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Hello, it's Alyssa Milano,

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Sorry Not Sorry. It's a collection of essays

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thoughts on life, culture, activism,

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and motherhood. You'll learn some things about

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me that I know you've never heard before and

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share in my story as an activist.

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This book is such a big part of my heart,

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and so are you, and thank you for that. Sorry

0:24

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1:29

Hi, I'm Alyssa Milano, and this

1:32

is Sorry Not Sorry.

2:01

One of the things I've been very open about

2:03

is my mental health. We have

2:05

stigmas in our culture, which

2:07

not only affect those who struggle with

2:09

mental health conditions, but also

2:12

treatments for those conditions. Dr.

2:14

Dave Raben helps people face

2:17

these stigmas. He's a board-certified

2:19

psychiatrist, neuroscientist,

2:22

entrepreneur, and inventor who

2:24

has studied resilience and the impact

2:27

of chronic stress on our lives for

2:29

over 15 years. Dr.

2:31

Raben and his team collaborate

2:34

with clients at the Apollo Clinic,

2:37

empowering clients to take control

2:39

of their mental and physical health by

2:41

tapping into our abilities to

2:44

adapt and heal ourselves.

2:50

The pandemic created an epidemic

2:52

of depression.

2:57

But

3:12

doctors are finding great success with

3:14

ketamine compared to antidepressants.

3:17

What is the real potential

3:19

of wearable technology in helping

3:21

with mental health issues? That's

3:23

a good question. I think that there's a huge

3:26

potential. I think we've just barely

3:28

begun to understand what that

3:30

potential really could be. While the social stigma

3:32

around mental health is lessened over time, we've

3:35

still got a long way to go. The phrase,

3:37

it's all in your head, can sometimes be used

3:39

to dismiss people's mental health struggles.

3:42

Hi, my name's Dr. Dave Raben, and I'm

3:44

here to cure mental illness.

3:47

Sorry, not sorry. Dr.

3:52

Dave, welcome to Sorry, Not Sorry. Thank

3:54

you so much for being with us. I'd love

3:56

for you to start out by telling our

3:59

audience a bit about.

3:59

about who you are and what you do.

4:02

Well, first off, thanks so much for having me. It's a pleasure

4:04

to be here with you. I am a bit of a rare

4:06

breed. I'm a psychiatrist and neuroscientist

4:09

who has an expertise in chronic

4:12

stress, performance and recovery. And

4:14

I focus my clinical practice and my research

4:16

on developing new treatments for treatment

4:18

resistant mental illnesses, which are now unfortunately

4:21

the majority of mental illnesses that we face

4:24

in Western medicine are mental illnesses

4:26

that don't respond to two or more gold

4:28

standard treatments. This is

4:31

the folks who struggle to get better with

4:33

Western treatments or folks who have always been very interesting

4:35

to me and trying to figure out more

4:38

ways and more natural ways to help people recover

4:40

and heal.

4:42

We hear a lot, especially with the

4:44

report that just came out about

4:47

mental health and the crisis that's in

4:49

the country and especially how

4:51

it's impacting young people.

4:53

We're issuing this advisory to sound the alarm. Surgeon

4:56

General Vivek Morthy says there's not enough

4:58

evidence to show social media platforms

5:00

are safe enough for kids and teens.

5:03

We see rates of depression and

5:05

anxiety and suicide and loneliness

5:07

going up among young people. And

5:10

I'm concerned that social media is an important

5:12

driver of that youth mental health crisis. This

5:14

is the defining public

5:17

health issue of our time, youth mental health.

5:19

Can you just give us a general overview

5:22

of mental health and the landscape in

5:24

the United States? And also it's

5:26

changing. How is it changing? Why

5:29

is it changing? What is happening?

5:31

That's a great question. I think that

5:33

just to keep it simple, the challenges we're facing

5:36

in the mental health community right now or

5:38

in general, the public health community, the

5:41

wellness of everyone, the

5:43

single biggest problem that we are facing, which

5:45

is also the single most expensive problem we're

5:47

facing right now is untreated mental illness.

5:50

We know from the statistics that there

5:52

are more people now suffering from

5:54

and meeting diagnostic criteria for mental illness

5:57

than ever before. And that number is

5:59

only going up.

5:59

rapidly. And we know that in

6:02

that same group and in a group that's

6:04

just next to that group, the number of people that

6:06

have substance abuse issues and who

6:09

have addiction issues or who just use too

6:11

much substance that

6:13

could be harmful,

6:15

anything from even alcohol and tobacco

6:17

and things like that are actually

6:19

skyrocketing. And we don't have good solutions

6:21

for it, but my specialty as a psychiatrist

6:24

is as an addiction trauma psychiatrist

6:27

in my training. And one of the things that

6:29

we see that's really contributing to this

6:31

is,

6:32

you know, effectively loneliness or disconnection.

