Modern Wisdom - #988 - Dr Rahul Jandial - Brain Surgeon: Inside The Dreaming Brain

Episode Date: September 1, 2025

Dr Rahul Jandial is a brain surgeon, neuroscientist, and an author. Why do we dream? For centuries, people have debated their meaning. Are they hidden messages, random brain activity, or something el...se entirely? Today, modern neuroscience is uncovering how the brain creates, processes, and remembers dreams, and what they may reveal about the inner workings of the mind. Expect to learn why we dream and the evolutionary importance of dreaming, what predicts a good or bad dream, and if there are any types of universal dreams we al have, what fuels erotic dreams and what effects does porn have on our dreaming abilities and content, if there is any practical science behind lucid dreaming, the biggest myths about the brain and the best diets and exercises to keep your brain healthy, what role lifestyle really plays in cognitive decline and how much is genetic, and much more… Sponsors: See me on tour in America: ⁠https://chriswilliamson.live⁠ See discounts for all the products I use and recommend: https://chriswillx.com/deals Get 35% off your first subscription on the best supplements from Momentous at https://livemomentous.com/modernwisdom Get a Free Sample Pack of LMNT’s most popular Flavours with your first purchase at https://drinklmnt.com/modernwisdom Get 5 Free Travel Packs, Free Liquid Vitamin D, and more from AG1 at https://ag1.info/modernwisdom Get $100 off the best bloodwork analysis in America at https://functionhealth.com/modernwisdom Timestamps: (0:00) The Importance of Comfort in Your Working Environment (5:09) Things You Believe are True But Can’t Prove (10:13) Did Freud Get Anything Right About Dreams? (13:41) Why Do We Dream? (20:50) Why are We Conscious of Our Dreams? (28:22) Why Do We Have Nightmares? (35:51) Should We Remember Our Dreams? (39:21) Do Our Dreams Correlate to Our Overall Health? (41:20) How Real is Dream Interpretation? (44:54) What Do We Know About Erotic Dreams? (57:54) How Does Porn Effect Our Dreams? (01:01:40) Where Does Inspiration for Dream Material Come From? (01:05:47) How Can We Activate Our Imagination? (01:09:07) Transcranial Electric Treatments (01:14:39) The Benefits of Awake Brain Surgery (01:20:29) How Dreams Differ in Brain Injuries (01:22:42) Can Thoughts in Dreams Be More Real Than Waking Thoughts? (01:26:12) Brain Myth-Busting (01:30:53) Is the Neuroscience Industry Overselling Tech? (01:34:07) The Contributing Elements of Cognitive Decline (01:45:22) The Impact of Stress on Brain Aging (01:57:29) Mind-Blowing Scientific Scenarios (02:00:51) Lessons Learnt from Terminal Patients (02:04:36) Find Out More About Rahul Extra Stuff: Get my free reading list of 100 books to read before you die: https://chriswillx.com/books Try my productivity energy drink Neutonic: https://neutonic.com/modernwisdom Episodes You Might Enjoy: #577 - David Goggins - This Is How To Master Your Life: https://tinyurl.com/43hv6y59 #712 - Dr Jordan Peterson - How To Destroy Your Negative Beliefs: https://tinyurl.com/2rtz7avf #700 - Dr Andrew Huberman - The Secret Tools To Hack Your Brain: https://tinyurl.com/3ccn5vkp - Get In Touch: Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx YouTube: https://www.youtube.com/modernwisdompodcast Email: https://chriswillx.com/contact - Learn more about your ad choices. Visit megaphone.fm/adchoices

Transcript
Discussion (0)
Starting point is 00:00:00 You just taught me there are left-handed surgical instruments. What's that mean? For left-handed surgeons, the way some of the graspers click, it's released with a maneuver where your thumb pushes something outward. For left-handed surgeons, that can be sort of clunky, so they make instruments where it's outward. For the left-handed surgeon is actually inward towards the midline, and for the right-handed surgeon, it's this way.
Starting point is 00:00:28 So there are left and right-handed instruments for different surgeons. Needle drivers, really, where you click onto a needle and it clasps so you don't have to keep pressure on it, and then you can do your maneuver. Steak knives also have serrations that lean one way or the other. I just learned that. I didn't know about that at all. I was just looking at it because I've got a buddy who's left-handed, and he's like pointing all this left-handed stuff out in the world. Don't use that one. It's going to cut completely incorrectly.
Starting point is 00:00:52 What I did learn was when you have a steak, I mean, I have to imagine this is, Sla-bang in the middle of your area of expertise, but you want to never cut with the grain of the meat. You want to be cutting cross-grain. Yeah, so that takes me to what's beautiful about surgery is like it's not like Legos. It's not like, you know, hammers and chisel. It can be with, you know, orthopedic surgeons and spine surgery. But when you have somebody who can lightly with a tweezer, a pickup, we call it, lift something up and you see some membranes that are holding two planes together. All right, let's say you have two planes of tissue
Starting point is 00:01:29 and they're held together with this fine web of membranes. You lift it up and you take a scissor upside down and you just spread lightly and the membranes fall apart and the tissue comes apart. You're not really trying to tug and pull. If you do that with finesse when the patient wakes up, they feel less injury, they feel less pain, less anesthesia, the operation goes better, less blood time.
Starting point is 00:01:49 So everybody thinks surgery is all the same steps. Do these 1,000 steps. No, it's sculpting, it's art. There's a finesse to it. it. And at some point, when you see somebody's good at something, it's like ballet. It's like something's being released. They're not like, and now I will do this step. And that's the part I love about it is talent. It's more talent than smarts. I love watching people in between doing the thing that they're supposed to do. So a good example of this is drummers. If you're ever watching a drummer play live, you loses a stick or he snaps or something like that. And he'll just immediately switch and he'll be playing with one hand and he'll just reach over and he'll grab another one. or if a guitarist's playing and bing, off goes a pick like that, and you'll watch him without even thinking about it.
Starting point is 00:02:35 He'll do something, grab a pick from there, roll it between his fingers and go back. And it's that liminal space. I'm just so comfortable with my working environment. And that's really cool to see. So that's an interesting word for me, liminal because there's kind of the thing I've been thinking about a lot. It's not the easiest thing to explain to people,
Starting point is 00:02:53 but I think that in nature, let me let me give an example what I call a liminal space I was uh I used to dive a lot I gave it up at a scary accident I almost I almost ran out of oxygen uh real deep uh off of Asia Asian coast there a palau and um it's I was like I've got kids I'll do this when I'm older now I'm older and I'm like I'm I don't have the energy but the place that I love diving the most was the cenotes of the Yucatan like where it's all flat maybe the asteroid landed there and killed all the dinosaurs and that's kind of thing but they have caverns, and there are underground rivers that meet the salt water.
Starting point is 00:03:32 So when you go from freshwater to salt water, in our body, salt water is a massive thing that has to do with cognition and balance. And a lot of fundamental things are controlled just by the salt in our blood and brain. And but when you're diving and you're in freshwater and then it's called a halocline and you're now fresh water's meeting saltwater, there's like five yards. It almost feels like five meters where it's blurry. So the transition from one state to another, at chemical, psychological, it doesn't happen in a millisecond. There's a liminal state.
Starting point is 00:04:03 And so when you take a look at the brain in 24 hours, I see at least four or five liminal states. When you're falling asleep, it's not a complete, I'm awake and now I'm asleep. There's a little window there about 15 minutes. Lucid dreaming when you're asleep, and I can verify it, and you have a little return of awareness.
Starting point is 00:04:22 to me, those hybrid, liminal transition states give us an insight. I mean, it's hard, right? Because I'm a brain surgeon. This is people expect everything for me to be proven. But I'm finding a lot of insight and understanding from these different liminal states. And then you can bring a narcolepsy in the middle where people suddenly fall asleep. They have interesting thoughts. When you wake up, a third of the world feels sleep paralysis and have like these
Starting point is 00:04:52 feelings of a goblin on their chest enough to where the stories are built around different cultures. So to me, those transition hybrid states of cognition, of feeling, of experience,
Starting point is 00:05:04 I think that's where the, that's where my head is really at these days. This might be getting you out of your skis a little bit. But someone asked me this question the other day and I thought it was such a great question. What is something that you intuit or act as if it's true or might believe, but you cannot prove with evidence or science. Is there anything that
Starting point is 00:05:28 comes to mind with that? Well, I mean, for me, the first thing that crossed my mind was love. It's this, you know, the term used to be ineffable. And so, like, beyond explanation, but you know it's true, beyond articulation, but it really motivates you or touches you, spiritual experiences right epiphanies a hunch like these are repeated experiences that people are reporting right and dreams could fall into that a little bit but there are repeated things that we are writing about through history and time aristotle wrote about lucid dreaming now that sounds like well come on lucid dreaming but it's rigorous so aristotle wrote about it thousands of years ago, a return of awareness within a dream, which sounds like, how could you ever prove that?
Starting point is 00:06:22 And 20, 30 years ago, and increasingly now, lucid dreaming is being proven rigorously in sleep labs. So I think that's one example. But when I hear that, what it tells me is, don't deny those insights. Don't rely on them blindly. Don't be manipulated by somebody trying to dazzle you with those kind of things. You know, cults. Sexy rhetoric. Yeah, cults, catch you in a vulnerable moment. My patients are vulnerable. The sexy rhetoric isn't just, you know, that this will heal you. But I was, you know, there were, there were a lot of, like, stem cell clinics that were affecting children's hospitals in San Diego.
Starting point is 00:07:01 Children's Hospital, San Diego, is real close to Mexican border of Tijuana. You know, we're in Austin, so you're familiar with that. And there were patients, families who were going there to get stem cell treatments that were, it wasn't that they were. it wasn't that they were proven. We knew they were sham. They weren't hurting them, but they weren't helping them. And sometimes those moms and kids would choose that over therapy that was moderately effective. So I think there has to be some, they have to be some safeguards to vulnerable people being manipulated.
Starting point is 00:07:34 Yet I'm fully ready to embrace intuition, hunch, those kind of things like where my dog has an instinct and hunch that comes from our. limbic system that exists within us, sort of the emotional centers of the brain, the deeper structures of the brain, that we shouldn't deny those. And creative people learn to tap into those. So the challenge for me is always how to liberate our understanding, my understanding, without it getting too woo-woo and leading to plus an expectation. Such a good point, man. It's such a good point. I really think about this a lot. What level of rigor and skepticism should we have? without closing ourselves off to alternative approaches to things. And I would say I lean on the rationalist, materialist kind of evidences side of stuff.
Starting point is 00:08:25 I tend to have a real anti-conspiratorial leaning to me. But that's been to my detriment a lot of the time because I think I've probably said no to stuff that my gut would have convinced me of saying yes to. like my brain has overruled my intuition and I'm kind of trying to allow that to be tapped into a little bit more. I'm trying to get that to reverse. Well, and so that's interesting. So liminal states, these hybrid states that exist in nature, deltas where salt water meets fresh water, where a waking brain goes to our dreaming brain. That's a cognitive delta, if you will. That's a theme that I'm working on in my mind. The other thing I'm working on,
Starting point is 00:09:10 working on is what we're discussing now is that to look at our capacities as a thermostat. It's a modulation. Inflammation's bad, bad, bad. And I say, that's not true. We need some inflammation to fight off bee stings and other things. But how is that thermostat set right for our lives? We fight off infections. But if the inflammation is too strong, it's like friendly fire can cause autoimmune disease. So rather than saying inflammation is bad or good, that this product anti-inflammatory. No, I actually need inflammation sometimes. I need stress sometimes. I need these capacities that I've kept my, our species going sometimes. But when they're running rampant without the necessary stimulus for them, then we have to identify it and use our coping strategies
Starting point is 00:10:01 and maneuvers and the things that the wellness industry is presenting to bring them back into the ecological validity, which is real-world scenario, worship my thermostat be. You mentioned dreams then. Is Freud totally obsolete? Did he get anything right when it comes to dreams? He got one thing right for sure. And before him, it wasn't really clear that dreams were coming from the brain.
