HealthyGamerGG - Alternative Medicine, Reddit Review | Community Stream

Episode Date: August 8, 2021

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You know, there have been some interesting posts and, you know, some people were like, there was a post recently about I wish things were more solution focused and stuff like that. So today we're going to dig into a lot of different posts on the subreddit. We're going to talk a little bit about like the cycle of success and failure, which is sort of like, you know, you get super motivated and you kind of go for it. And then eventually your motivation wanes and that kind of falls apart. We're going to talk a little bit about complementary alternative medicine. And we're going to, if we have time, you know, we're going to get to a couple of Reddit posts. So a couple of things, announcements. So I'm going to be going on vacation for, you know, a while, like a little while.

So this is going to be our only stream day today. And then we'll be back to streaming on the ninth, I believe. Okay. The good news is that we're still going to be uploading content to YouTube. So there should still be regular uploads and stuff. off. Sometimes people will wonder, oh, where's this thing from stream? Where's this thing from stream? You know, so like sometimes like we, you know, we just have an upload schedule. So, y'all can, y'all are welcome to, um, check us out on YouTube. So next thing. So let's,

before we kind of get started, so we had a couple of questions about, you know, how scientific or, um, not scientific Dr. K's guide is. And, you know, what is the relationship between like, um, you know, like, what? what are we getting in Dr. Kay's guide? So let me just share a couple of things, okay? So for people who are curious. So the way that the guides are organized, part of the way that I work as a psychiatrist and as a human

is that I do a lot of stuff that's psychiatry and then I do a lot of stuff that isn't psychiatry. And so the psychiatric portion that I do is pretty solidly evidence-based. And then the non-psychiatric stuff that I do kind of falls into like two camps. So there's sort of like the, has some basis of scientific evidence that I do. So for example, like I teach like meditation, right? And then the downside, though, is that a lot of the specifics that I believe about meditation are actually not scientifically valid. So what we have in Dr. Kay's guide is we have like, you know, the clinical track of depression.

We have the clinical track of anxiety. And this stuff is pretty much like quite solid in terms of its like scientific basis. We have a selected bibliography that we're going to be sharing with you guys for people who are interested in resources, like, you know, sources and things like that. The challenge, so we try to do this at Healthy Gamer is that we, you know, then we have a non-clinical track. And the challenge here is that, you know, some of this stuff is not really scientifically valid. So this kind of teaches more about meditation and things like this. The Sukapada is like the path of happiness or contentment. And so we teach actually specific meditation techniques to like understand the nature.

of suffering and happiness and contentment, but there have not been like randomized controlled trials on those techniques. So if we look at sort of the science behind, you know, this branch, there is science, for example, that meditation is effective as a treatment for depression. And in my experience as a clinician, and we'll get to this a little bit down the road when I sort of explain my perspective on alternative medicine, it is my experience as a clinician and as a yoga teacher or meditation teacher that, you know, there's a lot of specificity within yoga in meditation. They're like all these different traditions, all these different techniques. And I think essentially what's happened is we haven't really like done enough research to

really determine which techniques work for what things. But as a clinician, what I've, you know, because you try this as a clinician, you get 10 people in your office that come in with depression. And then you run your own internal like clinical trial where I'll try to teach someone meditation and then, you know, they'll say, oh, it really didn't help much and I'll teach something else and I'll teach something else. Right now, I'm just trying different techniques with different people and sort of trying to figure out what works. And then as a clinician, you begin to make observations and what I started to realize is, oh, like, my patients who are depressed actually have certain techniques that work better for them. And my patients who are anxious have certain

techniques that work better for them. That's really interesting. And then what I'll do is I'll look at some of the science behind it. We'll explain even sometimes, you know, even when I'm teaching meditation, I'll cite particular studies and things like that that sort of speak to physiology. But, you know, in terms of how scientific is Dr. K's guide, I'd say 50% of it is pretty scientific. And so part of the other approach to Dr. K's guide is that, you know, when I get different patients in my office, like some of them want only scientifically based stuff. And some of them are like, give me the good spiritual stuff. Like, I want a mantra. Like, I don't care about the science. Like, I want, I want a deeply spiritual, unscientific. Like, I don't care about science. I just want what works.

And so, you know, what we've tried to do in Dr. K's guide, and this is why the guide is not linear. Like, do you guys get this? Because each and every one of you is going to have your own threshold for how scientific you want it, how non-scientific you want it, how spiritual you want it, or whether you want it in between. And we're not here to sort of say that one is better than the other, right? So the reason it's Dr. K's guide is like, this is my opinion on the scope of science versus non-science. And we try to actually give you all a pretty balanced perspective.

And down here is Ayurveda. Well, I'll explain like the theory of Ayurveda and sort of where it comes from so that people can be like, okay, I accept it, I don't accept it. And then we're going to kind of talk a little bit about diet and herbs and stuff like that. And I'll share with you guys some of the science why I believe it works, but that some of these things haven't actually been tested yet. So there's like basic science principles that I believe apply to Ayurveda but have not been formally tested. So we kind of talk about that. Another big part of the Ayurvithic section down here is that I also talk about safety

concerns about Ayurveda, which we'll get to later in today's stream. But some people are like, how scientific is Dr. K's guide? And the answer is like half of it is pretty scientific, to be honest. And we sort of did that on purpose, right? So my experience as a clinician is that, and also personally, is that, like, there's a lot of value that we can gain from traditions that have not been verified by science. And the meditative tradition, I think, in my mind, is at the top of that list. And I want you guys to really think about this for a second. Like, you know, people were saying that meditation was effective at helping people with depression and anxiety for like, let's say, 300 years, okay?

And for those 300 years, actually a couple thousand, but let's just, let's focus on actually, not even 300 years ago. Let's go back in time 50 years. There were people who were saying, hey, like, meditation is actually really great. It really helps with my depression and my anxiety. And so the scientific community was like, that's whack. Like, that's crazy. There's no evidence that meditation supports it, right? So, like, that's what they said, because there wasn't evidence.

There wasn't scientific evidence. People had not done studies that meditation was effective. And so at that point, like, I know it's kind of weird, but was meditation effective? Yes. Science was just wasn't aware of it, right? So this is what I think we see, and we'll get to this a little bit more, but what we see is that there are some traditions of, you know, healing, which is a word that rubs me the wrong way in some ways, that have been saying that there are effective interventions for particular things, that science is sort of catching up. with. And now there's no debate that meditation is effective for all kinds of crap. But the point is that, like, science was slow, right? Like science, like, it's been effective for thousands of years.

It's not like something magical happened. And when we studied meditation, then it became effective. It's actually been effective all along. It's just the scientific community wasn't willing to accept it. And wasn't ready to accept it. And so, it's, we'll get to this kind of philosophically. But so part of what I share here is, is I believe, based on, the trends in meditation research that most of what like these particular meditation traditions offer, at least the ones that I share, I think we are going to discover that like a lot of it is going to be scientifically validated. And in fact, you know, there was, I recently saw a study about how narcissism is actually rooted in insecurity and not like overconfidence, which may sound like

common sense now, but for many years the prevailing theory was was not actually that. Or one prevailing theory. It depends on who you're talking to. Other people always sort of thought that narcissism was rooted in insecurity. But the yogis have been saying that narcissism is rooted in security for thousands of years. So, so, you know, in terms of like, where is the evidence? So 50% of Dr. K's guide is like pretty solidly scientific. And then the other half of it, I think the reason we chose to include it is because, in my personal opinion, you know, there's a lot of clinical value to it. I mean, it's not really a clinical. Clinical maybe is not the right word. but there's a lot of like real value to it.

And I think that science simply hasn't caught up. And then we also include the stuff that, you know, I don't know if science is ever going to catch up or not in our lifetimes. Like there's some pretty whack stuff. So we talk about mantra. And what I try to do in Dr. K's guide is sort of explain, okay, like here's mantra. Here's how it's supposed to work.

So I'm going to share that knowledge with people. And then I hypothesize how mantra works at a psychological level, neuroscientific level and spiritual level. And if we kind of look at those three levels, you know, the spiritual level is not based in science at all. And then like I try to hypothesize if we have studies that show that mantra meditation creates different EEG patterns, then how can we try to figure out, okay, we made that, like we made that actual observation, like what is the mechanism behind that? And that's where I enter a hypothesis realm. Right. So it's kind of weird.

But some of it is like there's basic science with extrapolation is like a lot of what the nine. non-scientific portion is, and it's just my way of thinking. So when I see a clinical observation or I see a scientific observation that is weird, what I try to do is try to figure out, okay, like if this observation is correct, which we sort of assume based on the quality of the study, then what are the mechanisms at play that like could suggest how mantra works? And so that's what I offer. It's kind of my opinion and me trying to make sense of this. When a patient comes into my office is like teach me a mantra and I'm like okay fine I teach them a mantra and then like six months later you know they're they're doing fantastic and I kind of scratch my head and I'm like

okay they've been meditating for two years now they're doing way better with a mantra like how do I make sense of that so then what I do is I like go and I read scientific papers and there aren't studies about how this particular mantra helps people in this situation that study doesn't exist so as a scientist or clinician or call it whatever you want what I try to do is like try to figure out, okay, what do we understand from science that could explain this outcome? And that's a really dangerous thing to do. I think practically it's very helpful, but it's very dangerous to do because, you know, you're coming up with a hypothesis to explain an observation. The observation is real, but it doesn't necessarily mean your hypothesis is, but you kind of do

the best that you can, which is sort of how Dr. K's guide is outlined, right? So it's like my opinion on this stuff. And I try to take a pretty scientific approach, but a lot of what I share is not actually like scientifically supported. Okay? So that's Dr. K's guide. So what we try to do is make things like applicable. So someone else on the sub-rider was like, I wish you would offer more solutions. And this is also like a little bit tricky because, you know, so there are a lot of solutions in Dr. K's guide. But like the more so the more tailored solution I offer to a specific problem, the further away we get from science. And that's sort of the tension that we hold as healthy gamer, it's personally the tension that I hold when I work with people is like,

you know, how do I figure out how much to be scientifically based and how much to be sort of like clinically based and like outcome based and sort of almost, you know, and it's tricky. Anyway. Okay. Based. So let's go ahead and start. We're going to talk more about alternative medicine, okay? But will there be DLC? What does that mean? DLC for what? Okay. Oh, yeah, I mean, so, you know, we're trying to figure out. So like, yeah, I mean, hopefully there'll be DLC, but this is where, you know, you guys tell us, like, y'all tell us. So if y'all like this, you know, so let's say that you guys watch Dr. K's guide and you're like, this is a steaming pile of refuse that is filled with pseudoscience and is not helpful at all, then we're not going to release DLC. And if you all are like, hey, this is actually really, really helpful. I really appreciate it. I've never had someone explain to me like the principles behind like how alternative medicine works. And I've been really curious. I've been struggling with depression for a long time and I'm taking a medication. But like my psychiatrist hasn't been able to explain to me like, you know, what are what are like alternative medical approaches to depression? What's the science behind it? Should I try it? Should I not try it? I really appreciate that. That was really cool. And I really liked like learning a meditation technique about depression. I thought it was fantastic. And those are actually separate things by the way. The alternative medicine lecture is in the clinical track, not the non-clinical track, because that is actually, you know, based in science. And it's what I think about as a clinician.

So if y'all tell us it's good, then we'll release more. Like, we'll make more. But that comes from y'all. Can you gift a pre-order to Dr. K's guide? I think you can gift Dr. K's guide. I'm not sure, though. All right? Lecture time?

Would you consider religion or meditation as copium? I don't really understand what copium is. Yeah, so one of the ones I'm working on is like Dr. Kay's guide to relationships, but we'll see if it ever sees the light of day. Just so you all know, like the guide took a long time, man. Like, I wrote two nonfiction books. There's like 160,000 words that were all scripted and then filmed. And the length is like nine feature length films.

We like filmed for a ridiculous amount of time. So if y'all tell us that it's like really, really worth our time and it's good, then we'll make more. But, you know, anyway. Otherwise, it's just piecemeal on YouTube and Twitch. Okay? So like we, you know, we're, yeah, y'all tell us. If you guys want it, we'll do it. And if y'all prefer the Twitch and YouTube kind of thing, then we'll, we'll do that.

