Huberman Lab - Tools for Overcoming Substance & Behavioral Addictions | Ryan Soave
Episode Date: April 21, 2025My guest is Ryan Soave, LMHC, a leading expert in addiction recovery with extensive experience helping people heal from all types of substance and behavioral dependencies. We discuss actionable tools ...for breaking out of the addictive cycle and staying free of obsessions and compulsions. We also examine the relationship between trauma and addiction. We explore the full recovery process—from detoxing and physical stabilization to building distress tolerance. We review evidence-supported tools to structure your life at each stage of recovery and highlight the power of learning “self-directed state shifting” through yoga nidra (NSDR), breathwork, meditation and prayer. We explain how to recognize signs of addiction in yourself and others, and the treatment options available across all levels of resources, from residential programs to 12-step. If you or someone you know is struggling with any kind of addiction, this episode offers practical steps to break free and stay free. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman BetterHelp: https://betterhelp.com/huberman Levels: https://levelshealth.com/huberman LMNT: https://drinklmnt.com/huberman Function: https://functionhealth.com/huberman Waking Up: https://wakingup.com/huberman Timestamps 00:00:00 Ryan Soave 00:01:32 Addiction, Addictive Behaviors, Relief 00:06:10 Rehab, Detox, Physical & Emotional Stability 00:13:33 Sponsors: BetterHelp & Levels 00:16:08 Recognizing Addition; Video Games, Parents & Responsibility 00:23:38 Experiencing Real Life vs Addictive Behavior; Dopamine Dynamics 00:29:38 Drugs & Feelings; Reordering Your Life; Roles, Kids vs Parents 00:40:03 Sponsors: AG1 & LMNT 00:43:13 Tool: 30 Days Abstinence & Addiction; Impact 00:46:10 Creating a Life Post-Addiction, Jellinek Curve 00:55:30 Tool: Emotional Weather Forecast, Gratitude, Plan, Strivings 01:02:48 Connection with Others, Mental Willpower Throughout Day, Defining Best Self 01:08:39 Emotional Weather Map, Navigating Life 01:10:16 Sponsor: Function 01:12:03 Tolerating Stress, Sailing Analogy, Discomfort 01:16:03 Building Distress Tolerance, Proactive Behaviors, Cold Plunge 01:23:55 Stilling Leads to Seeing, Tool: Recognizing Stress Response; Relationships 01:30:56 Yoga Nidra, Non-Sleep Deep Rest (NDSR) 01:38:54 Yoga Nidra & Authenticity, Breaking Patterns 01:45:45 Yoga Nidra Timing, Regulation of Autonomic Nervous System; Breathwork 01:52:53 Sponsor: Waking Up 01:54:28 Alcoholism, Social Acceptability, Community, AA, Powerlessness 02:02:23 Gambling, Kids & Susceptibility 02:08:58 Transmuting Energy, Running, Dopamine, Feelings 02:15:41 Cocaine, Amphetamine, Stimulant Addiction 02:18:21 Overcoming Porn Addiction, Shame 02:30:03 Struggle, “Discomfort Appetite” 02:36:09 Addiction Treatment, Detox, Rehab Centers, 12-Step Meetings, AA 02:46:54 Is Addiction the Problem?, Trauma, Stress & Addiction Cycle 02:49:05 GLP-1 Agonists & Addiction Treatment?, HALT; Addicted to Stress? 02:52:44 Sugar Addiction, Caffeine; Ibogaine, Psylocibin & Considerations 02:59:56 Helping Someone With Addiction 03:04:58 Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, Sponsors, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures
Transcript
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Welcome to the Huberman Lab Podcast,
where we discuss science
and science-based tools for everyday life.
I'm Andrew Huberman,
and I'm a professor of neurobiology and ophthalmology
at Stanford School of Medicine.
My guest today is Ryan Suave.
Ryan Suave is a renowned expert
in addiction treatment and trauma recovery.
Ryan has spent decades on the front lines
helping people overcome addictions to substances
like alcohol and various drugs,
as well as behavioral addictions,
including gambling, video games, and pornography.
His approach combines evidence-based protocols
tailored to each person's unique family history and needs.
During today's episode, we explore all aspects of addiction,
including the relationship between addiction and trauma.
Ryan shares insights from his extensive clinical work
and provides clear zero cost protocols
for effective recovery that leverage neuroplasticity,
which is your brain's ability to change
with intention and experience.
We discuss and compare residential treatment programs,
12 step programs, self-guided addiction recovery and more.
If you or someone you know suffers from addiction,
the information and tools offered in this episode
ought to be of tremendous benefit to initiate
and maintain sobriety from that behavior or substance.
Before we begin, I'd like to emphasize that this podcast
is separate from my teaching and research roles at Stanford.
It is, however, part of my desire and effort
to bring zero cost to consumer information about science
and science-related tools to the general public.
In keeping with that theme,
this episode does include sponsors.
And now for my discussion with Ryan Suave.
Ryan Suave, welcome.
I'm glad to be here.
Thank you for having me.
You're the guy that people call, reach out to,
cry to when everything comes crashing down.
That's kind of your thing.
Yeah.
And you have this incredible gift really to orient people
in time and space when that sort of thing is happening.
And you do this for men, women, teens, kids, adults, families.
You've pretty much seen it all,
although I'm sure there's more to come.
I would love for you to just explain to people listening
what addiction is and how you see it show up
in people's lives.
I know that you tend to get things like a trauma surgeon
would see the human body hemorrhaging
and in need of great support,
but how do you think about addiction?
First, I'd like to make a little bit of a distinction.
We're going to talk about addiction.
When we look at the DSMM the diagnostic manual that we use for
Diagnosing psychological disorders not really addiction as a diagnosis. That's not super important
Necessarily because we can talk about it in the term of addiction
But you know we can look at people and and and look at biological
Psychological and social factors and make a diagnosis to see that they've got a substance use disorder, an alcohol use disorder,
whether it's moderate or severe or they're dependent on it. And not to give people an out, but not all people that show up with an alcohol use disorder
for a point in time are necessarily an addict. They may not be forever. It might have been a life circumstance that kind of brought them there.
That said, someone that at a point in time in their life could have an alcohol use disorder or
substance use disorder, you know, they're probably prone to that and they probably shouldn't continue
down that path or gamble with it. So talking about addiction in general, I like to broaden that definition
to really, you know, question I'll ask people is does it have you or do you have it? Is
it driving you and your behaviors? Are you really leaning on it in a way that that's
your, your medicine? Because I don't really see addiction as the problem. You know, addiction
is the solution. Whatever they're addicted to is the solution to some underlying stressor.
I think as humans, when we're uncomfortable, when we're experiencing pain, our immediate
reaction is to get out of that.
When that stress becomes really big, we're going to look for the things that are going
to impact us a lot quicker, taking a drink, using a drug.
Now once people start doing that, depending on what it is, you know, if it's heroin
or fentanyl, they can become physically addicted to it very quickly or alcohol over time.
But I think the definition can be expanded to a lot of other things, maybe even things
that seem mundane, you know, and we can have addictive behaviors at different points in our life and maybe work have the same behavior
that sometimes is addictive and sometime isn't, you know, this is very mundane.
But sometimes I'm binge watching Netflix because I'm on a plane and don't have anything to
do or I'm sick and I can't get out of bed.
And other times I might have a really stressful day or have something going on that I don't
want to deal with and I end up watching TV too late and then I don't sleep and now is that a
addiction that I need to get treatment for or be pulled away from my family for probably not but it's I
Think in talking about addiction we want to understand, you know, what is it that?
People are using whether it's a substance or a behavior, and why are they using it?
You know, while I say addiction is not the problem, it's the solution.
It's a solution that becomes very problematic for people.
And you know, you will know this better than I will be able to explain it better than I
would, but you know, they get a benefit in their brain and body for feeling the sense
of relief that they'll feel when they use the substance.
You know, one of the doctors who initially supported the people who founded Alcoholics Anonymous,
his name was Dr. Silkworth, and he wrote this opinion, and he said,
men and women drink essentially because they like the effect produced by alcohol.
I believe that effect is relief.
So people are looking for some sort of relief.
And the question has to be, I I think when we're talking about addiction
What is it that they're looking for relief from?
so when
Somebody comes to you or somebody or in some cases is brought to you. Yeah, who is in the throes of addiction
What's your first line of attack so to speak Are you focused on what the underlying stressor is
or you're trying to stabilize them?
I mean, these are people who sometimes,
and sadly I've seen this in my friends,
fortunately who are now sober,
but people who wrap the truck around a tree
at seven o'clock in the morning,
having drank a bottle of wine and taken a Xanax
or jail or worse, right?
And so when somebody comes in, what are the first questions that you're asking and what's the goal?
Let's talk about the most acute first. So I serve as a chief clinical officer for Guardian Recovery.
We do treatment in different states. You know, we serve thousands of people a year and we have
medical detoxes that we start with. So if somebody needs to be detoxed from alcohol or drugs, you know, they're going
to come in, we're not going to start asking questions about what the underlying stressor
is. You know, we're going to first do medical assessments, nursing assessments. Sometimes
we have to send them to the ER if they're, you know, if they're in dire need or they're so acute that they can't even be
in the facility that we have, we're gonna just get them physically stabilized, you
know, and as we're getting them physically stabilized, you know, the thing
with addiction is a lot of people just say stop, but for people that just stop
and assuming they're not in danger like in alcohol, if you just stop you could,
you know, you can have seizures and die, you know. an alcohol, if you just stop, you could, you know, you can have seizures and die, you know.
Other drugs, if you just stop,
it can be extremely uncomfortable.
But even if they went to a detox and were able to stop,
their life doesn't generally get better right away.
In fact, a lot of times it gets worse.
Now, maybe it's better in the fact
that they're not about to die.
You know, they don't have these physical symptoms,
but emotionally, you know, they don't have these physical symptoms, but emotionally,
you know, they've been using this substance or this or alcohol as a, as a medicator. Now,
all of a sudden, the medicine's gone, you know, and they've got to deal with life. And so they
can actually feel a lot worse right when they come in. So first, what we're going to do is really
understand what's going on with them biologically so that we can
make sure they're safe. And then as we can support them over the days that they start, you know,
becoming a little more comfortable, their physical conditions start to stabilize, then we can start
to really understand what's going on with them and their environment, you know, what is their
pattern of use, you know, when do they use, what are the effects that it's having in their life?
You know, because we want to understand how it's playing out everywhere
like I said biologically psychologically and socially and and really get a clear picture of
Who this person is, you know, and sometimes people come in more motivated than others, you know
Sometimes they get brought to us like you said and I've seen it work either way that someone who's comes in and
says, I need help, you know, I'm willing to do anything that they end up not following through
with their treatment and other people that come in fighting and screaming end up, you know, doing
very well over time. I actually like it when people come in and that kind of struggle. I think, you know, the more people kind of struggle with
something upfront, it's kind of like the you pull an arrow back, you know, the
further you can pull the bow back and hold it, the more tension in it, the
farther it's gonna fly. And I really like when we have people who say, I'm not
gonna do this or I'm gonna leave, you know, they're actually telling us
something about themselves and where they are and we can be there
with them in that struggle. You know, sometimes people come in and they're
just like checking the boxes and they're gonna be a good student and everything's
fine because they're not drinking anymore and then we're never able to
really get to kind of the causes and conditions of it. You know, when they're
in a treatment setting, we'll have them for anywhere from, you know, seven days to
90 days. You know, we like to keep them, you know, and understand, you know, seven days to 90 days. You know, we like to keep them, you know, and
understand, you know, what's going on with them so we can meet them at their different
stages. And the environment, we kind of try to create a microcosm of their social universe
so that, you know, they can experience some stressors while they're... We're not creating
the stressors, but we're having them communicate with their families. We're having them face
some of the things they don't want to face. And we have a saying that says, you know,
treatment can't really begin until the crisis occurs. And what that means is more of the
internal or existential crisis. If someone's coming in and going, well, I'm great, everything's
great, you know, why were they, maybe things are feeling great right now, but why were
they drinking or using in a way
that was harming themselves, others,
ripping their lives apart?
Sometimes people will say addiction is a choice.
I don't buy that all the time, right?
But people will say that.
And I, what I would say to that is,
even if it is a choice, even if people could wake up and say I'm going to do this or I'm not, why would they continue to choose a life that
they're hurting themselves and others?
So while they're in treatment with us, we want to start to really understand who they
are, start to understand what is happening in their environment.
And then as they stabilize you know, stabilize more
physically, and then they stabilize emotionally as we can start to raise their capacity to
experience difficult emotions. I mean, I say this all the time to my clients, you know,
what I really do with them is help them learn how to feel bad. You know, we don't put that
on the website because no one's going to come to us to say, how can I feel really bad? But
I think that's, that's at the core of it.
How can we build a distress tolerance so that they can face discomfort,
they can face pain and not choose the thing that gives immediate short-term relief
that's going to end up hurting them and those around them, to allow them to really lean in to whatever that discomfort is.
And when people are able to be available for the depths of discomfort,
then they're really become more available for the heights of joy and satisfaction in life.
So we start to build that capacity so that then we can start looking at the beliefs
that maybe the limiting type beliefs that have been driving them that are often set
from earlier on in the life in their life in the way that they were shaped. You know,
and that's often what we talk about as trauma, not always a big event that that happened
on a single day, although that does occur, but the shapings that people had in their life that were the, you know, we're adaptive.
People are very adaptive and, you know, kids and as they're in their formative
years will develop strategies to live life that adapt them in a way that they
can survive the environments that they're in.
And, you know, if that adaptation, which was appropriate in their family, their school,
their environment, whatever it was, maybe all of those, was something that was more
toward like a survival response, like a fight or flight type response.
And now that's never resolved in some way, in a way. And then later in life,
they're still applying these adaptive strategies
in situations that it's not appropriate for.
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The thing you said earlier that's ringing in my brain
is does it have you or do you have it?
And I think for people listening and watching,
I think this is a really important distinction.
And maybe you could just elaborate
on how one starts
to answer that question.
Because these days we hear, you know,
people are addicted to social media,
people are addicted to sugar,
people are addicted to, you know, all sorts of things
and online shopping, you know, and on and on.
Let's just set aside alcoholism for the moment
because that's a unique case where, as you mentioned, immediate withdrawal can cause death
and it has its own kind of unique features.
But for everything else,
like if somebody out there is listening and they're like,
well, you know, I have a hard time clicking off
of social media, even though I know I need to sleep,
I need to study, or have a hard time disengaging from
video games, I think is a common one in a lot of young people.
How do they know if they're addicted?
Is there a litmus test?
I mean, could we test ourselves as individuals?
Like can I go an afternoon without it?
Can I go a week without it?
Is that the test?
I think that's a great test.
I mean, probably more than an afternoon or a week, but, you know, can I quit for a month?
And, you know, if you're – when you've stopped, if all you're thinking about is
either doing it or when you're doing it, all you're thinking about is how can I stop
doing this, that's a pretty good indication that it has you, you know.
And you also have to look at like what are the things that it's impacting in your life.
And that's one of the things we can help people kind of orient to.
And they might think that if it's somebody that comes to us that their family's saying
this is a huge problem, they may not see it yet.
Or they may be avoiding it.
We call that denial.
But a lot of times there's something deep down where they know that I'm really disengaged
from life.
I'm lonely.
I don't have the quality of relationships.
I'm not able to be motivated to do the things
that I want to do.
What if it still feels good to them, however?
Like family isn't saying, look, you know,
kid isn't getting their schoolwork done,
but it's kind of outrageous, you know,
like four hours a day playing video games,
three hours a day.
That might not even seem like that much to a lot of people,
but parents can see the opportunity cost of that.
This is time that kid isn't running around
and getting exercise.
This is time that is eating into sleep.
This is time that could be spent studying.
So maybe grades haven't cratered yet.
Right.
And we live in the quote unquote American dream model
where kids say, well, so-and-so makes millions of dollars
every year playing video
games.
So I'm actually on the path.
I think you see that fairly often these days.
Yeah.
I'll relate it back to drugs for a second.
You and I are the same age and you probably remember the, you know, this is your brain,
this is your brain on drugs when they cracked the, you know, showed the egg, this is your
brain and...
Yeah.
Disrespectful to eggs, which I'm a big fan of.
And then this is your brain on...
Well, it did call the egg a brain, so that was pretty good.
Oh, that's true.
Your logic is impactful.
Thank you.
And this is your brain on drugs and it showed the fried egg.
I think that was a terrible example for kids because most of the time when people do drugs
the first time, it doesn't feel like that.
It feels good.
It feels great.
It's over time when you keep doing that,
that it, you know, especially, you know, a kid that doesn't have all the responsibility and the
things in life that they might have or want to have later on, you know, they're not going to,
they're not going to see that that's a problem necessarily.
And some of their heroes are very public about the fact that they like
smoke a ton of high THC weed. I mean that when I was growing up that was associated with
lack of agency and
kind of being a quote-unquote burnout was the idea.
Nowadays there are just as many examples of people that smoke a lot of weed are vocal about that and
by all external measures are
doing very well, perhaps better than most.
It also wasn't as highly concentrated when we were kids.
I mean, this is pretty intense these days and can add some really long lasting effects
on people.
And there's some people that it's not going to affect in the same way other, you know,
it does other.
Some people are going to be able to smoke that amount
of THC or vape it or however they're doing it. Right. I mean, the delivery methods are
very, it's crazy these days because you know, you, people used to have to roll a joint,
go behind the store, you know, it's like an event to go do that now.
And you had to break the law.
You had to break the law. Now it's everywhere. It's in a candy. I mean, it's candy, right?
There's gummy's gummy bears.
Wild.
