The One You Feed - Brain Chemistry and The Science of Connection with Dr. Julie Holland

Episode Date: August 13, 2024

In this episode, Dr. Julie Holland discusses her latest book about brain chemistry and the science of connection. Eric and Julie explore the profound influence of technology and social media on mental and physical well-being. Dr. Holland offers practical strategies for restoring balance and fostering genuine connection in the digital age, drawing from her extensive experience and research. With a unique perspective as a psychiatrist and author, she provides valuable insights for those seeking to understand the impact of technology on mental health and the significance of authentic human connection. In this episode, you will be able to: Uncovering the healing potential of MDMA for PTSD therapy Exploring the transformative power of psychedelics in overcoming addiction Mastering effective strategies for nurturing and maintaining healthy relationships Understanding the profound impact of childhood experiences on adult well-being Harnessing the benefits of oxytocin for bonding and emotional healing To learn more, click here! See omnystudio.com/listener for privacy information.

How can we get into parasympathetic? What can you do to get out of fight or flight and get into parasympathetic? And, you know, for some people, it's put your phone down. Your phone is making you sick. Welcome to The One You Feed. Throughout time, great thinkers have recognized the importance of the thoughts we have. Quotes like garbage in, garbage out, or you are what you think, ring true. And yet, for many of us, our thoughts don't strengthen or empower us. We tend toward negativity, self-pity, jealousy, or fear. We see what we don't have instead of what we do.

We think things that hold us back and dampen our spirit. But it's not just about thinking. Our actions matter. It takes conscious, consistent, and creative effort to make a life worth living. This podcast is about how other people keep themselves moving in the right direction. How they feed their good wolf. Wolf. I'm Jason Alexander and I'm Peter Tilden. And together our mission on the Really No Really podcast is to get the true answers to life's baffling questions like why the bathroom door doesn't go all the way to the floor what's in the museum of failure and does your dog truly love you we have the answer go to really no really.com and register to win 500 a guest spot

on our podcast or a limited edition signed jason bobblehead the really no really podcast follow us on the iheart radio app apple podcasts or wherever you get your podcasts. Thanks for joining us. Our guest on this episode is Dr. Julie Holland, a psychiatrist specializing in psychopharmacology. As an assistant professor of psychiatry at NYU School of Medicine, she spent her weekends running the psychiatric emergency room at Bellevue Hospital for nine years and published her memoir, Weekends at Bellevue, in 2009. Dr. Holland is the author of many other books, including her newest one discussed here, Good Chemistry, The Science of Connection from Soul to Psychedelics. Hi, Julie. Welcome to the show.

Thanks for having me. I'm excited to have you on. We're going to be primarily discussing your book called Good Chemistry, The Science of Connection from Soul to Psychedelics. But before we get into that, we'll start like we always do with the parable. In the parable, there's a grandparent who's talking with their grandchild and they say, In life, there are two wolves inside of us that are always at battle. One is a good wolf, which represents things like kindness and bravery and love. And the other is a bad wolf, which represents things like greed and hatred and fear. And the

grandchild stops, they think about it for a second, they look up at their grandparent and they say, well, which one wins? And the grandparent says, the one you feed. So I'd like to start off by asking you what that parable means to you in your life and in the work that you do. Well, I guess the first thing it means to me is just where you place your attention, where you place your energy and what you're trying to accomplish. You know, one of the metaphors I use is like, first, you have to decide what a garden is to coordinate off and get rid of the rocks and change the dirt around and add the plants. Like the first thing you have to do is say this is going to be a garden. So some of the energy that I think I put toward things is figuring out

what to build, where to build it, what it's going to look like so that you can kind of defend your space with other people. But from a personal perspective, my two wolves are sort of like the yin and yang energies that I am constantly trying to balance. I am very naturally sort of yang testosterone heavy. I have things to do. I've got a vector, I have places to go, get out of my way. Whereas the yin energy is more receptive and hanging back and seeing what people say and taking it all in before you make a decision. So it's very easy for me to be sort of all in and aggressive and barreling forward. And where I really need to put my energy is to having more of a balance of yin, receptivity, openness. That's

my own sort of personal battle. I think I have issues with like impulse control, for instance, which I feel like is a very yang thing to just kind of shoot first, ask questions later, you know, shoot from the hip. So luckily I'm married to someone who's very introspective and receptive and takes a lot of time before making a decision. And it's like sort of what I call a slow metabolizer. I'm a very fast metabolizer. I'm like, if this has changed, then we have to accommodate the new thing and pivot. You know, whereas the person that I am emotionally yoked with is like, well, let's, let's think about this and see where it's all going. emotionally yoked with is like, well, let's think about this and see where it's all going.

So that's my real battle is to put the brakes on, not be all gas, to have some impulse control, to stop and listen and take things in, which is why I should stop talking now. Right, Eric? Well, I'm not going to touch that. It's interesting, though, as you were talking about your partner that you're yoked to, it made me think about a section in the book where you are talking about when we fall in love, there's this limerence period, there's sort of a high or not sort of, there actually is a high that comes from that. And then we settle into the harder work of building a relationship. And you have a line there where you say, the optimal outcome, the way out of the dead end, the dead end being the tendency to just kind of like keep looking for something else,

you accept and embrace all the disowned traits in your partner, and that helps you accept them in yourself. And I was thinking about how it sounds like you found the way to do that you found the way to appreciate the way in which your partner is different than you and how that is helpful. I'm not saying all the time you feel that way, but that in general you do. And how did you get to a place where you were able to see that as different, but a positive compliment to you versus this person is wrong about the way they see things or do things? Yeah, I would say it's constantly in flux, those things. Like Jeremy, through basically sheer will and brute strength has, you know, consistently reminded me that my way is not always the best way and that he is not the enemy, you know? So, and the truth is, you know, it's funny because

like if we played opposite each other, like a game of Scrabble, it would be a very close game and he would drive me crazy because he took forever. But if we're on the same Scrabble team and we're playing against our friends, we are unstoppable, you know? And so I just, I kind of remember that like we work better as a team and it's sort of like buckshot, you know, if I'm all white and he's all black and you put us together, we're covering a lot more ground. But because of the way I was raised to be self-reliant and trust no one and take care of myself and also, you know, those sort of very yang and I would say even maybe kind of misogynist sort of traits. Like I think I had internalized misogyny growing up. I was the youngest of three girls. My parents both wanted boys. They told us they wanted boys. I heard so many times growing up, Julie, you were our last chance for a boy. So there was some way

