Decoding the Gurus - Dr. K (Part 2): Rhetorical Judo Flips

Episode Date: July 8, 2024

Join Matt and Chris for a trademark 'short' episode as they continue to navigate the complex, occasionally controversial world of Dr. K in this second multi-dimensional episode. This time they take a look at some more recent content and reflect on whether they were wrong to identify Dr. K as such a strong advocate of Ayurvedic medicine. In their investigations, they explore the science of visualisation and manifestation, updated genomic information about the Doshas, and the power of mantras to bend the universe.But primarily they focus on the recent lively discussion between Dr. K and another famous YouTube Doctor, Dr. Mike. Their discussion touched on various topics including the mechanisms of science, the power of consciousness, personalized treatments, and the placebo effect. All good fodder for the DTG grinder even if it ends up, as it so often does, with Chris and Matt gently discussing their points of view about the nature of mind and the (alleged) mystery of subjective experience (we are sorry!).So join us for a thought-provoking ride through scientific criticism, holistic practices, and age-old East vs. West / Alternative vs Science-based medicine debates as we attempt to decipher whether Dr. K is a modern-era internet sage or a charismatic storyteller and alternative medicine advocate.LinksDoctor Mike: Debating The Value Of Eastern Medicine (Ayurveda) | Healthy Gamer Dr. KHeatlhyGamerGG: The Truth About Visualization & ManifestationHealthyGamerGG: Optimize Performance and Develop Self-Understanding with AyurvedaScience is Dope: Should we adopt Ayurveda | An Indian's response | Dr. Mike vs Dr. K

Hello and welcome to Decoding the Guru, itus the podcast where an anthropologist and a psychologist listen to the greatest minds the world has to offer and we try to understand what they're talking about i'm matt brown chris cavanaugh is my co-host he's the water to my fire the earth to my wind uh he's my complimentary dosha okay chris oh wow yeah that's very good the earth or water to fire isn't a great combination in general that's uh that means i ghost you and you know i stop you from flourishing ma i put you out oh i know you're the paper to my scissors no paper to my stone you're just not doing well with your analogies you're the paper to my scissors. No, paper to my stone. You're just not doing well with your analogies.

This is the problem with you kafas. You're slow to speed up, but you're top speed. You're like visor, you know? It feels like a slur calling me that. Look, everyone is a little bit kaffa, Matt. Everyone is a little bit kaffa. That's the way it works. We learned about this.

We learned about this. We did. We can't say we're not educated. But what are we learning about today, Chris? Well, we're back with Dr. K for part two in our tripartite examination of his content. And last time we looked at his outline of Ayurvedic understandings, but that was a video from 2019, which is from relatively early in this channel's progression. And we were going to look originally at a much more recent discussion debate he had with another doctor, Dr. Mike, which also touches on Ayurvedic debates, similar to what we were covering, but it's much more recent. I thought that would be fair to see if things have changed and progressed and also in

a different environment, instead of outlining, you know, the Ayurvedic system from a kind of interested practitioner point of view, more discussing it in the context of someone who might not fully endorse, you know, all of the same things, right? Might have some considerations. But as happens, Matt, I'm a Vata person and I'm mercurial. And I ended up listening to more content than we were supposed to cover. So before we get to the Dr. Mike conversation, there is a video called Optimize Performance and Develop Self-Understanding with Ayurveda. And that's from two years ago. And so this is kind of the midpoint. And again, it's speaking to his audience, outlining things from a kind of interested advocate point of view. But let's see if things progressed in that time.

And then, you know, we'll come right up to the present so first of all one point of concern was like the degree to which dr k's ayurvedic stuff is integrated to what he actually does right is it a an additional part is it the main component is not from the previous content that looked like it was a substantial component. It was at least the extra sauce that made him a lot more effective than his colleagues, right? As he described that. But he also applied it in more private enterprises. Listen to this, Matt. Okay.

So when I go to a corporation, I'll say like, hey, I can teach your staff to be healthier and like work with each other more harmoniously. And the way that I can teach all that is by teaching you about Ayurveda because it'll help you understand your temperament. And once you understand your temperament, the way that your individual mind functions, it will become clear why there is workplace conflict. Because you'll have a Vata who doesn't like structure and likes to innovate and likes to you know explore and you'll have a kapha who's like no no no we need like structure like we have processes for a reason we are organized for a reason like like when you stick to the processes when you get the best result and the vata is like let's go let's figure it out we'll figure it out don't worry man like why are you so stuck up bro like what's going on and the gaffer's like oh my god okay i knew it those bureaucratic nincompoops always trying to

interfere with me a caffers bloody covers all of them yeah they just i i find it was interesting that you know he's talking and he talks in this content about how there's some resistance to applying this kind of insight in a corporate environment because they like to think of themselves as rational stuff but basically it gets results smart you identify the bad guys in the cafes and the results speak for themselves yeah yeah yeah that is good um this is an aside but i've been involved in similar kinds of evaluations of interventions like this in in an organizational. And my God, it is a weak area of research because they very rarely include a proper control group.

And the problem is if you do any kind of intervention with groups of people, then you do a soft type measure afterwards, like a survey. Did you like it? Do you feel more cohesive? Are you happy with this? Everyone goes, yes. Everything goes up. Yeah. And my name is attached to studies, by the way, survey did you like it do you feel more cohesive are you happy with this everyone goes yes everything goes up yeah and my name is attached to studies by the way which which have reported on this stuff

and i encourage the lead author to put in lots and lots of disclaimers and caveats yeah um the other thing i'll mention chris is that this environment of corporate consulting executives love this stuff do you remember that our um our sense makers um often tend to be yes corporate consultancies and some of the worst psychology i have ever encountered has been highly highly popular in the c-suite type environments i mean even i think outside the realm of psychology management consultants sometimes bring value sometimes they are you know giving information that the corporation could not generate by themselves but other times they are getting paid large amounts of money to produce power points to jerk off and flat out um fat cats management yeah yeah so you know the corporate

sector is not exactly the kind of cut and frost like survival of the fittest environment it's often presented as no and it's certainly not a bastion of rigorous critical thinking you know in i actually did my honors chris in um you know the fourth year little project you do after undergrad in leadership organizational leadership just a random thing that a young kid like me would select and um my supervisor encouraged me to look at this question of transformational versus transactional leadership yeah now now can you guess chris which of those two is the good one i guess transformational yeah every every leader wants to be a transformational leader i mean that's not even the worst of course there was like covey's seven habits of highly effective people and but the more i looked at this research the more i realized like how much of it is just designed

to cater and flatter middle management types that want to feel like, yep, I'm a transformational leader. I'm so special. I bring something to this organization that nobody else can. Yeah. Well, now moving on from the corporate environment, because it comes up, but it's not a big feature of it. He does give something of a disclaimer at the start regarding the science here. So see if this sounds a bit better than, you know, the previous content. So at the beginning of what I'm going to explain to you guys, it is very scientifically valid. The further we go in today's teaching, the more we're going to leave science behind. Okay. So we're going to start like very scientifically grounded and I'll show you all a couple of papers, which I've shown

before. And then like the more that we get towards the corporate consulting side, I want you all to understand there have not been studies about the specificity of what I'm teaching. It's anecdotally very useful. People love it. People get better. I've certainly loved it. I think there is science there, but the studies have not reached that point, right? We're at the very basic level of studying Ayurveda scientifically, and it's been incredibly fascinating. But the closer we get to application, the more we're going to leave the solid foundation of evidence and sort of extrapolate from the evidence to come up with theories and conclusions. But a lot of the stuff that I'm going to teach you all towards the end, some of it has been actually verified through some personality assessments and things like that. But really,

we're going to like leave the evidence behind and it's going to be a lot more like clinically focused. Okay. So, um, you know, just, I want to just toss out that disclaimer. Okay. Questions. Ooh, I feel like we're at the beginning of a wild ride here yeah i think what we're talking about in the last episode with the the different types and the doshas and so on now that was that was grounded in in hard science but here here we live in the reservation strap yourself in you might that might not be clear but that is indeed reflective like he's going to argue that the doshik system is essentially completely validated by genomics and it's the application of that in you know specific environments that that bit isn't as on a solid ground but the the classification system is

like rock solid and I also want that reference there too. I'm going to throw out a couple of studies that, you know, I've mentioned before. And, you know, we saw in the last episode, this way of dealing with studies, like you described it, like influencers, like Huberman and Dr. K. Bean, Mike Pace, you know, a shiny study that seems to give the result that they want. And it's an incredibly fascinating study. And you can flash it up on the screen and you can read off some of the technical terms and then move on. There was a study, right, at Science P Lesson 0.05.

And, yeah, that's not the best way to approach science. But do you think it's good, then, the notion about, like like at least admitting that some of the stuff that you're going to talk about it isn't scientifically grounded like you're flagging that up the audience that is good he is flagging it up it's clinical experience it's anecdotal and uh yeah good on him yeah so about that clinical experience so one of the things that we try to do so i want you all to understand this okay about leaving science behind so behind. So I'm a clinician. So I know it sounds kind of weird, but most of clinical medicine is not scientific. And it sounds kind of weird, but you know, we have scientific trials, right? So we'll have trials that tell us, okay, this antidepressant you should use first, this

antidepressant you should use next, this antidepressant you should use third. And when an actual human being comes into my office, there's a protocol of the standard of like, what is, you know, on average, the most effective. But what I want y'all to realize is that like, on average, what may be the most effective is not very effective for like 40% of the population, right? So the goal of clinical medicine is to take a scientific foundation which is very well grounded and extrapolate it to an individual case and if we want to be really precise about it there are no randomized controlled trials about you there is not a single randomized controlled trial that looks at what antidepressant will be effective in you. Right? I know it sounds kind of weird.

All of the trials are what's effective on average. But if you think about where you are and where average is, there can be a big gap there, right? Like you are a very different person from the average person. I am a special person, Chris. Yeah, different from the average. He goes on to talk about height and saying you know if you take the average height and compare your you might be like wildly different from the app and i'm like

i'm not sure that's a one-to-one analogy because the whole point of clinical trials is medicine that works reliably it is not that it only works for individuals who fall into the complete mean point of a distribution, right? That's not the point of it. It's actually about identifying reliably effective medication. Yeah, yeah, which you cannot do by treating every single person as a unique snowflake. On the other hand, Chris, to be generous, I mean, I think there are lots of elements of truth in what he's saying in terms of that like practitioner knowledge like to a large degree like all jobs are like a trade um you could be a nurse you could be a clinician could be yeah you know a builder and there is stuff that you learn from books the stuff that you learn in terms of general principles and there's

also a kind of trade craft that you do learn and you, I think he's pointing at least partly to that, which I think we can acknowledge is a real thing. Yes, that's definitely the case. So he is, that part where he describes like people taking general principles from the existing evidence and then, you know, based on their experience and based on other sets of knowledge and whatnot that they work out a treatment for an individual.

That's completely true. I do think there's a little bit of the self-serving rhetoric that we saw before of like science is great you know but actually treating people i prefer the individual so like he's kind of saying look the science yes it gives a foundation but you know the oped ayurveda is what allows us to actually treat individuals better. So, yeah, Westervet isn't good in general, but not for you specifically, any one person. Yeah, but Ayurveda or some other complementary and alternative medicine is portrayed as being that hyper specific thing, which it cannot be. As we talked about in the previous episode, it cannot be both like a system of knowledge that is consistent and coherent that you can learn and also totally unique and specific to a given person so there is a bit of a bait and switch there like you can imagine say a gp right

they've got someone who's coming in they're saying that they're feeling very depressed right now on one hand this person could be like the sort of person who's very reluctant to come to the doctor you know it doesn't you know you remember recently they didn't even come in when they had some symptoms that were annoying them for months that kind of person right and another hand they could be like a histrionic sort of person that's that's always visiting is always talking about all kinds of imagined things and so your knowledge of that person and their history is going to influence, you're not just going to take this consultation

and do this little checklist with what they're telling you. You're going to integrate what you know about them. So that is the thing I think about this sort of individualized practice that any GP would agree with is absolutely real, right? Yeah, yeah, yeah. You have this knowledge of the person. But I think you can abuse that a little bit

because it leaves this wiggle room for you to inject. These are these things that science doesn't understand. And this is my OP power. Yeah, yeah. So I'm going to play a bit of a longer clip, but I think it's important. I want to get your reaction to this. So this is talking about the same topic as we covered last time, the kind of Ayurvedic classification system,

but maybe offering some clarifications on that. I want to see what you think about this. Okay. So number one, your dosha is not your Pokemon type. Look, I get it. You found a new framework. You're very excited about it. You heard about a new structure for understanding the self and your immediate impulse is something like, as long as I can figure this out, the best way to harness my guffa strengths and shore up my, the corresponding weaknesses, I'll be able to solve my problems. And maybe you will, whatever works, works. And I'm not here to tell you that you need to abandon the idea for the sake of some sort of immortal truth. If categorizing yourself as a bit, the somehow ameliorates your issues there, but for the sake of some sort of immortal truth. If categorizing yourself as a pitta somehow ameliorates your issues, there but for the grace of God go I. Have fun.

What I'm trying to make clear is that the dosha concept is not some rigorous definition of individual character. It is, like stated above, a framework for introspection. Like many other classifications of human personality types, it's primarily useful as a tool to get the individual to look inward and examine pathways that may not be obvious at first glance. Understanding your dosha, whatever that may mean, is not a solution in and of itself. It's only a tool to enhance self-exploration. More importantly, it's a tool that is only relevant

to the person using it. Your classification is of minimal importance to the people around you. It's an entirely personal concept. As a result, the people asking for advice on how to approach a situation as insert dosha type here are fundamentally misguided because this whole framework isn't going to provide you a solution. There's all sorts of solutions to all sorts of problems, and trying to peg an individualized solution to a DOSHA type, as though you're figuring out the best weaknesses to exploit in a Pokemon battle, is completely orthogonal to what you actually need. Framing your personal issues purely within the DOSha framework is going to lead you astray

because introspection doesn't solve problems. It helps you solve problems more effectively. The resolution is ultimately on you as an individual. The framework can't step into your place. Well, first of all, it does feel like he's reading that out and it's like a hostage video. Well, so just to be clear, he is reading from something there. So that's not his normal delivery. But what about the substance?

Well, I'm a little bit confused because it does seem a little bit contradictory to what we heard in the last episode there, Chris. You know, he's portraying it there is that this stuff about doshas and stuff, it's like a Rorschach inkblot test. It's something to kind of, you know, present you with some ideas, some framework for you to reflect on and hopefully build upon to get some insights about yourself. But you shouldn't read too much into it. And you can't just like cite someone's dosha

and think that you're going to, you know, know anything specific about them. But that doesn't seem entirely in keeping with what he said before. Yeah, very... Well, so I may have tried to trick you, Matt. That is Dr. K reading out someone else's

response from his subreddit, where they've written a comment, or somewhere on the Healthy Gamer community. Oh. Oh. I see. Now, here's Dr. K's response to that. This is a wonderful post.

I upvoted it, right? Love the post. It's a fantastic post. And unfortunately, there are huge swaths of it that are kind of wrong. OK, so let's take a look at this. So this person's argument is that there are a lot So let's take a look at this. So this person's argument is that there are a lot of systems of let's look at this. Okay. So, um, like many other classifications of human personality types, it's primarily useful tool to get the individual to look inward and

examine pathways that are not, that may not be obvious at a first glance. So this person is correct in, in some of these fundamentals. Okay. So, and like woe at a first glance. So this person is correct in some of these fundamentals, okay? And like woefully incorrect in others. So let's try to understand what's correct about this and sort of what isn't. I see, I see. You tricked me, Chris. I did trick you. A little bit the shit sandwich style there.

This is wonderful. I mean, it's great, isn't it? Also woefully inaccurate and huge shrifts of it are I mean, it's great, isn't it? Also, woefully inaccurate, and huge shrifts of it are wrong, but it's fantastic that it was posted and I uploaded it. Right. So this is a good use of psychology and providing feedback that you want to be received positively. Yes. So what did he find that was so wrong with this commentary? Oh, I'm glad you asked, Matt. In psychology, there are certain tests like the Rorschach or inkblot test is the best example of this. That's a projective test. And so the value isn't, you know, that something is objectively correct, but that we can use particular things to help people understand and serve as frameworks

for introspection. And that if you provide someone with a framework of introspection, the framework doesn't need to be objectively correct. The value is in the introspection. Okay. That's what this person's case is. And he's absolutely correct that in most situations of personality analysis, this happens to be true. As it turns out, Ayurveda is actually a little bit different. And the main reason for that is that Ayurveda is not just a system of introspection. It's something that is correlated to your genomics, right? So people have done studies which show that your doshik balance is not just

something that you use for introspection, but can actually be genetically identified. So if we look at the spectrum of human beings, we realize that some people are more prone to experiencing anxiety, and some people are more prone to ulcers, and some people are more prone to anger. So if we look at human beings and we do a scientific study and we stress 100 people out, 33 of those people will become anxious as a response to the stress. 33 of those people will become angry and irritable with response to those stress. And 33 people will become isolated and depressed with a response to those stress. Now, those numbers, I actually don't know if those are true or not, but the point is that we can make very real scientific observations about variances within the human population. And as we study Ayurveda, what we discover is that all of these variations which we can detect with people are actually correlated to their genome, right? We can actually look at these people who all get anxious. We can look at their genome and

see, oh, wow, all of the people who are prone to anxiety actually share common genes. Huge, if true. So Ayurveda is just genomics. Genomics, actually, people fit into these three categories. Wow. Yeah. So he's very clear there. And I think that it would be useful for people to pay attention that he's clear. It's not just an introspective framework. It's something that is validated by science repeatedly. It's essentially, if not a containing field for genomics, it's at least a hugely fertile area. So if it didn't have that, it might be like the other ones, but it has this very strong scientific grounding

and that makes it different than like the other ones. I don't remember any like genomic studies that have sort of identified this clustering in three categories well yeah i mean you do have them but they're all published by advocates of ayurvedic medicine so like we covered one of them last time but he he will reference those studies but even those as we saw that was slightly overstating how significant the evidence presented in them. So before we get out of the science component of it, Matt, there's a little bit more about the

genomics and the correlations there. So let me just play this. So like Ayurvedic genomics, establishing a genetic basis for mind-body typologies, right? So like, this is kind of interesting. So there's a significant correlation between HLA type and Prakriti. That's really fascinating. So HLA types are sort of individual receptors on some of our immune, on our cells, which immune cells recognize and stuff like that. But it actually, that HLA types, so these are things that are sort of like blood groups, right? That they actually correlate with vata, pitta and kapha. So it's sort of fascinating because I do think that where I disagree with this person

is that Ayurveda is simply a framework for introspection. Yeah, I think he's right. That is kind of fascinating. Definitely falls into the huge if true category because because what he's saying is that what we're finding is that there are these systematic genetic differences where it's basically sorting themselves into different clusters of people and this aligns with ancient knowledge of people falling into these three categories that we can tell from the way they look and their personality and so on which is also infers all kinds of things about you know how they should be treated for various ailments and so on how their bowel movements are and what their propensity to

develop yeah like autoimmune diseases and whatnot and what kind of foods they're like yeah yeah so it's very exciting news really that the genetic evidence has found these three clusters of people who have their different advantages and disadvantages makes them prone to certain things and um yeah advises for all the treatments yeah amazing yeah you say that matt as somebody that's not entirely convinced but did you not hear there was significant correlations that does that not matter to you science man i'm actually do you happen to know the answer to this chris because like i wonder what's according to ayurveda what is the theoretical reason like why do genes and also people fall into these three categories? Is there like a reason?

Is it just a fact of the universe? I'm just genuinely curious. Did you stumble across this? What is the reason why there are three types of people, three types of genes? So that's a great question um i mean it's not something that i've ever heard dr k mention and and like it's generally a thing with cam that they don't really explain why you know like nobody explains why there are this many star signs and nobody explains why there are

you know any of the things in the cosmology of of any cam but yeah i just that seems like a question that should normally arise right i just had a look and apparently it's referenced in various classical vedic texts and it's basically is discussing the creation and functioning of the universe through two fundamental principles consciousness and matter the three doshas are considered manifestations of matter and represent combinations of the five great elements so it's it's very you know like for humors yeah it comes from sort of philosophical slash theological scripture yeah i guess yeah yeah yeah yeah okay so that's where it's from but yeah so you know just reference to statistical significance and and whatnot as we covered last time

studies reporting that they find statistical significance between clusters of people and that um you can organize things into uh via principal component analysis or GWAS surveys. These all should be viewed very skeptically because there are mutually incompatible systems which will claim similar levels of evidence doing similar violence to these statistical tools. I have a similar question. Like he said before how, you know, they've found these correlations between the genetic signatures and the doshas.