Starting point is 00:10:30 That's a cool story too, because so he's about 100, and 10 years old. But before, he was the one like, look, it's your desires gone wild, your dreams. It's just freaky time and dreams, but it was coming from your brain. And it was only, at that time, it wasn't clear that this creature, this human being lying on the ground, mostly limp, body is cool, brain must be off, because they're not moving. So how could that inactive, flesh how could that inactive like the hibernating screen on your laptop right like how could that conjure up all of that crazy wild adventures dream state dream experiences so it was a guy named uh burger him was looking he was trying to actually understand so like the the old school people who were trying to understand things they were open to hunch and instinct and not to say paranormal but something that they liked exploring things that couldn't necessarily uh
Starting point is 00:11:36 be fully articulated, but that didn't stop the exploration, the search for the meaning in it. He felt like there was this potential for mental telepathy. And in looking for that, he put stickers on the surface of patient scalps. And at that time, they were just learning that, like, a wire to a sticker on your scalp didn't mean you had, you could just send electricity in, but you could also record. And so he's the first one that came up with the EEG that later turned into the EKG. And EKG is the three main nerves on the surface of the heart giving you a squiggle. familiar with. An EEG is 96 stickers recording the electricity generated by 100 billion neurons
Starting point is 00:12:13 that are like microscopic jellyfish, right? It's just a recording of the electrical phenomenon going inside. And when he, when he recorded that EEG, he didn't, he let her run. And at night, surprisingly, there was still electricity. And that sat for like 20, 30 years. But that was the first time, people are like, wait a second, the brain is still going off when we sleep. So much so that at certain parts of the day and certain parts of when we're in our sleep dreaming brain, the electrical activity is so strong that they call it paradoxical sleep that while you're asleep, just based on how wild your electricity is, you can't actually tell if you're asleep or awake. It's that hot. So it's not a quiet time. And so that's what Freud did was
Starting point is 00:13:03 say dreams come to the brain and now we've come to understand that the brain is always on it's on a 24 hours roughly cycle you go into a cave and you get the people in the cave and they're still on a 24 cycle right circadian rhythms like we're all built on this rotating planet like venus flytraps open and closed tides open and close we're on a 24 hour cycle but the brain electrically physiologically the amount of glucose usage when we sleep the brain is not resting And now that allows us to say, well, what is it doing? The most vibrant thing that the dreaming, sleeping brain is doing is conjuring up dreams. Okay.
Starting point is 00:13:41 Why do we dream then? Well, that's a massive question, you know. I mean, I would say the answer should come from the information we now have. Okay. So it's not chilling out. It's burning hot. And this one I got to unpack it a little bit. When I just said, look, the waking brain and the dreaming brain are equally vibrant electrically,
Starting point is 00:14:07 but they must be different. So one of the main things that happens when you go from the waking brain to the dreaming brain state is certain continents in our brain, not like a spot, but a network called executive network. Now they're trying to call it action network, but this is a very specific part of the brain of the prefrontal cortex and it needs a little bit of explanation. It's called the dorsal lateral prefrontal cortex. The frontal lobes are like this.
Starting point is 00:14:33 It's kind of on the outside. It's the executive network. It's the conductor that coordinates it all. It's responsible for calculation, processing, quick judgment, not a lot of instinct. And it tamps down other regions, such as the imagination network and those deeper limbic structures that are hunch, how my dog can tell when I'm trying to say, hey, come here, you know, like trying to give him a treat to trap him to put him back in his pen because we're going out for the night. That instinct comes not from the dorsalateral prefrontal cortex or of the
Starting point is 00:15:09 prefrontal cortex. So when you go from the dreaming brain back to the waking brain or waking brain to the dreaming brain, that region is dampened. It's never on or off. It goes from being like 51% active relative to the imagination network to 49. So the dreaming brain has a dampened executive network and a liberated imagination network and movement regions and emotional networks. So when we see the shifts and as the executive network comes down, it's compensated by the imagination network so you get that equivalent electrical activity. So when you think of it that way, dreams, why we dream has to be explained with what is going on with the dreaming brain. It's hyper-visual. It's hyper-creative. It's, uh, it goes into tremendous social
Starting point is 00:16:04 situations. And my big idea about it is it's not what others have said like. It's threat rehearsal. If you run from a woolly mammoth in your, and your dream, you're better off if you ever encounter one. Or it's a nocturnal therapist. We work out our emotions at night. It doesn't make, it doesn't fit the complexity. We have PTSD flashbacks. So what I think is happening is certain regions of the brain that are generally tamped down. for us to perform the task of the day are allowed to be liberated in the safe space of our temporary paralysis
Starting point is 00:16:35 of our dreams. Because in the brain, if you don't use certain neurons in certain capacities, they will wither. If I patch a kid's eye for therapeutic purposes, where it lands in the occipital lobe
Starting point is 00:16:46 will physically wither. And so I think the, what we dream to maintain our emotional and creative complexity as a systematic process where the brain takes turns in a 24-hour cycle being executive network dominant and imagination network
Starting point is 00:17:03 dominant. So all those capacities are there for us for the next environmental event we're not prepared for. So if you spent your entire day as a caveman logging all of the different fruits that you'd gathered over the last week and making sure that your cave is clean and working out where you're going to go to catch the next mammoth, all of that is very executive. It's very top-down. It's creative in some ways. But, not intuitively creative, but you have maybe not given yourself. The urgent always overtakes the important, and the urgent is very rarely going to be a creative pursuit.
Starting point is 00:17:39 Task on versus task off. Yes. Task on is outward, and that's the executive network. Of course it requires a little imagination and everything to navigate. That's why it's never completely on or off. And then task off is daydreaming. Dreaming itself is the most task off thing. and the brain wants to run rampant.
Starting point is 00:18:00 I mean, it's wild. If you look at some of the electrical activity, the glucose usage, it is not a quiet time. And so we can't deny that a process that makes us lie down burns that much energy when energy is hard to get and is lasted through generations and generations is essential. So my feeling is that any collection of neurons, Well, they're in a dolphin, like dolphins do one brain at a time, well, half brain at a time. So they can keep paying attention.
Starting point is 00:18:32 They'll sleep one hemisphere at a time. Penguins do like, they do micronap. They do like 10. So mingos see something weird with sleep as well. All the creatures, they have different ways. But when you get a collection of neurons, they got to sleep. And what happens when you sleep is not rest. It's a different type of neuronal activity.
Starting point is 00:18:52 Your body might be resting. Your heart might slow down a little bit. The liver's. cool. Body's cool, but the brain's on fire. And just to put it out there as a surgeon, when I've moved livers between moms to kids, you could take a piece of liver from a mom and move it to a kid. I've transplanted hearts and training. We're not really reconnecting the nerves again. The bodily tissue is a little bit autonomous. Sleep is not really for the body. I'm not saying that sleep isn't good for you. I'm not saying sleep shouldn't be a performance goal. I'm not saying,
Starting point is 00:19:25 when our body sleep it's our brain that builds the sleep pressure and when we sleep what does the brain do that's the most vibrant thing it does it dreams so i think dreaming is an essential feature of preserving a healthy brain and healthy mind in other news this episode is brought to you by momentus if your sleep's not dialed taking ages to not off you're waking up at random times and feeling groggy in the morning momentus's sleep packs How did I miss both of those? I hear to help. They're not your typical knock you out supplement, overloaded with melatonin, just the most evidence-based ingredients at perfect doses to help you fall asleep more quickly,
Starting point is 00:20:03 stay asleep throughout the night, and wake up feeling more rested and revitalized in the morning, which is why I take these things every single night and why I trust Momentus with my life, or at least with my sleep, because they make the highest quality supplements on the planet, what you read, on the label, so what's in the product and absolutely nothing else.
Starting point is 00:20:20 And if you're still unsure, they've got a 30-day money-back guarantee, so you can buy it completely risk-free, use it, and if you do not like it for any reason, they will give you your money back. Plus, they ship internationally. Right now, you can get 35% of your first subscription and that 30-day money-back guarantee by going to the link in the description below. Or heading to live momentous.com slash modern wisdom, using the code modern wisdom, a checkout. That's L-I-V-E-M-O-M-E-N-T-O-U-S dot com slash modern wisdom and modern wisdom, a checkout. Is there something interesting about the fact that we're conscious of our dreams? Because you could imagine a world in which the body shuts down, the brain shuts down,
Starting point is 00:21:04 and you don't have any conscious recollection of the fact that this thing happened. It was kind of, I guess, what you're suggesting is there are certain capacities that the brain needs and may need in future. There may be not quite as common as some other pathways that we use more frequently, And dreaming is one way for us to ensure that those myelin sheaths are kept nice and lubricated. They're moving quite accessible when we need them. They don't wither. They don't atrophies.
Starting point is 00:21:32 However, the fact that we're conscious of this, the fact that we can recall it, that there is a phenomenological, emotional experience of going through this, is that bit adaptive in your opinion? Or is that some spandrel side effect like a light bulb that? gives off heat as well as light. What do you think about the fact that we actually know that we have been through this thing? Because I could imagine a world in which you could retain the capacity without having the experience of being through it. Yeah, it's a massive question.
Starting point is 00:22:07 It's a fantastic question. And my opinion is to tell a few stories about how some of these things happen. So back to liminal states. I don't think any process in the brain, waking brain, dreaming brain is a rigid on-off process. So my feeling is when we remember some dreams, they're like solar flares that have leaked into our memory. And we wake up, we're accidentally sort of holding on to the residue of massive dreaming activity. that's my my hunch um and and the way to think about that is um the concept of self and autobiographical memory so when people talk about self self worth self this the the concept of self is created by a type of
Starting point is 00:23:03 memory there's procedural memory tying your shoe laces semantic memory stuff our phones record you know dates and stuff episodic memory like the episodes of our life and that what happens is they're stitched together by a capacity called autobiographical memory. And the thought here is from people who have certain types of psychoses, when they can't separate out their dream and waking state, certain patients with schizophrenia, it becomes quite confusing for them. So I think the dreaming process is richly active in all of us. The degree of recall is different between us and different in different stages of our life.
Starting point is 00:23:43 And so when we do remember a dream in the morning, or we wake up and we remember a dream, go to the bathroom and sometimes fall back into the dream, that these are just sort of the residues of a vibrant dream state that is breaking into our consciousness. I don't think that it's by design. I think it speaks to the capacity that we're never fully dreaming and never fully awake. And the best example of that is not sleep entry that Salvador Dali talked about or sleep exerith. We talked about sleep paralysis. But in the middle, certain drugs that we give our patients for Alzheimer's will make them have more lucid dreams. So the awareness of the dream state can happen when you're falling asleep, when you're waking up and you're holding on to some of the dreams. And there are habits you can do to hold on to them more.
Starting point is 00:24:34 But also in the middle of a dream, people can train to lucid dream. I know that sounds like, okay, there's a neurosurgeon talking about that, but it's rigorous. Galantamines and acetycholine antagonists that we give to improve certain functions in Alzheimer's patients, and they report a dose dependent increase in lucid dreaming. So I think the dream state and the consciousness, Nate, they're like two dimmers and they're overlapping a bit. And so when we remember something in the morning, rather than thinking that it's by design, I think it's sort of like an opportunity to have an insight into ourselves at a very emotional, very visual, very sexual time. Yeah, why did dreams often end up being so emotionally intense, do you think?
Starting point is 00:25:21 Well, because when you look at the areas that are activated preferentially in the dream state, it's the limbic system, which are the emotional centers. When you look at the dreaming brain, the regions that are activated, if you will, it's the visual centers. It's the imagination network. And then equally, you're dampening the executive network. So these big jumps of ideas and creativity and associations are not discarded by the executive network, as it would be during the day. It allows for that. Let me give you one specific example that I thought was really fresh when I was asked to prepare this book was, when you look at thousands and thousands of dream reports not yours or mine but like mine feel wild yours must feel wild but you start to see that very few people report doing math in their dreams I'm not saying like somebody's going to call in a right end say yeah but it's not like nightmares 100% reported it's not like erotic dreams sexual dreams over 90% teeth falling out being chased flying these are common dreams right math is very rarely reported and what I like is very rarely reported and what I like is
Starting point is 00:26:28 is, okay, if I take hundreds of years of patterns of dream reports, basically surveys, or Aristotle's comment about lucid dreams, now with modern neuroscience, it makes sense. If the executive network is dampened, that does calculation, it kind of makes sense to me that very few reports of math occur in dream reports. like that fits executive network goes down reports of math go down imagination network is liberated people report creative and wild dreams so it ties together what people are reporting for years why teeth falling out falling flying you know three dreams that i would guess almost everybody listening to this has had and before electricity and after electricity from the from the you know horse and carriage all the way to the electric car and it's like we need to to wait for airplanes to think that I could fall out of an airplane or for buildings to be
Starting point is 00:27:28 sufficiently high that you would fall from a skyscraper. Exactly. So that, so if we're getting mental health, um, is tied into certain families, nightmare one type of dream, nightmares, clusters in families. So nightmare disorder can happen. Territable. Well, or, you know, that's a complex word. I mean, you can have things cluster. I mean, you know, maybe those people are living in difficult situation. So it's hard, but there is a dream that clusters in family, just like certain mental health conditions would.