It's really wild.
And you know, the thing with those people
that are succeeding at it,
like when we really look at that,
like what percentage of the people is that, right?
It's a very, very small percentage.
Of course kids are gonna look at that and say, well, I can do that, right? It's a very, very small percentage. Of course, kids are going to look
at that and say, well, I can do that. I've had a conversation with my teenage son about
that. And even if they're playing games four hours a day, I imagine those guys that win
these video game, or they're the YouTubers that are making all kinds of money, I mean,
they're approaching it like a pretty intense job. You know, they're really working at it. But, you know, we don't want to take away that imagination
and creativity from kids. But, you know, it's our job as parents to look and see, you know,
the kids aren't going to see what's happening. You know, their kind of timing is like now or not now.
They're not really looking too far into the future. And that's a beautiful thing about being a kid as well.
It's our job to put those guardrails on
and as parents really understand what are the things
that may impact them over the longterm.
But we also have to understand,
it's easy for me to look at,
I had video games when I was a kid,
but it was Nintendo and Sega, and it was not as, it didn't pull you in as much and we were outside
all the time.
It was a little bit, you know, it was a different, we'd come in and play video games at night,
you know.
You know, now these things really pull you in and you're interactive and they communicate
with other people.
You know, they, a lot of kids have their social connection out of playing video games. I actually had a mentor once who was involved
in a leadership program with all these other adults
and they did their leadership program.
They were all over the world and they would meet
in I think it was World of Warcraft and play together
and they had different things that they would do
to work through whatever they were doing
in the leadership program.
So there is some benefits to it for people.
These kids can really connect with each other when they and especially through the pandemic
this happened.
I'm going to come back to what I was going to say about as a parent, it's easy for me
to look at and say, well, there's too much social media, it's too much video games, it's
too much this, it would be great if all that stuff was taken away.
Well, guess what? It's not going anywhere. You know, and I can't really
relate to it in the same way that my kids will relate to it. You know, I have younger
kids that I have no idea what's going to be there when they're of age to look at screens
or be in the world or communicate with others. But it's our job as parents to look at
and get to know our kids in a way
that we can see what are the things
that are gonna benefit them
and what are the things that aren't.
I don't think every kid shouldn't play video games.
No, neither do I.
I think that the contrast with the video games
that you played when you were younger
and then you mentioned going outside, I think I realize this is not a strict definition of addiction
by any means, but if something in the electronic sphere makes, quote unquote, real life underwhelming,
I don't know if that means it's addictive, but it certainly means it has a gravitational
pull, right?
And we can set this as a kind of a pillar for context when we talk about pornography,
for instance.
Right?
So when, I mean, there's a saying, right?
A picture is worth a thousand words.
And I would say as a vision scientist that a movie or even a reel or a clip on TikTok
is worth a billion pictures.
Never before have we been exposed to so many movies
with so much richness in sound and eyes.
The more times we see eyes
and you've got all this elaborate context
of whether or not you're talking about pornography,
whether or not you're talking about video games.
The sort of sensory richness
of it, richness feels like the wrong word, right?
But the kind of like the amount of sensory information coming in through any one of those
very brief experiences in a moment, it doesn't necessarily overwhelm the brain.
Clearly the brain can handle it.
But then you walk out into a landscape like a park with a couple basketball hoops and some paint drawn on the
concrete and a ball and it looks boring. It's the difference between eating as a kid, a
hot fudge sundae banana split and then being offered a plate of broccoli. You have to know
a lot about nutrition and care a lot about the long-term effects of nutrition on the
body to not think that
the hot fudge sundae is the better option. I mean, it just makes sense from a neural perspective.
So I wonder whether or not this definition of addiction or habit-forming behaviors or dependence
could be expanded to include the ratio of kind of gravitational pull versus how it makes other things seem.
Yeah.
Right? And obviously, I don't believe that we should remove technology. I think technology
is wonderful. But I could imagine that for a young brain and for an older brain, right? I mean,
can I just ask you, do you find any adults or do you encounter many adults who are addicted
or have a habit of excessive online shopping?
It's so easy to buy stuff online.
Just the barriers to entry are so low.
Yeah, absolutely.
Does that make sense?
This contrast between richness and dullness that exacerbates the dullness the more that
you engage in some behavior.
Yeah, and I want to be clear, you know, while I said it's not necessarily a problem for
everyone, I believe it can absolutely, the video games as an example can absolutely be
addictive.
I mean, there's been studies that have shown that, you know, it's impacting the brain in
the same way as a lot of drugs are. I've worked with kids who were,
video games were taken away and they were like,
and their wifi was shut down
and they were somehow stealing some console
and like in the bushes near another home,
somehow pirating their wifi
to play the video games during the day.
I mean, it sounds like an addict.
Like a crack addict.
You know, or, you know, in the streets.
Is it a kid?
A kid. Like, you know, probably 15 or 16 year old kid.
So they took away his Wi-Fi and video games and he's hiding. I'm chuckling, but it's terrible.
I mean, you can only imagine what's going on inside that kid that they can't, as you mentioned before, handle the discomfort
of this thing that's like their medicine.
It's the thing that makes them feel good.
And we have these adolescent treatment centers
and these kids come in and they'll be very dysregulated,
even if they've been off of drugs,
or usually it's a lot of marijuana these days,
and they start to clear up from that,
but they're extremely dysregulated, agitated, reactive.
And after sometimes three, four weeks, we start to see a completely different person.
And one of the things I'm convinced is that they haven't been with their phones, they
haven't been on social media, they haven't been playing video games.
And I'm not saying the answer is to take that away, but you can start to see the impact
that that has on them.
You know, they're so anxious about not being connected in that way or being, I would imagine,
in that universe that you're talking about that's hot fudge sundae all the time.
Like, who doesn't want to eat hot fudge sundae all the time?
Well, and then hot fudge sundae doesn't seem to taste so good.
No, then you need more hot fudge sundae.
Yeah, I mean, that's the dopamine dynamic stuff that,
thank goodness, Anna Lemke, author of Dopamine Nation,
made so clear that those big, fast inflections in dopamine
very quickly lead to smaller and smaller peaks in dopamine
from the same behavior or substance,
and then the trough of low that comes after is just immense.
In fact, there's just what I, the other day,
before I forget, there was a post on X of a guy.
He sold his company for a billion plus dollars.
And he was expressing the extreme depression
of not knowing what to do with himself now.
And everyone will say, oh, poor guy, right?
I don't illustrate that point to make it a point
about billionaires or not,
but it wasn't
the pursuit of pleasure.
It was the pleasure of pursuit that drives dopamine.
He gets the goal.
There's no more pleasure from pursuit because he's not pursuing anything anymore.
And you think, how could that possibly be?
He can buy anything he wants.
But the whole point is that dopamine isn't deployed for the reward.
It's deployed for the pursue the reward. it's deployed for the pursuit of the reward.
So that trough is a very real thing.
Yeah.
And in the trough, you're still not going to go back to a plate of broccoli.
You're going to keep going after the hot fudge sundae feeling, even though the hot fudge
sundae isn't giving it to you anymore.
Well, that's an extremely important point, that people are chasing a feeling.
I had a friend who thankfully is a recovered addict.
I obviously won't disclose who this is,
a former methamphetamine addict, very successful in life,
but had a serious meth issue.
Got sober and contacted me not long ago,
requesting some support because they were thinking
about abusing Adderall.
And we had a conversation, fortunately,
they didn't do this, he's doing great, goes to meetings,
has a sponsor, is taking care of that.
But the description of why they were pursuing this idea
of abusing Adderall was this recollection of a feeling.
You know, he kept talking about like,
I just remember that feeling. It was, you know, and everything You know, he kept talking about like, I just remember that feeling.
It was, you know, and everything felt,
and he was talking about something that I can't relate to
because I've never done meth,
have no intention of doing meth,
but it's almost like it was like a love affair
that had been spectacular,
that he was missing this person, but it was a thing.
You know, it sounded like love,
like I missed that feeling.
I think that's a very important point
because I see people as having spiritual relationships
with alcohol and drugs.
I mean, they use them as something
that makes them feel connected.
They feel whole.
I mean, what is alcohol called?
Spirits.
You know, that it's something that can allow them,
even for a period of time, to feel the way
that maybe they want to feel,
or not feel the way that they don't want to feel.
You know?
Can we dissect that a little bit?
To feel the way they want to feel,
versus not feel the way they don't want to feel?
I remember reading Augustine Burroughs' book, Dry.
He's a recovered alcoholic.
And there's this paragraph in there where he talks about his first drink of alcohol.
And I'm going to get the exact wording wrong, but it went something like, you know, on that
first drink, he felt—he's in the first person, he's saying, I felt it mesh with my blood and my physiology,
and my physiology felt correct for the first time.
And I thought, oh my goodness,
I certainly don't have that relationship to alcohol,
but I have friends who are serious alcoholics,
fortunately now sober, who describe alcohol that way.
From the first drink, it was like, this is, they say, this is me.
It's like they're finding themselves. And that's very different than avoiding
the way they felt previously. Most of them didn't pick up a drink the first
time because they were trying to find that person or because they were trying
to avoid something else. It was because there was booze at a party or booze at
home. Even the people that like him that are talking about alcohol like that, and I've heard this
story thousands of times, you know, from people that never read that book, you know, that
that's how they felt.
They couldn't have been using it most of the time to get away or to move away from how
they're feeling because they didn't even recognize that's how they're feeling.
That was just the world they were in.
You know, we're especially a lot of times this is kids and adolescents who that's the
first time they're drinking and they they don't realize that they could feel the way
that they're feeling.
You know, these are the way that we grow up are just the waters we swim in.
We don't often know that there's a difference between who we are and how we can be. And to be able to, a lot of people, the first
time, even the first time they'll do it. And it's not always like that for everybody,
right? Some people just are using it socially. And then later on, when there are stressors,
realize that, you know, I can use this to medicate as well, but the ones that are having the relationship that
you just described is, you know, they didn't even know.
They had no idea that life or their emotional state or their physiological state could be
different than it was.
So how do you persuade somebody that it's a good idea to take that away from themselves. Because I imagine some of the first thoughts
that go through their mind include,
I can't imagine life without that feeling.
You know, St. Augustine said,
and I'm not gonna get it exactly right,
but he said something like, you know,
well living depends on reordering your loves.
And he was talking about people living with a disordered life.
And the question it begged is, what are you loving the most?
And his argument, I think, was whatever you're loving the most becomes your God, your higher
power.
You know, if I'm loving money the most, if that's the most important thing to me,
then money is
my higher power.
The thing is, money will fail me, right?
Like you just talked about, like the guy could get a billion dollars and want to kill himself,
right?
Or if I put my relationship at the, you know, if I said, you know, the most important thing
to me is that my wife is happy, you
know, and that's my most important thing.
That sounds great, but she's not going to be happy all the time.
And when she is, I'm going to feel great.
When she's not, I'm going to feel like I'm doing something wrong.
You know, are we making sex the most important thing?
Are we making, you know, and his argument was love God first and then do as you do as
you will, like find the highest power because these powers don't that we're putting up
there like money, sex, food, all things that aren't problematic.
We need them.
They only become problematic when they're problematic, right?
When they're when we're making them that thing that's going to solve our problems.
What about kids? I know a number of people who are excellent parents who are super devoted to their kids
and they say like, my kids are my life.
My kids are, my kids are everything.
That might just be language, right?
They could also have a relationship to a higher power, but do you see people suffering by virtue of over emphasizing their kids or their, you
mentioned spouse, but as a priority in their life?
Yeah, and it's great that you made a distinction about just being language because, you know,
people can say those things like, my kids are very important to me.
Probably I would say, you know, one of the most important things in my life is to be a father, right? But if the energy in
the house again and again is that my kids are my life, what are, what a burden that
is for that child. That means that, you know, like that child might in those instances show up in a way that they need to be happy, they need to perform,
they need to, they can't show sadness, they can't, in order for their, that becomes their
job to make their parents okay.
And can you imagine that kid later grown up looking for a partner and the expectation
on that partner or the expectation on themselves,
just based on that role internalization of,
you know, like that they're the center of the universe
or that maintaining this beam of love
from the other person is essential
or else it feels life threatening.
Yeah, I mean, it's a covert form of abuse
to use our
children to meet our needs. You know, we're there to meet their needs,
depending on their age, right? I mean, we're going to, you know, you have an
infant, you're their highest power. You have to do it. They, they, uh,
they can't survive without you. You know, they can't feed themselves and you carry
them all the time, right? And then, you know, eventually they start crawling and
walking and you carry them more than, than you don't. And then eventually they're walking all the time and you're carrying them just a
little bit and, you know, then you're not carrying them anymore. If you're still carrying them all
the time when they're 16 or 17, that's a problem. But when we're using them to meet our needs
again and again, now it becomes their job to care for us. And most parents that do this, and I see this all the time, are not setting out and saying,
I'm going to use my child to make me happy.
They really have the best intentions.
And it probably comes out of however they were shaped growing up and how their family
was shaped growing up.
But you know, I see this, you know, with my kids, you know, sometimes I
come home, two, there are six and three, and I come home from work and they're like,
daddy, daddy, daddy, and they're running to me and they jump on me and it feels amazing.
And other times I walk in and like they've got a show on or something and I'm like,
hey kids, and they're like, they don't even say anything. Now, that doesn't feel great,
but what I know is that doesn't
mean they don't love me, right? If every day I came home and they were like in
the middle of something, I forced them to get up and give me a hug, you do this once,
it's not gonna be a problem necessarily, but if I did that every day and now I
need them to give me a hug in order for me to feel safe and comfortable coming
in the home or just feel happy, they're gonna start having the job of we got a hug daddy in order for him to have a nice evening.
That's a big job for a little kid to have. And I see that play out a lot in the
people that come to us and that they've unconsciously been assigned to these
roles in childhood like you know they're the hero of the family, you know,
we can use those the terms or the scapegoat or they're the, you know, but really what was the job
that they were given? You know, it's my job to take care of mom and dad, you know, maybe they were
in the middle of the relationship or, you know, if mom and dad are fighting all the time. But kids
are often assigned these roles early on
and then they don't know how to shed them later on.
And so then they just use that role later in life.
I mean, my field is full of people who are assigned roles,
you know, the therapists and nurses and things like that.
You know, we want to care for people.
But it's hard to parse some of that stuff apart, you know,
because we don't want to blame parents for
how their kids end up. But when we're doing work with our clients, we want to understand the
patterns that were developed, not to blame them, but to start understanding what were the systemic
challenges in the family system so that we can, you know, develop and deploy systemic solutions for them.
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There's this thing that happens around any conversation about addiction where at some point any logical listener starts to say, okay, well, and it sounds like everyone's addicted to something.
And it's so hard to stay right in the, you know,
between the lane lines of healthy and healthy because,
yeah, I like, I'm not speaking for myself because I'm not a drinker,
but like, I like a drink at the end of the day.
It helps me relax, makes me a better parent,
makes me a better spouse.
And I like it.
Is it my spiritual higher power?
No, but I like it. Is it my spiritual higher power?
No, but I like it.
Would I take 30 days off?
Prefer not to, but I'm not addicted.
But then you think, okay, well, a kid that likes playing video games, it lets him connect
with his friends.
He's doing it a bit excessively, but is he addicted?
Okay.
Obviously, if it's harming people's profession, it's harming
their relationships in very overt ways, then we place it into the category of addiction.
But there's this thing that happens in these conversations around addiction where people
start to go, okay, it sounds like I can't really enjoy anything that much because then
it takes over everything.
Like I'll come clean.
I've worked anywhere from 10 to 16 hours a day, five to six days a week on average
since I was 19.
Am I a work addict?
Workaholic?
Maybe, but I love my work and it's done wonderful things for my life and I have a life that
I wouldn't trade for anything.
Did I miss out on a lot of things?
Probably, but I also love the life I've lived and that I continue
to live.
And a lot of that comes from the relationships and experiences I've had through work.
So at some point, this is where diagnostic criteria become handy, but I do like the fact
that we have a litmus test now.
Could you take 30 days away from it and not completely lose your mind?
Or could you just take 30 days away from it?
If I didn't work for 30 days, that would be very difficult for me, but I could do it.
So how should we frame this thing of addiction so that people can ask themselves, like, do
I have it or does it have me?
I mean, I think how are you using it and what is it impacting, if anything, but to be able
to be honest with yourself about it.
You know, it's very hard to be, it's easy to say be honest with yourself about it, but
it's very hard to be honest with ourselves.
You know, that's where being in relationship with others, sharing what you're experiencing.
If you're taking 30 days off, really communicating to somebody else, whether it's a therapist
or a trusted friend, you know, how am I thinking about this?
You know, am I waking up every day wishing I could be doing this other than some?
Am I sitting in a business meeting completely dissociated from what's going on because I'm
really focused on that I'm not gambling or that I'm not drinking?
You know, you've got to be able to look at what it's impacting in the way
that we're thinking and the way that we're feeling. Can I ask you a question about how it's impacting
things? Because one thing I've observed in myself and in others is that sometimes behaviors that if
you if we were to just look at through a kind of tunnel vision, you'd say, wow, like this person just like works a lot or this person exercises a lot.
But it provides energy that feeds a bigger ecosystem.
You know, it gives me a sense of purpose.
I have great relationships through my work and relationships that are not through my
work but, you know, it sits not as my higher power but kind of at the center of my life
and a bunch of other things wick out from it.
And to remove that thing would be to disrupt the whole web.
I think that sometimes what scares people, especially, again, I can't relate to alcohol
specifically, but what my friends who have made the decision to try and quit or quit
drinking alcohol, for them, it's like their ability to socialize, the lack of anxiety while they're intoxicated,
knowing there's something to do for them as opposed to what they would fill that space
with.
