing, that you're opening up the aperture inside of your mind to pay attention to that
01:14:4780% that's coming back up.
01:14:48I'm saying it's not even paying attention.
01:14:50It's allowing the feedback loops to complete themselves.
01:14:53This is all metaphoric, by the way.
01:14:55Yeah.
01:14:56There is absolutely, as far as I know, no research on this.
01:14:59But it is, in a sense, the whole, I would say, underlying or implicit theory behind meditative
01:15:06work, meditative breath.
01:15:08That is, that we can literally travel, or body scans where people literally try to travel
01:15:14within their body.
01:15:15That it may sound like it's kind of weird or woo-woo.
01:15:19But think about what you're doing.
01:15:21You're allowing the neural circuits to send information into areas of your brain to have a degree of
01:15:27awareness.
01:15:28And then to act on that.
01:15:31Or allow, I would say, act on it may be, merely be, to be more patient and more, reduce your
01:15:38own muscle tone.
01:15:39So we think of activity as skeletal motor.
01:15:43But some of our activity is visceral motor, our organs and cranial motor, like the muscles
01:15:49of our face, as we have to start to appreciate these different sources of motor systems in
01:15:55our body.
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01:16:59How important do you think metabolic support is to provide a window of tolerance to somatic
01:17:05interventions?
01:17:06In terms of myocondria, that?
01:17:08Yeah, yeah, yeah.
01:17:10I think that, okay, now we start talking personal information.
01:17:15Okay.
01:17:16So I had, let's see, I had radiation and I had prostate cancer and I had treatments and the
01:17:25treatments really wiped me out.
01:17:27And they wiped me out so much that I couldn't walk up a flight of steps.
01:17:31And I, you know, I just was gone.
01:17:35Mm-hmm.
01:17:36And, um, in fact, we went to Greece and I couldn't even go to the banquet.
01:17:40We were at a, my wife was talking at a conference and the conference was on physiology of stress.
01:17:46She's an endocrinologist.
01:17:48She, by the way, she's the person who discovered the link between oxytocin and social behavior.
01:17:53Wow.
01:17:54So she, uh, basically talked to the organizer who was a very famous stress physiologist and said, "What's
01:18:01the matter with Steve?"
01:18:03You know, Steve wasn't going to come.
01:18:06And so he said, "It sounds like mitochondria."
01:18:09Okay.
01:18:10And, and then we talked to someone else and we got the answer.
01:18:14The answer was there are supplements that kind of signal the mitochondria to come out and
01:18:19play again.
01:18:20Hmm.
01:18:21And the one I took was called L-carnitine.
01:18:24It's, it's, it's off, over the counter.
01:18:27And I was now, I couldn't go even walk up a flight of steps or walk to my office.
01:18:33I took that.
01:18:34The next day I did two miles on an elliptical.
01:18:37Wow.
01:18:38Wow.
01:18:39So it was a switch change.
01:18:41And actually it may be helpful to you as you recover from long COVID.
01:18:45So what it is doing is signaling the mitochondria to, and the, and the ATP production is basically
01:18:52saying, "Come out and be productive again."
01:18:55Right.
01:18:56So there is a, could it be the case that you could be doing the work, doing the work, um,
01:19:03from a...
01:19:04Yeah.
01:19:05You would be metabolically incapable of the work having any impact.
01:19:10Bingo.
01:19:11Yeah.
01:19:12And the issue is you need certain resources.
01:19:13So you need to, the nerves have to communicate.
01:19:16And there's another thing about like neurotransmitters are part of that.
01:19:20And we haven't discussed that at all, but I will tell you that for, I'll say decades,
01:19:25I've been taking lecithin, which is a, has a phosphatidylcholine, a precursor for acetylcholine
01:19:32because acetylcholine is the, uh, used in the vagal neurotransmission and a lot of other
01:19:38neurotransmission.
01:19:39And I've been taking, and fish oil.
01:19:42So I've been taking a lot of precursors that are useful in neurotransmission.
01:19:47So, which is, yeah.
01:19:49I'm, I'm interested in the, the sort of journey or what happens if someone goes from having
01:19:55this narrow window of tolerance to regaining safety again.