Starting point is 00:28:04 And the fact that we share the same dreams with people living in wildly different cultural times, something's built in. And that again speaks to, I think, the new understanding we're having in the last 20, 30 years as we can have people be in brain scanners and fly. fall asleep. Have you got any idea about what makes for universal nightmare? Is this just something? I got a big, I got a big theory about it. And so, so, you know, this book was, this book was important for me. It was, I had written a few others. One was, you know, and then Penguin UK in London and said they've always wanted a book that looked at dreams and dreaming from a certain
Starting point is 00:28:55 perspective of somebody with a complicated life story, somebody who's had the professor chops, but also could tell a story. And I really took it, you know, it was, it was wonderful, actually. It kind of liberated me. Part of that process was me rolling around Dodger Stadium in L.A. going to pubs in London and sort of throwing this out because it had to be for everybody, right he can't it's not meant and the question i would get asked the most like my if dream wait if dreams are good for us why do we have nightmares it was just sort of a you got and so that was chapter two um nightmares are it's a tough thing to explain because it obviously like why why you know if if why would why would he cook that up and so the way i think about it is um you have to look at the mind
Starting point is 00:29:48 as something that needs cultivating in children just like walking and talking. And so just like we're not fully formed and we have to be taught to walk and challenged to walk and talk and engaged, at the same time in the mind, there are certain cognitive developments that are happening. So in, they're called longitudinal studies. They had families allow their children to be woken up for like 22 years and report like what they're dreaming about different times and like when they were two or three like it's just like it's a blanket it's not very dynamic it's not a lot of movement and then around four and five six
Starting point is 00:30:32 nightmares arrive for every child it's rare to find i did a lot of pediatric neurosurgery still do i have three sons in their 20s they have to be told that nightmares always arrive in children healthy children, unhealthy children, some of my patients who had brain injuries, it seems to be a part of the mind's development that's built in. It arrives for everybody. And then almost invariably, very few kids have nightmare disorder. It doesn't linger into the next day and ruin their day like it does for adults. So it's sort of like a wave of thinking that a species of dreams that arrives. And then around 11 or 12, you have erotic dreams that arrive, whether kids, kids are having sex or not or teenagers are thinking about sex or not. They arrive. And the last
Starting point is 00:31:19 one I see is sort of the maturation, like adolescents. The brain looks the same, but we change who we are. So I think there are three waves of sort of the development of the mind. And what happens around that age of four, five, and six is also the development of something called the default mode network. Like until then, children have a hard time reading minds. They can't tell if smiling uncle means well or means harm and that capacity arise at the same time as nightmares and so my big hypothesis it'll be hard to prove is that nightmares create a sense of self versus other by having these harrowing difficult experiences it sort of creates that the world around me is separate from who I am and this engagement of monsters and different things creates this default mode network
Starting point is 00:32:09 that allows us to start to see ourselves as separate from the world around us and to be a little bit more critical in evaluating the threats and the people and their intentions around us. That's my big thesis. And that would make sense adaptively because before age four, five, six kids are so unindependent that the need to be able to distinguish between I am here and that is something else is kind of pointless because you're not let out of the sight of Mom or Dad. Yeah.
Starting point is 00:32:38 you're in the rap still you're very close you're not being led i mean i think that's a good point the other point is that um that it's just like every every every kid has to be told it was only a it's only a dream it's only a nightmare and that there's this just like we talked about liminal states in the beginning like in psychosis people can't separate out uh you know awake versus dreaming um and that to stitch autobiographical memory we need to know these are awake thoughts And these are dream thoughts. And dream thoughts should not disrupt your awake thoughts. If there are these things that happen in your mind,
Starting point is 00:33:14 but they're not actually the daily steps that link your life together, right? That in children, I don't know if before nightmares, they know the difference between waking thoughts and dream thoughts. Like maybe nightmares inform the child. It was only a dream. So it's always been a puzzle to me. Until then, do they not know that what they experience, in their thoughts while sleeping was actually not real.
Starting point is 00:33:42 Could be discarded. I guess that the creativity network in kids is so much more alight even when they are awake. You watch in the space of an afternoon, a child's a firefighter and a postman and an astronaut and a sports star and a rock star and asleep and then awake again and back to being a postman. And yeah, I dream of being able. I literally do dream of being able to have that level of creative access again. And I think so that nightmares are serving something fundamental because they arrive in all of us. It is the universal dream.
Starting point is 00:34:14 We can all talk about what they serve and the purpose. And the last thing I would say about that, to be a nightmare, it has to wake you up. It's not a bad dream. Like you wake up the next thing. You're like, ooh, that's a rough night. Nightmares have to wake you up. Sear your memory to be considered a nightmare. It's the dream that has to wake you up and be vividly remembered.
Starting point is 00:34:34 So I think there's some mental cultivation going on with this process that we all year. We'll get back to talking in just a minute, but first, some things are built for summer. Sunburns, hot girl walks, your ex-posting their Euro road trip, and now lemonade and salt. Uh? Element just dropped their brand new lemonade salt flavor, and it's everything that you want on a hot day. Tart, salty, and stupidly refreshing. It's like a grown-up lemonade stand in a stick with actual function behind the flavor. Because, let's be real, if you're sweating through workout, sauna sessions, or just walking to your car in July, then you are a little. You are losing more than just water. Element replaces the electrolytes that your body actually need.
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Starting point is 00:35:47 That's drinklmnt.com slash modern wisdom. Do you think it's important to remember our dreams? Have they got deeper wisdom to tell us, or should we just allow them to be a sandbox that sort of lives on its own? I think based on what I've learned, I think it's the ultimate wellness habit that goes. underutilized you know because um first uh and just to give you some examples that you know the sleep entry period this liminal state were based on measurements we can show you're kind of awake you're kind of dreaming sleeping i mean people like edison in inception inception the movie was with a falling chair was a concept uh based off of dolly or edison where
Starting point is 00:36:37 They'd be working on some created project, and he had a key in his hand, a little metal basin, and when he'd fall asleep while rocking on a chair, he'll fall forward, the key would drop, and then he'd write down his thoughts. He felt that there was something that could be extracted from that dream entry, sleep entries day. Lucid dreaming is something we could talk about later, but that seems to be something that people report wellness with people athletes people who are visual spatial tend to have more lucid dreams i think that's an interesting thought that we can um uh we can learn that ability there's a little bit of sleep disruption about it and then when we sleep exit which is the time i use quite a bit is i have
Starting point is 00:37:24 the luxury of not always hitting the alarm and i take those last five 10 minutes of thoughts and i write them down first uh before going on social media or looking at my email and that seems to be an idea generator for me. I think there's sort of those practical elements that you can do. But if, for me, just at a philosophical level, when my brain, with my memory, with my imagination, not somebody else's memory, not somebody else's imagination, runs in a different mode, hyper-emotional, hyper-imaginative, and something leaks out of that that I can hold on to, I think it's worth taking a look at it. And even just the process of reflection, I think, could hold some insight. But I would tease that out, it would be that the dreams that leave a strong
Starting point is 00:38:08 emotional residue with a central image, I think it's okay to say, why did I have that dream, you know, be your own therapist in that capacity, because it's coming from your imagination and your mind. The concrete example I will give is some people who are feeling well, feeling like they're coping well, will have a return, will have nightmares pop up in their lives, which serve as sort of a thermometer. And so the nightmares, if they're progressive, like headaches, occasional nightmare is whatever it is. Occasional headache is whatever it is. But if there's a progressive uptick in nightmares, that can happen while the patient is having, the person is having such a fantastic life during the day. So that can be sort of a warning sign or a signal that
Starting point is 00:38:55 maybe you're not coping well. So I think we're just starting to get into those features of, of maybe people's dream life should be part of the vital sides. When I started training, it was like bread pressure and temperature. Now we ask about pain. We ask about wellness. We ask about living situation at home. I don't think in the world of mental health, it would be a stretch to start asking and engaging people with their dream life.
Starting point is 00:39:21 Our dream experience is predictive of something in health? You mentioned an uptick in nightmares across the whole board. somebody is dreaming more, dreaming less. They remember it more. They remember it less, more lucid dreaming, less, whatever. Question. More nightmares. Are there any correlations between that and someone's overall health?
Starting point is 00:39:41 Good question. The dream pattern related with overall health would be nightmares. So two types of nightmares. Pediatric nightmares, we talked about age four, five, six, which I think are cultivating the mind. They don't really lead to nightmare disorder where the next day is ruined. And then nightmares in adults, they can happen once in a while. That doesn't seem to be a problem, but four or five percent have nightmare disorder where it disrupts the next day.
Starting point is 00:40:09 And in that situation, whether it's in PTSD or whether it's in trauma or whether you're going through a difficult situation, tracking nightmares, their uptick or their improvement can be sort of a measure of how people are doing. But as far as what I've read about dream recall, dream patterns, that changes. out our lives. So a lot of adults say they don't remember many other dreams. My cancer patients, when they get to end of life, they tend to have these genre dreams are called end of life dreams. They tend to be of reconciliation. They tend to be more hopeful than you would suspect after getting surgery and chemotherapy.
Starting point is 00:40:47 So your dream within our lives from nightmares to erotic dreams to the way we dream as adults, to drugs that change the way we. we dream and how much we remember all the way to end of life dreams, if you don't think you have a lot of dream recall now, that doesn't mean it won't be there for you or it can't be cultivated. You just have to track dream experiences and prevalence throughout a whole lifetime, and you start to see that they come in waves, which I find, which is, you know, which is interesting. How real is dream interpretation? I don't think it's real at all. I mean, because I, you know, I mean, I can't do it for myself.
Starting point is 00:41:29 You know, like... So what hope is there of a lady in a shawl being able to do it on your behalf? Well, I mean, I think just we have to look at it conceptually, and I think we were just talking about that. It's my imagination. It's my memory. So, like, let's... How do you know what this snake means to me? Not just what it means to me, what it meant to me five years ago. I'm not the same person I was five years ago. Like, a bridge. Let's take a bridge, for example. For some of my patients, it's, you know, they might be thinking about suicide, or it could be reconciliation.
Starting point is 00:41:59 with a loved one. It could mean so many things within that context. How can it bridge for you and me mean the same thing? But past that, a bridge for me means very different things within the context of my own life. I don't think a static symbol can reveal a dynamic mental life. Well, this would fit in with your perspective that it's kind of a gymnasium training ground sandbox for the mind. High intensity training for the mind. Yeah, that we maybe we shouldn't give all that much credence to it. Maybe the brain is just kind of running away with itself
Starting point is 00:42:35 because, isn't it strange? People have intrusive thoughts all the time. They see somebody stood next to the edge of the road and they think, wonder what would happen if I pushed them in? I mean, I'm not going to do it, but. I wonder what would happen if I pushed them in? Oh, God, this would happen, and that would happen. Wouldn't that be thrilling?
Starting point is 00:42:51 And you go, okay, are you making some sort of inference about the sort of person that you are for having a, had that thought most people would say no you know just have intrusive thoughts that occur during the day and you go okay can't go to jail for thoughts so your intrusive thoughts when you're awake and conscious are not that indicative of the sort of person that you are and yet you're telling me that the dreams that you have when you're not conscious are worthy of interpretation that i've never thought of that before but yeah we're prepared to give we're prepared to dis-say something which we have way less control over when we're asleep.
Starting point is 00:43:32 But then, on the other side, you know, the devil's advocate position would be there are very few windows that we have into the subconscious. The subconscious can often tell us things about ourselves that maybe we have repressed, not being prepared to feel, and perhaps there is some deeper wisdom to be gleaned from when we're asleep. I agree with that. But I don't agree that. you know, the lady in the shoal.