So sometimes I feel like these addictive behaviors fit into a larger ecosystem so that it masks
any dysfunction, but it has this, again, gravitational pull so that it gets to bigger questions of like,
how are we supposed to live our life?
And I like this quote from St. Augustine, that a life well-lived is a constant reordering
of our loves.
Reordering of our loves, yeah.
Yeah.
Something like that.
So it gets to these questions of like, what is a good life?
This is a great discussion point that people will come and say, I just want to be happy.
I just want to be at peace.
First thing we have to ask them is, what does that mean?
We have to define it.
A lot of times maybe they're saying that happiness is kind
of the absence of all this bad stuff,
or that peace is everything outside of me is going OK.
Everything is fine.
We've gotta really explore with them, what, how would they know when they got there?
What a balanced life is gonna be different for everybody.
And especially with behavioral addictions,
it's not about necessarily removing those forever.
In fact, a lot of those we can't remove.
Food addiction, you can't remove food.
I mean, the things around sex addiction, you know, you're not
going to, I suppose someone could not have sex, but really a lot of that is about connection
and relationship and love and intimacy. You know, even gambling, you know, people don't
have to gamble, but you're dealing with money, you know, and you've got to touch it and spend
it and be around it.
Yeah, buying a house is an investment.
Or a gamble sometimes, as we've seen.
And we've got to look at how we're using these things.
And going back to drugs, you look at we've got pain medication.
Aside from being abused, we've got opioid pain medication.
Um, and then we've got heroin and both of them either came from or derivatives of
the poppy, which is a beautiful flower, right? So we've taken this flower and we've been able to make this, these drugs.
And one of them, you know, of course,
prescription pain abuse and fentanyl that we see is, is, you know, is course, prescription pain, abuse and fentanyl that we see is, you know,
it can be deadly.
But I think an argument can be made that it's probably saved more lives than it's killed
when used appropriately.
We're able to have surgeries that we probably never would have been able to have before
because of the medications that people can use.
And then we've got people who are either abusing that or taking heroin and dying, you know,
having a, you know, we started
calling it the opioid epidemic. I think 50,000 people died. It like surpassed the number of the
people in the US that died by car accidents. Last year was something like 100,000, right?
100,000 people die.
At least, you know, it's more than doubled. You know, now it's in a lot of different things.
There's a lot of kids that are taking something that they think is a less harmful pill, like a Valium or Xanax, and it's got
fentanyl in it and they die. You know, it's doubled since we started calling it an epidemic.
And of course, that 100,000 doesn't include all of the other drugs and alcohol. But, you
know, it goes back to how did we use it?
You know, we manipulated this flower in a way
that we can save lives and kill or die.
That's a more extreme example,
but how are we using the things in our life?
You know, are we using exercise as a way
to completely, you know, to dissociate from things.
If I take away that exercise, am I going to fall apart? Am I not going to be okay?
You know, and that doesn't mean don't ever exercise again, but understand, like, if I were to stop for a week,
do I fall into a deep depression? Not everybody is going to do that,
but if somebody's oriented in the way that it is a problem, that may happen for them.
And then it begs the question, like, what am I using this for?
What I think is so important about treatment for addiction and then recovery from addiction
is that, you know, at first it's about eliminating something.
It's about moving away from something.
But that's not sustainable.
Just to cut something out isn't...
Because it's being used for something,
to give them that sense of relief or that sense of peace
or that sense of connection or spiritual or otherwise.
They've got to eventually start building towards something.
You know, what's the life I'm going to create?
If you look at the 12 steps, the last part of the 12 steps is to practice these principles
in all our affairs, which means go out and build a life.
You know, don't find yourself really small.
We were talking beforehand, there was a, I think he was a biophysicist, I can't remember,
E.M. Jelenik.
He was at Stanford for a bit, the end of his
career. And he had done a lot of research on alcoholism and wrote a book in the 50s
or 60s called The Disease Concept of Alcoholism. And out of that book, there was a curve, and
you can look this up, it's called the Jelenik Curve. I don't think he actually created
the curve. It was credited towards him. In fact, I think he even kind of dissociated himself from it,
but it came out of his works.
And it starts off with at the top, and it's for alcoholism,
like where people start drinking.
And it's in the crucial phase as they start drinking more.
And at first, when people are drinking more,
their tolerance increases, but they
start to experience some problems.
They're hungover, they're late for work, they're having arguments, but it's nothing
that drastic.
And as they keep drinking and descending down this curve, actually they enter the, I think
it's called the critical phase.
And that's where actually tolerance decreases, right?
They're dependent on it.
They need it just to get by.
They need it to get to work.
You know, they can't keep the job. They can't keep their relationships.
Their physical body is starting to fall apart. They're getting sick because of it. There's
a lot of other factors in it. And then they, they come down to the bottom of this and,
and it's this cycle of drinking and stopping and drinking and stopping, you know, drinking until I can't anymore,
physically sick and then going back to it as soon as they can.
When those people are able to get treatment and find recovery, now the curve starts to
go back up and the recovery side of the curve.
And in the beginning, you know, they're not feeling that great.
They've lost the thing that helps them get through life. But if they can stay
in a contained environment, and that contained environment could be a treatment center or a
contained environment, like in a 12-step program, you know, where they're engaged in something,
I don't mean contained by the walls that you're in, but in some sort of in a community,
and they can stay away from it. Eventually, they start seeing that they see in others that they can stay away from it, eventually they start seeing that they see in others that they can build a life,
that they can go after the things that they wanted to go after, and they start finding pleasure from life rather than from the substance.
You know, they start to be able to handle the stressors of life.
Their tolerance for stress, instead of their tolerance for alcohol building, their tolerance for stress starts to build.
And then eventually they're kind of moving towards what we would call in Maslow's hierarchy
of needs, the self-actualization, you know, they're able to build a life that they never
thought they could have before.
You'll hear people say a life beyond my wildest dreams.
You know, and a lot for a lot of those people, that's just that I'm able to meet anything
with some sort of sense of peace.
And when I'm not, I think recovery is, it's not about finding a, let's just use the word
peace.
It's not about finding a sense of peace that you stay in.
You know, balance is not, I'm on both feet standing still.
Balance is like, like this, right?
And as we're taking risks in life as we should to really build awesome lives,
sometimes we're gonna feel way off kilter,
but with the recovery process,
to be able to recognize when I'm out of balance sooner
or out of peace sooner and return to it quicker,
recover again and again, you know,
and have the tools to know, you know,
what are the emotional conditions
that I might be facing on every day and what
am I made of and who am I that might bring to that?
So for instance, something I give to a lot of my clients is we call it like the emotional
weather forecast.
You know, when the first part of this is they've got to really know themselves and that's something
that we see in 12 step
a lot with oh we hear if you know people identify their character defects not everybody
I know it's familiar with 12 step, but that's one of the but as part of identifying your defects
You're also identifying your virtues right just like a balance sheet. You want to know your liabilities and your assets and
Sometimes those things are,
sometimes they change.
And if something that's a liability in this situation
might be an asset in this situation, right?
Like if uncontrolled anger and violence in my home
when my kids do something wrong and I'm not doing this,
but it is a liability.
If my family's attacked,
it's an asset, right? So understanding what these defects and virtue or assets and liabilities are
so that I really know myself. And that can be through a process of sharing with others and
in the 12 step, that's how they do it. We do it in therapy all of the time to kind of know who I am.
You know, actually, there's a line in one of the AA literature that Bill Wilson wrote
and he gives a definition of humility and it goes something like this, that humility
is an honest recognition of who and what we've become followed by a deep desire to become
who we can be. And it's not about like that I'm all bad,
it's just to note it, to recognize who I am.
If I don't know where I'm starting,
I can't know, just like finding directions.
If I asked, you know, to get directions to the studio
and your team started giving me directions from
over the canyon, but I was, you know, south of here, they're going to give me the directions
to turn left on this road and right on this, and I'm going to, I'm not going to know
how to get there.
I'm not, I'm going to be disoriented.
I'm going to feel lost.
I got to, it starts with really knowing where I am, who and, who and what I am.
And from there, then we can start to build a life.
So one of the things I give people a lot is once they kind of understand these assets
and liabilities of theirs, to look at each day ahead and say, first we start off with
gratitude, it kind of gives a mindset.
And gratitude just isn't about being thankful for things.
I really believe gratitude is meeting what is as it is. When I, that I always, when I give people this
and when I practice it myself, I try at least to be,
one of the things I'm grateful for,
to be something that I'm challenged by.
And not just to say, I'm gonna learn a lesson from this,
but I might not know what that is,
but to really express gratitude
for some challenge I'm having.
So that's kind of a mindset.
And then the next thing is just laying out your plans for the day.
And not like a detailed calendar, but like, you know, I'm going to take the kids to school,
go to work, travel, you know, have a business dinner tonight.
And then, so I kind of know what's happening that day.
And then from there, look at what's my emotional state currently?
What am I experiencing now?
Especially if it's like fears, resentments, anger, guilt, shame.
It could be something else.
It could just be like I'm feeling, I feel really solid today.
But when I can take what's going to happen today and what I'm already experiencing,
I can look at what I'm doing today and think, you know, there are some character liabilities
or defects that might come up.
Like if I have to travel today and I've got to take three flights instead of one, I can
know that if I know myself, I might say I could have the ability to become impatient,
controlling and look at my day to say, almost predict what are the emotional disturbances
that can happen that day.
And then coupled with the state that I'm in, if I'm already upset about something else,
I've got a higher likelihood of going into these reactive patterns that I don't necessarily
want to go into.
And so, you know, much like going on a trip where I would look and see what the weather
is going to be, you know, if it's going to be looks like it's going to be rainy the whole
time I'm there, I'm going to pack a raincoat.
Now, that doesn't mean
I'm not gonna get wet, but once I start getting wet, I can go get my raincoat
and put it on. Same thing in this, you know, the last part of it is to look for
what I'm gonna watch for because of my plans and my emotional state. Now I know
that I have to watch for being like maybe short or controlling.
I want to watch for these character defects or liabilities. And then what do I want to strive for?
I'm going to strive for being patient, tolerant, kind. Now, just because I write this down, just
like the rain jacket, doesn't mean I'm not going to experience these things. But when I can look at
like a day as an example, I can break it down in a chunk where I'm not
going to be shocked by I'm being impatient.
And as soon as I get impatient, I can remember, oh, this is what I'm looking, this is what
I want to watch out for today.
What do I need to, and I wanted to strive for being tolerant and patient.
So then I can use one of the tools that I might have that I've laid out.
It might just be if I'm in the airport, walk away, take a breath, you know, and recognize
and remind myself this is what I'm striving for today.
And in this exercise, we're putting out in front of us what we might be experiencing
based on what we know about ourselves and what we've learned about ourselves. And when we can do that, we can start living each day a little bit better,
or at least I find this with my clients, that they can chunk it down and say,
you know, they're not surprised by these emotional reactions.
And, you know, like I said earlier, we want to help people,
I try to help people learn how to feel bad, to recognize that, okay, I'm feeling disturbed,
I'm in a reaction, let me lean into it
rather than run away from it.
And we run away from it in different ways.
I might be snapping at the lady at the counter,
or might be someone that now I just totally withdraw
and don't say anything.
Yeah, numbing out is very common.
Yeah, it is.
I just want to repeat these different categories.
A small list of gratitudes,
including perhaps some things that we're grateful
that challenge us or things that we've received
or whatever it happens to be, a quick list of gratitudes,
plan for the day, what the internal emotional weather is,
like how am I feeling, irritated, rested,
what could be three or four things,
what to watch for and what to strive for.
I do think it's an extremely useful,
obviously zero cost, minimal, minimal time investment
protocol for lack of a better word,
that everyone, not just people who struggle with addiction
but everyone can benefit from,
because I think we tend to be so conscious
of like what to look for, what to strive for,
coming out of a morning journaling or a great night's sleep,
but then, you know, it's amazing how by 3 p.m.,
somebody cuts us off in traffic,
or we're being bombarded with too many things,
and all of a sudden we're not necessarily unpeeled, but we're not our best self.
Do you think there's value in sharing your list with somebody else?
Connection with others is so important, especially when I share something like this that's vulnerable
with them because it's not just about holding me accountable, but now I'm expressing it
in a way that others see it.
And we can have communication with them about having them share back with you too.
I have like 10 guys that I share this with every day.
And not that the way that I do things is the way that everybody should, but I ask other
people that I give this to to share it.
Because you're now expressing it.
And expressing something kind of brings it more into existence than if I'm just doing it myself internally.
And we've got to put these things in front of us because we will forget very quickly, you know, or like you said, coming out of a morning journaling or meditation session feels great.
I think most people decide to make a change and then, you know, on one day and then they don't think about it again in the way that they thought about it for months.
Like it happens every year on New Year's. They're not putting it out in front of them every day to be a reminder of what I'm going after, what's important to me.
And the brain is very different at different times of day and at night. You know, one thing that I subscribe to that, separate from this conversation, but perhaps relevant
is I don't believe any thoughts that occur
between 2 a.m. and 5 a.m.
But I just don't.
Whatever comes up, if I happen to wake up
in the middle of the night and have the,
I just don't, I've chosen to not believe those thoughts.
I might write something down.
I might have an insight that I'm interested in
or something that terrifies me or whatever,
but I just don't believe those thoughts
because I've had the experience thousands of times of them going back to sleep, waking up in the morning,
being like, that's ridiculous. That doesn't hold any water anymore. I think we're so vulnerable in
the middle of the night, our forebrain shut down, we can't strategize, all our safety mechanisms
are at their lowest and those thoughts just, they don't hold meaning. Now, that's not to say that some night owls
might not have some brilliant insights
in the middle of the night.
So this just relates to me and my schedule.
But I do think that we can make a decision
to behave one way and do things at 8 a.m.
And by 4 p.m., as a neuroscientist,
I can honestly say that your brain is not the same brain
at 4 p.m.
that it was at 8 a.m.
It's still you, but it's functioning so differently.
What's important, how it orders priorities,
how it interprets data.
It's not like a computer.
It's a dynamic machine.
And at different times of day,
you're working with a different set of hardware.
Literally, certain circuits are more active than others.
So I don't believe that we are capable of self-regulating
nearly as well as we could, certainly not perfectly,
if we don't have a reminder of our best self,
our aspirational self that we carry forward.
Whether or not it comes through other people or enforcement
or ideally comes from inside us,
but the expectation that we are going to spontaneously
and impulsively be our best self
is one of the biggest failures I think of education
and psychology and medicine.
And evidenced by the fact that I have many colleagues
who are scientists and physicians who have terrible addictions.
Some are sober, some are not.
These are brilliant people who have all the knowledge in the world about the inner workings
of the mechanisms that make people addicted, et cetera.
Anyway, I'm editorializing there a bit, but I feel very passionate about these zero-cost
tools.
But I have to say these tools can make a huge difference.
And what do you call this list?
What is it?
The plan for the day, what is this list?
Just like an emotional weather forecast.
You know, I mean, call it whatever you want.
But I think it can be part of a daily inventory too,
where at night you could look at and see how you did. I mean, I think you just talked about being your best
self. It's a way to kind of define what our best self is that day. Because what our best
self is, is going to change depending on the circumstances we're in. I've run into problems
before in my own life where, you know,
it's like the weekend and I'm really looking forward and like the weekends gonna be and
I don't let's say I don't do this extra because it's a Saturday and it's gonna be, you know,
I'm home and it's gonna be amazing.
I live with four other people, you know, two of three of which are children, they might
have other plans, you know, and or someone gets sick and we can't go to the do the thing
that we were gonna do and I can find myself
You know really grumpy and right in those character defects or liabilities
I also think being your best self isn't never engaging in those. It's not never getting angry, right?
I remember a teacher I had was talking about and I can't the, he was talking about some Indian yoga master, you know, that the student asked them, like, do the masters ever
get angry?
And he said, of course, but when they get angry, it's like writing on water.
It's there, and then it's gone.
You know, they're not holding on to it.
If you try to write on water, those letters are going to disappear right after you write them. There are emotional
disturbances that we're going to have, and it's part of life. We can't ignore
them. We should embrace them and lean into them. I think a real secret to
having a really fulfilling life is being able to embrace all aspects of
ourselves, the light and the shadow.
Because we can't just try to run from the shadow
and go to the light.
It's just, they're hand in hand.
In fact, they don't exist without the other.
Well, because they're both inside of us.
And they're both inside of us.
And they both have their purpose.
What is the purpose of the shadow in your mind?
And for folks that don't,
I mean, the shadow, we're using Jungian language here,
but, and there probably will be some folks listening
that say, and are thinking themselves,
well, I've never suffered from an addiction, et cetera.
But what we're really talking about here with this,
can we call it an emotional weather map?
Sure, that's great.
Because I like the idea of a map
and the forecast component.
Because it's not just how do I feel right now,
it's how do I feel right now, what's coming
and how am I going to prepare?
And there's some goal setting in it,
but you're not actually writing out your specific goals.
Just what am I striving for is I suppose a goal.
But what we're really saying is anyone
that's ever gotten anxious,
anyone that's ever gotten stressed,
anyone that's ever gotten angry,
whether or not you yell or not, right?
I mean, what you're talking about is a roadmap for being able to navigate the experience of being human.
Right, because what we're striving for is not our specific goals.
I'm not striving for success in this meeting.
I'm not striving for making this money today.
I'm striving for ways of being.