where I was operating of like, how tomboyish can I be? Can I be a bully? Can I be a brute and a bruiser? And those traits honestly served me really like being a pre-med, being a med student, being a psych resident. I kicked ass because I did it all myself and I didn't trust anybody to do it. But when you're a wife and a mother and a parent and a spouse, you can't act like a surgeon. It doesn't work. So when I was at Bellevue, I spent nine years running the psychiatric emergency room at Bellevue Hospital. And I was a cowboy. I was a tough guy. And that's how I survived in like a very challenging environment. I lasted longer than any psychiatrist at that psych ER had. I had the same

job for nine years. And I didn't get burnt out, mostly because I worked weekends and I had all week off to recover. But over those nine years, I got pregnant twice. I nursed babies twice. By the end of it, there was so much oxytocin, like drowning out the testosterone. I couldn't really work there anymore. I, you know, I got too soft. I became a softie and maybe you can be a softie there, but I couldn't, you know, I had to really be a tough guy to make it through. And I got punched in the face, you know, cause I was kind of being a bitch, pardon me, to a patient. And when I look back at my notes from Bellevue, you know, I wrote a memoir about my nine years in the psych yard. But when I look back at my notes, all my notes stopped after I got punched in the face. Like it really did something to me and how I went about

my job there. But I ended up writing about this sort of transformation from, you know, a butch tomboy, manly woman to somebody who had gone through having two kids and I couldn't be a cowboy in there anymore. What does being a tough guy mean in that sort of circumstance or that sort of situation? You know, at Bellevue? Yeah. Yeah. Now looking back, I would say tough guy at Bellevue means that I was like kind of an asshole. Like nothing got to me. I didn't care how sad the story was. I'd heard it all before.

It didn't matter. You know, I would say things like all of it is sad, so none of it is sad. Like I had a threshold that I got very hardened. And I wrote about this in my book, Weekends at Bellevue. I really wrote a lot about how hard I was when I came in and how softened up I was by the end. And that because I was soft, I couldn't really do the job because there's a lot of sad stories and, you know, there's terrible things that happen to people. And the people who end up with significant psychiatric issues and addiction issues, almost inevitably, they have had horrible childhoods. They've been sexually abused. They've been

physically and emotionally abused. They've had childhoods where they've had to be in fight or flight the whole time. And they end up as psychiatric patients and addicted to all sorts of drugs. So, you know, in a perfect world, you would have people coming in and you would do intense psychotherapy. God, what happened to you in your childhood? Let's process it. But like, the reality is you don't have time for intensive psychotherapy in a psych ER and every single patient would require that or a childhood transplant. So we end up using humor a lot as a defense and as a shield, you know, in the ER to sort of deal with the atrocities that we're seeing and sort of laughing it off. Maybe it's not what the patients want, but it was a way for the staff to stay connected,

to enjoy being at work and to get the job done. So, you know, a little bit of a callousness and a humor and a sort of gallows humor, maybe there where it's not appropriate, but that's what it took to, you know, show up every week and work, you know, these 16 hour shifts. Do you find that you're able, as you've become softer to use your words or less hardened, I might say more compassionate, maybe you won't agree with that phrase, but I'll use it. You know, I feel like even when I was a hard ass, I was compassionate with the people who really deserved it. The thing about Bellevue is there's a certain percentage of people who are gaming the system, who are pretending to be

mentally ill to get off the streets. They're hiding out from somebody or they just don't have any money. They've run out of money. They come in, they say they're hearing voices to kill themselves and others. And they think that that will be enough to get them admitted to the hospital so that they can have, you know, three warm beds and a place to sleep for a week or two. And, you know, I appreciate that they're looking for respite. But one of my main jobs was to basically keep the sharks out. You know, people who are chronically, persistently, mentally ill are really vulnerable. And if you've got any social people who aren't really sick, but they're pretending to be sick, the real patients are at risk and are vulnerable. So

it's my job to keep the sharks out. On the other hand, as I grew more compassionate, and I was always giving lectures at the psych ER about psychosis or about malingering, people faking and what to look out for. But the way I would start my malingering lecture after a while was like, look, even if they're faking symptoms, they are coming to the hospital for help and we're here to help them. And we got to figure out, look, you don't really look like you're hallucinating to me, but you do look like you're having a hard time and you run out of money and you're homeless. And let's figure out why that's happening. And, you know, might it be because of this, that and the other thing and not that you're actually psychotic, but at least you're still saying, I know you're coming to us for help. Let's figure out how we can really help you

instead of just give you this bandaid of a week off the streets. Right. And it speaks to the fact that somebody's in some degree of dire straits that they think a psych ward is an improvement over. Right. So let's, you know, start with the reality and sort of present them with the reality. Like, why is your life so chaotic that a week at Bellevue Hospital is a vacation? Right. Like what's going on to get you to this point? But, you know, it was a bit of a revolving door, Bellevue, people coming in and out. And sometimes the staff gets very frustrated that, you know, the same people aren't getting better and the same things that we're trying aren't working. It's because, you know, they need a new childhood. They need a childhood transplant. We need to be focusing on early education and Head Start programs and things like that to prevent addiction and violence and things

like that from taking root in childhood. You're very interested in involved in psychedelics as mental health treatments. True. Was that driven by a frustration with the fact that the system that you were embedded into you didn't seem to be working? No, because it came before Bellevue. I got frustrated with the system by the time I get to Bellevue. But my interest in MDMA as an adjunct to psychotherapy, for instance, I mean, some people may know MDMA better as Molly or ecstasy. But this idea that there was a substance that could help psychotherapy go deeper and act as a catalyst to therapy where you're really getting to the stuff that matters quicker. I mean, I guess that's a very Yang way