6:35

The

6:35

people feeling like they

6:37

are not able to bond

6:40

or have these really authentic meaningful

6:43

interactions with other human beings, where

6:45

we see eye to eye and we really like get each

6:47

other, and we can trust each other. And

6:49

we know that we're all human first before anything

6:51

else. And we're really like looking out for each other in our communities.

6:54

A lot of that has been lost, unfortunately,

6:56

and it doesn't mean we can't get it back. But I

6:59

think we were already struggling with these issues in the Western

7:01

world prior to COVID. And then when COVID hit,

7:04

isolation became a big issue. We all know

7:06

that things did not get better. They got a

7:08

lot worse in this area. And so anything

7:10

that we can do to strengthen

7:13

our connection to each other and our sense of connectedness

7:15

in our communities is critically important to

7:17

our health.

7:18

It's wild, right? I was in the airport

7:20

the other day, and I'm of that generation

7:23

that remembers before the internet and

7:25

before handheld devices. And

7:27

I just looked around while I was

7:29

waiting for my flight. And there were hundreds of people

7:31

in this airport. Everyone had their head

7:33

buried in their device. Everyone. There

7:35

was zero interaction happening,

7:38

unless it was like a mom running

7:40

after a toddler or something like that, which

7:42

is also a very lonely thing,

7:44

I think I have been very open

7:46

about my diagnosis, which is a

7:49

few I have generalized anxiety disorder

7:52

with complex post-traumatic stress

7:55

and OCD and panic

7:57

attacks.

7:59

And I got a

7:59

especially when I first revealed

8:02

this, because for me, yeah, it had panic

8:04

attacks when I was in my 20s, but I was

8:06

just like, okay, whatever, but it wasn't

8:08

until after I had Milo, my

8:11

son, that

8:12

everything just came tumbling

8:14

down, and I think it was because, you know, I

8:16

never treated what was happening in the first

8:19

place.

8:20

After bedtimes,

8:23

is it so silent? I didn't realize how loud

8:25

silence can be, and that was

8:28

really

8:29

tough. I don't actually know what

8:31

I expected motherhood to be, and I don't

8:34

know how easy I expected motherhood to be, but

8:36

I just never expected it to be lonely

8:38

in any way.

8:42

I think the loneliness, because

8:45

there is something very lonely

8:47

about those first few months of having a

8:49

baby. It's like you're in this postpartum

8:52

cocoon,

8:53

and it's the same

8:55

thing every day, and you have this super,

8:57

it's not lack of connection, it's

8:59

this super connection, right? You

9:01

have this baby that's looking up at you, that's

9:04

feeding off your body, and it's totally

9:07

dependent on you. You're waking up at three o'clock in the morning,

9:09

which is the stillest, most quiet part of

9:11

any day. It's dark, and I don't know,

9:13

I just, I hit a wall,

9:15

but

9:15

I do know when I was, I felt like I needed

9:18

to be public about it, and this was, I don't

9:20

know, maybe nine years ago, and then

9:22

and now there are real stigmas in the United

9:25

States that people with mental

9:27

health conditions have to confront

9:30

every day, and yet on the other

9:32

side of that, there's this dichotomy,

9:35

because it's also never been more mainstream,

9:37

and what I mean by that is, like I'm writing this

9:39

script, and the girl in it, she has OCD,

9:43

and she's like, it's never been more mainstream.

9:45

Like people use

9:47

these terms that we diagnose other people

9:50

by, you know, flippantly, like,

9:52

oh my God, I'm so OCD, I

9:54

have to have everything the way, you know? And so

9:57

we've de-stigmatized it by.

10:00

making it less

10:02

critical or important.

10:04

And I don't know how to combat,

10:07

like how to get people to see it, take

10:09

it seriously, but also

10:11

de-stigmatize at the same time

10:14

because you run the risk of, when you de-stigmatize

10:16

it, you run the risk of taking away its weight.

10:19

You're absolutely right. And it's a very strange

10:22

time for people with

10:24

mental health issues and for those of us

10:26

who treat mental health issues because of what you

10:29

described. And I'm so glad to

10:31

hear that you were able to

10:33

have the courage to come forward and talk about yourself

10:36

in that way and what you were struggling with because it's

10:38

people like you who really help

10:40

to dispel the shame around

10:42

the narrative that it's not okay

10:44

to have a mental illness or that

10:47

you're a less of a person if you have a mental illness.