August 18th is the tentative release date. Okay. Chat. So now, okay, one or two more questions about this, then let's get started. What is motivated state? That's exactly what we're going to talk about. Okay. So, I've noticed that there are a lot of people in this community who have sort of these cycles of like boom and bust when it comes to motivation. So there's a lot of people, myself included, who like, you know, you'll wake up one day and something weird will happen and you'll be like highly motivated. motivated. And then you try to, you know, you work really hard. And then there's like this thought in the back of your mind like, oh my God, like when is this going to end? I know it's going to end. And then you're like motivated for a week and then like it falls apart. And then you're kind of like you let things kind of fail and you don't follow up with stuff and things like that. And then you're kind of like you got a week or two of like you're in a gray zone where you're like, you know, not really feeling it. And then you feel ashamed of yourself and all this kind of stuff. And then eventually like you wake up and your motivation comes back. And then like, you know, then you kind of go back to it. So there's almost this cycle of success and failure. And if we want to understand the cycle of success and failure, we have to take a slightly different perspective on motivation that I think actually Western science is sort of missing out a little bit on.

And not to say that it misses out on it entirely, but if we kind of look at Western perspectives on motivation, right, so for example, we have a very strongly supported model of personality called the five-factor model. the five-factor model has this attribute called conscientiousness. And what conscientiousness is essentially like your ability to like complete tasks over a period of time. So if you look at median income and worldly success, it's correlated with high conscientiousness. So the people who have a personality trait of high conscientiousness are people that we call like disciplined, right? And those are the people that like are lucky because their personality is more oriented towards being conscientiousness.

and disciplined and organized. And they're the ones who can wake up at 7 a.m. every day and exercise before they go to work. And they apply to promotions on time. And they like, you know, keep their resumes up to date. And like they're very consistent and conscientious focused. And so in the West, we sort of think about and we can even see it in our language. So the way that our science is sort of structured is to sort of look at motivation or discipline or conscientiousness. is a trait, right? It's an aspect of who you are. It's part of your personality. And while

personality can certainly change over time, it's not like a temporary thing. So the word trait refers to something that is like kind of a permanent part of you. And then there are also states. So a state is something that is inherently fluctuating. So for example, states of consciousness. There's like being conscious. There's being asleep. There's a like fever is another example of a state, right? Being sick is a state. It's not a trait. It's not a part of who you are. It's something that fluctuates within you. And when I hear people talk about motivation, people, I've sort of noticed that there's a bias of talking about it like a trait, right? So there's two types of people. There's lazy people and they're disciplined people. They're unmotivated

people and they're motivated people. So this is sort of like trait like dialogue. And our science sort of supports this kind of hypothesis or bias, right, where we sort of like have five-factor analysis and we sort of like look at that and we say, okay, like there is actually like a conscientiousness trait to your personality and it's kind of inborn and it's relatively constant. So it sort of makes sense. It's scientific that, you know, people are disciplined and people are lazy. But if you really look at it, right, if you look at it very carefully, what you really discover in your own life is that motivation is actually a temporary thing. By nature, your motivation fluctuates over time, right? So like, just like we said, I mean, the whole problem is that our motivation fluctuates over time. And then we kind of get into a problem because, you know, if we acknowledge that our motivation fluctuates over time, like that it's essentially a state, right? So I'm highly motivated today. I'm not motivated tomorrow. Then, you know, it's kind of tricky because like if our, if our solutions are sort of trait based, if they're personality based, and people sort of try to figure out,

how can I become a disciplined person? That's where our target is. What we really try to do is become something that we're not. So we want to like flip a switch that turns on our motivation, like almost permanently, right? I want to become a motivated person. And that's what I sort of gear towards. That's what like success gurus will sort of talk about, right? Like this is how you become a motivated person.

But it's all very trait-based thinking. It's kind of interesting because, you know, in the East, they sort of think about motivation a little bit more like a state. So this is also a generalization. But if you look at yogis, for example, what they'll say is like, you know, the nature of the mind is that it fluctuates and that like motivation will naturally fluctuate over time. In fact, the definition of yoga, so there's a Sanskrit line, yoga chita vrutanirodha, which means that yoga is the cessation of fluctuations of the mind. That is literally the definition of yoga. And so what does that kind of mean? So how is it that yoga and meditation and yogis are like, they're like pretty hardcore, right?

Like they wake up at like 4 a.m. every day and they like meditate and do yoga and they're very careful about their diet and things like that. And so it's kind of interesting because like how does that, you know, what they kind of focus on is not becoming disciplined. What they focus on is controlling the state of their mind and acknowledge that by definition it's actually fluctuating. Okay. So I want you all to think about something. So what I'd like to share with you all today is an understanding of motivation as a state instead of a trait. So I want you to think about something. So if I play video games every day, let's say I wake up every day and I spend all my time watching Twitch and video games and YouTube and Netflix and whatnot.

So when I look at that, when I look at myself, I say to myself, I am unmotivated. And that is why I spend all my time playing video games and Netflix and whatever, right? So I want you all to think about this for a second. Is it because you are unmotivated that you spend all your time, you waste your time? They say, oh, if I was more motivated, I wouldn't, like, if I was motivated, I would go out and, like, get a job or exercise or whatever, if I was motivated. So, you know, if I was motivated, then I would spend all my time doing this stuff. But I want you guys to think, what's the chicken and what's the egg? Is the lack of motivation what causes you to play video games all day?

or is it playing video games all day that causes the lack of motivation? And so there's a really simple experiment for this, right? So like you think about your motivational level, let's say like you want to work on your resume. When you wake up first thing in the morning on a scale of 1 to 10, how much do you want to work on your resume? Let's call it a 4. Okay?

Let's say, like you don't even work on it. But if you measure your motivational level, it's like a 4 out of 10. And then like after you play like an hour of a game, what happens to your motivation? Are you like more motivated or less motivated to work on your resume? And then like after six hours of a game and eight hours of a game, like if you've been playing league for 10 hours, how motivated are you to work on things?

Right? And so it's interesting because most people are saying less. Some people are saying more. So we'll get to that in a second. Some people are saying the same. But I'm not saying that, you know, even without doing the behavior, your motivation towards the behavior will fluctuate.

I know it's kind of interesting, right? But if you really pay attention to yourself, we're not saying that if you say the same because you're not doing it, that's not actually correct. Your motivation actually fluctuates, which is a really fascinating discovery because then what we sort of realize

is that like playing video games induces low motivation, which is a really shocking discovery because that doesn't mean that you're lazy or disciplined, right? It's not a trait. It's that the things that you do will actively contribute

or not contribute to your motivation. So essentially what the yogi sort of discovered is a system where I would kind of think about it this way. There's certain actions. So I want you to think about motivation not as like a personality characteristic or like a stat on your character sheet. It's not like there are disciplined people

and undisciplined people. I want you to think about motivation as a bank balance. And there's some actions that you take which will contribute to the balance and then when you want to do something you will actually like pull from the balance. right? I'm going to make deposits and I'm going to make withdrawals. So if I, I know it sounds kind of weird,

going to the gym requires a withdrawal, right? But being at the gym actually makes a deposit, which is interesting. So now we begin to see like how disciplined people are able to do it. Because every time they go to the gym, they make a withdrawal, but they also make a deposit. And you all, you know, it's kind of like really fascinating because if you notice yourselves and, you know, the cycle of motivation, what essentially happens is like you do something, right? And then you feel motivated. You're like, okay, I clean my room. Good. Now I'm going to do this and now I'm going to do this and now I'm going to do this and now I'm going to do this. And if we spend all of our time playing video games, like what's happening to our motivation? Like we're making withdrawals from it, right?

Like if I'm decreasing my motivational capital when I waste my days. And so it's kind of interesting because then if we look at the cycle of motivation, inevitably what we find is as people become more motivated and they start doing more stuff. They start engaging in actions which require withdrawals, but they're not making the appropriate deposits. I know it sounds kind of weird. But if I start, like, you know, if I clean my room, that requires an energy investment and gives me a burst of energy. And then eventually what I'll end up doing is I'll take on like bigger tasks, more difficult tasks, like more challenging tasks that actually withdraw more of my motivational energy than I'm able to deposit. So a good example of this is like tackling, finding a job.

Right? Because like that task is so big that you don't really get the reward until the end, but there are all of these steps involved, which you may actually be making motivational withdrawals for, and then you kind of like run out of motivation. And I know it sounds like really, really weird, but if you look at people who go into cycles of success and failure, what they essentially do is like they start off lighting the candle and then they like light a firecracker. And then like they light like, you know, they just like burn all their motivation. away and then it's like a set of fireworks and then they feel completely spent afterward. And what I really find is that if you really want to sustain your motivation, you have to continually make deposits. So we see this in Addictions too, okay? So Addictions is a fantastic

example of this where, you know, someone is like, yeah, like I'm one week sober. Hell yeah. Like how did you get one week sober? I went to three meetings a week. And then they're like, I'm sober. It's great. I feel awesome. I'm going to start doing this. I'm going to start doing this because I'm sober now. I'm sober now. I'm sober now. And eventually what happens is like, oh, like, what about going to meetings? Oh, I don't need to go to meetings anymore. Like, I'm sober. I don't need meetings. I've done it. I'm three months sober. So they stopped going to meetings. Right. And at first they were like super careful. And they like went to their first barbecue where people were drinking and they were going to

meetings at the time. They're like, oh, I can handle this now. So they stop going to meetings and they continue going to barbecues. And then eventually what happens, they continue going to barbecues and then they relapse. And so like, how did that relapse happen? I thought you had it under control. like I thought you'd solved it. And they're like, yeah, now I am sober. It becomes a trait in their mind instead of a state. It's no longer something that I have to work towards. I have it on lock. I am sober now. I am disciplined. I don't need to worry about maintaining discipline because I am disciplined. And so essentially what we discover is that there are contributing factors to our motivation, which is a state, right? So you've got these motivational bucks. And it's going to fluctuate. over time. And instead of chasing after becoming a disciplined person, all you really need to do is like keep on making motivational deposits. In the case of sobriety, what it means is like you go to meetings, even if you're sober. You keep going to meetings. Because I see this all the time, you know, in mental health treatment especially, is that people love abandoning the treatment that

works. Like if I put someone on an antidepressant medication and six months later, they're no longer depressed. They come into my office and they're like, yeah, I want to stop the medication. Why? Because I'm not depressed anymore. It's a reasonable request, right? But like, let's understand how you got there. And so if you're experiencing cycles of success and failure, what I really want you all to pay attention to is what are, what is like the state of motivation that, what led to your state of motivation? So like really think a little bit about, you know, when people say like, okay, like I shouldn't play video games. I need to stop playing video games entirely. Whereas recognize that each hour of the day that you play video games, it actually makes like a

motivational withdrawal. So, and this is really dangerous thinking, because if I play like, let's say, Valorant for 10 hours a day or Dota for 10 hours a day, and I think to myself, if I play for eight hours a day, what difference does it make? Eight or 10, what's the difference? I'm not going to, you know, I'm not going to put together my life if I'm playing Dota for eight hours a day. Who the hell cares about 10 hours a day? like eight or ten what difference is them i'm a degenerate either either way and those are the people that don't acknowledge that playing dota for two less hours a day is actually going to boost your motivation by a small amount so i want you all to really focus on the state of motivation and you can

also kind of understand this with with food as well right so like you can think about when you eat like how much do you feel like studying how much do you feel like working and like depending on what food you put into your body, how does that affect your motivation? If I'm like, you know, if it noon rolls around and I ate like six slices of pepperoni pizza, like what's going to happen to my motivation afterward? What happens to my motivation when I drink coffee? What happens to my motivation when I take adderol? So we begin to see that once again, and this is why yogis have a very specific diet, because they sort of discovered something called the Satvik diet. You know, what the Satvik diet essentially does is like enhances the state of your mind so that you're like

highly motivated. And so it's kind of tricky because, like, you know, we think about discipline and laziness, but what we really don't think about is, like, what is the cost of eating six slices of pizza? It's not just calories, and you're like, I'm a degenerate. I don't care about calories. Like, whatever. Like, I'm overweight, whatever. Or you're not overweight. Maybe you've got a botam metabolism and you're totally fine. But what we don't really think about is each action that you take is going to be making a motivational deposit or a motivational withdrawal. And what I encourage you all to do is to really think about the state of motivation. and thinking about how does my motivation get altered, and how do I need to nurture it?

