Tools for Overcoming Substance & Behavioral Addictions | Ryan Soave

Welcome to the Hubberman Lab podcast, where we discuss science and science-based tools for everyday [Music] life. I'm Andrew Huberman and I'm a professor of neurobiology and opthalmology at Stanford School of Medicine. My guest today is Ryan Suave. Ryan Suave is a renowned expert in addiction treatment and trauma recovery. Ryan has spent decades on the front lines helping people overcome addictions to substances like alcohol, and various drugs, as well as behavioral addictions, including gambling, video games, and pornography. His approach combines evidence-based protocols tailored to each person's unique family history and needs. During today's episode, we explore all aspects of addiction, including the relationship between addiction and trauma. Ryan shares insights from his extensive clinical work and provides clear zerocost protocols for effective recovery that leverage neuroplasticity, which is your brain's ability to change with intention and experience. We discuss and compare residential treatment programs, 12step programs, self-guided addiction recovery, and more. If you or someone you know suffers from addiction, the information and tools offered in this episode ought to be of tremendous benefit to initiate and maintain sobriety from that behavior or substance. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is however part of my desire and effort to bring zero cost to consumer information about science and science related tools to the general public. In keeping with that theme, this episode does include sponsors. And now for my discussion with Ryan Suave. Ryan Suave, welcome. I'm glad to be here. Thank you for having me. You're the guy that people call, reach out to, cry to when everything comes crashing down. That's kind of your thing. Yeah. And you have this incredible uh gift really to u orient people in time and space when that sort of thing is happening. And you do this for men, women, teens, kids, adults, families. You've pretty much seen it all, although I'm sure there's more to come. I would love for you to just explain to people listening what addiction is and how you see it show up in people's lives. I know that you tend to get things like a trauma surgeon would see the human body hemorrhaging and in need of great support, but how do you think about addiction? First, I I'd like to make a little bit of a distinction. You know, we're going to talk about addiction. Um, when we look at the the DSM, the diagnostic manual that we use for diagnosing psychological disorders, not really addiction as a diagnosis. That's not super important necessarily because we can talk about it in the the term of addiction, but you know, we can look at people and and and look at biological uh psychological and social factors and make a diagnosis to see that they've got a substance use disorder, an alcohol use disorder, uh whether it's moderate or severe or they're dependent on it. And not to give people an out, but not all people that show up with an alcohol use disorder for a point in time are necessarily an addict. They may not be forever. It might been a a life circumstance that kind of that brought them there. Um, that said, someone that at a point in time in their life could have an alcohol use disorder or a substance use disorder, you know, they're probably prone to that and they probably shouldn't uh continue down that path or or gamble with it. Um, so talking about addiction in general, I like to broaden that definition to really, you know, question I'll ask people is does it have you or do you have it? Is it driving you and your behaviors? Are you really leaning on it in a way that that's your uh your medicine? Because I I don't really see addiction as the problem. You know, addiction is the solution. Whatever they're addicted to is the solution to some underlying stressor. You know, I I think as as humans, we when we're dis when we're uncomfortable, when we're experiencing pain, our kind of immediate reaction is to get out of that. And when that stress becomes really big, we're going to look for the things that are going to impact us a lot quicker. You know, taking a drink, using a drug. Now, once people start doing that, depending on what it is, you know, if it's uh heroin or fentanyl, uh they could become physically addicted to it very quickly or alcohol over time. Um But I think the the definition can be expanded to a lot of other things. Maybe even things that seem mundane, you know, and we can have addictive behaviors at different points in our life. And maybe we're have the same behavior that sometimes is addictive and sometime isn't. You know, this is very mundane, but sometimes I'm binge watching Netflix because I'm on a plane and don't have anything to do or I'm sick and I can't get out of bed. And other times I might have a really stressful day or have something going on that I don't want to deal with and I end up watching TV too late and then I don't sleep. And now is that a addiction that I need to get treatment for or be pulled away from my family for? Probably not. But it's I I I think in talking about addiction we want to understand you know what is it that people are using whether it's a substance or a behavior and why are they using it? you know that while I say it's addiction is not the problem, it's the solution. It's a solution that becomes very problematic for people. Um and you know you will know this better than than I will be able to explain it better than I would but you know they get a benefit in their brain and body for feeling the sense of relief that they'll feel when they use the substance. You know one of the uh doctors who initially supported the people who founded Alcoholics Anonymous his name was Dr. Silkworth and he wrote this opinion and he said men and women drink essentially because they like the effect produced by alcohol. I believe that effect is relief. So people are looking for some sort of relief and the question has to be I think when we're talking about addiction what is it that they're looking for relief from? So when somebody comes to you or someone or in some cases is brought to you Yeah. who's in the throws of addiction what's your first line of attack so to speak? Are you focused on what the underlying stressor is or you're trying to stabilize them? I mean these are people who um sometimes and you know sadly I've seen this in my friends um fortunately who are now sober but um you know people wrap the truck around a tree at 7:00 in the morning having drank a bottle of wine and it taken a Xanax or jail or worse. Right. And so when when somebody comes in, what what what are the first questions that you're asking and and what's the goal? Let's talk about the most acute first. So I serve as a chief clinical officer for Guardian Recovery. We do treatment in different states. You know, we serve thousands of people a year and we have medical detoxes that we start with. So if somebody needs to be detoxed from alcohol or drugs, you know, they're going to come in. We're not going to start asking questions about what the underlying stressor is. you know, we're going to first do medical assessments, nursing assessments. Sometimes we have to send them to the ER if they're, you know, if they're uh in dire need or they're so acute that they can't even be in the the facility that we have. Um, we're going to just get them physically stabilized, you know, and as we're getting them physically stabilized, you know, the thing with addiction is a lot of people just say stop. But for people that just stop and assuming they're not in danger, like in alcohol, if you just stop, you could, you know, you can have seizures and die. You know, uh other drugs, if you just stop, it can be extremely uncomfortable. But even if they went to a detox and were able to stop, you know, their life doesn't generally get better right away. In fact, a lot of times it gets worse. Now, maybe it's better in the fact that they're not about to die. you know, they don't have these physical symptoms, but emotionally, you know, they've been using this substance or this or alcohol as a as a medicator. Now, all of a sudden, the medicine's gone, you know, and they've got to deal with life. And so, they can actually feel a lot worse right when they come in. So, first, what we're going to do is really understand what's going on with them biologically so that we can make sure they're safe. And then as we can support them over the days that they start, you know, becoming a little more comfortable, their their uh their physical conditions start to stabilize, then we can start to really understand what's going on with them in their environment, you know, what is their pattern of use, you know, when do they use, what are the what are the effects that it's having in their life, you know, um because we want to understand how it's playing out everywhere, like I said, biologically, psychologically, and and and socially, and and really get a clear picture of who this person is, you know, and sometimes people come in more motivated than others. You know, sometimes they get brought to us, like you said, and I've seen it work either way that someone who's comes in and says, "I need help, you know, I'm I'm willing to do anything." That they end up not following through with their treatment. And other people that come in fighting and screaming, end up, you know, doing very well over time. I actually like it when people come in in that kind of struggle. I think, you know, the more people kind of struggle with something up front, it's kind of like the you pull an arrow back, you know, the further you can pull the bow back and hold it, the more attention in it, the farther it's going to fly. And I I really like when we have people who say, "I'm not going to do this," or, "I'm going to leave." You know, they're actually telling us something about themselves and where they are, and we can be there with them in that struggle. You know, sometimes people come in and they're just like checking the boxes and they're going to be a good student and everything's fine because they're not drinking anymore. And then we're never able to really get to kind of the causes and conditions of it. You know, when they're in a treatment setting, we'll have them for anywhere from, you know, 7 days to 90 days. You know, we like to keep them, you know, and understand, you know, what's going on with them so we can meet them at their different stages and and the environment. We kind of try to create a microcosm of their social universe so that you know they can experience some stressors while we're not creating the stressors but we're having them communicate with their families. We're having them face some of the things they don't want to face. And we have a saying that says you know treatment can't really begin till the crisis occurs. And what that means is more of the internal or existential crisis. If someone's coming in going well I'm great. Everything's great. you know, why were they maybe things are feeling great right now, but why were they drinking or using in a way that was harming themselves, others, you know, ripping their lives apart, you know, sometimes people will say addiction is a a choice. I don't buy that all the time, right? Uh I but people will say that and I I I would what I would say to that is even if it is a choice even if people could wake up and say I'm going to do this or I'm not like why would they continue to choose a life that they're hurting themselves and others. So while they're in in treatment with us, you know, we want to um start to really understand who they are, start to understand, you know, what is happening in their environment. And then as they, you know, stabilize more physically and then they stabilize emotionally, as we can start to raise their capacity to experience difficult emotions. I mean, I I say this all the time to my clients. You know, what I really do with them is help them learn how to feel bad. you know, we don't put that on the website because no one's going to come to us to say, "How can I feel really bad?" But I think that's that's at the core of it. You know, how can we build a distress tolerance so that they can face discomfort? They can face pain and not choose the thing that gives immediate short-term relief that's going to end up hurting them and th those around them to to allow them to really lean in to whatever that discomfort is. And and when people are able to be available for the depths of discomfort, then they're really become more available for the heights of joy and and satisfaction and and in in life. Um, so we start to build that capacity so that then we can start looking at the beliefs that maybe the the limiting type beliefs that have been driving them that are often set from earlier on in the life in their life and the way that they were shaped, you know, and that's often what we talk about as as trauma. Not always a big event that that happened on a single day, although that does occur. But the shapings that people had in their life that were the ad you know we're adaptive people are very adaptive and you know kids and as they're in their formative years will develop strategies to live life that adapt them in a way that they can survive the environments that they're in. And you know if that adaptation which was appropriate in their family, their school, their environment, whatever it was, maybe all of those was something that um was more toward like a survival response, like a fight orflight type response. And now that's never resolved in some way and in a way. and then later in life they're still applying these adaptive strategies in situations that it's not appropriate for. I'd like to take a quick break and acknowledge our sponsor, BetterHelp. BetterHelp offers professional therapy with a licensed therapist carried out entirely online now. I personally have been doing therapy weekly for well over 30 years. Initially, I didn't have a choice. It was a condition of being allowed to stay in school. But pretty soon I realized that therapy is an extremely important component to one's overall health. In fact, I consider doing regular therapy just as important as getting regular exercise, which of course I also do every week. There are essentially three things that great therapy provides. First of all, it provides a good rapport with somebody that you can trust and talk to about pretty much any issue with. 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One of the most important factors in both short and long-term health is your body's ability to manage glucose. This is something I've discussed in depth on this podcast with experts such as Dr. Chris Palmer, Dr. Robert Lustig, and Dr. Casey Means. One thing that's abundantly clear is that to maintain energy and focus throughout the day, you want to keep your blood glucose relatively steady without any big spikes or crashes. I first started using Levels about 3 years ago as a way to try and understand how different foods impact my blood glucose levels. Levels has proven to be incredibly informative for helping me determine what food choices I should make and when best to eat relative to things like exercise, sleep, and work. Indeed, using Levels has helped me shape my entire schedule. I now have more energy than ever and I sleep better than ever. And I attribute that largely to understanding how different foods and behaviors impact my blood glucose. So, if you're interested in learning more about Levels and trying a CGM yourself, go to levels.link/huberman. Right now, Levels is offering an additional two free months of membership when signing up. Again, that's levels.link, spelled, of course, LIK/Huberman, to get the additional two free months of membership. The thing you said earlier that's ringing in my brain is does it have you or do you have it? And I think for people listening and watching um I think this is a really important distinction. And maybe you could just elaborate on how one starts to answer that question because these days we hear, you know, people are addicted to social media, people are addicted to sugar, people are addicted to, you know, all sorts of things and online shopping, you know, and and on and on. Let's just set aside alcoholism for the moment because that's a an a unique case where as you mentioned immediate withdrawal can cause death and um uh it has its own kind of unique features but but for everything else like if if somebody out there is listening and they're like well you know I have a hard time clicking off of uh social media um even though I know I need to sleep I need to study or have a hard time disengaging from video games I think is a common one in in a lot of young people, how do they know if they're addicted? Is there a litmus test? I mean, could we test ourselves as um as individuals? Like, can I go an afternoon without it? Can I go a week without it? Is that the test? I I think that's a great test. I mean, probably more than an afternoon or a a week, but you know, can I quit for a month? And you know, if you're if when you're when you've stopped, if all you're thinking about is either doing it or when you're doing it, all you're thinking about is how can I how can I stop doing this? That's a pretty good indication that it has you, you know, and you know, you also have to look at like what are the things that it's impacting in your in your life. And that's one of the things we can help people kind of orient to. They might think that if it's somebody that comes to us at their family saying this is a huge problem, they may not see it yet or they may be avoiding it. We call that denial. But a lot of times it's they there's something deep down where they know that, you know, I'm really disengaged from life. I'm lonely. I'm I'm I don't have the quality of relationships. I'm not able to be motivated to do the things that I want to do. What if it still feels good to them? However, like family isn't saying, look, you know, kid isn't getting their schoolwork done, but um it's kind of outrageous. You know, you four hours a day playing video games, 3 hours a day, that might not even seem like that much to a lot of people, but parents um can see the opportunity cost of that. This is time that kid isn't running around and getting exercise. This is time that um is eating and to sleep. This is time that could be spent studying. So maybe grades haven't cratered yet, right? Um, and we live in the quote unquote American dream model, uh, where kids say, "Well, so and so makes millions of dollars every year playing video games, right?" So, I'm actually on the path. I think you see that fairly often these days, right? Yeah. I'll relate it back to drugs for a second. You and I are the same age, and you probably remember the, you know, this is your brain. This is your brain on drugs when they cracked the, you know, showed the egg, this is your brain, and Yeah. disrespectful to eggs, which I I'm a big fan of. Uh, but and and then this is your brain on Well, it did call the egg a brain, so that was pretty true. You're right. Your logic is impeccable. Thank you. And this is your brain on drugs and it showed the fried egg. I think that was a a terrible example for kids because most of the time when people do drugs the first time, it doesn't feel like that. It feels good. It feels great. You know, it's over time when you keep doing that that it, you know, especially, you know, a kid that doesn't have all of the responsibility and the things in life that they might have or want to have later on, you know, uh they're not going to they're not going to see that that's a problem necessarily. And some of their heroes are um very public about the fact that they like smoke a ton of high THC weed, right? I mean that when I was growing up that was associated with um lack of agency and kind of being a quote unquote burnout was the idea. Nowadays there are just as many examples of people that smoke a lot of weed are vocal about that and by all external measures are doing very well perhaps better than most. It also wasn't as highly concentrated when we were kids. I mean, this is is is pretty intense these days and can have some really longlasting effects on people and and there's some people that it's not going to affect in the same way other, you know, it does others. Some people are going to be able to smoke that amount of THC or vape it or however they're doing it, right? I mean, the delivery methods are very it's it's crazy these days because, you know, used people used to have to roll a joint, go behind the store, you know, it was like an event to go do that. Now, and you had to break the law. You had to break the law. Now it's every it's in a candy. I mean it's it's candy, right? It's gummy gummy bears. Wild. It's really wild. Um and you know the thing with those people that are succeeding at it like when we really look at that like what how what percentage of the people is is that right? It's a very very small percentage. Of course kids are going to uh look at that and say well I can do that. you know, um I would I've had a conversation with my teenage son about that, you know, and even if he's playing if they're playing games four hours a day, I imagine those guys that win these video game or they're the the YouTubers that are making all kinds of money. I mean, they're they're approaching it like a like a pretty intense job. You know, they're really working at it. But you know we don't want to take away that imagin imagination and creativity from kids but you know it's our job as parents to look and see you know the kids aren't going to see what's happen you know they're kind of timing is like now or not now they're not really looking too far into the future and that's that's a beautiful thing about being a kid as well. It's it's our job to put those guard rails on and as parents really understand what are the things that um may impact them over the long term. But we also have to understand, you know, it's easy for me to look at, you know, I had video games when I was a kid, you know, but it was Nintendo and Sega Sega and, you know, it was not as it didn't pull you in as much. And we were outside all the time. It was a little bit, you know, it was a different we'd come in and play video games at night, you know. Um, you know, now these things really pull you in and you're interactive and they communicate with other people. You know, they a lot of kids have their social connection out of playing video games. I actually had a um a uh mentor once who was involved in a leadership program with all these other adults and they did their leadership program. They were all over the world and they would meet in I think it was World of Warcraft and and play together and they had different things that they would do to to to work through their whatever they were doing in the leadership program. So there is some benefits to it for people. You know they