01:19:57Why is it that the nervous system seems to oscillate between hypo arousal and to hyper arousal?
01:20:04Okay.
01:20:05What you have, and actually I got an email from someone from a, a physician from the UK
01:20:11who says, the letters start.
01:20:13I have a client who's suffering from the polyvagal syndrome, which had no idea what he meant, but
01:20:18I read through it.
01:20:19And what it really was exactly what you're saying, moving from hyper to hypo and being poorly regulated
01:20:26in between that's because access to that ventral Vegas is not there.
01:20:32So the system goes in one direction and then goes in the other.
01:20:35Yep.
01:20:36When you have the ventral Vegas, it's kind of like a choreographer.
01:20:39It creates the, it enables us to repurpose fight flight into play.
01:20:45Repurpose immobilization into intimacy and restoration.
01:20:49So it's like, it's like this social net that's over us.
01:20:54And then when it's there, these other components really, uh, basically serve our needs.
01:20:59But when that, that's gone, we are basically functioning like, in a way, almost decorticate animals.
01:21:06You know, it's like we're down and we don't have this master regulator.
01:21:11So we're a regulated system.
01:21:12Oh yeah.
01:21:13Yes.
01:21:14Just much more at the, at the mercy of everything flip flopping from one side to the other.
01:21:18Some, uh, like an element that I wasn't aware of, but there's a paradoxical relaxation and
01:21:24startle response where the nervous system interprets parasympathetic states as threats.
01:21:30So as people start to relax, as the, as they start to get below the window of tolerance on the
01:21:35bottom end that their system sees that as a threat and bounces them out the top.
01:21:39Like, why would, why would that be the case?
01:21:40Why in a system that needs more relaxation, why would it bounce you out the top?
01:21:45This is what we talked about.
01:21:46The interoception of that calm state is now associated with vulnerability and injury.
01:21:52Right.
01:21:53So it's in a sense, our higher brain structures sabotage us.
01:21:57So the lower brain says, relax, you need it.
01:22:00The higher brain says, can't relax in this environment.
01:22:03It's to is prioritize this threat.
01:22:06Mm.
01:22:07Mm.
01:22:08And I guess this is where the safe and sound protocol would come in.
01:22:11Yeah.
01:22:12Slowly, slowly.
01:22:13With those who have that type of history.
01:22:15The, I would say the greatest surprise to me on this interesting journey, uh, was that the
01:22:22safe and sound could be a trigger.
01:22:25For people.
01:22:26I mean, it could create defensiveness.
01:22:29And I had no concept that in my theoretical model.
01:22:33So I had, how does something that only is broadcasting signals of safety or calmness, how can it be responded?
01:22:42And then you start asking the question, who are the people responding?
01:22:45What are their clinical symptoms?
01:22:46What's their history?
01:22:47And then it becomes a script.
01:22:50The script is that they were injured by, let's say a biological parent.
01:22:55Uh, and, and so the vulnerability of two signals that are in our DNA become signals now of threat.
01:23:05Um, why does tinnitus often show up in highly activated people?
01:23:12And what is it about the ear?
01:23:13That's got, I know some of your research has gone into the ear territory.
01:23:16Yeah.
01:23:17The issue with tinnitus, tinnitus is just, let's use it.
01:23:21It's not a very descriptive diagnosis.
01:23:24Uh, so the history of tinnitus is that people thought it was in a sense, uh, in the ear.
01:23:31And they actually did such things as aggressive surgeries and removed the entire ear, uh, internal
01:23:38ear structures.
01:23:39The tinnitus was still there even now.
01:23:41God, you would be really annoyed if you had your ear structure removed and you were still hearing
01:23:45ringing in your, in your head.
01:23:46That's right.
01:23:47Because it was now, uh, the solution to that is basically it's on the auditory cortex, that
01:23:52type of tinnitus.
01:23:53And the solution now is actually, they put a, a stimulator on the auditory cortex to scramble
01:23:59those sounds.
01:24:00So it, so that's one type of tinnitus.
01:24:03I have a tinnitus or had it, and it was, I have something called an acoustic or vestibular
01:24:10neuroma.
01:24:11It's a non-malignant tumor on the vestibular branch of the auditory nerve.
01:24:16And it was discovered because I started to get severe tinnitus.