Because it's not a trait, right? It's not like a house that I build and then stays up there. Motivation needs to be cultivated like a garden. Now, I can water it every day and it'll grow and it'll be great. But if I stop watering it, the garden's going to die. So most people that I work with who have cycles of success or failure, essentially, once they start harvesting fruit or vegetables or herbs or whatever from their garden, they stop taking care of it, which inevitably leads to the failure. So start to think a little bit more about motivation as a state

and start to think a little bit about how your diet, how your actions, how you're the company that you keep, how your environment, sort of gives you motivational deposits. And be really careful if you start to withdraw a ton without continuing to maintain whatever brought you the motivation in the first place. Questions. How do I get enough protein with a sativic diet? It's tough.

but remember that the Satvik diet, you can eat tofu and you can eat lentils. Right? So those are the two major sources of protein. But if you're going to be a bodybuilder and you're trying to eat one gram of protein per KG, I think is what it is, you know, that's really hard to do on the Satvik diet. Remember that Satvik people are not bodybuilders. What about discipline? So here's what I'd say about discipline. Discipline is what a high state of motivation looks like from the outlets.

outside. So if you actually look inside the mind of a disciplined person, they're not disciplined. Like, it's not very different from your mind. It's just, I know it sounds kind of weird, but discipline is like what we see from the outside. It's an emergent property. It's not actually a thing. Okay. Other questions. Yeah, so can you provide some practical examples of depositing and withdrawing stuff from your motivational bank? Absolutely. So like I've done, I have, right? So like, playing a video game, what does that do to your motivational bank? Decreases it. Or you're not making a deposit, right? So like if you think about doing a small task like cleaning, cleaning is going to be a motivational deposit and a motivational cost. But generally speaking, it's going to be an upswing.

So if we think about cleaning, this is the way I'd think about cleaning. So cleaning requires, withdraws five motivational points, but gives you a plus two for the next week every single day. right? So what we tend to see is that people who are highly disciplined, like we'll do multiple things. Going to the gym is a minus 10, but is a plus four for the next week. Eating a healthy meal may be like a minus two, but will be a plus one for the, like a plus three for the next three days. Right? So this is how I want you guys to think about your motivational bank. It's like, what is the small task every time I play a video game? Like, if I play one day of Dota, that's a minus two for the next 72 hours.

Right? And then eventually we get to like dopamine detox realm, where if you play that so much, then it's like a pretty bad like minus 30% or minus 50% to all motivational deposits. It's a 50% tax on every deposit that you make. So this is why if you look at people who like, you know, put their lives to together, they do so not by transforming themselves. Right? And even like this is the problem is if you look at like people who become successful and I fall into this camp, right?

I say, oh, I went to India and I found myself and then I became successful. And it seems like a magical like overnight thing. But I went to India at the age of 21 and I started medical school at the age of 28. There's seven years in there of like little successes and little failures that sort of build up over time. So it took me seven years to get on the path to success, let alone another like eight to actually like become qualified to be a decent human being. Okay. Is a Satvic diet going to be vegan? No.

So Satvic diets will include dairy. Actually, unless you take, unless you do like the East Asian version of a Satvik diet, which may be dairy free. Those will probably be vegan. Like if you eat at, you know, a monastery in Korea, like that'll probably be vegan. How does one to overcome more difficult obstacles to gain motivation? Is it just do it? No, so this is my whole point. So the way that you overcome a difficult obstacle is by making tiny, tiny deposits that are going to build up your motivational bank.

Right? So how do you overcome depression? Like, I've seen a bunch of these posts recently where people are like, I cleaned my kitchen today. Does that overcome depression? No. Is it a step forward? Absolutely. So you clean your kitchen one day.

You do your laundry day too. you like clean the living room day three and you go through your mail day four you look at your syllabus day five and each of those days is going to give you like a motivation buff that's like stacking and then what happens is people stack it stack it stack it and then they get to the point they're like

oh look at all this motivation I have now comes the cycle of success and failure because you've stacked up a buff of plus 28 motivation per day that starts decaying over time and then you stop doing the things to take care of yourself and then it all disappears. Right? So I want you all to stop thinking about discipline

or saying like, oh, I took a five-factor personality test and my conscientiousness is low. I'm screwed. Like, that's scientifically that's true. And you can still overcome it. Right? By using motivation buffs, which is the Eastern style. So if people want one really, really simple,

concrete thing to do to make a motivational deposit, it. One day a week, okay? Like, if you have medical concerns or something like that, like, make sure you talk to your doctor, but I'd say one day a week, do a fast that includes fruits, nuts, and dairy, and that's it. One day a week. And water, obviously. So, like, drink as much water as you want to. But, you know, you can still get a decent number of calories, so we're not saying, like, starve yourself, but, like, reduce what kind of macronutrients you take in. Fruits, nuts and dairy. That's it. Yeah. So if you've got, like, diabetes and stuff, you know, don't do this kind of thing, but, okay?

How does this help? It's going to give you a motivational buff of like plus three for the next few days. That's how it's going to help. No veggies. It's weird. I know. Right? So just give it a shot.

So I'm not saying you should do it for a prolonged period of time. You try it for a day and see if you like it. So a lot of people, I encourage all of you all to experiment with your diet. Try to figure out, okay, what are the foods that make me feel more motivated? What are the foods that make me feel less motivated? Start to make adjustments. And I think a good place to start is like, you know, you'll get some amount of protein, some amount of fat, and some amount of carbohydrate. It's a relatively safe thing to do. And if it feels really bad or you start to get concerned or whatever, like if you start to feel super weird, like just eat normally and you should be fine or go see a doctor.

Maybe ask your doctor before you do it. It's probably good advice. Okay. And so I want you all to all pay attention to what's happening right now. So in your life, motivation is a big problem. therefore it requires a big solution. So the other problem with cycles of motivation and failure is that like, see how your mind resists the solution. It's like, oh, that can't be enough. Because the problem feels so big to me that it must have a big solution. And then what happens when you go looking for a big solution?

You never find it, right? There you are looking for the magic bullet that's going to transform your mind. And then you'll be a disciplined person and you will be like one of those people. It'll be a personality transformation. This is why people stay stuck. So you have to experiment. Not all big problems require big solutions. Like someone has been addicted to alcohol for 15 years.

How do I get sober? It's such a huge problem. You go to meetings. You go see a therapist. That's it. It's like four hours a week. Three hours a week, two hours a week, maybe even one hour a week. It's really interesting.

So be careful when you're a month. mind tells you that a solution is too simple or too easy for your hard and complex problem. And what you really listen, I encourage you to think about it in your own life, right? Like when you realize something, you're like, oh, crap, it's so simple. I just didn't realize it. Right? So big solutions don't necessarily require big problems. I mean, big problems don't necessarily require big solutions.

Okay. All right. Is vitamin D deficiency messing with motivation too? Absolutely. So there's, you know, one of the tests that I always run, not always, but usually run for patients of mine who are depressed is vitamin D. So vitamin D deficiency is one of the causes for depression. And so we also know that, you know, supplementing vitamin D or getting someone's vitamin D level back to normal can be a treatment for depression. So this is where in the East, they sort of say that there's seven things that result in health. And one of them is sunlight. And that sunlight is like important to be healthy.

Um, okay. What are the others? Okay, so let me see if I can remember. Sunlight, food, water, air, sleep, exercise, and meditation. These are the seven things that you should do to take care of yourself. If you balance those seven things, you'll be in good shape. So air, water, food, sleep, exercise, sunlight, and meditation. These are the seven things. Right? quality of the air that you breathe or your exposure to air. So that could involve like going for

walks outside or things like that. You know, if you're in a highly polluted country or highly polluted city, like that may be one of the reasons that your health is bad. Right? So they've been saying that in India for thousands of years in China for thousands of years. And now we know that, oh, smog is like bad. It leads to asthma. Right? Pretty obvious. Yeah, I imagine environment is a part of it too. Yeah. So like I think environment is a big part of it. I think in the way that they yeah. So if error is worse than ever, like that's a problem, right? So like this is where, remember, that's what's necessary for health. We're not saying that you have easy access to it. And that's like one of the worlds, like the problems of the globe and human beings in society in

general is that like our air quality is decreasing. So yes, that's a problem. And that's why like people will get sicker, right? So do what you can to clean your air. And if, you know, if it involves like going out, leaving the city and going for a hike somewhere, like, that's great. Okay. Yeah, so you can supplement vitamin D via pill form, but I think sun's probably better. There's some evidence that when you take artificially produced vitamin D, that, you know, So if you look at most vitamins, what you'll see is that they have like hundreds of percentage or thousands of percentage of your daily requirement. And why is that? It's because generally speaking, different vitamins when produced in a synthetic manner have all the different isomers. And the different isomers have different biological activity.

So when you synthetically make a chiral compound, you'll create like an even number of isomers, right? This is like chemistry or organic chemistry 101. But when your body actually creates vitamin D, it's going to create only the isomer that the receptors will use. We'll get to this too. Why I don't say things like this off and on stream. Okay, so let me put it to you this way, chat. So we'll explain this. Our body has enzymes, and enzymes have chirality or what is called like handedness.

Okay? So if I look at my right hand and my left hand, the features of the hand are exactly the the same. The pinkies on the outside, thumbs over here, there's a ring finger over here, a middle finger and an index finger. If I were to describe the hands, they're identical in terms of structure, right? But there is a right hand and there is a left hand. They're like opposite. So these are like, so our body has, even though like if you kind of think about it, if I were to tell you to assemble a hand, if I took 50 people and I said, you know, assemble five, it told each person to assemble a wooden hand, roughly speaking, half of them would make right hands and half of them would make left hands. But there's a handedness to our hands and there is a handedness to enzymes and compounds that our body makes. So, and essentially what happens is like when you make something in a lab, you get an even amount of all of the isomers. And then when you package it into a supplement, like essentially our enzyme

is like, you know, a right-handed glove. And so if I create, you know, 50 left hands and 50 right hands, only half of them are going to fit into the enzyme and like activate properly. So that's what an isomer is. So our body has like a certain like right handedness to it or left handedness to it of enzymes of receptors of all of the above. And so this is why synthetic vitamins, you know, we'll sometimes have 200% because like isomerically like they may not be enough. Whereas if you get it made by the sun, it's going to be, you know, 100% of what your body produces is going to be like what your body recognizes. Now, let me ask y'all, was that explanation?

So sometimes I'll simplify things on stream. Does that help or not help? You guys like that kind of explanation, or do I lose y'all? Okay. So, for those of you who still don't get it, let's do this real quick. Okay. So I would say just check out the Wikipedia article on chirality. Okay?

All right. Let's look at the Reddits. Okay, so the first thing that I want to do, so I'm going to actually ask you all a question. Okay, maybe if there's a mod or on, we can do a poll. So we've got an option. A couple weeks ago, I looked at a post talking by someone who posted about, you know, Ayurveda is not your Pokemon type. It's like a framework for introspection.

And I sort of cited some evidence and suggested that Ayurveda is more than a framework of introspection and that there's like actual genetic basis for it. And then that comment sparked a number of different posts. So we've got two options today. One is that we can talk a little bit about alternative medicine, some of the caveats of Ayurveda, like how to understand alternative medicine, what really Ayurveda is and what isn't like maybe some safety issues around alternative medicine.

We can also, I'll explain a little bit about like what my personal experience and take is on alternative medicine and then also scientifically, like where I think the field is. Or what we can do is look at, we can look at like different Reddit posts that are not related to that. So it's like we can either teach more about CAM.

It's not necessarily Ayurveda. It's more about complementary alternative medicine and science. I'm not going to go into a lot of detail about Ayurveda specifically. It's going to be more a little bit more about like my personal journey of like, you know, how I became biased towards Ayurveda and how I think about alternative medicine. Okay, this is really close to 50-50. All right. So this is, so it looks like alternative medicine wins by a tiny amount. So the first thing, so we're, okay, let's talk about that.