these kids can really connect with each other when they and and especially through the pan pandemic this this happened. I'm going to come back to what I was going to say about as a parent. It's easy for me to look at and say, "Well, there's too much social media. It's too much video games. It's too much this." You know, it it would be great if all that stuff was taken away. Well, guess what? It's not going anywhere, you know, and I can't really relate to it in the same way that my kids will relate to it. You know, I have younger kids that I have no idea what's going to be there when when they're of age to look at screens or be in the world or communicate with others. But, you know, it's our job as parents to look at and get to know our kids in a way that we can see what are the things that are going to benefit them and what are the things that aren't. You know, I I don't think every kid shouldn't play video games. No, neither do I. I think that the um the contrast with the video games that you played when you were younger and then you mentioned going outside. I think um I realize this is not a strict definition of addiction by any means, but if something in the electronic sphere makes quote unquote real life underwhelming, Yeah. Um I don't know if that means it's addictive, but it certainly means it has a gravitational pole, right? And and we can set this as a kind of a a pillar for context when we talk about pornography for instance, right? So when um I mean there's a saying, right? A picture is worth a thousand words. Um and I would say as a vision scientist that a a movie um or even a real or a clip on Tik Tok is worth a billion pictures. You know, never before have we been exposed to so many movies with so much richness in sound and um and eyes. you know, the more times we see eyes and and you've got all this elaborate context. So whether or not you're talking about pornography, whether or not you're talking about video games, you know, the sort of sensory richness of it, richness feels like the wrong word, right? But the the the kind of like the the amount of sensory information coming in through uh any one of those very brief experiences in a moment, it doesn't necessarily overwhelm the brain. Clearly, the brain can handle it. But then you walk out into a landscape like a park with a couple basketball hoops and a um and some paint drawn on the concrete and a ball and it looks boring. It's the difference between eating a, you know, as a kid, you know, a hot fudge Sunday banana split and then being offered a plate of broccoli. Like you have to know a lot about nutrition and care a lot about the long-term effects of nutrition on the body to um to not think that the hot fudge Sunday is the better option. I mean, it just makes sense from a like a neural perspective. So I I wonder whether or not this definition of addiction or habit forming behaviors or dependence um could be expanded to include um you know the the ratio of kind of gravitational pole versus you know how it makes other things seem. Yeah. Right. Um and obviously you know I don't believe that we should remove technology. I think technology is wonderful, but I could imagine that for a young brain and for an old older brain, right? I mean, can I just ask you, do you do you find any adults or do you encounter many adults who are addicted or have a have a habit of excessive online shopping? I mean, it's so easy to buy stuff online. I mean, just the the barriers to entry are so low. Yeah, absolutely. So, does that make sense? like this contrast between richness and dullness that exacerbates the dullness the more that you engage in some behavior. Yeah. And and I want to be clear, you know, while I said it's not necessarily a problem for everyone, I I believe it can absolutely the video games as an example can absolutely be addictive. I mean, there's been studies that have shown and I I uh that, you know, it's impacting the brain in the same way as a lot of drugs are. You know, I've worked with with kids who were video games were taken away and they were like and their Wi-Fi was shut down and they were somehow stealing some console and like in the bushes near another home somehow pirating their Wi-Fi to play the video games during the day. I mean, it sounds like an addict like a crack addict, you know, or you know, in the street a kid like this, you know, probably 15 or 16 year old kid. So they took away his his Wi-Fi. Yeah. And video games and he's hiding. I'm I'm chuckling, but it's terrible. I mean, you can only imagine what's going on inside that kid that they can't, as you mentioned be before, handle the discomfort of this thing that's like their medicine. It's the thing, it's the thing that makes them feel good. And and we have these adolescent treatment centers and these kids come in and they'll be very disregulated even if they're, you know, they've been off of drugs or usually it's it's it's a lot of marijuana these days. and you know they they start to clear up from that but they're extremely disregulated agitated reactive and you know after sometimes 3 4 weeks we start to see a completely different person and one of the things I'm convinced is that they haven't been with their phones they haven't been on social media they haven't been playing video games and I'm not saying the answer is to take that away but you can start to see the impact that that has on them you know they're so anxious about not being connected in that way or being I would imagine in that universe that you're talking about that's hot fudge Sunday all the time. Like who doesn't want to eat hot fudge Sunday all the time? Well, and then hot fudge Sunday doesn't seem to taste so good. Then you need more hot fudge Sunday. Yeah. I mean that's the dopamine dynamic stuff that um thank goodness uh Anna author of Dopamine Nation made so clear that those big fast inflections in dopamine very quickly lead to smaller and smaller peaks in dopamine from the same behavior or substance and then the trough of low that comes after is just immense. In fact, there's just what I the other day before I forget, there was a post on AXA of a guy. He sold his company for a billion plus dollars and he was expressing the extreme depression of not knowing what to do with himself now. And everyone will say, "Oh, poor guy, right? I don't illustrate that point to make it a point about billionaires or not, but it wasn't the pursuit of pleasure. It was the pleasure of pursuit that drives dopamine. He gets the goal. There's no more pleasure from pursuit because he's not pursuing anything anymore. And you think, how could that possibly be? He can buy anything he wants. But the whole point is that the dopamine isn't deployed for the reward. It's deployed for the pursuit of the reward. So that trough is a very real thing. Yeah. And in the trough, you're still not going to go back to a plate of broccoli. You're going to keep going after, you know, the hot fudge Sunday feeling even though the hot fudge Sunday isn't giving it to you anymore. Well, that's an extremely important point that people are chasing a feeling. I had a friend who um thankfully is a recovered addict. Obviously, won't disclose who this is. A former methamphetamine addict, very successful um in life, but had a serious meth issue. Um got sober and contacted me not long ago um requesting some support because they were thinking about abusing aderall. And we had a conversation. Fortunately, they didn't do this. um he's doing great, goes to meetings, has a sponsor, is taking care of that. But the description of why they were pursuing this uh idea of abusing aderall was this recollection of a feeling, you know, he kept talking about like there's I just remember that feeling. It was, you know, and everything felt and he was talking about something that I can't relate to because I've never done meth. have no intention of doing math, but his it's almost like it was a like a like a love affair that had been spectacular that he was missing this person, but it was a thing. Yeah. If it sounded like love, like I missed that feeling. I think that's a a very important point because I see people as having spiritual relationships with alcohol and drugs. You know, I mean, they use them as something that makes them feel connected. They feel whole. I mean, what do we what is alcohol called? Spirits. You know that it it it's something that can uh allow them even if for a period of time to feel the way that maybe they want to feel or not feel the way that they don't want to feel, you know. Can we dissect that a little bit? um to feel the way they want to feel versus not feel the way they don't want to feel. I remember reading Augustine Burough's book dry. He's a recovered alcoholic and there's this paragraph in there where he talks about his first drink of alcohol and I'm going to get the exact wording wrong but it went something like you know on that first drink he felt he's in the first person he's saying I felt it mesh with my blood and my physiology and my physiology felt correct for the first time and I thought oh my goodness like I I certainly don't have that relationship to alcohol but I have friends who are serious alcoholics fortunately now sober who describe alcohol that way from the first drink. It was like this is they they say this is me. It's like they're finding themselves. Yeah. And that's very different than avoiding the way they felt previously. Yeah. Most of them didn't pick up a drink the first time because they were trying to find that person or because they were trying to avoid something else. It was because there was booze at a party or booze at home. Even the people that like like him that are talking about alcohol like that. And I've heard this story thousands of times, you know, from people that never read that book, you know, that that's how they felt. They they couldn't have been using it most of the time to get away or or to move away from how they're feeling because they didn't even recognize that's how they're feeling. That was just the world they were in. You know, we're especially a lot of times this is kids and adolescence who that's the first time they're drinking and and they they don't realize that they could feel the way that they're feeling. You know, these are the the way that we grow up are just the waters we swim in. We don't often know that there's a difference between who we are and how we can be. And to be able to a lot of people the first time even the first time they'll do it and it's not always like that for everybody, right? Some people just are using it socially and then later on when there are stressors realize that you know I can use this to medicate as well. But the ones that are having the relationship that you just described is you know they didn't even know they had no idea that life or their emotional state or their physiological state could be different than it was. So, how do you persuade somebody that it's a good idea to take that away from themselves? Because I imagine some of the first thoughts that go through their mind um include I can't imagine life without that feeling. You know, St. Augustine said, and I'm not going to get it exactly right, but he said something like, you know, a well-living depends on reordering your loves. And he was talking about people living with a a a disordered a disordered life. And and the question it begged is what are you loving the most? And his argument I think was whatever you're loving the most becomes your god, your higher power. You know, if if I'm loving money the most, if that's the most important thing to me, then money is my higher power. The thing is money will fail me, right? like you just talked about like I could the guy could get a billion dollars and want to kill himself, right? Or if I put my relationship at the, you know, the if I if I said, you know, the most important thing to me is that my wife is happy, you know, and that's my most important thing. That sounds great, but she's not going to be happy all the time. And when she is, I'm going to feel great. When she's not, I'm going to feel like I'm doing something wrong. you know, are we making sex the most important thing? Are we making, you know, and and his argument was love God first and then do as you do as you will? Like find the highest power because these powers don't that we're putting up there like money, sex, food, all things that aren't problematic. We need them. They only become problematic when they're problematic, right? When they're when we're making them that thing that's going to solve our problems. What about kids? Um, I know a number of people who are excellent parents who are super devoted to their kids and they say like, "My kids are my life. My kids are my kids are everything." Um, that might just be language, right? They could also have a relationship to a higher power, but um do you see people um suffering by virtue of overemphasizing their kids or their you mentioned spouse, but as a priority in their life? Yeah. And and it's great that you made a distinction about just being language because you know people can say those things like I my kids are very important to me probably I would say you know one of the most important things in my life is to be a father right but if the energy in the house again and again is that my kids are my life what what are like what a burden that is for that child. That means that in know like that child might in those instances show up in a way that uh they need to be happy. They need to perform. They need to they can't show sadness. They in order for their becomes their job to make their parents okay. And can you imagine that kid later grown up looking for a partner and the expectation on that partner or the expectation on themselves just based on that role internalization of you know like that they're the center of the universe or that maintaining this beam of love from the other person is essential or else it feels life-threatening. Yeah. I mean, it's a it's a covert form of abuse to use our children to meet our needs. You know, we're there to meet their needs depending on their age, right? I mean, we're going to you have an infant, you're their highest power. You have to do it. They they they uh they can't survive without you. You know, they can't feed themselves. And you carry them all the time, right? And then, you know, eventually they start crawling and walking and you carry them more than than you don't. And then eventually they're walking all the time and you're carrying them just a little bit and you know, then you're not carrying them anymore. If you're still carrying them all the time when they're 16 or 17, that's a that that's a that's a problem. But when we're using them to meet our needs again and again, now it becomes their job to care for us. And most parents that do this, and I see this all the time, are not setting out and saying, "I'm going to uh use my child to make me happy." They really have the best intentions. And it it probably comes out of however they were shaped growing up and how their family was shaped growing up. But, you know, I I I see this, you know, with my kids. You know, sometimes I come home, I two that are six and three, and I come home from work and they're like, "Daddy, daddy, daddy," and they're running to me and they jump on me and and and it feels amazing. And other times I walk in and like they've got a show on or something and I'm like, "Hey, kids." And they're like, they don't even say anything. Now, that doesn't feel great. But what I know is that doesn't mean they don't love me, right? If every day I came home and they were like in the middle of this and I I forced them to get up and give me a hug, you do this once, it's not going to be, you know, a problem necessarily, but if I did that every day and now I need them to give me a hug in order for me to feel safe and comfortable coming in the home or just feel happy, they're going to start having the job of we got to hug daddy in order for him to have a nice evening. That's a big job for a little kid to have. And I see that play out a lot in the people that come to us in that they've unconsciously been assigned these roles in childhood like, you know, they're the hero of the family, you know, we can use those the the terms or or the scapegoat or they're the, you know, but really what was the job that they were given? You know, it's my job to take care of mom and dad. you know, maybe they were in the middle of the relationship or or or you know, if mom and dad are fighting all the time, but kids are often assigned these roles early on and then they don't know how to shed them later on and so then they just use that role later in life. I mean, my field is full of people who are assigned roles, you know, the therapists and nurses and things like that. You know, we want to care for people, but it's hard to parse some of that stuff apart, you know, because we don't want to blame parents for how their kids end up, but when we're doing work with our clients, we want to understand the patterns that were developed. not to blame them but to to start understanding what were the systemic challenges in the family system so that we can you know develop and deploy systemic solutions for them. I'd like to take a quick break and acknowledge our sponsor AG1. 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There's this thing that happens around any conversation about addiction where at some point any logical listener starts to say, "Okay, well," and it sounds like everyone's addicted to something and it's so hard to stay right in the, you know, between the lane lines of of healthy and healthy because yeah, I like I'm not speaking for myself because I'm not a drinker, but like I like a drink at the end of the day. It helps me relax, makes me a better parent, makes me a better spouse, and I like it. Is it my spiritual higher power? No, but I like it. Would I take 30 days off? Prefer not to, but I'm not addicted, you know. But then you think, okay, well, a kid that likes playing video games that lets him connect with his friends. Um, he's doing it a bit excessively, but is he addicted? You know, okay. Um, obviously if somebody if it's harming people's profession, it's harming their relationships in very overt ways, then we place into the category of addiction. There's this thing that happens in these conversations around addiction where people start to go, "Okay, it sounds like I can't really enjoy anything that much because then it takes over everything." Like, I'll I'll come clean. I've worked anywhere from 10 to 16 hours a day, 5 to six days a week on average, right? Um, since I was 19. Am I a work addict, workaholic? Maybe. But I love my work and it's done wonderful things for my life and I have a life that I wouldn't trade for anything. Did I miss out on a lot of things? Probably. Um, but I also love the life I've lived and that I continue to live. And a lot of that comes from the relationships and experiences I've had through work. Right. So, you know, at some point, this is where diagnostic criteria come become handy. But I do like the fact that um we have a lipmus test now. Could you take 30 days away from it and not um completely lose your mind? Or could you just take 30 days away from it? if I didn't work for 30 days that would be very difficult for me but I could do it. Um so how should we frame this this thing of addiction and so that people can ask themselves like do I have it or does it have me? Yeah. I mean I think how are you using it and what is it impacting if if anything but to be be able to be honest with yourself about it. I you know it's very hard to be it's it's easy to say be honest with yourself about it but it's very hard to be honest with ourselves. You know, that's where being in relationship with others, sharing what you're experiencing. If you're taking 30 days off, really communicating to somebody else, whether it's a therapist or a trusted friend, you know, how am I thinking about this? You know, am I waking up every day wishing I could be doing this other than some am I sitting in a business meeting completely dissociated from what's going on because I'm really focused on that I'm not gambling or that I'm not drinking? you know, you've got to be able to look at what it's impacting in the way that we're thinking and the way that we're feeling. Can I ask you a question about the what how it's impacting things? Because one thing I've observed um in myself and in others is that sometimes behaviors that if you if we were to just look at through a kind of tunnel vision, you'd say, "Wow, like this person just like works a lot or this person exercises a lot." Um but it provides energy that feeds a bigger ecosystem. You know, gives me a sense of purpose where I have great relationships through my work and relationships that are not through my work but you know it it sits uh not as my higher power but kind of at the center of my life and a bunch of other things wick out from it. And to remove that thing would be to disrupt the whole web. I think that's sometimes what scares people. Um, especially again, I don't I can't relate to alcohol specifically, but what my friends who have made the decision to try and quit or quit drinking alcohol, for them it's like the their ability to socialize, the lack of anxiety while they're intoxicated, the um knowing there's something to do um for them as you know, as opposed to like what they would fill that space with. So sometimes it I feel like these addictive behaviors fit into a larger ecosystem so that it masks the dis that any dysfunction but it's but it has this again gravitational pull so that you know it gets to bigger questions of like how how are we supposed to live our life and I like this quote from St. Augustine you know that a a life well-lived is a constant reordering reordering of our loves. Yeah. Yeah. Something like that. So it gets to these questions of like what what is a good life? This is a a great uh discussion point you know that you know people will come in and say I just want to be happy I just want to be at peace. First thing we have to ask them is what does that mean? We have to define it. A lot of times maybe they're saying that happiness is kind of the absence of all this bad stuff you know or that peace is you know everything outside of me is going okay everything is fine. you know, we've got to really explore with them what how would they know when they got there. You know, what a balanced life is going to be different for everybody. And especially like with behavioral addictions, you know, it's not about necessarily removing those forever. In fact, a lot of those we can't remove. Food addiction, you can't remove food. I mean, the things around sex addiction, you know, you're not going to I I suppose someone could not have sex, but really a lot of that is about connection and relationship and love and intimacy, you know, even gambling. You know, people don't have to gamble, but you're dealing with with money, you know, and you've got to touch it and spend it and be around it. Yeah. Buying a house is an investment. Yeah. or a gamble sometimes as we've we've seen, you know, and we've got to look at how we're using these things, you know, and and going back to drugs, you know, you look at like we've got pain pain medication, you know, aside from being abused, right? We've got opioid pain medication. Um, and then we've got heroin. And both of them either came from or derivatives of the poppy which is a beautiful flower right so we've taken this flower and we've been able to make this these drugs and one of them you know of of course prescription pain abuse and fentanyl that we see is is you know is it can be deadly but I think an argument could be made that it's probably saved more lives than it's killed when used appropriately. We're able to have surgeries that we probably never would have been able to have before because of the medications that people can use. And then we've got people who are either abusing that or taking heroin and dying. You know, having a, you know, we started calling it the opioid epidemic. I think 50,000 people died. It like surpassed the number of the people in the US that died by car accidents. Last year it was something like a 100,000. Right. 