Starting point is 00:44:01 I don't agree that it can be made universal, right? I dream of a bridge. You dream of a bridge. And it's filled with emotion. It's a vibrant bridge. Okay, go ahead and explore it. You explore it for yourself within the context of your life. And I'll explore it in the context of my life.
Starting point is 00:44:25 For me, it might mean suicide. For me, it might mean San Francisco, where I went to college. For you, it might mean something else. So I think the dream residue being a window to our own individual at that moment, subconscious, hyper-emotional, hyper-visual, hyper-sexual state, yes. But a symbol that captures it between two people, let alone between your former self, I just don't understand that can happen conceptually. What about erotic dreams?
Starting point is 00:44:56 what have we come to learn about what fuels it I mean why not I mean the it's firing I mean you know why not that I mean that's uh it's this is that was chapter three because I remember we're talking about like I wanted to hit everything up up right off the top why we dream nightmares really nightmares and then erotic dreams um it's fascinating because it's another thing that happens before the erotic act. Kids don't have, kids who have never seen a monster and have a puppy,
Starting point is 00:45:33 they'll have nightmares that are wild. That's, that's coming, that's descending through our psychological inheritance. Erotic dreams. People have them before the erotic act. It's almost like an instruction guide. And what's fascinating to me is there's not a lot out there.
Starting point is 00:45:53 90 something percent when you go from sexual dreams and erotic dreams over 90 percent report having them the terminology well i don't know i think it's more inclusive so we start when you do surveys in other cultures they're more willing to sort of say yes erotic the term seems to be more it's easier for them to say yes to that right okay because a little less porn vibe yeah and it would also imply maybe hugging cut kissing that's not that's not exactly they're not doing it with their partner perhaps well and then the next thing is when you ask and as we get into more online surveys this is going to be great and more people are included but like 80% report infidelity and then the infidelity is with a small group of people like a repugnant boss or like family it's weird the tribe the characters and the characters in the uh the you know the cast and crew is narrow the acts are wild and so when you take that data healthy relationships have infidelity dreams, unhealthy relationships have infidelity. Those are sort of the surveys out there.
Starting point is 00:46:58 And that leads to a lot of cool conversations. But from a neuroscience point of view is, that's the part that really trips me out, is that around the time of erotic dreams, even before, you know, the pituitary has dripped the hormones that release all the hormones, a cascade in our body that leads to the sort of changes of maturity, is that the sense. the same fingertips that do touch can now do caress. And it's not like a new nerve got built in there. It's the capacity to perceive sensuality changes where the sensory nerves land in the brain.
Starting point is 00:47:41 It goes to the opposite side to a motor sensory strip in the sensory region. So around the time of erotic dreams, we developed the ability to have erogenous, zones where a light touch on a back can be a turn on rather than just bumping in somebody in the subway. That capacity doesn't really exist at age six or seven. And no new nerves are being deposited. It's a perceptual change in the brain. That's interesting. Yeah. So to me, I like thinking about, I don't have any big answers for that. I just want people to walk away from that and say, so those changes, the ability to be aroused happens around the time of erotic dreams. And often it's before you're actually mature. So I just
Starting point is 00:48:22 seems to me again that erotic dreams are arriving almost universally in adolescence to prepare for the act of procreation and to create the drive in our mind that we later carry out in our bodies. That's the way I see it. I wonder whether, I mean, this is almost certainly going to have been the case throughout history, if you've got a particularly prudish society, Victorian England, they still get it popping. Well, of course, you're not going to be able to, but I I wonder how many people that had these erotic dreams back then would have, there would have been a real source of shame for them because I'm cursed. My subconscious is contravening the norms of my culture and God is looking down on me,
Starting point is 00:49:15 especially if you're told that God is watching if you masturbate, God is watching who you're attracted to. You know, infidelity is one of the worst things that you should ever do. You should be loyal to your husband or your wife. And these dreams are like 80% infidelity and it's all with people around you. It's your mom.
Starting point is 00:49:30 It's your boss. You know what I mean? It's the boss you hate. Yeah. Yeah. I think it must have led to a lot of inner conflict. And so that when I write about erotic dreams and you look at it in different cultures,
Starting point is 00:49:43 you know, my feeling is this is a way that are just like we learn to walk and talk, nightmares do something, because they're a universal dream, erotic dreams do something. They happen in all cultures. They've happened over hundreds of years. They're happening with internet porn. They're happening in Victorian ages. And that to really start to think of the patterns of our dreams are not infinitely wild. That's the, and then what really teaches me is the patterns of our day are not infinitely wild. We build and break habits in similar ways we fail in similar ways like the brain is not infinite it does have some some boundaries in the way it works in the dreaming the very least godrails yeah or for example
Starting point is 00:50:29 dreams are not infinitely wild in the sense that you you don't do math in your dreams so there is at least one boundary right and then they tend to have certain patterns and now i'm using that to think about that we fail in different ways while we're awake in our lives and if you look at 10,000 people, the ways that people fail and succeed also start to follow some patterns that I think can guide us to like, hey, our brains and minds work a certain way. And when we learn about that, then you can say, where are we in this? How is our thermostat? Is a victory today just getting out of bed and not saying, hey, wellness, I got to feel well or just, I got to get at bed and get on the bus and get to the cancer center? Like, so I want to personalize that whether you're the
Starting point is 00:51:16 attic this is a side riff man but whether you're like there's this uh there these people in recovery are really good with horses in the kentucky derby whether you're into horses and racing or not but somehow the horses can tell somebody who's been through something and has earned and trained themselves to be calm like they have a better rapport with the animals no way yeah it was featured when it came out and so then and then there's like then you know like i was in san francisco i saw this person really struggling to not use you know just really just fighting that. And then I got a buddy in London who lends like this North Saharan seven marathons in a row, you know, just to show everybody he can. And when he's pushing to complete that seventh marathon
Starting point is 00:51:56 or that the person using is really pushing to not inject, I think it's actually the same brain processes and patterns that are working inside. And if we can learn how those work, how those can be deployed, how those falter, then we have a universal toolkit. And that's what this dreaming book, that's what I told you earlier was like, it's really important for me is because it's helped me actually understand that if the dreaming brain follows patterns, which seems infinitely wild, right, that you brought up, then, okay, so then our waking brain, we follow certain patterns. And we're not incarcerated by it. But if we learn those rules, rules of survival, rules of how our day can be empowered or watch out for that
Starting point is 00:52:44 booby trap and that falter and watch out for this attentional magnet because it's going to trip you up like you could have a uh you could have a toolkit you could have a guidebook to your own to your to your to your to your to your to your own mind and i that's where i want to take things going forward and that's what the dreaming book has taught me a quick aside you are probably not eating in a fruit and vegetables and you know it and this is going to help good news ag1 just released their next gen formula and for the first time ever they've also released flavors, berry, citrus, tropical and original. It's a more advanced and clinically backed version of the product that I've been drinking
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Starting point is 00:54:22 ag1.com slash modern wisdom what do you make of the prevalence of the repugnant boss in erotic dream i don't know if it's a power dynamic you know or it's uh you know i i don't know or the family. I mean, my idea was sometimes, yeah, the repugnant boss. But the narrow list of characters, I thought, a hypothesis, again, there's many things we can talk about that can't be proven, but evolution at bottlenecks. Like, there were times when, like, it's crazy if you think about it, like, how many different hominid species there were at one time. And maybe homo sapiens were down to.
Starting point is 00:55:08 a few hundred thousand or a few thousand at that time and maybe it was an evolutionary advantage to only procreate within the tribe like that's a very hypothetical scenario but there's there's a field called evolutionary psychology that are cognitive archaeology that the way we think was an advantage that led us to to thrive in competition with other other hominids because you know People are like, oh, bigger brain, the brain is strange. Stop that. Theanderthals had bigger brains. But something with our minds was the advantage.
Starting point is 00:55:44 It wasn't just the size compared to Neanderthals. And that's why I love like evolutionary psychology. And the way we're thinking now is something we've inherited that was advantageous hundreds of thousands of years ago. But we have to now adapt that to the modern life. Okay. So if we're thinking adaptively here, I'm also a huge EP fan. Yeah, yeah, yeah.
Starting point is 00:56:07 If we think adaptively, the repugnant boss or the family member very well maybe were not particularly well used to having 200,000 people available on Hinge or Tinder or in our local city that are our age and hot trot, there's usually only a very, very small group of people that are here. And perhaps the sleep dream of that is, what if I test this out? How does that make me feel? What does that mean for me? Because there aren't that many other people that are available and probably should see if this is actually going to work or not. I mean, that's possible. I mean, now, as far as the characters in our erotic dreams,
Starting point is 00:56:55 whoever writes this book next, it's going to have a lot more surveys from a lot of different types of people speaking a lot more openly about these things. And then they're going to have to figure out, like, you know, I mean, celebrities are part of the erotic dream. They're considered part of the tribe, like Brad Pitt or whatever, like celebrities show up and feel familiar. Something to do with status, maybe. Or familiarity that you see them so much, you feel like they are.
Starting point is 00:57:19 I don't know. We're just riffing. But I'm curious to see that with social media and stuff, how influencers do they show up in a similar capacity as conventional celebrities that I grew up? Let me warn you right now. You do not want the pillar talk of a podcaster in your dream or not, you know. People are going to call in, they're going to write in now. No, thank you. Look, look, you went... A pugnant boss, Chris.
Starting point is 00:57:41 Yeah, you slept with a podcaster. What did you expect to happen after? God, it's three hours and he's still going on about the biggest gun of World War II. Will you shut the fuck up? Hey, look, I mean, you asked for that. You knew what you were getting into. On the erotic dreams thing, I don't know whether we have enough longitudinal data to work this out. I would be fascinated to see what impact the prevalence of porn has had in changing the sort of erotic dream.
Starting point is 00:58:06 men cycling through even more partners in one sexual fantasy are they being influenced by what they see on screen? I certainly know that if I read it... That's a massive book. It's just 10 years. Somebody just needs to rock that.
Starting point is 00:58:19 I like to read fiction before I go to bed and I've been... I have an admission to make. I've been getting into chick stuff. A lot of chick stuff. Freedom McFadden, the housemaid, Housemaid's Tale. Alex Michaeladies,
Starting point is 00:58:33 who wrote The Silent Patient, It's like thrillers. Really by chicks, but not necessarily only for women. Really good. Like, easy, easy reading. Usually a woman in her early 30s that's kind of looked over who fixes some sort of crazy murder thing that happens. That impacts my sleep like fuck, dude. Like, I go to bed and I've got, but it's usually interesting.
Starting point is 00:58:58 It's a particular, so you think, okay, if the thing that I read before I go to bed, I'm also watching the Tour de France Unchained on Netflix at the moment. For some reason, I'm not. having many cycling dreams, if these two things are happening, we have to assume that people who use porn a lot, the volume. How is that not impacting erotic dreams? I think that's the, I think that's the experiment that's, that's ongoing and somebody younger than me will see that that's the opportunity here to look at that. And in the context of dreams, the, it's super physiologic
Starting point is 00:59:36 stimuli is another concept like you know the the you can't look away because it's just so it's just like a coked up version of something and so you may have some finesse and emotional regulation and you
Starting point is 00:59:51 may be able to sort of in your own competition it wants to be like I'm not going to look over there because yes I feel desire and lust for that that image but that pops up once or twice but when it's just like on loop and you can't I'm surprised
Starting point is 01:00:07 porn addiction is only 5% given just the super physiologic stimuli that it is but yes the impact on dreamscape the modern world's impact
Starting point is 01:00:21 on dreamscape is as big as the when there were rumors that when black and white television went to color that dreams also became to color there's some urban legend about that like
Starting point is 01:00:31 I mean the world was in color but when color magazine and color TV came out, there are small reports that our dreams were more in color. Wow. But the point is whether that somebody can further explore that or not, but right now this is a PhD thesis for somebody right now if they want to run it. How unsurprising that the things you consume will influence the way that your subconscious works at night?
Starting point is 01:00:59 But sometimes not, right? Like it's an inconsistent process of feeding your dreams. And that's what I like about it is that you think like this, you think your dreams are only going to have the thing that you're worried about and it doesn't. So it has, it's metaphorical. Like you might have a lot of anxiety about something and then your dream is filled with anxiety. But it's like, it's like Vietnam veterans when they were going to divorces. They would have their PTSD come back.