10:49

That's absolutely not true. And the other

10:51

thing, the other common misconception is

10:53

that there's something wrong

10:54

with us that we were born with. That's

10:56

the reason why we have a mental illness and we're

10:58

never going to get better.

11:00

And I think that what neurosciences

11:03

and the science of psychiatry and psychology

11:05

are really starting to show and have

11:07

been starting to show over the last 20, 30 years, it's

11:10

very exciting, is that we

11:12

actually have the ability

11:14

to make, by changing the way we think about

11:16

mental illness and what's causing it, we have the

11:18

ability to actually not just treat

11:21

it

11:21

all the time and then give people lifelong

11:24

diagnoses, but we have the ability to

11:26

get people to what we call remission

11:29

or symptom freedom. And that's really

11:31

the goal. And that's always been the goal from our

11:33

perspective as clinicians, but I think patients,

11:36

that hasn't been passed on.

11:38

You would never say to someone with a broken

11:40

bone to just ignore their pain. That'll

11:43

just pass one day. You

11:45

would never say about someone who

11:47

has cancer that they're

11:49

just faking it. It's just all for attention.

11:52

You would never say to someone in a wheelchair,

11:54

just stand up, it's all in your head.

11:58

You would obviously never say that to them.

11:59

any of these kinds of people because they

12:02

didn't ask for it in their life. It's not like they

12:05

chose to put it in their life. Should

12:07

be the same for any other sickness or disability.

12:10

No one asked to put this into their life,

12:13

so they can't just snap out of it. Unfortunately,

12:16

many people with mental illness have been

12:18

told at least once in their life just snap

12:20

out of it.

12:22

The medication style of prescription that

12:24

we use and the way we treat mental

12:26

health issues has caused a lot of problems

12:28

where people learn rather than

12:30

learning to rely on what we have in here to heal ourselves, knowing

12:33

that we have the ability to heal without

12:35

anything from the outside. We start to rely on medication

12:38

and doctors and things from the outside. And it's

12:40

not to say that those are all bad. They're very

12:42

good use cases for those things. There are

12:44

a lot of people who do get benefit from a

12:46

lot of mental health medication.

12:48

That being said, it's

12:49

not the only option. And if it changes

12:52

the way that we think about mental health, where it

12:54

makes us think we need it

12:56

to heal, then it actually can be

12:58

destructive to the healing process and can squelch

13:01

or decrease our own power in

13:03

our own healing process. So when

13:05

we talk about the stigmatizing mental illness now,

13:08

based on what the latest neuroscience is showing,

13:10

we actually talk more about not

13:13

the diagnostic terms that you were mentioning earlier,

13:15

like the depression, the anxiety, the OCD,

13:17

but we talk more about trauma. Because

13:20

the diagnostic terms like the OCD

13:23

and the depression and the depressive disorder and

13:25

the PTSD, those terms are clinical

13:27

terms. Those are our words that were created

13:29

for us as clinicians to pass on and

13:32

communicate about patterns of illness and how we treat

13:34

them better. But they were never really meant to

13:36

be passed down to the average person or

13:38

to any patient. They were meant for billing and they

13:40

were meant for doctors talking to doctors

13:42

and other clinicians. But

13:43

what we're talking about with our clients and

13:46

what the data is showing is that all of these different

13:48

mental illnesses, whether they're called depression

13:50

or they look like PTSD or they look

13:52

like anxiety disorder or OCD, they

13:55

come from unprocessed, unresolved

13:57

traumatic events.

13:58

And our bodies store that.

13:59

information and they come out in all these different ways,

14:02

ADHD too.

14:03

And so when we talk about de-stigmatizing

14:05

mental illness in a meaningful way, without

14:08

it losing its significance,

14:11

what we're really should be changing. The language

14:13

too is let's talk about trauma, right?

14:15

Let's talk about challenging events where

14:17

we have had one or multiple, very meaningful

14:20

or significant, intense, challenging events

14:22

that we weren't given adequate support afterwards.

14:51

Also generational trauma. The

14:53

trauma doesn't even have to be our trauma.

14:55

It could be our family's trauma that is passed

14:58

down. I mean, I have traumatic experiences

15:00

that happen to me and then traumatic experiences

15:02

that happen to my mother that she never

15:05

healed herself, that she passed her

15:08

anxiety about onto me

15:10

and her children. There's so many things

15:13

that are going on and I think support is

15:15

the right word. I was never given

15:17

support. My friends had to me, you know what, you

15:19

need to go into deep

15:21

healing and the only way out is in. And

15:23

I was like, oh, okay. And

15:26

like I 51, 50 myself. That's how bad

15:28

it was. And I found this one guy while I was in

15:30

this public mental health facility,

15:32

who was like, let's sit down. Cause I was going

15:35

to the emergency room with these panic attacks

15:37

because nobody was helping me.