01:24:19It was like hearing sounds of, of being in the kitchen and people throwing dishes.
01:24:24It was not a calming humming.
01:24:26It was a lot.
01:24:27And then I actually, uh, okay.
01:24:28So there are two issues on that.
01:24:31They, uh, the medical community, this is 2002 said, there's only a one solution as you need
01:24:39to have surgery.
01:24:40I said, well, will that do?
01:24:41They said, we, we, we're going to do, we'll have to cut this out, the tumor, and you'll be
01:24:48able to have hearing.
01:24:49However, you're going to lose hearing, which is really the consequence of the surgery.
01:24:53And, you know, I, I'm not your average or your normal patient.
01:24:58So I went and did my literature search and I started to read the publications were not
01:25:05giving me any information, but the conference papers, which are done before publications
01:25:09start to tell me about what would be called watch and wait.
01:25:13And they basically said, look, a lot of people don't get surgery.
01:25:17Nothing happens.
01:25:18It just, they, they live.
01:25:21They, so it's not going to kill you.
01:25:23And if it grows big, then you, which is extraordinarily rare.
01:25:27Now, what I found out was that when I was quote stressed, uh, the, uh, the tins would bother
01:25:34me.
01:25:35Okay.
01:25:35This is where your question is.
01:25:37And in fact, this is now 25 years ago or 20 years ago.
01:25:42Um, now in Miami visiting my father and, uh, and I'm driving across a railroad track and
01:25:49on the tracks as I go to the tracks, the tins is going on and off on and off.
01:25:54Okay.
01:25:55So there was a physical component.
01:25:58And what I was dealing with was in the literature.
01:26:01When I read the material, there was an inflammatory component to, to the expression of the tumor.
01:26:09So I started to take high doses of fish oil and the tins disappeared.
01:26:14The fish oil has a anti-inflammatory.
01:26:19Yeah.
01:26:20So, so what I'm saying is that that the, what I was getting, my temperature to this was due
01:26:26to the actual nerve being inflammatory, inflamed, and I could control that with fish oil.
01:26:36So I was very fortunate.
01:26:37And now I don't even know that I have tinnitus.
01:26:40Why would it be the case that a dysregulated or a lower tolerance system would worsen tinnitus?
01:26:46Why is that an infection?
01:26:47Well, because it is, because inflammation is part of that, uh, defensive system.
01:26:53Oh, okay.
01:26:55Yeah.
01:26:56Okay.
01:26:57So let's go back, uh, rewind the tape.
01:26:59And we're talking about clusters of symptoms that are together.
01:27:03Inflammation is one of them.
01:27:05So the whole family of things happen.
01:27:09It's not merely your heart rate gets up, your regulation of heart rate and sweating.
01:27:14The inflammatory component is there as well.
01:27:18Hmm.
01:27:19Yeah.
01:27:19That makes complete sense.
01:27:21I'm interested in the link between the vagal nerve and the gut microbiome and biome.
01:27:26What do you make of that connection?
01:27:28Well, just remember that 80% of the vagal fibers are afferent.
01:27:33And where's the vagus going is in your gut.
01:27:37It's really monitoring your gut.
01:27:39I would think most of our, many of the vagal afferents are really gut receptors.
01:27:44So.
01:27:45Why would that be the case?
01:27:46Just because digestion is really important?
01:27:48Yeah.
01:27:49It's not digestion.
01:27:50It's, it's toxins.
01:27:53And the other thing you got to think about what your gut is.
01:27:56It's not, it's a farm.
01:27:58It's a farm for molecules that your body needs.
01:28:01Think of it that way.
01:28:02You are, you're raising all kinds of things in your gut.
01:28:06The flora of your gut is complex.
01:28:08Mm hmm.
01:28:09So, uh, so basically, uh, uh, I, I've actually been doing, uh, the past decade, quite a bit
01:28:17of work in gastroenterology and was showing that most, a lot of, of these syndromes within
01:28:24GI, which, uh, is also another one of these, uh, disciplines where it's very hard to document
01:28:31pathophysiology with the symptoms that the autonomic nervous system is highly dysregulated in many
01:28:39of the individuals who have gut problems, including chronic, uh, uh, vomiting syndromes
01:28:45and symptoms like that.