You know, how I'm going to be that day in the face
of the stressors, whether that meeting goes well or not, whether I make the
money or I don't, whether I get the answer that I wanted or I don't, that I'm
striving for this way of being. There's a line that I heard from a country singer
once that I think he heard in a 12- step meeting that said, you know, peace is not
finding calmer seas. It's building a better boat. You know that, you know, how are we going to navigate the storm? Not how are we going to avoid the storms? I'd like to take a quick break and
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You alluded to this earlier when talking about balance
as a dynamic process, not a static process,
that part of peace is knowing that when distress comes,
you'll be able to tolerate it.
Yeah.
As opposed to there's no distress.
And I know people like this that are constantly trying
to move through the channels of life,
create their own little estuaries around things so that there's never any disruption.
Yeah.
We want to be able to tolerate that distress enough to make choice and respond rather than
react to whatever it is.
It doesn't mean that we're not going to navigate out of the storm.
I think of it like this. If we go back into the 17 or 18 hundreds when the only way to get from England to America was to navigate or to sail in a wooden sailboat, right?
A sail ship, whatever it was called. And let's say we took the most experienced sailor with the best ship. But this time, rather than using his skills
of navigation and sailing, he said,
"'The seas are calm and the weather's good.
"'I must be going the right way.
"'But if the seas are rough and the weather's bad,
"'I must be going the wrong way.'"
And every time the seas were calm, the weather's nice,
he just kept going in the direction he was,
but every time he came across waves and rain, he'd turn.
Is he ever going to get there?
Potentially, let's say it's calm the whole way, or he might end up navigating all the
way down around South America and then coming back up.
Neither one of those is the answer.
The answer is that when he meets the storm, he can use
his skills of navigation as a sailor and understanding the weather and his
experience to say, okay, this is something I navigate through, this is
something I navigate around, but he doesn't just react based on the external
conditions. And we react constantly to our external conditions based on what we're perceiving is going on.
You know, I'll preface this by saying I think I believe one of our biggest, if not our biggest
challenges human beings and our psychology is that we confuse discomfort with threat
and respond to discomfort as if it's threat.
You know, this goes back, I can use the diagnostic criteria for PTSD, not that everybody that
experiences this has PTSD, but when you look at the diagnostic criteria and the DSM-5,
which is the fifth version of the, it's the most recent version of the diagnostic manual, it says that the person was exposed to,
it's like exposed to death, uh, threatened actual or threatened death
or actual or threatened violence or actual or threatened sexual violence. In the DSM four, it said real or perceived.
And what that means is, you know,
we can have a similar or exact reaction to something that is actually happening, like
you're attacking me, hopefully you're not going to attack me, but like you were, as
if you threatened to attack me.
You know, if I believe that I'm in danger, then I can have the same, I'm going to have
the same fight or flight response or the same reaction in my body as if I am actually in
danger.
It's interesting that I think our legal system recognizes this in that you can be arrested
for assault or battery.
Battery is you hit me.
Assault is you threaten to hit me or threaten to kill me.
We actually in a way recognize this idea of perception in our legal system. It's actually, it's also I believe what the, forgive me for saying it in a way, recognize this idea of perception in our legal system.
It's actually, it's also, I believe what the, forgive me for saying it in this way,
but the quote unquote success of terrorism is.
It's not that this event happens, it's that we leave that event thinking,
it's not that those buildings came down, it's that we think, we believe that all
of the buildings are going to come down, right?
It's terror.
I think that because we were talking about addiction,
and now we're talking about perception of threat
and distress, we want to make sure
that we tie those things back to one another.
No, I think this is a very important conversation,
because at the heart of addiction,
but also at the heart of a challenged life, challenged
in the ways that life shouldn't be challenging, is this lack of distress tolerance.
And I have a question about distress tolerance specifically.
What can we do to increase our distress tolerance?
What practices?
Maybe we just have to experience distress to know how to navigate distress.
We're going to experience distress.
We experience it all the time.
And I think it's, and you may be able to articulate this even better than I can, but, you know,
we need to look at stress, right?
Not all stress is bad.
We need stress.
We need stress to move around in this chair.
I need to be able to walk around.
My muscles need to tense and I need that stress.
Was it Hans Selye's work around eustress and distress?
We're going to experience distress
and it's not about avoiding distress,
it's how are we gonna walk through that distress?
And so I like to break practices down
into a couple different ways.
So proactive and reactive.
Proactive are gonna be things that we schedule.
I'm gonna do, you talked about yoga nidra,
we can talk about that a little bit more.
You call it a
non sleep deep rest, other forms of mindfulness and meditation
that actually allow us to raise capacity in our nervous system.
Going to therapy, coaching, being involved in a community,
doing physical exercise, these are things that we're going to
schedule going into the cold plunge, which does allow us to
experience something
and stay a little bit longer.
And it gives us, you know, it's so much,
we have one at home and when friends come over to use it,
it's so funny because I think the first time
they're gonna do it, and I know you've had a lot of people,
we actually, I was at your home a couple years ago
and there was a guy who was doing it for the first time
and he's like a big, I don't remember this,
he's like a big athletic guy and he was freaking out, getting into terrified, right?
And it's just cold water.
There's no, it can't, I mean, it could hurt you if you're in there for however long to
get hypothermia, but it's not going to hurt you.
So having practices like that, that allow us to move through that level of fear can
translate to fear or distress can translate when it comes in real time
for something that I know I can walk through this.
Yeah, because adrenaline is ubiquitous
in stressful circumstances,
which is just a bunch of science nerds speak for.
The stress response is always an increase
in autonomic arousal or alertness,
a shrinking of the visual field, an increase in heart rate,
a tendency to move.
People will say, but I freeze. Actually, the freezing response, this is kind of interesting.
My lab studied this. Lindsay Soleil published a paper in Nature about this in 2018. She was a
graduate student in my lab. The freezing response is an active behavior. Trying to hide from an
intruder in your home in the closet, you're trying not to move.
So people think, oh, you know, people freeze under stress.
No, the freezing response is an active response.
You know, the adrenaline dump, as it's sometimes called, is what essentially creates the freeze
response.
It's why people can't remember things when they get up on stage if they have a fear of
public speaking.
And I was going to, I forgot to mention in the cold plunge, cold water is a highly reliable way to elicit
an adrenaline response.
Yeah.
It's just a great training for this feels uncomfortable.
I want to get out, but I'm going to learn to control my thinking in this uncomfortable
circumstance.
Yeah.
So that would fit into the proactive, right?
So that's something that you can proactively start to be able to manage
that adrenaline as you're telling me in the body, right? You're able to
manage those feelings because what does it come down to? It's these
sensations in our body that we're experiencing that feel really
uncomfortable. And we might be able to sense them a little earlier if we
have some training. I just want to throw in one little science tidbit as long as we're talking about using
cold as a way to manage distress tolerance is that the first 15 to 20 seconds after the
adrenaline response hits and it hits very fast, your forebrain, which is involved in
all your contextual decision-making and clean, clear strategies of what best to do
is essentially shut down for about 20 seconds.
If you can make it 20 seconds, you have a far better chance of not doing something really
stupid and doing something that's very adaptive.
Now there may be circumstances where you don't have 20 seconds, but if under stress and riding out that 20 seconds is generally going to be a very adaptive approach,
because then your forebrain comes back quote unquote online,
and you could really start to make strategic decisions based on those particular circumstances.
And so that's what's happening when we get experienced,
people say get triggered by something that's uncomfortable
for us, right?
You really, you get a text message from your boss or your partner that says, we need to
talk later, right?
A lot of people, I don't know about you, but when I get, we need to talk later, it's not
my favorite text in the world to get, right?
So someone might get that text and then they immediately go into like their
perception or their beliefs or their kind of narrative about what that means. I'm gonna be rejected. This is gonna be disappointing.
It's gonna be really hard and those perceptions or beliefs are coming out of their past. So now
sitting there looking at a text message, which is really just a
neutral, it's all events are neutral. We bring the meaning to them and we want to bring meaning to them, but it's just words
on a screen and we don't even know what it means yet.
You're looking at those and you're not even in the present that more, you're in the past.
And we're never really out of the present.
People say get present.
That's the only place we live.
It's where we oriented past, present or future.
In this moment, now that I'm going into this narrative
from all the other times that I was,
let's say I'm making up that I'm being rejected
or I'm not gonna get what I want,
now I'm oriented to the past.
So we could say I'm disoriented in that moment.
Or to the future, you're anticipating what might be said,
what's gonna happen.
You're out of the moment.
But I would say that the anticipation
is still something that's coming out
of what we've experienced before, right?
And then from there, we go into an automatic reaction
and it's like a fight or flight response.
It might not seem like that because we don't,
we might not be thinking I'm gonna die from this,
but if, you know, we might be thinking
I'm not gonna be okay.
And what is I'm not gonna be okay?
That gets carried out and it's triggered in the body,
I would say in the same way as I'm at threat.
I'm in danger.
And this is where we're confusing discomfort.
Because even if I am going to be not going to get the answer I want,
or I'm going to be abandoned, it's not life-threatening.
It's not actually threatening.
It's perceived threat. But I respond to that perceived threat as if it's actual threat.
And I might respond by kind of going after the person.
Like, I need to know right now being obsessive about it.
I might respond by withdrawing completely and hiding from it.
But it creates this cycle of kind of an automatic reaction to things that doesn't allow me to
build tolerance for that, that stressor, right?
The solution to that is first be aware that that's, that's happening.
And once you're aware that that happens and it happens to us all the time, once I recognize
that I'm in this cycle below to, to below to find a way to stop, to intervene
on that, to take a break from it, it might be just those 20 seconds.
It might be something that, it might be taking a few breaths.
It might be walking away from it.
Can I interject something there?
Because one thing that stemmed out of a prior conversation we had is I think, you know, these aspirational responses
of, okay, like the stressor hits, I'm going to take a,
I'm going to create the gap between stimulus and response
that, you know, was it for Victor Frankel
or something like that referred to?
Sounds wonderful, but in real time,
everything's different.
It's very hard.
Everything's different.
And so, you know, what can we do to prepare?
What are the things, I like this notion of proactive tools
that we can schedule,
cold plunge being one of them.
We'll talk about yoga nidra and some other things.
But one of the things that I've learned
is that there are sensations in the body that come about,
and it will be different for different people,
but there are sensations in my body that come about very fast because the adrenaline response is fast.
And the more that I pay attention to those,
the more I'm able to pick up on them
at earlier stages of the stress response.
Kind of like seeing a big wave coming from further out.
And the yogis talked about this.
I learned about this also from you that like in meditation,
we can start to seek the,
it's mystical language, but like the subtle ripples
of our perception, whereas when we're going through life
and we're just kind of around, it's like being on a train
and we're just seeing stuff go by all the time.
The concept is stilling leads to seeing.
I love that.
The more that we can still the mind,
the easier we can see what's actually happening
versus what we perceive is happening
So what you say is so true that it is hard if the first step is to
After we recognize that this is something happening is to stop when we're in the middle of response. How do we stop?
Something that I work with the people and I actually heard you talk about in a different way that I really appreciated in one of your essentials podcasts where, you know, in that moment when we're in that reaction, you know, the sympathetic nervous system has been activated.
The solution though is not to deactivate the sympathetic, it's to activate the parasympathetic. So our
practices and tools that I think are the most beneficial is how do we activate the parasympathetic?
A great question to ask ourselves once we recognize that we're in some sort of stress response,
I like to tell people to ask, is, am I or is anybody around me
in immediate physical danger?
And if the answer is no, first off,
if I can ask that question, it's probably the answer is no,
but most of the things that we experience every day
are not life-threatening.
Actually, probably the thing that we experience every day
that's most life-threatening
that doesn't bother most of us is driving in a car, right?
I mean, we're hurtling down the road and just trusting that someone's not gonna cross over that other line.
But that won't scare us, but, you know,
getting someone that you're in a
committed relationship with or that you're emotionally attached to that says something you don't like might throw you into a spiral.
I mean, it speaks to the unbelievably powerful aspect
of human connection.
Yeah.
I mean, likewise with the earlier example
of the kid in video games,
we think about this kid and the video game
as like the only players in the interaction,
but to take a video game away from a kid
is to also remove him from his social context.
We know that social isolation is one of the most potent stressors for any mammal, especially
humans.
I mean, from what I've read, tribes would basically shame someone out of it if they did
something really terrible.
They would send them out of the tribe and that was like death.
They only survived together.
Now we can live alone because of, you know, technology and human advancement, but like,
live physically alone. But, you know, we're not at the top of the food chain really,
you know, if we were out in the jungle or back when we were nomadic, and we still have that within us, that we need that connection, we need that.
So we're talking about distress tolerance.
We have an emotional weather map tool that can prepare us.
There are things that are proactive,
like cold plunge or meditation.
In the moment, we can hopefully create more of a gap.
And of course we were talking about this
in the context of addiction, but as you were saying,
with the behavior or the substance
is the medicine against discomfort.
Can you go back to that theme just a little bit
to really hammer that home,
that when somebody comes to you initially,
you're saying, okay, like what are you using?
How often are you using?
How's this impacting your life?
Trying to get them to see all that. But once they
move past that, are you trying to get them to see like what they're really afraid of?
Let me frame this a little differently. Many years ago, you said, it's kind of incredible.
We're having an academic discussion and you said, it's kind of incredible. If we can tolerate
discomfort for one second, then we can tolerate it for two seconds. If we can tolerate discomfort for one second,
then we can tolerate it for two seconds.
If we can take discomfort for two seconds,
we can do it for five seconds.
Once you start to realize that all you have to do
is experience discomfort as a series of moments,
suddenly you realize that you have an immense capacity
to manage discomfort.
And I was like, I sat with that for a long time.
Why do you think it's so
hard for us to do that? Even though in theory, that's exactly how it works.
I think this is where we get hijacked by the part of our nervous system that is kind of
binary and looking at its life or death. You know, if we perceive this as danger, it's
going to respond as as danger. We don't want that part of the nervous system
and we don't want it having discernment. We want it really when we're actually faced with,
you know, I say if you and I are walking across the road here and a car is about to hit us
and you see it, I don't want you to stop, breathe, meditate, you know, have compassion for the driver.
I want you to, you know, react immediately,
push me out of the way, even if we get hurt
and break a leg, I wanna, we need to live.
You know, the problem happens when I, you know, go home
and I say something to my wife and she disagrees with me
and I react to her like she's a car about to hit me.
You know, it becomes an appropriate response
at an inappropriate time.
We don't wanna lose that. And so it becomes so hard response at an inappropriate time. We don't want to lose that.
And so it becomes so hard because we're in this kind of, I believe this fight
in our, in our nervous system to say one part of it saying, you need to act or
you're not going to be okay.
And the other part saying, I don't want to keep doing this in your mind.
You know, I know that I'm in this room or in your lab with virtual reality
goggles on, but that one part of my body thinks I'm falling when really I'm watching a video
game.
So maybe the best we can do is prepare.
These proactive tools seem increasingly important to me.
Can we talk about yoga nidra?
I talked about non-sleep deep rest a lot on this podcast.
Yes, I decided to take yoga nidra,
which is a thousands of years old practice
and rename it non-sleep deep rest
because I wanted more people to do it.
Thank you for doing that.
I mean, I've taken some heat,
but I wanted more people to do it.
And it's a zero-cost tool that
I think is very valuable.
I learned it from you.
I went out to where you work and observed that this is the first thing that people do
every morning when trying to get sober.
This is the first thing that people do – that you have them do every morning when they're
trying to identify and overcome their traumas, including full-blown PTSD.
I don't want to share some of the stories
that people shared out there,
but a couple of them were very intense.
I mean, when I'm talking about PTSD,
I'm not talking about like had a bad semester in school.
I'm talking about people who were co-sleeping
with their kid and the kid died.
And it was like, it was a very intense thing
to hear those stories. And it was like, it was a very intense thing to hear those stories.
And it was also a beautiful thing
to see people's transition through their traumas,
in some cases their addictions, or both.
And every day started with an hour of NIDRA.
What is it about NIDRA?
How did you discover NIDRA?
And how did this come about?
Because I think it's an extremely, extremely important tool
for a number of reasons.
But how did you start incorporating this
into trauma and addiction treatment?
I was working at a place in central Florida
and near there, it was a treatment center.
And not far from there, there happened to be an ashram
started by an old Indian guy who had come over from India in the 50s or 60s.
He's in his 90s now and is kind of credited as one of the people to bring yoga to the
West, one of many.
It was the Amrit Yoga Institute and they were running some workshops and I ended up doing a training there.
That opened a door for me to start doing some other things. I'd been practicing breathwork and
this was all part of my own journey. And then I got introduced to yoga nidra and it was just a very
powerful tool. And in these workshops that I was in, I saw some pretty amazing things happen for the people that were taking trainings.
We were there, you know, for, I remember we were there for, it was a 10-day training and
you could take it as 10 days or you could take 5 days and then come back for 5 days.
And there was a woman who had been there for a 5 day and was coming back and when she was
there at the first part, she was a single mom, she had two boys,
they were probably under 12.
And she was completely stressed by them.
Like completely stressed.
She was, could not almost handle being a mom.
And she practiced this, she decided to come to this training
and then she went home and it was several months in between,
and when she came back, I remember in the opening group,
she shared that she'd gone home and had not changed anything.
The only thing she did was practice yoga nidra,
I think twice a day in the morning and the evening,
and she's like, my boy's changed.
And I actually don't think the boy's probably changed at all.
But she was someone who was filled with anxiety and stress,
and the kids were picking up on that.
And she wasn't able to tolerate the discomfort or distress
of her children or boys just being boys.
I don't even think they were really probably behaving more
than an eight and 10-year-old does differently.
But she couldn't handle it.
And now she was able to kind of build this distress tolerance by practicing this meditation.