Starting point is 01:01:26 They weren't, they weren't dreaming about fighting with their lovers or spouses. So dreams arise in a way that's metaphorical. and requires interpretation by the person who's having the dreams what do you think that says about where the inspiration for dream material comes from i think it's a constant it's so so i think during the day we are just stay with me now um if we took if we took a if we took a brain we flattened it out and we said well they were continents right thinking of the brain is this spot or that spot sometimes if we injure a certain spot like a nail i used to
Starting point is 01:02:05 to take care of a deal out of trauma nail gun injuries they come in with like a nail stuck in you know or they'd have a fall and a blood clot would come out you would say you take out a certain part and they would lose a certain capacity you say oh this is what does this it's not like that it's like he throw or london you know if you have an issue at lax it's going to disrupt something globally but it's not that lax does flights l a hub that controls flight throughout the planet similarly there are spots in the brain hubs that control broad processes throughout the brain. And what I like about it is that these injuries have informed us about how the brain works. And when you have an injury in that dorsalateral prefrontal cortex, which is these little spots here that, that's the
Starting point is 01:02:54 conductor of your whole brain while you're awake, those people struggle with math. And so it's, okay, it plays a role in that. And if you flatten out the brain and you, you're have these different continents and lobes and structures hypothetically you have certain parts that are ramped up during the day during executive network they're they're not in one area they're connected by a lot of things like like where's the economy i mean is in the cities and wall street it's everywhere but there are some hubs so the executive network is one it's like like in las Vegas where belagia where those waterfalls go up think of the executive network as those neurons and their connections they're like 51%.
Starting point is 01:03:34 they're running shit right now and the imagination network is 49 and and when you dream it it kind of flips you have 49 51 hypothetically okay but when you when the when you're when you're when daytime and it's executive network you're still pulling from imagination to to run to get the task done you're still thinking if i went left if i went right it's called counterfactual thinking if i go this way last time i got hurt you know you're still imagining plus executive network. And what happens with dreams is when the executive network falls back, your brain uses imagination and its own mental workspace. And the biggest example of that is dreaming. So think of the brain is always on. And there's always a, there's always a balance between
Starting point is 01:04:26 executive network and imagination network. And the examples of the most dominant time when your executive network is happening, is under threat when you have to navigate a crisis. And the biggest example of when your imagination network is most dominant, let's say 54 to 46, is when you're dreaming. But everything in between is a dance between, you know, execution and idea. And what I like, this is just a side riff. Like they did this thing about analyzing poetry or book cover designs. and they would put these people in fMRI machines and the idea generation is mostly imagination network
Starting point is 01:05:09 but to figure out if you came up with a good idea you had to toggle back to dominant executive network otherwise you just got a bunk idea right and so I don't want people to walk away thinking that we're at liminal states that we're all one or all the other and there's a thermostat in our life and how to cope but there's also a balance
Starting point is 01:05:31 of executive network and imagination network and there are things created people do to bring in the imagination network but imagination requires executive function and really great executive function
Starting point is 01:05:45 still requires imagination. What are some of the ways that people who want to activate their imagination network more effectively when they're awake can do that? Ooh, all right, so I got some stories for this one.
Starting point is 01:05:58 There are some examples that speak to, again, a damaged executive network liberating a lot of imagination. One example is alcohol. It dampens the executive network. And some people feel that they're more creative on alcohol. And it's dose dependent. You know, not 10 drinks, not one drink.
Starting point is 01:06:20 I mean, alcohol has to be really handled with care at different doses. It makes you feel different things. Number two, frontotemporal dementia that Bruce Willis has, These patients in Alzheimer's clinics, when they have a certain injury to that part of their brain, there are publications. If people go on and look it up, they show them and they're like artistic abilities, they can paint a lot better. Dementia and injury to the executive network leads to a liberation of hidden artistic, like painting, drawing talents. So those are two examples.
Starting point is 01:06:55 Some people get hit with lightning bolts and even if it's one person, the, the electrical shift can release, can change that executive network to... No way. Yeah, yeah. I mean, they're out there for savants. So when I say this, I want people to look it up, you know?
Starting point is 01:07:12 And that's also one flew over the cuckoo's nest where that movie made a portrayal of shock therapy is very negative and it generally was. But now we create, we send in electricity and create a seizure to break people out of suicidal thoughts and stuff. So there are a lot of things, and those people sometimes have more.
Starting point is 01:07:29 creative ideation. So we know that there are hidden, hidden creative abilities in all of us. And the executive network is, is raining them in to get the task done, to drive on the freeway, to be on the tube. So how can we extract those? I would go back to sleep entry where that's a window where Salvador Dali thought you have good idea generation. Sleep exit is also a time where the executive network hasn't fully come back online, if you will. So your ideas will, I have a lot of ideas during that time. Bad ideas, good ideas, but it's an idea generator. And then during the day, what you have to realize is you're not going to hit
Starting point is 01:08:10 an undirected thought is actually the thought you want when you're trying to be creative. It's hard to have a triple espresso and then drop creative stuff. It's the liminal time waking up, meditating, exercising. focusing on something like a flow state partially but not you know not exclusive driving doing the dishes playing pickleball but partially engaged and then something and then something and then you can't demand it you have to cultivate it you can't white knuckle creativity it's highly highly irritating another espresso let's yeah running back fuck it um yeah that's that's certainly something i've found to be true um sitting down and
Starting point is 01:08:57 demanding yourself to be creative is a reliable way to ensure that you're not creative. You have to flirt with it. I mean, that's why it's not a gift everyone has, but it can be cultivated, you know. You mentioned there about some of the transcranial electric stuff. As a neurosurgyny person in that world, what do you make of this sort of new revolution? I know that depression, anxiety, some compulsions are being treated with this now. Yeah, what do you make if the... It's real, right?
Starting point is 01:09:31 But it's also very easy to go on Amazon and get one for $4.99 where they got the little headband and being positioned in the same way. So the stuff where it's real is rigorous, it's intense, it's at massive elite centers. Usually 30 days of back-to-back treatment as well. Yeah, and not a 30-day refund like on Amazon, right? So every time I...
Starting point is 01:09:57 neurosurgery was neurosurgeonee was a funny word um we have to be able to talk about things like instinct and hunch because that leads to the fullest capacity right smarts plus instinct who doesn't want that sports has the best thing like you know under pressure how people perform that can't that can't be white-knuckled either the the brain has to be thought about in scale you cannot answer all of these questions with the brain like people talk about it's like you can't It's not a homogenous organ. It's not a liver. If you dice up the liver at different areas and you put it on a magnifying glass,
Starting point is 01:10:33 it's the same cell, essentially, for the most part. The brain has so many different cell types, so many different architectural components, floating inside a, you know, it's buoyant. It's floating or striated liquid. It doesn't actually sit on the skull, you know. And like, so it's an ecosystem of little electrical molecular machines like tiny jellyfish that are spraying electricity and chemicals at each other. And as we talked about before, with those stickers,
Starting point is 01:11:00 you can record electricity. You can also deliver electricity. And that would be shock therapy. And now what's less disruptive is delivering using magnets. So for people who are familiar with physics, I'm not. I took all the classes to go to medical school. But electromagnetic fields, they can influence each other.
Starting point is 01:11:23 So you can pulse a magnet, through the skull, and it can change the local electricity of a certain region. So you can actually put a magnet on the surface, no incision required, and pulse to the motor strip and make somebody's arm move because back to, it's an electrical currency that leads to dreams, you know, it's measured at night with dreams. It can be, it can be tickled. And so now at Stanford's doing some good stuff with another. the places is, well, what if you have obsessive compulsive disorder? Somebody else makes the
Starting point is 01:12:02 diagnosis. The term is not used casually, let's say. It's not like, oh, I'm obsessed, but somebody really is like, man, I turned that doorknob 120 times today. So they're looking at the pulse can be used to dampen the dorsal lateral prefrontal cortex. Oh, and it can be used to heighten. so if you pulse that area every day for 30 days and you dampen it a little bit and at the same time somebody gets therapy and you do cognitive reappraisal like the parts of therapy that I like are some of the ways where you're basically training yourself and you say hey that's not dirty don't don't worry about it or that door is locked you don't need to wash your hands 80 times a day like you're you've been struggling with that fight the whole time people will OCD, they know they shouldn't. And now if you pulse that area that's kind of made it, you know, difficult for them to control, that combination is leading to results that we haven't been able to find by just giving medicine.
Starting point is 01:13:01 So it's real, but the thought that you can buy this and then do it for yourself. Self-administer. Yeah, or with with a device that looks the same, but is not delivering the same technology. But that is the future of mental health is a combination of therapy, magnetic pulsing, occasional medicine, and that as a cocktail, not just like three different types of antidepressants,
Starting point is 01:13:28 which were helpful for people, but a mixture of talk therapy, a mixture of exercise, talk therapy, magnetic pulsing, all non-invasive. And if you can get a 10, 20% improvement in what was going on right now, I think that's fantastic. Before we continue,
Starting point is 01:13:45 you, if you haven't been feeling as sharp or energized as you'd like, getting your blood work done is the best place to start, which is why I partnered with function because they run lab tests twice a year that monitor over 100 biomarkers. They've got a team of expert physicians that take the data, put it in a simple dashboard and give you actionable insights and recommendations to improve your health and lifespan. They track everything from your heart health to your hormone levels, your thyroid function and nutrient deficiencies. They even screen for 50 types of cancer at stage one, which is five times more data than you get from an annual physical. Getting your blood work drawn and analyzed like this would usually cost thousands,
Starting point is 01:14:21 but with function, it is only $500, and right now, the first thousand people can get an additional $100 off, meaning it's only $400 to get the exact same blood panel that I use. Just go to the link in the description below or head to functionhealth.com slash modern wisdom. That's functionhealth.com slash modern wisdom. You've triggered dreams while people were awake during brain. surgery. What's that tell us about? I mean, this is how the, I mean, this was a story back in, uh, I noticed in my 20s when I was in training. So, um, um, so there's this thing, you know, some, some patients benefit from
Starting point is 01:15:00 being woken up with, with their skull open in surgery. How could you benefit from that? Because whereas this dorsal lateral prefrontal cortex, we kind of know where it is, whereas the movement area like the hand region we kind of know where it is you know just based on an MRI it's consistent in you and me and others language is in a neighborhood it's in the left temporal lobe right around here and there is no there is no specific address for it it's different in both of us and so to figure out um where language is so you don't hurt it as you're trying to enter the deep brain through that area you have to map the brain and let me and so what we're trying to do is to get to it so
Starting point is 01:15:46 the neurons the bodies of the jellyfish molecular jellyfish are all on the surface and then their axons and tentacles converge into the middle of the brain so the cortex the canopy the tree tops is where all the where all the thoughts are happening if you will and so what we're trying to do is identify the parts of the tree top right here the cortex that when you stun the activity in this tiny little area, it doesn't lead to any issues with them talking or understanding. And this isn't just like they'll still be able to text. You can hurt the whole capacity of language.
Starting point is 01:16:25 So the only way to do that is to wake them up in surgery. And there's a, you numb the scalp, you put them under anesthesia, you open the skull, it's like ice fishing. Then there's a little covering on the brain called the Dura Matters, It's like a, it's like, you know, like a sort of a skydiving parachute material. You can pick it up and stitch it at the end. You open it up and then there it is. It's beautiful.
Starting point is 01:16:49 It's stunning. It's white, speckled with blood vessels. And then you let them wake up slowly over 30 minutes. The probe of fall is lightened. And then somebody engages them and you have them count and sing and sometimes even play the guitar. like UCLA's got a YouTube video with somebody doing that like bigger capacities right
Starting point is 01:17:10 not just like pinch your finger but and so they'll sing like they'll sing or they'll count and it'll do it in multiple languages one two three four five six one two three four five six and then you'll then you'll take a little spot a little electrical pen faint has been electricity and the brain can't feel when it's being touched
Starting point is 01:17:29 it only feels through the nerves it sends out so when you dissect the brain on an awake patient they have no idea what's going on and you tickle the spot and you stun those like collection of neurons there maybe the size of like a tiny pea and they keep counting one two three four five one and you say okay
Starting point is 01:17:46 I can go through this little piece to the deeper brain and I won't hurt their language abilities so you put a little white piece of confetti on there are a number and then you go next to it and then you'll find areas that cause speech arrest you'll say it'll be like one two three four you'll buzz there'll go one two three
Starting point is 01:18:04 three three three three three three three that's for real you guys can look all that up that's been going on for 60, seven years and you said that caused speech arrest you put a little red piece of confetti so at the end the surface of the brain as you're going deeper it looks like Swiss cheese and you've you've identified the portals through which you can dissect to take out the deeper tumor and not injure their language why is the language such an important indicator That's a big question. I mean, I think it kind of makes us who we are. I mean, it was sort of a differentiating thing for mammals is language and then all the complexity that comes with language.