So the first thing that I want to say is that, you know, the real challenge with streaming is that I have a balance to strike between depth. and breath. And what we tend to find is that, you know, going super, super deep and explaining a lot of nuances and caveats and details, like the chirality piece, generally speaking, with the feedback that I've received is that most people don't want, like, too much detail. Right? And even if we think about this one, like, most of the polls that we get are like 70% in favor of something. So this is one of the challenges that I face, which is like the more detail that I go into, the more like academic I become. and talk about caveats and this kind of crap, I feel like the more people I lose. And that's part of the reason that I sometimes oversimplify things. So let's go ahead and start. I'm not going to read all these posts

because they're good, but they're long. So let's start with this. We're going to take a couple look at these, and then I'm going to sort of share a couple of thoughts, okay? Please consider these important caveats when discussing or researching Ayurveda. Even in the Dosha system, people or individuals take care about generalizations.

Fantastic. The scientific evidence for Ayurveda has not reach the standard of being accepted by most scientists. Also, generally speaking, fantastic. And Irobedic treatments are not well regulated and you should be very careful, especially about medicines, many of which have toxic heavy metals. Also fantastic. Okay. So this kind of person goes on to say a lot of good stuff. Okay. It turns out that they sort of point out that the paper that I cited is a terrible paper. And they are actually correct. It is a terrible paper. It was a terrible citation to show on stream. And we'll, I'm not going to get too much into that, but they're spot on.

So I really appreciate them for correcting me in the future. When I talk about genomic analysis, I'm just going to show a different paper. The challenge is I've got like 100 papers on this. So I just kind of pick some that, not really at random, but I think I need to be more careful about that. And so then they sort of talk about, you know, they take strong exception to overwhelming genetic evidence, which is a fair point. We'll kind of get to that in a second. So, like, this is, the point is that this is a fantastic post. I encourage all y'all to take a look at it. I think that the person brings up a lot of criticisms, which I think are really fair.

You know, I still will get to why I believe what I believe, but I think their criticisms are really good. So this is another one. And so, that being said, I find myself very skeptical of the claims he makes regarding Ayurveda. all the papers are from journals dedicated to alternative medicine. So we'll talk about that point in a second. Until there are studies from more reputable journals like yoga and meditation have been getting more recently, I don't think you can safely claim the three dosha's map onto genotypes,

which is also a good point, which we'll get to, okay? So, like, we'll talk about what is a reputable journal and things like that. Dr. Kay, I'm considering pre-ordering. Oh, let's upfoot this one too. but I don't fully buy into the emphasis on Ayurvedic practices, how much of it is based on this? So the short answer is that, you know, I can go back to this. But essentially, like if you look at Dr. K's guide, it goes up here. And these are the videos on Ayurveda.

So there's one, two, three, four, five, six, seven, eight. So eight out of 78 videos are going to be related to Ayurveda. Okay? So the majority of it isn't highervada. And so I want to emphasize once again that the reason we made the guide the way that we did is because we recognize that within this population, there's a spectrum of what people are interested in and what they're willing to accept. So they're going to be the people who are a little bit more conservative, right, from a five-factor model are going to be a little bit lower on the openness scale, which is totally fine. and then they're going to be the people who are like the hardcore yoga hippies, right? And they're going to be like, science is bad.

And I don't need science. So like what we're trying to do is I'm trying to share my perspective on something like depression. And I think the real value is that like, or what I've come to appreciate about depression is that looking at it purely scientifically is not as useful as taking a spiritual approach to it. And looking at it purely spiritually and like ignoring. what science has to tell us is also like not that effective. So generally speaking, there are a lot of different approaches and what I really view our job or what I try to do is give y'all different approaches. It's not to give you guys truths, but to actually give you all hypotheses, right? And then for, for you, like for example, our motivation lecture today, like go and try it out and then y'all tell me,

hey, this is stupid. Or, hey, actually, this really helped me. So now let's talk a little bit about alternative medicine. So let's just lay out a couple of different things. So the first is that when it comes to criticisms on the internet, there's an inherent power dynamic between the person who's offering the criticism and the personality. Right. So like, I have the option of reading through each of those posts and kind of picking them apart. And I'm the cult leader. So I'm going to get like more support than the people on Reddit. Right. So there's a very selective opportunity for me to like, engage in discussion. So I want to acknowledge that inherent power dynamic at the get-go, and it's one that I'm going to do my level best to avoid. So the first thing that I want to say

is that, like, I don't think that I am more knowledgeable than Reddit. So I encourage all to check out those posts. I thought all of them were good. I think those people are good. Please don't get upset with them or anything like that. In fact, I think that their posts elevate the level of discussion, which is ultimately how this community is going to find the best answers. the best answers from Healthy Gamer are not going to come from me because I don't have all the truth the best answers are going to come when I say

hey guys I think this is true and then y'all are going to prove me wrong and in that process we will get to the truth of it right we'll find our answer not out of my truth but where my teachings fall short and that's really where like

the money's going to be do you guys get that like that is how science proceeds science proceeds by one person coming up with an answer and someone saying actually it's not quite like that there's this kind of approach so I think this is a really good discussion so and I'm sort of I you know if people think that I overstep in terms of the power dynamic and stuff please call me out for it I was debating whether we should have like some kind of discussion but then I thought that that that you know that may have a power dynamic so I don't know so I'm just going to talk about I'll turn to medicine okay okay so I'm going to share my story

right? So I was generally speaking skeptic growing up, you know, was pretty like scientifically oriented, still am. And I went to India at the age of 21 and thought that like all this yoga stuff. Like I remember learning yoga in summer camp when I was growing up and I was like, eh, like whatever. You know, like meditation yoga. Like, what's the big deal? It's just like exercise. And then I actually did yoga for a while and it's like, wow, this stuff is amazing. Like it transformed, you know, the way that I thought, the way that I understood myself. I thought it was really fantastic. And so, Being a scientist, I then went and researched it. So I got my first job as a research assistant in India, or like at the ashram, really. So it's not, I don't know if it's really a job. But I started like, I asked people like, is there science behind this stuff? And they said, actually, yeah. So there's a research lab nearby where they're doing EEG analysis on people who are meditating. So I went and I joined that lab and I learned a little bit about EEG, started to learn a little bit about neuroscience, things like that.

And so I was like, oh, this is cool. Like it seems like there's some scientific stuff. And so I was in India and at the ashram, you know, there were lots of people. Like some people were into energy healing and some people were like, you know, into this or that or whatever. There were some people into Ayurveda, some people into homeopathy and things like that. So then I started my journey. And over the course of that journey, I don't talk about this much, but, you know, so these are like, here's a list of the things that I became certified in or learned how to do. I am a certified crystal healer.

Okay. So this is going to be cool. If you guys want citations. So you guys are about to see Dr. Kay's rock collection of crystal healing. You guys want to see my crystal healing stones? So I have a set of

stones that are supposed to be used for crystal healing. I acquired these stones 17 years ago. And so I went to a crystal healer and I said, hey, I hear you're a crystal healer. Can you teach me how to be a crystal healer? And they said yes. Okay? So they like, they like offered, you know, I

bought these stones for crystal healing. I was like, all right, let me learn this crystal healing business. And then, like, so I started looking at the science behind it, and then I sort of realized, like, hey, you know what? I don't think this is a real thing. And so then I went and studied with a lot of other people. So, like, I went to an energy healer, right? So I'm a certified Reiki healer, chat. I also learned Bachflower remedies, if anyone has even heard of that. And then let me just see if I've got other... Yeah, so like I studied all kinds of stuff, right? So like, I studied...

Call Pepper's Medicine. Right? So the practice of Western holistic medicine. So I studied a lot of different stuff. And what I found is that, like, most of it doesn't work. Right? Or if it does work, so energy healing is a good example of this. So if it does work, it doesn't work consistently enough.

And there's like insufficient. regulation to be reliable. So I also studied with like homeopaths, for example, naturopaths. And there's a reason why I propagate Ayurveda over the rest of that crap. Now, you can still say that, you know, the threshold for Ayurveda is not met, which is fair. But in my mind, like having studied a bunch of this stuff, like there are some systems of medicine, which I think have real values. So like, and I think Ayurveda and traditional Chinese medicine are good examples of this. So I don't know if you guys have heard of this,

but there's a kind of drug called a statin. Okay? So a statin is a blockbuster drug. So what happened is a pharma company developed a statin, which are HMG-CoA reductase inhibitors, and they lower your lipids. So these are like really, really strong evidence for, you know, there's like, let's see if I can, New England Journal of Medicine.

statin, right? So, like, this is fantastic. So this is a Cleveland Clinic. Where's Nedgeam? Here we go. Okay, so see reactive protein levels and outcomes after statin therapy. So the New England Journal of Medicine is probably the most reputable journal out there. So the way that journals sort of, the way we determine how good a journal is is by something called impact factor, which is the more that your journal, gets cited by other journals, like the higher the impact factor of the journal. So what science do other people rely on? That's the quality that we sort of say when we say reputable journal or not reputable

journal, it tends to be on impact factor, right? So we have the New England Journal of Medicine, which is like, wow, this is really fantastic. Like statins, like, they work really well. They're the standard of care for cardiac care. Right? And so we kind of say that, okay, so statins are a discovery of like Western medicine, right? Let's see. Okay. So, it turns out that statin drugs are actually a purified form of a Chinese medicine called red yeast rice. Okay? So for like thousands of years before Western science discovered statins, like statins have been used to treat cardiac conditions in, and this is Wikipedia, right? So you guys can decide whether you want to trust.

this or not, have been used to treat like cholesterol conditions in China for like thousands of years before statins developed. So this is kind of an interesting, so this is essentially what I discovered is that like there are some systems of medicine which actually like mindfulness is another great example, right? Because like people have been doing meditation in in like Indian China for thousands of years and now we say it's a scientific treatment. But like it was a scientific treatment long before Western science sort of verified it, right? Or it wasn't a scientific treatment. It was an effective treatment long before we verified it. So what I really discovered is that when you look at things like energy healing and you look at things like homeopathy,

when you look at even some things like chiropractic, what you really discover is that there are different systems of medicine and some seem to be like very, you know, are giving us like good options. So another example is like Ashwaganda. Okay, so like, let's see if they have on Wikipedia. Any trials here? Okay, so we're going to skip past Ashwaganda. Let's let me think about one that we'll find more reliably. Oh, here's a good one. Okay, so Kerkumann, hopefully we have this on Wikipedia. So, so it looks like Kerkumin has been, this is interesting. I know this guy. Uh, so a, okay, so like it looks like there, you know, the evidence of curcumin's effectiveness, I think it's like pretty effective. So I think that there's been a lot of, you know, misconduct in the scientific community,

uh, about the healing powers of curcumin. Um, but generally speaking, I think there's like a substantial evidence that curcumin is a cent, like, does have anti-inflammatory properties and stuff like that. That's been pretty well demonstrated. So this is another example of essentially like an Ayurvedic medicine that has been tested. And in some cases, found to be, you know, filled with research fraud in terms of the Western verification. But I think that like there's decent, you know, studies and stuff that show that, you know, it doesn't have some effect in cancer. So I think that essentially the reason I kind of settled on Ayurbetic medicine and traditional Chinese medicine. So like a few years ago, you know, actually maybe around 2005 or 2006. I kind of sat down and I looked at all this different stuff that I learned and I realized like, oh, actually like, I think most of it is unreliable, but it seems like these two Western, these two traditions of Ayurveda and traditional Chinese medicine seem to have like a decent amount of stuff behind them.

So then I kind of spent some more time studying Ayurveda. I have also found a lot of like clinical impact in terms of like when people adopt Ayurvedic diets and balance their dosha's and stuff like that. So in my experience, I go into more details on Dr. K's guide about this. But in my experience, my, is anecdotal, okay, so there isn't research around this. It's just my clinical experience. That when I have patients who go on proper Ayurbedic diets, it's easier for them to come off of medication. It's just an anecdotal observation. Now, let's talk about the caveats to that. So the first is that it's possible that people who are able to go on a diet and have the mental

wherewithal to stick with a diet. are mentally healthier and therefore will require less medication, right? That's a very important like caveat that we need to think about. So it may not actually be the Ayurvedic diet at all. There may be a selection bias that people who are more likely to go on, who can stick with a diet, are less likely to need medication in the first place. So for every conclusion that I offer y'all, there's essentially like a caveat to that. And then there's a caveat to that too. This is all stuff that I've thought through, right? So when I look at my patients and I'm like, Hmm, is this person just more capable of doing stuff than someone else?