100,000 people died at least. You know, it's more than doubled. Um, you know, now it's in a lot of different things. There's a lot of kids that are taking something that they think is a a less harmful pill, like a Valium or Xanax, and it's got fentanyl in it, and they they die. You know, it's it's doubled since we started calling it an epidemic. And of course, that 100,000 doesn't include all of the other drugs and alcohol and um but you know, it goes back to how did we use it? You know, we manipulated this flower in a way that we can save lives and kill or die. That's a more extreme example. But how are we using the things in our life? You know, are we using exercise as a way to completely, you know, uh to dissociate from things? If I if I take away that exercise, am I going to fall apart? Am I not going to be okay? You know, and that doesn't mean don't ever exercise again, but understand like if I were to stop for a week, do I fall into a deep depression? Not everybody is going to do that, but if somebody's oriented in the way that it is a problem, that may happen for them. And then it begs the question like, what am I using this for? What I think is so important about treatment for addiction and then recovery from addiction is that, you know, at first it's about eliminating something. It's about moving away from something, but that's not sustainable. Just to cut something out isn't because it's being used for something to give them that sense of relief or that sense of peace or that sense of connection or spiritual or otherwise. They've got to eventually start building towards something. You know, what what's the life I'm going to create? If you look at the 12 steps, the last part of the the 12 steps says to practice these principles in all our affairs, which means go out and build a life. You know, don't don't find yourself really small. We we were talking beforehand there was a I think he was a biopysicist. I I I can't remember. Emelick, he was at at Stanford for a bit, the end of his career. and he had done a lot of research on alcoholism and I wrote a book in the ' 50s or 60s called the disease concept of alcoholism and out of that book there was a curve and you can look this up it's called the gel curve I don't think he actually created the curve it was credited towards him in fact I think he even uh kind of dissociated himself from it but it came out of his works and it it starts off with at the top and it's for alcoholism like where people start drinking and it's in the um crucial phase as they start drinking more. And at first when people are drinking more, you know, their tolerance increases, you know, but they start to experience some problems. They're hung over, they're late for work, they're having arguments with, but it's nothing that drastic. And as they keep drinking and descending down this curve, actually, they enter the I think it's called the critical phase. And that's where actually tolerance decreases, right? It's it's they're dependent on it. They need it just to get by. They need it to get to work, you know? they they're they can't keep the job, they can't keep their relationships, their uh physical body is starting to fall apart, they're getting sick because of it. There's a lot of other factors in it. And then they they come down to the bottom of this and and it's this cycle of drinking and stopping and drinking and stopping, you know, drinking until I can't anymore, physically sick, and then going back to it as soon as as they can. when those people are able to get treatment and find recovery now the curve starts to go back up the recovery side of the curve and in the beginning you know they're not feeling that great. they they've lost the thing that helps them get through life. But if they can stay in a contained environment, and that contained environment could be a treatment center or a contained environment like in a 12step program, you know, where they're engaged in something. I don't mean contained by uh uh the walls that you're in, but in some sort of in a community, and they can stay away from it. Eventually they start uh seeing that they see in others that they can build a life that they can go after the things that they wanted to go after and they start finding pleasure from life rather than from the the the substance. You know they start to be able to handle the stressors of life. their tolerance for stress instead of their tolerance for alcohol building their tolerance for for stress starts to build and then eventually they're kind of moving towards what we would call in Mazo's hierarchy of needs the self-actualization you know they're able to build a life that they never thought they could have before you'll hear people say a life beyond my wildest dreams you know and a lot for a lot of those people that's just that I'm able to meet anything with some sort of sense of peace and when I'm not I I think recovery is it's not about finding a let's just use the word peace it's not about finding a a a sense of peace that you stay in. You know, balance is not I'm on both feet standing still. Balance is like like this, right? And as we're taking risks in life as we should to really build awesome lives, sometimes we're going to feel way off kilter. But with the recovery process to be able to recognize when I'm out of balance sooner or out of peace sooner and return to it quicker, recover again and again, you know, and have the tools to know, you know, what are the emotional conditions that I might be facing on every day and what what am I made of and who am I that might bring to that? So for instance, something I give to a lot of my clients is we call it like the emotional weather uh forecast. You know, when the first part of this is they've got to really know themselves and that's something that we see in 12step a lot where they'll we hear if if you know people identify their character defects. Not everybody I know is familiar with 12step, but that's one of the but as part of identifying your defects, you're also identifying your virtues, right? Just like a balance sheet, you want to know your liabilities and your assets. And sometimes those things are sometimes they they they change. And if something that's a a liability in this situation might be an asset in this situation, right? Like if uh uncontrolled anger and violence in my home when my kids do something wrong, and I'm not doing this, but is is a liability. you know, if my family's attacked, it's an asset, right? So, understanding what these defects and virtue or assets and liabilities are so that I really know myself and and and that can be through a process of of of sharing with others. And in the 12step, that's how they do it. We do it in therapy all of the time to kind of know who I am. You know actually uh one of there's a line in one of the uh AA literature that Bill Wilson wrote and he he gives a definition of humility and it goes something like this that humility is an honest recognition of who and what we've become followed by a deep desire to become who we can be. And it it's not about like that I'm all bad. It's just to note it to to to recognize who I am. If I don't know where I'm starting, I can't know just like finding directions. If I asked, you know, to get directions to the studio and your team started giving me directions from uh uh over the canyon, but I was, you know, south of here. They're going to give me the directions to turn left on this road and right on this, and I'm going to I'm not going to know how to get there. I'm not I'm going to be disoriented. I'm going to feel lost. I got to It starts with really knowing where I am, who and who and what I am. And from there, then we can start to build a life. So one of the things I give people a lot is once they kind of understand these assets and and and liabilities of theirs, you know, to to look at each day ahead and say, you know, first we start off with gratitude, you know, it kind of gives a mindset and gratitude just isn't about being thankful for things. I I really believe gratitude is meeting what is as it is. you know that uh I always when I give people this and when I practice it myself, I try at least to be one of the things I'm grateful for to be something that I'm challenged by and not just to say I'm going to learn a lesson from this, but I I might not know what that is, but to really express gratitude for some challenge I'm I'm I'm having. So, that's kind of a mindset. And then the next thing is just laying out your plans for the day. and and not like a detailed calendar, but like, you know, I'm gonna wake, you know, take the kids to school, go to work, travel, you know, have a business dinner tonight, right? And then so I kind of know what's happening that day and then from there, uh, look at what are my what's my emotional state currently? What am I experiencing now? Especially if it's like fears, resentments, anger, guilt, shame. It could be something else. It could just be like I'm feeling I feel really solid today. But when I can take the what's going to happen today and what I'm already experiencing, I can look at what I'm doing today and think, you know, there are some character liabilities or defects that might come up. Like if I have to travel today and I've got to take three flights instead of one, I can know that if I know myself, I might say I could I have the the ability to become impatient, controlling, and and look at my day to say almost predict what are the emotional disturbances that can that can happen that day and then coupled with the state that I'm in. If I'm already upset about something else, I've got a higher likelihood of going into these reactive patterns that I don't necessarily want to go into. And so, you know, much like going on a trip where I would look and see what the weather's going to be. You know, if it's going to be looks like it's going to be rainy the whole time I'm there, I'm going to pack a rain coat. Now, that doesn't mean I'm not going to get wet, but once I start getting wet, I can go get my rain cat and and put it on. Same thing in this. You know, the last part of it is to look for what I'm going to watch for because of my plans and my emotional state. Now, I know that I have to watch for being like maybe short or controlling. I want to watch for these character defects or liabilities. And then what do I want to strive for? I'm going to strive for being patient, tolerant, kind. Now, just because I write this down, just like the rain jacket, doesn't mean I'm not going to experience these things. But when I can look at like a day as an example, I can break it down and in a in a chunk where, you know, I'm not going to be shocked by I'm being impatient. And as soon as I get impatient, I can remember, oh, this is what I'm looking this is what I want to watch out for today. What do I need to and I wanted to strive for being tolerant and patient. So then I can, you know, use one of the tools that I might have that I've laid out. You know, it might just be if I'm in the airport, walk away, take a breath, you know, and and recognize and and remind myself this is what I'm striving for today. And in this exercise, we're putting out in front of us what we might be be experiencing based on what we know about ourselves and what we've learned about ourselves. And when we can do that, we, you know, we can start living each day a little bit better. or at least I find this with my clients that they they can chunk it down and say, you know, they're not surprised by these emotional reactions and and and you know, like I said earlier, we we want to help people I I try to help people learn how to feel bad, you know, to to recognize that, okay, I'm feeling disturbed. I'm in a reaction. Let me lean into it rather than run away from it. And we run away from it in different ways. I might snapping at the lady at the counter or uh you know might be someone that that now I just totally withdraw and don't say anything. Yeah. Numbing out is very common nowadays. Yeah. I just want to repeat these different categories. Um a small list of gratitudes um including perhaps some things that um we're grateful that challenge us or things that we've received or whatever it happens to be. A quick list of gratitudes plan for the day. what the internal emotional weather is like how am I feeling irritated rested what it could be three or four things what to watch for and what to strive for I do think it's an extremely useful obviously zero cost minimal minimal time investment protocol for lack of a better word that um everyone not just people who struggle with addiction but everyone can benefit from because I think we we tend to be so conscious of like what to look for, what to strive for, coming out of a morning journaling or a great night's sleep. But then, you know, it's amazing how by 3 3 p.m. somebody cuts us off in traffic or, you know, or we're being bombarded with too many things and all of a sudden we're we're not necessarily unpeled, but we're not our our best self. Do you think there's value in sharing your list with somebody else? connection with others is so important, especially when I share something like this that's vulnerable with them because it's not just about holding me accountable, but now now I'm I'm I'm expressing it in a way that others see it and we can have communication with them about, you know, having them share it back with you, too. I have like 10 guys that I share this with every day, you know, and not that the way that I do things is the way that everybody should, but I ask other people that I give this to to share it because, you know, you're you're now expressing it. And expressing something kind of brings it more into existence than if I'm just doing it myself internally. And we've got to put these things in front of us cuz we will forget very quickly, you know, or you like you said, coming out of a morning journaling or meditation session feels great. I think most people decide to make a change and then, you know, on one day and then they don't think about it again in the way that they thought about it for months. Like it happens every year on New Year's. They're not putting it out in front of them every day to be a reminder of what I'm going after, what's important to me. And the brain is very different at different times of day and at night. You know, one thing that I subscribe to that is separate from this conversation, but perhaps relevant is I don't believe any thoughts that occur between 2 am and 5:00 a.m. But I just don't whatever whatever comes up if I happen to wake up in the middle of the night and have a I I just don't I've chosen to not believe those thoughts. I might write something down. I might have an insight that I'm interested in um or something that terrifies me or whatever, but I just don't believe those thoughts because I've had the experience thousands of times of then going back to sleep, waking up in the morning being like, "That's ridiculous. It doesn't it doesn't that doesn't hold any water anymore. I think we're so vulnerable in the middle of the night. Our forebrain shut down. We can't strategize. All our safety mechanisms are are are you know at their at their lowest and those thoughts just they don't hold meaning. Now I'm not to say that's not to say that some night owls might not have some brilliant insights in the middle of the night. So this is just relates to me and my schedule. But I do think that um we can make a decision to behave one way and do things at 8:00 a.m. and by 400 p.m. As a neuroscientist, I can honestly say that your brain is not the same brain at 4 p.m. that it was at 8 a.m. It's still you, but it's functioning so differently. What's important, how it orders priorities, how it interprets data. It's a it's like a it's not like a computer. It's it's a dynamic machine. And at different times of day, you're working with a different different set of hardware. Literally, certain circuits are more active than others. So, I don't believe that um we are capable of self-regulating nearly as well as we could, certainly not perfectly, if we don't have a reminder of our best self, our aspirational self that we carry forward. Whether or not it comes through other people or enforcement or ideally comes from from inside us. But the expectation that we are going to spontaneously and impulsively be our best self is one of the biggest uh failures I think of of education and psychology and medicine and evidenced by the fact that I have many colleagues who are scientists and physicians who have terrible addictions. Some are sober, some are not. These are brilliant people who have all the knowledge in the world about the inner workings of the mechanisms that make people addicted um etc. Anyway, I I I just I'm editorializing there a bit, but I feel very passionate about these zerocost uh tools, but I have to say these tools can make a huge difference. And um what do you call this list? What is it the plan for the day? What what is this list? uh just like an emotional weather forecast, you know? I mean, call it whatever you want, but I I I think it can be part of a daily inventory, too, where at night you could look at and see how you did, you know? I mean, I I I think you just talked about being your your best self. Like, it's a way to kind of des, you know, define what our best self is that day, you know, because what our best self is is going to change depending on the circumstances we're in. You know, I I I've run into problems before where, you know, in my own life where, you know, it's like the weekend and I'm really looking forward to I'm like the weekend's going to be and I don't let's say I don't do this exercise cuz it's a it's a Saturday and I it's going to be, you know, I'm home and it's going to be an amazing I live with four other people, you know, two of three of which are children. they might have other plans, you know, and or someone gets sick and we can't go to the the do the the thing that we were going to do. And and I can find myself, you know, really grumpy and right in those character defects or liabilities. I also think being your best self isn't never engaging in those. It's not never getting angry, right? I I remember a teacher I had was talking about and I can't remember the he was talking about some Indian yoga master you know that they the the student asked them like do the do the masters ever get angry and he said of course but when they get angry it's like writing on water it's there and then it's gone you know they're not holding on to it if you try to write on water those letters are going to disappear right after you write them you know that there's there are emotional disturbances that we're going to have and It's part of life. We can't ignore them. We should embrace them and lean into them. I mean, I think a the a real secret to having a really fulfilling life is being able to embrace all aspects of oursel, the the light and the shadow because we can't just try to run from the shadow and go to the light. It's just it's they they they're handinand. In fact, they don't exist without the other. Well, because they're both inside of us. And they're both inside of us and they both have their purpose. What is the purpose of the shadow in your in your mind? And for folks that don't know, I mean the shadow, we're using Yungian language here, but and and there probably will be some folks listening that say and are thinking themselves, well, I've never suffered from an addiction, etc. But what we're really talking about here with this, can we call it an an emotional weather map? Sure, that's great. Because I like the idea I like the idea of a map and the forecast component because it's not just how do I feel right now? It's how do I feel right now? What's coming? And how am I going to prepare? and and there's some goal setting in it, but you're not actually writing out your specific goals. Just, you know, what what am I striving for is I suppose a goal. Um, but what we're really saying is anyone that's ever gotten anxious, anyone that's ever gotten stressed, anyone that's ever gotten angry, whether or not you yell or not, right? I mean, what you're talking about is is a is a road map for the being able to navigate the experience of being human, right? Because the stri what we're striving for is not our like specific goals. I'm not striving for like success in this meeting. I'm not striving for making this money today. I'm striving for ways of being, you know, how I'm going to be that day in the face of the stressors, whether that meeting goes well or not, whether I make the money or I don't, whether I get the answer that I wanted or I don't, that I'm striving for this way of being. There's a a a line that I heard from a country singer once that I think he heard in a a 12step meeting that said, you know, peace is not uh finding calmer seas, it's building a better boat. You know, that you know, how are we going to navigate the storm? 