So like, how do they know what dosha people are in? Is there a questionnaire they fill out? How do they measure it? Yeah, he covered that last time. For like a questionnaire and also, you know, assessing physical characteristics and questions about temperament but there are so there are questionnaires developed to help categorize people into the

relevant primary dosha i guess cool cool cool cool cool cool just just checking i was just curious yeah yeah so the myers bridge also came up last time and there's a little bit of discussion with it here but what's really interesting is that if you actually look at like, you know, papers that look at science, what you discover is that three basic genopsychosomatotypes, or birth constitutions, have different nuclear receptors, which are expected to regulate the expression of specific genes, thereby controlling embryonic development, adult homeostasis, and human metabolism of the human organism in a profound way. This is not a framework for introspection, my friend. This is something that has been

scientifically shown to be baked into genes, okay? So this is why I emphasize Ayurveda over astrology or so, because I've studied a lot of stuff. Okay, guys? I've studied like Vedic astrology, not so much Western astrology. I learned how to read tarot cards. I'm an energy healer. I don't talk about any of that crap. I'm also somewhat familiar with Myers-Briggs, but I steered away from Myers-Briggs. The reason I steered away from Myers-Briggs is because when I looked for evidence for it, what I found is that there's the Myers-Briggs Institute, which publishes a lot of evidence, but there is very little independent verification of the Myers-Briggs model, which I have been able to find. Okay? But before Chris, in the last episode, he was holding up the correspondence with the Myers-Briggs

as proof of confirmation of the Ayurvedic doshas. Yeah, I think it's more that like Myers-Briggs is a dirty mirror reflecting the insights from Ayurvedic medicine, but imperfectly. So there's some relevant insights. That's why people might see parallels. But one thing that's notable there, again, just it's not us. It's not editorializing. He is very specifically saying this isn't spiritual esoteric nonsense. This is

science. It's all in genomic studies and this kind of thing. But also I just want people to note I've studied tarot. I'm an energy healer. I've looked into astrology or whatever. So Dr. K is a bit of a seeker. Well, I'd say it's quite a resume. Yeah. So he is saying, to be clear, that all of those, they ended up, he doesn't talk about them much because he's found the system, which actually is more science than that.

But that I think is worth noting. And also in a different conversation, this is his conversation with the influencer, Rekful. He mentions this. Like I'd been working with gamers for years, but there's just no way that I can help like every person out there. And I've got to do like I've got to reach people more. And so I'd sort of set myself up to kind of be like the next Deepak Chopra or something like that. I was like very like ambitious and, you know, had a lot of like.

In this way right now, you're AOE helping people. Absolutely. That's exactly what this is. One on one yeah it's aoe right yeah so i realized that i can't like single target this shit it's just not gonna work like yeah you know after the ama i probably got hundreds if not thousands of requests for help yeah so he was very ambitious as a young man to be the next deepak chopra the next deepak chopra he's comparing himself. That's what I've been saying. People disparaged me. It's saying I was setting myself up as the next Deepak Chopra.

Most science-minded people don't have Deepak Chopra as a target goal. If that is the point of a comparison, that should serve as an indicator to people that you're into esoteric, non-scientific stuff. And if that's the comparison that's drawn. And just again, Matt, one more to Gil DeLily. This is from another episode where he's talking about visualization and him describing himself and his reputation. When I was practicing in Boston as a psychiatrist, I kind of developed this reputation for being into the New Age stuff, right? I had studied for years in India to become a monk,

studied Eastern medicine. And so a lot of patients would come to me specifically because they'd be interested in, like, harnessing the energies of the universe. And they'd come to me and be like, Dr. K, Dr. K, do you believe in the power of manifestation and the law of attraction? Can you help me, like, do that stuff? K, do you believe in the power of manifestation and the law of attraction? Can you help me do that stuff? Do you really believe in it? Is this real? You've gone

and studied in the Himalayas and stuff. And I'd be like, sorry to disappoint y'all, but actually, it's kind of a bunch of BS. Because I looked into the science of it, and I was like, this is actually kind of ridiculous. And most of this is misunderstandings from the fields of quantum mechanics. And then I looked into the research even more, and I sort of discovered something really bizarre, that visualization is actually capable of achieving things that are scientifically kind of impossible. I mean, they're not scientifically impossible, but they sound scientifically impossible. So today, what we're going to do is help you understand both sides of those coin, and then also help you understand how to actually like effectively visualize to transform your life into lots of success and bring all kinds of things that you want into your life.

Right. He's blowing a little hot and a little cold there, right? Yeah. On one hand, it's all a bunch of BS. On the other hand, we're going to talk about how to do visualization properly. Yeah. So I think that this will come up in the Dr. Mike thing. There is a benefit to presenting yourself as like, I'm not, you know, like a woo minded

person. You know, I'm not uncritically accepting all of this nonsense. Like I approach things skeptically and find that there is lots of crap out there. But the stuff that's actually good, Matt, the stuff which is true, that stuff actually blows your mind, right? And like, if you present yourself as, I'm a little bit credulous, I tend to believe things that fit my approach, that's not going to make, like everybody who promotes alternative medicine or even outright like pseudoscience and conspiracy theories, they all present themselves as, like, I'm unusually skeptical,

but even I was convinced by the quality of the evidence, right? So he's doing it, I think, there a bit better than most. But the main reason I wanted to play that clip was he again mentioned that he was known as the doctor that was into alternative stuff that had interest. So that's why people would approach him to talk about the science that was into alternative stuff that had interest. So that's why people would approach him to talk about the science of visualizations and stuff.

So it's just from Dr. K's own account. He is a Deepak Chopra like psychiatrist, right? Interested in alternative mortalities. He studied at a complimentary and alternative medical institute. Right. Like so, although he sometimes presents himself as mastering the Western method before he started to look at the East and what was there. It seems like from the very start, he was at least quite open to alternative approaches and, you know, esoteroteric traditions if not had a very strong

interest in them yeah it does seem so and um actually in the clip you played just before the last one when he was giving the rationale for why he's focusing on i think being a broadcaster and a streamer rather than a clinician is that he needs to help more people and there's too many people aoe healing you know what that is matt no what's that gamer reference area of effect healing not the targeted at an individual but you do an area of effect oh uh oh perfect perfect analogy yeah that's right so you know that is that is a nice rationale, right? It has the best reasons, right? There's too many people out there. I need to help as many people as possible.

I can't, I'm only one man. I can't help people one at a time. I need to help people at a more broad scale level. And that is a good rationale for why you should be a streamer and an influencer. I mean, like just looking at his YouTube channel here, Dr. K explores shit life syndrome. Dr. K talks to a proud Trump supporter with David Pakman. Why shit life syndrome is holding you back.

Dr. K talks meaning, purpose and motivation. Like this is clickbait stuff, frankly, for sort of self-help with it yeah but isn't that just the algorithm you know writing the algorithm you have to like make your clickbait thumbnails and whatnot if you're an influencer to some degree this is you know maybe the actual content is fine but the thumbnail and title is a bit yeah you know well well, clickbaity. Well, the thing is, Chris, I've listened to a bunch of these videos after reading the title and they are pretty much what they say on the tin

and it is clickbait content. And, you know, there's nothing like inherently wrong with being a streamer or posting clickbaity stuff on YouTube. I mean, really. I mean, look, Hasan's a look, Hassan's a streamer. Destiny's a streamer. Both fine people. Both fine people.

Fine people on both sides. I guess I was just highlighting the idea that he is presenting this choice of vocation in... In very lofty terms, yes. This will come up in the dr mike stuff more but um yeah so also matt i should mention we've jumped forward in time now so we've moved on from the

ayurvedic outline to the truth about visualization and manifestation and this is just from 11 months ago so this is this year and i know that you're a fan of quantum stuff. So I thought you might appreciate some of this. The key point here is that somewhere along the way, there were some revolutionary discoveries in quantum mechanics. And then there were some very common kind of like interpretations about what this means. But if we really look at the science of it, it's kind of BS. So I recently saw one study, for example, that the people who believe in this kind of like law of attraction or manifestation in the universe subjectively think of themselves as more successful. And they also think that the reason that they're more

successful is because they're like really good at attracting and harnessing the energies of the universe. But objectively, they are more likely to be bankrupt, they are more likely to be in financial hardship, and they are more likely to be taken advantage of by other people. So at this point, I'm pretty convinced that the best way to make money using the law of attraction and manifestation is to sell courses to other people to teach them how to harness the energies of the universe. I think that is the most consistent way that leads to financial success. So it's kind of BS, right?

Good. Yeah, yeah. I thought so too. If you listen to this, you would think, ah, like he's not a credulous advocate. He's like kind of realizes there's a lot of BS around quantum mechanics and, you know, common misinterpretations and whatnot.

And that the people who claim to be teaching you about visualization, the main benefit is to them. That's true in general. Yes, that's true. That's true. Don't bother manifesting people. There's no need.

Yeah, but in any case, I think it's fair to say that Dr. K, at least in some of that content, is hitting the right kind of skeptical notes about over-interpretation of quantum effects to support visualization, right? Which fits with his initial framing of there's a lot of bullshit around us, a lot of people peddling, like,

you know, get rich quick through visualization, the secret kind of stuff. And he thinks this is crap. But he also did say no, but the more he looked into it, the more he found out there was more interesting stuff there. So what is the on the other hand? On the other hand, you have people like Arnold, Arnold Schwarzenegger. And Arnold is this guy who's a big believer in visualization. And if you listen to his talks about like bodybuilding, acting or becoming governor of California, he's like, yeah, I really believe in visualization. When I visualize something, it like helps me achieve that thing or it happens. And that kind of got me scratching my head, right? Like, hold on a second. I mean, how is this person able to be like a top tier bodybuilder, top tier actor, and actually get elected to the governor, like being the governor of California? Like, that's crazy.

Those are three different domains. And this dude swears by visualization. So I looked into the research even more. And what I sort of discovered is there's some crazy stuff out there about the science of visualization. So one of my favorite studies on this, which is kind of unbelievable, is that if you have a group of older people, so we're talking about studying a geriatric population, and they visualize exercising, okay? They don't actually physically exercise. They visualize exercising. It increases their muscle strength by up to 36%.

it increases their muscle strength by up to 36%. So if I take a group of old people and I tell them, hey, visualize exercising, they physically get stronger by 36%. This is insane. So if you actually look at the research on visualization, by the way, most of the research actually has to do with physical performance. So they're talking about like athletes and Olympic athletes and stuff like that. They'll do randomized trials where people are like working out physically and then working out physically plus visualization. And the people who use visualization will actually like be stronger. And the craziest thing, the reason I cite that study, it's kind of one of the weirdest ones, is that this is like wild, but you can be sitting on your ass at home. And if you visualize working out, your body will get physically stronger. The effect size tends to be stronger in older populations. And that's kind of gets complicated.

But basically, I think that even in younger populations, it seems to work. Okay. So this, Chris, this feels like the kinds of sighted studies that you would be prone to look into. Well, this is true though i had difficulties locating this particular study because it doesn't give any information except for you know that figure about stronger by 36 percent right up to 36 percent which sounds like a headline summary and a puff piece written about it and when i did look into similar claims if you remember huberman talking about i i can't remember the exact details but it was it was again a similar sort of thing like people weren't actually doing things just like told to imagine or you know they

were told that that's what it was a cleaning burns more calories and then lo and behold they burnt that's much more calories right and and all of this research tends to be would you believe small samples p-values hovering around 0.05 and shocked i'm shocked shocked i tell you yeah not pre-registered and in this case like the comparison comparison, I did find some studies and like, let's assume that the effects are real, which I think is giving them a lot of credit to begin with. But even if they're real, the comparison is usually having elderly people do some targeted visualization exercise where they sit and, you know and imagine things like during that, but during a session, right, where they're set to do something against the control. And then at the end, the

people who do the visualization report better outcomes. Now, here he's claiming like demonstrable outcomes, like 36% higher strength. If this were true, it would be a huge claim because he's not talking about things at the margin he's talking about like a 36 percent improvement than people now maybe it's less with younger people but simply by sitting on your ass and imagining doing something and he wants to say this is the power of the mind. And the other evidence that he mentioned was Arnold Schwarzenegger being successful in multiple domains and swearing by visualization. And that strikes to me that, one, this tendency to cite these studies and remember headline findings and treat them as that they're definitely valid. And the reliance on anecdote there was a successful individual he was great in all these different domains and he said that

visualization works we cannot simply dismiss that because yeah arnold schwarzenegger was successful right so yeah maybe arnold schwarzenegger ate nothing but fish we. We seriously consider that concept of eating nothing but fish because Arnold Schwarzenegger, he excelled in these three different domains. You know what? I have an interest in MMA, and I often hear MMA fighters talk about what gives them the edge and occasionally they venture into talking about science and whatnot. Now, of course, they're elite level athletes,

so they know how to train. They're doing these very, very rigorous training systems. But when it comes to their claims about medicine, much like Joe Rogan, you just cannot trust their accounts because they will swear by magnetic bracelets or they pray to the sun god the day before and he delivers. Right. Athletes are some of the most superstitious people on the planet. And they're very often drawing incorrect conclusions about work. Now, they do want to do things that work, but typically the thing is that they're putting in these massive amount of hours doing this practice and they wear a special band or they have a special

meditation practice and they will accredit it to often the esoteric practice that they do or visualization technique but i think the very very heavy lifting is done by the hours and years of practice. The heavy lifting is done by the heavy lifting. Yeah, I mean, look, it's a common thing in human psychology. Like apparently the people that went to war, like in World War II, American servicemen, for instance, were incredibly superstitious. So it didn't matter if you were driving a tank they had this thing of attaching things to their tank and that all the officers

told them you know they looked into it no this is not going to protect you from the shells of the german tanks it's not going to do anything at all but in the end apparently the top brass just decided look it was better to just let them do it because it was like an emotional support blanket it helped them do their job and so i think the general principle is when you are deeply invested in something it's a really high stakes thing that you're putting that everything is riding on it and it could be an mma fight you could be a top tier athlete or you could be some poor bugger that's sent off to drive a tank or fly a b17 then you will be extremely prone to superstition very naturally because you'll be looking for anything anything at all that might

help give you a little bit of an edge yeah this is actually a research area i'm familiar with because rituals often relate to situations where there is uncertainty or you know yeah high stakes and they give what could be described as the illusion of control but also they can give genuine psychological relief from anxiety right because so maybe you can't control the outcome of the test that you've taken but you know you know, your muller going to the shrine or the church to say the prayer, people, when you ask them about the mechanism, they'll admit that, yes, well, I don't think that,

you know, God or the Buddha is actually going to go and change the results on the test. But the point is, usually, that it gives the people a feeling of, you know, relief and that they've done something. This is where the effect of placebobos come in, right? Because the psychosomatic benefits of that reassurance can help you drive the tank better, fly the B-17 better, do the fight better.

Because, you know, these are extremely stressful, high stakes events where being a bit discombobulated and fearful and uncertain is going to be a big liability. So yeah, it is a difficult thing to investigate carefully. Well, also, and this relates to some of the stuff we said last time, that actually there's been these studies, and I would say in some cases not so great studies, but nonetheless, there are studies that suggest that when you add more steps or more intricacy to ritual instructions, that people regard them as

being more effective, right? Something with more steps, with more specificity, with more reference to higher powers lead to people ascribing greater likelihood that things will work. There's a beautiful distal connection there with gambling research, which is that, you know, there are certain kinds of gambling games that lead themselves to delusions like superstitious and fallacies about gambling and when the games sort of have a kind of complexity to them it could be the complexity in the win schedule of a of a pokey machine or or you get given more information about that the roulette wheels come up you know this number this number this number so you can see the patterns.

You know, so you've got the raw material. And so we've got a concept called cognitive complexity, which is if you provide the raw material for the mind to kind of operate on, then you'll have greater proclivity to generate cognitive fallacies or superstitions based on it. See? Overlap there, Matt. We'll put some studies

in the show notes. And since there are studies, that means it's all true. So on this subject of visualization, so this is kind of highlighted, right? That he's calling out the BS, but he thinks there is diamonds in the rough there. And in particular, he makes this distinction. So now the question is, well, hold on a second, because here you are, you're saying that like visualization doesn't work, right? And there's evidence that shows that people who like believe in the law of attraction, they end up being more bankrupt. And on the other hand, you have these people like Arnold, and you have some studies which show that like thinking about working out or visualizing working out actually leads to improved grip strength. So which is it? Like,

how do we understand this? And there's a really simple way to scientifically understand this. Visualization works for anything inside you, but does not work for anything about that happens outside of you. So if I visualize the world changing, nothing's going to happen. If I visualize myself being successful in the world, that will lead to change. And let's understand that scientifically because if we think about the mind, the mind doesn't have any capacity

to change anything outside of me, right? Like I can't use telepathy or telekinesis to like lift objects. Like the mind can affect things within the body. And when we really look at the effect of the mind on the body, then we have tons of evidence that the mind does all kinds of weird things in the body. So we know that there's something called the placebo effect, which means that if I think a treatment will work, it will work. If I take a sugar pill, but I believe it is a treatment, I will see a clinical improvement. I didn't have anything to object to there, Chris. I think that's broadly

true. Yeah. I mean, there is an interesting thing in psychology, which is that having some irrational cognitions can be beneficial to you. Thinking that you're kind of better looking than average, you know, have better capabilities of whatever, business now, so whatever, than the typical person, they may be somewhat delusional but that kind of overconfidence is better on average it can lead to problems but on average it's better than being having a realistic appraisal and certainly a negative appraisal of yourself yeah so we were just talking about the elite athletes or whatever they you cannot trust their the cause and effect that they ascribe to things, but they can sometimes, potentially at least, improve their performance by feeling like they've managed the uncertainty of the situation via ritual or practices or whatever the case might be.

And that might be a psychological impact, which goes on to affect their performance, right? So that is sort of in line with what Dr. K is saying there. performance, right? So that is sort of in line with what Dr. K is saying there. But that bit at the end where he leans towards the mind having a lot of power over the body. Now, there is plenty of respects in which that is true. Although I would want to add the refinement that the mind is a part of the body and the product of the body's processes happening. So the notion that the mind affects the body, of course, because the mind is in the body and is connected to all other parts of the body. But if you view the mind as an external thing,

which maybe the body is interacting with or the brain is helping to pick up, that can be a different conception because then you can view it that the mind, in essence, is the actual thing which has control over various elements of the body, right? And I think that's closer to Dr. K's interpretation is that consciousness is the ground of reality and matter is interacting with consciousness.

And just to give some support to that interpretation, let's listen to this clip. And if y'all are really interested in the more like weird spiritual consciousness manifests the universe kind of thing, check out Dr. K's guide because we go into a ton of detail about the nature of consciousness and how it interacts with the universe. And what is the theoretical basis of like mantras and how they affect things outside of you. Now, the last thing that I'm going to talk about is going to be kind of weird because now that I've explained to you what the science of visualization is, where it's BS is, where it's legitimate, and kind of like how it works, I'm going to torpedo everything I just said and share with y'all what my personal opinion is, which is that I believe that consciousness can

manifest in some way in reality. Now, this is not a scientific belief by any means. This is just based on my experience of my own sort of meditative practice. So for example, like 20 years ago, now, wow, it's been 20, 20 years ago, I was given a mantra by a tantric in India. And this was a guy who like gave me a mantra. And I was like, I want a mantra that will channel the energies of the universe to like make me spiritually successful in life and materialistically successful in life. And he was like, OK, I will give you. And he just like gave me this mantra.

And he's like, just chant this mantra every day and you'll harness the energies of the universe and you'll be more successful than you realize. And at the time, I was like a college dropout with like a less than a 2.0 GPA. And I was like, OK, like maybe I'll just do this thing and I'll give it a shot. And what I sort of found is that it's kind of bizarre. But the more that I do the mantra, the more that I saw it absolutely helped me spiritually and then also like helped me materialistically in some weird way. And I've had some sort of experiences in meditation where I sort of feel connected with other things. And then the kind of last thing, I don't know if this is going to make any sense, but my wife has the

ability to bend the universe to her will. So he acknowledges that he's moving into the realm of non-scientific claims and so on. But I just want to highlight that, you know, you can hear the enthusiasm coming there, right? And he said, if you come and look at the course, you can see how mantras can affect things outside of you, right? So you know a mantra, it's just a chant. So he's talking about magical chants that increase your personal success, not just your internal psychology, but external material success. And that there is some sort of other consciousness that you can become connected to through meditative practices and so on.