Or is the actual diet what's affecting them? Right? So it's interesting. It's challenging. So this is why alternative medicine is tricky. So then what happened is I studied Ayurveda for a while. And then you can say like, so a lot of people will say I'm biased towards Ayurveda. And so that's like kind of an interesting, you know, point to make.

So am I biased towards Ayurveda? Probably, right? So let's just think about this. Like what are the things that lead to bias? So Ayurveda is an Indian is a system of Indian medicine. And I myself am Indian. So there's a decent chance that I have a cultural preference and cognitive bias towards Ayurveda.

Now, the caveat to that is that like Ayurveda was just easier for me to study because like I didn't know anyone in India. I mean, I didn't know anyone in China. But I knew a bunch of people in India and I kind of speak the language and stuff. So like studying that stuff was just easier. So the reason that I picked that over Chinese medicine, I actually learned some Mandarin. I shui she a day han Yu. You know, I tried to learn Mandarin

so that I could read texts on Tai Chi instead of texts on yoga and, like, you know, read a couple of texts, but what I really found is it was really hard for me to read Chinese. And so am I biased towards Ayurveda? Probably. But this is also where I, you know, I'd like to push back a little bit against that because I think that, like, the conclusions that I drew on Ayurveda,

I drew for a reason. I studied a lot of different. systems of medicine and really settled on like yoga meditation and Ayurveda because I think they have the most science to support them. So now let's talk about science and alternative medicine. So, you know, there are a couple of things here and I'm just going to point, you know, I think this person made a good argument. So I'm going to try to show this, right? So let's take a look at this. Okay. Let's just think through this for a second. So I still might find myself very skeptical of the claims he makes regarding Ayurveda. The papers he cited yesterday,

didn't alleviate any skepticism. All the papers are from journals dedicated to alternative medicine. Okay. So that's an interesting point. Okay. And it's one that this person brings in here. Okay. I'm trying to find. Okay. So I do not think that is true today that no one is investigating Ayurveda and that's why there are no high quality papers. There are hundreds of papers published yearly within India and an Ayurveda friendly alternative medicine journals. But honestly, my impression of their scientific qualities that they are poor. Right? So this is... Oh, hello?

Yeah. Sorry. Okay, thanks. So, like, this is also a good point, right? So that there's higher quality that a lot of the journals that publish stuff about Ayurveda are Ayurvedic journals. And so you could say that these Ayurvedic journals have a bias, which I think is probably, is true. And at the same time, there's sort of like a counter argument to that, which is that, you know, if I'm, if I'm going to do research on pharmacology, where is that research likely to be

published? It's likely to be published like in a pharmacology journal. So you could say that pharmacology journals have a pro-pharmacology bias, which is like sort of true. You could say cardiology journals have a pro-cardiology bias. You could say gastrointestinal journals have a, you know, pro-gastrointestinal bias. There's a slight difference. There's actually an important difference there because one is an intervention and one is like an organ system. So it's like what does a pro-gastro-gastro-Gi bias even mean? So like it's a good point that, you know, a lot of this research is in these Eastern journals

that have a bias towards that thing. So this is where like personally having read a lot of these papers, here's my conclusion. The first is that there is more academic dishonesty in Indian in Chinese journals than in Western journals in my overall approach. This is what I would say, is that there's more dishonesty. I've seen just flagrant dishonesty in Eastern academic journals. I'm not saying that they're all like that, but I do think on average it is worse. And just because on average it is worse does not mean that there is not good science being done in those two countries. and that those journals should not, should be completely discredited.

And when you kind of say, like, yeah, they're published in alternative medicine journals. And yeah, that's because like, that's because it's sort of still considered alternative medicine. I'm pretty sure if I did a very good trial on Ayurveda and submitted it to the New England Journal of Medicine, I'm pretty sure it would not get published, right? Because like the editors there are going to be like, what is this? You know, it's kind of interesting. So you can make an argument for publication bias. you can make an argument that those journals are biased,

and I think that's fair. But I personally, so this is just my opinion, right, I think that just because a journal is sort of has a pro-Iro-Irobeda bias, does not negate on face value the research that is published in that journal. So if we're going to say that, you know, Ayurvedic research to discount all of those journals because we assume that they're biased, which I do think they're more biased than Western journals,

for sure. I also think that the quality of science, that they do is worse. But I think we're actually doing ourselves a disservice. And based on my reading of the literature, I think there's enough good stuff there to kind of warrant, like, that's what I sort of base it on, right? So, like, looking at, you know, Reiki, like, I've looked at, like,

Reiki papers as well, and, like, there doesn't seem to be a whole lot there. So Reiki appears to improve quality of life and is relatively, like, related to the placebo effect, but it doesn't look like there's any kind of, you know, biological plausibility for, like, how Reiki actually functions. You know, people have been looking for chi and prana for thousands of years or a hundred years in science and we haven't been able to find it. Whereas if you look at stuff like red yeast rice, like that's a real thing, right? Like a drug company took an ancient Chinese medicine, purified it, patented it, and called it its own. And like, that's a blockbuster drug.

So is there value to doing that? Do I think that that drug company is evil? No, because I think that like there's value to, you know, really figuring out what works and what doesn't work and purifying the compound that's responsible for it and, you know, doing high quality studies on it. But in my sense, when there's a tradition that essentially gave us statin drugs, in my mind, that tradition increases in value, in my mind. Now, you can say that's inappropriate. Maybe that was a one-off and you shouldn't increase the value of that tradition. But like, when there's a tradition that gave us three things, right? So like, ancient India was like, hey, by the way, there are three things you can do to take care of

your health. One of them is a thing. One of them. is meditation. One of them is yoga and one of them is Ayurveda. And when we have two of those, two of the things that the tradition is given that have seemed to work out really, really well, it gives me some amount of faith or bias absolutely in the Ayurvedic tradition. Now let's talk a little bit about Ayurveda. So the first is that you'll, y'all will notice that when I talk about Ayurveda, I don't really talk about Ayurbedic herbal formulations. There's a really good reason for that. okay. So I'll talk a little bit about this in Dr. Kay's guide, but, okay, these are fantastic. So this point is excellent. So I would like to give extremely strong warnings against buying any type of off-the-shelf Ayurvedic medicine anywhere in the world.

There is very little regulation concerning the production of Ayurvedic materials. There is a particularly problematic line of Ayurvedic theory called Rasa Shastra, where minerals are combined with herbs to make Ayurvedic medicines. So I completely agree with this, which is why I wrote a white paper to the FDA about why Ayurvedic medicines and herbal medicines from external countries need to be regulated. Right? So I completely agree with this. It's an excellent point. And this is where, like, Rasa Shastra is just the beginning of it. Okay? So like if you guys really want to understand why you should not take herbal formulations. So this is what Rastashastra says. So there's a branch of Ayurvedic medicine called Rastashastra.

And what Rastashastra says is that there are mercury, arsenic lead, gold, silver, can be used as medicines. And there's probably some evidence to this because we know that these heavy metals are cytotoxic. So my guess is that what Rastashastra essentially, like, this is where I extrapolate, okay? So I think what happens is there are probably autoimmune conditions. And what they give people in autoimmune conditions may be like heavy metals because it kills the growing white blood cells. And you could have a therapeutic benefit there. If you actually look at the texts on Rasa Shastra,

what you'll see is that the Ayurvedic folks will say, if I take lead and I boil it in milk and ghee for a certain amount of time with certain herbs that removes the toxicity from it. That's like what's in the Ayurvedic texts, okay? If you guys really want me to, I can pull some. something off the shelf and find you a reference. So that doesn't hold biological plausibility to me. So like I don't recommend Ayurvedic herbal medicines because like that's scary, man. The interesting thing is, and this is weird because I know this person was criticizing me, but now I'm not only

going to support their point, I'm going to further educate why are the Ayurbetic medicines are dangerous. Irobedic medicine, so if you look at, I don't know if this person actually read these, but I'm pretty sure that if you look at these papers, so this person is, is saying, oh, Irobedic Rasa Shastra is like using, Rasa Shastra is using minerals as treatments, right? But if you actually look at these paper, I'm pretty sure I know this paper. Yeah, this is Richard Saeper, okay? So this guy was like literally, like my first job at Harvard was at the place where like this guy was also faculty.

So he's like, was a friend of one of my main mentors. Okay? So the interesting thing is that this study, which looks at heavy metal content of Ayurbetic herbal products, is not just looking at Rastashtra. So this is another important point. So you may say, okay, if Ayurbedic medicine says Rastashtra says use heavy metals for, you know, for therapeutic purposes, am I okay taking herbs that have no Rastashtra? And the answer is no, that is unsafe. And why is that? That would be weird.

How would you rationalize that? If it's not Rastashastra, shouldn't it be safe? No. And that is because heavy metals contaminate herbs. So where are these Ayurvedic medicines grown? A lot of them are grown in India. Where are they grown in India? They're grown in places that have industrial dumping nearby.

And so one of the things that I explained, like literally wrote a paper about this to the FDA. So if you look at heavy metal in Ayurbetic medicine, part of is it Rasa Shastra. and this is true of like things in China and India in general. You have to be really careful because they have a lot of industrial dumping. And if I have groundwater that has lead and I have like lead in the soil and crap like that, it gets uptaken by the herb and will actually be in the herb despite the herb actually being like Ashwagandar or red yeast rice or whatever. So you have to be really, really careful about taking Ayurbetic medicines.

I completely agree with this person. And this is the challenge that I personally face is like I don't recommend Ayurbetic medicine. like I don't say, hey, you guys should go out and take herbs. Because if we start talking about herbs, there's a whole bunch of stuff that comes with it. There are caveats and nuances that come with all of the stuff. So I completely agree that, you know, there's a reason why we don't recommend like Ayurvedic medicine on stream, right? There's a reason why we sort of go for the pick your Pokemon type, because that's the stuff

that generally speaking is safer. So when I'm sort of talking about Ayurved, I'm sort of talking about like Ayurved and its impact and the mind. and I am absolutely using it as a framework for introspection, but I also think that there's good science behind it. You can sort of say, okay, well, those are like topical journals that are going to be biased towards Ayurveda, but that's sort of like a very interesting selective reasoning, right?

So if I say that, you know, the world was made 6,000 years ago and I don't really trust science because scientific journals are going to have an anti-religious bias, therefore I'm going to discount scientific journals because of their anti-religious bias, and then once I discount the anti-scientific journals, like my point stands. It's kind of an interesting thing, right? So if there's actually research being done in these journals,

which we have to acknowledge probably have, or undoubtedly have a pro-Iro-Irobedic bias, it doesn't necessarily mean that we should discount all of it, right? And so this is where we get to some really interesting things, which is, and the last thing that I'll kind of share is, it gets even more complicated than this, okay? So I don't know that we will ever see a solid Ayurvedic public, in a highly reputable journal for a medical reason. And here's the reason why. So what's the gold standard?

And so now I'm going to ask you guys a couple of questions. Okay. What is the gold standard of research in Western medicine? Okay. Excellent. Randomized controlled trial. Can someone please explain to me what what is the scientific basis behind a double-blind randomized control trial? Sure. What is the scientific basis behind a randomized control trial? Why do we hold that as the gold standard? Hold on a second. Hold on. Okay. Objectivity removes bias. Remove statistical noise. So like this is interesting.

Okay. So what a randomized trial aims to do is to remove any individuality from the trial. Right? So why do I randomize things and have a control group? It's because I want to remove age. I want to remove gender. I want to remove any kind of individual factors like race or things like that. I want to remove all of the individual factors.

So all I'm left with is the pure disease process and the pure treatment. So I want to see as tight of a correlation, I want to just test the disease outside of people. So I'm going to randomize, right? So that's how we're going to remove the noise. and therefore I will see whether the treatment works for a person. So this randomized controlled trial is the result of a system of medicine that assumes that a disease process is independent of a person. You guys get that?