01:28:48What direction is that going from?
01:28:53Is that low tolerance nervous system giving you bad gut?
01:28:56Is that bad gut giving you low tolerance nervous system?
01:28:58Like what do you make of the gut biome's effect on the nervous system?
01:29:01Okay.
01:29:02You need to take some, do some resident breathing now and realize that when we talk about a system,
01:29:10it's bi-directional.
01:29:13It's really sending up signal and we know we can influence by how we feel.
01:29:17So we know our gut reacts to things happen in our environment.
01:29:20And we know if we have a stomach ache, we're really, our capacities become very, very limited.
01:29:26So we know that the sensations from the gut can disrupt our daily life.
01:29:31And we also know that our daily life can disrupt how our gut works.
01:29:36Now we start talking about what it is to be having a system.
01:29:40Another thing that tends to be missing from our own narratives of explaining how our body works.
01:29:46Is there a sex difference in how nervous systems operate?
01:29:51Well, for decades I've tried to neglect that question.
01:29:55My wife has always informed me that there are sex differences.
01:30:00And the answer is probably.
01:30:02I mean, I think we can say that there are some basic mechanics that are in a way asexual.
01:30:09And since systems work the same way.
01:30:12But there are different demands on, let's say, different sex as a subspecies.
01:30:18Different demands on women than on men.
01:30:20And at different times of their lives.
01:30:22So there's a time course that's going to be different.
01:30:24I think it's so understudied.
01:30:27Because most of the research on health has been done on males.
01:30:32Because females had more variability.
01:30:35And especially when it comes to clinical trials.
01:30:38Variability kills you in clinical trials.
01:30:41Because people wanted cause and effect relationships.
01:30:44Yeah, yeah, yeah.
01:30:45I think what I'm interested in around the sort of sex difference for nervous systems is male socialization, anti-social behavior situations, loneliness, stuff like that, certainly seems to show up in men more than in women for a variety of reasons.
01:31:06But I'm wondering whether male socialization is partly a nervous system challenge uniquely.
01:31:13I don't know.
01:31:14I mean, I haven't thought of it that way.
01:31:16I keep thinking of our socialization process of males and females and the history of humanity,
01:31:25which was, you know, different social circuits for men and for women historically.
01:31:32And the issue and also the notion of birthing and how that was really a communal event.
01:31:37Well, I'm actually more interested now in the other part of the lifespan.
01:31:43And that is how poorly we as a species are doing with end of life, which is not really discussed or worked on.
01:31:52And so I'm getting very interested in palliative medicine and with a desire that we have tools that enable us to literally smile and wave goodbye at the end of our duration year,
01:32:08as opposed to trying to preserve life and make people fearful of the dying process.
01:32:14That's interesting.
01:32:15Yeah.
01:32:16I mean, think about it, because how many episodes have you had interviews on?
01:32:221,150 maybe.
01:32:24Okay.
01:32:25Okay.
01:32:26How many have talked about palliative care or end of life?
01:32:31Less than 10.
01:32:32Yeah.
01:32:33And we're all going to die, right?
01:32:35I think.
01:32:36And it just gives you a glimpse into how we are so unprepared for the, in a sense, the whole life, the passage.
01:32:49Yeah.
01:32:50Yeah.
01:32:51Yeah.
01:32:52I think it makes at least a little sense about why, especially around the nervous system, people understand that something which impacts you at the beginning lays the foundation and can be an echo which is heard throughout the remainder of the journey.
01:33:06We don't talk about grandparent trauma.
01:33:07We talk about childhood trauma because the trauma doesn't tend to move backward in time.
01:33:12It tends to move forward in time.
01:33:14So, I understand why.
01:33:15It feels like investing in an early stage startup as opposed to a company that's very mature because, well, how much more is there to go?
01:33:22But you're right.
01:33:23I mean, like everybody is going to pass away in the fact that we haven't looked at palliative care with the same level of scrutiny.
01:33:32Even compassion.
01:33:33Let's use the word compassion.
01:33:35Well, it's the one type of discrimination which is still almost universally accepted is ageism, right?
01:33:42Like, it's the one thing that you're never going to get pulled up for.
01:33:46You can say on a daytime TV show.