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Function currently has a wait list of over 250,000 people, but they're offering early access to Hubberman podcast listeners. Again, that's functionhealth.com/huberman to get early access to Function. You alluded to this earlier when talking about balance as a dynamic process, not a static process. That part of peace is knowing that when distress comes, you'll be able to tolerate it. Yeah. As opposed to there's no distress. And I know people like this that are constantly trying to move through the channels of life, create their own little estuaries around things so that there's never any disruption. Yeah. We want to be able to tolerate that distress enough to make choice and respond rather than react to whatever it is. You know, it doesn't mean that we're not going to navigate out of the storm. I I think of it I I I I think of it like this in uh if we go back into the I don't know 17 or 1800s when the only way to get from England to America was to navigate or to sail in a a wooden sailboat, right? A sail ship, whatever it was called. And let's say we took the most experienced sailor with the best ship. But this time, rather than using his skills of navigation and sailing, he said, "The seas are calm and the weather's good, I must be going the right way. But if the seas are rough and the weather's bad, I must be going the wrong way." And every time the seas were calm, the weather's nice, he just kept going in the direction he was. But every time he came across waves and rain, he'd turn. Is he ever going to get there? Potentially, let's say it's calm the whole way. Or he might end up navigating all the way down around the South America and then coming back up. Neither one of those is the answer. The answer is that he when he meets the storm, he can use his skills of navigation as a sailor to and and understanding the weather and his experience to say, "Okay, this is something I navigate through. This is something I navigate around." But he doesn't just react based on the external conditions. And we react constantly to our external conditions based on what we're perceiving is going on. You know, I'll preface this by saying I think I believe one of our biggest, if not our biggest challenge as human beings and our psychology is that we confuse discomfort with threat and respond to discomfort as if it's threat. You know, and this goes back I can use the the uh uh diagnostic criteria for PTSD. Not that everybody that experiences this has PTSD, but when you look at the diagnostic criteria criteria in the DSM5, which is the fifth version of the it's the most recent version of the diagnostic manual, it says that the person was exposed to um it's like exposed to death uh threaten actual or threatened death or or actual or threatened violence or actual or threatened sexual violence. In the DSM4, it said real or perceived. And what that means is, you know, we can have a similar or exact reaction to something that is actually happening like you're attacking me. Hopefully, you're not going to attack me, but like you were as if you threatened to attack me. You know, if I believe that I'm in danger, then I can have the same I'm going to have the same fight orflight response or the same reaction in my body as if I am actually in danger. It's interesting that our I think our legal system recognizes this in that uh you can be arrested for assault or battery. Battery is you hit me. Assault is you threatened to hit me or threatened to kill me. We we actually in a way recognize this idea of perception in our legal system. It's actually it's also I I believe what the forgive me for saying it in this way, but the quote unquote success of terrorism is it's not that this event happens. It's that we leave that event thinking it's not that those buildings came down. It's that we think we believe that all of the buildings are going to come down, right? It's it's it's it's terror. I think that because we were talking about addiction and now we're talking about perception of threat and distress. I want to make sure that we tie those things back to one another uh one another. No, I think this is a very important conversation because what we're, you know, at the heart of addiction, but also at the heart of a challenged life, challenged in the ways that life shouldn't be challenging, is this lack of distress tolerance. Yeah. And I have a question about distress tolerance specifically. What can we do to increase our distress tolerance? Like what practices Maybe we just have to experience distress to know how to navigate distress. we we're going to experience the stress. We experience it all the time. And I think it's it's and and you may be able to articulate this even better than I can. But, you know, I think we need to look at stress, right? Not all stress is bad. We we need stress. I need stress to move around in this chair. I need I need to I need to be able to um uh to walk around. My my muscles need to tense and I need that stress. I think was it Han Sier's work around ustress and and distress? We're going to experience distress and it's not about avoiding distress. It's, you know, how are we going to walk through that distress? And so I I like to break practices down into a couple different ways. So proactive and reactive. Proactive are going to be things that we schedule. You know, I'm going to do you talked about yoga nidra. We can talk about that a little bit more. You call the non-sleep, deep rest, other forms of mindfulness and meditation that actually allow us to raise capacity in our our nervous system. um uh going to therapy, coaching, being involved in a community, doing physical exercise. These are things that we're going to schedule going into the cold plunge which does allow us to experience something and stay a little bit longer and it gives us you know it's so it's we have one at home and when friends come over to use it it's so funny because like the first time they're going to do it and I know you've had a lot of people we actually I was at your home a couple years ago and there was a guy who was doing it for the first time and he he's like a big I don't remember this but he's like a big athletic guy and he he was freaking out getting into terrified right and it's just cold water. There's it can't I mean it could hurt you if you're in there for however long to get hypothermia, but it's not going to hurt you. So having practices like that that allow us to move through that level of fear can translate to fear or distress can translate when it it comes in real time for something that we that I know I can walk through this. Yeah. Because adrenaline is ubiquitous in stressful circumstances, which is just a bunch of science nerd speak for the stress response is always an increase in autonomic arousal or alertness, a shrinking of the visual field, an increase in heart rate, a tendency to move. People will say, "But I freeze." Actually, the freezing response, this is kind of interesting. My lab studied this. Lindsay Cle published a paper in Nature about this um in 2018. She was a graduate student in my lab. The freezing response is an active behavior. Oh yeah. Trying to hide from from an intruder in your home in the closet, you're trying not to move. So people think, oh, you know, people freeze under stress. No, the freezing response is an active response. You know, the adrenaline dump, as it's sometimes called, is is what essentially creates the freeze response. It's why people can't remember things when they get up on stage if they have a fear of public speaking. Um, and I was going to I forgot to mention in the cold plunge, cold water is a highly reliable way to elicit an adrenaline response. It's just a great training for this feels uncomfortable. I want to get out, but I'm going to learn to control my thinking in this uncomfortable circumstance. Yeah. So, that would fit into the proactive, right? So that's something that you you can proactively start to be able to manage that adrenaline as you're as you're telling me in in the body, right? You're we're able to manage those feelings cuz what does it come down to is a it's a these sensations in our body that we're experiencing that feel really uncomfortable and we might be able to sense them a little earlier, right, if we have some training. I just want to throw in one little science tidbit as long as we're talking about using cold as a way to manage um distress tolerance is that the first 15 to 20 seconds after the adrenaline response hits and it hits very fast your forebrain which is involved in all your contextual decision- making and clean clear strategies of what best to do is essentially shut down for about 20 seconds. If you can make it 20 seconds, you have a far better chance of not doing something really stupid and doing something that's very adaptive. Right now, there may be circumstances where you don't have 20 seconds. But if under stress and riding out that 20 seconds is uh generally going to be a very adaptive approach because then your forebrain comes back quote unquote online and you can really start to make strategic decisions based on those particular circumstances. And so that's what's happening when we get uh experienced some people say get triggered by something that's uh uncomfortable for us, right? uh you really uh you you get a a text message from your boss or your partner that says we need to talk later, right? A lot of people, I don't know about you, but when I get we need to talk later, it's not my favorite text in the world to get, right? So, someone might get that text and then they immediately go into like their perception or their beliefs or their kind of narrative about what that means. I'm going to be rejected. This is going to be disappointing. It's going to be really hard. And those perceptions or beliefs are coming out of their past. So now sitting there looking at a text message which is really just a a neutral it's it's all events are neutral. We bring the meaning to them and we want to bring meaning to them but it's just words on a a screen and we don't even know what it means yet. You're looking at those and you're not even in the present that more. You're in the past and we're never really out of the present. People say get present. That's the only place we live. It's what where are we oriented? past, present, or future. Right in this moment, now that I'm going into this narrative from all the other times that I was, let's say I'm making up that I'm being rejected or I'm not going to get what I want. Now, I'm oriented to the past. So, I'm we we could say I'm disoriented in that moment or to the future. You're anticipating what might be said, what's going to happen. You're out of the moment, but I would say that the anticipation is still something that's coming out of what we've experienced before, right? And then from there, we go into an automatic reaction. And it's like a fight orflight response. It might not seem like that because we don't we might not be thinking I'm going to die from this. But if you know we might be thinking I'm not going to be okay. And what is I'm not going to be okay? That gets carried out and it's triggered in the body. I would say in the same way as I'm at threat. I'm at I'm in danger. And this is where we're confusing discomfort because even if I am going to be not going to get the answer I want or I'm going to be abandoned, it's not life-threatening. It's not actually threatening. It's the it's perceived threat, but I respond to that perceived threat as if it's actual threat. And I might respond by kind of going after the person like I need to know right now, being obsessive about it. I might respond by withdrawing completely and and and hiding from it. But it it it it creates this cycle of kind of uh an automatic reaction to things that doesn't allow me to build tolerance for that that stressor. Right? The the solution to that is first be aware that that's that's happening. And once you're aware that that happens, and it happens to us all all the time. Once I recognize that I'm in this cycle below to to to find a way to stop to intervene on that to take a break from it. It might be just those 20 seconds. It might be uh something that uh it might be taking a few breaths. It might be walking away from it. Can I interject something there? Because one thing that um stemmed out of a prior conversation we had is I think you know these aspirational um responses of okay like the the stressor hits I'm going to take a I'm going to create the gap between stimulus and response that you know was it Victor Frankle or something like that referred to sounds wonderful but in real time everything's very hard everything's different and so uh you know what can we do to prepare what are the things I like this notion of proactive tools that that we can schedule. Um coal plunge being one of them. We'll talk about yoga nidra and some other things. But um but one of the things that I've learned is that there are sensations in the body that come about and it will be different for different people. But there are sensations in my body that come about very fast because the adrenaline response is fast. And the more that I pay attention to those, the more I'm able to pick up on them at at earlier stages of the the stress response. Kind of like seeing a big wave coming from further out. And the the yogis talked about this. I learned about this also from you that like to in meditation, we can start to see the quote, it's mystical language, but that like the subtle ripples of our perception. Whereas when we're going through life and we're just kind of around, it's like being on a train and we're just seeing stuff go by all the time. The concept is is stilling leads to seeing. I love that. The more that we can still the mind, the easier we can see what's actually happening versus what we perceive is happening. So what you say is so true that it is hard if the first step is to to after we recognize that this is something happening is to stop when we're in the middle of response. How do we stop? um something that I work with the people and I actually heard you talk about in a in a different way that I really appreciated in uh one of your essentials podcast where you know in that moment when we're in that reaction you know the the the the sympathetic nervous system has been activated the solution though is not to deactivate the sympathetic it's to activate the parasympathetic. So, our practices and tools that I I think are the most beneficial is how do we activate the parasympathetic? A a great question to ask ourselves once we recognize that we're in some sort of stress response. I like to tell people to ask, is am I or is anybody around me in immediate physical danger? And if the answer is no, first off, if I can ask that question, it's probably the answer is no. But most of the things that we experience every day are not life-threatening. Actually, probably the thing that we experience every day that's most life-threatening that doesn't bother most of us is driving in a car, right? I mean, we're h hurtling down the road and just trusting that someone's not going to cross over that other line. But that won't scare us. But, you know, uh uh getting someone that you're in a a committed relationship with or that you're emotionally attached to that says something you don't like might throw you into a a spiral. I mean, it speaks to the unbelievably powerful aspect of of human connection. Yeah. I mean, likewise with the earlier example of the kid in video games, we think about this kid and the video game as like the the only players in the interaction. But to take a video game away from a kid is to also remove him from his social context. We know that social isolation is one of the most um potent stressors for for any mammal, especially humans. I mean, from what I've read, and you know, tribes would basically shame someone out of it if they did something really terrible. You know, they would send them out of the tribe and that was like death. You know, they only survived together. Now we can live alone because of you know technology and human advancement but like ser like live physically alone but you know we're not at the top of the food chain really you know if we were out in the in the jungle or back when we were uh nomadic and we still have that within us that we need that connection. We need that. So we're talking about distress tolerance. we have a a an emotional weather map tool that can prepare us. There are things that are proactive like cold plunge or meditation um in the moment we can hopefully create more of a gap and and of course we were talking about this in the context of addiction but as you were saying with the behavior or the substance is the medicine against discomfort. Can you go back to that theme just a little bit to really hammer that home that when somebody comes to you initially you're saying okay like what are you using how often are you using how's this impacting your life trying to get them to see all that but once they move past that are you trying to get them to see like what they're really afraid of um let me frame this a little differently many years ago you said it's kind of incredible we're having an academic discussion and you said it's kind of incredible if we can tolerate discomfort for one second then we can tolerate ate it for 2 seconds. If we can take discomfort for 2 seconds, we can do it for 5 seconds. Once you start to realize that all you have to do is experience discomfort as a series of moments, suddenly you realize that you have an immense capacity to manage discomfort. And I was like, I sat with that for a long time. Why do you think it's so hard for us to do that? Even though in theory that's exactly how it works, I think this is where we get hijacked by the part of our nervous system that is kind of binary and looking at it's life or death. You know, if we perceive this as danger, it's going to respond as as danger. We don't want that part of the nervous system and we don't want it having discernment. We want to really when we're actually faced with, you know, I say if you and I were walking across the road here and a and a car is about to hit us and you see it, I don't want you to stop, breathe, meditate, you know, have compassion for the driver. I want you to, you know, react immediately, push me out of the way, even if we get hurt and break a leg. I want to we need to live. You know, the problem happens when I, you know, go home and I say something to my wife and she disagrees with me and I react to her like she's a car about to hit me. You know, it becomes an appropriate response at an inappropriate time. We don't want to lose that. And so it becomes so hard because we're in this kind of I believe this fight in our in our nervous system to say one part of it saying you need to act or you're not going to be okay and the other part saying I don't want to keep doing this. In your mind, you know, I know that I'm in this room or in your lab with virtual reality goggles on, but that one part of my body thinks I'm falling when really I'm watching a a video game. So maybe the best we can do is prepare. These proactive tools seem increasingly important to me. Um can we talk about yoga nidra? Um I talked about non-sleep deep rest a lot on this podcast. Yes. I decided to take yoga nidra which is a thousands of years old practice and rename it non-sleep deep rest. Um because I wanted more people to you for doing that. I mean, I I've taken some heat, but I wanted more people to do it. And I, you know, it's a zerocost tool that I think is very valuable. I learned it from you. I came I you know, I went out to uh where you work and observed that this is the first thing that people do every morning when trying to get sober. This is the first thing that people do every that you have them do every morning when they're trying to identify and overcome their traumas, including full-blown PTSD. And I don't want to share some of the stories that people shared out there, but a couple of them were very intense. I mean, when I'm talking about PTSD, I'm not talking about like had a bad semester in school. I'm talking about people who were co-sleeping with their kid and the kid died. Yeah. And it was like it was a very intense thing to to hear those stories. And it was also a beautiful thing to see people's transition through their traumas in some cases their addictions or both. And every day started with an hour of Nidra. What is it about Nidra? How did you discover Nidra? And how did this come about? Because I think it's an an extremely extremely important tool for a number of reasons, but how did you start incorporating this into trauma and addiction treatment? I was working at a place in um central Florida and near there it was a treatment center and not far from there there happened to be a a an ashram um started by a old Indian guy who had come over from India in the ' 50s or 60s he's in his 90s now and is kind of credited as one of the people to bring uh yoga to the the west one of many um uh it was the Om yoga institute and uh they um uh they were running some workshops and I ended up doing a training there that opened a door for me to start doing some other things. I I'd been practicing breath work and this was all part of my own journey and then I got introduced to to yoga nidra and um it was just a very powerful tool and in these workshops that I was in I saw some pretty amazing things happen for the people that were taking trainings. We were there um you know for I remember we were we were there for uh it was a 10-day training and you could take it as 10 days or you could take 5 days and then come back for 5 days and there was a woman who had been there for a 5day and was was coming back and when she was there at the first part she had she was a a single mom she had two boys I they were probably under 12 and she was completely stressed by them like completely stressed. She was uh could not almost handle being a mom and she practiced this. She decided to come to this training and then she went home and it was several months in between and when she came back I remember in the opening like group she shared that she'd gone home and had not changed anything. The only thing she did was practice yoga nidra uh I think twice a day in the morning and the evening and she's like my boys changed and I actually don't think the boys probably changed at all but she was someone who was filled with anxiety and and stress and the kids were picking up on that and she wasn't able to tolerate the the discomfort or distress of her children or boys just being boys. I don't even think they were really probably behaving more than you know an 8 and 10year-old does differently but she couldn't handle it and now she was able to kind of build this uh distress tolerance by practicing this meditation you know and nidra means sleep. So it's a sleep-based meditation. Yeah. Do you want to just briefly describe what it looks like? Generally what it looks like is first a person lays down and ideally they'd be laying on their back unless they they can't lay on their back but you you lay on your back and get in a very comfortable position. the it's a guided practice and one of the reasons it's guided is uh it it it's kind of becomes a technique that disappears the technique and what I mean by that is if you're sitting doing meditation and you're doing something where you have to focus on a mantra or which is not this is not an uh exclusion of that I mean people so but when you're doing that you kind of have to focus on that mantra so sometimes having to focus on something can