And nidra means sleep.
So it's a sleep-based meditation.
Yeah.
Do you want to just briefly describe what it looks like?
Generally, what it looks like is first the person lays down and ideally they'd be laying on their back
unless they can't lay on their back,
but you lay on your back
and get in a very comfortable position.
It's a guided practice
and one of the reasons it's guided is
it kind of becomes a technique that disappears,
the technique and what I mean by that is
if you're sitting doing
meditation and you're doing something where you have to focus on a mantra or which is not,
this is not an exclusion of that. I mean, people, so, but when you're doing that, you kind of have
to focus on that mantra. So sometimes having to focus on something can, can bring you out of it.
And in those practices, bringing you out of it is beneficial too, because
you want to be brought out of it.
And then you can find ways to get back into it, it being the, the,
the meditative experience.
So you're, you're, you're laying down and there's generally, um, uh, a
series of kind of, I'll say physical movements.
It's not like yoga doing stretching.
It might be something like tensing and relaxing your muscles.
It might be something like massaging your face as you're being guided through this to
kind of just relax the body.
And after a certain point, and in a lot of the teachings that when I do it or I've been
taught, there's a certain point at which all movement stops and you just want to follow
the—you're just instructed to follow the you just you're just instructed to follow the the the person's voice in
Yoga nidra we are nidra we set an intention
Like an intention might be like I'm at peace with myself as I am in the world as it is
Something like that something that you want to
Bring in or a state that you want to experience. I know that you distinguish
I believe you distinguish non-sleep deep rest as like yoga nidra without intention.
Generally without intentions or mystical language. It involves the, I think the most critical
part of non-sleep deep rest and yoga nidra that to me, the overlap in the Venn diagram
includes self-directed relaxation, the ability to do that, which of course,
the incorporation of long exhale breathing
will facilitate that,
because it pushes down on that side of the seesaw
that is the parasympathetic nervous system
and really gets it engaged,
regardless of how stressed you are,
as you pointed out,
getting that parasympathetic nervous system.
The idea that people's mind can be active but their body is still,
I think is a very powerful state. You're not trying to fall asleep. So the end goal is in reach for
everyone. It isn't like you're going to fall asleep. It's like, actually, you're going to not fall asleep.
If you fall asleep, it's okay. And actually, sometimes people think they're asleep, but when
I'm guiding them, and I'll give a direction like, you know, to roll
over on their right, on their side at the end and they do it, but they thought they
were asleep.
So they were, they w we believe is happening in that is they're in this, the brain states
of sleep while still being awake.
Once they're in that relaxed space after doing some movement in the beginning or the space
to be relaxed and still, I should say still versus relaxed, still
physically, is through breath, different breath exercises,
specifically ones that have long exhales, right? That's like you
said, it activates the parasympathetic nervous system,
and then guiding them through their body in some way. So it
might be is one called 61 points where you identify all these different points
in the body, starting with the forehead down to the pit of the throat, and then all different
parts from your shoulder down to your fingers and then all the way down to your toes.
And people being able to kind of move their awareness in their body kind of gets them
away from that thinking and doing into the more feeling and being.
They're putting their awareness on their body
rather than everything external.
One of the great strengths of doing NIDRA or NSDR as it were
is that we take ourselves out of the prediction mode
and we can experience life unfold in real time moments.
It sounds so mystical, but actually it was Josh Waitzkin
who was on this podcast, the former chess prodigy,
martial arts champion, et cetera,
on the Joe Rogan podcast, he said something
that I wanted to share with you,
which felt appropriate now,
which was he said there are two ways to go through life.
One is metaphorically speaking,
as a passenger in the dining car on a train
that's going 80 miles per hour,
and you're experiencing what's in that train
and you're seeing things go by,
that's the non-conscious lower way to experience life,
lesser way to experience life.
Where you want to be is strapped to the front
of that train safely, experiencing space and time
as they're happening, flowing by you and through you
as a series of moments.
And I really think I credit Nidra and NSDR
with an ability to see life unfold as an observer and still have
the ability to participate.
So you're not like dissociated, you're not stepped back, you're not ahead of yourself,
you're like right where you need to be.
Right.
Does that capture it?
I believe so.
I might take that, the train example, a little bit different direction where I always will
say it's like, you know, you're either on the back of the bus and you're being driven around or you're
driving the bus. You know, it's not that you're just on, and he may not have been
saying this, but just not on these rails experiencing it like this, that you have
control autonomy and have the ability to be authentic and authentic in a way not
authenticity gets kind of thrown around and people like I just, I just am who I am.
Well, most times when people are doing that and they're just acting however they're feeling in the moment,
they're not who they are, they're who they were or they're, you know, they're acting out their past experiences.
Authenticity in the way that I'm talking is more like, like auth is the same in author, right?
It's like authorship that you become the author of your life, you know, that you're able to
write the story going forward because a lot of what we're doing before that is just plagiarizing
from our past, stuck in the cycles of our kind of programmed reactive patterns that
came out of the ways that we were shaped.
And things like NIDRA where we can start to activate the parasympathetic
nervous system, again, distinct from deactivating the sympathetic and be able to pause and be
able to look at kind of choice.
You know, in that cycle I was talking about earlier where we're being reactive, the first
thing is to stop.
Well, how do we stop?
It's by building these abilities to have this distress tolerance,
even if it's for a few seconds and take a moment to be able to get present and
look. And what I mean by that is get, look, look at what's actually happening.
This isn't every time someone sent me a text message and, uh,
or every time someone's ever abandoned me or disappointed me,
or every time I've been afraid,
it's just this one moment where I get a text that says we need to talk later.
And from that, now that can break the cycle enough that I, instead of automatic reaction,
I'm in choice. And I'm making a choice out of kind of all options of how I'm going to handle this. Now,
it might still mean that I go, could we talk about it now
in a text response? But that would be very distinct from kind of sending 20 text messages
in rapid succession, succession saying, what do you need? Why are you doing this? Am I
in trouble? You know, whatever it is we're saying, but you've been able to, to, to move
to the front of the bus and now you're driving it, right? You're moving kind of out of, you're being,
instead of being at the effect of life, you're being at cause. I feel like most people learn
how to control their body, but most people don't know how to control their mind, meaning they don't
know how to control their thinking. Yeah, and there's a great line in an Indian text, it's called the
There's a great line in an Indian text, it's called the Atma Gita, I think it is, where it says something like, the end of the say is like, man thinks his enemy is out there,
but really the man's uncontrolled mind is his only true foe.
I don't know if we need to garner complete control over the mind.
I think the way to do that is to be able to kind of find ways to
relax back from what the mind is doing and saying and the, you know, like you said, ignoring the
thoughts between two and five. You know, I think there's a lot of thoughts that we have that we can
ignore. You know, our thoughts are not fact. It's this input or that I'm getting and we tend to
grab onto the thoughts that I think that we've had before that have helped us survive situations even if the way that we've survived
those situations is to cause destruction.
We know how to live.
Example would be someone who's in an abusive relationship again and again.
That person, I've never met that person that said, I can't wait to get in the next
relationship. So it's abusive. You know, it could be a man or a woman. In this
case, let's say it's a woman. You know, maybe the only men that she was around
growing up were controlling or abusive. And she had some experiences with men
who were very similar. And then that's the environment or the waters that she
started to swim in. She knows how to survive that kind of man or if you're a man that kind of woman. And when
they do find even if they want that relationship that's loving, caring, kind
and patient, no conflict or not that type of conflict, even though they want that
when they get into it, it doesn't make sense because they've never done it
before.
They're still going to be potentially relating to that person with these past
reactive patterns.
You know, I always say this when my wife and I've, you know, if you're in a relation, I, we have a great marriage and great marriage also includes
disagreement and argument, right?
It also includes love and connection and all of that stuff.
and argument, right? It also includes love and connection and all of that stuff. And when we're in an argument, it's almost like I'm not talking to her and she's not talking to me.
It's like my past is talking to her past and her past is talking to my past.
When we can stop and get out of that cycle for just a moment, then we can make a choice
that will move us toward the direction that we want to move. And that choice can seem risky because if we haven't done it before, it goes
against every, or let's say that that choice might go against everything that
we've developed in order to survive the situations that we've come out of.
So now instead of arguing, I'm going to be vulnerable.
That's going to feel very scary.
Yeah. arguing I'm going to be vulnerable. That's going to feel very scary. Yeah, Laurie Gottlieb, a psychologist,
was on this podcast and saying, and I totally
subscribe to this, that people are more willing to stay
in a bad situation often, something that's not
adaptive for them because it's familiar versus stepping
into something that could be better for them because it's familiar versus stepping into something
that could be better for them, clearly better for them and they can understand that cognitively,
but they somehow cling to what's familiar.
I think that's just the way our nervous system is wired.
Like you said, staying in the battles, repeating the battles that are familiar to us, that
we know how to win.
We just, instead of authoring something new, we're plagiarizing from our past, just again and again.
Yeah, I love that phrase, plagiarizing from the past, even though it's something to avoid.
How often should people do NIDRA at, or NSDR and at when? What time of day?
I think, I think I've told you this before, right? The first, probably the best time is to do something in the morning and in the late afternoon.
Second best time would be in the evening and third best time would be anytime you can.
So it's not easy.
It could be anywhere from 20 to 35 minutes, right?
So it's not easy for people to find that based on, find that time based on the schedules
they have, but set a time that you're going to do it.
When we schedule and have proactive tools, we don't know if we're going to need
them in that moment.
What it means is regardless of whether I need it or not, I'm going to do it.
You know, it's kind of like I tell people with therapy and about therapy and coaching
all the time.
If the second best time to get therapy is when you're in crisis, the best time is when
you're not.
That's when you can, we can grow. So scheduling proactively will allow us to either maybe solve a crisis that we're in
or help us have the tolerance in that moment. Like I wake up stressed and I'm able to then do
this practice and then I'm not stressed or I wake up not stressed and I'm able to do this and it
helps to build the ability for me to kind of drop back into that state.
Because that's what I, I think as we practice things like yoga nidra, um, we're able to
more quickly move from a dysregulated state to a regulated state.
I don't know if you've had that experience.
Definitely.
I think of, um, stress and alertness and calm, all of it, as the autonomic nervous system,
right? Parasympathetic being calmed, calmer states, sympathetic being more activated states.
And I think of it like a seesaw. And I think, you know, when we're asleep, we're mostly
parasympathetic. When we're very stressed, we're mostly, mostly, so it's the balance.
And, but the way I think about things like NIDRA is as a person on that seesaw, you are that
person and you're learning to press on one side.
When you're stressed, the hinge of that seesaw is very tight.
So it's hard to activate the person with that much more than when like you come out of sleep,
you're still a little bit relaxed perhaps.
And then it's easier to push on that.
So you might find that learning NIDRA is easier then.
There's always value to learning how to work both sides
of the seesaw and actually sometimes we need to know
how to ramp up the level of stress,
as in the case with the cold plunge.
We're deliberately activating the sympathetic
nervous system and we're saying, aha,
but I'm doing it as this kind of person surfing
on the seesaw and so I know how to balance here so that when I'm there again,
I recognize this place. So that's kind of how I think about it.
Yeah. And also I have found in practicing Yoganajara non-sleep deep rest that it makes
other practices easier. That like when I want to do a five minute meditation, you know, and one of the things that I
think is super valuable for people is to set aside, you know,
proactively schedule these times that you're gonna do longer periods of rest or a practice,
but also recognize that you don't, you know, there might be things that you can do for a minute or two minutes.
This is what Pavel Satsulin, who is a world-class strength coach
who was on this podcast, talks about greasing the groove.
You know, you want to get good at pull-ups?
Do two pull-ups every time you walk through the doorway
from a pull-up bar.
I think, metaphorically speaking,
that, you know, like the workout in the gym,
people think of that as the endpoint,
but actually, you know, we used to do physical labor
as a species, right?
So I look at the workout in the gym as the ability to lift boxes on moving day,
to move furniture without getting hurt. I love going to the gym, but it's not an end in itself.
Same thing like a long run is the ability to go hiking with friends without having to train for
it and not worrying about, you know, gassing out half, you know, halfway through. So I think that
these practices are preparation for real life stressors. They're the gym for your mind.
They're the gym for your mind.
And we don't talk enough about emotional fitness and the world is clearly metabolically ill
with obesity, diabetes, et cetera, but we are also dealing with a massive mental health
crisis that I do believe stems primarily from an inability to regulate this autonomic nervous
system thing.
Because we can say, well, sleep's the foundation
of mental health, which it is, and physical health.
A lot of people have trouble sleeping.
How to get better at sleeping?
Get better at relaxing.
How to get better at relaxing?
Yoga nidra, and SDR.
And then, you know, so I feel like the tools exist,
and I'm so grateful that you pointed me
in the directions of these tools.
And it can be very simple.
You know, one of my teachers used to say that
the breath is the mind made visible, and if you want to change your mind, change your breath.
I mean, of course, do a yoga nidra, it might take 30 minutes, right?
But if you're in a moment where you're feeling really activated, change your breath.
Specifically like a long exhale.
I love that breath is the mind made visible it's beautiful and and so true. That was Amrit Desai I should give him credit.
Okay wonderful. It's the quickest way to move us to create an activation of
the of the parasympathetic nervous system. Quickest way you know and it this is
where you know people will think meditation is so hard, breath work, which there's many
different forms of breath work, are hard, which they can be, I suppose, hard in the
way that we've got to find the time and it can be uncomfortable.
But I'll tell people, take a minute and breathe.
And if even a minute sounds long, take seven breaths.
Like who can't take seven breaths at any point
in the day? You're going to do it anyway, right? We never aren't breathing, but if we can bring
our attention to that and you can schedule that, like, you know, I'm going to do that before I get
out of the car to go to the office. I'm going to do it before I go to lunch, after a meeting,
before a meeting, or you can just say, anytime that I'm feeling like this, I can, I can take
seven breaths.
It might end up being two minutes, like a TV commercial.
And those things add up, and they build on each other.
And the more that we practice those,
the more that we do raise that capacity
to experience distress.
First, it helps us activate that part of the system
and teaches us, like your analogy in the gym.
But we also start building a habit around doing something
like this so that we can weather whatever storm's coming
and we start to orient toward it.
I'd like to take a brief break and acknowledge one
of our sponsors, Waking Up.
Waking Up is a meditation app that offers hundreds
of guided meditation programs, mindfulness trainings,
yoga nidra sessions and more. I started practicing meditation when I was about 15 years old,
and it made a profound impact on my life.
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In recent years, I started using the Waking Up app
for my meditations because I find it
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to really be consistent with my meditation practice.
Many people start a meditation practice
and experience some benefits,
but many people also have challenges
keeping up with that practice.
What I and so many other people love
about the waking up app is that it has a lot
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and those meditations are of different durations.
So it makes it very easy to keep up
with your meditation practice,
both from the perspective of novelty,
you never get tired of those meditations,
there's always something new to explore
and to learn about yourself
and about the effectiveness of meditation.
And you can always fit meditation into your schedule,
even if you only have two or three minutes per day
in which to meditate.
I also really like doing yoga nidra
or what is sometimes called non-sleep deep rest
for about 10 or 20 minutes,
because it is a great way to restore mental
and physical vigor without the tiredness
that some people experience when they wake up
from a conventional nap.
If you'd like to try the waking up app,
please go to wakingup.com slash Huberman,
where you can access a free 30 day trial.
Again, that's wakingup.com slash Huberman to access a free 30 day trial. Again, that's wakingup.com slash Huberman
to access a free 30 day trial.
People are probably starting to realize
that overcoming addiction is about more
than just white-knuckling it.
It's about more than just going to meetings,
although that can be very useful.
It's about having a roadmap of the day,
having a plan, knowing what weather patterns
to look out for internally and externally.
It's about having a way to deal with distress,
having a way to calm down.
Let's talk a little bit more about specific addictions.
Maybe I'll mention a couple of different categories
of addiction
and maybe you could reflect on some of the unique features
of that in your experience,
not necessarily neurobiologically,
but in terms of strategies for confronting in oneself,
those things, right?
Like strategies for trying to overcome them.
Because I hear from thousands of people really
about different addictions in themselves and people
close to them.
So let's start with alcohol.
What is unique about alcohol addiction that people should know?
And these could be extensive answers, they don't have to be, but that could be helpful
to them.
Alcohol is an interesting one.
I think alcohol and most drugs have a lot of similarities,
although alcohol tends to be the one
that is the most socially acceptable.
I mean, drinking is part of our culture.
If you don't do it, you catch some flak sometimes.
Oh yeah, I mean, I think some of that's been changing,
and some of it thanks to you.
I mean, I can't tell you how many people that I've
ended up talking to because they listen to your podcast
on alcohol.
Just from a health standpoint, so people
are starting to look at that, it's become,
it's less like the Mad Men 50s people drinking at lunch,
but it's still very much part of the culture and everything.
Happy hour, happy day, you know, I mean, look at the...
Sunday fun day.
Have you ever been in one of these retirement communities, like in where people are retired
and just drinking all the time or...
Really?
Oh, yeah.
There's a real stigma to not being able to drink for people.
You know, I don't mind sharing, I've been sober for quite some time
and that was a challenging thing.
Like the first wedding I went to
or the first work event that I went to,
I didn't know how to talk about it with people.
Now it's no big deal, it doesn't bother me at all.
And if it does, sometimes I don't like to be around people who are just getting wasted.
But I'll leave the wedding at 10 instead of 2.
Most of the people thought I was there till 2.
But I left it at 10 because they're
doing whatever they're doing.
But it's very challenging because having a glass of wine
at dinner or a beer after work or thinking about people, it was always a thing,
the first time a dad and a son share a beer, there's a lot of romanticizing around it.