of talking about it, right? But like more efficacious, you know, more effective, faster, deeper, better. So that appealed to me even before I went to medical school. I got very interested in MDMA in the context of psychotherapy when I was an undergrad. You know, this is like the mid 80s. I'm a pre-med at Penn. The summer of 85, I was actually living in a castle. There's a castle on campus that was like a fraternity house. So I was living in a castle. All of a sudden, I started hearing about this drug that they were calling Adam that they were using in therapy that, you know, therapists were giving to their patients. And I got very interested. First of all, it was a new drug and I was an undergrad studying psychopharm. So the fact that there was a new drug, I was all, I didn't even care if it was in therapy or not, just the fact that it was a new drug. Like I knew all about all the other ones so far and I

tried most of them and this was a new one. So that was exciting. But the fact that it was actually being used as a catalyst during therapy, it's one of the reasons that I ended up really committing to psychiatry and not neurosurgery when I went to medical school. I knew I was going to do something with the brain. I was always very interested in the brain and drugs, but the reality of what neurosurgery is and what neurology is versus the reality of what life as a psychiatrist was, it was really no contest for me. I got very interested in psychosis, you know, schizophrenia and bipolar. And I mean, it's also fascinating, you know, the things that go wrong and right with the brain. So I got interested in psychedelics as a treatment modality before I even went to med school. And honestly,

it was one of the things that kind of fed me and kept me going when med school was impossible and ridiculous was, you know, this sort of carrot. But I wrote a little haiku or something once and it was like, it takes a mighty lure to nurse the hardships we endure. Like med school is hard and you're not treated very nicely. And residency is sometimes more of the same and it's a real slog, you know, and you got to have a reason to go through all of this. And for some people, it's like, my dad's a doctor, I'm going to be a doctor. It was very familial. I didn't have that. But I did have this idea of MDMA-assisted therapy sort of pushing me to go to med school, get my residency, be a psychiatrist. You know, it's an exciting time to be a psychiatrist because we've got a few more tools at our disposal, and we need every tool you can imagine.

I would assume then that the recent, and I don't know the exact timeframe, but I believe in the last six months, ruling by advisors to the FDA that MDMA treatment posed more risks than benefits was a bitter pill. So I would love to break this down. And I was really tempted to do the wolf thing and talk about this, but I decided it wasn't appropriate. So the way to get FDA approved is that you do phase one, phase two, phase three clinical trials. And there were multiple centers that did this kind of work. It wasn't just one place. There were a lot of different groups that were running people through an MDMA-assisted therapy protocol. During phase two, which is not the data that FDA needs to

approve, they really look at phase three data, but during the phase two multicenter trials, there was one cell, one center, that ran four subjects. One of those subjects, there were egregious boundary violations and grossly inappropriate things that happened between a researcher and a research subject at this one cell that ran four subjects during phase two. There were no other improprieties phase three. There's no problem with the data phase three, but people got very fixated on this terrible egregious boundary violation. But I would argue that one terrible thing that happened from one cell of a site that ran four people should not discount the hundreds of other people who were run through the studies who had a benefit and who did well and who didn't have egregious

boundary violations. And this is really a situation of like one bad apple should not spoil the whole bunch. And particularly the data should not be impugned by one boundary violation. The data is powerful and strong. And the bottom line is that a lot of people who had PTSD, once they made it through the MDMA assisted therapy protocol, they did not meet criteria for PTSD anymore. They did not have their symptoms. So, you know, we don't say cured in psychiatry, but you could at least say that the end of the study, those people wouldn't have made it into the beginning of the study because they weren't appropriate because they didn't have the

symptoms needed for the study. As many as two-thirds of people responded robustly, and you don't see those numbers in any other treatment. So we've got more and more people with PTSD, we have more and more veterans committing suicide, and we have a medicine that if used appropriately in the context of ongoing therapy will markedly decrease PTSD symptoms and the desire to be dead. So I'm still very committed to FDA approval. You know, I listened to the talks that whole day, June 4th, from 8.30 to 6 p.m., and FDA spoke first. And I was very heartened by everything that FDA had to say. They seem to really understand the situation and the fact that it is nearly impossible or purely impossible to have a blinded study because everybody knows pretty much who took

MDMA and who didn't, you know? So that's called functional unblinding. But still, the study was blinded and the data is powerful. And, you know, we're going to have to see what FDA decides because the advisory committee does not know as much as FDA about this. And there's a handful of about five or six people who are really committed to supporting the victim from the phase three trial. And, well, they should be supporting this victim.

But to stop MDMA from getting approved means that you're enabling the PTSD to continue in millions and millions of people because you are protecting one person who had a terrible experience. And I don't agree with that calculus at all. Right, right. It seems that the committee was extrapolating from there to the fact that MDMA itself was the reason that people acted inappropriately, which I think is an extrapolation. Yeah, it's really easy to sort of name names and call names. And I'm tempted to, you know, out the boundary violator and say how terrible he is. I don't fully understand the situation. I mean, this was a married couple who was doing this work. As far as I know, they stayed married

after this boundary violation and everything that happened with this third person. I don't pretend to understand, you know, what happens with couples and taking in somebody to live with them or another lover or, you know, how that works. I understand it's very fraught. I will also say that, you know, in the underground scene, we had situations where married couples, one or both members of the party ended up, you know, being involved in boundary violations also. So, you know, we all sort of had this idea that like a male-female therapist couple would keep everybody safe. And it turns out, not always. Right. Whether in research or underground or in regular psychotherapy or with a dentist, there are often boundary violations and weird shit happens, you know, in regular psychotherapy or with a dentist, there are often boundary violations and weird

shit happens, you know, in regular therapy without the meds. But yes, MDMA is going to make you more vulnerable, more trusting, more open. And that's why what's been proposed to FDA is that it's in the context of ongoing therapy, that it is not just a one-off with somebody that you don't know and don't have any therapeutic alliance with. Right, right. Let's move on from psychedelics, at least for now. We may find our way back there. But I'd like to focus on the heart of your book, Good Chemistry, which is about the science of connection. You say our species is categorized, and I love this, is obligatorily gregarious.