01:33:48You can say on a comedy show.
01:33:49You can shout it at somebody that cuts you off on the street.
01:33:52Like, very, has anybody ever stepped in and said, "Hey, hey, don't talk about his age like that, man."
01:33:59Like, no one's stepped in to do that.
01:34:00People have said it about race, about sexuality, about gender, like all of these different things.
01:34:06Ageism is this one that, Arthur Brooks told me this.
01:34:09Well, the part that is affecting me directly is understanding that the world that
01:34:16I had lived in for so many decades is not very accommodating for people who are getting frail.
01:34:24Yeah.
01:34:25Well, you are spinning yourself upside down a couple of times every morning, so...
01:34:29I'm doing fine.
01:34:31I was going to say, the frailness thing, I wouldn't...
01:34:33No, but the issue is, when you're doing fine is when you should be exploring the future, is really what I'm saying.
01:34:43Yeah.
01:34:44So, just going back to the sex differences thing, you've said that co-regulation is the biological basis of love.
01:34:51That we literally regulate each other's nervous systems.
01:34:54Yeah.
01:34:55What do you think are the implications when a man has never experienced consistent co-regulation?
01:35:02Like, potentially, especially from a father?
01:35:04I think we can see that in, let's say, the politics of today, so that our culture is not...
01:35:17Okay, so there's a lot of...
01:35:19Okay, the consequence of what we're really saying is, the experience of being vulnerable is part of the experience of having relationship.
01:35:29And if we can't cope with our own vulnerabilities, then we have difficulty navigating the world we're in.
01:35:36And I think there's times when being bold or being impervious to or not acknowledging vulnerability serves us well.
01:35:49Yep.
01:35:50But there's also other periods where it basically locks us out of community.
01:35:56And I'm kind of watching this because, to me, it's the script of life is becoming...
01:36:05I think what you were saying about things that happened early in life, we can see it moving on.
01:36:10I think that script is now, to my mind or my eyes and my ears, become quite predictable.
01:36:19You know, it's like saying, I can see the consequences.
01:36:22And the issue is, it doesn't fit with my view when I was young.
01:36:28My view was, A, we can all be who or whatever we want to be.
01:36:32I was quite an idealist, and I basically felt that options that I could do, everyone else could do.
01:36:40I didn't have an appreciation of, let's say, the permissiveness that was given to me through whatever lineage I had or the opportunities I had.
01:36:54I didn't see them as special.
01:36:58And I didn't see the skill set or the insights as special.
01:37:01And I think part of what...
01:37:03Because we're trained in a sense to have a type of humility.
01:37:06What I'm saying is that the concept of really being compassionate and benevolent is really an understanding that others don't have what we have.
01:37:15It's such a good point.
01:37:17I had a conversation with a friend in Bali earlier this year.
01:37:21And, you know, I'm explaining to him about this journey that I've been on.
01:37:25I've spent two years trying to piece myself back together after mold, Lyme, EBV, CMV, long COVID-y stuff.
01:37:33And then just as I've got myself to where I felt I'd made really great progress, this dysautonomia kicks in.
01:37:40And now I've got this new fight, and I'm irritated, I'm tired, I'm agitated of having to do this.
01:37:48I'm starting to get apathetic. I'm like, I'm just constantly having to be strong and having to show up.
01:37:52And I'm even trying hard at not trying hard.
01:37:54I'm trying hard at being empathetic. I'm trying hard at doing this stuff.
01:37:57He gave me this big, long voice note in response.
01:38:00And I think it speaks to what you're saying.
01:38:02And he said, "I don't know of a single person who has fully and truly understood humanity without going through a long period where they didn't know if they were ever going to get better."
01:38:13And he said, "This is the difference between just having a hard time and having a life-changing difficulty that you face."
01:38:19Because in one of them, everyone's been through a hard time. Everyone's lost a job, everyone's lost a parent, everyone's lost a whatever.
01:38:25But the difference he said is not knowing whether or not you'll get better.
01:38:29And that is so true that now when I look around, I've got more compassion for people who are ill.
01:38:36I've got more compassion for people who are struggling with addictions.
01:38:40I've got more compassion for people who are seemingly annoying.