Starting point is 01:18:45 But it is housed in a neighborhood. And unlike the frontal lobes, there's not a lot of redundancy. So the motor strip is the same. Apes, you know, humans, the same. Language, it's kind of a fuzzy address. One frontal lobe can be injured with a spike, with a tumor. And people are mostly fine. I mean, they go home, they drive, they go to work.
Starting point is 01:19:14 So there's a maximum redundancy in these, the prefrontal cortex is a, it's an important word, it's front of the front. It's the things that pushed our foreheads forward. And it has three very interesting components, the dors, lateral prefrontal cortex which is mostly out here dorsal up lateral it's just fancy then there's an orbital frontal cortex which just sort of sits above the eyes and that does a lot of like when people were injured there they can't change their political views or they don't get like social fopa like there's a lot of complex social things that happen up here with a lot of redundancy and then language and feelings of
Starting point is 01:19:53 spirituality and stimulating here where people like have nightmares smell burnt toast that's temporal lo and that's a fuzzy area without a lot of redundancy and then the motor strip is a very precise area so there are different regions you have to learn
Starting point is 01:20:10 how to dissect around and through and some of them can have a little bit of damage and you still function relatively well and some of them even a tiny bit of damage and it's wrecked yeah and that's the craft is how do I get to the deeper brain
Starting point is 01:20:23 how do I which without damaging anything that doesn't have redundancy yeah how do dreams differ in people that have got brain injuries or really severe trauma um that's a good question the um the range of injuries vary the range of drugs vary i couldn't i couldn't figure out like the dreams on drugs was just so wild i couldn't find a pattern i mean you know people smoke weed uh they don't remember much or are they having fewer dreams or fewer less dream recall and then there were stimulants and antidepressants and all the different combinations.
Starting point is 01:21:00 I couldn't find a consistent pattern for it to become a chapter. I think that would be for the next author. And similarly, in brain injury, there wasn't really a consistent pattern. With exception to one, the thalamus is sort of like this, the pineal gland that they talk about being the third eye. We remove that. Melatonin goes away. and we remove that, and patients are fine.
Starting point is 01:21:27 So I'm not saying that people shouldn't believe in that concept, Descartes and the third eye, but the pineal gland is essentially evisted, it's like a appendix. But the central, like the size of an egg, there's something called the thalamus, which is sort of the gate for all the sensations coming up and it refines the movements going out.
Starting point is 01:21:47 When you have injury in that area, they tend to have a lot more lucid dreams immediately afterwards. So like, like, it's almost like there's too much arousal permitted in the sleeping state because the thalamus is injured, right? The gatekeeper has stopped keeping the gate. Right, because the gate is, again, nothing is ever off. If there's an alarm that goes off where you smell smoke, you're going to pop up out of your sleep and dreams.
Starting point is 01:22:12 And that, what is let through, and they used to do all kinds of weird things like have people sleep and they put their hand in a glass of water or a bucket and see what that changed. The point there is a thalamus is, is the gatekeeper that lets certain things through. If that part is injured, let certain things through and says,
Starting point is 01:22:31 time to wake up, there's an alarm. If you injure that part, you get a more lucid dreaming. Awareness seems to creep into the dreaming state a little bit more readily. Could you see in some ways the thoughts that people have in their dreams being more real or more accurate
Starting point is 01:22:48 to their sense of self than their waking thoughts? They're unencumbered by the executive network, amping everything down, their sense of self, the story that they have arched together, this is who I am and this is what it means to be me. I had a conversation with Dr. David Spiegel about hypnosis. And it sounds not too dissimilar that maybe in some ways we're liberated. So, yeah, I wonder whether, yeah, some of the thoughts we have in dreams could be more real than the ones that we have when we're awake.
Starting point is 01:23:17 Well, I don't know. But I will tell you that some dreams require, no interpretation, right? You're stressed out about giving a talk. You show up naked at the podium. Your end-of-life dreams, those tie up. But as we discussed earlier, let's not hold dreams to a standard we wouldn't waking thought. Like, we have all kinds of junk thoughts and thoughts that we don't want to hold on to, thoughts that don't reflect who we really are. And I think similarly for dreams, it's a wild landscape. What it is is your brain in a hyper-emotional, hyper-visual, hyper-visual, sexual hyper imaginative state that is creating experiences at the neuronal level not at the
Starting point is 01:24:02 you're paralyzed so you're not living them out but it's from your memory it's from your life story right it's drawing upon all that imagination that's liberated from the bank of memories and experiences you've had and i think in that way it's personal this individual and maybe doesn't give a truer insight but it gives a different insight so you got to think about your life when you're awake when you're waking up We were falling asleep, hold on that dream that stuck around a little bit longer, and just use all those portals to stitch the story of are you liking where you're at and maybe you need to change or maybe you need to be at peace with yourself. I think the main thing that it makes me think is that it's a reminder we have way less
Starting point is 01:24:46 control than we think we do. I love that. I think that's the main thing. Shit is firing. We are not driving. I mean, and during the day too, right? I think that goes back to the, but if we learn the ways in which at this time, I have less emotional regulation, at this time, I have more emotional, right? Like, if we knew, it's not that we have a lot less control, but it's almost like riding, it's like the stream of conscience, like there are some boundaries and you are, you are sort of riding on a river, you're being tossed around, but you have some, you can drop a hand and control and pivot and move around a little bit.
Starting point is 01:25:20 So I think if it allows for failure not to be permanent, allows for triumphs not to be permanent, and it allows for us to say that it's okay to not have a linear goal of self-improvement and growth mindset. Like to me, it's cyclical. There's the winter in our life. Victory is sometimes just getting up. Victory is sometimes not, you know, just not falling apart if you get a cancer diagnosis
Starting point is 01:25:47 or your child gets ill. So I'm trying to come up with universal ways of understanding how our brains and minds work. So it applies to the elite 900 running 100 mile athlete or the person saying, you know, I don't want to use this oxycontin that I got after surgery. I'm trying to give this up, you know, that it's the same universal processes at play. It takes a judgment out of it, too. Going a bit more broad than just dreams, someone that spent a lot of time looking at the brain. What are the myths that are widely held about the brain that don't know you the most? Would you wish people would stop believing about the brain?
Starting point is 01:26:26 I wish they would stop talking about it as the brain, as if it's a homogenous singular entity, the brain, the heart. And I think it's, I think it requires just one level more. And the way I would say is, I'd love for people to have a sense of scale in their explanations and podcasts and stuff. Is it at the neuronal level? Is it at the network level, executive network or imagination network? Is it at the lobe level, the anatomical level, temporal lobe and language? Is it at the global electricity level, seizures, dreams?
Starting point is 01:27:12 And so when people say, well, the brain prefers this, the brain thinks this. It doesn't make sense to me because it's not descriptive of the tremendous diversity in this ecosystem in our skulls. So I would love to see one more level of, not proof, but a little detail or precision. Depth of explanation that goes beyond the brain as if it's like muscle or liver. Yeah, yeah, yeah, yeah, yeah. Right? So then that way you'll know if people have really thought it out. That's one.
Starting point is 01:27:44 And then the number two is this myth that we only use 20% of our brain? No, I mean, the whole brain lights up. But to do one thing, we may only use 20% because it's really an energy hog. So the brain wants to be efficient and fall into patterns. And the last one is that it's limitless, you know? Your body's limitless. Your mind is limitless. Actually, no, I think you can be closest to limitless in your behavior.
Starting point is 01:28:14 If you realize that there are patterns and proclivities and tendencies that all human brains and minds have and to try to identify when somebody does it well, what are their coping strategies? When somebody's struggling the way in which they falter with their goals, maybe I don't, I'm not falling apart now, but there's a lesson there for me because I don't know what's coming down the road. I haven't gone knocked down yet. And that's called ecological validity where it has to constantly be tested in real world. where it's slonario. So to me, the learning that the brain is not limitless, limitless, and the brain creates a mind that is reciprocal. Brain makes the mind. Mind can change the brain a little bit. And then the biggest conundrum is why the mind doesn't always translate to behavior. You're like, convinced I'm not going to do this or I'm going to do this. He just can't get it done.
Starting point is 01:29:07 That bridge between mind and behavior is also another, an area I'm looking at. And that's where the coping strategies go, rather than saying, oh, don't drink, don't smoke. It would be nice to say, when the thought of smoking a cigarette comes in your mind, these are the processes going on. Break it at the cognitive level with step one, two, three. Avoid the intentional magnet. Do this. Don't look at it. Definitely don't let that smell come into your nose. Okay, now it's in your body. You had a whiff of smoke that your partner's having. Now your body's jonesing for it. Your hair is sticking up. bring in these strategies here somatic therapies deep breathing like to know the ways in which we falter and then to apply strategies because the brain has uh uh is not limeless it falters in a certain way
Starting point is 01:29:56 triumphs in a certain way it's a little bit more prescriptive to the way what stage in your you know failure or triumph you're at would give a little bit more precision to rather than because it could it can get overwhelming i would never tell my cancer patient like you know just just be well or you can do it. They have to be coached through the process. So I'm trying to come up with a universal toolkit to understand this is what I'm feeling. This is the way most brains and minds and people falter when at this stage of addiction, of desire.
Starting point is 01:30:29 And at this step, I want to use these strategies. Okay, now I'm going to get the cigarette. Okay, now I want to use mitigation. Give away the pack. you know like but not to just give a global strategy don't smoke don't smoke but if you're being pulled in that direction here's the game plan uh that's what i want to build a universal toolkit do you think the neuroscience industry is overselling some of the new tech that's coming along fMRIs brain scans of all different types we can detect onset of Parkinson's CTs
Starting point is 01:31:07 CT scan with contrast, all of this stuff. Are we, are they making promises that the sort of insights can't cash, no? I think so. It started like 20, 30 years ago, we needed these scans to do surgery, to do brain surgery. So I'll tell you this is another story. My professors, when you had a blood clot, they would see like somebody's eyeball was, you know, pupil was big. and they would call it exploratory treffination with a hand drill just start with the patient's family's consent 34 years ago there were no CT scans and they would just make random holes till
Starting point is 01:31:47 they hit hit blood like drilling for oil then a CT scan came out and changed everything you could see which side the blood clot was on it's fantastic right they're coming out of hospitals for neurosurgery then we try to figure out like function and that's where fMRI started and because MRIs don't have radiation, you can elect a bee in there. You can get MRI every day. Cat scan has radiation. And so neuroscientists started putting people in there. And what I would say is what's happened is the term is being thrown around, brain scans,
Starting point is 01:32:18 but the information, nobody's explaining it, that this area is activated. But what if you activate the area that, you know, stops a function, that's different than activate an area that grows a function, right? So there's a modulation of the brain. You don't, not all activation is good, not all inhibition is good, right? And so that those nuances are not getting out. But the term brain scan can be used by any author now. And I'm not saying that, I mean, everybody's an expert in the brain, right?
Starting point is 01:32:56 Because we have one. So I don't, I'm not saying that we should limit that. But the question should be one step. further that what what is the meaning of that a brain scan shows this and the way to understand in my opinion what the meaning is is to ask how is that experiment set up right like just to say so you have a thousand people who think of puppies in an fMRI and then you have a thousand people who don't think of puppies and think of snakes in fMRIs and then you're looking at the differences, puppies effects on mental health versus snakes affect on mental health, that experiment
Starting point is 01:33:39 can't be set up. Because you can't stop the person thinking about puppies, puppies, and you can't really control the person thinking about snakes, thinking about puppies. There's no way to set that experiment up. So when it says brain scans show this, I think if I were an interviewer, I'd say, well, how is that experiment set up? And I think that way we would get past some of the fluff that's out there because there has to be an experiment that justifies the answer. And then just throwing out brain scan, I don't think, is enough. What role does lifestyle really play when it comes to cognitive decline? Massive.