What does that mean? Yeah, I like saying obligatorily gregarious. What does that mean? Yeah, I like saying obligatorily gregarious too. It feels good in my mouth. I was afraid I was going to stumble over it, but it came out okay. You did greater. Yeah. So the idea is that we are obligated. It is part of our biological imperative that we are gregarious, which means friendly. So homo sapiens sapiens, that we are gregarious, which means friendly. So homo sapiens sapiens, if we are not social, we do not survive, right? And if you think back to our time on the savannah, we lived in multi-generational homes. We were a part of a clan. There'd be several families that would be part of a clan together. And within the clan, there was cooperation in building a shelter,

hunting, sharing food, sharing resources, making sure everybody got a mate and was mating. And so within that clan, if you were ostracized, if the clan decided that, you know, you're not on our team and you're not with us and they ostracized you, you would die. Ostracism back on the Savannah meant very likely death because no one would help you build a shelter. No one would feed you, wouldn't share the kill with you. You would not mate. If you didn't die, at least your genetics aren't getting spread, which is part of our imperative is to clone ourselves, basically

reproduce. So we still process ostracism and not being in the group and being in the in crowd as an existential threat that puts us into fight or flight. So when we are disconnected from our community, from our friends, from our family, and then I would also argue disconnected from ourselves and our own bodies, which happens every time we open up our phone, or disconnected from the planet and the earth, which happens every time we open up our phone, all of this severance and disconnection puts us in fight or flight. It puts us in the sympathetic nervous system, which is not where your body wants to be. Your body wants to be in the other side, which is called parasympathetic. That's where we can rest, digest, and repair. And not just repair our bodily functions.

The only time the body does any major repairs is when you are not in fight or flight, when you are in parasympathetic. Rest, digest, repair. Not just bodily repair, social repair, right? You get into a fight with somebody, you say something stupid because you're in fight or flight, then you feel calm and you're in parasympathetic and then you can repair the social disconnect that happened. Your social skills suck when you're in fight or flight, right? You know, you're more likely to break and, you know, disconnect than you are to connect. So when you are in fight or flight. You're more likely to break and disconnect than you are to connect. So when you are in fight or flight, the main sort of juice that runs your sympathetic nervous system

are things like cortisol and adrenaline. And adrenaline in the brain is known as epinephrine. But cortisol and adrenaline are sort of the main chemicals that enable you to be in fight or flight. And the longer you're in fight or flight and the more you're exposed to cortisol, the worse your body is. You get fat, you can't sleep, your immune system is a mess, your blood sugar is a mess, and your body can't repair itself. When you are in parasympathetic, which is rest, digest, repair, that is primarily not adrenaline and cortisol, but rather oxytocin and something called acetylcholine, which is involved in memory. But the oxytocin is the hormone and neurotransmitter that allows you

to open up, trust, connect. Oxytocin is very much involved in parent-infant bonding with a nursing baby or just any baby who's dependent on you. It's also involved in like a post-orgasmic bonding state, which is why I said in Moody Bitches that you should be careful. You think you're having casual sex with somebody, but if you have an orgasm, you're going to be in this post-orgasmic state, which is a high oxytocin state. And you may find yourself emotionally bonding, even though you didn't mean to. So oxytocin is involved in wound healing, body repair, social repair, and it's involved in all the sort of trusting and bonding that happens between parents, between lovers, between teammates, even, you know, that little like

pat on the butt, the football or the pat on the shoulder or the hug, all those things, eye contact, handholding, spooning, they all enable the release of oxytocin. And oxytocin feels good. I'm Jason Alexander. And I'm Peter Tilden. And together on the Really No Really podcast, our mission is to get the true answers to life's baffling questions like... Why they refuse to make the bathroom door go all the way to the floor. We got the answer.

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It's called Really, No Really, and you can find it on the iHeartRadio app, on Apple Podcasts, or wherever you get your podcasts. Let me ask a question. Let me ask a question. I've never thought of this question before, even though we've had plenty of guests who talk about the parasympathetic and sympathetic nervous systems. That makes it sound like you just switch into one or the other. Is there a clean line between them? Is there a way that you could say, Eric, you are in parasympathetic, or Eric, you are in sympathetic, Like you could say, Eric, you are in parasympathetic or Eric, you are in sympathetic. Or is it more like many things? There's a gradiation in there. I think it's okay to say it's a spectrum.

And the truth is there's one specific situation where there's actually a couple situations where they both come into play, where you're in both. Okay. But if you think of it on a spectrum, I'll get on my phone and I'll scroll and I'll scroll and I'll start to notice that my heart rate's going up a little bit and my hands are getting a little sweaty and they're getting a little clenchy and oh, maybe I'm clenching my jaw. And like, sure enough, you know, whatever I'm reading and responding to or not responding to is putting me in fight or flight. I can feel it in my body.

So I would argue that even if it is a spectrum, you reach a point where you say, I'm over the line. You know, I've gone from ash gray to charcoal gray, and it's not good for your body, you know, and the longer you're in fight or flight, the worse it is for your body. So one of the things that I talk about in good chemistry is how can we get into parasympathetic? What can you do to get out of fight or flight and get into parasympathetic? And, you know, for some people it's put your phone down. Your phone is making phone down. Your phone is making you sick. Your phone is making you miserable. I mean, I have a private practice in psychiatry. I talk to my patients and it comes up quite a bit that they feel like their phones

are making them depressed. Their phone is making them anxious. They feel like they're addicted to their phones. And we talk about sort of having a media diet or a social media diet or a media fast, you know, sometimes you have to stop, you know, you're soaking in all this terrible news and it's terrible news about things that are happening all over the world that you can't do anything about. You know, the way we make a laboratory animal depressed or anxious so we can study it is we put them in a situation where they feel bad and they can't do anything to stop it. You know, you shock them and you shock them and they don't know where the shock is coming from and they can't stop it and they get depressed and they get anxious. And it's like, I feel like

this is what's happening with people on their phones is that they're getting into this learned helplessness situation where, oh my God, so terrible what's happening in Ukraine. It's so terrible what's happening in Gaza. You know, the world is a mess. America is a mess. Even the psychedelic community now we're fighting and it's a mess. And like, you know, where do you turn for peace? And so soaking in all that unrest and unease is going to put you in a sympathetic place. It's not good for your body. So sometimes just like you have to watch what you eat and maybe flour and sugar is not that great for you. And so you learn to limit or cut out flour and sugar. And I would argue that TikTok and Instagram and all these things, Twitter, Facebook,