So like, I feel like if that is your personal experience and you have all the beliefs that he's discussed with Ayurvedic systems and you are into tarot and Reiki and astrology and so on, the materialist scientific psychiatrist has faded quite far in the background. I'm not sure he was ever a really strong character. sure he was ever a really strong character yeah there's real want and badly with this kind of thing isn't there because the very conservative and real part of it is that the brain is is obviously connected with the physical world the the sympathetic and the parasympathetic nervous system like you said the brain is literally part of the body the the hormones and neurotransmitters are constantly interacting so things like visualization and practices to make yourself feel calm or confident or whatever are going to affect your performance which you're going to have an effect out there in the real world but there is a

segue there which i think you're hinting at when it comes to doing chants or doing visualizations and claiming that they're going to affect things in some other way in the physical world. Yeah. And to link this to his views about science, listen to this. And sometimes I'll even talk to like my patients about this and I'll ask them, like, I'll just ask them straight up, like, do you ever been in the university or will? And if you know what I'm talking about, you know what I'm talking about. If you don't know what I'm talking about, it's going to sound like absolute BS. But this is where, like, I'm a skeptic by nature.

And even when science tells us that something is complete BS, the tricky thing about science is that science is the best system to learn about the world. I think it's objectively superior than basically every other system. But it is also wrong way more than it's right, right? Like for 50 years ago, people in scientists thought that meditation had no mental health benefits, let alone physical benefits, right? That's the thing about science. It's wrong way more than it's right. There's quite a switch there, right? Like I feel that this is the rhetoric bit where you say, you know, look, I'm really into science. I think I recognize science is much better at describing the world.

It's give us quantum physics. It's give us, you know, useful drugs and so on. But like I'm skeptical. So I'm even skeptical about science right yeah it doesn't have all the answers chris yeah i actually you know this is a weird bow to draw but like isn't this similar to like so many of our gurus in the political sphere of which dr k absolutely is not one of the weird things we notice is how they very much promote themselves as a progressive liberal rational person you know that's who they are and then the main thing that they're about and the thing that seems to be their

main drawcard to their audience is kind of the opposite of yeah that they're presenting them as and is isn't there a correspondence there with dr K where on one hand he does take pains to emphasize he's a science guy, it's the best of all possible systems, citing studies and so on. But actually the main drawcard, the thing that he's most passionate about is this other stuff. Yeah, it does feel a little like that. And I'll just play one more clip, Matt, before we get to the Dr. Mike stuff. So we had two years ago, 11 months ago. This is from one month ago, a conversation with Parrot Software, a streamer person. And it's just a little bit, a little bit, but I just want to show that these things

do creep in seemingly still. So the key thing about dharma from almost like a scientific perspective is it is that which allows you to act and persistently act outside of the variance of emotions and outcomes. So the reason that I'm kind of asking you this kind of stuff is because like, I get a lot of vibes from you that track to this concept in the meditative tradition from having done a lot of meditation in a past life i think i've mentioned that to you before because you you have you intuit a lot of things that are like normally taught and so when people when they say like okay like so if you if you spawn and you're level like 50 as opposed to level 10 how do we understand

that oh like you just x XP'd up prior to spawn and then you carry over. When you respawn, you carry over some experience. You're saying I'm on new game plus. So you got, the guy is kind of intuitive because in a past life, he had done lots of meditation, perhaps. Oh, oh, I see.

I was trying to figure out what the analogy was to gaming but he's intuitive because just like in a game where you respawn at level 50 he's respawned he's he's reincarnated at a higher level because he's been there before yes and this does come up fairly often in conversations with streamers about you know that they are seem particularly attuned in some way are these are the same as his wife that can bend the universe to her will? Is that connected or different things? Yeah, maybe, maybe.

But it's a completely different thing. It's from a month ago. And I think fans of Dr. K will say, well, he wears his interest in spirituality and whatnot on his sleeve. He admits and he will acknowledge when he's going into more speculative religious and esoteric stuff but i i do think there's a constant framing of it as in line with

science or at least informed with science and that when there's mention of science it's kind of framed that well this isn't scientific, but that science, you know. Science is catching up, you know, to the extent that science has been able to look at this stuff, it's confirmed all of the stuff genetically and so on that we've found, but it's catching up, but this is beyond science. This is going further. So now to get to the Dr. Mike stuff. So all the stuff we've listened to, I think it would be reasonable for somebody that wants to have a conversation with Dr. K, specifically somebody that's talking about discussing medical topics online to general audiences as a medical practitioner around

some of these issues about promoting Ayurvedic concepts, because it's clear that Dr. K does that in his content, at least to a certain extent, right? So this does come up in the conversation with Dr. Mike. And here's Dr. Mike introducing Dr. K. Dr. K, more commonly known by his channel tag Healthy Gamer, is a popular psychiatrist who has found success online educating on the intersection of mental health and gaming. He has a viral Twitch stream where he interviews creators about their spiritual and mental health, myself included. Today, we are planning to dive in and speak about his new book, How to Raise a Healthy Gamer, which is available now. But we actually found ourselves in a somewhat contentious discussion about Ayurvedic medicine. Ayurveda is an ancient

Indian medical system based on ancient writings that rely on a natural and holistic approach to physical and mental health. For what it's worth, I think as an expert, Dr. K is one of the most honest, if not the most honest voice when discussing the benefits and harms of Ayurvedic practice. So as ecstatic to speak and learn about what's valuable versus what's not about the Eastern practice. I actually learned a lot in this conversation, and I hope you will too. Okay, so that's a very positive introduction. Yeah. Yeah. And you got the point that, you know, there's going to be contentions, but Dr. K is a valuable, honest voice, right? That Dr. Mike respects him him coming on having to have this conversation and

so on and now mike this is not the focus of the episode but next time when we looked about the public therapy not therapy issues and you know the ethical considerations here i just want to flag up that this also did feature in the episode this was like the kind of first part of the episode was covering that. And we're not going to go into that now, but you can hear just a little bit about how that topic is introduced by Dr. Mike. It's very rare that I sit in front of someone who has significantly more experience discussing health to a huge audience online, because there's not many people doing it, period. But to do it for the amount of time that you've done it, not just years that

you've been online, but also when you stream, you spend a lot more hours in front of the audience. For me, when I make content online, you know, we hyper edit a fast paced moving video, 10, 15 minutes. Now I'm entering a little bit more into the podcast space. How do you do it and not get in trouble? So I, you know, it's a great question. So we'll see how much trouble I get into. Well, let's get into troubles today. That'll be fun. And so I think a couple of things to keep in mind, right? So I think just being super careful about what you say, what you don't say. I think steering clear of like medical advice. So I think the way that I kind of frame things is when I make content online, I almost think about my target audience as like residents. So if I'm talking about, let's say, a clinical condition like borderline personality disorder, I frame it in the way of, okay, if I was teaching a group of residents or medical students or even pre-meds, how would I explain this condition? So that's really what I usually think about. And then

I'll prepare lectures and just keeping it more educational. Okay. So Dr. K has a lot of respect for his audience. Doesn't talk down to them and talk to them as if they're medical students. So it's not medical. Doesn't diagnose. It's not medical advice. It's educational. Yeah. We did listen to some clips where there did appear to be something approaching diagnosis, but I suppose it was diagnosis in the Ayurvedic sense. So maybe that's the loophole there. In any case, so in the conversation, they get talking about the therapy stuff as mentioned,

and it moves on a little bit into talking about the difference between life coaching and spiritual guidance versus therapeutic or psychiatric care or this kind of thing. So in part of it, they get to the issue about what was known in India or pre-modern alternative medicine system versus modern medicine, right? But in this case, framed as the West versus the East. So is like a life coaching session or a spirituality session, a diluted medical treatment? I think medical treatment is oftentimes a diluted spiritual pursuit. Oh, tell me more. So if you look at meditation right so we use mindfulness for um you know clinical treatment but if you really look at the development of meditation

the meditation was designed to help people attain moksha enlightenment nirvana this is why we developed it so they were not interested in treating depression or anxiety that's not why they did it they did it to attain a state of superhuman bliss, let's say. So yeah, they're both making correspondences between clinical medical treatments and spiritual practices, including striving for enlightenment. You can either think of one as a watered down version of the other. Perhaps that was a throwaway line. I guess both of them are open to the idea of seeing them as basically being on the same continuum right although the interesting thing

in this part is that dr k is presenting modern therapy or as a watered-down version of spiritual insight which would fit with all the clips that we've been listening to, which is what he was talking about when he was saying Ayurvedic is opied versus modern medicine, right? That's the things that work really, really well are the things that he has drawn from Ayurvedic medicine that his other practitioners don't use. So it fits with that. And here, I think Dr. Mike takes a slightly naive approach that gets him in a little bit of trouble, but then listen to this. I think when you look back so far, time-wise, their definitions and understanding

is gonna be greatly different. So they would never have said mindfulness is a treatment for anxiety, depression, because they didn't have those terminologies. I hard disagree there really so you think that existed like the idea of major depressive disorder generalized anxiety absolutely right so so we have for example like ayurvedic medicine which diagnoses mental health conditions right so you have i'm not familiar with that so tell me about this yeah so you have medical

systems so this is the big thing is that medical systems would diagnose things like depression, bipolar disorder, stuff like that. And the reason that I say that meditation was not developed to treat a mental illness is because they say that it's they're like, I invented this thing to help people attain enlightenment, get rid of suffering. And then along the way, you will treat your mental illnesses. But that's not the goal. Okay, so how did he get himself into trouble there, Chris? The issue is whenever you ask practitioners of alternative medicine or people with knowledge of historical systems and imply that in previous eras, people didn't know anything. And actually,

in previous eras, people didn't know anything. And actually, as we've covered, and as Dr. Kess explained, there were very complicated systems of medicine and philosophy that categorize, you know, people in their whole bunch of different things. There's early Buddhist stuff, which is dealing a lot, you know, introspective practices, in general, do quite a lot of ruminating about how the mind works and pathologies of the mind and so on. So Dr. Mike saying, yeah, you know, that anybody would recognize depression as a thing. It's basically opening up the ground for you to be corrected, that you have a closed mind about what people knew in the past but actually dr mike is right in the sense that people didn't know quite a lot of fundamental things about how the mind actually worked but also just how the body works so that's what he's talking about yeah but yeah yeah like i'm sure in

almost all traditional cultures they had some concepts which applied to, say, mental illness, schizophrenic type behavior. But it would often be infused with all kinds of concepts, including spirits, that do not appear in a modern clinical definition of the syndrome. and he's gonna eat a little bit because he's essentially saying you know oh you're saying like in india and stuff that they didn't have the concept of like hysterical women or this kind of thing and that allows it to be presented as like a more humanistic and more thoughtful development than like victorian england psychology or whatever which is probably true in many respects but i think there's also the issue that people look back on those systems with rose-tinted glasses, because when you look at the actual history, there's lots of corresponding, you know, the misogynistic kind of descriptions and so on, including the monastic manuals.

In any case, let's hear a little bit more of that discussion. The reason why I'm so skeptical about this is I look at how mental health was discussed in the 1900s of like histrionic personality disorder versus hysteria in women. Like very judgmental, very culturally based at that time. You're saying that didn't exist 5,000 years ago? No, no, no. So, dude, the East and West are completely different, man. Like it's like night and day. Okay.

So let me just give you a couple of examples. So like if you look at an Ayurvedic textbook, they had a super cool diagnosis for diabetes. Okay. They had – they say go pee next to an anthill. If the ants drink your urine, then you're diabetic. Right? So they had a lot of understanding of physiology. What did diabetes mean to them?

Because to me, it means checking someone's hemoglobin A1c and seeing it fall in a specific range. But if I'm trying to put myself in their shoes, I have no measurements of that. I have no, I'm not even aware of bacteria, right? Antibiotics don't exist. I don't know. I think they have certain herbs that have antimicrobial properties. They understand the process of sterilization. They do? Oh, yeah. I mean, we just did a video on the history of the first gentleman who recommended washing hands in between treating morgue patients and delivering babies in the 1800s.

What was that? 1850s. Yeah. I mean, so, so I may have a, a, a rose tinted glasses when I look at Eastern medicine. I don't think Eastern medicine is perfect by any means, but they absolutely. So yeah, a little bit of double talk there, which is quite common. I've heard it before where you conflate like a practice. So it can often be the case that a folk practice

or a practice that's developed in a pre-modern society is extremely effective in doing something. I think there are so many examples, but there was one that I'm aware of, which is Indigenous people in Australia had an extremely complicated process for processing some of the foods that one could gather in the bush. And it's a harsh

place, Australia. A lot of the foods require an awful lot of processing to take out poisonous compounds before you can eat it. And while it's really impressive that anyone could develop that process without understanding the chemistry involved. Following that process to get the result, and you can learn it via trial and error over many generations even, does not entail an understanding and having a decent model of what's actually going on and why it works. So I think you have to be a little bit careful in saying that there was a heuristic practiced anywhere,

could be in medieval Europe or in medieval India, that may have been effective. It doesn't mean that they had an understanding of why it works. And it certainly doesn't imply that the underlying theoretical model, which might be attached to that, is in any way validated. Yes. And there are plenty of similar kinds of examples that you can look at of quasi-diagnostic tests that people had in history. I actually went down a bit of rabbit hole with this and found out that in addition to tasting urine, people also evaporated it to see how much sugar was left. So Dr. K is talking about attracting ants. And this is a common thing that is mentioned

by advocates of Ayurvedic medicine to show, you know, they understood the principles. But Dr. Mike is making the correct point that there's lots in ancient medicine that is observing effects of something. But the actual underlying system doesn't understand the correct mechanism of diseases. So it gets things wrong, right? So

it's, you need to balance the humors. He's also exactly right when he's saying, when I talk about diabetes, I mean, you know, the specific medical definition that we know is the underlying mechanism and we have different subtypes of diabetes and so on, so dr case like when he says you know processes like sterilization we developed that and that was a big change in dr case like well people knew you know way back yeah and you're like no they did it they did it like you know we have an intuitive dislike of bodily waste or or like vomit or so right? Like we're not attracted to that in general. But that's not the same as understanding about bacteria and infectious diseases. And India had the same trajectory that all countries did whenever modern sanitation and

medicine was introduced with life expectancy and public health going up. Yeah, that's right. If that was already known, then you wouldn't have seen the benefit from those modern methods. Yeah, I mean, it's very similar to the medieval theory of miasma. You know, they knew they could observe that people would contract contagious diseases in, you know, underserviced, dirty kind of areas where people were close together.

They were often smelly. So, you know, they had a theory that it was in the air, there was some kind of miasma. It wasn't totally off track and in many cases would yield useful heuristics, but it was totally wrong and it didn't actually give you insight into the most effective ways to remediate it. Another good example is alchemy. I mean,

people make fun of the alchemists, but they were smart, diligent people who were doing their best to understand chemistry in a pre-modern context. They had a lot of practical applied knowledge, some of it quite useful, but they had no underlying correct model of atomic structure right so they were never going to really get anywhere and they indeed had a lot of superstitious pseudo-religious aspects to their practice because you know it's not because they were silly or there was anything wrong with them. They just didn't have a scientific model yet. So they were sort of grasping at straws, I suppose, to explain the effects that they were observing. Yeah. So there's a description, Matt, just for an example. I don't know how to pronounce this name, but it might be Areteus of Cappadocia. That's definitely not it. But it's a Greek physician from the second half of the second century.

And this is him describing an affliction. And actually, the term that is used is diabetes. But diabetes is a wonderful affliction, not very frequent among men, being a melting down of the flesh and limbs in the urine. The patients never stop making water but the flow is incessant as if from the opening of aqueducts the nature of the disease is chronic and it takes a long period to form but the patient is short-lived if the constitution of the disease be completely established for the melting is rapid the

death speedy and there's mention in this about the taste of the urine and and so on right like so yes people were getting sick. People were noticing things. There were healers and whatnot. But that's not the same thing. There's a reason that like modern medicine and public sanitation leads to these massive improvements in length of life and chance of surviving childhood and whatnot. On the other hand, Dr. K says this. Dude, like, so even if you look at in Indian culture, this is how well they understood microbiology.

So in Indian culture, we eat with our hands, right? Okay. So, you know, we also don't have toilet paper. So anytime. I don't know that. So like if you look at like ancient India, like not just, you know, toilet paper is a relatively recent invention. Of course. So how did people inia clean themselves after having a

bowel movement they would wash with their hands so you you and then this is how well they understood microbiology you never eat with your left hand you always eat with your right hand and you always wash with your left hand that's funny to me because you view that as like them practicing microbiology i view that as them stereotyping and being rude to people who are left-handed yeah no i mean but but there's something they were aware of the bacteria but they weren't aware that some people preferred to use no they were absolutely aware that they were left-handed people what they realized is i don't care if you're left-handed there needs to be a convention okay where bacteria that come out of your ass should not be put in your mouth.

Sure. And that is more important than the handedness because they literally lived in a society where there were endemic diseases like cholera and stuff like that. So for the sake of sanitation, they would always have you eat with one hand and you never use this hand. So Dr. K's logic there is incredibly bad. Washing yourself with water is a very hygienic practice in my opinion. Perfectly fine. Toilet paper, not so great. So Dr. K's logic there is incredibly bad. Washing yourself with water is a very hygienic practice, in my opinion. Perfectly fine.

Toilet paper, not so great. Good. Just for the record. Yeah, hot kicks coming out to your mouth. But, you know, it's just the wrong conclusion to draw that people, you know, use one hand for one, one hand for the other, that they intuitively or naturally kind of

associate feces with being dirty and not wanting to have that in contact with stuff you put in your mouth that does not mean that you have an understanding of microbiology it just means that you're a normal human being having normal human intuitions i don't think cavemen were walking around smearing feces in their food either. It tends to be a fairly strong aversion to that. So, yeah, the logic doesn't hold up there. And Dr. Mike raises the issue about potential survivorship bias. Like, are we just remembering the hits? Which is almost certainly true, but also, as we've just talked about, I think that's actually maybe slightly too kind,

describing this as an important hit. But in any case, here's Dr. K responding to that and also potentially offering some criticism of Ayurveda. This is great. Okay, so let's look at that in a couple of different ways. So it's absolutely a possibility of survivorship bias. So let's also remember that there are a lot of things in Ayurvedic medicine that are not correct, right? So this is where, and what tends to happen is we don't propagate those. And then what ends up happening is a survivorship bias where the stuff from Ayurvedic medicine, like let's say ashwagandha or brahmi or meditation, these are the things that we now associate because we remove things like heavy metals in the usage of medicine. So there's something called rasashastra in which they'll use things like arsenic, mercury, things like that as treatment. But that is not nearly as popular.

But that's absolutely a part of Ayurvedic medicine. treatment but that is not nearly as popular but that's absolutely a part of ayurvedic medicine so to say that ayurvedic medicine is right i think is a gross over generalization because there are eight branches of ayurvedic medicine some of them have scientific support some of them have scientific evidence that they're actually harmful now there's even a counter argument to that which is that they may have known something about the usage of these chemicals that we don't. Right. What do you think of that, Chris?

So first of all, I think people would correctly give Dr. K some credit that he's willing to acknowledge that there's elements of Ayurvedic medicine which are likely wrong or harmful. So you deserve some credit for that. But it is notable that almost immediately after talking about the fact that there is branches that include arsenic and mercury being used as treatment, then saying, you know, on the other hand, they may have known some stuff that we didn't about how those things work and he immediately shifted to pointing out that it's got a self-correcting process by which it discards

the things that don't work so yeah yeah so there's that but superficially i think this looks like acknowledging that the system is not perfect but that's a low bar to say that a system of medicine is not giving perfect treatments all the time. But in any case, after mentioning that, they go back to discussing, you know, why even if that's the case, we should be wary about dismissing the possible insights there. So a good example of this is if you go back 60 years ago and someone shows up and says, hey, you don't need to take an ssri for your mental illness you can sit there and meditate and what would science have said 60 years ago about meditation that it's useless absolutely right and that's what we did say and so they figured something out that

based on our modern understanding of biology at the time was literally useless, was so antithetical to everything that was a revolution in biological psychiatry. We're like, this is complete BS. And we were so confident. And today it turns out that we're grossly wrong about meditation. Yes. But again, are we just pointing out the one time we were wrong and we were actually right the huge majority of the time?