And alcohol, I don't think alcohol is evil. I mean, I think listening to what you've talked about,
it is poison, but I don't like anything else in moderation.
I don't think it's going to, it's a terrible problem.
I'm not anti-alcohol, but you know, what is it doing to you and what are you using it
for?
So I think what the good side of that being part of the culture is when people can find a community,
like a 12-step community or some other sort of peer community where people aren't drinking,
that is really what helps them a lot. They're not alone in this. And I think the movies and TV do a
terrible job representing what 12-step meetings are like.
It's usually like they show a circle in a church basement and everybody's talking about
how they can't drink that day.
I'm sure you've seen that in television, right?
In reality, of course, that happens sometimes, but most people are there really trying to
use that program as a design for living and to build really amazing lives.
When you look at the 12 steps when it comes to alcohol, alcohol is only mentioned in the first one.
Everything else is about how you live your life.
You know, that first step is about admitting we are powerless and that our lives have become unmanageable.
And powerlessness is actually an awesome concept.
I mean, people will look at powerlessness
and think that means I'm weak,
that means I can't control my life.
But really, defining where you're powerless
is the first step in finding great power.
Because if I just keep going out every day
and I start fighting a battle
that I'm gonna lose every single day, and even if it wasn't addiction, like every day I just go out and
taking on the five biggest guys on the block when I'm a kid, I'm going to lose that every day.
I'm not going to start winning until I realize I can't beat them in the way that I'm doing it.
So go do something else. Powerless, where we identify where we're powerless, then we can go find great
power.
And that's where the concept of higher power comes in.
And higher power to a lot of people is God and whatever their concept of it.
Sometimes higher power is just a group of people in the community.
You know, I will see that anywhere from the relationship with God to like me and you talking
is a higher power.
Two heads are better than one.
You know, I'm going to be able to reflect to you and you're going to be able to reflect back.
I'm going to share with you and you can reflect back to me and help me see things differently and shift a perspective.
Because a lot of our healing is just a perception change.
Like, I'm just going to see things a little bit differently than I did before. So that community and the ability for them to be in service to each other
and help each other is a...
I think that's the antithesis of I'm part of this drinking culture.
And that's not only unique to alcohol, but because there's such that,
you know, there's not usually like a socially acceptable, like you don't see crack advertised on television, right?
You see alcohol and it's in it's in everything.
Now we do see gambling in on television quite a bit, which is,
Yeah, let's talk about gambling.
I like the way, by the way, that you frame alcohol.
It's being offered to us all the time after a certain age.
And so it, you know, it's a challenging one for people that are challenged with alcohol
addiction or alcohol use disorder.
And 12 Step, I think is, right, it's free.
It's in every city.
It's a powerful program.
Certainly there are data.
I should just mention this.
You know, I think people will hear oh, it's a cult etc
There was a study actually that run at Stanford
Some years ago will provide a link to the coverage of that study and the study
Which took a very objective look at 12 step for the treatment of alcoholism and other substance addictions
and actually the
investigators the people that ran the study were very skeptical going into it,
and the results were pretty remarkable. And they changed their initial perception coming out of it
that it can be very, very effective for people, especially given that you can do it when you travel,
you can go to meetings in other cities. And as you mentioned, it's not the depressing picture
that people think of a bunch of people
whose lives are destitute in a basement.
Sometimes people are coming in with some hard stuff,
but there's often a lot of humor.
There's a lot of common challenge.
It's very, there's a lightness there
that a lot of people might not anticipate.
People taking on life, not hiding from it.
Yeah, love that.
Gambling.
Not everybody that gambles has a gambling problem, just like
everything else.
But when it does become problematic,
it's a very challenging disorder to treat.
I mean, I don't know where the study came out of it.
At one point, I had seen some research
that said that the highest
rates of suicide were among gambling addicts and what I've seen with that is
it's like their whole world starts to get really small you know it's weird
because in the way that I look at it it's it's really the only addiction if
it's an addiction for that person right not everybody that gambles is getting right but the ones that are addicted it seems to me to be the only addiction if it's an addiction for that person, right? Not everybody that gambles is gambling, but the ones that are addicted,
it seems to me to be the only addiction that the next hit can solve all your problems.
So you're down $300,000. You could bet that and win it. I don't think anybody thinks,
like really thinks, I mean, in the moment, they're probably out of their mind, but they don't think,
you know, if I shoot this next, if I take, if I, if I shoot heroin, my life is going to get better in the long run.
They might be thinking it's going to get better right now because I'm not going to get sick.
I'm going to feel good, whatever it is for them, but they don't, they're not thinking
that this is going to solve their problems.
They know it's not.
And so it, it, it fortifies what you were talking, we were talking about before is continuing
to go after the Hot Fudge Sunday,
except they can get it.
It's interesting because I've talked to different people and sometimes the hit isn't
in the winning, sometimes the hit isn't in the losing for them.
Really?
I've had people tell me that.
I don't really understand that, but I think then they have to go back after it again.
I believe them. They're the ones suffering from it, but I think then they have to go back after it again. I mean, I believe them.
They're the ones suffering from it, but wow.
And it's becoming a real problem with kids.
There's a lot of sites to gamble on now.
They can bet on a lot of crypto sites.
You can bet on anything.
Kids are playing in these online casinos that are probably operated overseas that are not regulated at all.
And, you know, casinos that are regulated become very wealthy, winning on a very small margin.
I'm sure these casinos don't ever lose, right? They're making it up.
It's in our face all the time. It was, I was reading, Willie Mays died recently as a baseball player, San Francisco giant,
before we were around.
But he was banned from baseball for life.
I think they ended up letting him back in because he took a contract from, I think it was Bally's,
he wasn't betting on sports.
So this was in the 80s, he took a contract
because he would go there and meet with their high rollers
once a year for like a week.
Just play golf with them, hang out with them.
He wasn't betting on baseball,
and he got banned from baseball.
Now, you watch a baseball game or go to a baseball stadium and different betting sites are,
different betting sites are mentioned all over the place.
You watch any sporting event and it's out there and that's not the only thing people are gambling on.
But I don't know if you watch sports right now with the basketball on or the Super Bowl was on,
I mean, it's showing people with a phone showing that they're winning, you know,
a hundred, there's a celebrity on there winning $186,000.
I think the number was, you know, and then couple that with
kids that are pretty susceptible already looking at those unicorn type people
that are making millions on YouTube, playing video games or professional poker players.
Yeah, professional poker players or even ones that aren't gambling that, you know, they're
out there and they became a creator and they're making millions of dollars a year by having
people follow them like that.
That this, this there's a way to make a, you know, that their significance is going to
come from making a lot of money really fast, you know, and then they see this way to do
it without having to work or anything like that. And it's rigged to lose. I mean, you know, and then they see this way to do it without having to work
or anything like that.
And it's rigged to lose.
I mean, they're going to lose.
Dopamine without effort.
Yeah.
That's the danger.
I was, you know, I've said it many times
on this podcast elsewhere too.
It's like any high rapid inflection in dopamine
that doesn't require effort,
aside from being a kid and your parents get you an ice cream
or it's your birthday, all you did is you were born
and to get those presents and you deserve that,
it's your birthday, great.
But in life, like dopamine that doesn't require effort
to obtain is the slipperiest slope.
Yeah, and the gambling's not for the kids,
isn't just, and adults, but it's not just
on betting on like what we think we might traditionally think of betting on a sporting
event or something like that.
It's, you know, we see it in cryptocurrencies, not that there's nothing, it's cryptocurrencies,
but people going into it without any knowledge or any sort of sophistication and just putting
all their money in it and, you know, up and down, we see it, we see more sophisticated people doing it as adults on in real estate investments
or stock market or owners of company taking big bets on things.
And it doesn't mean that there's aren't people that are taking calculated risks.
I'm talking about people who are like day trading when they, you know, and there are
people that day trading do great.
But then there's a lot of people that see this person day trading great they, you know, and there are people that day trade and do great, but then there's a lot of people that see this person day traded in great and then they,
they do it and don't do so great, right?
Their lives collapse.
So are you seeing more people coming to you with gambling addiction?
Yes.
It's not always then the primary thing though.
There's a lot of people that are coming in with substance
use or alcoholism and we find out that they're also doing that.
The thing is people addicted to gambling aren't always seeking treatment.
By the time that they are ready to, they might not have the money for it.
They might not have the job with the insurance.
If we are talking about insurance and treatment centers, there's not really a benefit for long-term gambling treatment. You know, you have to kind of look
at the anxiety and depression around it. And sometimes they get put in with people who
are just who are suffering from anxiety and depression, and we're not really focusing
on the specific gambling issue. We also see people that, you know, they stop drinking and they're able
to stay sober that way and they haven't really organized or ordered their life in a way that
they're building towards something and that energy from the addiction of alcohol or drugs
goes to gambling.
Yeah, I was going to ask you about that. We'll talk about a few other patterns of addiction
and types of addiction, excuse me.
But this idea that when you remove the quote unquote medicine, there's a lot of distress and discomfort
that comes up for people.
And some people are able to white knuckle it as it's called.
Some people can develop tools to try and work
with that distress, become more distress tolerant.
Some people will transmute distress.
Sometimes yeah, it goes into running ultra-marathons, which doesn't necessarily mean that it's an
addiction, but I've seen and we know some people who got sober and stayed sober basically
by running a lot.
Yeah. A lot, a lot. Yeah.
A lot, a lot.
You know?
Do you think that that increased like VO2 max allows for ability to handle distress
better?
Sure.
I think that running can calm the mind over time.
Runners who run a lot, most of them are pretty tired or a little bit tired.
And maybe that's part of the solution.
You know, if you have a dog that needs a lot of physical movement, you put it into a small tired or a little bit tired. And maybe that's part of the solution.
If you have a dog that needs a lot of physical movement, you put it into a small space and
it doesn't get that chance to run around.
You see this in zoos and animals develop these what are called stereotopies.
Like you see the lion that's cutting literally a trench in the dirt.
It's really sad to see.
That animal is designed to roam and you give an animal the opportunity to expend this energy that's stored up in its
mitochondria and it does and it can relax and it can sleep.
I mean, they still have to do the work of getting sober, these people.
But you know, moving your body through space is a way of transmuting energy out of the
body.
So you come home, you're like, relax, eat a meal.
It's like there's a calming effect to endurance activities.
For me, nothing changes my mind, my mood and nervous system better than even a
20 minute run. I mean, I think they're also getting the benefits.
If you're walking or running, you're getting the benefits or similar benefits
to what people get from EMDR. I mean, just the natural movements of the eye.
In fact, EMDR, which is eye movement, desensitization and reprocessing was the woman who discovered it,
discovered it by going for a walk and realizing
when she put something that she was distressed by
in her mind at the end of the walk, she felt better.
Yeah, Francine Shapiro, she was in Palo Alto
walking behind Stanford when she made that discovery.
There's a, as long as we're talking about this,
I find that this is coming up because online behavior,
gambling, looking for somebody to get drugs from, the foraging is where the dopamine is
released.
We were talking about this earlier.
Foraging mentally is the same from the perspective of the dopamine system as foraging physically
through space.
Think about what the dopamine system as foraging physically through space. Think about what the dopamine system evolved for.
It's like any animal, including us, searching for water,
searching for food, searching for mates.
We rest at night, but it's the movement forward through space
that satisfies that dopaminergic system.
And in fact, the major, I don't want to go off
on too much of a tangent here, but the major system
for movement in the body, not just reward and motivation, is dopamine. That's why people with Parkinson's lose dopaminergic
neurons and they can't generate smooth behavior anymore. And it's interesting that NIDRA and
NSDR, the most impressive study in my mind, is the one that shows these big increases in dopamine
from resting. So I feel like physical movement... There's like a 65% increase in dodgy dopamine or something like that?
It's incredible. There's something about still body active mind that ramps up our dopamine stores
and then prepares us for movement.
Does the dopamine store get ramped up when we're sleeping?
Yes.
So I mean I think that's the... I mean the... anecdally, they'll say that, you know, a 30 minute yoga nidra is
equal to about three hours of REM sleep.
I don't know that that's true or not, but it's hard to equate, but I'm just saying
anecdotally, you know, but it makes sense.
And I think, yeah, there's some, there's some truth to that basic statement or basic truth
to that statement.
I think that transmuting just the energy that would otherwise become distress or that starts
as distress, like when we're stressed, we need to get that out of our body.
And I think that drugs like cocaine and amphetamine, big increases in dopamine and then crashes,
you're essentially dispelling the energy.
I'm not so sure that it's always about pursuit, that that's kind of, like you said, it's
like the gambling addict
that actually wants to lose.
There's something about it.
Well, they wanna lose, but they recognize
that they felt that.
That was the hit.
Or they felt one there.
I'm sure they felt it when they won as well.
Well, when you're really low,
the only place you can go from there is up.
When you're really high,
the only place you can go from there is down. Yeah, this is so important because I think, you know, what is discomfort? What is the distress
we're experiencing? It's not our thoughts. We don't feel our thoughts. We feel our feelings.
They call them feelings, right? Because we feel them. What are we feeling? We're feeling some sort
of sensation in our body. It's energy.
It's energy, which is energy. And when we're feeling that energy in an appropriate situation,
like I'm feeling intense adrenaline and excitement when I'm going on a roller coaster that I
like, you know, and I'll pay money and stand in line to do that. If you wake up on a Tuesday
morning in your bed and you start feeling that it's anxiety, fear, desperation, you know, it's
still just energy in our body and everybody will experience things
differently. I could probably ask you because you've got insight, you know, if
you're experiencing anger where it is. If somebody asked me, you know, I can
experience that in my hot belly, like heat between my eyes, my shoulders feel
really tense, you know, if I'm scared, where do I feel that, my hot belly, like heat between my eyes. My shoulders feel really tense.
You know, if I'm scared, where do I feel that?
You know, I feel like an emptiness in my stomach and a kind of tension in my body.
You know, people can name it.
And sometimes just naming it, you know, what it is versus kind of running through like
I'm anxious, I'm afraid.
Instead of saying I'm anxious or afraid,
being able to go, well, my heart's racing.
I'm feeling tension in my shoulders.
Talking about the experience.
And the goal isn't always just to dissipate it,
but we can be with it because the idea that I'm anxious
and I can't get out of it then causes more anxiety.
That's right.
And so these practices that we can,
anything that we can build where we just kind of lean
into the discomfort a little bit and then lean out, we start to build capacity.
We pendulate through kind of activation and resource until we have a larger range of motion.
What about, and I'll bundle these, things that really hit the dopamine system hard,
like in your observation, cocaine, amphetamine being the most salient ones, Adderall and
other stimulants.
Is there something unique to those addictions that you see in people that come in that give
them kind of special requirements for how to overcome those addictions?
Yeah, I mean, it's interesting.
I think in the, up until sometime in the 80s, I'm not going to have this right.
They didn't even, I think they didn't really see cocaine as addictive because you didn't
become dependent on it like you would heroin or alcohol.
Yeah, somebody wrote a book called, I think it was Dr. Gold, 1-800-COCAINE, where they were starting
to see that we could classify addiction as a psychological addiction.
I might have that a little bit off, but I think it's somewhere in that neighborhood.
There's not a physical detox from stimulants like amphetamines or cocaine like there is from heroin opioids or alcohol and benzodiazepines.
Coming off stimulants is really hard.
It's really hard.
It's really hard.
Right.
But there's an obsession of the mind that gets triggered and it's this psychological
addiction that they can't seem to get out
of. I would imagine that you could probably describe it. What's happening with the huge
surge in dopamine and then dropping off of it. I'm not sure exactly where it falls in
that, but you know, there's a, they used to think that people couldn't, you know, recover
from crack cocaine. That's what we were told. You do it once and you're addicted.
I don't want to say that's not true,
but there was no real evidence for that.
It's just smoking crack, aside from shooting cocaine,
like intravenously, leads to the fastest increase in dopamine.
It's the rate of increases just as important as the peak.
In working with those, I mean, there's a lot of energy
that goes into just having them
kind of still.
I mean, I think a lot of, you know, stimulants kind of, I see it as they help the physical
body kind of match with the internal state of the nervous system.
I mean, I think that's one of the reasons we see stimulants work for ADHD.
I mean, you probably understand the biological reasons, but it seems to me that it kind of
levels out their experience.
I mean, I've seen people that when they take stimulants, they get really calm.
Yeah, having a mismatch between your brain level of activity and your bodily level of
activity is really rough.
So let's talk about some process addictions. These days I hear a ton of really
desperate stories, mostly from young guys. I've heard from maybe four or five women
on this, but literally thousands of young men about porn addiction. Every time I hear
about it, I feel so fortunate that I grew up in a time where, or maybe I just don't have the wiring for it. And if I did, I would be, I'm pretty open on this podcast.
It's never been an issue for me. And they're telling me that they can't stop watching porn.
I get the sense that they're not enjoying this experience anymore, because they're reaching out to me saying how in
the world can I quit and what do I tell them? I remember and again I don't know
this study but I remember somebody referencing many years ago when I was
first getting in the field that porn addiction at the time specifically related to Video pornography, which is what it all is now, right?
It was having the same impact on the brain and young men as crack cocaine
I mean, it's extremely powerful has a lot of other
Effects in that it sets up a very unrealistic
idea and perspective of what
sex and intimacy is, You know, it also can help or can lead to kind of setting their sexual template.
You know, they can quickly escalate just like you would escalate, kind of back to
the Hot Fudge Sunday where it doesn't work anymore from, you know, something that might seem
like normal sex to violent sex to really out there things that can bring a lot of shame
that they're even watching and it can escalate quickly and then have an impact on their own
lives and relationships because they're playing out those relationships or
that amount of intimacy depending on what they're doing also if there's masturbation
along with it in a fantasy.