Like those are tied hand in hand. I want to figure out how to treat depression, not treat a person. And so this is what's frustrating. It does make sense. It makes a lot of sense. It makes great sense. right? It's really good. So it's a fantastic approach for figuring out how to treat a population. So then what we have, I know it sounds kind of weird, just bear with me, okay? It's like,

makes so much sense and is so baked into our psychology that like it can be hard to understand a different way of thinking. It's kind of like non-Euclidean geometry. Okay. So I'm just going to share this is my perspective. Okay, you guys, I don't have to be right here. So if there's a paper that says SSRIs are effective for depression. And a patient comes into my office. Will an SSRI be effective for that person? And the patient has depression. But hold on a second.

We have so much evidence that SSRIs are effective for depression. Doesn't that mean it's going to be effective for this person? But hold on a second, guys. Like, wait, wait, hold on a second. But there's all, I'm telling you guys, there are papers in the New England Journal of Medicine. There are so many papers that show that SSRIZRs. our eyes are effective for depression. It meets the highest standard of Western evidence.

There are Cochrane reviews. It is the standard of care. Doesn't mean it is effective for a person. On average, yes. Is it effective for this person? So this is the problem with Western medicine. Okay. So I'm not saying it isn't great, right? So the other key thing to remember, chat, is I studied all this alternative medicine and then what did I do? Do you all know what I did after studying all this crap in India? What do I do next? Who knows my story? I went and became a medical doctor. Right? I went to allopathic medical school. Okay?

So here's the downside of the RCT, is that it removes all individuality. And if you have a system of medicine like Ayurveda, that assumes that treatment has to be tailored to an individual, the second you create an RCT, you destroy the majority of the therapeutic value of the Ayurvedic tradition. So this is where I think if we want to see a really good paper on Ayurveda, we shouldn't do RCTs.

We need to do cohort studies. The best evidence that we're going to find of Irobeda, because the RCT is like philosophically the antithesis of how Ayurveda approaches medicine. Ayurveda says that no treatment can exist outside of a person, that there is individuality within the person, and Western medicine is sort of moving in this direction too, which we'll get to in a second.

But that essentially, like, you can't create a treatment for a disease, that a disease must manifest within a person and there are individual factors within the person which will cause that disease to manifest in a particular way and that treatment of that person requires not just addressing the disease process but involves addressing the individual like manifestation of the disease within the person.

You guys get how that's very different from Western medicine. Right? And so I'm not saying one is like better than the other because I think each one has advantages. So let's think about the downside of the Ayurbetic tradition. The downside of the Ayurvedic tradition is that there's like little consensus. Because we don't know on average what works. Right?

Like we have a bunch of individual people with a high degree of variability of their treatments, their diagnostic processes, etc. So we don't really know, like it's hard to tell, like is a field whether this stuff is like good or not good. On the flip side, we have Western medicine, which is really, really good at, like, looking at populations and figuring out what's good for populations, but it's actually quite poor at determining, like, what, if I prescribe Prozac to a person, what's going to happen to that person, I don't really know.

But that's the direction that Western medicine is actually moving in. It's actually moving closer to Irobeda, because now we have this, you know, field of emerging personalized medicine. And so a good example of this is there are some companies that I've used from time to time. They don't seem to be great yet, really, but where, you know, where you, you know, you can actually perform genetic analysis on a patient to see how they will respond to a panel of medications. And so what these companies essentially do is like we don't know, you know, we know that on average, SSRIs are about the same. But as a clinician, we know that there's a high degree of

variability in terms of which SSRI you prescribe and how someone will be able to tolerate. So like our system in psychiatry is if someone comes in with depression, give them an SSRI. If it doesn't work, give him a different one. And if that doesn't work, give him a third. And if that doesn't work, then give him something else. That is like literally the sequence of events. And like, why is that our evidence-based procedure? It's like how, what, like, it's like try A. And if that doesn't work, pick something else and then pick something else. And if that doesn't work, then give them a different class. And so now what's happening is we have these like companies, right, where I can do genetic analysis and the company will tell me, hey, this person is like a high metabolizer of this drug.

so it's unlikely to be effective, and they're a low metabolizer of this drug, it's more likely to be effective, and they're a very low metabolizer of drug number three, they'll probably get side effects with this drug. So we're moving more towards a personalized thing that is stepping away from the RCT. You guys get that? Why do trial and error, though? Isn't that dangerous? Because science tells us to do trial and error. And is it dangerous? Absolutely. like so when this person asks isn't that dangerous why do trial learners because that's what the evidence-based standard is and that's exactly the weakness of Western medicine is because Western medicine is not personalized it works great on populations so this is now we get to a tricky thing right so like this is what

the standard of psychiatry is like if you go to a psychiatrist and you have two psychiatrists and one does evidence-based practice their patients will likely do better on average than the one who does not do evidence-based practice. And at the same time, there are a lot of patients in there that are going to kind of get like rolled by the system, which is what our system of medicine does. There's a system to it, right? And this is my personal experience with prescribing SSRIs. We'll get to a couple other things in a second. My personal experience is that for a third of patients, it's revolutionary. It really works the way that it's supposed to. For a third of patients, it seems to help some, but isn't really, you know,

isn't that big of a deal. For a third of a patient, it really doesn't do anything. That's just like my anecdotal experience. And now if you look at, you know, all of the studies that for such a long time, we're saying SSRIs are like, Prozac is the wonder drug, right? Like everyone needs more Prozac. You know, even now they're like reports from the World Health Organization that we need to be prescribing more SSRIs. And now there are also papers that have come out where that have sort of shown that actually like 70% of the benefit of SSRIs are non-pharmacologic. Okay?

How do you all understand that? Like, what does that mean? But hold on a second. If 70% of prescences or placebo is like, how come we have so much evidence that it works really well? What do you guys think about that? So this is the other interesting thing.

There are also biases in Western medicine. I'm not going to compare because I think really there's more academic dishonesty. I've witnessed more academic dishonesty in India than I have in the U.S. But here's the other thing. I think the folks in India, I want to say on balance, at least in terms of my exposure, I don't think they're as rigorous or as good of scientists as the folks in the U.S. Now, here's the problem.

So if you've got better scientists in the U.S., what do you think that does for our studies? Let's just think this through, okay? Okay, so hold on. Hold on, hold on, hold on, hold on, hold on, hold on, okay? So, okay. So now I'm going to share with you guys something little, like, it's a secret, okay? I'm going to share with you guys a secret. So there are companies out there that provide scientific subjects, right?

You guys know this? Like, there are companies out there that provide scientific subjects for studies. Like, you can sign up to be a subject in the study, right? So there are companies that have studied and figured out which people, so out of all of their recruits for scientific studies, a company figures out which ones are placebo responders and which ones are placebo non-responders. So they figured out which people are more likely to have a placebo effect and which people are less likely to have a placebo effect. Then what they do is they take all the people who don't have placebo effects and they go to a scientific study and they say, hey, we have a bunch of placebo non-responders. This will remove the placebo effect from your study. What does that mean about the study that's being done? What is it going to show?

Once we remove placebo, what's it going to show? Hold on a second. Let's think through this, chat. It's a good study then. That's exactly the argument they make. This is the right answer. Biggest drug effect. You are correct.

If you remove placebo on paper, isn't that better because we're removing the placebo effect. More effect, more extreme. Then I take it to, so this is like, guys, I'm telling you, this is happening at the highest levels of medicine. Okay. If I take a group of placebo non-responders, I'm going to show a bigger effect. What's that going to do to my likelihood of like publishing in the New England Journal of Medicine? Eureka, it works. Exactly. Because I'm a good scientist and I have now removed the effect, right? And it's all solid science. You will look at the medicine. You will look at the method section, and I know this is kind of interesting, do you guys know, have you all noticed that

in the method section, they don't tell you how people were recruited? Like a lot of method sections will be like really vague about where the patients come from. It's interesting. Okay. So now the question, so now we're going to get advanced, okay? So we're going to amplify our effect size because we're removing the placebo effect. If we remove the placebo effect, that means that the control group is not going to have a placebo effect. So, like, we're going to amplify the effect of the drug, right? But that's going to be real because we're removing placebo and placebo is bad. So then the question is, once the drug comes to market and, like, Prozac, or like, whatever, fluoxetine, or whatever your SSRIs, hits the shelves.

And we say, like, oh, my God, it's a landmark drug. Look at this gigantic effect size. It's going to be awesome. What is the external validity of that study? For those of you who know what external validity is. the external validity is lower, right? So what the, so there's a concept in science that external validity is, if I do a study, it's like a controlled environment, right? So if I do a study and then I take that study, if I, it's a controlled environment. So the external, the higher the external validity is, that means that the controlled environment mirrors the real world. So the higher the external validity is, the more likely the study results will apply in a real world. setting. Okay? And so essentially what it's doing is shattering the external validity. And this is why we had so many papers about how awesome SSRIs are. And then decades later, it's like, by the way, 70% of his placebo.

It's like how did that happen? I want you all to really think about this, right? So if you, like, you can say that, you know, Eastern medicine is, you know, they're not as rigorously scientific as we are. But there's a very dangerous assumption there that that means that our met like the end result is better. Whereas what I've seen is that it's complicated because what's happening is like we have so like we have a different kind of like academic dishonesty that goes on in the West. These scientists are so damn good that they figure out exactly what's in the rules and what's outside of the rules and they tweak things to be like like completely good science. In fact they make the argument that we're reducing the placebo effect. That means that our science is cleaner.

We're removing more individuality from the equation. We're removing more placebo effect. And they're absolutely amplifying the effect size, but it's not like they're doing anything bad, right? The reason the effect size is better is because we're removing placebo. And then the external validity of the study goes down. And so then what happens is you end up like this, where like a blockbuster drug came out.

Right? Like, oh my God. Hey, did you all know that there's an awesome pain medication called Oxycontin? Oh, wow, this is awesome stuff, man. It's a long-acting opioid that is not going to be as addictive. Because it's not short-acting. It's not like morphine. People aren't going to be able to get high over it, yo. There's really good science behind this.

We have a lot of people that have signed on. It's FDA approved. The level of scientific rigor is through the roof, man. It's so good. It's safe. I promise you, look, I have the studies to prove it. Right? So this is the really scary.

thing about having really, really good scientists is that they're really, really good at figuring out how to work the system. Now, there's still people that, you know, like, you can make a good argument, right? You can say that, like, the pure science is one that has less placebo effect. Like, that's a damn good argument. It's an amazing study. On paper, according to Western medicine, it's like, awesome. You can make that, right? Because, oh, wow, then we're isolating the disease process and the drug even further because we're removing placebo from the equation. Our experiment is more pure. You are absolutely correct.

And the external validity goes down. And so this is kind of what I see in terms of like Ayurveda and stuff too. Is that like in Ayurveda essentially it's that individuality, which like once we remove from the equation and we get a nice clean effect, like it's, we're going to lose a lot of the impact. Because the whole idea behind Ayurbetic medicine is that you are an individual and that like things need to be tailored to you. right, that treatment needs to be tailored to you.

So one of my favorite studies about bipolar disorder is something called step BD. Awesome trial. It's a naturalistic study. And I personally trust naturalistic studies more than RCTs. So a naturalistic study is when you follow a patient over time and you kind of say, hey, we're going to treat people and we're just going to see what happens. It's not going to be an RCT. So there are all kinds of biases that get introduced.

but I really like naturalistic studies because like, you know, so what will happen with a pharma company, right? So if I'm testing an antipsychotic, like, let's say eripiprizole, in a pharma company, like what I'm going to do is I'm going to recruit people, I'm going to pay them, and they have to take the friggin pill because otherwise they don't get paid, right? So like, I'm going to give 100 people this pill. And like this is a good example of this is like Olanzapine. Okay. So like, and then like, where? We're going to see how much their hallucinations get better. And they take the olanzapine every day.

It turns out that their hallucinations get way better. Now, I give olanzapine to someone in real life, and so then I get FDA approved because olanzapine is like it works. It reduces their hallucinations. It's great. I give olanzapine in real life, and people stop taking it. Can anyone guess why they stop taking it, even though it is so effective? Anyone's been on olanzapine?

My condolences. weight gain. You gain like 40 pounds. Not a small amount of weight, like 40 pounds. You get huge, very quickly. Makes people gain weight like a motherfucker. And so doing the FDA approval, like you'll see that, like if you guys opened up the list of like side effects on medications that you get, it's huge. It's on there. So the RCT tells us, there's the papers that show that olanzapine fluoxetine is one of the most effective combination. for bipolar disorder. It's like one of the best evidence-based things for bipolar disorder.