That is what I think makes Western medicine the best. So what makes Western medicine the best is we're the best at pointing out when we're wrong. How true is that, Chris? To what extent is meditation an amazing cure for mental illnesses? This is a huge thing that Western medicine was totally oblivious of. Well, is a quite a broad literature on this right but it's essentially mixed in with the mindfulness literature and the issue there is you have a lot of studies claiming that mindfulness is you know very very good and on par with other treatments for depression but in general depression is a difficult thing to treat. And, you know, in the same way,

there are studies showing that exercise and tango dancing or whatnot can be effective for treating depressions, but usually not the most severe types of depression. These tend to be for lower level chronic depression so and that literature has a lot of issues so dr k presents it that it's been completely vindicated which is a narrative which is very popular in various medical circles and you can point to lots of meta-analyses which are showing that but i would say in general there's an issue about that being overhyped but i i do think that

for those people that are inclined towards mindfulness and introspective practices doing that or doing tai chi or doing something can be beneficial in the same way that maybe talk therapy can be for different kinds of people so yeah i think it's that you know in general it's a fuzzy area sure yeah i mean like exercise is undoubtedly going to improve your mood if you can do it regularly um conscientiously but like you said when you're talking about the really serious clinical levels of depression then telling someone to go for a jog is generally not going to help um so i expect this yeah that's right i expect the same thing would be true of meditation at least yeah i mean but even so i mean even if you put all of that aside the point

that he's arguing is a relatively narrow one which is that there could be some ideas from traditional cultural practices that you could then try out test using scientific methods and and they might point you in the right direction they might turn out to right and they might have in a previous area have been chauvinistically like culturally chauvinistically dismissed as inferior or irrational and whatnot. I think we can all agree that in previous years, some things are chauvinistically dismissed. Yes, even today. Well, I will say that that presentation, though, Matt, it does rankle me a little bit,

because it is the case that there has been dismissive views of other cultures, right? You know, you're familiar with colonialism, I imagine. I have heard of that, yes. But there is also a fairly consistent thread in Western societies, including at the elite level and amongst medical practitioners, which is very interested in any non-Western medicine or treatment or philosophy, right? You can see it in the Theosophist movement. You can see it in the New Age movement.

You see it all over the place. And just to show my cultured nature, there is a play called Juno and the Peacock by an Irish playwright, Sean O'Casey. It's from the 1920s. I remember because I was forced to study it when I was in secondary school. And there's a character in it who is presented as like wants to present himself as a worldly individual. individual and he's constantly referencing the brahmin and the mystics in the orient that he's been studying who you know have allowed him to understand matters and part of the joke in it that he's getting things wrong he's kind of misusing the terms and whatnot but it shows that

that was a common thing that like the educated people would be interested in the ancient wisdom of the orient and that this is a common trouble so just this notion that it was always treated like meditation what the hell is that there's no validity or use to that no there's also always been a healthy fascination and the kind of exotic attraction to that from people in the west so i just want to point out that dr k in his presentation often overlooks that there is a romanticism attached to those traditions as well as a you know a dismissive aspect so indeed it's just a point i want to make and if you remember about the issue about depression and there being different types did come up in the previous content. And this theme is continued here.

Their system of diagnosis presumes that there is not a treatment for depression. And then what we do is we take that thing, we remove all the individuality, which is a core part of their system of medicine. which is a core part of their system of medicine. So their whole system of medicine is that, so there's even like, so for example, they believe that, you know, the man, I'm extrapolating here based on my expertise. But if you look at like depression, there are three subtypes of depression. So there is neurovegetative depression, right? So difficulty getting out of bed, things like that. Then we have anxious depression. We recognize these as two clinical entities.

There is a really interesting third subtype of depression called depression with anger attacks, where the primary manifestation is frustration and anger as opposed to feelings of sadness. Now, the really interesting thing is if you look in Ayurvedic medicine, they say that there are three dominant elements. There's like the earth element, There is the wind element. And then there is the fire element. So if you take this depressive pathophysiology and you stick it in someone who is a predominant earth type, you will end up with a neurovegetative depression. If you stick it in a person who's a wind type, you will end up with an anxious depression. And if you stick it in a fire type, these are like Pokemon, you will end up with a depression with anger attacks. So even in their literature, they have these three subtypes of

depression built out. And they say that it correlates with something about your alleles and how they manifest, your phenotype. Right. So he's linking now the we know what he's saying we know what he's saying yeah yeah we know what's going on here i i see that there are three sort of main categories of depression um as well as there being a bunch of specific sorts of types but i'm not sure if he described them quite correctly like did he describe one type as being depression with anger attacks uh yeah isn't that one of the subtypes that he discussed like the you remember the depression doctor that was raising that as like a non-acknowledged like subcategory yeah according to a quick little search here i see that we have major

depressive disorder clinical depression persistent depressive disorder which is a more chronic sort of version and bipolar depression which is you know this alternating of depression with periods of mania yeah i don't know if i think he might have adjusted the descriptions of them a little bit so as to fit the uh things yeah yeah yeah that wouldn't be a huge surprise but i i the main point i wanted to make in raising this is that the stuff that we heard in the first video from four years ago, where he was talking about this issue about Western medicine, only having one model of depression, right.

And one treatment, you hear the echoes here quite clearly. He has a very similar view then as he does now, although at least here he is acknowledging that there are different types in modern medical systems as well, right? Yeah. Well, let's continue this East versus West paradigm that he's presented. I want it to be more accurately modern versus traditional, but he keeps framing it as Western versus Eastern. The problem is there's such a pissing contest between Western medicine and Eastern medical practitioners that no one on the East is willing to say, yeah, this treatment sucks.

So the way, the one thing that we do really, really well, which is I think why allopathic medicine, talking about selection biases, but let's talk about not selection biases in a, the reason that Western medicine is dominated so much is because we are so good at pointing out when our medicine is wrong. So if you look at things like thalidomide or, you know, like that's such a great example of, oh my God, revolutionary medicine solves nausea. And by the way, we're never going to use it ever again. right? And so we're really good at that. And the biggest problem in Eastern medicine is they are so hung up on getting

widespread acceptance. There's this ego battle going on between Eastern medical practitioners and Western medical practitioners that Eastern medical practitioners are not willing to say, oh, hey, by the way, this treatment actually sucks. Is that because a lot of those treatments are less based on the scientific method and are more culturally based? So I think they're based on the scientific method, but they don't look at the mechanism in the same way that we do. So if we look at scientific method, what is scientific method?

It is having a hypothesis, testing that hypothesis, observing results. So I think they did that. Is that the scientific method? What's the issue then, Mark? That is the issue indeed. Well, I thought the Indian fellow who did the very good science-based evaluation of Dr. K and was very critical of these traditional methods, pointing out their problems and their dangers he he actually described the problem quite similarly to dr k at the beginning which i think is true which is that you're going to have a natural cultural affinity and and have pride in your distinct cultural

background and a lot of that ayurvedic stuff is linked to that so if you're if you're a proud indian if you have nationalist feelings etc then you're going to want to defend it to the hilt so i thought at the beginning anyway dr k was take was was okay he was noting that there is like a kind of ego battle right between different different people and that the Western slash modern medicine might be better at discarding treatments that don't work. When it comes to this issue about science, though, I think this is a crucial issue. So let's hear a little bit more about that. But they absolutely applied the scientific method. So I don't think that you can develop as robust of a system of medicine.

The big difference, though, is that we're really good at instrumentation. So in the West, it's not even technically a part of the scientific method. You can just, you know, a child can make observations, test hypotheses, and come up with conclusions. I mean, every time a child's learning to walk, that's what they're doing. Absolutely, right? But they don't use a microscope. They don't use a microscope. They don't understand anything about anatomy.

So one of the things that I think we've actually mistaken is that in the East, they use the scientific method quite robustly. They just don't use instrumentation. So what they did is figured out all of these correlations and causations and developed these kind of heuristic systems. Even something like the concept of an organ is actually an abstract concept, right? It it's not you can make an argument that there's no such thing as an organ there's just everything is just cells you can just say that about anything about a cell yeah right that's like I think Deepak Chopra's main thing

is like what is HIV that's a concept that you've created in your mind it's like well wait hold on yeah so think it's very easy to go. So I think they applied the scientific method, but what they didn't have was good instrumentation to elucidate the mechanisms, right? So they didn't have microscopes. They didn't have, but they were still able to make observations that when you have a diabetic, they're going to have sugar in the urine. And if you have sugar in the urine urine you can test for that by if ants drink your urine yeah this is a style of argument or a line of argument that i've i've heard a lot chris um yeah it's very popular in complementary and alternative medical actors right yeah and like for better or worse the you know science has been glorified reified it's like the good thing you can't be you can't be

anti-science right um so what you do regardless of what you're arguing for it could be anti-vax stuff it could be other therapies it could be anything really is that you you broaden the definition of science or you and you describe these other things as also being science or this other thing not being real science and you know it gets quite tricksy i would say i don't want to get into a long boring discussion about what exactly science is because you can debate about it but it's certainly you cannot lump everything like a child learning to walk or noticing in your own personal experience in your own practice that x seems to be associated with y it involves a lot more of a systematic procedure than that modern science emerged from previous traditions and there are elements of scientific thinking that you can find in lots of pre-scientific systems of thought.

But what they lack are very critical components that make things different. And it's why in the modern era, we can fly in planes or we can develop the vaccines. And in the pre-modern period, we still had people that cared a lot about all these things. We still had people making observations, but we didn't have the same technology develop or treatments, right? Because there were important components missing. And yeah, so he's not wrong. I've even heard developmental psychologists talking about that you can think of children as like little scientists testing things and then kind of working out how the world works. But they also come preset with, you know, intuitions about things. But in any case, it's not like these analogies are completely foreign.

But it's also the case that little kids are not scientists. They're not. So you have to be clear about what the distinctions are. And I think just to play a clip, Dr. Mike does do a good job of pointing these issues out. So like, listen to this. I think a lot of their scientific method approach is more so finding correlations and things that happen which can be a form of scientific method and an introductory form of scientific method but then in order to see if your correlation is valuable can you affect it can you uh reproduce it can you generalize it that is always missing in eastern medicine yeah i disagree really so tell me more yeah so like i mean that's how they came up with these things like ashwagandha and brahmi and some

of these things that we use in psychiatry turmeric yeah so you've got the pointing to things that there is evidence that they work or have come to be used in modern medicine so like they discovered them without using you know clinical trials and and whatnot so they must have been impossible they must have been doing science of some kind yeah yeah yeah so that's that's not an accurate conclusion there right because like you can be just to be clear you can be correct and you can identify treatments of work without having the correct underlying understanding of the mechanisms involved and whatnot.

I do think this is something that's very familiar if you've spent time around CAM debates with medicine, but I don't think it's something that people intuitively get. So these arguments often sound on the face of it superficially plausible, right? Especially if you yourself are not somebody that does science, right? Because like, well, why would you know the various mechanisms that are necessary for a system to be scientific versus not?

But see if you can hear any echoes in this next clip, Matt, from the content from four years or so back. Let's see if any of it has survived. So when you randomize, so we view the RCT as the hallmark, right? There's a huge problem with the RCT. So let's say I show you an RCT that says that cholesterol, let's say like cholesterol lowering medication. What is the outcome for an individual patient when you prospectively give them a cholesterol med? You're talking about number needed to treat. No, I'm not talking, oh, sure.

But so if I come to you today- 99% of the time for the individual, it's not gonna have an impact. But for the general population, you will see. So this is really important to understand. So our system of medicine does not make predictions about individuals. It makes predictions about populations.

So Ayurvedic system of medicine is completely different because they don't care about populations. They care about individuals. So their whole system. So if you think about randomized controlled trials, what we're literally doing in that trial is removing the individuality from our system of medicine which then creates a problem of external validity so the basic problem of our studies is that we can do a study on 10 000 people but you know this is a clinician this is why we need clinicians because your human brain needs to take all of this data and then translate it to apply it to an individual. So in the Ayurvedic system of medicine, they think that randomized controlled trials

are the antithesis of practicing medicine. Yes, strong, strong callbacks to the material we covered last episode. Chris, I'm just resisting the temptation to rebut this again. Well, you can at least exercise your muscle a little bit. A little bit. What's just the condensed version of the issue there?

Well, I'll just remind listeners of this false dichotomy between individuals and populations. An RCT, or in fact, any statistical analysis is making predictions on individuals. Yes, it is assessing an effect, which is working on a measurably large number of those individuals, such that you can detect it in the composite. But it just makes no sense to contrast that with a kind of phenomenological point of view, where you sort of translate it with your human brain, to put it in Dr. K's terms, in order to be able to apply it to an individual person it just doesn't make sense sorry well you might you might feel some catharsis smut because dr mike is going to help you out by pushing back a bit so

let's listen to some pushback we're throwing away randomized controlled studies because they're imperfect to the individual i think we need to look at it deeper and say, right now, this is the best knowledge we have for the general public, which will ultimately be the best for you because this is the best information we have. In the future, as algorithms, as information gets better, I think we can better individualize randomized controlled studies so that we can run simultaneously thousands millions of experiments to know instead of 80 patients i need to give this blood pressure medicine to prevent the heart attack only 10. so now i'm targeting the therapy more towards the individual and less towards the general public but so then ideally what you would

want is not even a randomized controlled trial. You would want trials on an individual, right? Because that's when you produce perfect correlation between your scientific methodology. Absolutely not. Explain that to me. Too much bias when you're treating a single person. But isn't that what you're looking for? Is you want an amount of bias that is specific to the person? Again, this just makes no sense, does it? Like, how could you collect all of this data from a single person? Like, let's say you wanted to test a vaccine. How could you give the person the same vaccine 10,000 times?

It doesn't make sense. Unless it's a special repeated measures type design, you cannot create a science of Matthew Brown and have journals and stuff like that, which with all these researchers all over the world figuring out this collective knowledge about the best way to treat Matthew Brown, it's not going to work.

Well, and what is happening here as well is that Dr. Mike is talking about like individualized medicine, which is something that modern medicine wants to get to right where you know in the you can imagine a future med bay where your specific gene is like sequenced immediately and the medicine is calibrated perfectly to your system but as as matt and dr mike are, you can't get to that level of specificity without clinical trials that would identify what genes are doing what and so on. And you can't do that with one

person. So I'll play a clip, Matt, where Dr. Mike is trying to explain this. If we could get to a point where that did work and we can recognize that, okay, this person has this kind of serotonin transporter gene and this kind of medication is effective do you think that is that the kind of goal of personalized medicine is to create a system of understanding this person as an individual not worrying about the population it's what are your polymorphisms so we can figure out the perfect medicine for you yes but the only way we can get there is with randomized controlled trials how so in order for us to know that this works on this person oh we have a randomized control trial that this is effective for lots of people yeah so

the methodology is personalized and then we we are doing a randomized control trial on personalized methodologies to see that personalized. That I'm with you 100%. Okay. So when I look at the Ayurvedic system, I think they're closer to that personalized methodology. Don't you feel like there's so much bias in that approach, though? Do you agree with Dr. Mike? That Ayurveda is closer to the science of personalized medicine? No, that's Dr. K.

Sorry. Dr. Mike is saying there's a lot of bias inherent in claiming that you're just focused on an individual and you're not trying to extrapolate out the general population's effects right which we've already covered that they do do you know if you remember we listened to clips from this exact conversation where dr k is talking about applying principles out from the individual to the general population right And then goes on to say he isn't. Like, I'll just play it here in case anybody didn't hear in the previous episode. So if you look at our Western system of medicine, the idea is that a disease process is independent

of an individual and has a treatment. So the whole point of an RCT is let's remove all of the individuality, all of the specificity from an individual patient because if we take an individual patient, we treat cholesterol in this individual patient. We have no idea how that's going to apply to the other 9,000 people we treat because this person is an individual. So let's remove individuality from the equation. Let's look at high blood pressure and let's try to isolate this disease process. Then we run into a problem in Western medicine because you can isolate this disease process in a laboratory. But the moment that you have a real person in front of you, things get complicated. Agreed? 100%. So Ayurvedic medicine just looks at it from the opposite direction. They kind of say,

okay, let's start with an individual and let's understand what works for this person and then they also generalize they sort of also have you know diagnoses right which obviously means that it's not it's not there's diagnoses that are shared amongst individuals but they start from a more individual lens we are starting at a population level and we are trying to narrow down to personalized medicine. They start at personalized medicine and they sort of extrapolate out to a more general way. Isn't that flawed by design? No. It's only flawed by design if you presume that the population base and the system, the existence of a disease process that is independent of people exists. Oh, I find it so frustrating because he conflates so many things in a muddled way and to come to

some conclusions that are not connected with any of them. Well, one thing I didn't mention last episode, Chris, is that he's conflating the idea of like a universal treatment, like a non-tailored treatment with an RCT. There is no connection between those two things. You can do an RCT with, say, Freudian psychology, which maybe assumes nothing and treats everyone, explores the different things and does completely different things with every individual within this abstract framework. And you can still evaluate that with an RCT.

You allocate half the people to the Freudian method of counseling, add some other people to Ayurvedic, get some more people, and set them to a control where they get told to cheer up. So he's conflating that with the idea of testing something that is non-tailored that is universal like like a vaccine and they're separate things so he can argue against non-tailored treatments but you know as as you said this is not something that anything about modern medicine is against we would love to have the information such that our treatments were tailored not just to men or women or older people or younger people but tailored even more specifically

about other information about you like like your your dna some sort of profiling there so um you know all these false dichotomies get sort of thrown up and his conclusion is is that ayurveda respects the individual and cares about and treats the individual whereas modern science doesn't it just kind of ignores the individual and sort of pulls out some little aspect of them and only cares about that it's just annoying logically it's it's very very calm centered logic right it's across all disciplines and traditions in complementary and alternative medicine. The narrative is always the same. Western medicine only deals with the kind of symptomology.

It doesn't deal with like the core illness and they don't really care about individuals. They're just treating people as illnesses. And Matt, this point about RCTs that you brought up, Dr. Mike does try to highlight that this is the wrong point to get bogged down on. So he tries to highlight this by talking about alternative designs and hierarchies of evidence. And I thought this was quite good.

I think when you say we should do a cohort study to see if it is non-inferior, to me, that's the same thing as an RCT. Like, it's not the gold, like for us, an RCT is the gold standard, right? But we have levels, a hierarchy of evidence and cohorts are still up there. It's not just mechanistic, right? Like if you do a cohort study. But a cohort study and RCT are two completely different study designs. I agree. But in terms of weight of evidence, they're high levels. No, no. But a weight of evidence is fine. But what I'm saying is that the RCT as a study design is antithetical to the system of medicine.

Sure. And I'm just using RCT because it happens to be the gold standard. Let's take cohort. Let's take RCT. All the higher levels of evidence. They're not done for Ayurvedic medicine, at least the majority of it. So granted, we can't do RCT, but we can do cohort. Those things aren't done. taking what they're doing and you're seeing it as a leaning towards story towards observation away from the evidence-based model and i see it as full one-sided well i i don't follow you you said earlier a statement that it leans towards the story based the individual based versus the group randomized controlled.

I think it doesn't just lean in that direction. I think it's fully in that direction. Yes, at least in the theory, as we talked about last episode in the practice, it might well be that you get categorized according to your dosha and you get given one of the things that are on the shelf.

And in fact, it's not maybe quite as tailored as the philosophy um entails well i i think there yes this is absolutely true but i also think that he is dr mike that is is talking about that as opposed to being an alternative system of medicine. It's primarily like cultural narrative, right? It's like a non-scientific application of medicine based on building the narrative, not on testing treatments. And that's what he wants to argue, that why the evidence matters yeah he's not talking about rcts specifically he's talking about he's talking about systematic data gathering and testing things properly you know and it's true there are some things that cannot be investigated

easily with rcts the link between smoking and cancer for instance we couldn't get one group to smoke for their entire lives and then come back and see if more of them died of cancer in 60 years' time. We had to do different kinds of studies there. But the important thing is that you gather large amounts of data and analyze it rigorously. You don't take this alternative epistemology that cam tends to endorse i know i have a good part here matt that i want to get to where dr k provides uh like acknowledgement of limitations but just before that just to round off this point about individualized versus not and to highlight

the same use of gamer analogies and whatnot that we experienced in earlier Dr. K content. This is, again, from the Dr. Mike interview. Listen to this. So we have, let's say we'll use a video game analogy. So we've leveled up to level 100 on population-based medicine. And then the reason that we have good clinicians and bad clinicians is that the good clinicians are the ones who have leveled up to level 50 on individualized medicine. In Ayurveda, they've leveled up individualized medicine to level 100, but their population-based medicine is level 10. I think when you use that example, when you level up to 100 on the individual level, your data is fraught with error and bias and subjectivity because you're not studying it

en masse. And there's so many mistakes that you could make when you're just treating an N of one. Yeah. Yeah. This is fundamentally what it comes down to. You cannot base any kind of evidence-based practice, but on a purely phenomenological individualized level, you can't say it doesn't even apply to people specifically. If you're studying plants, you couldn't say,

okay, I'm going to study this particular tree, not other trees, just this one and find out what makes it unique and all the special things about it. That is not going to give you a reliable source of information to understand anything about trees in general or that species in general or that species in general and so on you need to collect large data sets and analyze them rigorously it definitely sounds nice to talk about there being a system of knowledge that is based all about you

or about me matthew brown it's very flattering to think of everything being customized just for me somebody staring deep into my eyes and finding out the essential mathiness of me and what I specifically need without recourse to any other people. But while I might pander to my vanity, that is not going to help me. Yeah. not going to help me yeah and so matt we've heard you know like this this all sounds very familiar to the content that we've previously heard focus on the individualizing thing recognizing that there's a trade-off but essentially ayurvedic is better that was the constant message that we got but there is a slightly different emphasis placed in this conversation. So there's actually a misunderstanding here that comes into play. So listen to this clip. This is a fundamental problem with Ayurvedic

medicine, which is that the good thing that we get, this is why I think allopathic medicine has grown so well, is because it is reliable. Ayurvedic medicine, I do not know that it is even 10% as reliable as the practice of Western medicine. So if you think that, why do you discuss Ayurvedic medicine principles often? Because I think there is a huge amount of utility to it. Okay. Okay. A huge amount of utility to it.