Well, what I'm also hearing is that anytime they are in a real life intimate scenario,
which seems to be fewer and fewer times nowadays in the younger generation that they're having sexual anxiety, sexual
performance issues, which makes sense if their brain and nervous system is getting wired
by porn to observe sexual behavior as opposed to being in the experience of intimate sex
behavior, right?
Two different things to be in the experience versus watching someone else's experience
of it, which is what pornography is.
Yeah. to be in the experience versus watching someone else's experience of it, which is what pornography is.
Yeah.
This was probably 10, 15 years ago where we're treating some, treating a lot of soldiers
that had come back from Afghanistan or Iraq and they had access, this was like the first
wars where they had access to the internet.
There's a lot of other things.
So there was a lot of kind of combining of
sex and violence, right? They're around a lot of violence and then they're watching
sex and then that kind of sexual template would set around like an order for them to
get pleasure out of sex. It would need to be aggressive or even violent or very risky.
So there's all these things that kind of collapse
Together there were other things going on was like the first time that they had also really had access to video
Video chats to be able to like be on a battlefield and then come back and be talking to their
Spouse about something that's going on with the kids. It was very
confusing in environment for those guys and men and women. You know,
the porn addiction is a tough one, you know, because it's everywhere. I mean, now you
can find it on any social media almost. Maybe not anyone, but it's not really limited.
And even if it's not, I know certain states
have just put in, where you have to put in your ID to get it,
but there's tons of ways around that and other sites
that people can go to.
And I've run into that with a lot of,
it does seem to be young men.
And it's a way for them to play out some sort of fantasy around connection and relationship and it's, it makes their world really small.
I don't think it's the same as gambling, but it can make it, it can make their world
very, very small in that they're instead of finding relationships out in the world,
and it's not necessarily a relationship, but they're what they believe
they're getting out of a relationship,
they're then getting out of watching porn.
It seems like basically stopping completely is the answer.
And people say, and I'm not trying to moralize here, right?
I'm not telling people what's moral about this.
I just know that any behavior or substance
that leads to quick repeated inflections in dopamine
is going to create a groove in
the nervous system where you're going to crave that thing and it's going to give you a lower
and lower sense of satisfaction over time.
The only way to reset that circuit is to stop and do something else in its place, ideally
that's adaptive.
These are people that are asking you how they can stop.
They're telling you, I can't stop,
how do I do it?
So it can be similar to other addictions.
You know, I mean, first the admission part
that it's a problem or awareness it is,
and then being able to start to talk to somebody
and start to take some accountability around it.
Not accountability like you're doing something wrong,
but to be able to have some sort of identify
the behaviors that start leading to that. You know, I mean there – that can be done in therapy.
There's other 12-step groups that can help people with that to identify what their sobriety would
look like if you want to call it sobriety, what it looks like. And if it does involve not watching
any porn, then that's the rule set that they have. And then they figure out either with their therapist or in their treatment center or with their
sponsor or community in 12 step, like, how am I going to be held accountable to that? And that
might be doing the things like we talked about, laying out, looking at your day ahead. At the
beginning, they might need to look at things like, you know, there's ways and
software out there to not be able to look at that on your phone or have an accountability partner
that can, you know, you have to, they have to approve websites you go to. And that's not to say
that they have to do that forever, but it's something that's available, right? You know,
50 years ago or 30 years ago, someone had to like find their dad's porno mag somewhere and then look at it.
You know, now it's on their phones or computers. Well, we know that
increasing accessibility increases addiction. This has been studied over and over again and
people say, well, what about red light districts and things? And there's some caveats that have to do
with when you create areas within cities where certain things are allowed. But you know, this has been tested many, many times.
It's also true and it's kind of a duh.
But to quote Anna Lemke, it's impossible to get addicted to a substance or a behavior
that you've never taken or engaged in.
Right.
So some things are best avoided entirely.
Are there specific 12-step programs for porn addiction that are separate from, say, sex
addiction? If you people look it up, I'm sure there's meetings out there programs for porn addiction that are separate from, say, sex addiction?
If you people look it up, I'm sure there's meetings out there that are specific to that.
There are some treatment centers that have tracks that deal specifically with that.
There's therapists that work very closely with that.
I believe that there are some 12-step.
There's pretty much 12-step programs for any sort of... Within things like SA or SLIA,
there'll be subsets of meetings for people that are with a very specific condition.
And one of the reasons I wanted to discuss this today is because I hear about it so much is,
unlike alcohol or drugs, there's a kind of extra layer of shame associated with pornography addiction for people.
You know, so many times we've heard, oh, like this celebrity was an alcoholic or drug addict,
you know, wrapped their car around a pole, was arrested, this and that.
Then they get sober and everyone still loves them, loves them more, right?
If we knew that a given celebrity was like a porn addict or something, we look at that
person differently, especially if they're male.
We just look at them differently.
And so reducing some of the shame around it, I think is key to helping them recover.
Because I can tell you, the questions initially came in
kind of like as is often the case with men
when they're trying to talk about issues,
that they were kind of cloaked in like,
what are your thoughts about nofap,
which is this thing where guys withhold ejaculation.
Does it increase testosterone?
Turns out in the short run it does.
In the long term, it's probably not good for the prostate, et cetera.
But then it turned out they were really asking about masturbation.
They were really asking about pornography.
And then all of a sudden, I don't know what changed out there, but there's been this deluge
of questions from young guys of how they can stop engaging in online porn.
A key to that is what you said about we look at them differently.
You know, they're going to keep it secret.
You know, and there's a saying, secrets keep us sick,
but I believe there's like a real, almost a biology to that,
in that, you know, if you're holding it in, not sharing it,
you know, there's no really place for it to go,
but shame.
And shame separates us and separate.
We're not connected and not connected.
We're alone and alone.
We're, you know, we keep carrying that forward alone.
We're dead.
You know, maybe not in that sense anymore, like we talked about earlier, but like we're
not really living. And so they're, you know, these guys are hearing you on a podcast
and then DMing you, right?
They're probably not in a personal close relationship
with you, right?
It's easier to send it there
than maybe go ask for help with somebody in their area
or go to a meeting or something like that
because of the stigma.
So it's good that you've opened up the ability for people to do that, somebody in their area or go to a meeting or something like that because of the stigma.
So it's good that you've opened up the ability for people to do that, but to continue to
direct them back to, you know, let's try to treat this like we would any other addiction,
at least from the standpoint of you've got to talk about it.
You've got to have some sort of admission.
You've got to be able to find a community around it.
You want to be able to do work, you know, most likely with a therapist or a team of
therapists that can help you understand what's driving that behavior.
You know, and you know, you and I have had long discussions about trauma before.
That's something I've worked with for many years or most of my career as I came into
being a therapist.
You know, and in trauma therapy,
we're often going back to seeing,
like we do a history and really kind of understand
where the patterns started, you know,
and it's really helpful, you know,
for me as a therapist when I can see where it is
because I can start making sense of how people
are behaving this way as adults
when I can see all of the experiences they had
and especially the more negative impactful ones
which tend to impact the brain.
Like you always say, fastest way to plasticity
is through a traumatic event.
I believe that's how you say it.
Yeah, one trial learning.
It just takes once, unfortunately,
but luckily there's plasticity in the other direction too.
It just takes a little bit longer.
I think that's where addiction comes in too, because you can kind of feel a sense of plasticity
if I'm drinking or if I'm doing drugs.
I don't know if that's the actual term for it, but I'm not feeling like my brain is so
stuck in that direction.
I can act a little bit differently.
What comes to mind to kind of encapsulate all of it because it gets to the underlying
mechanisms I think is, you know, beware the things that come easily and quickly.
Like really beware those things.
If it's pornography and you can get to experience of, it's not the experience of sex, but the
illusion of pseudo sex, right, if it's easily available, beware of that thing.
If it's a feeling of relaxation from a drink,
beware of alcohol.
Yeah.
If it's-
Fast money.
Yeah, if you are very proficient at,
you know, you find you lift a weight, you build muscle,
you get attention for it, beware that thing,
because there are all these positive reward signals
that are masking what soon will happen,
which is that that thing is going to make you
lopsided internally and make you crave it more.
And so I think that there's something about this,
things that come easy, it's a problem.
And I think I kind of like that in the sense that,
because many people are struggling
and we don't often glorify the struggle.
We're all trying to struggle our way out of struggle,
but struggle is distress.
And as long as we're struggling,
we're in the distress tolerance.
I'm not saying people shouldn't aim to succeed,
but, and forgive me for going a little long
on this reflection, but I remember in graduate school,
I had a paper that got accepted by the journal Science,
which is like one of the three apex journals,
Nature Science and Cell.
And I was like over the moon.
Yeah.
I was like, oh my God, like, this is amazing.
I first authored paper in science.
Like some people never do that in their career.
I was doing it as a graduate student. And my dad, who this is amazing. Like first author paper in science. Like some people never do that in their career. I was doing it as a graduate student.
And my dad, who's a scientist said,
prepare for the week afterward
when you wonder if you'll ever do it again.
I was like, okay, kind of a postpartum crash.
And then my graduate advisor, I said, do we get to celebrate?
Like, do we get to like throw a meal or a party?
And she goes, no.
Like, I suppose I could buy you a pizza,
but that would be stupid.
And this is Barbara Chapman, and very blunt.
And she said, no, the pleasure was the work
of doing the paper.
And I was like, I got it.
And that's what taught me to repeat that process.
I didn't always publish in science,
but certainly in other great journals, again and again.
It's like the reward is in the process.
The effort is the reward.
And if there's no process or no effort, I mean,
and we don't struggle.
In one way, we're struggling with so much.
And in other ways, we don't struggle
with the stuff that we probably need to struggle with
to move the energy out of our body.
I mean, Michael Easter's book, Comfort Crisis, is great.
It's like we used to walk like 10 miles a day,
and we're not burning that energy.
So we're just sitting there with this energy
that used to just get disseminated.
We'd wake up in the morning,
move through the stressors of the day,
good, bad, and different.
Even good things are stressful.
If you have to go to three birthday parties on a weekend,
even if they're fun, you're tired at the end.
Sounds like a dad.
Yeah, it is a dad.
I go to a lot of birthday parties
and try not to get sick because of, you know, at them,
especially when they're at these little indoor gyms
and ball pits.
Well, it's rewarding raising kids,
but what's interesting, Michael Easter,
you know, with the comfort crisis,
I mean, doing these hard misogi, as he calls them, you know, I mean, think about like self-imposing discomfort
so that you don't get pulled into the illusion of comfort by these other things. I mean,
I think it's coming clear to me now that the things that come easy are the traps.
Yeah.
They're the traps. So folks, if you're really good at something, doesn't mean don't lean into it, but if something comes really easily for you, you have to be very mindful
of that thing and other things around it. Sounds like you created discomfort for yourself.
Maybe there's like a discomfort appetite that if we don't satisfy through healthy
things, we will satisfy through unhealthy things.
That's a very interesting concept.
I mean, I don't know where that would exist in the nervous system, but because you hear, oh, we're trying to avoid pain and go toward pleasure.
But those models are that's true. But those models are too simple.
So I like the idea of a ration of discomfort to experience every day.
Isn't it that we're kind of built to expend energy and then sleep and then wake up the next day and expend energy and sleep?
And if we're not expending the energy
how can we sleep and then we wake up with more and
We just carry the stressors from the day before rather than just breaking it down. I mean, that's what's one of the beauties of you know
Recovery where they talk about one day at a time
well one of the
You know this last couple weeks
There's always something each year that really pops that gets kind of viral overnight.
Last year it was the Haq Tua girl.
This year it's the morning routine guy, the guy that he shows his morning routine.
And they got millions and millions of hits.
And this guy does like cold water on the face.
He's working, he's praying, he's doing all these things.
He's wearing no shirt.
He's super jacked.
Like he was getting attention for different reasons anyway.
Huge following.
And the best comment ever was, oh man, this guy's going to come after me.
He seems like he's got his life organized.
Someone put a comment, this guy spends all day preparing for the next day, which is the
worst thing about optimization, right?
The whole purpose of tools like sleep or nidra and all these things that you
can, and you taught me this, really good protocols let you lean into life more, not less. It's not
about withdrawing and getting into a wellness loop where you're just preparing for the next day.
It's about being able to lean into the third birthday party where you're like, oh, and the
kids are sick and you know you're being exposed to all this stuff, but you're there because
where you're like, oh, and the kids are sick, and you know you're being exposed to all this stuff,
but you're there because your daughter needs to be there
and she's elated to be there.
Yeah.
Can we put on the shelf that perhaps we have an appetite
for discomfort that we can either satisfy
through healthy things or unhealthy things?
I think that's a good way to put it.
Can we call it the suave, Huberman proposal?
We can call it that.
We'll go Huberman's suave, that's fine.
Addiction means that somebody's already in the pit.
Like they haven't done the,
okay, I have an appetite for discomfort,
I need to satisfy with adaptive things.
They're in the pit.
So if you would, if people out there listening
are in a place where they're like,
they know that something's got them
as opposed to them having it,
where they're wondering or someone they know,
and especially if it's somebody they know,
what do you suggest?
I mean, this isn't kind of like call the suicide hotline.
I mean, unless they're suicidal, obviously.
A lot of people don't have means to start therapy with a world-class addiction therapist,
trauma specialist.
Some do, some don't.
What do people do?
Well, there are a lot of options for people out there.
Sometimes they don't think that they have them
because they don't have means.
But in our centers, we strive to create access.
And I know a lot of others do too.
So it's not just people that pay out of pocket.
There's insurance.
And we build some quality treatment centers for people
with Medicaid in different states. We don't know what's happening with that at the moment, but you know, it's
currently, they can get treatment for that.
So if they're in a state where they needed like detox or, you know, they're in a place
where if they try to stop drinking or using, it gets pretty significant.
There's services out there for them. Another great thing though is to just
go straight into a 12-step meeting. They're everywhere.
How do people find those meetings?
They go online, Google 12-step in your area. If it's, you know, there's narcotics anonymous,
there's alcoholics anonymous, there's cocaine anonymous, there's overeaters anonymous, there's
gambling anonymous. I mean, if you, every one of them has a central office. The organizational structure especially of like Alcoholics Anonymous is really incredible.
We could do a whole episode on it.
There's no leaders.
It's a very flat organization.
Politically unaffiliated.
Politically unaffiliated.
They have a vow of poverty.
If somebody died and donated a million dollars, they can't take more than 10,000.
Really?
Yeah.
There's only trusted servants.
There's no leaders.
There are people who are employed that do administrative work,
but everything else, and it's been like this for 80-some years.
It's really quite incredible.
And there are online meetings.
There's online meetings.
They're all over the world.
You can find them at any time.
That's one of the beauties of 12-step meetings,
is that obviously I'm a therapist.
We have treatment centers.
It's nice to get people to come to those.
And it's great for people to be able to step out.
But there's things that we can do that they can't.
They're not going to medically detox them.
They can't keep them out of a safe environment
for a period of time.
But a kid with a porn addiction, somebody who's abusing alcohol or addicted to food,
shopping, gambling, they can find a meeting.
They can find a meeting.
Yep, they can find a meeting.
And you know, I always tell people to try six different ones.
They're free.
You know, you're going to find your group.
I mean, listen, they're run by peers.
So this is like something that was developed as, it would be like if somebody developed
a therapeutic modality 80 years ago
and then passed it on to everybody that they gave,
that every client they had and then they ran it.
I mean, it's not run by professional counselors,
although there are professional counselors
and then there's every walk of life from,
I've been around people who are anything
from priests to rabbis to doctors. There's no prejudice in the disease. But you can build a community
where people are willing to help and be in service to each other. And you can't call
a therapist any time during the night. You can't just look up and find a meeting and
go. And at this point with things online, you could find a meeting 24 hours a day anywhere. And the meeting's not going
to solve it necessarily. But the fact that you're moving in that direction, you know,
you're spending an hour, if you're spending an hour thinking and reflecting and talking
about it, even if you're not like in silent meditation, it's almost like a meditation. If you're spending an hour hearing people talk about how they recovered and helping you,
it's an hour that you're not doing the other thing. And in the beginning, that might be the white knuckling of it, right?
But the idea is to get out of white knuckling, you know?
And so the beauty of the 12-step programs, which was founded by the guys that started Alcoholics Anonymous and then it was Dr. Bob Smith and Bill Wilson.
And the way they discovered it was by helping each other.
Bill Wilson had been trying to get sober for a long time.
He'd been introduced to something called the Oxford Group, which was more of a religious
group based in Christianity.
And they had like a four, I think it was a four-step process, which the 12-steps are
just kind of really expanded on.
But there's a, in the literature, there's this beautiful moment where Bill Wilson had
been trying to stay sober for a while, and he was, but he was really white-knuckling
it.
And he'd been at his home in New York, he'd been going into the hospital and helping others,
and he found by trying to help others, he stayed sober. And he's a guy that had struggled for a very long time.
And none of those guys were staying sober, but he was,
which was kind of, he first kind of conceptualized this.
And then he was on a business trip in Akron, Ohio,
which is where this Dr. Bob Smith lived.
And he was staying at this hotel,
I think it was called the Mayflower Hotel in the history.
And he had come out of a business meeting, I think it was called the Mayflower Hotel in the history. And he had come out of a business meeting.
I think it didn't go the way he wanted.
And he walked in.
And in the story, he's describing
hearing the bar and the kind of clinking of the glasses
over here and the kind of the call of the bar.
And he had some change in his pocket.