whatever you're doing, pay attention to how your body feels. You know, they don't call it doom scrolling for nothing. And it's not just that you start thinking bad thoughts, but your body on some very basic level does not know the difference between reading about a woman whose kid has just died in an earthquake and being the woman whose kid has just died in

an earthquake. You see that picture of a woman holding a dead baby in front of a pile of rubble. I don't know about you, Eric, but like, I feel it in my chest, in my torso. I see something like that. And I'm like, oh, as if this terrible, sad thing is also happening to me. And that's like, I have a lot of empathy. I have a lot of compassion and that's good. Unless I'm scrolling past image and image and you know, there's famine, there's genocide, there's war. What can you do about any of it? So it's really not good for your physical and mental health. Sorry to be a downer. Well, I agree with you. And I think that any thinking person in today's world is wrestling with these questions of to what extent do I remain informed as if

informed is a virtue on its own, which I'm not entirely sure it is. But to what extent do I remain informed versus do I go too far into it? I think everybody wrestles with these things. I have a few ideas. Malcolm McLuhan, I think is the one who said that when you act as if your nervous system is on the outside of your body, you're going to be in a very unnatural situation. And the media is making us have eyes and ears all over the world, right? So we're experiencing trauma. Like, okay, a thousand years ago, you might experience trauma once or twice. Maybe there's an earthquake in your town. Maybe there's a fire in your town, but not every single day, whenever you want, can you see that there are earthquakes and fires happening and you're

experiencing them to some degree, obviously not as if you're burning, but your brain is still having that panic response. What I would argue is that what's better for you and your community is that you focus on what is actually around you, that you can't fix the Middle East, right? But you could volunteer at your community resource center in your town and drive somebody to their doctor's appointment. You're going to feel good giving back to your community and you are actually doing something that makes a difference instead of scrolling and not being able to make a difference with all these terrible things that are happening somewhere. So the other thing I want to say is, you know, the hunter gatherer brain that we've inherited,

we don't need to hunt for food anymore because God knows the food is everywhere and there's calories available everywhere as soon as you open your hand and there's cheap, plentiful calories everywhere. So now that we don't forage for food, we forage for information. We think that the more information we have, the safer we're going to be. And that may be true, but mostly what's happening is that we're getting terribly depressed and feeling hopeless and demoralized and helpless. We can't do anything to change it. So good chemistry was all about like, close your laptops and go outside, go be in nature, you know, sit next to a tree. The tree will help to calm you. You know, you can go on earth time instead of social media time and, you know, have a very different experience of what's really going on around you. What's really going on in the environment that

actually will have an impact on you? And get involved locally. Greek philosophers were talking about this doctrine of control, what you can control versus what you can't. And I think Stephen Covey in his book, Seven Habits of Highly Effective People, gave to me the best example of this. And he talked about, imagine two circles, right? There's a big circle and within it, there's a small circle. And the big circle is your circle of concern, everything that you possibly are concerned

about or care about. The small circle is your circle of influence. And the idea is you would want to spend more time in your circle of influence, obvious, right? But the thing that he said that really opened this for me was he said, the more time you spend in your circle of concern, but not your circle of influence, your circle of influence shrinks, right? And the more time you spend in your circle of concern, but not your circle of influence, your circle of influence shrinks. Right. And the more time that you spend in your circle of influence, the more it grows. And that to me really put all this into really clear state that like this concerning myself with all the problems of the world wears me out and I don't do anything. Right.

Whereas if I'm taking clear, targeted, positive actions, it feeds you and I'm going to be more effective if my true concern is less suffering in the world. You will have an impact locally and it will give you the energy to continue to have an impact. And maybe it scales up, who knows? But you can't start with fixing the world. So I think what happens is people get kind of paralyzed by how terrible everything is and they do nothing. And the other thing I'll tell you, my patients do this all the time. They'll talk like, I know I should exercise.

I know I should do this, but I'm not motivated. And as soon as I figure out how to get motivated, I'll do it. And I'm always like, it just doesn't work that way. If you start a thing, anything, just start it, then you'll get motivated to continue it. And that's about the best you're going to get. But waiting around to feel motivated to go exercise, that may never happen. Put your sneakers on, go out the door and start walking. You'll be motivated to continue. Yeah. It's such

common sense, but not common practice. You know, when I was in recovery, we used a phrase and listeners of the show are probably tired of it by this point, but it illustrates exactly what you said, which is sometimes you can't think your way into right action. You have to act your way into right thinking. Yeah. And also that sort of act as if, and your body will follow, you know, if your body starts, your mind will follow. But yeah, I agree that right action can precede right thinking. Absolutely. You know, it's funny because chemistry was written before COVID, right? So a lot of the suggestions in there are a little timed out, unfortunately. Like, you know, there was this whole idea of like, not only do you like put your phone down, put your laptops down, but go be with people face to face,

skin to skin, hug, kiss, have sex, you know, like just connect, go connect. And then like COVID came and it was really, pardon me for saying, but it was just like a huge kind of cock blocker, you know, that people couldn't do these things that would really help them feel better. I mean, I literally had a patient who was trying to get pregnant during COVID and she's like, what am I going to have like sperm mailed to me? Like, you know, COVID really was a cock blocker for her. A lot of the advice in good chemistry temporarily could not be acted upon. And now it can be. Yeah. Yeah. You talk about this idea of staying glued to our phones and it feeling good and us maybe getting a little bit of connection from it. It's synthetic.

Right. And you say there's a great saying in addiction medicine, which is you can never get enough of something that almost works. And I mean, I think that's so true. I love that quote. Maybe that it was Gabor Mate that said it but I'm not sure but that is one of my favorite quotes that I use a lot and it is really true you know if you're scratching around the itch you're never really going to get any relief. Yeah. You know we see this sometimes with like even like a food situation right we're like I really have a craving for pasta but I shouldn't have pasta so I will go eat this instead and that didn't really work so then I'll also eat this other thing. And like, by the time I'm done eating around the craving, if I had just

had a couple of forkfuls of the pasta I wanted, I would have been done with it. I've actually ingested, you know, 600 more calories than if I had just eaten the thing. So I think that that's true with our sort of hunger for connection also is that we do other things to sort of plug the hole. And, you know, social media friendships are not going to give you what a real friend is going to give you, you know, and texting is great, but it's not going to give you the same thing that like eye contact and hugging or handholding is going to give you like, you know, we, we are designed for physical connection and we are trying to fill that hole with technological, synthetic, virtual connection. And it's not ever going to really scratch the itch.