Sounds contradictory, but what does he mean? Well, he's going to go on to that but i want to make one note there he said i do not know that it is even 10 as reliable as western medicine right that's what he said 10 as reliable as western medicine so dr mike when he talks about this later as it comes up it's kind of presented a bit differently and it leads to i don't know misunderstanding or not but like it's kind of recasting what he said but i i want to make the point that he said you know it could be 10 as reliable as western medicine but to follow on from that point, listen to this. Before this whole healthy gamer thing, my actual area of interest was evidence based complementary alternative medicine. So there are all kinds of problems that we haven't even

touched on. I mean, here you are saying, what about this? What about this? I can dismantle Ayurvedic medicine because there are fundamental weaknesses. The first fundamental weakness of Ayurvedic medicine is that you have no way to gauge practitioner reliability. The good thing about allopathic medicine is that at least in the United States, if you finish a medicine program, there are standards that people can expect. If you go, you're a family physician, I'm a psychiatrist, but two people have a heart attack on an airplane, they're going to get some comparable care, right? Even I can handle that some. So the biggest problem with Ayurvedic medicine is when you have this individuality, how do you judge the quality of a practitioner? How do you know ahead of time whether this person is good or bad, whether there's biases in their patient population? good or bad, whether there's biases in their patient population, if their patient population has high socioeconomic status, and this practitioner is very charismatic, so they're

engaging the placebo effect, how do you even know that their treatments are working at all? This is a fundamental problem with Ayurvedic medicine. Yes, so certainly hamming up the problems that he sees with Ayurvedic medicine, but that does contrast with what he was saying before about it being a superpower about it enabling him to be oped i suppose hello part of it here i think is that you do have to note that one of the main issue he's drawing here is like how do you identify the actual quality practitioners right right? And that suggests that there is fundamentally very good stuff. If you can discern the bad practitioners from the good practitioners, then you'll

be able to get to really, really effective treatment, right? So it's acknowledging that there's a problem, but the problem is one of quality control in a way, right? Not one of the underlying system right but in in any case again this this returns to the 10 mark right and dr mike i think also makes a bad framing of things here but uh so listen to this you mentioned we need to bring some of Western medicine into Ayurvedic practice to improve Ayurvedic practice. I view that as not an optimal use of, time is probably the wrong word.

I would view, based on how you describe Ayurvedic medicine, that there's a lot of problems. 90% of it has issues, et cetera, et cetera. medicine, that there's a lot of problems, 90% of it has issues, et cetera, et cetera. Why not take what works of Ayurvedic medicine, the art aspect of it, and bring it to Western medicine as opposed to bringing Western medicine and trying to fix something that is really very problematic already so far gone? It's a great question. So the first thing is that I think the question is sort of moot because I think both are happening simultaneously so I think as we

progress in our scientific understanding of medicine we are moving closer to Ayurveda so that's happening automatically because I think that it as we're discovering more of truth we're just moving in a particular direction of individualized medicine, which is the whole backdrop. So, Matt, did you catch the issue there with the switch? So Dr. K said, I don't know that it's 10% as reliable as Western medicine. And Dr. Mike converts that to if you acknowledge that 90% of it has issues, right? if you acknowledge that 90% of it has issues, right? And Dr. K doesn't correct him here,

but he didn't say initially 90% of it is bad, right? He said 10% as reliable. It could be 10% as reliable. Yeah, yeah, yeah. So this is going to, because this will not get reframed. And I think moving forward that like Dr. K, there is even a part where he accepts that framing. But like, I think it's important because that would be presented as Dr. K said, you know, he acknowledged 90% of it as rubbish, but that isn't what he said. He said, it could be 10% as reliable as Western medicine. And it's Dr. Mike Kupriyam's idea as 90% being negative. Right. Okay.

You might not see why that matters, but I think it matters because it will be used rhetorically in various arguments. And just as he is doing here, you know, as he said, he's somebody that studied complementary and alternative medicine. So he knows how to present the devil's advocate criticism of his system, right? And in just outlining it, it makes it seem like you're, you know, that you aren't adopting a strong position because you're able to see the pros and cons of both sides. But as we've seen in the previous content and in this conversation, he is not actually taking a position which has a very balanced perspective. He is very in favor of Ayurvedic medicine being applied. I'm very critical of Western medicine. i i feel that there's like subtle reframing going on here that it came to be slightly how this conversation was interpreted positively by people okay all right right so not

quite following but i'm sure it will become clear okay but in any case the issue that i think with dr mike here is that when he reframes it as like why not take bits of ayurvedic medicine and adopt it into and he accepts the western medicine framing that sounds like a very colonialist endeavor like why don't we just why don't we just appropriate a few bits and yeah and forget about their philosophical and historical context and like let's just take out you know what works and put it into western medicine right and that framing is what alternative medicine practitioners always want to suggest right that like western medicine is just extractive. And so Dr. Mike is doing the rhetorical work here. And just to highlight, Matt, that Dr. K is not so down on Ayurvedic. Listen to this.

So I think maybe I'm foolish. Maybe I'm optimistic. So here's where I'm coming from. Here's why I don't think it is an unsolvable problem. So if you look at the history of humanity, we've been faced with unsolvable problems that get solved. So I have faith that if we were to leverage even 10% of the brain power in scientific weight that we have in allopathic medicine towards Ayurveda, I think we could, it'd be amazing what we would accomplish. That's my gut instinct. I don't know that that's true. Is it potentially an unsolvable problem? Absolutely. So what I think though, is that what I've seen already is that it doesn't take a whole lot. So if we just put 10% of the, you know, brain power into ayurvedic medicine, it will, it'll reap huge, massive rewards, right? So that doesn't sound like somebody that thinks 90 of it is crap no i guess not but i'm not quite sure what he's wanting the scientific brain power to do is it to

go ahead and test some proposals inspired by analytic practice in a scientific way and then understand the mechanisms and so on that is integrated into into a modern scientific framework or is it to do something else my cynical view is he wants more gene-wide association studies that validate the support that validate there is yeah that's what i suspect he means but you know if you take it charitably he wants to apply like critical evaluative methods to better identify you know treatments that work from from don't but um i think in the eternal struggle between conventional medicine and complementary alternative medicine there is is like a natural solution, which is to take the practice that could be informed

by some traditional cultural activity or could be informed by practitioner experience. People work in a particular hospital, notice that something works or informed by homeopathy or some other modern instantiation of CAM and then go ahead and test to see whether or not the effects hold up. And if they do, then start to puzzle out what are the mechanisms there and understand scientifically how this thing works. But this is not a proposal that is embraced by people from the other side of the fence,

because they quite rightly identified that what that approach assumes is that complementary medicine that has been demonstrated to work is just becomes medicine, right? So what they do want to do is to carve out a place for, you know, holistic spiritual practice that sort of plays some of the role of medicine but isn't subject to the same kind of testing therefore they do not want you to unweave the rainbow and they're much more interested in sticking with those theoretical frameworks it could be a color cosmology or it could be homeopathy's weird thing or you could take energy therapies, or it could be Ayurveda, or something else. Those sort of philosophical spiritual frameworks are important to the practice of CAM and important to the appeal of CAM. Therefore, they're not going to abandon them, and they're not going to sort of submit themselves, I think, to knowledge extraction

to benefit conventional medicine. Yes, yes. So a little bit more on this, Matt, and then we're going to get to an inflection point in the conversation that's quite important. But here's a bit more. And that statistic that I keep hardly knowing about, the 10%, 90%, it's going to make an appearance again. So listen.

We have the starting point of randomized control data, population-based data that we can then tailor an art and improve our art we definitely need to improve our i will never not support that ayurvedic medicine has such a fraught foundation and we're like let's bring randomized controlled and evidence and all that to this fraught concept already. Why? I don't think that the fundamental concept is fraught. In fact, I said there's like 90, like 10% of it is only valuable. Yeah. So, but I don't think the fundamentals are fraught. I think the fundamentals are actually, I think the reason we practice, the more we practice the art of medicine, the closer we are to the Ayurvedic system, because that's what their system is.

It's an individual treatment. But we end up there yeah versus starting from there i think that's a drastic distinction yeah i think that's important and i think he's speaking his truth there which is that the thing that cam adherents like is the the philosophical and spiritual foundations of it it is the chakras it is the the energy patterns it is the colors and so on they're actually not so much interested in testing whether or not turmeric or this particular thing works reliably because that's not really the basis of the appeal they do like the philosophical framework but i think what dr mike is getting at there is that like the framework is cloud castles built in the sky you would be there is no reason to

think it is worth investing a whole bunch of effort into validating yeah and you've heard a little bit of like confrontational tone appear in these questions. Not very strong, actually, but, you know, just just a hint. But you're going to hear it a bit more. So, like, just note the rising temperature in the conversation here. So so so let me ask you this. Do you think what do you think is a better system of medicine, a system that is population-based or a system that gets outcomes that are tailored to the individual? Let's say that I could perfectly diagnose you.

I did all the genetic stuff. I could analyze all of your phenotypes. I could analyze even things like your digestion, your – hold on. Digestion, your absorption of of nutrients what kind of absorption difficulties you have and i understood all of this information about you which one do you think would be better of course you created a perfect example but that doesn't exist so the foundation of ayurveda starts with that yeah but it's nowhere near it it's not even close oh this is that that's where that's where you got to be careful right so I think that it's way closer than what we give it credit for.

You're saying they have a perfect understanding of each individual? They do not have a perfect understanding. What I'm saying is that the direction that they are moving in is to focus on the individual. So we don't even focus on the individual. We focus on the individual. So we don't even focus on the individual. We focus on a population. Again, with this care for individuals versus abstract populations. But you heard Dr. Mike getting frustrated, right? Yeah, I did. I did.

I did. I mean, but the thing that they're talking to and that the thing that Dr. K is defending is the theoretical framework of Ayurveda and saying that this is a valuable thing that deserves serious scientific investigation and validation. And I just want to remind people what these theoretical frameworks are. And before I describe, Chris, what the theoretical framework for Ayurveda is, just very quickly, let's take energy therapy

first of all. Let's see whether or not this framework is deserving of serious scientific investigation. It proposes that there's a biofield, an energy field that surrounds and permeates the human body, that there are chakras, that there are meridians, that are pathways where life energy flows through the body. There is a universal life force that can be channeled for healing purposes and i'll stop there let's say homeopathy right they've got a theoretical framework it says that there's a law of similars right like cures like there is potentialization right where you can potentialize

water basically by bringing into contact with things there is also this idea of individualization in both of those, and also the vital life force and holistic approaches, etc. Ayurveda, very similar. There's the three fundamental doshas, of course, that we've heard about, that imbalance between these doshas leads to illness, that all matter is comprised of five basic elements, and it's these different elements that provide the vital essences that the body needs, digestive fire, toxic residues, seasonal patterns, and so on. So the thing about CAM is it's not just practitioner knowledge or a traditional cultural knowledge where you'll figure it out

through trial and error and intensive observation that such and such works. It is actually a spiritual cosmology that is attached to the practice and that's the aspect of it that is appealing both to the people that like to use it and the practitioners. And I think that that's the thing that Dr. K is defending and so I'm with Dr. Mike in that it is not a stable foundation. Absolutely. Absolutely.

Yeah. And I completely agree with that, Matt. But I also think there is the possibility of falling into a rhetorical trap here laid by Dr. K and his framing. And I think it relates to all those systems that you just described because any of them can do this right so listen to what dr mike starts saying here in the way that he frames things because he's getting frustrated right so listen to this why do you think in eastern culture we never got not we, but why hasn't it moved to a labeling system,

a randomized controls? Why has there been so much disconnect between randomized controlled stuff happening in Western medicine, but that is firmly pushed against in Eastern medicine? Why do Eastern people not like randomized controlled trials? Yeah, like why didn't throughout time, like the way Eastern medicine is talked about now is more similar to how Eastern medicine was talked about 500 years ago. Okay, yeah. Than Western medicine talked about now than how Western medicine. Completely. Why is that?

Why is it seemingly stuck in the past? For lack of a better word. What do you think are what's the differential diagnosis for why something doesn't change over 500 years? My. You see, like the point I want to make there is that so what has happened because of the constant repetition that it's Eastern versus Western is that Dr. Mike has now implied and Dr.

K helps him along saying, so you think Eastern people don't like randomized control trials? And it's, he is now essentially in the position of saying the East is backward, right? Like that's what he essentially says. Like they don't change. Whereas like Western medicine develops and like what's wrong and it sounds it sounds bad right like it's a it's a bad look chief to me suggesting that only the west changes and that i think that's by design here so like and i think the correct thing instead is to like this is why it should be framed about modern versus traditional

or scientific versus non-scientific. Yeah, you can't overestimate the importance of that framing because it bears repeating that a couple of hundred years ago, medicine as practiced in the West was as unscientific as Ayurveda or anything else. That is the traditional european cultural health practices are largely bullshit right that should be emphasized right and all kinds of people all over the world endorse practice and receive evidence-based modern scientific medicine today

so you really have to reject that framing that Eastern people like this and Western people are like this. Yeah, and so, you know, when you read out those descriptions, right, Matt, it's completely valid to point out that these are pre-scientific. They're like spiritual or metaphysical concepts that we don't have scientific evidence for but because of that conflation of those two positions it can come across as western people dismiss you know anything that doesn't fit within their paradigm as opposed to science has consistently shown that these systems are not correct and that's the issue i think is like that that presentation that it's like western cultural close-minded chauvinism is the like the bait and switch which happens so easily and and it's really effective it's a really effective treatment because like who wants to be a dismissive western chauvinist who yeah who thinks that the rest of the world is like stuck in the past and

unable to adapt like and i don't think like that to be clear i that's why i think anybody doing scientific modern medicine regardless of race color creed nationality whatever it would get to the same things because it's a system of what it's not a like a specific culture no and it's not it's not derived from any particular culture that's right yeah that's what i meant to say it is a specific culture it's a scientific culture but not a specific national culture and this is the issue if i think like the western medicine branding so that leads to this where Dr. K switches to say, you know, I'm being presented as the pro-ayurvedic person. This is not really fair. I feel like I'm adopting a pro-ayurvedic stance because of the way you're asking questions, but I don't use ayurvedic medicine with the

majority of my patients. I use evidence-based techniques with the majority of my patients because they are reliable. And at the same time,'m with you that i don't know so if you look at this text called jarak samita there's like tons of treatments in there i have no idea how many of those are effective as meditation we even have evidence that some of them are harmful like rasa shastra right so i steer clear of because, but then the problem in the Ayurvedic system is if you go talk to an Ayurvedic doctor, many of them will not say, oh yeah, this doesn't work. That's a huge problem, right? They'll say like, oh, we don't understand it well, or they'll like kind of poo-poo.

And maybe they're right. Maybe we're right. I don't know. So I'll be the first. So my area of expertise is evidence-based complementary and alternative medicine. So the whole point is that there's something very valuable here. This is my belief, something very valuable here, and we need to separate the chaff from the wheat. We need to figure out what is actually really useful here. It's very difficult to argue with someone like Dr. K because he's so manageable.

He changes his stance dramatically from one context to the next so here i guess he's in skeptical mode no yeah ayurvedic is just a you know he barely uses it it's just some interesting ideas i think we should investigate it but until then i wouldn't use it but we've heard him talk about it as a superpower that does it's constantly validated it's a science that's the difference right like it's it's been constantly proven to be correct and like the limitations of population-based medicine is something he observes constantly so which is it so so when someone rhetorically shifts like that dramatically then it can put the interlocutor very much off balance because it's not clear you know it's it's like a shadow boxer yeah yeah yeah and also in this case again now there is a shift to so dr

k is being presented as like a non-scientific person because he's being forced by the confrontational attitude of dr mike oh yes that. Dr. Mike has forced him to defend Ayurveda with his confrontational attitude. Yes. Yeah. So now I will, like, here's a bit that's in the middle, because you'll hear Dr. K admitting flaws, but also listen to him essentially say that there were miracle treatments that he's observed in Ayurvedic. So this is somewhere falling in between both of the narratives he wants to promote. Part of the reason that, you know, I studied Ayurvedic. So this is somewhere falling in between both of the narratives he wants to promote. Part of the reason that, you know, I studied Ayurveda, fell in love with it, and then I went to medical school. Because what I saw is that I have no idea what's the quality of education

I'm going to get. I have no idea what's the reliable, what the reliability of some of these methodologies are. I've seen things that are medical impossibilities from Ayurveda. With my own eyes, I've talked to patients that are medical impossibilities, like paralysis, being able to polio paralysis, right, which is a permanent condition. That's not something that generally speaking gets better. These people are able to walk. And so when I look at that, it gives me pause and it says to me, there is potential here. So what did I do? Did I say, oh my God, there's potential here. Let me go to Ayur say oh my god there's potential here let me go to to ayurvedic doctor and and i'm going to indoctrinate myself no i went to medical i went

to medical school focused on evidence-based complementary alternative medicine realized that in the grand scheme of being a doctor in the world today each of us can make a contribution what do i want my contribution to be i I saw something that I thought was very worth. I saw something that I saw potential in. And I said to myself, even if 90% of it is shit, I can't judge whether 90% is good, 10% is good, 50%. I have no idea. But there's something here that we in the West can benefit from. And that's been what my focus is on. I think he's been quite straightforward there. And I believe him when he says that, you know, he's, he's seen things and he believes that there's value in it. And it's really just like a person, he's expressing a personal subjective, you know, love for it,

which, which is understandable, right? You, you've given his background and you get deeply involved with this thing. You can like it a lot and you can sort of firmly believe in your heart that there's got to be something to it you may be struggling a bit when it's come to backing that up i'd just like to say that my uncle had polio and um the doctors told him he would never walk again and he got better he got better thankfully and um walks fine you saw a miracle i saw a miracle too he didn't he didn't have ayurveda treatment i didn't think he had any complimented alternative treatments put back in the 50s or early 60s i think but you know if he had then and someone was around you

could observe that and go and become a lover of ayurveda or whatever he happened to have been treating maybe he was drinking vinegar eating yeah yeah. So people can get very misled from personal experiences. Yes, absolutely. But when I described it as a narrative, I mean it in both the good and negative sense of that, because I think that Dr. K is rhetorically effective and he can slip between these modes, right? And here he is doing the, I'm an evidence-based person. You know, I'm not an alternative medicine blind advocate, but the framing there is important because what he said was, you know, yes, I saw these amazing things, but so what did I do? Did I go, you know, to try and get that all endorsed? No, I went to become a, what did he say? Evidence-based complementary alternative medicine.

Yeah, right. But so how many evidence-based CAM practitioners are known for debunking or for finding studies that show that CAM doesn't work? It's almost zero. It's almost zero because they all go and find that whatever particular brand of complementary alternative medicine that

they like just so happens that the studies almost always turned out positive right so like you can be more evidence-based but that is in essence a field dominated by advocates for alternative medicine right you can counter this by showing me the people that have studied CAM approaches and become people that are, you know, arguing against the integration of CAM into medicine. There's a handful of them and they're all known, right? So he presents it as I was being skeptical, but that is just being an advocate in a different variety. So that's the bit that I want to call out. And we went here from saying he doesn't really use Ayurvedic treatments, right? Like they're not a really big part, but listen to some of this, Matt. So this might sound familiar.

What do you like about Ayurvedic medicine? What is that part? So I like that they focus on the individual. Got it. What else? So I like that they look at, so just as a psychiatrist. So like one thing that I really appreciated was this concept of like a cognitive fingerprint. So we have this in some ways in terms of like five factor model and stuff like that. We have these personality assessments.