And it was in the 1930s, early 1930s, maybe 34, 35.
And then there was a bank of phones over here.
And so he was kind of pulled between the bar and the phones.
And for whatever reason, he went to the phones.
He paused, and he went there.
And he called.
I forget who he called.
Maybe the hospital.
And he asked if there was, I think
he basically asked if there was any drunks in the town
he could help. And they directed directed him to in some way to this this doctor who was like the local town doctor Bob Smith and he was
also
An alcoholic who had struggled for a long time and they met and he well
I think he went to his house or he might have been in the hospital at the time
I could have the history a little bit wrong. But they met and started talking.
And I think Bob relapsed one more time.
But they started talking and helping each other.
And then they went and helped another guy.
And then they went and helped another guy.
And there's a whole history to how it developed
and then how they wrote a book together.
The book was really meant to send.
It was written like four years later.
Send the information
about alcoholism and alcoholics anonymous to everywhere in the country where they didn't
have meetings. They started having these meetings and helping each other through this step process
that they developed. And it's really interesting because this was one man's decision. Instead
of going to the bar or going to the phone,
instead of going to the bar, he made one phone call
and that transformed millions of lives.
I mean, there's millions of members around the world.
I think he was called the other Time Magazine or Life
Magazine's 100 most influential people of the 20th century.
And there's still people who find recovery.
And then they gifted those steps to all of the other things like cocaine anonymous and
alcoholics anonymous.
And it's not for everybody, and they'll even say that in the literature.
That's why I wouldn't consider it a cult, because they'll say, we don't have a monopoly.
And of course, you're going to meet personalities in there, but the organization itself is agnostic
to religion, to ideas, to politics, and it's
a place that people can come and with a common problem and find a common solution.
And these meetings can be the place that hold people as a container.
I always see our treatment centers as like a container of space and time where people
can come in and really kind of let themselves fall apart and we can start helping them build their life back.
But these 12 step meetings are like a container and they have a, you know,
people will, people are, you know, excited in there to reach out and connect
with you. And it's in those moments of connection that we can really find
healing. I mean, look at what happened to him. Instead of going into the bar and connecting
with the people in there and drinking,
and he had enough evidence to show that drinking would,
it didn't take him in the right direction.
He was able to make a phone call,
connect with somebody else, and it created all these connections
later on.
And it's not a place that people go just to white knuckle it.
I mean, that's why they might get in there.
Nobody usually comes there because they, you know,
had one bad night of drinking.
It's usually, as some people say, no one comes in here a winter.
They've been on a losing streak.
And that's OK.
But to be able to admit that and really discover who you are
and share that with others and find frivolity and joy
in the depths of people's pain, and they can really understand that there's hope,
there's promise, and there's a way out.
And these people who are struggling
aren't going to necessarily find that in their first meeting,
but they might get the hope and the connection with others.
And so they're available out there.
And if you don't like the 12-step and the spirituality,
there's other recovery programs out there.
There are other peer support groups out there,
like Smart Recovery or Refuge Recovery,
and they'll talk about things in a different way.
So it's not about finding a specific dogma,
go out and try different things.
Even the act of trying different things
is gonna help them move out of being stuck
if it's like the porn addiction, right?
And then people do reach a certain point in acuity, especially with drugs and alcohol,
that they need to be in a facility.
You know, and that might be a hospital, it might be a treatment center.
And you know, you can, there are resources for that.
I think it's a good place for people to start if they don't have the resources to be able
to attend a treatment center or work in therapy.
Thanks for sharing that avenue for people with all sorts of addictions, not just alcohol.
And for the families.
Al-Anon for the people is for the families.
There's co-dependence anonymous.
There's families anonymous.
There's adult children of alcoholics anonymous.
Adult children of alcoholics is really about dysfunctional
family systems that people might have grown up even if their parents weren't alcoholics.
So there's stuff out there for everyone.
Prior to this conversation, I solicited for questions from the internet about addiction,
broadly speaking, and got some great questions.
The first question is, is addiction the problem?
They put the in quotes.
Or is addiction an attempted solution to a different but less obvious problem?
The short answer to that is both.
The addiction is really the solution to some sort of discomfort or stress
that they're experiencing, but then the addiction itself becomes problematic. I would say that
addiction is the solution in the sense that it's the person's attempt to solve or to
find relief from whatever stressor they're experiencing, but it's a solution that becomes
problematic. So it takes on a life of its own. It becomes its own trauma itself.
Drinking alcoholically and blacking out is a trauma to your body, to your brain.
The things that people do in addiction become more traumatic.
I think there's this cycle that I always use in the background called trauma, stress,
and addiction.
Expanding the definition of trauma to wound, it starts
with a wound and then stress is the relationship to that wound, much like a limp after a broken
leg. When stress gets big enough, people look for relief and so they look to behaviors or
substances which then can, if the stress is big enough and repeated, can become alcoholic. So that stress is not really the wound,
it's the relationship to it.
Like I said, the limp after the broken leg,
but that limp, while it's not the broken leg,
informs how we walk or don't walk,
how we run or don't run, how we view ourselves,
how we view the other people in the world view us,
and all of those things together can lead to a level of stress where people find relief, and since it's chronic, then they keep using.
But then the behaviors and things that they do while they're using or drinking create
a trauma itself, which then leads to more stress, which then leads to more addiction.
So it becomes kind of this perpetual motion machine, if you will.
So the medicine becomes the source of stress.
Yeah.
Are GLP-1 agonists, things like Ozempic, Wigovia, et cetera,
being used for addiction outside the context of weight loss?
Interesting question.
And will this happen in an official capacity
or remain off-label use?
They're asking your opinion.
Are GLP-1s being used to treat addiction to food?
And do you think it can be useful for treating addiction to other things?
I believe that there's some initial research going on that it can help with cravings and
addiction in general.
It makes sense to me.
I mean, I've heard that anecdotally over the years that people that were diabetic and
also alcoholic, but the diabetics that maintained their blood sugar properly had less chance
of relapse.
I mean, there's this very simple kind of an acronym called HALT you may have heard
of, hungry, angry,, Tired, which seems
so simple, it used to drive me crazy, but it's so true that, you know, people tend
to be at higher risk for relapse or using when they're either hungry, they're angry,
they're lonely or they're tired.
And sometimes those things are all together.
And those are times in which I would imagine their system is looking for something to,
I mean, if you're hungry, you're looking
to elevate your blood sugar.
And if you can maintain that, I would imagine that it would have some interesting effects.
I was just at a meeting with some of the executives of the major insurance companies, our company,
and has a private meeting with them.
And they were talking about that some of the things that they're looking for.
I don't know that, I'm sure it's been used off label, but I don't know of anybody that's using it yet on label for any of that.
Can somebody be addicted to stress? Meaning are habits addictions?
Those are sort of two questions. Clever, this person snuck in two questions. First question, can somebody be addicted to stress? I think that people can be set,
have their nervous system set in a way
that they need that level of stress or activation
in order just to kind of get to baseline,
in order to kind of feel alive.
You know, I've seen that a lot when I've worked with,
especially special forces combat veterans, coming know, coming home, like a lot
of the mundane stuff almost didn't feel like they felt alive, you know, and of course, this isn't
everybody, this is the ones that were coming to me, but that they needed to be involved in like
really risky behaviors or really high adrenaline behaviors kind of felt like they were just getting
to kind of baseline of being normal. It wasn't even like taking them to another edge. And, you know, that makes sense
to me because a lot of like what basic training or the training that they do later on for
more special forces is while it's skills training, it's really nervous system training, right?
It's the ability you could, it's the ability to do those skills under an
extreme amount of stress or lack of sleep and everything like that. So if they're kind of
oriented in that way, then when they come home or they're in environments where it doesn't,
it takes a lot to bring them up just to that level of like, what might feel normal for them,
their kind of system is set up much higher than here and they've got to get up to that
to just feel alive.
So I don't know if addicted, maybe it is addicted.
I feel like they have a need, you know.
It's a drive.
It's a drive.
Intensity addiction.
That's it.
You and I know some people with that.
Yes.
Yeah. I'd like to know about social behavior addictions,
social media, coffee, sugar, even work addiction.
And as always, thank you for tackling hard topics.
I guess that was directed toward me,
but you're the one who's about to try
and tackle this topic.
So are those things really addictions?
Are people addicted to sugar, addicted to coffee?
Do they meet the classic definition of addiction?
Well, they're not going to meet a, a, a, a diagnostic criteria, progressive,
et cetera.
Yeah.
But what is the diagnosis?
It's always this, uh, progressive.
I don't know if it was, was it on your podcast or did I read about this
somewhere else where when they took, you know, there's the classic study about taking rats with cocaine and they'll, they'll, they had water and,
and cocaine and they would like press that lever thousands of times to get the cocaine.
Somebody else repeated that but added one that had sugar in it and their cocaine use
went significantly down when sugar was also present.
Well meth addicts will consume sugar and meth more readily than either one alone.
I mean we see this when people get sober, you know, that there's people that will get
very heavy, you know, they'll engage in what looks like a food addiction.
And when we peel that back, I can't tell you how many times I've heard of, you know, people recognizing their first addictive behaviors going to the sugar bowl and, you know, taking spoonfuls of it. I've actually heard people say that food addiction and probably specifically around sugar is often the primary addiction for people. It's kind of like how they get in there. I'm sure that's not true for everybody. But I think if we broaden the term of addiction beyond what a use disorder is in the DSM and
move towards do you have it or does it have you, absolutely.
I mean I don't think we can become sugar dependent in a way that if we stop it, we're
going to go into some sort of major withdrawal but I would imagine there'd be some sort
of withdrawal. Same with caffeine. I've seen people'd be some sort of withdrawal. Same
with caffeine. I've seen people go into psychosis with caffeine. I never want to
find out what happens. You might just always be in psychosis, caffeine
psychosis. Thanks for that. No, not you. I mean I love caffeine but I
can take that out. I can sleep well. No, no, that's fine. I actually can sleep on it too.
Well, I don't drink caffeine past 2 p.m. occasionally.
I don't either, but once in a while I do and it doesn't...
You're definitely getting less REM sleep in there.
I'm sure I am.
But you look rested.
Not last night.
Lot of questions about Ibogaine, probably because the incredible work of my colleague
Nolan Williams at Stanford, the single Ibogaine trials for people getting over alcoholism,
meaning one taking Ibogaine once or twice
and mostly in veterans was covered on the Rogan podcast
and Nolan's been on here.
What are your thoughts on the use of Ibogaine
and other psychedelics?
Let's leave MDMA out of it
because that's more for the treatment of trauma
and it's not actually a classic psychedelic, but things like psilocybin, ibogaine for people
seeking relief from alcohol and drugs specifically, but maybe other addictions.
You know, I've seen some pretty incredible things happen with people.
And I'm glad that the studies have been going on specifically around psilocybin in the US.
I'm not really aware of any around Ibogaine.
So anybody that is doing Ibogaine treatments are either, you know, I don't know if they're
finding it in the US or they're going to Mexico or wherever.
Has to be done in Mexico.
They're doing the brain scans at Stanford before and after.
It's not currently in the new administration.
So they are doing some studies around it. The rates of remission from alcohol use disorder and other substance use disorders is somewhere
– there's a range, but 40 to – in some cases 80% with one or two Ibogaine trials.
But this is with therapeutic support.
There are a bunch of other things happening there.
And then there's evidence of brain plasticity in a number of brain areas.
Yeah.
So I don't know enough about the studies happening before, like, they were doing this where Stanford
was doing a study and taking people down to Mexico or people going down there to do it.
It was kind of a lot of, I don't know how else to say it, but renegade folks doing it
outside wasn't always, you know, run by medical teams and people making sure that everybody
is safe, at least from my experience,
although then I've seen some amazing things around it.
My general take on psychedelics, if I look at PTSD, post-traumatic stress disorder, I
really see that as you could almost substitute state disorder in there for stress because
people get stuck in a certain state and let's call it the survival state. And that's, as I've said, one of our biggest challenges
is that we go into survival mode
and we don't need to go into survival mode,
an appropriate response at an inappropriate time.
And so things like psychedelics,
or we actually can see this with breath work,
and can help people have an experience
where they recognize another state,
you know, that they can be in another state,
not another state of the US,
but like they have access to something other than survival
and those touchstone experiences
can really give them something to build on.
I think like any other approach to medicine
that seems miraculous at times, there's a lot out there of,
this worked for me, so everybody should try it. There's what I'm most concerned, I'm not concerned
about the effectiveness of overall of psychedelics because I think there's definitely a place for
them, but I'm really most concerned about the ethics that we develop around them, who's delivering
it, what are the rule outs,
you know, I know we weren't, we were going to leave MDMA out, but I know some of the
map studies, it was like three sessions, I think it was over. And I don't think that
the, the world that kind of sees those is then taking that, especially in the personal
development world and going, we're going to do three sessions. It can kind of come be
something that we do all the time, you know, or microdosing all
the time.
I don't know enough about it to see if that's going to have an impact.
And you know, there are people with psychological and psychiatric disorders that it can really
impact in another way, you know, definitely.
Schizophrenic bipolar.
And you know, you know, I look at it like, you know, antibiotics like penicillin saved a lot of people, but
then there's people that it kills, right?
I can eat peanuts and get protein out of them.
And I know people that eat peanuts and they can die.
So we-
Lousy source of protein, by the way.
Lousy source of protein, eggs, let's say.
But there's a real, we need to really understand the ethics around it and the timeframe and
then make sure that people are following that up with something
because I think you've used this example before
of like kind of being on a trampoline
and you can jump up and see the top of the building,
you know, and you can see where you wanna be,
but you haven't built the staircase or the elevator yet,
we gotta go out and build the staircase and the elevator.
So I think they're a great window into how we can be
and an experience of this person that I can be,
but I don't think that there's going to be like some immediate structural change
that's going to last.
And the danger in that is then people start using that over and over again
and can lean on that as a crutch.
Last question.
If we know somebody or are close to somebody that's clearly suffering from addiction
or struggling with addiction,
what can and should we do?
This sounds like somebody who is aware
of the all too common scenario of this kid,
this parent, this coworker, this significant others,
clearly an alcoholic, clearly a drug addict,
clearly addicted to fill in the blank.
What can people reasonably do, assuming that person is not in a medical crisis yet?
I think one of the biggest things we can do is talk to them, but also without shaming them.
And if you don't know how to talk to them, reach out for some help yourself.
Like I said, there's family support meetings like Al-Anon that you can
go to.
If you reach out to a treatment center like ours, you can, we're happy to talk to the
families and help point them in the right direction.
But having an open conversation without shaming them and understanding that this is a, you
know, approaching it with the idea that this is a disease
and like we're talking to a sick friend
now that we're talking to a bad person.
Can I ask slash offer one,
which is if a 12 step meeting is an open meeting,
as they call it, like an open AA meeting,
you could offer to go with them.
When they do the around the circle thing,
if you go and you don't want to say anything,
you just say pass, no one's gonna.
And a lot of places they don't even do around the circle.
So you could go with them, you could take them to a meeting.
Yeah, as long as it's what's called an open meeting,
you don't have to be an alcoholic or an addict
to go to that meeting and so you could take them.
You could even go and just observe,
believe it or not, some non-alcoholics
have come to 12-step meetings that were open meetings
to learn more about it, to then be able to go help somebody
that they know.
And reach out and find a therapist
that can do an assessment.
In our mission to create access, we
have been really doing some kind of innovative stuff
around virtual
care and in-home care.
So when there are people that are resistant and maybe if they even, it is true that they
need to go to a residential treatment center that we can offer this different service that's
much lower cost and covered by insurance that we can come in and kind of build a relationship
with them.
And, you know, in some ways, sometimes it works for them and they're able to move through
it and other times we're able to move through it.
And other times we're able to help them witness
their failures and then having done complete assessments
with them, get them to the correct level of care
and make sure that the family has everything they need.
So those options are out there as well.
I've seen the work you do help so many people,
so, so many people.
And so I'm just very, feel very lucky
you come on here and share with a lot more people.
And I'm sure you'll get some outreach.
We'll put links to where people can find you
and some of the resources and things that you're up to
and the papers and other things mentioned.
But yeah, on behalf of myself and everyone listening
and watching, I just want to say thank you.
You're doing incredible work.
I was reflecting on this a lot before coming out here,
but I really appreciate what you do in the world,
and especially knowing you and knowing how
and why you started it.
And there wasn't this grand vision at the end.
It was like, I'm just gonna help people today.
I mean, you literally was like,
I'm gonna help people today.
I'm gonna write, do these little diagrams
and these little things, and I'm going to
help them today.
And helping people today and the next day and the next day has led to you having such
an impact in the world.
I was telling someone on your team earlier, your work makes my work easier.
I've had men specifically, mostly men that come to me more open because
of what they've heard you talk about. And conversely, I've had men that we're working
with that are very closed off and then I'll have them listen to something that you've
done and it opens them up. My wife wanted me to tell you, she's a therapist too, and she was running a group this morning with a group of kind of more mentally ill folks, and they were doing a group on stress
management and she used a video of the physiological sigh.
So she wanted to say thank you for that.
But I know lots of therapists that are using that, and it's just you make our jobs easier
by bringing awareness to the challenges and problems that are out there.
So I really, really appreciate that.
Plus I just appreciate you as a human being
and very much value our friendship.
Thank you for that.
That's extremely gratifying to hear.
And I'd be remiss if I didn't say that we're not for you
and your support and the many things you've taught me and our friendship,
I definitely wouldn't be doing this
and maybe wouldn't even be here today at all
in the biggest sense.
So thanks for everything.
I appreciate you.
Thank you.
Thank you for joining me for today's discussion
with Ryan Suave.
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