And like getting people to take it is really hard. So I'm not sort of here, like I recognize now, like this may sound like bashing Western medicine, but like I'm a psychiatrist and I prescribe a Lansapine. But what I think like the point of sharing this is is that it's complicated. So you all can say that I have a bias towards Ayurveda and you'll probably write. On balance, here's why I believe. what I do about Iron Weather, because I think that if you look at the studies, and I know it's kind of interesting, but if you want to talk about bias, like, let's just think about discounting

particular journals, right? Oh, like, you don't think that the New England Journal of Medicine has some kind of bias? Like, yeah, I'm just going to discard all the alternative medicine journals because they're alternative medicine journals, and it's kind of like, wait, you're going to discard the things that are devoted to studying this thing, and then you're going to make a conclusion? Like, you can, sure, they have a bias, but I, you know, you know, you know, you're not. you know, personally, I wouldn't do that. Like, I just don't, you're allowed to do that. You're allowed to say there's mainstream journals and there are less mainstream journals.

And this is kind of the last thing that I'd say is, so that, you know, it's been interesting to be a proponent of meditation for 20 years. Because I've watched what's happened. 20 years ago, I was advised to not say that I was interested in meditation on my medical school application. Because people told me, they're like, hey, if you say you're into meditation, like they're not going to let you into medical school. I was like, okay. And now it's like half the applications that are like people like, oh, I'm super into mindfulness.

Like, how has that changed? Meditation has worked all along. And like at the beginning, so now we sort of think a little bit about the history of science, right? So the New England Journal of Medicine sometimes publishes scientific discoveries. But I think most of the studies on meditation were not in the New England Journal of Medicine. So then if you're really looking at the frontier of medicine, like, where is it? So the New England Journal of Medicine absolutely publishes a lot of very good landmark studies. But they're very careful about what lane they're in, and they're not interested in other lanes.

So I think that there's all kinds of publication bias here at play, which is fine. You can discount it. You can say those journals aren't good. Their impact factor is good. They're done in foreign countries. And since it's not done in Europe or North America, the science has to be shit, right? Oh, those editors are in India. Like, damn, talk about, let's forget about reading their research.

Oh, that publication is from China. Like, that can't be good. Let's just knock it out. And that's not bias. Right? So you can, and like, I'll be the first to admit. Like, I've seen more academic dishonesty in India than I have in the U.S. But what I will say, the academic dishonesty in India is flagrant and incompetent.

It's like, they're like, we're just. just going to make numbers. And sometimes people wonder, like, why I don't have more publications. It's because I was working at a lab for a little while that was, like, really bad. So I was like, you know what? I actually don't want my name on this because y'all are straight up fabricating data. And, like, so I think the science in India is worse. I really do. I hate to say it. But on average, I think it's worse. But I've also seen here that there's very sophisticated scientists who, you know, like my statistics professor once told me, you know, statistics is like a bikini.

What it reveals is enticing, but what it conceals is vital. And my experience of like doing research here has been that there's like a lot more of that kind of stuff where there are like little things that they do, which you just won't catch. And when I discovered this whole thing about like recruiting placebo non-responders,

it blew my mind. Because it's such a good scientific argument, but it destroys the. external validity of the study. You know, it... Anyway, so kind of going back to... Let me just think about if there are any other points that I want to make. So, yeah, so there are a couple of other points about Ayurveda.

So the first is that I think one of the biggest problems with Ayurveda is that they don't let... So here's what Western medicine does really, really well that I think Eastern traditions of medicine really don't do. So there's a pissing contest going on right now between Eastern medicine and Western medicine. And the Eastern medicine folks are like, we want to be treated the same as Western medicine. Okay? So they're like, we're just as good. How dare you have a monopoly on the best medicine?

I'm just as good. The one thing that's awesome about Western medicine, and like this is, I'm just such a huge fan of this, is that in Western medicine, we have published studies which show that SSRIs are 70% placebo. So one of the things, this is, I think, the thing that allows Western medicine to be, like, frankly, superior. Like, I think there's a reason why there are Western medical hospitals all over the world, and there are not Ayurvedic hospitals all over the world. It's part of the reason why I chose to become a medical doctor instead of an Ayurvedic doctor. There's a part, there's a reason why, like, my basis of everything that I talk about, well, is more in yoga, but, like, yoga and, like, Western medicine, right? We talk about depression. We talk about narcissism.

We talk about these kinds of things. Like, that's baked in. We talk about anxiety. And that reason is because Western medicine is good at letting itself fail. Right? So, like, when we looked at the curcumin paper, is there fraudulent research? Yes. But we're good at double checking ourselves.

That's the one thing that this is the biggest bias in Ayurbetic medicine, which makes me distrust the actual treatments. Right? So I don't advocate for the actual treatments. because Irobedic doctors are not willing to let their treatments fail. So the strongest benefit of Western medicine and scientific integrity is publishing papers that show that, hey, by the way, Oxycontin isn't great.

Hey, by the way, SSRIs maybe 70% placebo. Hey, by the way, like, it's really hard to get people to take olanzapine. So we're really good at pointing out our own shortcomings in the West. The biggest thing is that the Ayurbedic docs are so concerned about like, losing ground to the allopathic docs. They want to be treated just as well. So they don't, and this is anecdotal, okay? They're much less likely to let their treatments fail.

Because I don't believe, so like, okay, like, we're just going to pick two random books. All right. So the two books are the Yoga Ratnakara and the rationale of Ayurvedic psychiatry. So there's a lot of good stuff in this book. Right? Like, there's a lot of good.

like effect of Yashitimadhu and peptic ulcer, cool. Like, you know, Ashwaganda. Like, there's a lot of good stuff in here. The problem is that we don't know what's good and what isn't. Right? So this is the big thing that Western medicine does really well,

which Ayurveda really needs to do. And before I start advocating for more like Ayurbetic treatments, the challenge is that we don't know like what works and what doesn't in Ayurbedic medicine. And that's because it's really hard to study the treatment, right? that's the whole problem, is that you can't study the treatment outside of an, like,

Ashwaganda works or doesn't work, that doesn't make any sense in the Ayurvedic system. It doesn't work independent of a person. It works in a person. So this is the real challenge, is it's very hard to tell what is BS in the Ayurvetic system and what is valuable. And that's like a huge problem. So it's a problem that, you know, people are really working on. So there's like, you know, Ayurbedic researchers are I think like figuring this stuff out. It's going to take time.

personally, you know, the reason I tend to be like more pro-Ireveitha is because what I see in Ayurveda today is exactly what I saw in meditation 20 years ago. And so as a clinician, like, I don't, I mean, when someone comes into my office and they're suffering, I've got a choice to make, right? I can either go down the evidence-based protocols, or I mean, I do. But like by the time that the Ayurvedic research gets figured out, like this person is going to be 20 years older. like their life is going to be like, you know, things will have been determined. So personally, I'm not saying this is correct. I'm just saying it's my personal bias.

I'm more open to experiment with people, which, by the way, and that sounds kind of weird. Kind of weird. But as far as I know, I'm the first psychiatrist who like really talks a lot about mental health on Twitch. And why do you think that is? You guys don't think that I had conservative mentors at Harvard Medical School who told me not to do this? like and and you know speaking of which i think harbord's a fantastic place because just so you guys understand

you know i got criticized and and sort of dressed down by some of my supervisors for like being pro meditation and pro iirveda and stuff like that right they were like hey what you're saying is out of line it's not supported by science you need to stop doing it we had discussions about it and like a year or two later they let me teach it right so what i really love about that institution I think this is what's great about, like, Western medicine, is that we tend to be, like, pro-discussion. And this is what I love about those Reddit posts, is, like, by all means, like, tell me I'm wrong.

I'm not right. Right? So, like, the same people that were like, hey, you can't be sharing this crap with patients, there's not enough evidence behind it. Or the ones who are like, hey, we want you to come and teach about alternative medicine. And it's like, it's a beautiful balance.

And what it really comes down to is, like, understanding the whole scope of the nuance. So does Ayurbetic medicine work? So there are a couple of different things that I'm going to go back to Reddit for a second. Okay. So this is fucking solid. Do not take Ayurbetic medicines without speaking to and showing them to your qualified doctor. Absolutely. Irobedic medicines are not well regulated. You should be very careful. Absolutely. Hey, all papers are that, you know, I personally I'm okay with that. Like, I think there are topical journals, so that's fine. How can you say that research on Ayurveda is reliable, but research on Myers-Briggs is not? Because there's an actual Myers-Briggs Institute, which is proprietary and owns it, whereas Ayurveda is not owned by anyone, right?

It's sort of like it's a system. So, and this is fine, too, that you can say that until there are studies from more reputable journals like yoga and meditation, I don't think you can safely came that the three dosas map onto genotypes. Like, you can, that can be your threshold, right? You can have a threshold that until Western journals start publishing this stuff, I'm not going to believe it because I believe Western journals more than Eastern journals, which is fair. Like, you're allowed to do that.

That's completely reasonable. And at the end of the day, you know, I saw a post on here recently about like, Vata and ADHD. But what I can't, I think there's a lot of like really, really important points that these people are bringing up. Which is that, you know, I talk about Ayurveda. And I just don't, because this is a challenge, right? Like when I gave the lecture about kind of Ayurveda and like understanding the Vatapita types, like this is the challenge is that if I could, I would teach you guys for eight hours about all of the nuances as I understand them about the ups and downs of Ayurveda.

This has just been one hour, chat. I could do this for another seven. Really going through an understanding, okay, like, what are the downsides of Vatapita Kaffa? Is there any consistency in the way that they're diagnosed? So one person kind of cited that the croneback alpha between different practitioners is bad, which is correct. So now, like, if you look at more of the studies, right, so like what people in Iran have realized is that there's, like, actually, like, a software that's published by one person or, like, one company that looks at genetics and, like, really, like, tabulates questionnaires and has done factor analysis to determine your Dosha. Like, when you really look at the methods that these people are employing, like, I think they're good. right so what I really look at when I look at a paper is not where it was published what I really read is the method section because the money is going to be there and this fucking stupid reference that I showed this reference is god awful and I'm so glad that this person called me out on this

like this person looked at the method section and only 28% of the people in the paper that I cited had a consistent doshed determination this paper is absolutely shit and how to they determined it was absolutely shit, they looked at, they didn't look where it was published, although they talk about that too. But the convincing argument this person makes, which I, you know, I glossed over or forgotten, to be honest, which is dumb of me, is that like 28%, they invalidated 3,400 people and only 900 of them had a dominance of one prokruti. Like, how the fuck are you going to determine anything based on that? Now, the reason that I believe in, you know, Iogenomics is because I just happened to cite a bad paper. Like, if you look at many papers on Iogenomics, so, like, I was reading a paper the other day about COVID.

And now what people are doing is they're getting more sophisticated. So what they'll do is they'll have one Ayurvedic physician. They'll put it through Ayuzoft. And they'll look at the concordance between the individual Ayurvedic physician diagnosis and the concordance with Ayuzoft, which is like a, you know, a software that's sort of using factor analysis and other things determines what your dorship balances. And then they'll have that brocruti confirmed by a separate Ayurvedic physician for concordance. so that methodology is like far better than the paper that I shared. And so that, you know, that's a reasonable complaint.

Like, really, it's a crappy paper. But the challenge is that, you know, when I share something like, hey, I think Iogenomics is a real thing. It's because I read 100 papers on iron genomics. And I just happened to cite a really bad one. And so on balance, like, you can look at all of those 100 papers and you can say, this has a problem, this has a problem, this has a problem. That would all be fair, actually.

but then at some point, you know, you have to make your individual judgment about where you are on the threshold of science. And in my, you know, really, I think that like there, you know, I've seen enough to where I'm convinced that Iogenomics is like a thing. And I think it's quite interesting. And it sort of makes sense, right? Because we know that like there are certain characteristics that are irritable between people. And we know that Dorshas tend to be like somewhat inherited and things like that. So I don't think it's really that wild. Yeah.

you know, at the end of it, I think, so here's some takeaways about Ayurveda. So the first is that personally, I think it, out of all of the complementary alternative medicine stuff out there, I think yoga, meditation, Ayurveda, and Chinese medicine are the four that I support the most. Now, are there downsides to all of these things? Like, absolutely. I also will freely admit that while there is strong evidence to support all four of these systems, at least in my opinion, that a lot of what I share goes far beyond the evidence and is extrapolated from the evidence. Because I've just seen enough of like evidence-based medicine to where they're like just problems with it. Like we think evidence-based medicine is fantastic.