But these personality assessments are usually done at the population level. And so the translation down to the individual is not as clinically useful as some of these Eastern conceptions of cognitive fingerprint. So when I work with a patient, doing a five-factor assessment has very little bearing on my clinical practice, but doing more of an Ayurvedic personality assessment has a lot more utility in my limited biased experience compared to some of these generalizable personality assessments. There are some cases where those can be good, but I think that some of this stuff is quite revolutionary. So we went from the claim that he doesn't really use Ayurvedic in his practice. He focuses on evidence-based treatments.

But now he's saying personality assessments like the Big Five or something like that, they're not really clinically useful. But what is useful are these Ayurvedic personality assessments. And again, there's this thing where somehow this is not a population-based classification system when we've seen that it is indeed a very generalizing population-based classification system where you have three values,

and yes, they're in different quantities, but you categorize them into specific types that will be associated with specific ailments, specific body types. So just like, and this is only a matter of minutes from going that I don't use this in my practice to this is much more utility based on my clinical practice. Yeah. Yeah. With Dr. K, the contradictions abound. yeah with dr k the contradictions abound like this contradictions not only logically in the kinds of stuff he claims things being you know ultra individualized versus being population

based logically inconsistent but at the same time he contradicts himself from like five minutes ago he takes a different stance depending on the line that he's taking and the general impression i have is somebody who is rhetorically very gifted is a very good speaker but is really focused on saying things that suit the moment that sound good in the moment yeah so i don't quite trust what he says i'm afraid well so one more callback matt we've we've had the callback to the cognitive fingerprinting, right? And the issues with the five-factor model or that kind of thing. Now a bit about Ayurvedic diets and the gut biome. Also in my clinical practice, what I've seen is if people adopt Ayurvedic diet,

they're more likely to have sustained remission at lower medication doses or be able to come off medication. that is nothing magical by the way i think they just sort of figured out gut microbiome observationally and that now we're discovering the mechanism but it's really interesting that their first line treatment for mental illnesses seems to be diet and my guess is the mechanism has got microbiome modification to support serotra i mean neurotransmitter precursor production. That's my take. And what I've seen very clinically is when I apply some of these principles to my clinical practice, that patients tend to do better. So we've got like, no, no, Ayurvedic isn't the big part,

but now we also have the diet adjustments coming in as like, these are more clinically effective and get people off medications, right? right so again the contradiction should be apparent the other thing chris that i noticed throughout is that when he makes a claim uh in favor of ayurveda inspired practice he backs it up pretty much every time by this is what i believe this is what i've seen from my personal experience this is what i think you know and what I've seen from my personal experience. Yeah, this is my belief. This is what I think. And it sort of slipped in there many times. But yeah, I mean, that's the backup he's got. Like that's fundamentally the argument he has

for everything he's saying. He's not able to refer to other things because there isn't a great deal of either conceptual or empirical support there. But like it sounds quite sounds quite um rhetorically effective doesn't it when you say chris i've seen things that you wouldn't believe i've seen things that were medically impossible and they just work anyway so but really if you pay attention he's doing nothing more than expressing his personal admiration so now matt we heard in the clips coming up to this that Dr. Mike was

getting frustrated. And now you've had this like quite rhetorically powerful thing. So some people might respond like, you know, positively. But Dr. Mike's response is a little bit negative. And this leads to a switch in the conversation. But like, first of all, here's what Dr. Mike does. Dr. Mike, more specifically, makes some harsh comments. and Dr. K gets a bit angry. Why not take the concepts of those things, like improving the cognitive fingerprinting of modern tools, focusing more on the individual approach, and stop calling it and talking about Ayurvedic medicine? Because it's sexy to talk about Ayurvedic medicine because it's sexy to talk about ayurvedic

medicine because people are passionate about it but 90 plus is crap and yet i feel like we're keeping it afloat well i don't know that it's crap and you don't know that it's crap well we know that it's crap because of how it got to where it is because of the lack of reliability the randomization no but we don't know it's crap we just don't know that it's not crap there's a because of how it got to where it is because of the lack of reliability the randomization oh we don't know it's crap we just don't know that it's not crap there's a difference and when someone makes a claim that this water will prevent you from dying or this this is the anti-aging water do you know that this is not gonna prevent you from living forever like do you know that I'm

lying about this no I don't right you Like, do you know that I'm lying about this? No, I don't. Right? You need to do a trial. But I'm very comfortable as a doctor now saying, no, that's not happening. Yeah. Because mechanistically, it's not there. The evidence isn't there.

And I've gotten to the point where even though I don't have the evidence. Yeah. Very important distinction, Chris. It's not crap. We just don't know that it's not crap yeah so that that thing where he said the 90 thing again right but now if dr k thought that it was 90 crap he wouldn't be so triggered right by someone saying we know like 90 plus is rubbish right so this is a why i'm saying like

that wasn't what he said he said you know he said even if it is 10 as reliable so this kind of annoys him because dr mike is strongly saying most of it is crap and dr mike got a bit aggressive there but now this is the junior flip so here. So Mike, what frustrates you so much about Ayurvedic medicine? I'll tell you why. It leads to a fundamental misunderstanding of healthcare for a large percentage of patients. It opens room for health gurus and hucksters to take advantage of people and it actually diverts our attention from ways that we can improve medicine okay so now I'm understanding this conversation a lot better so so I noticed that this was becoming very antagonistic which was really weird because I actually agree with the majority of what you're

saying I I see that yeah right so so I actually agree with the majority of what you're saying. I see that. Yeah. Right. So, so I'm the first to kind of say like, I'm the one who said, Hey, like 90% of it, I think could be crap. And so I was kind of struck a little bit. And then that's when I realized like, I'm not talking to someone who has an open mind.

I'm talking to someone who has a mind made up. I'm talking about it from a truth seeking perspective. So my mind's not made up. If you presented some data or information here that showed Ayurvedic medicine is way more accurate than you think it is, I would have changed my mind today. Yeah, so that's, it's interesting, but I think- I definitely have a bias from what I've learned so far.

So poor old Dr. Mike. He has to admit that he's closed-minded, that he's biased, that he has this preconception that Ayurveda is bad. So let's dig into that, Chris, and find out why that might be. And Dr. K, so there's this thing about when you make a better comment on a conversation, with that you're in, by the way, right? Like there's this thing about when you make a better comment on a conversation, with that you're in, by the way, right? Like we saw this with the sense makers.

They would say, you know, one of them, when they wanted to position themselves as the king sense maker, they will say, I'm just seeing in this conversation dynamics, these kind of things, right? That's right. You're talking a lot. You're talking a lot, Chris. And I'm listening. And like, why do you think that might be?

Exactly. Dr. K is a psychiatrist and someone with lots of experience. Here, he kind of breaks the flow and is like, this is becoming aggressive. Have you noticed that? Why do you think that is? I have another great example of this. Call back to Eric Weinstein talking to uh mcquest

mcquest you know i'm feeling i'm feeling very attacked or whatever he said at the moment you know and this it is amazing to see this in action and how effective it is it wasn't it wasn't so affected against uh mcwest because to his credit, he just ignored it, which is the right approach. But it can be a very effective form of, I guess, passive aggression, where you can put the person on the back foot and get them to explain themselves why they are disagreeing with you, why they are arguing their position. And you set yourself up for a win. And poor old Dr. Mike here, I think, walks straight into it. Yeah. No, he did answer very well, I think, at the start. He did.

When he was asked, like, why does this annoy you? Right. And he gave a very reasonable answer. But the fact that he got emotional, that's it. That's the crack. Yeah, that's right. If he accepts the premise that he's become annoyed then obviously that's a bad thing right you're letting your emotions but you'll see matt that he doesn't entirely let's see how this goes on right so this is

what happens next how is this conversation for you emotionally exciting in what way so do you feel anything besides excitement? Full excitement that we're finding a way to truth-seek together. Because unlike many people who talk about Ayurvedic medicine in this space, I think you do it incredibly honestly. So because I agree with you, but I think there are a couple of things to keep in mind. So when you make a statement like, you know, 90% of it is crap, that indicates bias to me because we don't know that.

You make a very good argument that we can't we have to be skeptical based on our understanding of things that if I say I show up today and I say like, oh, like, here's a pyramid. If you meditate under the pyramid, like it could work. And then you can always make the counter argument that until you study it, we don't know they could be right. Right. always make the counter argument that until you study it we don't know they could be right right and what i'm also detecting from you is like i think i'm detecting this emotion of frustration because of hucksters and these kinds of people so i think your understanding of ayurveda comes from these people and so that's why i was i was kind of surprised because usually in conversations i am representing your view a lot more yeah right. Right. So I'll go to these academic conferences with a lot of Ayurvedic practitioners and I'll say like, hey, like we don't know.

There are eight disciplines of Ayurveda. We have some limited evidence of this particular thing, Brahmi, turmeric, ashwagandha, like a set of herbs. We don't have a whole lot of stuff on this. And so I think it's just been really interesting. Now I understand a lot more why this conversation is going the way that it is, which is that you're asking me all these questions, which I get the sense that you're sort of open to the answer. But I think you're asking questions that are not open ended questions. You're asking questions where you already have a hypothesis and you are asking me to reflect upon that hypothesis or even counter that hypothesis or support it. That's fair. Yeah. Yeah. Yeah. Dr. K's skills in therapy are really coming to the fore here. You can imagine someone talking to a patient saying, you know, I'm seeing a lot of resistance here. You know, like why, why do you feel so opposed to what i'm proposing it like in

other words like dr k isn't shy about arguing his corner expressing his very strong views but there's something wrong with dr mike for having an opinion about this not being open to to what is proposing strongly yes and remember just there again matt he pointed the 90 comment you said 90 of it is crap like how could you make that strong statement but a moment ago he was claiming he said that before anyone else like to show that he's open-minded but now it's being presented as like that is a disqualifying comment for someone to be like, so which was it? This is why this thing stuck with me. I know it's very close to Eric and the flex interpretation of the flex comment. Yeah.

I mean, like I think Dr. Vakey is speaking loosely, but I think in his mind, he was just restating what he thought they'd agree to him, that 90% of it was not based in any kind of evidence. Yeah. And that thing here where he says, you know, I'm usually in your position. I'm usually the skeptic, you know, asking the Ayurvedic practitioner. Possibly that's true. But if so, it simply speaks to the issue, right, about the Ayurvedic community. But Dr. K, as we've seen in the content that we've looked at, he is not usually taking Dr.

Mike's position in this conversation. He has taken the same position that he has in all the other content that the Western medicine, yes, it has its uses. It's good with instrumentation. It's good at a population level. But in clinical practice, what works is dosha questionnaires, finding out the diet. This can get people, be cured in ways that they aren't. But then when useful, it's just addressing it. You know, I don't even apply these things very often in practice. And this thing as well, we're asking people to reflect on their emotions. Right. Like, so how are you feeling?

Because there's a charge moment in the conversation. But and Dr. Mike, you know know this is best to frame it positively but like he's also an interviewer who is now being flipped around to like being reflecting on the way that you've been asking questions have you been an open-minded interviewer dr mike like have you were you pushing the point of view are you open to exploring new ideas no yeah how well does that go with northern island chris when somebody asks you to reflect on your emotions yeah let's see uh welcome to bring this approach to a right to reply if you want the talk to came by them so then this also goes to this so listen to this bit i think our hypothesis is

similar yeah so i i think though and our standpoint is similar i think that you would benefit from studying ayurvedic medicine agreed which is what i'm hoping in this conversation i can learn more about it so i think just this individualized approach it's so axiomatically different i think there's value to it without a doubt so dr mike has to um i think he finds himself in a position where he needs to be a lot more accommodating a lot less um disagreeable and to concede a bunch of things because he has sort of accepted the positioning that dr k took there which is that he's being too antagonistic he's being too close-minded yeah he needs to be he needs to so i just i mean you have to you have to respect the art even though it's not a good thing to do uh it's it's been very effective in this case even though as you said dr mark's initial reply was very good i think he he took it on board and he's emphasizing you know actually we agree right we

were fundamentally in agreement on all this stuff where you know basically on this no you weren't no you weren't like listen to the replies there's a wide gulf in your presentation but now the dynamics of this situation call for emphasizing, you know, and emphasizing that Dr. K, he thinks Dr. K is a very, you know, reasonable person that can see the pros and cons, right? Like, so there's this, and just to show how much this has shifted things. So this is what then comes next. So you were mentioning, you know, alternative energy systems and this way of thinking so they were like oh have you heard of meridians or nadis like this i've heard of them but i don't really there's

this idea that we have this vital life energy that flows through us it flows through these channels we biologically looked for and it doesn't we can't find anything well we can't measure it yet right we might in the future we might not just have the tools to currently measure yeah so i'm open to that yeah so and that's where some people are looking for it and one person for example discovered that there are interstitial channels basically that don't have a tissue difference there's a change at the level of the electrical conductance but there isn't like a physical like you know anatomical thing yeah so dr mike now being a very good boy he's agreeing that uh you know there could be there could be energy flows throughout the body there could be a vital

life force we just don't perhaps have the tools yet to measure it it's like with the star wars thing that connects and binds us chris we we can't measure it but we can't say it's not there yeah and i'm open to that and like yeah so that was dr mike you know you're injecting like maybe modern medicine like it's just it doesn't have the tools to validate that i'm open to that look how i'm open look how open minded i am that's uh i think i mean i feel sorry for him to be yeah yeah but i i think he has been successfully flipped and all the clips i'm gonna play from now till the end are of this tenor right so gone is the questioning and like kind of pushing back or or even you know he's not about to call

ayurvedic medicine primarily crap that's me let's be clear that's not gonna happen so dr k is now on his thing so here's this point about take more about tai chi and yoga so we know for example that yoga and tai chi outperform standard exercise when it comes to things like osteoarthritis or mental illness there are rcts you're familiar with that familiar with that familiar with that research that they outperform it i'm not sure okay so there's some studies that show that um so and then that that so actually let's do a quick aside so that's what makes me really wonder about the value of some of these traditions because if we look at studies that show that yoga is superior

to physical exercise um so there's one paper from, I think, 2016, the New England Journal of Medicine on Tai Chi and osteoarthritis that basically showed that it was very effective. So then, interestingly, from a scientific perspective, if we say, okay, like, if all that exists is physical, then exercise should be the same as Tai Chi. The other way to think about it is that even if it's still physical, it's not necessarily that energy exists. But when you use this heuristic or this concept of energy and you develop a practice based on that concept, the physical biological postures that you do are somehow superior to this other set of postures that is exercise.

Does that make sense or did I lose you there? Did that make sense for you, Matt? Did you lose me? Yeah. Yeah. So first of all, do we know that? Do we know it, Chris, that yoga and Tai Chi somehow, for some reason, we don't know why it could be something non-physical is demonstrably superior to other forms of exercise well we know that there are bound to be individual studies or even potentially meta-analyses that show that so that would that would settle it wouldn't it matt like if there is studies that have presented that and and or meta-analyses. Well, case closed.

Yeah, if you can find a study out there, then we know it. We know it. Just one thing though, Matt, is that we are being like slightly flipping because sometimes I feel that for people that aren't versed in methodologies and issues in science research. It is true, generally, that meta-analyses are a higher level of evidence than individual studies, right? But there's a

phrase which a lot of people know, which is garbage in, garbage out. And essentially, out and essentially meta-analysis cannot make up for limitations in individual studies. So you have to contend with the weaknesses of the studies. If you get a whole bunch of weak studies together, it doesn't suddenly make them strong studies, right? So like there are meta-analyses that say ivermectin is an effective treatment, bad meta-analyses, right? So this is the issue. You cannot simply rely on that existing. So I might be delivering the point, but just to explain.

Yeah. It's the kind of thing we've said before. Yeah, so just following along with his line of argument there, which is we purportedly know that these practices are superior to these other forms of exercise and according to dr k they should be exactly the same but actually unless there's some non-physical mysterious explanation perhaps something to do with ayurveda but that's actually not true right like there could well be like a difference between a couple of different versions of exercise and it could just be due to like a variety of things about which yoga is different from other forms of exercise right

yeah or tai chi or whatever right so you know but he has jumped straight to a kind of a all right this this is a non-physical explanation. It's a mystery. It challenges so-called buttoned down reduction of science. Therefore, Ayurveda. Yeah, it can't be explained any other way. And you're like, well, it can. There's a whole bunch of much more mundane explanations. Even if we accept that the overall finding is valid,

you still don't leap immediately to metaphysics. And if it sounds like we are doing that, like being unfair, and that's not what he's saying, listen to this. So we have a study. You can look at the paper. I'll send you the reference. So Tai Chi and osteoarthritis outperforms physical exercise. Okay. So now let's understand Tai Chi is based on this theory of vital life energy, which we have no scientific evidence about. So then the question becomes, how do we explain this result that this practice, which is based on a non real thing, outperforms a seemingly comparable practice, they're both just moving around.

So there are two explanations for this. One, or probably more, one is that this thing does exist and is not measurable. The second is that even if it doesn't exist, the concept of this existing and something about the way that they developed those practices

based on this concept, it's still just completely biological. but because we were considering qi, we developed this different set of movements. And if you look at someone who just does stretching or calisthenics or whatever, these other physical practices, that there is a difference in the physical practice. Does that make sense? Does it make sense? Yes. You have to think hard to follow along with his logic there. But being charitable, Chris, the logic I think is that there is a practice like Tai Chi based on a sort of theoretical framework that involves energy flowing through the body and meridians or whatever the case may be. case may be and that if there is uh some benefit to tai chi over and above what you would normally expect from doing similar kinds of exercises but not following that theory then this sort of supports the idea that there is something to the theoretical framework i think that's what i'm saying yes so like one way that you would want to check this is

comparing tai chi with like slow moving exercises that are not derived from the theory of like meridians and chi flow and what that and you know i'm aware and i could i could very easily imagine yeah like a variety of practices that involve what muscles and stretching and tension postures and so on. I don't see that you need to have a spiritual theory of energy flows. Yeah, it is the case that often those things do involve some metaphysical or spiritual layering on top even you know like kind of

acting postures or like the alexander technique or whatever like there's there is a kind of i don't know like a pseudo science gravity that comes around like a philosophical layer on top of various you know physical movement therapies movement therapies. I'm just, I'm just saying that, like, I can imagine you don't need it, but I'm struggling to think of many examples where popular ones don't include some philosophical or esoteric framing. Yeah, of course they do. But in order to sort of test whether or not this evidence, if it exists, But in order to sort of test whether or not this evidence, if it exists, we have to emphasize if it exists, if there was actually like a proper, well-conducted RCT that really showed that there was a measurable benefit to doing it the Tai Chi way versus a proper control, think that involves a lot of other similar kind of muscular physical exercises but doesn't somehow involve the metaphysics which is kind of hard to imagine really because it would be kind of very similar right because i don't see that you need the metaphysics in order to do the stretching and

so so you could imagine some different movements right so instead of like worms saluting the sun you do chris waving to his mate at the fish and chip shop right yeah it might be in terms of biomechanics a very similar thing but it's just totally meaningless in terms of the spirituality and the the philosophy so let's say there was and i'm sure people haven't done those tests but if they did then the idea is that okay so we so we understand what's different about this sort of philosophically inspired movements. Yeah, but I don't see the attachment of the philosophy to a particular set of practices. Like if the practices work, I don't think that proves

that the philosophy underlying it has got stuff. It doesn't, but i feel like you're falling into dr mike's trap as well that he is saying well but you know if these work we can just take the movements out and whatnot and dr k's retort to that is no you can't because the reason they work is because of the the system that in. So even if you took the movements out and they worked in a different context, the insight was derived from the metaphysical, spiritual, biomechanical model of the body. I see. Right. I see.

So now the problem, one issue with that argument, for example, if you were taking the evidence in totality, for example, is that while Dr. K could easily find acupuncture studies, for example, which show positive results and meta-analyses, which is giving people either acupuncture not on acupuncture points, right, just like randomly inserting them, and or needles which do not pierce the skin but feel like they do. That's the sham acupuncture control. Invariably, acupuncture does not do better than these controls, right? But they are rarely used. So that would suggest that actually it isn't the meridians that are doing the work. But in any case, it's a counter point about that kind of thing. But he's talking about a specific case here, right?

Yeah. Well, I think following along with his logic i think i'm actually okay with it if true right big if true right if if there was some mysterious benefit attached to these specific yoga practices that are inspired by ayurveda or some other sort of yeah traditional philosophy and you came up with a bunch of other good controls like you just described right yeah biomedically identical performed them yeah and and you even gave people what you'd have to do is actually make up because of the placebo involved in terms of the sort of benefits that people perceive in their being a sort of a rich philosophy attached to why they're saluting the

sun in this particular fashion you just make one up right one that's plausible but but not real and kind of random and if you ran that kind of study i would be gobsmacked if you could show a difference but if you did if you did then i would hand it to dr k i'd go yep you know i i think i think you've i think we've shown that there is something well in those insights. Yes. Again, this is going to sound like biohumbug, but it's important. But it wouldn't be impressive if you showed that in a single study because you could randomly find the effect just from random noise, right? Like in a study. It would all depend on how well-powered the study is and whatnot.