can bring you out of it and in those practices, bringing you out of it is beneficial, too, because you want to be brought out of it and then you can find ways to get back into it. It being the the the meditative experience. So, you're you're you're laying down and there's generally um a a series of kind of I'll say physical movements. It's not like yoga doing stretching. It might be something like tensing and relaxing your muscles. It might be something like massaging your face as you're being guided through this to kind of just relax the body. And after a certain point and in a lot of the the teachings that when I do it or I've been taught there's a certain point at which all movement stops and you just want to follow the you just you're just instructed to follow the the the person's voice. In yoga nidra we or nidra we set an intention like an intention might be like I'm at peace with myself as I am and the world as it is. something like that something that you want to bring in or a state that you want to experience. I know that you distinguish I believe you distinguish non-sleep deep breaths as like yoga nidra without intention generally without intentions or mystical language. Right. It involves the um the I think the most critical part of non-sleep deep rest and yoga nidra that to me the the overlap in the ven diagram is includes um self-directed relaxation the ability to do that which of course the incorporation of long exhale breathing will facilitate that because it pushes down on that uh side of the seessaw that is the parasympathetic nervous system and really gets it engaged regardless of how stressed you are as you pointed out getting that parasympathetic nervous system that um the idea that people's mind can be active but their body is still I think is a very powerful state. You're not trying to fall asleep. So the end goal is in reach for everyone. Yep. It isn't like you're going to fall asleep. It's like actually you're going to not fall asleep. If you fall asleep it's okay. And actually sometimes people think they're asleep but when I'm guiding them and I'll I'll give a direction like you know to roll over on their right on their side at the end and they do it but they thought they were asleep. So they were where they what we believe is happening in that is they're in the the the brain states of sleep while still being awake once they're in that relaxed space after doing some movement in the beginning or the space to be relaxed and still I should say still versus relaxed still physically um is through breath different breath exercises specifically ones that have long exhales right that's like you said it activates the parasympathetic nervous system and and guiding them through their body in some way. So it might be there's one called 61 points where you identify all these different points in the body starting with the the forehead down to the pit of the throat and then at all different parts from your shoulder down to your fingers and then all the way down to your toes. And people being able to kind of move their awareness in their body kind of gets them away from that thinking and doing into the more feeling and being. They're putting their awareness on their body rather than everything external. One of the great strengths of doing nidra or NSDR as it were is that we take ourselves out of the prediction mode and we can experience life unfold in in real time moments. It sounds so mystical but actually it was Josh Weightskin who was on this podcast the the former chess prodigy um martial arts champion etc. on the Joe Rogan podcast he said something that I wanted to share with you which felt appropriate now which was he said there are two ways to go through life. One is metaphorically speaking as a passenger in the dining car on a train that's going 80 miles hour and you're experiencing what's in that train and you're seeing things go by. That's the non-concious lower way to experience life. Lesser way to experience life. Where you want to be is strapped to the front of that train safely experiencing space and time as they're happening, flowing by you and through you as a series of moments. And I really think I credit Nidra and NSDR with an ability to see life unfold as an observer and still have the ability to participate. So you're not like dissociated. You're not stepped back. You're not ahead of yourself. You're like right where you need to be, right? Does that capture it? I believe so. I might take that the train example a little bit different direction where I always will say it's like you know you're either on the back of the bus and you're being driven around or you're driving the bus. You know, it's not that you're just on, and he may not have been saying this, but just not on these rails experiencing it like this, that you have uh control, autonomy, and have the ability to be authentic. And authentic in a way, not authenticity gets kind of thrown around and people like, I just I just am who I am. Well, most times when people are doing that, they're just acting however they're feeling in the moment. They're not who they are. They're who they were or they're, you know, they're they're acting out their past experiences. Authenticity in the way that I'm talking is more like uh like off is the same in author, right? It's like authorship that you become the author of your life. You know that you're able to write the story going forward because a lot of what we're doing before that is just plagiarizing from our past, stuck in the cycles of our uh kind of programmed reactive patterns that came out of the ways that we were shaped. and things like nidra where we can start to activate the parasympathetic nervous system again distinct from deactivating the sympathetic and be able to pause and be able to look at kind of choice you know in that cycle I was talking about earlier where we're being reactive the first thing is to stop well how do we stop it's by building these these abilities to have this distress tolerance even if it's for a few seconds and take a moment to be able to get present And look, and what I mean by that is get look look at what's actually happening. This isn't every time someone sent me a text message and uh or every time someone's ever abandoned me or disappointed me or every time I've been afraid. It's just this one moment where I get a text that says we need to talk later. And from that now that can break the cycle enough that I instead of automatic reaction, I'm in choice and I'm making a choice out of kind of all options of how I'm going to handle this. Now, it might still mean that I go, "Could we talk about it now?" in a text response, but that would be very distinct from kind of sending 20 text messages in rapid ree succession saying, "What do you need? Why are you doing this? Am I in trouble?" You know, whatever it is we're saying, but you've been able to to to move to the front of the bus and now you're driving it, right? you're moving kind of out of um uh you're being at instead of being at the effect of life, you're being at at cause. I feel like most people learn how to control their body, but most people don't know how to control their mind. Meaning they don't know how to control their thinking. Yeah. And there's a a great line in a Indian text. It's called the uh atmaagita I think it is where it says something like the the the end of the is is it's like man thinks his enemy is out there but really his unc the man's uncontrolled mind is his only true foe. I don't know if we need to garner complete control over the mind. I think the way to do that is to be able to kind of find ways to relax back from what the mind is doing and saying and the you know like you said ignoring the thoughts between two and five. You know I I think there's a lot of thoughts that we have that we can ignore. you know, our thoughts are not fact. It's this input or that I'm getting. And we tend to grab on to the thoughts that I think that we've had before that have helped us survive situations even if the way that we've survived those situations is to cause destruction. You know, we know how to live. You know, example would be someone who's in an abusive relationship again and again, right? That person, I've never met that person uh that said, "I can't wait to get in the next relationship." ship. So, it's abusive. You know, it could be a man or a woman. In this case, let's say it's a woman. You know, maybe the only men that she was around growing up were controlling or abusive. And she had some experiences with men who were very similar. And then that's the environment or the waters that she started to swim in. She knows how to survive that kind of man or if you're a man, that kind of woman. And when they they would find even if they want that relationship that's loving, caring, kind, and patient, no conflict or not that type of conflict. Even though they want that, when they get into it, it doesn't make sense because they've never done it before. They're still going to be potentially relating to that person with these past reactive patterns. You know, I always say this when my wife and I have, you know, if you're in a relation, I we have a great marriage and great marriage also includes disagreement and argument, right? It also includes love and connection and all of that stuff. And when we're in an argument, it's almost like I'm not talking to her and she's not talking to me. It's like my past is talking to her past and her past is talking to my past. When we can stop and get out of that cycle for just a moment, then we can make a choice that will move us toward the direction that we want to move. And that choice can seem risky because if we haven't done it before, it it goes against every or let's say that that choice might go against everything that we've developed in order to survive the situations that we've come out of. So now instead of arguing I'm going to be vulnerable, that's going to feel very scary. Yeah, Lori Gotautlib, a psychologist, was on this podcast and saying, and I totally subscribe to this, that people are more willing to stay in a bad situation often. Um, something that's not adaptive for them because it's familiar versus stepping into something that could be better for them. Yeah. Clearly better for them. And they can understand that cognitively, but they somehow cling to what's familiar. They I think that's just the way our nervous system is wired. Like you said, you know, staying in the battles, repeating the battles that are familiar to us that we know how to win. We just instead of authoring something new, we're plagiarizing from our past just again and again. Yeah, I love that phrase plagiarizing from the past even though it's something to avoid. How often should people do nidra at or where NSDR and at when what time of day? Um I think I think I've told you this before, right? The first probably the best time is to do something in the morning and in the late afternoon. Uh second best time would be in the evening and third best time would be anytime you you can. So it it's not easy, you know, it could be anywhere from 20 to 35 minutes, right? So it's not easy for people to find that based on uh find that time based on the schedules they have, but you know, set a set a time that you're going to do it. You know, when we schedule and have proactive tools, we don't know if we're going to need them in that moment. What it means is regardless of whether I need it or not, I'm going to do it. You know, it's kind of like I tell people with therapy all in about therapy and coaching all the time. Uh if the second best time to get therapy is when you're in crisis. The best time is when you're not. That's when you can we can grow. So scheduling proactively will allow us to either um maybe solve a crisis that we're in or help us have the tolerance in that moment. like I wake up stressed and I'm able to then do this this practice and then I'm not stressed or I wake up not stressed and I'm able to do this and it helps to build the ability for me to kind of drop back into that state because that's what I I I think as we practice things like yoga nidra um we're able to more quickly move from a disregulated state to a regulated state. I I don't know if you've had that experience. Definitely. I think of um stress and alertness and calm, all of it as the autonomic nervous system, right? Parasympathetic being calm, calmer states, sympathetic being more activated states. Um and I think of it like a seessaw. And I think, you know, when we're asleep, we're mostly parasympathetic. When we're very stressed, we're mostly mostly symp. So, it's the balance. And but the way I think about things like nidra is as a person on that seessaw you're you are that person and you're learning to press on one side and when you're stressed the hinge of that seessaw is very tight. So it's hard to activate the person that much more than when like you come out of sleep you're still a little bit relaxed perhaps um and then it's easier to push on that. So you might find that learning nidra is easier then. Um there's always value to to uh learning how to work both sides of the seessaw. And actually sometimes we need to know how to ramp up the level of stress as in the case with the coal plunge. We're deliberately activating the sympathetic nervous system and we're saying aha but I'm doing it as this kind of person surfing on the seessaw and so I know how to balance here so that when I'm there again I recognize this place you know. Uh so that's kind of how I think about it. Yeah. And and and also I have found in practicing you're going to draw your non-sleep deep breaths that it makes other practices easier that like when I want to do a five minute meditation you know and one of the things that I I I think is super valuable for people is to to set aside you know proactively schedule these times that you're going to do longer periods of of rest or of practice but also recognize that you don't you know there might be things that you can do for a minute or two minutes. So, this is what Pavl Satsulin, who is a, you know, world-class strength coach, who was on this podcast, talks about greasing the groove. You know, you want to get good at pull-ups, do two pull-ups every time you walk through the doorway from a pull-up bar. I I think metaphorically speaking, the, you know, like the workout in the gym, people think of that as the end point, but actually, you know, we used to do physical labor as a species, right? So, I look at the workout in the gym as the ability to lift boxes on moving day, to move furniture without getting hurt. I love going to the gym, but it's not an end in of itself. Same thing like a long run is the ability to go hiking with friends without having to train for it and not worrying about, you know, gassing out half, you know, halfway through. So, I think that these practices are preparation for real life stress. They're the gym for your mind. They're the gym for your mind. And we don't talk enough about emotional fitness and the world is clearly metabolically ill with obesity, diabetes, etc. But we are also dealing with a massive mental health crisis that I do believe stems primarily from an inability to regulate this autonomic nervous system thing because we can say well sleep's the foundation of mental health which it is and physical health a lot of people have trouble sleeping how to get better at sleeping get better at relaxing how to get better at relaxing yoga nidra and SDR and then you know so I feel like the tools exist and I'm so grateful that you pointed me in the directions of these tools and it can be very simple you know one of The teachers used to say that the the the breath is the mind made visible and if you want to change your mind change your breath I mean of course do a yoga nidra it might take 30 minutes right but if you're in in a moment where you're feeling really activated change your breath specifically like a long deep a long exhale I love that breath is the mind made visible it's beautiful uh and and so true that was desai I should give him credit okay wonderful it's the quickest way to to move us to to to create an activation of the of the parasympic nervous system quickest way you know and it this is where uh you know people will think meditation is so hard breath work which there's many different forms of breath work are are hard which they can be I I suppose you know hard in in the way that we've got to find the time and it can be uncomfortable but it you know I'll tell people take a minute and breathe and if you if even a minute sounds long take seven breaths. Like, who can't take seven breaths at any point in the day? You're going to do it anyway, right? We never aren't breathing. But if we can bring our attention to that and you can schedule that like, you know, I'm going to do that before I get out of the car to go to the office. I'm going to do it before I go to lunch, after a meeting, before a meeting. Or you can just say anytime that I'm feeling like this, I can I can take seven breaths. It might be end up being two minutes like a TV commercial. And those things add up and they they build on each other. And the more that we practice those, the more that we do raise that capacity to experience distress. First, it helps us activate that part of the system and teaches us like a like a like your analogy in the gym, but we also start building a habit around doing something like this so that we can weather whatever storm's coming and we start to orient toward it. I'd like to take a brief break and acknowledge one of our sponsors, Waking Up. Waking Up is a meditation app that offers hundreds of guided meditation programs, mindfulness trainings, yoga nidra sessions, and more. I started practicing meditation when I was about 15 years old. And it made a profound impact on my life. And by now, there are thousands of quality peer-reviewed studies that emphasize how useful mindfulness meditation can be for improving our focus, managing stress and anxiety, improving our mood, and much more. In recent years, I started using the Waking Up app for my meditations because I find it to be a terrific resource for allowing me to really be consistent with my meditation practice. Many people start a meditation practice and experience some benefits, but many people also have challenges keeping up with that practice. What I and so many other people love about the Waking Up app is that it has a lot of different meditations to choose from. And those meditations are of different durations. So, it makes it very easy to keep up with your meditation practice, both from the perspective of novelty. You never get tired of those meditations. There's always something new to explore and to learn about yourself and about the effectiveness of meditation. And you can always fit meditation into your schedule even if you only have two or three minutes per day in which to meditate. I also really like doing yoga nidra or what is sometimes called non-sleep deep rest for about 10 or 20 minutes because it is a great way to restore mental and physical vigor without the tiredness that some people experience when they wake up from a conventional nap. If you'd like to try the Waking Up app, please go to wakingup.com/huberman where you can access a free 30-day trial. Again, that's wakingup.com/huberman to access a free 30-day trial. People are probably starting to realize that overcoming addiction is about more than just white knuckling it. It's about more than just going to meetings, although that can be very useful. It's about having a road map of the day, having a plan, knowing what weather patterns to look out for internally and externally. It's about having a way to deal with distress, having a way to calm down. Let's talk a little bit more about specific addictions. Maybe I'll mention a couple different categories of addiction and maybe you could reflect on some of the unique features of that in your experience. not necessarily neurobiologically but in terms of strategies for confronting in oneself that those things right like strategies for trying to overcome the because I hear from thousands of people really about different uh addictions in themselves and and people close to them so um let's start with alcohol um what what is unique about alcohol addiction that uh people should know and this doesn't these don't these could be extensive answers they don't have to be, but that that could be helpful to them. You know, alcohol is a is an interesting one. A lot I think alcohol and and most drugs have a lot of similarities. Um although alcohol tends to be the one that is the most like socially acceptable. I mean, drinking is part of our culture, you know, and if you don't do it, you you catch some flak sometimes. Oh, yeah. I mean, I think some of that's been changing and some of it thanks to you. I mean, I can't tell you how many people that have ended up I've ended up talking to because they listen to your podcast on alcohol, you know, um, just from a health standpoint. So, people are starting to look at that. It's it's become, you know, it's less like the Mad Men 50s people drinking at at lunch, but it's still very much part of the culture and everything. H happy hour, happy day, you know? I mean, look at the You ever been to one of these retirement communities like in where people are retired and just drinking all the time or Oh, yeah. There's a a real stigma to not being able to drink for people. You know, I I I you know, I don't mind sharing. I've I've been sober for quite some time. And that was a that was a challenging thing. Like the first wedding I went to or the first uh you know, work event that I went to, I didn't know how to talk about it with people. Now I it it's no big deal. I don't it doesn't bother me at all. Um and if it does, you know, sometimes I don't like to be around people who are just getting wasted, but I you know, so I'll leave the wedding at 10:00 instead of two. You know, most of the people thought I was there till 2, but I I left it I left at 10:00 cuz they're they're doing whatever they're doing. But um it it's it's very challenging cuz you know having a glass of wine at dinner or uh you know a beer after work or you know thinking about you know people there's like a it was always a thing like the first time a dad and a son share the share a beer like there's a lot of romanticizing around it and I alcohol I don't I don't I don't think alcohol is evil. I mean, I think listening to what you've talked about it, it is poison, but I I don't like anything else in moderation, I don't think it's going to it's it's a terrible problem. I'm not anti-alcohol, but you know, what is it what is it doing to you and what are you using it for? Um I so I I think what the good side of that being part of the culture is when people can find a community like a 12step community or some other sort of peer community where people aren't drinking it can you know that is really what helps them