Yeah. I was thinking about texting recently because my general sense was like, well, you know, texting is not as good as a phone call, which is not as good as seeing a person in person. But it's better than nothing. And I believe that to be true. What I realize, though, is with certain people, I'm actually like in far more regular contact with them than I would be if it was a phone call or having to see them. Right. And so I don't think it's that it doesn't have a place, but it's not going to be a replacement for it. I think it can be a nice addition to. Yeah.

To me, it's almost like vitamins versus food. You're always going to have better nutrition if you eat colorful foods than if you take a supplement. Look, I get a lot of pleasure. We all do. I mean, I get a lot of pleasure from texting my kids. My kids don't want to talk on the phone. They want to text. So we text and it's great. You know, I end up because I'm like Gen X, I'm like dictating long texts, you know, and then I get back like, okay, but I still enjoy feeling in touch with them. There's no question. I mean, my daughter's in London, you know, I'm actually, I'm going to go see her next week. And it's, this is the longest we've been separated.

I feel it in my body that I've been like physically separated from this person who came out of my body, like the longest ever. And like, yeah, we text and it's great, but I can't wait to like, have a real hug, you know, it's long overdue. So yeah, it's better than we text and it's great, but I can't wait to like have a real hug. Yeah. You know, it's long overdue. So yeah, it's better than nothing, but it's definitely not as good as a real thing. And, but I would also argue again, the brain doesn't completely fully differentiate you like synthetic texting from talking or whatever. Like, I don't know.

I just know it's like good, better, best. And the best is rolling around naked with somebody that you really love. That's a high oxytocin state and that's what's best for your body. As a member of Gen X, you not only are dictating a long text message to your daughter, you're making sure it's grammatically correct and it has all the right punctuation. I am. Me too. Me too. And then you're right. I'm all about the comma.

Yeah, totally. Maybe not an Oxford comma, but plenty of comma. Yeah, I do. I'm guilty. I keep asking myself, I'm like, I know this doesn't matter. And yet I can't stop doing it. Yeah, because for me, it's such a sign of intelligence that I know how to spell your and your. Apropos of nothing, Gen X, but I just saw a picture of Vice President Kamala Harris from back in the late 80s, early 90s, when all of us were wearing our hair a particular way and wearing makeup a certain way. And I was just like, oh, my God, she is like, absolutely my demographic. 100%. Like, that's how my hair looked that year. Yeah, you know, it was just kind of really funny to see, like, you know, we all had this kind of

like short on the sides and curly on the top thing for a while. And so did she. We've talked about oxytocin. And I think many people have probably heard of oxytocin as sort of the bonding chemical. You brought up a chemical that I haven't heard about in years. I remember hearing about it and being fascinated by it. It's a brain chemical. Vasopressin. Yeah. So the first thing I will say about vasopressin is it's really complicated and my publishers didn't want it included because it muddies up everything. As straightforward as oxytocin is, I feel like vasopressin is much less straightforward. It's more complicated. One thing for sure is that it's more active in men than in women. And women, oxytocin is more active than men. Like oxytocin works very well in an estrogen rich environment.

Oxytocin is a little bit embattled in a testosterone rich environment. Vasopressin does not have those same sort of constraints on it, but it does a lot of the same things. But there was one thing we didn't mention, which is like if you're in or out of the in group, you know, everybody thinks like oxytocin and vasopressin is all this kind of touchy-feely granola kumbaya, you're, you know, bonding and trusting and openness, and it sounds lovely and like, you know, flowery. But the truth is that oxytocin and vasopressin are also involved in discerning who is on your team and who's not on your team, who is friend or foe, basically. Are they in your clan or are they in the opposing clan? And so both oxytocin and vasopressin are involved in that sort of discernment. You know, nothing makes a

group more cohesive, I think, than if they have an enemy, you know? I don't want to talk too much about politics, but it's one of the things that really drives politics is that you come together in your distaste for the other group. And that is a heavily, I would argue, vasopressin and oxytocin-fueled state to be in. But it feels good, right? Because you're all on one team and you feel the cohesion of being on a team. And, you know, everybody wants to be on the winning team. And the more cohesion the team has, the better they are at winning. So xenophobia, for example, right, is sort of about are you on my team or are you on the other team?

You know, looking at immigrants as other and as them. There's a great TED talk called Them is a Four-Letter Word. You know, this idea that you don't have compassion, that you've othered them into something different from yourself. And this actually gets back, Eric, to what you were talking about with partners and being yoked and them having sort of disowned things about you that you project onto them. And people do this in groups too, in a dyad or a partnership of marriage or something. Let's say, for example, that, I mean, these are real examples, but I feel like in my childhood, if I was sad or if I was scared, I was sort of rejected. You know, I had to be tough and happy. And so don't be sad and scared or bad things. I go rejected. You know, I had to be tough and happy. And so don't

be sad and scared or bad things. I go out in the world and I fall in love with and marry somebody who on some level, at least to me, presented as a sad, scared person. And because I embraced him and sort of, you know, engulfed him and we became one entity, I was able to get those things that were rejected out of me and I had put away and I was able to sort of accept them and accept the sad and scared parts of myself, blah, blah, blah. Same thing in groups. You know, there's a group cohesion and we're good and they're bad. And, you know, you project all the things that you don't want to own. For instance, as an example, let's say that a Republican actually really likes having sex with men, but they feel like that's not part of the Republican image. And so they're

going to say that they're all about family values and that being gay is wrong. And they're going to kind of double down. And so they're, they're rejecting this part of themselves. They put it on the other and they say, those people that have those feelings about wanting to have sex with men, they're bad. And I'm against them. When really, it's self-hatred. It's projected self-hatred. They're taking that part of themselves they can't accept. They're putting it on the other people.

And they're saying they have that thing. And now I'm allowed to hate them. Because I was told that those things were bad. And I shouldn't be those things. So, you know, the basic things that vasopressin does has nothing to do with what we're talking about. The basic things that vasopressin does has nothing to do with what we're talking about. Primarily, it is an antidiuretic hormone that helps to control the balance of water and electrolytes so that you don't get too overhydrated.