But, you know, I remember seeing a statistic from years ago. I don't know the paper that 70% of like experiments in scientific journals are not reproducible. and like we've seen this stuff with like oxycontin and SSRIs and things like that vaccines cause autism curcumin like dishonesty like all this kind of crap where you know like a lot of what we thought we understood we don't really understand quite as well as we thought right but at every step of the way the biggest problem that I have with like Western medicine is it tends to be incredibly arrogant like there were people who you know just like these people like hey the evidence isn't there for meditation yet, which they were right 20 years ago. The evidence wasn't there. But that doesn't mean it doesn't work, right? That just means that Western science hasn't verified it, which then gets down the track of, okay, how do you know, like, how do you know what to trust before something is verified? Shouldn't you wait until everything is verified? And that's where you have to sort of decide, like, what are you, you know, do you want to rely on things that are going to work 100% or do you want to be like a little bit

at the edge? And temperamentally, you know, this is probably as a cognitive bias on my part, like, I tend to be at the forefront of things. So that means that sometimes, not sometimes, most of the times, we make mistakes. Right? So there's a reason,

like, temperamentally, like, why I believe in I, or that I think it's part of the reason that I started streaming on Twitch is because I look at a situation and, like, is streaming on Twitch a good idea?

Like, what is the data behind it? There isn't. But I don't always think that that should stop you. So when it comes to, like, what you should do personally, I do think there are a lot, there's a lot of good stuff to think about, okay? So the first thing is like, there's a reason why I don't say go talk to your, if you have any mental health questions or concerns, please go see an energy healer.

I don't say that. What I say is go see a licensed professional. So there are other problems in Ayurveda, which is that the system of like licensure and things like that is like all over the place, especially outside of places like India. There is no license to practice Ayurbetic medicine in the United States. doesn't exist. In Europe, I'm not sure. I mean, in some states, there's, you know, you can practice and stuff. But generally speaking, like, the quality control on Ayurvedic practitioners is very poor. So I don't say go see an Ayurbetic professional, right? I say go see a licensed mental health

professional. And because the quality is poor, like, you can have all the research in the world. Like, let's say that India produced the best, highest quality, most honest, like awesome researchers, no bias, and all those journals are great. I still want to. wouldn't tell you to go see an Ayurbanic professional. Because research done in India has to translate to the actual clinician that you're going to see. There has to be a guarantee of a particular kind of quality, which we don't have. Even if there's a lot of good evidence that Ashwaganda is an effective herbal supplement for A, B, and C. There's good evidence for it, really. I still don't tell people to take Ashwaganda. Why? It's because there's no quality control. Right? So like

the herbal supplement lobby lobbied really hard. to not get stuff checked, to not have herbal supplements be under the regulation of the FDA, which means no one's checking it. There was another study, I don't know if this person cited it, but that long post is really good. A study that showed that something like 70% of herbal supplements do not include what they claim to include.

So people randomly grabbed crap and just tested it. And what they found is 70% of it didn't include what people claimed it include. And half of it doesn't include any of it. Like half of it was just like rice flour. Like rice filler. It's like not even like there was like no act. So some percentage of it was like no herbal.

Like none of the compound actually exists. You're just taking rice filler. So it's not regulated, which is why I don't recommend it. Right. So in Dr. K's guide, we talk about herbs and we sort of tie share some of these problems. So the cool thing is that, you know, I think the people who posted this stuff on Reddit, if you guys watch Dr. K's guide, hopefully you'll be a little bit more okay with my perspective there.

Because I talk a lot about this herbal, you know, heavy metal contamination and liver toxicity and all this kind of crap with herbs. It's bad. You've got to be careful. So there's a reason I don't recommend that stuff. And like even if theoretically Ayurbetic medicine is legit, which I think it is,

I'm still not recommending it because there's no guarantee of quality control. Questions? Oh, placebo effect real. So here's what I think. So I don't think the placebo effect is actually a thing. So I know this sounds kind of weird, but I don't believe in the placebo effect. So if you really think about it, technically, what is the placebo effect?

It is a therapeutic observation that we do not have the science to understand. That's really what placebo is. Right? So the only reason we call it, and this is another thing that I think is a little bit arrogant about Western medicine, is that placebo is just all of the mechanisms that can result in therapeutic benefit that we just don't have insight into. That's what the placebo is. Placebo is willpower. Notice it. See, this is the thing. Everyone assumes that the placebo effect is mental. But like, we actually don't, we have some evidence of that, actually. But like,

the placebo is just all the mechanisms of mind that we haven't understood. So just to give you guys an example. So we know that there's psycho-neuroimmunology. So we know that the state of your mind can affect your neurochemistry, which, can then affect the activity of your immune system. So we know that, for example, you know, like mindfulness and yoga and Tai Chi actually like affect rheumatologic conditions, right? And so how does that work? So what years ago people thought were like, they were like, oh, Tai Chi is a placebo. Right? So, oh, speaking of Nijum. Okay, so let's find, right? So like, let's take a look at this. one of my old mentors

Dr. Wong Oh crap oh no my thing is so bugged okay anyway so hopefully it'll come up in a second can you all see this

so there are like articles in the New England Journal of Medicine about Tai Chi and so I think like what we're discovering is okay let me see if I Yeah, for some reason, my stream labs is kind of messed up.

There we go. Hold on. Let's try this. There we go. Okay. So here's like a good example. An RCT of Tai Chi for fibromyalgia in the New England Journal of Medicine, which last time I checked had the highest impact factor in the world. I could be wrong there. Maybe something like nature is probably higher, but at least in medical research. Super high impact factor either way. Right? So like at this point, like Tai Chi, you know, this was published back in two,

So, like, Tai Chi was a legit thing in New England Journal of Medicine, like, treated it seriously, right? But if you look at the history of Tai Chi 40 years ago, Nijim wouldn't have published this. There has to be, like, a certain amount of, like, building up in smaller journals, sometimes before things are, like, legitimized. But I think this is a good example of, you know, when we look at things like fibromyalgia and Tai Chi and stuff, essentially, like, we think, okay, placebo effect means it's just in your mind, whereas not necessarily. there are probably like different kinds of immune system stuff and like, you know, alterations in cortisol levels and like things like that, like cytokine levels, things like that,

that will all be responsible for what we call the placebo effect. So I think placebo is, my understanding of it, is it's all of the mechanisms of medicine that we don't understand. So we're able to observe their effect, but we don't understand it. So we assume it's in the head, which I think is false. Does belief have a particular impact on your physiology? Sure. But that doesn't mean it's all in your head. If you can observe something in your physiology, that means by definition it's not in your head. So homeopathy is a good example of something that does not fit my criteria that I personally use. So what I like to see is evidence, consistency, and biological plausibility.

So I've reviewed articles like homeopathic trials that look good. Like they seem to show clinical results. And so, you know, I'll say, hey, I'll approve papers because the science seems good. But personally, I don't advocate for it because I don't think it has biological plausibility. So it just doesn't meet my personal threshold. And I also don't know, like, a big part of why I sort of value TCM in Ayurbeda is because like TCM gave us statins, basically. So that's like a big win. I don't know that homeopathy has, you know, there's another aspect of medicine which I haven't

really talked about, which is, you know, medical systems are Darwinian. Okay. So like what you tend to find is that the medical systems that work have a natural selection and will stick around. And the medical systems that don't work will, like, die out. So like the Greek theory of humors has been around for a couple thousand years too, but they don't, no one uses it. So if you look at medicine, you know, like Culpeper's medicine.

is like a, you know, Western perspective on medicines, which you can't learn. So I think that homeopathy, you know, is a relatively, I think, more recent invention, right? I don't think homeopathy is like 5,000 years old. Whereas like Ayurba is like 5,000 years old. And it's stuck around. And if you kind of look at it, like it sort of makes sense, right? Because they will actually give people herbs and things like that. And Chinese medicine has different kinds of herbs that will use, like Ashwagon.

in Ayurvedic tradition, you know, a couple of promising herbs or things like Ashwaganda, turmeric, you know, there's some good stuff in there. Yeah, so someone saying I tried homeopathy when medicine couldn't do anything for me anymore and it worked for me. I had a great specialist though. Qualification and quality control is a problem in this field. I completely agree.

So this is what I've seen, okay? So like I'm an energy healer and like I've seen people have really good clinical responses from energy healing. Like some really cool stuff. And I can't reliably make recommendations because you don't know what the quality of your average energy healer is going to be. And this is what's really confusing. If you really want to be an unbiased physician,

you know, like when someone comes to you and says, hey, I tried homeopathy and it works. If you're unbiased, it worked for me. That's what they say. If you're unbiased, what is your response to that? Seriously. What do you all think? Right?

So that's where like, like, I'm like, cool. Tell me more about that. And then like, you know, I'll try to, figure out, okay, is this reliable? Because when we make recommendations, we want them to be reliable. So even though, you know, the Ayurvedic stuff that I shared last time, which was like not really scientifically founded, right? There's evidence that Ayurvet is correlated to your genetics. I still think that evidence is overwhelming. You should just, you know, read 30 papers and then get back to me. And maybe I can post a couple later. So maybe the burden of proof should be on me and not you.

but when it comes to like the stuff that I share on stream, the stuff that I share on stream is the stuff that I feel like reliably has helped like a lot of people. And it's challenging because if you go to someone who's trained in IRA, they won't know what, they may not know what I'm talking about or they may have a different perspective. So let me think about, you know, let's just see this together. Let's just see what we can figure out real quick.

And then we'll, who are you going to raid, chat? Shit, I'm so late. Let's just see what we can figure out together, okay? Okay, so exploring IEGenomics approach for understanding COVID-19. Let's look at the methods. Where's your methods? What the fuck? There's no methods.

Okay, forget this one. So this looks like a hypothesis. We don't want that. Let's look at the references. So this looks like a good paper. Yeah, so I mean, I would say just, you know, look around. Like, I don't have, this looks like. a good opinion paper, but maybe they'll have some good references in there. Let's take a look at,

damn it, where is the, my God. Okay, well, we're going to have to read this closer. Okay, maybe I'll look over this myself and then get back to you so we don't have to do it on stream. Who do you all want to read? I mean, who do you all want to read? So, by the way, you know, I did mention some time ago that some Ayurvedic physicians are seeing correlations between COVID progression and Dorshik balance. So, I mean, I'm just, you know, I'm just, you know, I'm curious about this paper. But I haven't read it, so I don't know if it's... I just want to find one of these papers that talks about Ayo Soft and stuff like that. Those are pretty cool. But, okay, we can raid, we can raid Destiny. It's fine. Don't raid Crip or Destiny, chat?

It's no-life Crip, right? Okay, we'll raid Crip. What's he doing? Streaming Heartstone, I assume, or New World or what? What's he doing nowadays? leaked okay so I hope this was helpful to y'all you know I just want to emphasize once again like the folks on Reddit said you know be careful about Iyerveda

it's not you know it's a system that I think has a lot of value and at the same time really needs to be like rigorously analyzed now personally I've done a lot of exploration of Iirveda and what I kind of have taken

away from it are some of these frameworks for introspection. But I've also seen enough to where I think there's real science behind it. And really, it's going to take like 10 or 20 years for us to really see that science and like verify it. And that's just how medicine works, right? Because science is slow. I kind of see Ayurveda being where meditation was like 30 years ago. And it's just going to take time for us to figure out what an Ayurveda works and when it doesn't. And in the meantime, you know, just remember that because we don't know what works and what doesn't. I'd steer clear of herbs. I'd steer clear of supplements. Definitely talk to your doctor and be careful when approaching people who claim to be like Ayurbetic therapists

because we don't really have a good sense of their quality control. Mine included, like there are a lot of Ayurbedic doctors that I'm sure will say, I don't know what the fuck I'm talking about. So anyway, take care and I'm off to vacation. We'll see you all in a couple of weeks.