Starting point is 01:34:13 I'm seeing a lot now. I'm big behavioral genetics stand as well. I think that heritability has got a fettered past, but it's real important. And I think that more people should learn about behavioral genetics than do. I think there's a lot being laid at the feet of lifestyle because It's something that we do have control over in a meritocracy where people feel like they want to be able to author their own life. This idea that you are being puppeted by some stuff that happened literally before you were born, like as you were conceived, is very disempowering as an idea to a lot of people. But I also think it's super informative. And if you can kind of get past the initial discomfort of, there's some stuff that I didn't choose that I'm at the mercy of. but on the flip side of that
Starting point is 01:35:03 lifestyle as well so talk to me about cognitive decline and it's contributing elements lifestyle genetics how do you come to think about it DNA is not destiny especially when it comes
Starting point is 01:35:17 to the brain and mind like I mean DNA might be destiny for like heart attacks and stuff like that or certain there are certain medical conditions that are very linked to genetics epigenetics but
Starting point is 01:35:28 whether you have a proclivity or tendency to have Alzheimer's or dementia or not, whether you want to stave that off because you don't want to know based on a new Alzheimer's test or whether you've been given a diagnosis and you're trying to work through it. The treatment is all lifestyle and behavioral. The medicines are limited. They exist for early diagnosis and Alzheimer's, but the treatment is all lifestyle. The way I think about it is five key things to do, or a handful of key things to do is one, you've got to keep the arteries open.
Starting point is 01:36:07 We've been talking about the beautiful brain. You have four arteries coming up. They get into this beautiful branching pattern. It's exquisite. Parts of a loop over each other. It looks like a chandelier. We call it the candelabra. And they get narrower and narrower. So you've got to irrigate the flesh. So whatever is good for keeping hard arteries open, and kidney arteries open is also good for keeping brain arteries open.
Starting point is 01:36:31 Exercise. Yeah, or taking the anti-collestral pills that are long established and mostly safe, like pretty safe, you know. So exercise, yeah. But exercise does a couple of them. So you've got to keep the plumbing open to irrigate these neurons. Number two is you have to eat a certain way. And I know there's a lot of diet stuff out there, and that's a whole theme.
Starting point is 01:36:56 but the thing that over decades has been proven to preserve or even increase cognitive health, cognitive function, is the mind diet, which is the closest thing to it is pescatarian. It's mostly plants, fatty fish. And the reason, so I like to take it one step deeper. The reason it's fatty fish in omega-3s is you mentioned the word myelin before. And so the neurons and the axons, the way they make the electricity communicate faster is that the cable is wrapped with a fatty sheath that's called myelin and then the electricity actually jumps across the little gaps they have and it goes faster than if it does not myelin coded. And thought can actually deposit myelin preferring that thought to happen again. That myelin sheet is made from omega-3s.
Starting point is 01:37:52 So there's a specific fat that's needed for myelin and that's omega-3s and fatty fish. You can get in flaxseed and other things too. So keeping the plumbing open, given the brain the material it needs. Now, we're at the scale level, right? Okay. And then you go in a little deeper. The timing of eating is interesting. I do think there's some pretty strong neuroscience evidence of intermittent fasting.
Starting point is 01:38:19 I know a lot of diet things out there, but. skipping break if you have the luxury of skipping breakfast skipping going to 16 hour windows will if you don't eat you're not going to just drop dead and the brain the brain is a uh a hybrid vehicle the brain can live off of neurons can you know thrive and and use glucose or ketones and so after 16 hours your liver will will turn out ketones if you haven't eaten so that's how you live past you know, the 16-hour window if you don't consume anything. And that switching back and forth in intermittent fasting, the cognitive test now, now we're getting from flesh to mind, people seem to have more focus, people seem to have more, it's not about weight loss,
Starting point is 01:39:10 but intermittent fasting, it's letting the brain have glucose and ketones a couple of times a week. That's interesting. So your suggestion here is that all ketones, someone that's doing a full ketosis or carnivore-style diet or somebody that's doing a classic sort of omnivore-style diet, which when you're grazing, typically you're not going to drop into ketosis unless you forget to eat carbs for a couple of days or something. You're suggesting that there is a principal brain benefit and neurological benefit to the switching between these two fuel sources. Correct. That's interesting. Weight loss is separate. Yeah, yeah, yeah. And autophagy and the, yeah, but also, I mean, there's a lot of ways to lose weight.
Starting point is 01:39:50 But this is, we're talking about how to stay sharp, keeping the flesh healthy, keeping the plumbing open, those arteries, you know, vascular health, exercise can do that. What we eat, giving your brain the right materials, and the mostly plants will clear out the sludge and the antiox. You know, the plants work because they got, they have antioxidants and tannins in these things that clear the sludge that these little molecular machines called neurons make, right? It's, that's why plants are good for your brain. Are there any that you prioritize? In plants? Yes.
Starting point is 01:40:24 I don't think it really matters. It's hard, again, I can't find the experiment where they got a thousand people eating spinach and they got a thousand. But I can tell you over 30 years, whether it's blue zones or the Mediterranean diet, now specifically called a mind diet. It's Mediterranean diet. And those people, they get a lot less Alzheimer's than people who don't. So I can't distill it. down to that. But Michael Pollan, you know, he's great. Mostly plants and some fish. And then the indulgence of the burger or the caviar or the, or the vegan, you know, burger patty. It's all up to
Starting point is 01:41:01 you. But the staple is pescatarian. Then we talked about the timing of eating, what to eat, the timing of eating. And then, um, I think the other one that's, we're just on the timing of eating thing. Outside of the intermittent fasting thing, is there anything else to say on that? It's primarily at some point, a couple of 16 hours. No, it was like ketones. A couple of 16 an hour fast per week is probably a good idea. Yeah, and relatively easy to do. You can have black coffee in the morning.
Starting point is 01:41:29 I feel great when I do, when I fast, I feel really, really great. Yeah. And that's another theme. I'm trying to tie in like things that I've worked for the ancients, you know, whether it's again back to Aristotle or fasting in different things. Again, for people who have the luxury of this, right? Most, there's a lot of food insecurity. I'm just giving you the conceptual answer.
Starting point is 01:41:48 And then the, you know, the fourth thing is, it is movement. So exercise is his movement. But for my patients, what we've seen is that when you're vertical, like, people think, like, it's got to, you know, you got to have, you got to have the gear, you're out there. You're just, you look like you're auditioning for the Equinox commercial or whatever. Like, that's great. And I'm knocking that. But for most people, just standing for my patients, the trajectories of patients who can stand and get up from a. Boilet and stand and get to the couch is so much better.
Starting point is 01:42:21 Being vertical requires postural muscle activity. So what I would say is walking and movement are also cognitive protective. And you mentioned exercise. Now, so exercise and movement does a couple of things. One, it keeps those arteries open that we talked about. As far as the food, number two, what to eat, pescatarian, third, and mind. mind diet. People can look all these terms of third, when to eat, intermittent fasting for ketones and the cognitive benefits, thinking benefits, not structural.
Starting point is 01:42:55 Fourth is exercises that this ecosystem requires nutrients, not neurotransmitters that are being sprayed between neurons, but in the milieu, in the garden, if you will. And there are things like growth factors. Obviously, BDNF is a popular one. I had a grant from the Department of Defense studying it. I'm familiar with it. What I want people to know, know is when you exercise, it's not like it's released from, you know, like your thigh muscle and swims up to your brain and says, hey, I'm helping you out now, that these chemicals are housed in the brain. And exercise is the cue, is the signal for your brain brain to release them on themselves. BDNF is released from the brain for the brain when you exercise. And I think
Starting point is 01:43:45 that's a thing that's powerful. Outside of the cardiac and weight loss, I'm just talking about a little bit of movement a couple of times a week. And all of a sudden it starts to feel like, hey, I could do these things. Yeah. They're pretty low bows to entry. But high impact and proven. And then the last one is you got to think, man, you got to challenge yourself. I mean, if, you know, if you say, you know, you ask them how to run faster, say you train your biceps. I mean, it's a thinking flesh. If you don't, if you don't push it to the next level of complexity and thought and challenge, not too hard where you quit, just like video games. If it's too hard to get to, if to level up, we tap out. If it's too easy, we're not engaged.
Starting point is 01:44:27 So finding whatever you're engaged in from puzzles to complex conversations, that it needs to be challenged with thought, with ideas, with creativity, with reading those novels, reading at night. So the fresh content that's engaging and requires you to think, think differently, think wildly, think in ways you haven't before, I think that's an essential part of also. That doesn't mean everybody who was a professor lived longer, did better than, you know, people were just rocking out, not not approaching it that way. But creative ideation, I think, is as valuable as just raw processing power. It's not all about doing math and puzzles.
Starting point is 01:45:16 I think challenge yourself to be creative is an intelligence in itself. What about the impact of stress on brain aging? Well, I mean, this is a big question now. So this whole thing about cortisol is like, okay, I don't have an answer for that. I know people who live in a constant stress, It seems like constant stress is bad for you in a lot of ways.
Starting point is 01:45:43 I also know thrill seekers, surgeons, athletes, every time they do something exciting, cortisol is up, okay? And they don't have accelerated brain, you know, brain aging. So I don't have an answer for whether cortisol is doing it, whether stress is doing it, whether it's just a rough life, whether it's struggling with thoughts you can't control, which revert back to your brain and injure your brain. I don't have an answer for that,
Starting point is 01:46:14 but I think with the story I would tell you about that is there's a tumor called Pheochromocytoma, and it sits on top of the kidneys, and it releases all these, what basically look like you're extremely stressed out. And is that how it feels as well? That's the essential question, my man. They don't come in like, ah!
Starting point is 01:46:34 That is the essential question, my man. That's a banger. That's total. I don't have the answer, but I'm leaving you with things. I hope. I want to know the answer. But the brain contextualizes all of this surge of stuff that's happening. Interesting.
Starting point is 01:46:48 Do you know Rick Hansen? You're familiar with Rick? Neuroscience guy. He wrote Hardwiring Happiness. I read that and spoke to him. He became a good friend. And then the more neuroscientists that I speak to, the more I realize that a lot of the stories,
Starting point is 01:47:06 that we tell ourselves are kind of repurposing mechanistically what's happening in the mind. But the weird thing is nobody talks about the story you tell yourself about your knee injury, right? You know, someone snapped their ACL and it's not about thinking your ACL back into contact.
Starting point is 01:47:25 We understand that there's a mechanism that's going on in here and that that really needs to be fixed and that there's a pretty well-established process that you go through in terms of rehab and it's progressive overload and tendons really love to be under. time and attention, so you're going to do this, and you're going to get range back,
Starting point is 01:47:38 and there's a combination of stretching that you get with strength, and the more range that you get the less. You know, all of this is mechanistically very well understood. But the thing is, there is no massively phenomenological sense of having an ACL. There is one for everything that happens in the brain. And I really got into psychology, human nature, you know, Angela Duckworth or the James Clears of the world. Morgan Housels, you know, a lot of people that write very astutely about human nature and about psychology. And I go into evolutionary psychology, which is even maybe one step
Starting point is 01:48:15 further removed, right? That's like the source code and a lot of accusations of just those stories and things like that. And that's really cool and compelling. The more that I spend time thinking about this stuff, the more I try and come back to mechanistically what's happening in the brain, because it really does feel like, for instance, with gratitude from Rick's understanding here, he basically sees happiness as your ease of access to being grateful about what's going on. And he has a very simple process that is well understood and just reflects the mechanism of what goes on in the brain, of have an experience, enrich it and absorb it. And it's just this little acronym that you go through. I thought, that's so great.
Starting point is 01:48:57 That feels, to me, one of the problems that a lot of people have when they read stuff to do with human nature and psychology is it feels so fucking wishy-washy. You're like, I, give me something to grab onto. It's like my puppy's example. But let me just jump in right there. I like that. And what really just gets me jacked in a positive way is when I see that our behavior and our minds work in a way that's actually reflected at the neuronal level.