01:38:44Like even stuff that you think is elective. Everybody's got compassion for somebody that was born disabled.
01:38:51Everybody's got compassion for someone that was abused as a child.
01:38:54But what about that person who just never seems to stop, is never able to stop talking about themselves or their accomplishments?
01:39:01And I'm like, I see so much more now.
01:39:04Hey, something's happened at some point in this person's past.
01:39:08Either something's happened to them or they were born and this is something that their predisposition, right?
01:39:13They didn't get to choose either of these things.
01:39:15Like, fuck, as annoying as you are, I should give you a lot of compassion.
01:39:20And that's been born out of this experience the last two years of really trying to sort of grapple and battle with this thing.
01:39:28That's been the biggest takeaway, humility and more compassion.
01:39:32Yeah, Chris, as I listen and hear the array of vulnerabilities that have hit you, to me they're all the same.
01:39:42Even the hypersensitivity is sensitive to mold.
01:39:45The system does not have resilience.
01:39:47That's what you're saying.
01:39:49Now, this is where the beautiful big cortex is useful.
01:39:54So we evaluate, okay, my system does not have resilience.
01:39:59I can move my system into places where it's going to be less vulnerable.
01:40:05Now, what does that mean?
01:40:08It means different things to different people.
01:40:10It's all based upon whether your daily demands, like doing podcasts, are nourishing to you at this stage of your recovery or they're not.
01:40:20And I think that becomes the first question to ask yourself.
01:40:24I mean, I'm just talking to you as a person, not as a therapist, but as the observer.
01:40:30And I think that's really the first question that you really have to come to grips with.
01:40:34Of course, that is, in a sense, containing you is the work.
01:40:40And this is what you do.
01:40:41This is how you define yourself.
01:40:43And the question is, if you didn't have that to define yourself, how is your body going to feel?
01:40:50So the issue is you can't deal with the vulnerability of the disease entity that has invaded you unless you can deal with how you can feel without the container that may now be contributing to the expression of the symptoms.
01:41:08Dependent on whether it feels nourishing or sapping.
01:41:11That's right.
01:41:12Very interesting.
01:41:13One thing I haven't mentioned, what do you make of stellate ganglion blocks?
01:41:17What do you think of SGBs?
01:41:18Yeah, well, so Eugene Lipoff, who I know quite well, is really one of the originators of that.
01:41:25And I'm very, okay, from my view, it's turning, okay, is actually something that we alluded to implicitly.
01:41:35If your sympathetics are now overextended, you're going to be locked in to fight, flight, and you're going to continue to do that.
01:41:44And if you downregulate them, the parasympathetic calming has an opportunity to express itself.
01:41:51That's what I think is happening.
01:41:53I mean, the stellate ganglion is actually dampening that whole limb of the sympathetic sufficiently that the parasympathetic vagus can start to express itself.
01:42:05Okay, but the utility of it has been really in terms of the world of trauma or PTSD, as far as I can tell.
01:42:15And PTSD is manifest in different ways.
01:42:20There are people who are locked into a state of fight, flight, and I think that's really the great toolkit to help treat it.
01:42:30But there are those who are kind of locked into a shutting down, withdrawal, and immobilization.
01:42:35And I'm not sure if that's going to be helpful for that group.
01:42:38Yeah, that's interesting.
01:42:40I've seen some research that says deeply traumatized baby mice require three generations to get back to a normal nervous system state.
01:42:48Do you feel like that's true for humans?
01:42:50You're asking what I call, okay, so they talk about intergenerational trauma.
01:42:56I like to use the word transgenerational.
01:42:59Because I think the country where we live, and I imagine the UK as well, historically, is a transgenerationally traumatized environment.
01:43:09And what it doesn't, okay, you don't have to assume that it's epigenetics or the genes have been modified and transmitted.
01:43:18All you need to think about is what is the culture.
01:43:21So think of the UK and the private or the boarding schools.
01:43:26And, you know, basically stripping kids from childhood.
01:43:30And then making this the elite.
01:43:35And totally.
01:43:38These are the trendsetters moving forward culturally.
01:43:41Yeah.
01:43:42Or they were the leaders.
01:43:43So I met a, actually became a friend.