That's primarily what it does. It's also like a vasoconstrictor, which means it increases blood pressure. If you lose blood volume, it comes around so that it keeps your blood pressure up. Those are sort of the main things it does. But then also in males, it reinforces pair bonding, keeping you mated, but also reinforces aggression of like sort of territorial aggression, like what I sometimes refer to as territorial pissings. This is my territory. You can't cross over into this line. If you do, I'm going to attack you. That's very much a vasopressin thing. I'm Jason Alexander.

And I'm Peter Tilden. And together on the Really No Really podcast, our mission is to get the true answers to life's baffling questions like why they refuse to make the bathroom door go all the way to the floor. We got the answer. Will space junk block your cell signal? The astronaut who almost drowned during a spacewalk gives us the answer. We talk with the scientist who figured out if your dog truly loves you

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Go to reallynoreally.com and register to win $500, a guest spot on our podcast, or a limited edition signed Jason Bobblehead. It's called Really No Really, and you can find it on the iHeartRadio app, on Apple Podcasts, or wherever you get your podcasts. So let's talk a little bit about psychedelics and addiction.

little bit about psychedelics and addiction. And I think it is a nuanced and complicated area. I am a recovering alcoholic, heroin addict. I usually don't state this, but in addition to those two, I was a prodigious marijuana user. So I have watched this psychedelic unfurling over the last decade where it's really started to get traction in both mental health and spiritual circles very interestingly and also very cautiously given my history and given I've had some really tremendously bad trips in my past. And so let's talk about first, just that link between psychedelics and addiction, whether psychedelics are actually addictive. And then furthermore, what do we see that are some of the possibilities that psychedelics might give for healing addiction? Yeah. So, I mean, you could tell by the length of your question how complicated it is, right? Like, psychedelics can potentially help people who are addicted and psychedelics can potentially make things worse if you're addicted. And some of it depends on which medicine we're talking about. So there's one way of talking about psychedelics, which is a very broad umbrella. You know,

anything that helps you see the way your mind works could be considered a psychedelic. And if you use that broad term, then things like ketamine and cannabis fall under the psychedelic umbrella and MDMA. If you're using a more narrow term where you're like, okay, let's just say the classical psychedelics are like LSD and mushrooms and mescaline. Those three, the classical psychedelics, there really isn't any addiction in terms of tolerance, dependence, withdrawal, sort of the classic things physiologically that you would see in addiction. So I'm going to start with sort of the broad statement that in general, what has not been reported is tolerance, dependence, withdrawal with the classical psychedelics, LSD, mushrooms,

mescaline. So put those aside because I do think they may be helpful in treating addiction. So we'll come back to them. Where we get into trouble with, quote, psychedelics and addiction, ketamine, which is really not officially a psychedelic. It's definitely not a classical psychedelic. Ketamine is actually a dissociative anesthetic. And ketamine is the most addictive of the psychedelics. Full stop. If you are the kind of person who has addictive tendencies, you tend to get addicted to things, I do not recommend that you do any sort of self-administration of ketamine. You very well may end up in trouble.

MDMA rarely causes problems with addiction. It's not something that you can really take chronically. It feels worse and worse every time you take it, basically. If it turns out that really you've got sort of something you think is MDMA, but it's not, and it's methamphetamine, obviously you're going to get into trouble. Methamphetamine is much more addictive than MDMA, which is methylene-dioxymethamphetamine. I've never seen a case of MDMA addiction, but I have heard about people who, you know, go clubbing and take ecstasy and, or molly as the kids call it today. And, you know, maybe they're taking it multiple nights in a row or multiple weekends in a row. Like we know that's not good for you. No one is saying that's good

for you. Cannabis has an addictive potential, a hundred percent. We all know people who've gotten addicted to cannabis. The percentage is, you know, they put it at roughly 9%. It might be higher now with a higher THC percentages. It's still not nearly as addictive as, I mean, I don't know that it matters to like put things in order, but I would argue that cigarettes, heroin, cocaine, alcohol, cannabis, kind of in that order from top down of how addictive things are, how hard it is to quit. It's harder to quit smoking cigarettes than it is to quit. It's harder to quit smoking cigarettes than it is to quit heroin. It may be harder to quit heroin than it is to quit cocaine. It's harder to quit cocaine than it is to quit cannabis. Then the other thing I'll just have to

say, it's sort of a cop-out sounding, but you can get addicted to anything. Obviously, we know people who get addicted to masturbation, to shopping, to gambling, blah, blah, blah, blah, blah. So we have to cop to the fact that there's also something called a process addiction where you can get addicted to any behavior, right? Right. And some of these things that we might think of as less addictive, like cannabis is going to, I think-

You can still have process addiction. I think it ends up co-opting a little from both, right? Yeah. I agree. And the same with food, right? You can have a process addiction around eating. You know, what's a drag about food addictions is that you have to eat or you'll die. Right.

You don't have to drink or have to smoke pot. So it's, you know, it's really, really tough when food is your drug of choice. As a psychiatrist who works with addiction quite a bit, as a friend and colleague of Gabor Mate, and also Elias Dakwar just wrote an amazing book about addiction. You may want to talk to him. I will say that a lot of people who work in this friend and colleague of Gabor Mate, and also Elias Dakwar just wrote an amazing book about addiction. You may want to talk to him. I will say that a lot of people who work in this field feel like part of addiction is sort of like a spiritual illness where there is a lack of meaning and a demoralization and a sort of just trying to numb an existential angst. And so in those situations, cannabis or other psychedelics, classical

psychedelics that may give you sort of a meaning making experience or fill you with some sort of hope or plans for the future, that can be helpful in treating an addiction. More directly, I really want to let people know that there's a plant called Ibogaine that is from a shrub of the iboga tabernathy plant. I'm probably saying tabernathy wrong. Anyway, ibogaine, which you will be hearing more about, seems to specifically really help with opiate addiction. Seems to sort of reset the receptors so that you get rid of the whole tolerance withdrawal issue. And also gives people a very intense psychedelic experience where they do a bit of a life review and sort of come to the conclusion that the opioids have not been helpful. And it becomes easier to quit physiologically and psychologically after Ibogaine experiences. So