Starting point is 01:49:30 Mm-hmm. Mm-hmm. You know, so like if you stress stem cell reservoirs just enough, they'll make one of themselves and release a new neuron. So they're always replenishing them. They're never, they're inexhaustible in that way, right? They're stem cells. But if you stress them out too much, they'll go into senescence or they'll die. And then you start to realize, wait, that's kind of how life is, right? Then you, then I like to take it all the way to like international space stage. There's not enough gravity. Those bone cells in space in our thigh bone, when they come back on the ground, they got a rehab for a week or two. The lack of gravitational stress leads to withering of osteocytes for astronauts. And so the same concepts in bone cells in space
Starting point is 01:50:19 or stress in the human brain that there is a necessary amount of stress that leads to growth. But if it's too much, we fracture. If it's not enough, we don't blossom. And I like to take those concepts to then coping. And so, for example, like, this thing about resilience was tripping me up for a little while. Like, what does that mean?
Starting point is 01:50:44 You know, like, be resilient. Like, I always try to think, like, I got to be able to say this to my sons. I got to be able to say to a newly diagnosed brain cancer patient. Yep. And what I learned from that is it's sort of this systemic and processive resilience, which is basically like the resilience you bring to the. fight, you know, the strength you bring to the fight, and then the process what the fight reveals in you. And what I like about that is that each cell, each person, each human is in their
Starting point is 01:51:10 own individual path and has accumulated a set of experiences. And my hope is universal coping skills and they're ready to engage the world in front of them. And that could be a lottery, that could be falling in love, that could be being diagnosed with cancer. And they're coming equip with some skills and in that cyclical nature of stress and growth that happens repeatedly in our bodies. Like, that's actually what's happening in our lives. There's a cyclical nature of a springtime in ourselves and our body, a winter in our cells and life, and that there is no, like, linear trajectory towards wellness or a moment of arrival
Starting point is 01:51:52 or a final clarity because you just don't know what the challenge or the gift in front of you is. Well, certainly one thing that I can say with almost absolutely certain. is that you do not develop capacity to deal with things while you're dealing with things. Your capacity to deal with things is almost always developed in advance and revealed during. So it's one of the best justifications for mindfulness that mindfulness is preparing for the worst day of your life. That's what meditation is. Meditation is preparing for the worst day of your life. It's the day that you lose your job and your dad passes away on the same morning.
Starting point is 01:52:30 It's a day that your partner gets a cancer diagnosis and you find out that you're no longer employed, whatever it might be. If you're in the thick of it right now, I've been in the thick of it for a good bit of the last 18 months, you're doing your very best to not go under. And then you're fight, fight, fight. And then when you get a break, and it's really,
Starting point is 01:52:57 actually this is interesting. it's only difficult times that reveal to you holy fuck i couldn't really make much progress during that i was just trying to survive the urgent outweighed the important so much that all i could do was kind of trying to hold it together okay so what's the implication of that when you do not have something that's super urgent in front of you when you're not putting out fires it's a really really really really good time to develop some more capacity psychological resolve yes that's the time that you try to get your meditation habit in, that's the time that you work on your health.
Starting point is 01:53:30 You refine, you're training for the fight that has yet to come with a toolkit that I'll never finally make, but I mean, that's what I'm trying to get at. And back to the cells, cells go through a period of dormancy. And at that point, not dying is actually the victory. And then there's a springtime, just like in nature. And this happens in our biology. And I think it happens in our psychology that you're talking about.
Starting point is 01:53:55 And that those moments, there's a temporal nature, there's like reflection and going back and saying, okay, what are the lessons I learned? How would I handle it better forward? I love all that. I'm actually trying to come up with when you feel like you're drowning or about to fall apart.
Starting point is 01:54:12 In that short temporal window, are there things we can do at that time? How do we interject right then? Yeah. The time sensitive maneuvers. Yeah, I like, I very much like being able to step in on stuff that's acute.
Starting point is 01:54:26 It's all well and good talking about building up your resilience and all the rest of it. But if you're in the fucking fight, you go, hey, I can't go back six months ago and start a meditation practice. Tell me what to do right now. Right. And so what I would say is if, you know,
Starting point is 01:54:40 I would say is that urges that hijacked the body are very fascinating to me. When the thought is now recruits the body, just a whole new fight. Whether that's addiction, whether that's desire. Because now there's a feeling that if I don't go in this harmful direction, that I will feel ill.
Starting point is 01:55:08 So now you're not just trying to stop a thought. Let's take an example of having a cigarette again. It's not just, I don't have a cigarette, don't have a cigarette. It could cause cancer down the road. It's bad. It's bad. You promised everybody you wouldn't. They might smell it on you.
Starting point is 01:55:19 Whatever you're thinking. Don't look at it. Look at those shiny boxes of the gas station, right? But then when you have that waft, and it goes from the nerves in your old factory bulb to your frontal lobe, and now you're just like, oh, man, that reminds you of so much. People have physiologic changes. So now the fight is controlling your mind and body, and I believe the maneuvers are different when it goes from your mind to your body. And the management of bodily urges requires bodily techniques. breathing techniques are the same ones I use in surgery.
Starting point is 01:55:55 Sometimes when I was learning and you feel like that, ooh, around that corner that tumor is going to run away from you. I mean, you got to, you got to not, you got to, it's going to either going to freak out or you're not going to freak out. And the simplest thing I can tell you is like when you hyperventilate, it creates a feeling of anxiety. Well, you've got to take it the other way. The first maneuver is just control your breathing.
Starting point is 01:56:16 Nobody knows. The room is just like da-da-da-da-da-da-da. And you're just like, whoa, whoa, whoa. whoa, whoa, you know, this could, this could run away from me. And so I have my own maneuver that I do in that moment is just stop talking, you know, and there's something I call out. I say, I need 15. And they're like, okay, everybody pay attention.
Starting point is 01:56:35 Back to your positions that he might say, I need this from the wall, I need this from the wall. And the whole thing is just get that breathing paste. I'm not talking about one nostril. I'm not getting into all that. I'm just trying to tell you physiologically, if I pace my breathing, I can, slow down this swell of fear and panic that's in my guts when things run away from me. I try to use the same thing with a lover and with a conflict, but that's a specific toolkit
Starting point is 01:57:02 that has a physiologic basis that I can explain that the ancients use is in the acute moment. And I'm hunting now, you know, the next year or so. But are there other maneuvers that that we're all equipped with that can work while you're, you know, while you feel like you, uh, You're falling apart or you're drowning or you're struggling, you know, at that moment. Not in Riverview, not in the future, I will. Right now. Right now, what do I do? Is there anything you've ever seen in surgery that shook your belief in signs?
Starting point is 01:57:38 Um, not in surgery. Surgery is a physical performance, is ballet. But, um, I have had, I have had patients in the psychological sciences. I've had patients where I just look. I'm like, I don't know. I don't know how the great majority of cancer patients get dressed, come in, and are ready to get the worst news of your lives every three months when we do the scans.
Starting point is 01:58:12 It's come back or it didn't go away. I mean, it's just, it's just so heavy. and the what the fight brings out in them or the coping skills they've brought and it's inconsistent I'll get to the more philosophical way so it's inconsistent somebody comes in
Starting point is 01:58:30 they've got the wellness techniques they're the CEO they get hit with that C word it's you don't know what you're going to get and then somebody comes in they're struggling with something they look disheveled you're like this person's not going to handle as well it brings out something in them so I think this feeling that
Starting point is 01:58:46 that arrival in some sort of wellness and achievement or clarity understanding of life is misguided because we don't know what's coming next. I think it's cyclical, develop your skills, time sensitive skills, in the review, being prepared for being what's forward. That's the way I've been approaching it. And as far as shook my belief in science, I would say something recently has liberated my view in science. It's through science we can have understanding that we might not. So there are these near-death experiences. Those electrodes are being recorded. People in Canada,
Starting point is 01:59:20 and a study starting to come out that when the heart stops for the first few minutes afterwards, the brain just deploys all its chemicals and electricity. So whereas other organs whimper to death, like the brain is struggling, the heart stops.
Starting point is 01:59:34 And then if you measure the electricity, because you can actually have a DNR, you can say, like, if I have a heart attack, don't touch me. Do not resuscitate. And they're still monitoring. You still get a live feet of the brain electricity.
Starting point is 01:59:46 So you would think the heart stops, then the brain electricity stops, but it goes for a minute or two afterwards. And it's wild. It's fierce. It's not like, beep, beep, boo. It's a sur. So that's a measurement.
Starting point is 02:00:00 What does it mean? That's for everybody to explore. But to me, it's like, okay, so there'll always be just amazing neuroscience information coming from hospitals and patients. That's a little bit more than just scanners. Right? And when those people are resuscitated,
Starting point is 02:00:15 and why do they all universally say I saw it's a film strip of my old life and you know there's a consistent pattern of what happens if you drown or if you have a near-death experience and are resuscitated in whichever manner they come back reporting the same thing film strip of their life wide stories they saw loved ones and when you look at the electricity it's very consistent with dreaming and memories so to me I love the fact that now we might be able to explain why near-death experiences are a consistent perception or experience for for people so i love seeing that stuff come out yeah i'm interested in what working with terminal patients has taught you about living life well everything um yeah everything um you know it's has thousands now i mean um 52 Massive experience, we've had three adult sons, massive life experience. But since 25, I've been taking care of some of the sickest people in the hospital. Brain injury for 10 years. Half your life?
Starting point is 02:01:26 Yeah, I was a kid when I started, you know. I mean, I look at people in their 20s. I'm like, whoof. I was like 26 or 27. I wrote about it for a vice article. I would drew care. I mean, I helped families land their patients, I mean, their family members and remove the breathing tubes and say their last rights and wishes
Starting point is 02:01:45 and all the different cultural elements that come into it in ICU. I was 27 years old. And I started to see there were patterns in the ways the brain and mind respond when the finish line comes closer. It's not trauma. You're gone.
Starting point is 02:02:04 You don't know it. It's, okay, three years, two to five, seven. You can't quantify it, but you know it's coming now. It's in sight. And they had a universal. All of them say the same thing again. When that finish line comes into view, and it's the lessons I think everybody else talks about,
Starting point is 02:02:25 but they have a similar thing about reconciliation, forgiveness, about having spent more time with their children. Usually it was like busy dads at that time, my 20s, you know. And I incorporate that. I had a lab. I raised my kids. Didn't take them just to the baseball games. the practices, spent a lot of time to them, and that they seemed unencumbered.
Starting point is 02:02:48 They weren't so the little things don't get to them as much. And the question then becomes, how do we take those lessons without actually having, you know, if hypothetically the Finnish God willing is 25 years away from you, how can I actually live it like it's five years from now? And that's the lesson that my cancer patients had taught me is, one, start now. with what you would if you had, you know, you do five-year curves and to build your coping skills because the ones that I saw do well,
Starting point is 02:03:24 they had techniques. I mean, I'm just coming back to this. And like I learned one from one. Like every three months, the scans, let's just imagine brain scan, two, three hours, six hours, who knows what it's going to, you show up in clinic. It's another hour to wait to hear it for somebody. And so they would do this thing where,
Starting point is 02:03:43 Like, look, the 11 weeks in between, I can hold on to myself and say, this is not the time to be stressed. But I need to have a week when I'm just completely losing it. Like, you can't just not be stressed about that. But they were able to compartmentalize it to have like 11 good weeks and then another shitty week because, oh my God, I got another brain scan and see Dr. John Dio. And so I started to see those techniques they were using to make the most of their cancer journey. The support network is nice, but the support network can be surprising.
Starting point is 02:04:17 It's not always who you think it is. You know, once that cancer word arrives, relationships break up, surprising relationships form. And so, you know, no triumph is forever and no tragedies forever. But if you come equipped with your own personal and psychological toolkit, you know, we make the most of this run. Heck, yeah. Talk to John Diel, ladies and gentlemen. Why should people go? You don't want to keep up to date with everything you've got going on.
Starting point is 02:04:40 Just, I don't know, I'm a surgeon at City of Hope Cancer Center. I think that's the easiest thing is look up Dr. John DeL at City of Hope and then, you know, things will pop up. But I appreciate you having me on. I appreciate you too, man. If you are looking for new reading suggestions, look no further than the Modern Wisdom Reading List. It is 100 books that you should read before you die. The most interesting, life-changing, and impactful books I've ever read with descriptions about why I like them and links to go and buy them. and you can get it right now for free by going to chriswillx.com slash books.
Starting point is 02:05:16 That's chriswillx.com slash books.

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