01:43:46He's written a book called the basically about the damaged elite of the UK because they become the prime ministers and all these other people.
01:43:54And he's really saying their bodies are locked into states of defense.
01:43:58So their ability to be compassionate is quite compromised.
01:44:04Oh, that's so fascinating.
01:44:06And then you're in an environment which probably makes that worse.
01:44:09It rewards a stoic stiff upper lipness.
01:44:12I am not affected by this.
01:44:14I'm a safe pair of hands to drive this organization forward.
01:44:17Yeah.
01:44:18Or even, you know, the bit about the English view of sexuality.
01:44:23Do it for the queen.
01:44:25Or, you know.
01:44:26I've never pulled that one out, but I will.
01:44:30Or if the line was, it will be over in a few minutes.
01:44:33Just don't worry about it.
01:44:34Yeah.
01:44:35Think of queen and country and just keep going.
01:44:37Yeah.
01:44:38Yeah.
01:44:39Yeah.
01:44:40Yeah.
01:44:41It's not one of loving and engagement and connection.
01:44:44It's something else.
01:44:45Duty.
01:44:46It's closer to duty.
01:44:47Yeah.
01:44:48Right.
01:44:49Obviously, you've been working on this theory for a long time and it's unbelievably influential.
01:44:56What are the strongest criticisms of polyvagal theory in your opinion?
01:45:02Which criticisms do you think are fairest?
01:45:04Okay.
01:45:05So my view is this is quite a trigger to me because the criticisms are not of the theory.
01:45:11The criticisms have been misrepresentations of the theory.
01:45:15And so I don't mind criticism because they will improve articulation of what this is.
01:45:21Every criticism that I've seen has been really a misrepresentation of what the theory said.
01:45:28And really, what you have are people who think they know what the theory is and who are making statements.
01:45:34And I'm interested.
01:45:36What are the most common misconceptions when criticisms are being lodged then?
01:45:44Well, they don't understand the evolution of the vagal system.
01:45:48The fact that the nucleus where the vagus comes from in the ventral vagus is an older nucleus long before mammals is fine.
01:45:57But they didn't have cardioinhibitory fibers until mammals had it.
01:46:01Right.
01:46:02So they don't understand the distinction between an anatomical structure and its actually components neurophysiologically.
01:46:10They basically don't understand that polyvagal theory was never about the nerve.
01:46:15It was about the organization of this integrated brainstem system.
01:46:20They just don't understand what it's about.
01:46:22And what does that lead them to wrongly conclude?
01:46:26What are the implications of not understanding that?
01:46:28What's the criticism that's levied because of that error?
01:46:31Oh, well, they say it's not based on physiology.
01:46:34And what they've done is misrepresent every point of it.
01:46:37And what they may quote accurate physiology, but it's not relevant to what the theory actually states.
01:46:44So it's been, in fact, I created AAI, Polyvagal Scholar, and it has one basic rule.
01:46:53You have to have fidelity to the theory.
01:46:56And I have not gotten a criticism that it doesn't basically kick out because the theory has not been accurately represented.
01:47:03The theory, in a sense, the theory has evolved over decades with more clarification.
01:47:10And I'm just finishing two papers.
01:47:13One is on an architecture of the theory, but it's not of the Vegas.
01:47:18It's of this whole mammalian organizational system that enables us to co-regulate.
01:47:25It enables our social behavior now to impact on our health and physiology.
01:47:30And they miss all of that.
01:47:32They get stuck into something that doesn't exist.
01:47:35And this has been going on for almost 30 years.
01:47:38So it's like, you know, I basically have said this.
01:47:41I'll read the papers.
01:47:43And if you can't read them, you know, don't tell people that you have.
01:47:48I mean, it's like--
01:47:49That's a mic drop if I've ever heard one.
01:47:51But I will also say that it's double-edged.
01:47:53The more people criticize it, the more lights that are shining on it.
01:47:58Yeah.
01:47:59It's like it's not unknown.
01:48:01And it's really interesting because the clinical world, which really gave it traction, it works for them.
01:48:11The interesting part is the neuroscience world is too, let's say, siloed to understand the organizing principles of it.
01:48:21So it's kind of like ahead of its time, we're pulling things together.
01:48:26Because it requires an understanding of the interaction of too many components.