a lot. You know they're not alone in this. And you know I think the movies and TV do a a a terrible job representing what 12step meetings are like. You know, it's usually like they show a circle in a church basement and everybody's talking about how they can't drink that day. Um, I'm sure you've seen that in television, right? And in in reality, of course, that happens sometimes, but most people are there really trying to use their that program as a design for living and to build really amazing lives. When you look at the 12 steps, when it comes to alcohol, alcohol is only mentioned in the first one. Everything else is about how you live your life. You know that first step is about admitting we were powerless and that our lives have become unmanageable. And powerlessness is actually an an awesome concept. I mean people will look at powerlessness and think that means I'm weak. That means I I I can't control my life. But really defining where you're powerless is is is the first step in finding great power. Because if I'm if I just keep going out every day and I start fighting a battle that I'm going to lose every single day, and even if it was an addiction, like every day I just go out and I am am, you know, taking on the the five biggest guys on the block when I'm a kid, right? I'm going to lose that every day. I'm not going to start winning until I realize I can't beat them in the way that I'm doing it. So, go do something else. You know, powerless. When we identify where we're powerless, then we can go find great power. And that's where the the concept of higher power comes in. And higher power to a lot of people is God and whatever their concept of it. Sometimes higher power is just the group of people and the community. You know, I I will see that anywhere from the relationship with God to like me and you talking is a is a higher power. Two heads are better than one. You know, I'm going to be able to reflect to you and you're going to be able to reflect back. I'm going to share with you and you can reflect back to me and help me see things differently and shift a perspective because a lot of our healing is just a perception change. Like I'm just going to see things a little bit differently than I did before. So that community and the ability for them to be in service to each other and help each other is is a I think that's the antithesis of I'm part of this drinking culture and and I that's not only unique to alcohol, but because there's such that you know there's not usually like a socially acceptable like you don't see crack advertised on television, right? You see alcohol and it's in it's in everything. Now, we do see gambling in on television quite a bit, which is incredible. Let's talk about gambling. I I like the way, by the way, that you frame um uh alcohol. It's being offered to us all the time after a certain age. And uh so it, you know, it's it's a challenging one for people that uh are challenged with alcohol addiction or alcohol use disorder. Um and 12step, I think, is right. It's free. It's in every city. It's um powerful um program certainly that there are data I should just mention this you know I think people will hear oh it's a cult etc uh there was a study actually that run at Stanford um some years ago we'll provide a link to the coverage of that study and the study which took a very objective look at 12step for the treatment of alcoholism and other uh substance uh addictions um and actually the investigators the people that ran the study were very skeptical going into And um the the results were pretty remarkable and they they they changed their uh initial perception coming out of it that it can be very very effective for people especially given that it's you know you can do it when you travel you go to meetings in other cities and as you mentioned it's it's not uh it's not the depressing picture that people think of a bunch of people whose lives are destitute in a basement. Sometimes people are coming in with some hard stuff but um there's often a lot of humor. There's a lot of common challenge that it's it's very it's very um there's a there's a lightness there that might a lot of people might not anticipate. People taking on life, not hiding from it. Yeah. Love that. Um gambling, not everybody that gamblings has a gambling problem just like everything else. Um but when it does become problematic, it's a it's a very challenging disorder to treat. I mean, it's uh I I don't know where the study came out of, but at one point I had seen some research that said uh that the highest rates of suicide were among gambling addicts. And what I've seen with that is it's like the their whole world starts to get really small. Um you know, it's weird because in the way that I look at it, it's it's really the only addiction if it's an addiction for that person, right? Not everybody that gambles is gamb. But the ones that are addicted, it seems to me to be the only addiction that the next hit can solve all your problems. So you're down $300,000, you could bet that and win it. I don't think anybody thinks like really thinks I mean in the moment they're probably out of their mind, but they don't think, you know, if I shoot this next if I take if I if I shoot heroin, my life is going to get better in the long run. They might be thinking it's going to get better right now because I'm not going to get sick. I'm going to feel good or whatever it is for them. But they don't they're not thinking that this is going to solve their problems. They know it's not. And so it it it it fortifies what you were talking we were talking about before is continuing to go after the hot fudge Sunday except they can they can get it, you know. And it's interesting because I've talked to different people and sometimes that the hit isn't in the winning, sometimes the hit is in the losing for them really. I've had people tell me that. I don't I don't really understand that, but I I think then they have to go back after it again. I mean, I I believe them, you know, they're the ones suffering from it, but wow. And, you know, it's becoming a real problem with kids. You know, there's a lot of sites to gamble on now. Um, you know, a lot of they can bet on a lot of crypto sites. You can bet on anything. There's and kids are playing in these online casinos that are probably operated overseas that are not regulated at all. And you know, casinos that are regulated become very wealthy, winning on a very small margin. I'm sure these casinos don't ever lose, right? They're making it up. Um, it's in our face all the time. It was uh I was reading Willie Mays died recently as a baseball player um San Francisco Giant uh before we were around. But he uh was banned from baseball for life. I think they ended up letting him back in because he took a contract from I think it was BS. He wasn't betting on sports. So this is in the 80s. He took a contract because he would go there and meet with their uh high rollers once a year for like a week just play golf with them, hang out with them. It wasn't he wasn't betting on baseball and he got banned from baseball. Now you watch a baseball game or go to a baseball stadium and different betting sites are uh different betting sites are mentioned all over the place. You watch any sporting event and it's it's out there and and that's not the only thing people are gambling on, but I don't know if you watch sports right now with the basketball on or you know the Super Bowl was on. I mean it it showing people with a phone showing that they're winning, you know, hundred there's a celebrity on there winning $186,000 I think the number was, you know, and then couple that with kids that are pretty susceptible already looking at those unicorn type people that are making millions on YouTube playing video games or poker players. Yeah, professional poker players or even ones that aren't gambling that, you know, they're out there and they became a a creator and they're making millions of dollars a year by having people follow them like that this this there's a way to make a you know that their significance is going to come from making a lot of money really fast, you know, and then they see this way to do it without having to work or anything like that and it's it's rigged to lose. I mean, they're they're going to lose. Dopamine without effort. Yeah, that's the danger. I was, you know, I've said it many times on this podcast elsewhere, too. It's like any high rapid inflection in dopamine that doesn't require effort. Aside from being a kid and your parents get you an ice cream or it's your birthday, all you were all you did is you were born. It's and to get those presents and you deserve that. It's your birthday. Great. But in life, like dopamine that doesn't require effort to obtain is um is the slipperiest slope. Yeah. And the gambling is not for the kids. Isn't just and and adults, but it's not just on betting on like what we think we might traditionally think of betting on a sporting event or something like that. It's, you know, we see it in cryptocurrencies. Not that cryp this is nothing against cryptocurrencies, but people going into it without any knowledge or any sort of sophistication and just putting all their money in it and you know up and down. We see it, we see more sophisticated people doing it as as as adults on uh in real estate investments or stock market stock market or owners of company taking big bets on things and and it doesn't mean that there's aren't people that are taking calculated risks. I'm talking about people who are like day trading when they you know and there are people that day trade and do great but then there's a lot of people that see this person day traded in great and then they they do it and don't do so great right it it their their lives collapse. So, are you seeing more people coming to you with gambling addiction? Yes. Um, it's not always then the primary thing though. There's a lot of people that are uh coming in with substance abuse or substance use or alcohol, you know, alcoholism and we find out that they're also doing that. The thing is people addicted to gambling aren't always seeking treatment. You know, by the time that they are ready to, they might not have the money for it. you know, they might not have the job with the insurance and and you know, if we are talking about insurance and treatment centers, there's not really a a benefit for long-term gambling treatment. You know, you have to kind of look at the anxiety and depression around it. And sometimes they get put in with people who are just who are suffering from anxiety and depression and we're not really focusing on the specific gambling issue. We also see people that, you know, they stop drinking and they're able to stay sober that way and they haven't really organized and ordered their life in a way that they're building towards something and that energy from the addiction of alcohol or drugs goes to gambling. Yeah, I was going to ask you about that. Uh we'll talk about a few other um patterns of addiction and types types of addiction, excuse me. Um, but this idea that when you remove the quote unquote medicine, there's a lot of distress and discomfort that comes up for people. And some people are able to white knuckle it as it's called. Um, some people can develop tools to try and work with that distress, become more distress tolerant. Um, some people will transmute distress sometimes. Yeah, it goes into running ultramarathons, which doesn't necessarily mean that it's an addiction, but um I've seen and we know some people who uh got sober and stayed sober basically by running a lot. Yeah. A lot. A lot. You know, do you think that that increased like V2 max allows for ability to handle distress better? Sure. I think that running can calm the mind over time. runners who run a lot, most of them are pretty tired or a little bit tired, right? Um, and maybe that's part of the solution. You know, if you have a dog that needs a lot of physical movement, you put into a small space and it doesn't get that a chance to run around. I mean, you see this in zoos and animals develop these what called stereotopies like you see the lion that's cutting a literally a trench in the dirt. It's really sad to see. you know, that animal is designed to roam. And you give an animal the opportunity to expend this energy that's stored up in its mitochondria and and it and it does and it can relax and it can sleep. I mean, they still have to do the work of getting sober. Um, these people, but you know, moving your body through space is a way of of of transmuting energy out of the body. So, you come home, you're like relax, you eat a meal, it's like there's a calming effect to endurance activities. For me, nothing changes my mind, my mood and nervous system better than even a 20-minute run. I I mean, I think they're also getting the benefits if you're walking or running, you're getting the benefits or similar benefits to what people get from EMDR. I mean, just the natural movements of the eye. In fact, EMDR, which is eye movement desensitization and reprocessing was the woman who discovered it discovered it by going for a walk and realizing when she put uh something that she was distressed by in her mind at the end of the walk, she felt better. Yeah. Francine Shapiro. She was in Palo Alto walking behind Stanford when she made that discovery. There's a um as long as we're talking about this, it's funny that this is coming up because I online behavior, gambling, um looking for somebody to get drugs from, you know, those are the foraging is where the dopamine is released. We were talking about this earlier and foraging mentally is the same from the perspective of the dopamine system as foraging physically through space. Think about what the dopamine system evolved for. It's like any animal, including us, searching for water, searching for food, searching for mates. We rest at night, but it's the it's the movement forward through space that satisfies that dopamineergic system. And in fact, the the major I don't want to go off on too much of a tangent here, but the the major system for movement in the body, not just reward and motivation, is dopamine. That's why people with Parkinson's lose dopamineergic neurons and they they can't generate smooth behavior anymore. And it's interesting that NIDRA and NSDR, the most impressive study in my mind, is the one that shows these big increases in dopamine from resting. So I feel like physical movement 65% increase in indogenous dopamine or something like that. It's incredible. There's something about still still body active mind that ramps up our dopamine stores and then prepares us for Does a dopamine store get ramped up when we're sleeping? Yes. So I mean I think that's the I mean the yog anecdotally they'll say that you know a 30 minute yoga nidra is equal to about 3 hours of REM sleep. I don't know that that's true or not but it's hard to equate. Yeah, of course. But I'm just saying anecdotally, you know, but it makes sense. And I think, yeah, there's some there's some truth to that basic statement or basic truth to that statement. I think that transmuting just the energy that would otherwise become distress or that starts as distress. Like when we're stressed, we need to get that out of our body. And I think that um drugs like cocaine and amphetamine, big increases in dopamine, then crashes, you're essentially dispelling the energy. I'm not so sure that it's always about pursuit. That that that's kind of like you said, it's like the the gambling addict that actually wants to lose. They want to lose, but they they recognize that they felt that that was the that was the hit or they felt one there. They I'm sure they felt it when they won as well. But well, when you're really low, the only place you can go up go from there is up. You know, when you're really high, the only place you can go from there is down. Yeah. This is so important because I I think you know what is discomfort? What is the distress we're experiencing? It's not our thoughts. We don't feel our thoughts. We feel our feelings. They call them feelings, right? Because we feel them. What are we feeling? We're feeling some sort of sensation in our body. Yeah. It's energy. It's energy, which is energy. And and when we're feeling that energy in an appropriate situation, like I'm feeling uh intense adrenaline and excitement when I'm going on a roller coaster that I like, you know, and I'll pay and money and stand in line to do that. If you wake up on a Tuesday morning in your bed and you start feeling that it's anxiety, fear, desperation, you know, it's still just energy in our body. And everybody will experience things differently. I could probably ask you because you've got insight, you know, if you're experiencing anger, where it is. If somebody asks me, you know, I can experience that in a hot belly, like heat between my eyes. My my shoulders feel really tense. You know, if I'm if I'm scared, where do I feel that? You know, I I feel like an emptiness in my stomach and a kind of tension in my body. You know, people can name it. And sometimes just naming it, you know, what it is versus kind of running through like I'm anxious, I'm afraid. Instead of saying I'm anxious or afraid, being able to go, well, my heart's racing, I'm feeling uh tension in my shoulders. Talking about the experience. And the goal isn't always just to dissipate it, but we can be with it. Because the the idea that I'm anxious and I can't get out of it then causes more anxiety. That's right. And so these practices that we can anything that we can build where we just kind of lean into the discomfort a little bit and then lean out, we start to build capacity. We pendulate through kind of activation and resource until we we have we have a larger range of motion. What about, and I'll bundle these, things that really hit the dopamine system hard, like in your observation, cocaine, empetamine being the the most salient ones, aderall, and other stimulants. Is there something unique to those addictions that you see in people that come in that give them kind of special requirements for how to overcome those addictions? Yeah, I mean, it's interesting. I think in the um up until sometime in the 80s, and I'm not going to have this right, they didn't even I think they didn't really see cocaine as addictive because it it you didn't become dependent on it like you would heroin or alcohol. Yeah. Somebody wrote a book called I think it was it Dr. Gold 1800 cocaine where they were starting to see that we could classify addiction as a psychological addiction. I might have that a little bit off, but I I I think it's somewhere in that in that neighborhood. There there's not a a physical detox from stimulants like amphetamines or uh uh cocaine like there is from heroin, opioids or alcohol and bzzoazipines. Coming off stimulants is really hard. It's really hard. It's really hard, right? But it's there's a obsession of the mind that gets triggered and it's this it's this psychological uh addiction that they can't seem to get out of. I would imagine that you could probably describe it what's happening with the huge surge in dopamine and then dropping off of it. I'm I'm not sure exactly where it falls in that, but you know there's uh they used to think that people couldn't you know recover from crack cocaine. That's what we were told. You do it once and you're addicted. I don't want to say that's not true, but there was no real evidence for that. It's just smoking crack aside from shooting cocaine like in introvenously leads to the fastest increase in dopamine. It's the rate of increase is just as important as the peak, right? In working with those. I mean, there's a lot of uh energy that goes into just having them kind of still. I mean, I think a lot of, you know, uh, stimulants kind of ma I I see it as they they help the physical body kind of match with the internal state of the of the nervous system. I mean, I think that's one of the reasons we see stimulants work for ADHD. I mean, you you probably understand the biological reasons, but it seems to me that it kind of levels out their experience. I mean, I I've seen people that that when they take stimulants, they get really calm. Yeah. Having a mismatch between your brain level of activity and your bodily level of activity is really rough. So, let's talk about some process addictions. Uh, these days I hear a ton of really um desperate stories, mostly from young guys. I've heard from maybe four or five women on this, but literally thousands of young men about porn addiction. Every time I hear about it, I feel so fortunate that I grew up in a time where or maybe I just don't have the the wiring for it. And if I did, I I would be I'm pretty open on this podcast. I I it's never been an issue for me. Um and they're telling me that they can't stop watching porn. I get the sense that they're not enjoying this experience anymore because they're reaching out to me saying, "How in the world can I quit?" And what do I tell them? I remember, and again, I don't know this study, but I remember uh somebody referencing many years ago when I was first getting in the field that porn addiction at the time, specifically related to um video pornography, which is what it all is now, right? Um it was having the same impact on the brain and young men as crack cocaine. I mean, it's extremely powerful. has a lot of other effects in that it sets up a very unrealistic idea and perspective of what sex and intimacy is. You know, it also uh can help uh or can lead to kind of setting their sexual template. You know, they can quickly escalate just like you would escalate. you kind of back to the the um uh hot fudge Sunday where it doesn't work anymore from you know something that might seem like normal sex to violent sex to really out there things that um can bring a lot of shame that they're even watching and it can escalate quickly and then have an impact on their own lives and relationships because they're playing out those relationships or that amount of intimacy intimacy depending on what are doing also if there's masturbation along with it in in a fantasy. Well, what I'm also hearing is that anytime they are in a real life intimate scenario, which seems to be fewer and fewer times nowadays in the younger generation, that they're having sexual uh anxiety, sexual performance issues, which makes sense if they're if their brain and nervous system is getting wired by porn to observe sexual behavior as opposed to being in the experience of of of intimate sex behavior, right? two different things to be in the experience versus watching someone else's experience of it which is what pornography is. Yeah. This was probably 10, 15 years ago where we were treating some but we treating a lot of soldiers that had come back from Afghanistan or Iraq and you know they had access this was like the first wars where they had access to the internet and there's a lot of other