15:40

And they're scary. And they're scary. You don't know if you're

15:42

dying or what. And I had this baby at home

15:44

and I felt like the only place I could

15:46

be taken care of was in the emergency

15:48

room. So anyway, 51, 50 myself and

15:51

this guy that was this doctor that was

15:53

there was like, I really think this is

15:55

hormone related. You've just had a baby.

15:58

And I was like, and I miscarried before the baby. and

16:00

he was like, yeah, so that can mess with your hormones.

16:02

I have this one doctor I'd love to refer

16:04

you to that only deals with

16:07

hormones and women during

16:10

hormonal stages of their lives.

16:13

It's puberty, during pregnancy,

16:15

postpartum, and menopausal women.

16:18

And that's all he did, his entire practice.

16:21

And he saved my life. That's amazing.

16:23

Dr. Sporego saved my

16:26

life. Nobody was connecting

16:29

the dots between, especially then, this was

16:31

again, 11 years ago, connecting the dots

16:34

between postpartum, depression,

16:37

and anxiety. Because I didn't have that

16:39

like, oh, I want nothing to do with my baby. I

16:41

had the like, all I want to do is hold my

16:43

baby. All I want to do is fold his clothes. You

16:45

can't touch my baby. I'm holding my baby. You

16:47

know what I mean? Like, I didn't put him down

16:50

for the first two years of his life. I had the

16:52

opposite of it, but it was definitely it.

16:55

And I'm so grateful for him, but

16:57

also that there's all of these things that are

16:59

happening now in mental

17:02

health.

17:05

We've learned something profound about

17:07

what's sometimes called the plasticity

17:10

of the brain. That the brain is malleable,

17:13

is able to change. We

17:14

can take that up and scale that up to levels

17:17

where it's actually changes in the brain circuitry,

17:19

how brain regions are communicating with

17:21

each other over time, and as a result

17:23

of environmental influences. We

17:26

think of it in changes in synapses, how

17:28

these neurons are actually touching each other and

17:30

communicating with each

17:32

other. And

17:35

we know in depression that the number

17:38

and the strength of these interconnections

17:40

decreases. With ketamine,

17:43

we see a regrowth in

17:45

the interconnectedness and number

17:48

of these synapses to connect with each

17:50

other.

17:53

Actually,

18:00

first, will you just describe the drug to us,

18:03

what it is, how it's used, things

18:05

like that? Sure. And

18:07

yeah, sometimes it just requires us to think a little

18:09

bit outside the box to solve these problems. And

18:12

unfortunately, modern medicine hasn't trained

18:14

doctors as well to think outside the box. Back

18:17

in the day, we used to do that all the time.

18:18

Also, with the pharmaceutical companies

18:20

pushing their drugs, that's a whole

18:22

other part of this.

18:24

Right. It creates a very rigid framework

18:26

for physicians. And so I think we have a lot

18:28

of other tools, to your point, right? That's

18:31

the idea is we have so many other tools. We have

18:33

ketamine. I am also, I didn't

18:35

mention this earlier, I am one of the few psychiatrists

18:38

who is training ketamine assisted therapy

18:40

and MDMA assisted therapy nationwide.

18:43

I also train other clinicians to do that

18:45

work because there's very few of us who

18:47

actually train others and it's a very important

18:50

field. And coming out of that

18:52

work and the understanding of how ketamine

18:54

and

18:54

MDMA

18:55

in the therapy environment, which are

18:57

drugs that are not administered

19:00

daily, they're administered every couple

19:02

weeks or every several weeks with intensive

19:04

psychotherapy before, during and after the

19:06

medicine really serves as a therapy

19:09

amplifier by amplifying

19:11

effectively and supporting how safe

19:13

we feel in the therapeutic experience and in our

19:15

own skin.

19:17

And so when you use these medicines,

19:19

we don't often, not that many people will talk

19:21

about the similarities between medication and experiences

19:25

like ketamine and MDMA therapy. But one

19:27

thing they have in common, which is a big part of my research

19:29

is that they all support

19:31

and amplify the safety bond that we

19:34

have and the trusting bond between me, the

19:36

clinician, the provider and whoever

19:38

the patient is so that you can effectively

19:41

as a patient

19:42

or a client feel safe enough to go

19:44

back inside yourself, which might

19:46

feel like a scary place sometimes or all the

19:48

time and go back and reevaluate

19:50

some of the ways that we've made meaning

19:52

around ourselves, the way we think about ourselves,

19:54

the way we've been taught to think about ourselves

19:57

and see ourselves and what the experiences

19:59

course of our lives have taught us and

20:02

when we have the opportunity to feel safe enough

20:04

to reevaluate that

20:05

then we can start to really

20:08

become like bring forth that vulnerability

20:10

expose our vulnerability.