But what you would want to be able to show is that you could consistently find this effect. Different research groups could find this effect and so on, right? So, yes. Yes, right. It takes more than one study to demonstrate this, of course.

Yeah, you say you would be gobsmacked. I wouldn't be gobsmacked by a single study. I wasn't referring to a single study, Chris. I was referring to the outcome of a program of research by critical researchers from different labs and so on, right? I should have given you more credit. Yeah, give me more credit, man. But returning to Dr. K, I think the way he said it, though,

sounds very plausible, right? He sets up these two things. There's only two. There's two explanations. He thinks there could be other ones. And, you know, the, the sort of intuitive thing to do is to agree with him, right? Yeah. And he talks about the issues with publishing and how they kind of misrepresent that. So listen to this.

So the moment that we remove that spirituality from it, I think we we we lose that value generating aspect right so why do we have to lose that like for example you took the principles of those breathing practices of slow the mind or energize the mind and you adapted them to modern medical defined conditions yeah why does it why in this scenario do you feel like you're losing the spiritual connection? Because when we publish papers about it, the more that I include that information, which is really where I got my answers from, right? The more that I include that, the less likely it is to be published. Why? Because people don't publish that. Why? I don't know. Because it's not scientific.

But the science mechanisms, theories, are not scientific in nature. Yeah. So I could have a thought today that I would put up for scientific testing. How in the world would a company not want to publish something if something works simply because the beginnings of it weren't scientifically valuable if you look at the studies the evidence-based studies right these are the studies that are published so if you look at like new england journal of medicine thing on tai chi you'll find almost no you'll see a small section in the background that tai chi is an ancient practice based on this theory you won't have a single line about what is actually happening to the chi in your body when you do this kind of thing.

So there is a strong publication bias against this kind of stuff. I don't know why. I mean you have to ask the journal editors. What is the value of including the history of it? It's not history. What I'm talking about is they have a mechanism, right? So they have a theoretical mechanism with which they develop a practice. And we know from evidence, RCTs, that the practice is quite effective.

Just a small thing there, Chris, before you reply to the substance, because at the beginning, he alluded to his studies and his publications on this topic. Whenever people do that, I always look them up on Google Scholar. And just for a very brief search, it appears that he may have co-authored two studies. He may have written one paper on meditation and depression, a novel solution to the burden of mental illness in India. And he may be the fourth or fifth author on an experimental study.

I can't see any other research published by him. Okay. So you're just pointing out that he's not exactly a very prolific published researcher on this topic. Which is not a crime, but he did imply that when he publishes on this or tries to publish on it i guess big science has stopped him from publishing just a small note yes that is true the implication you would get from the comment is that he's often publishing things like this or trying to but yeah that that wouldn't seem to be the case. But also, I think that the discussion there is saying,

like, you know, it's hard to include stuff about, we believe it's working because of the way that the qi flows and, you know, this kind of thing, or because of the Ayurvedic dosha system, right? And he's correct that that would be hard to get published in mainstream journals because it's not scientifically evidenced. So it would be like getting a result that is positive and then attributing it to the worship of the sun god Amaterasu, right? Like, you might have a system of exercises

that are based around, you know, the history of believing in this particular god, but it would be odd for a scientific journal to include a thing saying, so, you know, we cannot rely that the sun god is making the process more effective. Yeah. I mean, this is entirely normal, isn't it?

I mean, you could write a paper, for instance. You might have genuine evidence regarding, say, difficult gaps in the fossil record in a pre-Cambrian shale somewhere. And it might be perfectly legitimate, and you could publish that. But if you then go on to talk about how this is evidence for intelligent design, then you probably will have difficulties publishing it. And you might say, oh, it's because researchers are prejudiced against intelligent designs. It's a perfectly good theory, just like any other theory for why we're seeing the gaps. But

actually it's not. It's not a good scientific theory. And that's probably why you don't generally see it. And the one other thing I would notice just that there's a line in it where Dr. K is saying that when we publish papers about Ayurvedic or this kind of thing, it's difficult to include the information about where they really got their answers from right so the point for me is that you know that is suggesting that the fundamental basis is the ayurvedic system right and and yet again in this conversation it was presented that isn't even really what it uses in the practice so yeah just mixed mixed messages. But this follow-up, because we did actually hear a bit of doubt,

CPN again from Dr. Mike, why can we not just remove things from the context and see if they work? And we get the conversation being steered back to Dr. K's lean. Yeah. So, man, this is where things get fun. So let me ask you this.

Where do the thoughts in your mind come from? I don't know if I have the answer to that. What do you think? Neurons, blood flow, firing, creating action potentials. Okay. So neurons, blood flow, firing, creating action potentials are all the same, right? Like you're, okay.

So you having a thought right now? Yeah. Where's that thought coming from? My brain. Okay. But is there any other thing in the causal chain that is creating that thought? Is there anything else in the causal chain creating the

thought? Sensation, receptors, et cetera? Right. So the simple idea. So one of the places that thoughts in our brain come from, this is based on the yogic concept. So sure, it's translated through the brain, but we know that our sense organs are a source of thoughts. This is why advertising is a thing. If I show something to your eyes over and over and over again, it will trigger certain thoughts. It will trigger certain desires. Agreed? Okay. So where else do thoughts come from?

So we can also have thoughts. I'll speed run this. You're welcome to question it. Memories, et cetera. So we've got the introduction of the mystery of consciousness, Chris. This is one of your favorite topics. Yeah, perennial favorite. But you can hear Dr. Mike trying to give,

you know, like the answers. He kind of senses a chap, right? But also often when I see Dr. K do this, it does this with streamers as well, that it is somewhat like people haven't given this much consideration. You know, like I guess this is what Sam Harris, why he thinks it's mind blowing as well. Like to say, you know, you are not your thoughts like, you know, like. Like, you know, like, but to me, this is a kind of rhetorical technique where you start to say to people like, well, what caused you to think about that?

Where did that come? Did you generate like, did you decide that you were going to say this sentence? Like, wasn't there other causes that are not related? Do you know everything that is, you know, motivating you to say something and like and the ultimate thing is to kind of point out that you know what you thought of as your agentic control is actually embedded in these processes and caused by very different things and you can use that for different purposes you can use it to suggest that there's what what like no true agency right that we're living in a deterministic universe or the other thing is to like problematize

the notion of consciousness that people operate around and so that's what Dr. K is doing here. Yes indeed indeed there's a very specific point that he's wanting to get to with this and it's interesting because it's a very it appears like a very long leap right he's leaped from defending uh i guess spiritual holistic intangible

processes as being an important part of of what should be you know an extension to science something beyond science and he's looking towards uh the mystery of consciousness you can't explain consciousness if you can't explain consciousness if you struggle to say where your thoughts come from. If you struggle to say, am I something else apart from an agglomeration of cells, then you've made some space for the mysteries, I suppose. Yeah.

So this is a little bit further on just to see where this line kind of goes. So, but how do we know that cognition exists? Because we can test it. How can we test it? By asking someone a question by giving them a command and seeing an outcome. Right. But so then what are we actually measuring? We're

measuring words and actions. We're not we can't detect a thought. So for all you know, so like, am I thinking right now, like, to me, the definition of a thought is a signal. So you have an experience of thoughts, right? Correct. But we don't have, so we can do EEG, we can do fMRI, but this measures electrical activity. It measures blood flow to the brain. We can observe the impact of thought, but we actually have no, and maybe someone will prove me wrong. I've been

asking this to a lot of neuroscientists and psychiatrists. We don't have any proof of the existence of thought. So we just can't measure thoughts, right? So I can't detect thoughts. I can't verify for you that thoughts exist. I mean, he's right. I mean, he is right that subjective consciousness is not something that is the experience of it by definition, right? It's not something that one can objectively measure. I don't want to get into a discussion of consciousness, but I just want to say this is a very familiar thing. Once people start talking about consciousness and the mystery of consciousness, I feel like Dr. K here is at his most Deepak Chopra-esque because you can create this fascinating mystery of consciousness i feel like dr k here is at his most deepak chopra-esque because you can create this you know this fascinating mystery of consciousness open the door and go

well there are things that science can't explain chris why not why not spirit but you know yes you cannot hook someone up to the brain image atomizer and have their thoughts projected on the screen right where like fred flintstone is running around or whatever we cannot do this but like we can't measure thoughts aren't thoughts like just part of cognitive activity which we can measure and show that it's going on right like i i think the key thing there chris is that by definition so his definition of thoughts there is it's not any of the physical manifestations of thoughts right like neural activity things you say um things you might describe about your experience none of that is the thing the definition that he's working to is the

subjective experiential thing which if you think about it is by definition unmeasurable because it's a subjective experience you you and other people keep saying that and i i just don't think it's true like because take for example map there was a study done where they had the tree in this kind of software right with like brain activity interface on people looking at various images and the brain activity right and they were able to get the thing to reproduce the image that people were looking at you know about this like they spelled out the word neuron so what's that what what that happened there those are just the signs of consciousness aren't they chris like well but so those people were looking at a word which the

software was able to reproduce like a visual image of it so is that visualizing the subjective experience of thought but how is that different from me saying, hey, Chris, right now I'm looking at a word that says bunk. I'm giving you a sign, a measurable, tangible indication of what I'm subjectively experiencing, which is what that experiment is showing. So I'm not disagreeing with you, really. I'm just saying that the trick here, it's a bit of wordplay, right? It's how you define it. You define it in a way such that it is unmeasurable. Yeah, I get what he's up to, but I'm asking you.

You're a word flame. Okay, Dr. K, get out of the way. This is between me and Chris now. I'm not going to be tricked into another discussion about consciousness, Chris. I will not do it. Just that's one thing. So you said you cannot measure the subjective experience of like thoughts but what i just described assuming it's a true description is it not measuring the subjective

experience you're saying you could tell me right but you don't need to because the brian user interface has shown me on the screen what you experienced so how is that not measuring the subjective experience of someone? Because you don't know that that person is subjectively experiencing it. That could be a P zombie, right? That just has a bunch of neurons that's encoding it, right? They could be like a large language model

that can look at the thing, perfectly comprehend the word and you could probe it and go, oh, look, I know what the large language model is looking at. It's looking at this word, right? Because you could probe it and go oh look i know what the large language model is looking at it's looking at this word right because you're probed it but they're talking about the subjective experience of the thing which by definition is not something you can probe what if it is what if it's the cmrs that what if there isn't an extra special source? Like the experience of doing that with that kind of brain is that. What if there is nothing else apart from the signs or the measures or indications of conscious experience?

No, no, no, no. It has to be. We will cut all this. It's not like. But I'm just going to say it's like saying the eyes work like this we know how the cones and the stuff register the light signals

and we understand how the brain can reinterpret those signals to produce a visual system right you know all about that but we don't know what it's like to see we can't tell that everybody's eyes that they actually produce this is the classic that's the classic thought experiment about qualia right which is that we don't know that your experience of red is the same as my experience of red like seeing the color color red. Yeah, but why would it be different?

We both know that we point to the same objects and go, that's red, right? Yeah, yeah. But your experience of it could be completely different to mine. Right, but why? But that's the thing. Well, why would it? No, I'm saying, why would it? We have the same software.

We have the same... It could be arbitrary. A lot of things in neurodevelopment are kind of arbitrary, like the way things get wired up. It could be that redness for you is a different kind of experience. All right, we'll never resolve it. I mean, I'm with you. I find it incredibly frustrating and I don't like it. This is why I don't want to talk about it. Cause I think it's just,

this is philosophical fucking, you know, navel gazing. You can't, you can't, you can't investigate it. So you can't answer those questions. I'll just remind you that Kevin Mitchell said that I was right.

He might've said you were right about something stupid. It doesn't matter. Okay. Okay. So after that sidetrack into consciousness, which was being exercised from the podcast. So yeah,

the thing is that Dr. Mike is pointing to various signs that we can indicate that people are thinking and are having thoughts and whatnot. And Dr. K is constantly saying,

but those aren't actually the actual individual experience. So that doesn't really matter. And you can play that game all day like the same thing works again with saying you know who are you well i'm a you know i'm an irish man oh oh like so you are you know like just yeah going down through categories until you get the atoms or till you get to. Yeah. Who are you really, Chris? Once we strip away these layers of the onion.

Yeah. You didn't invent Irishness. So you inherited a bunch of, you know, like just that you can do this, the construction of conceptual categories in so many different ways. Um, and, and Dr. K is doing one version of it here and yeah. So it gets to this, which is where it was always going to go. There's a bunch of spiritual practices that are designed to dissolve the ego. And in that process, once you dissolve your sense of self, then you get access to transcendental states.

So some of this stuff we know is scientifically correct. transcendental states. So some of this stuff we know is scientifically correct. Some of this stuff we have some scientific theory of mechanism, like default mode network, psychedelics, ego, death, and meditation. And then even beyond that, though, the transcendental stuff, we have no idea what's going on there. What is going on on a practical level? Like maybe not on a measurable level, but how would you describe it to me? So I would describe it to you as the nature, How would you describe it to me? So I would describe it to you as the nature, the basic unit of existence is consciousness. And consciousness coalesces into energy and energy coalesces into matter.

So we can affect things in the material world by working on the level of matter, or we can access the consciousness level, which will then dribble down into manifestation in the real world. And I'll be the first to admit that that makes no scientific sense. I think it does. Why not? It's the same way that, you know, when people incorrectly say... This coming from you, Mike? What? Why?

I just expected the staunchest... That's why you think I'm a disbeliever, but I'm not. I think also you have to remember, I'm not an allopathic physician. Oh, that's your deal. I'm an osteiever, but I'm not. I think also you have to remember, I'm not an allopathic physician. That's your deal. I'm an osteopathic physician. Well, I'm with Dr. K here. It is incredibly unscientific. I understand his worldview and it's one that he shares with a lot of other people, that consciousness, there's a spiritual energy and it's like a mind-body dualism thing right where you can affect the world ideas like manifesting arise from this and um you know even

you and i disagree about some of the subtleties here so i think it's understandable that people get confused but it is it is really a wrong way of trying to understand the world and a very unscientific one when you posit that the consciousness is like a fundamental building block of the universe. And at the other end, you've got atoms and electrons and so on. The idea being that this conscious essence affects the world and the world can affect the consciousness and that they're interacting with each other. And it's just a road to nowhere intellectually but it's a common belief that he's got yes well that's true but i think that one issue there is that people will read that as you're saying you know this is a mysterious topic whatever however that's definitely bullshit. That worldview is just nonsense on stilts, which I think people might read as dismissive. And I would say that he thinks consciousness is a thing.

I think consciousness is a thing. I just don't think it's a special separate thing from the material world and universe that we exist in. He thinks thinks as you said like there's a dualistic structure or maybe more but in essence that the stuff that modern medicine is dealing with is matter but people are composed of matter and mind and yeah a proper holistic practice just deals with both of those things yeah and that and that's what i think is a road to nowhere i recognize there are interesting philosophical debates at the margins, but that worldview, that dualistic worldview is a waste of time. Sorry.

Well, I think you can hold that worldview all you want, but if you hold it, you have to acknowledge, you know, it's not supported by science, which to his credit, he does say there. But this is why I think it's worth understanding that Dr. K's content is based on this worldview. All of the stuff that we've heard, all of the clips are about tapping into this power of consciousness and spiritual practices, which then allow the BS medical stuff to be supercharged. So kind of to what he said, that this is just the frosting on his evidence-based practice.

No, you can see now where he's more comfortable, that he's fundamentally highlighting, this is the basis. This is why he thinks that Ayurvedic is OP. This is why he thinks manifestation can occur in different ways and so on. So like it is not an incidental fact. You know, he might believe in heaven and hell, or he might believe in doshas. No, no, no.

It is more like a Christian scientist who their metaphysics and philosophy strongly impacts how they perceive what is effective in medicine. That's why it's important, I think. Yeah. And the reason why I say it's a road to nowhere is not because I think the mind is interesting, the consciousness isn't interesting, that we shouldn't be thinking about thoughts and complex systems and so on. It's rather that when you hold that kind of worldview, what you do is you carve out this region of things which are measurable, things that you can investigate using scientific practices, and then you carve out this other section, which is spiritual, which is metaphysicalysical consciousness whatever you want to call it but the but the important point for me is that it's ineffable like it's unknowable except

through some sort of revealed kind of experiential thing and he often gestures towards his personal experience and he just knows this he's seen it you know he can feel it and and that's what people do because it can't be investigated any other way you can't unweave that rainbow and so the reason i think it's not a a useful path is is more that it by design it can't be investigated well but i think that that is the the trap that like sam harris and dr k will set for you because their counter argument to that and the counter argument of all people involved in those kinds of practices, yes, there is, Matt, a way that you can investigate it.

There's centuries-old programs of very rigorous... Introspective practice, is that what you're going to say? Introspective practices that understand the mind and these systems. And if you did it, if you did those practices, you would be able to reliably produce the same outcome. So it is a science of the mind. It's just one that you have not investigated and that science doesn't properly comprehend. Okay. Well, that's a lovely trap, but I'm just going to leap straight over it with a great big hop because the simple rejoinder is that isn't science right you just like we said before like a child learning to walk it's very amazing it's very cool it's not science

right science is about documented methods replicable things about actually objective measurements it's not about hey i personally did this thing and it really worked for me so trust me but their argument isn't that this is the thing their argument is exactly all the criteria that you just said that you do this and you will produce replicable results reliably and consistently in that you can document it is what introspective practices have but they will say that you can't like unt it. You can't understand the reasons why. The reasons why are kind of intangible, right? Like you said before, they would object to you sort of carving out saying, oh, this kind of whatever yoga seems to work really well.

Let's figure out exactly the reasons for that. And you said before that they would say, no, no, no. It makes no sense to do those things without embracing the entire spiritual kit and caboodle, which can't be investigated. You and Dr. Mike, you will get in trouble with Dr. K because they will say, yes, we do have a system that explains why this happens. We just outlined it.

It's meridians or it's the doshic energy systems. But you can't measure those things, right? You can't measure doshik energy systems and it's but you can't measure you can't measure those things right you can't measure doshas you can't give questionnaires i give up you win all right you and dr k win i i you tell me how do you argue nothing how do you argue against this i don't know well you don't say that they don't have clearly Clearly nonsense. No, no, no, no, no, no. You do not say that they don't have systems that are giving explanation for these observable findings that they have.

The issue is that the claims, like there's so many incompatible systems claiming the same thing. Like if you follow this set of introspective practices that you will confirm the reality of these competing energy descriptions, which are not the same, which are based on mutually incompatible systems of metaphysics, but they're all relying on the same claim. You're on sounder grounds, Matt, when you say it's the same as like the revealed truth of prophets from a religious system which which it is but

they have a system right so you don't say to people who reveal the truth that well but you don't have any system to explain why you got revealed truth or what your really truth comes from they do they've got complex theologies no i appreciate they have a system right like people that believe in extraterrestrials have a whole cosmology and a whole elaborate but baroque system of explaining why things happen. But as we've heard through this episode in the last one, there is a resistance, a kind of in principle resistance to disentangling that system and isolating the components and measuring the components and figuring out what does what. And that I think is what makes it ineffable and uninvestigatable. Well, correct.

Things will come up where the intentions of the researcher matter and various other things, right? The effect will disappear if there's skepticism applied. Yeah, exactly. But you have to be careful. Let me give you an example. Like hypothetically, because I've seen different versions of acupuncture, and I've seen at least one version where what they're targeting are like lymph nodes, right?

Or perhaps nerves. I could be getting mixed up, maybe both. So I've seen explanations like that. And I've also seen explanations where they're tapping actual energy, you know, more intangible energy lines and centers and so on now the latter one you can't you just can't investigate because this thing is is not you can't point to it it's it is a religious kind of concept but on the other hand if if they are basing it on say targeting nerves or lymph nodes then you can actually test it and and see okay well if if they're if they're

targeting this lymph node you can see whether it's having an effect on that you can understand the mechanism oh it's releasing toxins or not toxins but you know what i mean something from this thing and actually figure out why if there is an effect why there is an effect so it's investigatable in principle but you know from what from what we've heard there is like a resistance to that there is very quickly a gesturing at no you can't unweave the rainbow you can't disentangle these little things many of them are on a different non-physical level and that's what dr k is constantly speaking to which is that you know this is why he brought up consciousness because he he wants to point to the importance of the realm of the non-physical, which is in principle not measurable.