things. So there was a lot of uh kind of uh combining of sex and violence, right? they're around a lot of violence and then they're watching sex and then that kind of sexual template would set around like in order for them to get pleasure out of sex it would need to be aggressive or even even violent um or risk very risky you know so there's all these things that kind of collapse together there were other things going on was like the first time that they had also really had access to video uh uh video chats to be able to like be on a battlefield and then come back and be talking to their spouse house about something that's going on with the kids. It was very confusing in environment for uh those guys and men and women. Um you know the the porn addiction is a is a tough one you know because it it's everywhere. I mean now you can find it on any social media almost not maybe not anyone but it's not really limited you know and and even if it's not you know I know certain states have just put in where you have to put in your ID to get it but there's tons of ways around that and other sites that that people can go to and I've run into that with a lot of it does seem to be young men you know and it's a way for them to play out some sort of fantasy around connection and relationship and it's it makes their world really small. I don't think it's the same as gambling, but it can make it it can make their world very very small in that they're instead of finding relationships out in the world. And it's not necessarily a relationship, but they're what they believe they're getting out of a relationship, they're then getting out of watching porn. It seems like basically stopping completely is the answer. And people say, and I'm not trying to moralize here, right? I'm not telling people what's moral about this. I just know that any behavior or substance that leads to quick repeated inflections in dopamine is going to create a groove in the nervous system where you're going to crave that thing and it's going to give you a lower and lower sense of satisfaction over time. And the only way to reset that circuit is to stop and do something else in its place. Ideally, that's adaptive. These are people that are asking you how they can stop. You know, they're telling you, I can't stop. how do I do it? So, it can be similar to other addictions, you know, I mean, first the admission part that it's a problem or awareness it is and then being able to start to to talk to somebody and start to take some accountability around it. Not accountability like you're doing something wrong, but to be able to have some sort of identify the behaviors that start leading to that. You know, I mean, there uh that can be done in therapy. There's other 12step groups that can help people with that to identify what their sobriety would look like, if you want to call it sobriety, what it looks like. And if it does involve not watching any porn, then that's the rule set that they have. And then they figure out either with their therapist or in their treatment center or with their sponsor or community in 12step like how am I going to be held accountable to that? And that might be doing the things like we talked about laying out looking at your your day ahead. at at the beginning they might need to look at things like you know uh there's ways and software out there to not be able to look at that on your phone or have an accountability partner that can you know you have to they have to approve websites you go to and and that that that's not to say that they have to do that forever but it's something that's available right you know 50 years ago or 30 years ago someone had to like find their dad's porno mag somewhere and then look at it you know now it's on their phones or computers well we know that accessibil increasing accessibility increases addiction. Right? This has been studied over and over again and people say what about red light districts and things and there's some caveats that have to do with when you uh create areas within cities where certain things are allowed but you know this has been tested many many times. Um it's also true and it's kind of a duh but to quote on ampki it's impossible to get addicted to a substance or a behavior that you've never taken or engaged in. Right. So some things are best avoided entirely. Um, are there specific 12step programs for porn addiction that are separate from say sex addiction? If you people look it up, I'm sure there's meetings out there that that are specific to that. There are um some treatment centers that have tracks that deal specifically with that. There's therapists that work very closely with that. And I I believe that there are some 12step I mean there's pretty much 12step programs for any sort of you know within things like SA or SLA there'll be subsets of meetings for people that are with a very specific condition. And one of the reasons I wanted to discuss this today is because I hear about it so much is unlike alcohol or drugs, there's a a kind of extra layer of shame associated with with pornography addiction for people. Um, you know, so many times we've heard, oh, like this celebrity was a alcoholic or drug addict, you know, wrapped their car around a pole, was arrested, this and that, then they get sober and everyone still loves them loves them more, right? If we knew that a given celebrity was like a porn porn addict or something, we look at that person differently. Yeah. Especially if they're male, we just look at them differently. And so reducing some of the shame around it, I think, is key to to helping them recover because I can tell you there's the the questions initially came in kind of like as is often the case with with men when they're trying to talk about issues that they were kind of cloaked in like what are your thoughts about nofap, which is this thing where guys um withhold ejaculation, okay? Does it increase testosterone? Turns out in the short run it does, in the long term it's probably not good for the prostate, etc. But then what it turned out they were really asking about masturbation. they were really asking about pornography and then all of a sudden I don't know what changed out there but there's been this deluge of of questions from young guys of how they can stop engaging in online porn. A key to that is what you said about we look at them differently. You know, they're going to keep it secret, you know, and there's a saying secrets keep us sick, but I believe there's like a real almost a biology to that. And that, you know, if you're holding it in, not sharing it, you know, there's no really place for it to go but shame. And shame separates us. And separate, we're not connected. And not connected, we're alone. And alone, we're, you know, we keep carrying that forward. Alone, we're dead. You know, maybe not in that sense anymore, like we talked about earlier, but like we're not really living. And so they're, you know, these guys are hearing you on a podcast and then DMing you, right? They're probably not in a personal close relationship with you, right? it's it's easier to send it there than maybe go ask for help with somebody in their area or go to a meeting or something like that because of the the stigma. So, it's good that you've opened up the ability for people to do that, but to continue to direct them back to, you know, let's try to treat this like we would any other addiction at least from the standpoint of you've got to talk about it. You've got to have some sort of admission. You've got to be able to find a community around it. You want to be able to do work, you know, most likely with a therapist or a team of therapists that can help you understand what's driving that behavior, you know, and I I, you know, you and I have had long discussions about trauma before. That's something I've I've I've worked with for many years or most of my career as I came into being a therapist. Um, you know, and in trauma therapy, we're often going back to seeing like find we do a history and really kind of understand where the patterns started, you know, and I it's really helpful, you know, for me as a therapist when I can see where it is because I can start making sense of how people are behaving this way as adults when I can see all of the experiences they had and especially the the the more negative impactful ones which tend to impact the brain. Like you always say, fastest way to plasticity is through a traumatic event. Um I believe that's how you say one trial learning. It just takes once unfortunately. But luckily there's plasticity in the other direction. It just takes a little bit longer, right? I think that's where addiction comes in too because you know you can kind of feel a sense of plasticity, you know, if I'm if I'm drinking or if I'm doing drugs, right? I don't know if that's the actual term for it, but I'm not feeling like my brain is so stuck in that direction. You know, I can I can act a little bit differently. What comes to mind for to kind of encapsulate all of it because it gets to the underlying mechanisms, I think, is, you know, beware the things that come easily and quickly like really beware those things. If it's pornography and you can get to experience, it's not the experience of sex, but the um the illusion of pseudo sex, right? Right. If it's if it's easily available, beware of that thing. If it's a feeling of relaxation from a drink, beware of alcohol. Yeah. If it's um fast money. Yeah. If it's you you are very proficient at um you know you find you you know lift a weight you build muscle you get attention for it beware that thing because there all these positive reward signals that are masking what soon will happen which is that that thing is going to make you lopsided internally and make you crave it more. And so I think that there there's something about this uh things that come easy it's a problem. And I think I kind of like that in the sense that um because many people are struggling and we don't often uh glorify the struggle. We're all we're all trying to you know struggle our way out of struggle. But struggle is distress and as long as we're struggling, we're in the distress tolerance. I'm not saying people shouldn't aim to succeed, but um and and forgive me for going a little long on this reflection, but I remember in graduate school, I had a paper that got accepted by the journal Science, which is like one of the three apex journals, Nature, Science, and Cell. And I was like over the moon. Yeah. I was like, "Oh my god, like this is amazing." Like first author paper in science. Like some people never do that in their career. I was doing as a graduate student. And um my dad who's a scientist said, "Prepare for the week afterward when you wonder if you'll ever do it again." I was like, "Okay." Kind of a postpartum crash. And then my graduate adviser, I said, "Do we get to celebrate?" Like, "Do we get to like throw a meal or a party?" And she goes, "No." Like I suppose I could buy you a pizza, but that would be stupid. This is perfect chap. And uh very blunt. Um, and she said, "No, the pleasure was the work of doing the paper." And I I was like, "I got it." And that's what taught me to repeat that process. I didn't always publish in science, but um certainly in other great journals again and again. It's like that that the reward is in the process. Like the effort is the reward. And if there's no process or no effort, I mean, and we don't struggle, in one way, we're struggling with so much and in other ways we don't struggle, you know, with the stuff that we probably need to struggle with to move the energy out of our body. You know, I mean, Michael Easter's book Comfort Crisis is great. You know, it's it's like, you know, we used to walk like 10 miles a day and, you know, we're not burning that energy. So, we're just sitting there with this energy that used to just get disseminated or we'd like wake up in the morning, have move through the stressors of the day, good, bad, and different. You know, even good things are stressful. If you have to go to three birthday parties on a weekend, even if they're fun, you're you're tired at the end. Sounds like a dad. Yeah, it is a dad. I go to a lot of birthday parties and try not to get sick because of, you know, at them, especially when they're at these little indoor ballping kids. But what's interesting, Michael Easter, you know, with the comfort crisis, I mean, doing these hard masogi challenges, he calls them, you know, I mean, think about like self-imposing discomfort so that you don't get pulled into the illusion of of comfort by these other things. I mean, the I think it's coming clear to me now that the things that come easy are the traps. Yeah, they're the traps. So folks, if you're really good at something, doesn't mean don't lean into it. But if something comes really easily for you, you have to be very mindful of that thing and other things around it. Sounds like you create a discomfort for yourself. Maybe there's like a discomfort um appetite that if we don't satisfy through healthy things, we will satisfy through unhealthy things. That's a very interesting concept. I mean, I don't know where that would exist in the nervous system, but because you hear, oh, we're trying to avoid pain and go toward pleasure, but those models are that's true, but those models are too simple. So, I like the idea of a ration of discomfort to experience every day, isn't it, that we're kind of built to expend energy and then sleep and then wake up the next day and expend energy and sleep. And if we're not expending the energy, how can we sleep and then we wake up with more and we just carry the stressors from the day before rather than just breaking it down. I mean, that's that's one of the beauties of, you know, recovery where they talk about one day at a time. Well, one of the um you know, this last couple weeks, there's always something each year that really pops that gets kind of viral overnight. Last year it was the Hakua girl. This year it's the morning routine guy, the guy that he shows his morning routine and it got millions and millions of hits. And um this guy does cold water on the face. He's working. He's praying. He's doing all these things. He's he's wearing no shirt. He's super jacked. Like he was getting attention for different reasons. Anyway, huge following and uh the best comment ever was, "Oh man, this guy's going to come after me. Uh he seems like a like a like he's got his life organized." Someone put a comment, "This guy spends all day preparing for the next day, which is, you know, the worst thing about optimization, right? The whole purpose of tools like sleep or [ __ ] and all these things that you can, and you taught me this, really good protocols let you lean into life more, not less. It's not about withdrawing and getting into a wellness loop where you're just preparing for the next day, right? It's about being able to lean into the third birthday party where you're like, and the kids are sick and you know, you're being exposed to all this stuff, but you're there because your daughter needs to be there and she's elated to be there. Yeah. Can we put on the shelf that perhaps we have an appetite for discomfort that we can either satisfy through healthy things or unhealthy? I think that's a a good way to put it. Can we call it the suave hubman? We can call it that. We'll go suave. It's fine. Addiction means that somebody's already in the pit. Like they haven't done the the okay, I have an appetite for discomfort. I need to satisfy with with adaptive things. um they're in the pit. So, if you would um if people out there listening are in a place where they're like they know they're something's got them as opposed to them having it where they're wondering or someone they know and it and especially if it's somebody that they know, what what do you suggest? I mean, this isn't kind of like call the suicide hotline. I mean, unless they're suicidal, obviously. I mean, a lot of people don't have means to like start therapy with a world-class addiction therapist, trauma specialist. Some do, some don't. What do people do? Um, well, there are a lot of, you know, options for people out there. You know, sometimes they don't think that they have them because they don't have means, but, you know, in in our centers, we, you know, strive to create access and I know a lot of others do, too. So, it's not just people that pay with out of pocket. There's insurance and you know, we build some quality treatment centers for people with Medicaid in different states. You know, that's um we don't know what's happening with that at the moment, but you know, it's uh currently they can get treatment for that. So, if they're in a state where they needed like detox or, you know, they're in a place where if they try to stop drinking or using it gets uh pretty significant, um there's services out there for them. Another great thing though is to just go straight into a a 12step meeting. They're everywhere. How do people find those meetings? They go online, Google 12step in your area. If it's, you know, there's narcotics anonymous, there's alcoholics anonymous, there's cocaine anonymous, there's overeaters anonymous, there's gambling anonymous. I mean, if you every one of them has a central office. The organizational structure, especially of like Alcoholics Anonymous, is really incredible. We could do a whole episode on it. There's no there's no leaders. It's a very flat organization, politically unaffiliated. Politically unaffiliated. They have a vow of poverty. If somebody died and donated a million dollars, they can't take more than 10,000. Really? Yeah. There's only trusted servants. There's no leaders. The the there um there are people who are employed that do administrative work, but everything else and it's been like this for 80ome years. It's it's really quite incredible. And there are online meetings. There's online meetings. Um they're all over the world, you know. Um you can find them at any time. That's one of the beauties of of of 12step meetings is that, you know, I obviously I'm a therapist. We have treatment centers. I I um it's nice to get people to come to those and it's it's great for people to be able to step out, but there's things that we can do that they can't. I mean, they're not going to medically detox them. They can't keep them out of like, you know, in a safe environment for a period of time. But a kid with a porn addiction, somebody who's abusing alcohol or addicted to food, shopping, gambling, they can find a meeting. They can find a meeting. Yep. They can find a meeting. And you know, I always tell people to try six different ones. They're free. you know, you're going to find your group. I mean, listen, they're they're they're run by peers. So, this is like something that was developed as it would be like if somebody developed a therapeutic modality 80 years ago and then passed it on to everybody that they gave they every client they had and then they they ran it. I mean, it's not it's not run by professional counselors, although there are professional counselors in them. There's every walk of life from I've you know, been around people who are anything from priests to rabbis to to doctors. there's no prejudiced in the in the in the disease. Um, but you know, you can build a community where people are willing to help and be in service to each other. And you know, you can't call a therapist any time during the night. You can't just look up and find a meeting and and go. And at this point with things online, you could find a meeting 24 hours a day anywhere. And the meeting is not going to solve it necessarily, but the fact that you're uh moving in that direction. You know, you're spending an hour if you're spending an hour thinking and reflecting and talking about it. Even if you're not like in silent meditation, it's almost like a meditation. If you're spending an hour hearing people talk about how they recovered and helping you, it's an hour that you're not doing the other thing. And in the beginning, that might be the white knuckling of it, right? But the idea is to get out of white knuckling, you know. And so the beauty of the 12step programs, which was founded by the guys that started Alcoholics Anonymous and then it was Dr. Bob Smith and Bill Wilson. And the way they discovered it was by helping each other. Bill Wilson had been uh trying to get sober for a long time. He'd been introduced to something called the Oxford group, which was more of a religious group based in Christianity. and they had like a four I think it was a fourstep process um which the 12 steps are just kind of really expanded on. Um, but there's a there's in in the literature there's this beautiful moment where uh Bill Wilson had been trying to stay sober for a while and he was, but he was really white knuckling it. And he'd been at his home in New York, he'd been going into the hospital and and helping others. And he found by trying to help others, he stayed sober. And he's a guy that had struggled for a very long time. And none of those guys were staying sober, but he was, which was kind of he first kind of conceptualized this. And then he was on a business trip in Akran, Ohio, which is where this Dr. Bob Smith lived. And he he was staying at this hotel. I think it was called the Mayflower Hotel in the in the history. And he had come out of a business meeting. I think it didn't go the way he wanted. And he he walked in and in in the story, he's describing hearing the bar and the kind of clinking of the glasses over here and and the kind of the call of the bar. and he had some change in his pocket and it was in the 1930s, early 1930s. Um, maybe 34, 35. And then there was a bank of phones over here. And so he was kind of pulled between the the bar and the phones and for whatever reason he went to the phones. He paused and he went there and he called I forget who he called, maybe the hospital, and he he he asked if there was I think he basically asked if there was any drunks in the town he could help. And they directed him to in some way to this this doctor who was like the local town doctor, Bob Smith. And he was uh also an alcoholic who struggled for a long time. And they met and he I think he went to his house or he might have been in the hospital at the time. I could have the history a little bit wrong. But they met and started talking and I think Bob relapsed one more time. But they started talking and helping each other and then they went and helped another guy and then they went and helped another guy and there's a whole history to like how it it developed and then how they wrote a book together. The book was really meant to send it was written like four years later send the information about alcoholism and alcoholics anonymous to everywhere in the country where they didn't have meetings. they started having the these meetings and helping each other through this step process that they they they developed. And