01:48:31So you can't criticize the theory based upon the vagus.
01:48:36You can't criticize it based upon any single pathway because it's not about that.
01:48:42And by criticizing on it, you're not understanding what the theory is stating.
01:48:47So I'm actually extraordinarily confident that time is-- I may not be here, but it will survive me by far.
01:48:58And the issue is because what I am now writing about is giving people a toolkit to understand what the theory is.
01:49:06So they don't get pulled into, let's say, false arguments.
01:49:12What I would say if someone criticizes, show my one basic statement, show me in the literature where I made that statement.
01:49:21It's as simple as that.
01:49:23And I mean, that's all I'm asking.
01:49:25And the bottom line is it doesn't really matter to me if you want to argue with me.
01:49:30It matters to me if you represent my work accurately.
01:49:33That's my--
01:49:34I'm going to use your statement when somebody misquads me on the internet as well.
01:49:38Yeah, well, see, that's the world you're in.
01:49:41And to me, the internet world and the social media world is so vulnerable because people can say anything.
01:49:49But they can also say that you've said anything, which is the false accusation equivalent.
01:49:55Right.
01:49:56We spent an entire episode talking about when people's nervous systems are too dysregulated, too sensitive, a window of tolerance, which is too constrained.
01:50:05Can a person's nervous system be too safe, lead to risk aversion, lack of ambition, inability to tolerate challenge?
01:50:14But like the pacification of people, is there such a thing as too safe?
01:50:18Okay.
01:50:19So what I see, I wouldn't--
01:50:21My interpretation was, what if a nervous system feels too safe?
01:50:26Does that make them too vulnerable?
01:50:28See, I'm actually going to the other side.
01:50:30Yeah, yeah, yeah, yeah.
01:50:31And I actually was very concerned about that.
01:50:34I was actually thinking that that was a possibility.
01:50:37And the issue is, so it's like, if I feel safe, am I going to be, not detect signals of danger?
01:50:47That was my concern.
01:50:49And I'm basically, I feel much better after pondering this for quite a few years, that our nervous system, the healthy nervous system that has the capacity to connect and to basically love and share and trust is usually the nervous system that can detect threat.
01:51:07As well.
01:51:08Mm-hmm.
01:51:09Mm-hmm.
01:51:10So it's like, we're talking about a well-regulated system that enables this co-regulation to occur, tends to be the same system that can adjust and navigate to this complex world.
01:51:22Unreal.
01:51:23Stephen Porges, ladies and gentlemen.
01:51:24Stephen, you're so great.
01:51:25I've got, I have a million more things that I want to talk about, about relating, about child rearing, about, uh, pediatrics and stuff, but we can, we can save that for another time.
01:51:34Mm-hmm.
01:51:35Um, I just really, I really appreciate you.
01:51:37I really appreciate you giving me, uh, and, and everybody a language with which to experience or to understand the way that we experience the world as far.
01:51:45I've been on the, the front lines of this, so to speak with my own, uh, sort of priorities over the last two years or so.
01:51:52I've come to basically believe that our nervous system, uh, we are our nervous systems when it comes to the way that we interact with the world around us.
01:52:02And it's the single most influential thing in terms of how we experience the world and how the world experiences us.
01:52:07So giving us language and, and, and insights about how to, how to navigate that and understand it is awesome.
01:52:12So I just wanted to give you your flowers there.
01:52:14Well, thank you, Chris.
01:52:16And my summary of what you just said is that you're polyvagal informed.
01:52:21Um, I mean, that's when you see the world through the way that you described it.
01:52:25That's what the theory was for.
01:52:27It's for us to understand that when the nervous system or what I'm basically saying, our physiological state is really, uh, a major component of our behavior and who we are and our feelings.
01:52:41In my world, that's the world of academia would be poly, polyvagal informed in my world of the internet and degenerate culture would be polyvagal pilled, but we'll, we'll, we'll allow us to do one or the other.
01:52:51Steven Porges, ladies and gentlemen, Steven, you're great.
01:52:53I appreciate you.
01:52:54And I can't wait to speak to you again soon.
01:52:55Well, thank you, Chris.
01:52:56Thank you very much.
01:52:57Thank you very much for tuning in.
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