Right. But the whole discipline of evidence-based calm research exists to counter that and say that, well, but we even know you cannot unweave the rainbow. You can't demonstrate that these practices are effective. So this is why I just think you have to be careful about any sweeping statements because that would immediately be pushed back. Well, I don't care about evidence. I'm on the board of journals that are based on examining the evidence in clinical trials for this kind of thing right so i think when you look at the statements that we've looked at you can see that there is a constant like flipping back and forth between those modes but that's why i think in the same way that dr mike finds himself tied up at times from saying something about like people don't investigate this or this kind of thing that's that's all I'm saying is I think I take your point I take your point

well look fortunately I'm not I don't really care about winning arguments I'm just giving my opinion here Chris I'm just yeah I'm just preparing you for the round of reply. This is considering me your Mickey. So just to bring it back, Matt, we heard earlier in the earlier content about manifestation. And again, I want to point out that all the stuff that we heard in the earlier content, you hear echoes of here in this discussion with Dr. Mike. So it wasn't that this was isolated you know, isolated things where he's talking

like kind of loosely about the ideas and when he's in more lockdown mode, they don't apply. Like, listen to this. So what I mean by that is you take something called a Sankalp or a resolve. So whatever Sankalp you use during Yoga Nidra gets implanted into your mind

and then starts populating your mind during your regular time. So when I use this with patients, for example, who have a history of trauma and have self-esteem problems, so like, you know, we came up with one sun gulp, which is like, I deserve to be whole. So it's not that I am a good person. I'm going to manifest things in the universe. And there's interesting science on manifestation and stuff, which we can get to. But, And it's just this idea that if you literally look at a patient who is struggling, their mind will have 100 thoughts over the course of the hour. And there is a particular practice that allows us to add 10 thoughts of whatever we want. So this is sort of the spiritual value of a Sankalp. And even there's even more non, even psychological benefits to it.

There are spiritual benefits and transcendental benefits and all this kind of stuff, which is really what a Sankalp is about. A Sankalp? Is that what he said? Sankalp. Sankalp. Sorry. So this would, this would highlight that conjoining, you know, this is just a way to interrupt negative thought spirals and, and, you know know get people to breathe cycles by focusing you know on like reciting something or something like that and plus there are transcendental spiritual things which is what it's really about building up but you know yeah no i see what you're saying it's like a foot in both camps where you get to on one hand go look it's very scientific it actually

accords well and you know science is now rediscovering and finding confirming these yourself at the same time it's magical there's a whole bunch of extra stuff going on i'm interested in the manifestation thing chris is there is there more on this well there is what we heard there's a whole youtube video about the science of manifestation and like you can imagine how it would be reframed here right that yes you know i agree that all that stuff is bullshit but actually there are really good studies showing that you know you can grow extra muscle and stuff just from thinking about doing exercise and so on and so speaking of youtube shorts chris i don't think i did i mention this that i stumbled upon a fun youtube short from dr k which i think is on a similar vein. Science proves enlightenment. And it was

set up at the beginning of he's going to run through some of the scientific evidence for enlightenment. So I thought this would be interesting, but actually, no, no, he didn't cover any of the supposed scientific evidence for enlightenment, but it was actually how to become enlightened with five tips and it was things like avoiding coffee and not using your device before you go to bed it was very youtube shorty yeah it was yeah well i i can't imagine that so the the claims often i'd strip the evidence but after these kind of conversations with dr, he's essentially got them to largely agree that they're in agreement. And Dr. Mike is eager to make this point as well.

I think you and I see eye to eye on this topic really pretty much one to one, maybe 99.9% of the way. I think we see eye to eye on Ayurvedic stuff almost. Yeah, that sounds like really really close um my question is when you're doing that practice and you're doing the informed consent um and you're doing it before the evidence is hasn't caught up to it yet how would you feel if when you let's say a patient comes into a doctor's office and the doctor says hey look this medicine has never been proven to work for your condition through scientific rigor, but I'm going to give it to you anyway. Just trust me. Do you have an issue with that? That's a good question, but I like the framing.

Oh, and one thing. So you heard at the end of the clip that Dr. Mike is an osteopath. He agrees he's not allopathic. And, you know, as we covered before, allopathic is the denigrating name that holistic doctors use for mainstream, modern medicine. Yeah. Yeah. So, I mean, by that stage, he's also at the point of saying, you know, why would I oppose that, you know, mystical energies can come down and affect matter? So he's, he's fully swapped the role from skeptic to, you know,

like open-minded seeker. But yeah, I thought that's just interesting that he wants to highlight, you know, I'm not purely allopathic. I'm not one of them. Yeah. No, no. Well, okay. Well, putting, putting aside the fact that Dr. Mike is rolling over to have his tummy rubbed, he asked a good question, which is that, is it fine from your point of view to be practicing therapy or practicing medicine based on things that do not have a scientific evidence base, based on your personal convictions rather than an evidence-based? And that's a good question.

That's a good question. Do you want to know what the answer is? There's a fascinating study by a guy named Ted Katchuk. So he's a placebo researcher out at Harvard and was a mentor to my PI. So he did a super interesting placebo study. He said, I'm going to give you a placebo. This is a placebo, but we know that placebos work. And he said, I think going to give you a placebo. This is a placebo, but we know that placebos work. And he said, I think this will help you. And turns out that the placebo helps even if people

know it's a placebo. Sure. So I think that, you know, off-label prescribing, as long as you do it with informed consent and the doctor has some kind of rationale behind why they're prescribing it, I think that's reasonable. It's an interesting defense, isn't it? It's an interesting defense. Yeah. We know there's a placebo effect and also combined with off prescription, which is a different thing, right? Because that is that there is an effect, but it's not the one that the drug is originally approved for. That's right. So a placebo is not the same. It's not equivalent to any kind of treatment for which there is not an evidence base for its efficacy for a particular thing. Oh, is it that much? Maybe I have one more clip just to send that off.

Here's what I think could be going on with neuroscience, with this, with this. And then I'll put it to the patient and let them decide right aren't you just giving them a placebo and calling it a placebo by doing that what is a placebo you're giving them something that is unproven so far by our western methods and saying there's no evidence for it so you're saying it's a placebo. You're admitting that to them, to the patient, but you're saying you think it would help. What is a placebo? How would you define it? To me, the description of placebo is something that we do not feel like would help the patient through a mechanism by which we understand.

Yeah. So here's how I would describe placebo. Placebo is things that work that we just don't have mechanisms for. That's right. Yeah. Yeah. Right. So, and that's where I would say, here is the hypothesized mechanism, but I think we have to do it.

I wouldn't call it a placebo, but you could absolutely make the argument that you were engendering the placebo effect. But I think that that is absolutely necessary. So they're both giving incredibly misleading descriptions of the placebo effect, aren't they? And what a placebo is, right? So he's saying that a placebo is anything that works for which science has not yet understood the mechanism for how it works. That is not a placebo. That is a vastly broader range of things. A placebo is something that we know with a strong degree of confidence has no inherent therapeutic value. And it's something that is useful because it can mimic the real

treatment that we give someone and therefore is useful as a control in medical research, randomized control trials, so that you can take into account the fact that people often say they are feeling better or think they're feeling better or even maybe experience some kind of improvement when they believe that they are being taken care of and being treated and so on. So it's a useful control. So by conflating those two things, he's mounting an interesting defense of non-evidence basedbased medicine isn't he yeah because he's essentially saying you know it's a bit like the rfc clark quote you know any sufficiently developed technology will seem like magic and any sufficiently mystical medical treatment will be labeled a placebo that's kind of what he's going for but yeah you're you're right that that's's kind of muddying the definition of placebo.

Like if placebo has actually worked, right? Like there was some placebo, unless it was a sugar pill. But it turns out that sugar was exactly what this person needed to whatever, reduce the symptoms of such and such. Then it would be a bad placebo, right? It actually wouldn't be a placebo because it's actually a different effective treatment for the condition i mean it's not complicated i don't want to make it so complicated because it's not no so like i i think the bit that could confuse people is you can be on

a placebo treatment and get better but that doesn't mean the placebo work. Worked. No. Right. Like it's not the effect of the placebo. And it's not necessarily also your mental. I think this is another mistake that people make. It can simply be regression to the mean or, you know, just normal variation. So like when you get the cold, what eventually happens? You get better. How many people have eternal colds? Very few, right? Some unlucky unlucky people but everybody gets better and then if you took something that was a pill

you might also get better and then if you were in the study this could be attributed to a placebo effect but actually you could have just got better from regression of the mean. And there's actually a literature around this, around the placebo effect versus... It turns out that perhaps before we thought that those mental effects were stronger than they were because we're confusing what you said, which is reversion to the mean, when you take a measurement, but you selectively take your initial measurements when things are particularly bad, because that's when you get a treatment, right? And then, as you said, things that are bad, if you're feeling really good one day, you'll probably feel worse the next day. And if you're feeling really bad one day, you'll probably feel better the next day. So that selective sampling leads to an effect. So that gets conflated with placebo effects.

But the important thing here is that that's a terrible defense of non-evidence-based medicine. First of all, saying that, hey, it's the same as a placebo. As long as people believe in Ayurveda, then it's the same as believing in a sugar pill. That isn't actually a very complimentary thing to whatever your non-evidence-based treatment happens to be. And the second thing is that it's actually, there's a total mismatch because he's claiming that actually these alternative treatments for which there is not currently evidence actually do work. We just haven't discovered the mechanism for why they work. And that isn't the same as a placebo, not at all. Yeah. So just to round off this point, Matt, this is where it ends up.

Are people engendering the placebo effect? Almost certainly. And this is where there's even a, I'm in a worse position for this, to kind of support your point, which is that there's a huge selection bias of people who come to my practice. So people who come to my practice are looking for, they already have a preset idea of, okay, this guy's going to teach me something special. I give something special, it fulfills their expectations, and they see a clinical benefit. The clinical benefit is, the reason people come to me is because people have been to 10 psychiatrists before. I'm not trying to toot my own horn or anything. A lot

of people will come to me and they've tried other things. I mean, I even started a consult service at MGH where the majority of my patients were from other psychiatrists because they wanted to learn this stuff. So there's even a selection bias, which I absolutely have to consider. My take though, is that there is a very real mechanism to this. So I don't think, and that could still be placebo. Dr. My question is, yeah, my question is, how do you, you're so honest with this and i love this so i have to give you huge props to this because i can't tell you how many doctors will claim i've helped 10 000 people and i'm like but selection like the people who are coming to you no i have

i have a bigger placebo problem so that's amazing that you're yeah like taking that into consideration Yeah. Like taking that into consideration. Terrifies me, Mike. So now the question is, how do you decide or decipher between what you're doing being truly beneficial versus is this a placebo effect or does it not matter? So I can't decipher. And does it matter? Is it important to decipher?

In a theoretical perspective? Absolutely. I mean, you know, on one hand, at the beginning there, that was, you could think of it as being like a good degree of insight. Yeah, mea culpa. It's kind of disarming, isn't it? To sort of forthrightly acknowledge things. He's certainly right. Selection bias. Selection bias. When enthusiasts go to a particular alternative therapy they're super keen on it they

want to believe they are they're all set up for walking away happy basically but then i feel like he's sort of disarming dr mike there with with this sort of frank honesty before shifting to the conclusion which is but despite all that, I have complete confidence in what I'm doing. And I believe that it's true because I've seen the results. I've seen that it works, my clinical experience, et cetera. Yeah. This is the behavior of a seasoned calm advocate. You acknowledge limitations and you get prayers for doing that by Dr. Mike, who's like, this is incredible that you can be so open about this. But it doesn't fundamentally alter any of the things that you're claiming. And also, just again, Matt, so throughout this,

there's this double step of I'm not really focused on this thing in my practice. I'm offering evidence-based things. I'm very critical of Ayurveda. I see lots of issues with it. I'm very concerned about all of these science-y,-based things. I'm very critical of Ayurveda. I see lots of issues with it. I'm concerned about all of these science-y, methodological things. But, and then it switches to the unequivocal confidence.

But also I'm renowned for having this approach and people seek me out because they know that this is the thing I'm going to do. I thought it was just a small bit of the treatment study. Like, that's the bit where it really depends

on what suits the given argument, whether it's a core part of the practice, which distinguishes what he does and he's seeing the effects, versus it's just a small thing that, you know, I'm not actually pushing on anybody or suggesting. It's just I found some benefit in this and like here it's that he's well known as this figure that can cure people through these practices that other people don't have so it that that suggests it's a core differentiating factor

in your practice so i know how you feel that inconsistencies chris um i'm very upset about it i'm very upset about it and uh well uh so that's the dr k and dr bike conversation and i i think if you listen to it you don't see this big distinction from the other material that we looked at it's just presenting the same kind of arguments from manifestation to, you know, the scientific basis of doshas and so on, along with some recognition of limitations and issues with the evidence base in Ayurvedic medicine. But he's still a very strong advocate for it. And the judo flip that he does psychologically on dr mike i think is very effective and that's more in line with the last part that we'll look at the kind of therapeutic

stuff um yeah so yeah yeah so i i think the judo flip was very effective and i think the other rhetorical techniques we saw for instance this bringing in consciousness into the equation running the argument there are there are things beyond our ken things that are difficult for you science man reductionist to explain therefore maybe there are other things we don't know that we can't measure that are having an effect on our health and on our world cosmic mental things and you know the mea culpas, the recognitions, like positioning yourself as a critically minded person who recognizes the limitations of it,

those are usually stated as a point from which to springboard to the opposite point of view, which is like having a great deal of confidence in these things which you know as as you said is represented in his practice and all the other things he said so i feel like a lot of rhetorical techniques were used effectively but it doesn't wash with us chris doesn't wash with us it doesn't and there's a video called ethics which will come up in the next episode it's more about whether he's practicing therapy on stream or not but after all the stuff that we've heard you know from two years ago from 11 months ago from a month

ago from the dr mike video from one or two back. Let's see how this compares with what he states here about the stance he takes on Ayurvedic medicine. HG has gotten to where we are today because of the feedback from our community. So I'll give you all just one simple example of this. In the past, I had talked a fair amount about Ayurveda. Generally speaking, when I talk about Ayurveda, I talk about it more from a personality analysis standpoint. And as part of the support for Ayurveda, I cited a couple of scientific papers.

Seven months ago, someone in our community made a post sort of questioning the veracity of the research that we were citing. And it turns out that they made really, really good arguments. So we talked about it on stream, addressed their criticism. Turns out that a lot of their criticisms were actually really good. And for the last seven months, we haven't said a word about Ayurveda. Internally, we're going through the process of reviewing a whole body of Ayurvedic research. My point here is that sometimes at HG, we'll say particular things that we believe are correct, and we'll even do some research and we'll cite papers and stuff like that. But no scientific paper is perfect. And as members from our community

will point out those kinds of things, we will absolutely adjust our behavior. So one of the things that we really value and hold ourselves to a very high standard about is actually accepting feedback from our community, which is really, really helpful and is actually really responsible for the impact that we've been able to achieve. Chris, just a bit of a meta observation. Yeah. It feels very corporate, doesn't it? Like those sorts of statements, like it's carefully honed, it's carefully crafted to minimize, you know, detrimental blowbackback it seems like it's crafted by a public relations team and i just it's just a a feeling that i have with dr k that a lot of what he says is very carefully modulated to min max public perceptions well certainly when he's responding to criticism, as that video is, right? And in this case, he's, one, pointing out that they're willing to correct things, you know, when they find out that there's issues with it.

But I would just say this video is before pretty much all the content that we played, especially, you know, before the Dr. Mike video and stuff. So I don't know that I would agree that there's no more real mention of Ayurveda on Healthy Gamer GG. I've certainly detected that here and there in the material that we just discussed, you know, like the visualization or the discussion with Dr. Mike. No, Chris, everything that's said about Ayurveda

is based on the research. They're carefully reviewing the research and the research isn't perfect. And sometimes there will be studies that are a little bit subpar. So, you know, naturally, not everything they say about Ayurveda will necessarily be true, but they're committed to going back through the research and correcting their mistakes. It's really very admirable. They're doing the work. They're doing the work. Yeah. So, you know, opinions may vary on the extent to which that is a core component of the content

or sprinkling on it. And I do want to say that it is perfectly possible. And I know various people who have commented that, you know, while we've been making the series that they have been helped by Dr. K's material and that they don't focus on the like Ayurvedic part. It's not an important focus for them. And I think there is a whole host of like material out there that you could consume where it wouldn't come up, or if you noticed that it would just be here and there, like additional references. But I think when you look at Dr. K's output in totality, it is not a minor part of his output, and it is not an insignificant feature for the way that he approaches the topic of therapy or medicine in general so

yeah now chris i mean on on that note i i agree with you i think it is it is an important aspect of his brand but like you said a lot of his content doesn't have that stuff injected into it i stumbled across another thing that he'd posted which was um again it was very youtubey clickbaity top five ten tips to do whatever but it was about um how to say no and how to how to basically not be aggressive or submissive set boundaries that kind of thing and i watched that well these are all these are all good tips yes it's pop psychology but it's not it's not bad advice. So that stuff does exist too. I think we want to acknowledge that. Yeah, yeah, yeah.

So, you know, we'll see if the final thoughts to the last episode, which is about the therapy or non-therapy, the online in-depth interviews with streamers and discussing trauma and so on, or life experiences and philosophies and whatnot. So that will be the last stage of the Dr. K episodes. Then we're out of the Dr. K market. So thank you for indulging us.

This two part is basically like that previous content from four years ago was like an in-depth, overt advocacy for Ayurveda. But all the content that we've looked at now is more recent. And I think there are very obvious through lines in like the arguments being presented and whatnot. And in a lot of ways, it's bog standard cam, but it's actually quite skillfully done in a way that I haven't seen so much in kind of mainstream output.

So that's why I thought it's interesting to look at. But I think it would be hard to argue that was a part of his output, you know, a couple of years ago, but he doesn't really do that anymore. Like, no, I would dispute that strongly. Yeah. And all of this is actually entirely separate from the issues that we'll look at next time which is around the conversations that he has with streamers you you could be doing those with a completely different metaphysical or therapeutic approach and the issues would arise

that do so that's all i'm just justifying our three-part structure, I think. But that's... You don't have to justify it to me, Chris. It's fine. We can do that. Good. Okay, part two done. Looking forward to part three.

Yep, yep, yep. And lastly, Matt, lastly, I'm just going to thank a couple of our patrons, the people that are there supporting us, keeping us afloat when times are hard and skies are gray uh colin fardy andreas hawkins edison yee james sean carmody patrick browers connor carry anna j sam mountjoy sam mod, Sari Saxi-Dallum, Pitiful Noob, Sigrun Underdal-Borlag, IDW Dinner Club, Minotaurus Rex, Jacob Lincoln, Dr. Wallabong, Ethan Blythman, Zedd, Joshua Davies, Blythman, Zed, Joshua Davies, Marcin Junksi-Doumont,

Carly Neidart, Jack Gibbons, Dina Cruster, Jake Lawrence, Saeed Polat, Jameson Shipley, Ethan Milne, OhNo, Joe Rimmel, Ryan Nesseldroth, Annamay, Chris Cant, Bobby Lamont, Privateer,

Jeannie HB, or Jean HB, Benjamin Aldridge, Amber Wodzinski, Mike Hansen, Reservoir Frog, Richard, Saeed Montazadi, Nina Davies, Heller Gerverding, Decent Stalactite, and Dawn Candy. Oh my God. Well done. That's a lot of patrons. Thank you. Thank you for supporting what we do. It's people we've missed. Are we catching up? Are we?

You've missed, Chris. Your responsibility. Galaxy brand, possibly unclear which theater that they're in, but they all received the Galaxy brand shoutout. We tried to warn people what was coming, how it was going to come in, the fact that it was everywhere and in out. We tried to warn people. Yeah. Like what was coming,

how it was going to come in, the fact that it was everywhere and in everything. Considering me tribal just doesn't make any sense. I have no tribe. I'm in exile. Think again, sunshine.

Yeah. That's me. I'm everywhere and in everything. That's my tag. Yeah, you're all around. You're much like the consciousness and the doshik vedas. They connect in binders, Chris. They do.

So we'll be back for another episode with discussions of consciousness shortly. We need to do a guru that doesn't talk about consciousness but that's actually hard that's actually hard you need to exercise some self-control and not to hey look at it or or you just avoid saying extreme things and then say but we're not going to talk about that your own rhetorical sleight of hand. No, I'm just speaking common sense, Chris. That's it. Speaking the truth to power. Right.

Well, we're almost out of the Dr. K mini season, but one more time. One more time to the grindstone, but we might take a break in the middle with another guru pop and then we'll see so yeah okay all right see you next time good night and God bless Thank you.