um it's really interesting because this was one man's decision, you know, instead of going to the bar or going to the phone, instead of going to the bar, he made one phone call and that transformed millions of lives. I mean, there's millions of members around the around the world. you know, he was like I think he was called either Time magazine or Life magazine's hundred most influential people of the of the 20th century and there's still people who find recovery through and then they gifted those steps to all of the other things like Cocaine Anonymous and Alcoholics Anonymous and you know it's not for everybody and they'll even say that in the literature. That's why I don't I wouldn't consider it a cult because I'll say we don't have a monopoly, you know, and of course you're going to meet personalities in there, but the the organization itself is agnostic to religion, to ideas, to politics and it's a place that people can come with a common problem and find a common solution. And these meetings can be the place that hold people as a container. You know, I always see our treatment centers as like a container of space and time where people can come in and really kind of let themselves fall apart and we can start helping them build their life back. But these 12step meetings are like a container and they have a you know people will people are you know excited in there to reach out and connect with with you. And it's in those moments of connection that we can really find healing. I mean, look at what happened to him. Instead of going into the bar and connecting with the people in there and drinking and, you know, he had enough evidence to show that drinking would, you know, it it didn't take him in the right direction. Um, he was able to make a phone call, connect with somebody else, and it created all these connections later on, you know, and it's not a place that people go just to white knuckle it. I mean, that's how they might get in there. Nobody usually comes there because they, you know, had one bad night of drinking. It's usually, as some people say, no one comes in here a winner. you've been on a losing streak and uh and that's okay. But to be able to admit that and really discover who you are and share that with others and find frivolity and joy in in in in like in the depths of people's pain and they can really understand that there's there's hope, there's promise and there's a way out. And these people who are struggling aren't going to necessarily find that in their their first meeting, but they might get the hope and the connection with others. And so they're available out there. And if you don't like the 12step and the the the spirituality, there's other recovery programs out there or other peer support groups out there like Smart Recovery or Refuge Recovery and and they'll talk about things in a different way. So, it's not about like finding a specific dogma. Go out and try different things. You know, even the act of trying different things is going to help them move out of being stuck in that if it's like the porn addiction, right? Um, and then people do reach a certain point in acuity, especially with drugs and alcohol, that they need to be in a facility, you know, and that might be a hospital, it might be a treatment center. Um, and you know, you can there are resources for that. I think it's a good place for people to start if they don't have the resources to be able to attend a treatment center or work in therapy. Thanks for sharing that that avenue for people um with all sorts of uh addictions not just alcohol and for the families. Alanon for the people is is for the families. There's codependence anonymous. There's families anonymous. There's uh adult children of alcoholics anonymous or adult children of alcoholics is really about uh um dysfunctional family systems that people might have grown up even if their parents weren't alcoholics. So there's there's stuff out there for for everyone. Prior to this conversation, I solicited for questions from the internet about addiction, broadly speaking, and got some great questions. The first question is, is addiction the problem? They put the in quotes. Or is addiction an attempted solution to a different but less obvious problem? The short answer to that is both. the addiction is really the solution to some sort of discomfort or stress that they're experiencing, but then the addiction itself becomes problematic. I would say that addiction is the solution in the sense that it's the person's attempt to solve or to find relief from whatever stressor they're experiencing. Um, but it's a solution that becomes problematic. So, it takes on a life of its own. It becomes its own trauma itself. you know that drinking alcoholically and blacking out is a trauma to your body, to your brain. The things that people do in addiction become more traumatic. I think there's this cycle that I always use in the background called it's trauma, stress, and addiction. And expanding the definition of trauma to wound, it starts with a wound and then stress is the relationship to that wound much like a limp after a broken leg. And when stress gets big enough, people look for relief. And so they look to behaviors or substances which then can if the stress is big enough and repeated can become alcoholic. So um that stress is not really the wound, it's the relationship to it. Like I said, the the limp after the broken leg, but that limp, while it's not the broken leg, informs how we walk or don't walk, how we run or don't run, how we view ourselves, how we view the other people in the world view us. And all of those things together can lead to a level of stress where people find relief. And since it's chronic, then they they keep they keep using, but then the behaviors and things that they do while they're using or drinking create a trauma itself, which then leads to more stress, which then leads to more addiction. So it becomes kind of this perpetual motion machine if you will. So the medicine becomes the source of stress. Yeah. Are GLP-1 agonists things like ompic, wiggoi, etc. being used for addiction outside the context of weight loss? Interesting question. And will this happen in an official capacity or remain off label use? They're asking your opinion. Um, are GLP1s being used to treat addiction to food? And do you think it can be useful for uh treating addiction to other things? I believe that there's some initial research going on that it uh it can help with uh cravings um and addiction in general. Um it makes sense to me. I mean, I've I've heard that anecdotally over the years that people that were diabetic and also alcoholic, but the diabetics that maintained their blood sugar properly had less chance of relapse. I mean, there's this very simple uh kind of an acronym called HALT. You may have heard of hungry, angry, lonely, tired, which seems so simple. It used to drive me crazy, but it's so true that, you know, people tend to be at higher risk for relapse or using when they're either hungry, they're angry, they're lonely, or they're tired. And sometimes those things are all together. And those are times in which I would imagine uh their system is looking for something to uh I mean, if you're hungry, you're looking to elevate your blood sugar. And if you can maintain that, uh, I would imagine that it would have some interesting effects. I was just at a, um, a meeting with some of the executives of the major insurance companies, our our company, uh, and has a private meeting with them and they were talking about that's some some of the things that they're looking for. I don't know that I'm sure it's been used off label, but I don't know of anybody that's using it yet on label for for any of that. Can somebody be addicted to stress? meaning are habits addictions? Those are sort of two questions. Clever. This person snuck in two questions. First question, can somebody be addicted to stress? I think that people can be set have their nervous system set in a way that they need that level of stress or activation in order just to kind of get to baseline, in order to kind of feel alive. You know, I I've seen that a lot when I worked with when I've worked with um especially special forces combat veterans, you know, coming home, like a lot of the mundane stuff almost didn't feel like they felt alive, you know, and of course, this isn't everybody. This is the ones that were coming to me, but that they needed to be involved in like really risky behaviors or really uh high adrenaline behaviors kind and it felt like they were just getting to kind of baseline of being normal. It wasn't even like taking them to another edge. Um, and you know, that makes sense to me because a lot of like what basic training or the training that they do later on for more special forces is while it's skills training, it it's really nervous system training, right? It's it's the ability you you could it's it's the ability to do those skills under an extreme amount of stress or lack of sleep and and everything like that. So if they're kind of oriented in that way, then when they come home or they're in environments where it it doesn't it takes a lot to bring them up just to that level of like what might feel normal for them. Their their kind of system is set up much higher than here and they've got to get up to that to just feel alive. So I I don't know if addicted it maybe it is addicted. I feel like they have a need, you know, it's a drive. It's a drive. Intensity addiction. Um, that's a you and I know some people with that. Yes. Yeah. I'd like to know about social behavior addictions, social media, coffee, sugar, even work addiction. And as always, thank you for tackling hard topics. I guess that was directed toward me, but you're the one who's about to try and tackle this topic. So, um, are all are those things really addict addictions? Are people addicted to sugar, addicted to coffee? Do they meet the classic definition of of addiction? Well, they're not going to meet a a a diagnostic criteria for progressive, etc. What is the diagnostic? It's always this progressive. I don't know if it was was it on your podcast or did I read about this somewhere else where when they took you know there's the classic study about taking rats with cocaine and they'll they'll they had water and and uh uh cocaine and they would like press that lever thousands of times to get the cocaine. Somebody else repeated that but added one that had sugar in it and their cocaine uh use went significantly down when sugar was also present. Well, meth addicts will consume sugar and meth more readily than either one alone. I mean, I we see this different drug. We see this when people get sober, you know, that, you know, there's people that will get very heavy. You know, they'll engage in what looks like a food addiction. And when we peel that back, I can't tell you how many times I've heard of, you know, people recognizing their first addictive behavior is going to the sugar bowl and, you know, taking spoonfuls of it. that I've I've actually heard people say that uh food addiction and probably specifically around sugar is often the primary addiction for people. It's kind of like how they get in get in get in there. I don't I'm sure that's not true for everybody, but I I think if we broaden the term of addiction beyond what um a use disorder is in the DSM and move towards do you have it or does it have you? Absolutely. I mean, I don't think we can become sugar dependent in a way that if we stop it, we're going to go into some sort of major withdrawal, but I would imagine there would be some sort of withdrawal. Same with caffeine. I've seen people go into psychosis with caffeine. I never want to find out what happens if I quick. You might just always be in psychosis. Caffeine psychosis. Thanks for that. No, not you. I meant all Yeah. I mean, I love caffeine, but I keep that out. I can sleep on No, no, that's fine. I actually can sleep on it, too. Like, well, I don't I don't I don't drink caffeine past 2 p.m. Occasionally. I don't either, but once in a while I do, and it doesn't You're definitely getting less REM sleep in there, but but you look rested. So, not last night. Um lot of questions about Ibeane probably because um the incredible work of my colleague Nolan Williams at Stanford with these single Iagain trials for people getting over alcoholism meaning one taking Iagain once or twice and uh mostly in veterans was covered on the uh Rogan podcast and Nolan's been on here. What are your thoughts on the use of Ibagane and other psychedelics? Let's leave MDMA out of it because that's more for the treatment of trauma and it's not actually a classic psychedelic. But things like psilocybin, ibagane for people seeking relief from alcohol and drugs specifically, but maybe other addictions. You know, I've seen some pretty incredible things happen with people. Um it's uh I and I'm glad that the studies have been going on specifically around psilocybin in the US. I'm not really aware of any around ibagane. So anybody that is doing I gain treatments are either you know I don't know if they're finding it in the US or they're going to Mexico or wherever which has to be done in Mexico they're doing the brain scans at Stanford before and after okay it's not currently in the new admin so they are doing some studies around it the rates of remission from alcohol use disorder and other uh substance use uh disorders is somewhere there's a range but 40 to in some cases 80% um with one or to Ivagane trials but this is with therapeutic support there are a bunch of other things happening there and then there's evidence of brain plasticity in a number of brain areas yeah so I don't know enough about the studies happening before like they were doing this where Stanford was doing a study and taking people down to Mexico or people going down there to do it was kind of a lot of uh I don't know how else to say it but renegade folks doing it outside wasn't always you know run by medical teams and people making sure that everybody is safe uh at least from my experience although then I've seen some amazing things around it. My general take on psychedelics. If I look at PTSD, post-traumatic stress disorder, I really see that as you could almost substitute state disorder in there for stress because people get stuck in a certain state and call it the survival state. And you know that's as I've said one of our biggest challenges is that we go into survival mode when we don't need to go into survival mode, an appropriate response at an inappropriate time. And so things like psychedelics or we actually can see this with breath work and can help people have an experience where they uh recognize another state, you know, that they can be in another state, not not another state of the US, but like uh they have access to something other than survival and those touchstone experiences can really give them something to build on. Um, I think like any other approach to medicine that seems miraculous at times, there's a lot out there of this worked for me, so everybody should try it. I there's what I'm most concerned I'm not concerned about the effectiveness of overall of psychedelics because I think there's definitely a place for them, but I'm really most concerned about the ethics that we develop around them. Who's delivering it? What are the rules? You know, I know we weren't we were going to leave MDMA out, but I know some of the MAP studies it was like three sessions. I think it was over and I I I I don't think that the the world that kind of sees those is then taking that, especially in the personal development world, and going we're going to do three sessions. It can kind of come be something that we do all the time, you know, or micro doing all the time. I don't know enough about it to see if that's going to have an impact. And you know it there are people with psychological and psychiatric disorders that it can really impact in in another way you know schizophrenic bipolar and you know you know I look at it like you know antibiotics like penicellin saved a lot of people but then there's people that it kills right I can eat peanuts and uh get protein out of them and I know people that eat peanuts and they can they can die so we lousy source of protein by the lousy source of protein eggs let's say uh but there there's a real we need to really understand the ethics around it and the and the time frame and then make sure that people are following that up with something because I think you've used this example before of like kind of being on a trampoline and you can jump up and see the top of the building, you know, and you can see where you want to be, but you haven't built the staircase or the elevator yet. We got to go out and build the staircase and the elevator. So, I think they're a great window into how we can be and an experience of this person that I can be, but I don't think that there's going to be like some immediate structural change that's going to last. And the danger in that is then people start using that over and over again and can lean on that as a as a as a crutch. Last question. If we know somebody or are close to somebody that's clearly suffering from addiction or struggling with addiction, what can and should we do? This sounds like somebody who is aware of the all too common scenario of this kid, this parent, this co-orker, this significant other is clearly an alcoholic, clearly a drug addict, clearly addicted to fill in the blank. What can people reasonably do assuming that person is not in a uh medical crisis yet? I think one of the biggest things we can do is is is is talk to them, but also without shaming them, you know. Um, and if you don't know how to talk to them, reach out for some help yourself. You know, there's, like I said, there's there's family support meetings like Alanon that you can go to. Um, if you reach out to a treatment center like ours, you can um we're happy to talk to the families and and help point them in the in the right direction. Uh but having an open conversation without shaming them and understanding that this is a you know approaching it with the idea that this is a disease and a and a like a like like we're talking to a sick friend not that we're talking to a bad a bad person. Can I ask slash offer one which is if uh if a 12step meeting is an open meeting as they call it like an open AA meeting you could offer to go with them uh when they do the round the circle thing you if you go and you don't want to say anything you just say pass no one no one and a lot of places they don't even do around the circle so you can you could go with them to you could take them to a meeting. Yeah. As long as it's an what's called an open meeting. You don't have to be an alcoholic or an addict to go to that meeting. And so you could take them, you could even go and just observe. Believe it or not, some non-alcoholics have come to 12step meetings that uh were open meetings to learn more about it to then be able to go help somebody that they know and and reach out and find a a a therapist that can um do an assessment in our mission to create access. Um we have been really doing some kind of innovative stuff around virtual care and inhome care. So when there are people that are resistant and maybe if they even it is true that they need to go to a residential treatment center that we can offer this different service that's much lower cost and covered by insurance that we can come in and kind of build a relationship with them and you know in some way sometimes it it it works for them and they're able to to move through it and other times we're able to help them witness their failures and then have h having done complete assessments with them get them to the correct level of care and make sure that the family has everything they need. So those options are out there as well. I've seen the work you do help so many people um so so many people and so I'm just very feel very lucky uh you come on here and share with a lot a lot more people. Yeah. And I'm sure you'll get some outreach. Well, we'll put links to uh where people can find you and some of the resources and things that you're up to and um and the papers and other things mentioned. But yeah, on behalf of myself um and everyone listening and watching, I just want to say thank you. you're doing incredible work. I was uh reflecting on this a lot before coming out here, but you know, I I really appreciate what you do in the world and especially knowing you and knowing how and why you started it. And there wasn't this grand vision at the end. It was like, I'm just going to help people today. I mean, you literally was like, I'm going to help people today. I'm going to write do these little diagrams and these little things and I'm going to help them today. and helping people today and the next day and the next day, you know, has led to you having such an impact in the world. You know, I you I was telling someone on your team earlier, your work makes my work easier, right? I've had men specifically, mostly men that come to me more open because of what they've heard you talk about. And conversely, I've had men that we're working with that are very closed off and then I'll have them listen to something that you've done and it opens them up. My wife wanted me to tell, you know, she's a therapist, too, and she was running a group this morning with a group of kind of more uh mentally ill folks and they were doing a group on stress management and she used a video of the physiological sigh. So, she wanted to say thank you for that. But I know lots of therapists that are using that and it it's it's just you make our you make our jobs easier by bringing awareness to the the challenges and problems that are out there. So I really really appreciate that. Plus I just appreciate you as a human being and and very much value our friendship. Thank you for that. That's extremely gratifying to hear. And I'd be remiss if I didn't say that were not for you and your support and the many things you've taught me and our friendship, I definitely wouldn't be doing this and uh maybe wouldn't even be here today at all uh in the biggest sense. So, thanks for everything. I appreciate you. Thank you. Thank you for joining me for today's discussion with Ryan Suave. To learn more about Ryan's work and to find links to the various resources discussed during today's episode, please see the show note captions. If you're learning from and or enjoying this podcast, please subscribe to our YouTube channel. That's a terrific zerocost way to support us. In addition, please follow the podcast by clicking the follow button on both Spotify and Apple. And on both Spotify and Apple, you can leave us up to a fivestar review. And you can now leave us comments at both Spotify and Apple. Please also check out the sponsors mentioned at the beginning and throughout today's episode. 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