I think you're going to be hearing more about Ibogaine for drug addiction. And I really, I think there's a lot there. The problem is that ibogaine is potentially toxic to the heart, cardiotoxic. And there are a few ways to get around this. You can do an EKG and an echo to make sure your heart's okay before ibogaine, or you could potentially take magnesium during the ibogaine to lessen the cardiac effects. But that is one clear example of a psychedelic treating addiction with really impressive results. I would also argue I have patients who have quit being addicted to pain meds by using mushrooms. I have had patients quit being addicted to pain meds by using ayahuasca. I do think that there is value in a guided psychedelic experience, in tackling childhood trauma, and just maybe kind of

unraveling where things went wrong, where things went south. You know, you weren't an addict when you were eight, you weren't an addict when you were 10. What happened when you were 12? Because from 13 onward, there was an issue. You know, it's like you can kind of look back and see the narrative, figure out where things went wrong. I think in the context of like supportive psychotherapy, the classical psychedelics, ayahuasca, ibogaine could be very helpful in treating addiction. And then there's cannabis, which is complicated because, you know, it's sort of like the people's psychedelic. Cannabis

is a psychedelic if you use that big umbrella term where it's mind manifesting and it shows you how you think. And there are people who are using cannabis in high doses as a psychedelic the same way that you would use psychedelic-assisted therapy. Whether they're treating addiction or not, I could not say. Yeah, and obviously I feel like I always hear other podcasters do this, so I suppose I should do it. None of this is medical advice. No, I'm not your psychiatrist. I'm not your doctor. I'm speaking in generalities.

Yeah, we're not encouraging or condoning. We're just discussing. Yeah. And there are a lot of risks. And it's important to talk about the risks. You know, unfortunately, with our nation's drug policy, the number one risk is that you don't get the drug you thought you were buying. And it's more dangerous than what you were hoping to get. And, you know, I often tell the story when I was a teenager, I'd heard a lot about mescaline. I was very interested in mescaline. I wanted to try it. I inadvertently ended up trying PCP. It wasn't what I wanted. And I got a very intense psychotic experience, which was not, you know, the unifying, you know, peak mystical experience I was hoping for. But it got me very interested in psychosis and psychiatry. And it got me really

interested in harm reduction. And counterfeit drugs and drug substitution is one of the things that makes drug taking so dangerous. And as long as we have the drug policy in America, we do, that's the number one risk. The number two risk is just not getting good information. You know, it's hard to get reliable drug information. Our government isn't great at giving us all the information. And then it's hard to figure out, you know, whether you should trust whoever's giving you this information. So that's also a real casualty of the drug war is, you know, the truth. Right. I think that's a really good point is it is really difficult to get good information on what are considered illegal substances, right? Because you're right, the

governing bodies are just interested in demonizing them by and large. And then you get the people who are unabashed advocates of it. Right. And that's not what you want either. with FDA approved drugs, where you have some sense of the truth being disseminated to some degree about the pros and the cons, the side effects, the benefits. The other risk besides drug substitution or misinformation is that when you are altered on a psychedelic, you are in an exquisitely vulnerable, plastic, impressionable state. It is a non-specific amplifier. Everything comes in more. And so it's really important that you are in a safe space, that you are around people who make you feel safe, that you're in a good headspace when you start the experience. I mean, that's all set in setting. And that you are not around bad actors. And it's, you know, it's hard to tell. You know, I jokingly refer to

something as like shamans behaving badly. You know, there are people out there who say they're shamans. Shamans gone wild. Shamans, yeah. But like, you know, it's not funny. I mean, it's, you know, sadly, you know, the phrase is funny, but the reality is really sad and terrifying that there's always going to be people who are going to take advantage of other people. You know, there are bad actors in the world. There are people who are going to take advantage of other people. You know, there's, there are bad actors in the world. There are people who are going to take advantage of somebody who's trusting and in an open state. And so you really have to do sort of the homework ahead of time that you are at a good retreat, that you're with a good guide, that you are actually taking the medicine you think you want. And, you know, like there are

so many variables that need to be accounted for. And there's no question that in a medical model, it's safer because there's no counterfeit drug substitution. You're not over hydrating or overheating or doing any of the crazy things that can get you into trouble with MDMA where, you know, you're like dancing for hours on end. You're not taking breaks. If you're sitting in the, in your therapist's office, talking about childhood trauma, you're not overhydrating or overheating and you haven't taken a counterfeit drug. So already, like three major risks are mitigated in the medical model. The reality is that most people don't take psychedelics under a medical model. They use a recreational model. And sadly, the recreational model in our country is going to be less safe. Unfortunately, you know, you have to do more work

to make sure you're going to be safe. The government, unfortunately, in this situation is not going to, at least for now, is not going to be guaranteeing your safety. Yep. Well, that is a wonderful place for, well, it's actually not a great place to wrap up because there's about a hundred other things we could discuss about it. However, what it is, is time to wrap up. I segued into my usual habitual, that's a great place for us to stop. It's not a great place, but that's where we are. You and I are going to continue to discuss these issues and a little bit more in the post show conversation, which listeners, we would love to have you join our community where you get post

show conversations, ad free episodes, and all sorts of other wonderful things by going to oneufeed.net slash join. Thank you so much, Julie, for coming on. Absolutely. My pleasure. If what you just heard was helpful to you, please consider making a monthly donation to support the One You Feed podcast. When you join our membership community with this monthly pledge, you get lots of exclusive members-only benefits. It's our way of saying thank you for your support. Now, we are so grateful for the members of our community. We wouldn't be able to do what we do without their support, and we don't take a single dollar

for granted. To learn more, make a donation at any level, and become a member of the One You Feed community, go to oneyoufeed.net slash join. The One You Feed podcast would like to sincerely thank our sponsors for supporting the show. I'm Jason Alexander. And I'm Peter Tilden. And together, our mission on the Really Know Really podcast is to get the true answers to life's baffling questions like why the bathroom door doesn't go all the way to the floor, what's in the museum of failure, and does your dog truly love you we have the answer go to really know really.com and register to win 500 a guest spot on our podcast or a limited edition sign jason bobblehead the really know really podcast follow us on the iheart radio app apple podcasts or wherever you get your

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