20:12

So here's the amazing thing about

20:15

your brain it's made to

20:17

rewire itself all the time

20:20

this is called neuroplasticity. Scientists

20:23

used to think that after childhood our brain was pretty

20:25

much locked in place but now

20:27

that we have better imaging technology we

20:29

can literally see how the brain changes

20:32

depending on how we use it.

20:34

And that unlocks all

20:36

of the healing in mental illness recovery which is

20:39

absolutely astounding. The challenge

20:41

with these medicines is that as great as they work

20:43

when delivered properly and that they're incredibly

20:46

safe they're really often expensive

20:48

and hard for people to access. There's almost no

20:51

studies in children of these medicines in the mental

20:53

health space and so that's actually from studying

20:55

how these work that actually led to the discovery

20:58

of Apollo at the University of Pittsburgh which

21:00

I'm wearing on my chest and I'm also the chief

21:02

medical officer and co-founder of poly

21:04

neuroscience

21:04

and we developed this technology

21:06

to also by understanding that

21:08

safety pathway through MDMA research and ketamine

21:11

research to activate the safety response in our

21:13

bodies through soothing touch that helped to

21:15

calm the body and help people feel safe enough

21:17

to heal and safe enough to be vulnerable and safe

21:20

enough to get through their day.

21:21

Listen I don't want this to sound

21:24

like an infomercial but I gotta say I have

21:26

a little girl who suffers from

21:28

anxiety she started to get a panic attack

21:31

last night and I put this device on

21:33

her the Apollo on her she was asleep

21:35

in five minutes. Yes it

21:37

works. It was

21:39

pretty amazing and

21:41

she was like okay I'll try because you

21:44

know at that age they just want to feel good they

21:46

don't want anything else.

21:47

I think so much focus is on how

21:49

technology is harming

21:52

us

21:53

humanity especially with AI

21:56

and social media and all the things where

21:58

we hear the disconnect and all those things.

22:00

I think the only way out of that is to actually

22:03

lean into how technology

22:05

can actually help us.

22:07

Without a doubt. And that's the entire focus

22:10

of our work is that we have

22:12

so much access to technology, advanced

22:14

technology, things that we have never

22:16

had access to in the history of humankind.

22:19

And we have that now and it's cheaper

22:22

than ever. And it's more accessible

22:25

to people than ever. And in the case of people

22:27

like your daughter last night, other than

22:29

holding her and sitting with her and rocking her

22:31

back to sleep yourself, what other tools

22:33

do you have as a mom? Right? There

22:35

really isn't anything else. You don't want to give your kid

22:38

medication. It's really hard to teach kids

22:40

that age to meditate and deep breathe and do

22:42

the mindfulness exercises for falling

22:44

back asleep and self soothing. And so

22:46

tools like this that are

22:49

safe and can give some

22:51

of that sense of safety back by harnessing

22:53

technology and what we can

22:55

do with neuroscience and sound

22:57

and vibration are really exciting because

23:00

again, it's something you can use for anybody and

23:03

kids need it more than ever because kids

23:05

aren't the best candidates for medication. And the same

23:07

with elderly folks and the same with pregnant women

23:09

and postpartum women. And if you can avoid medication

23:12

in those populations, then that's a huge

23:14

win.

23:40

And just to reiterate, we're not saying

23:42

that medication is bad. Medication is good.

23:44

I'm still on a bunch of medication and

23:46

it's not bad. But

23:48

I look at all of this as just

23:51

tools in the toolbox. Right. And

23:53

some tools work for some parts of your life.

23:56

Unfortunately, things like benzos

23:58

and all of that, they mess with you.

23:59

with your brain, they mess with your sex drive,

24:02

all of the things. We had Michael Pollan

24:04

on the podcast and talked so much about

24:06

the pathways in the brain and how they get

24:08

so calcified and how things

24:11

like ketamine and LSD and psilocybin

24:13

and MDMA are helping the pathways

24:16

get reestablished so that you're not

24:18

falling into the same rut. What advice

24:20

do you give to someone to try to get out

24:23

of the rut,

24:24

to take the steps necessary to access

24:26

care? Or even what advice would

24:28

you give to the people who love these

24:30

people? Yeah, it's a great question.

24:33

And there's a lot of advice that I can give because it's

24:35

my job. But I'll focus on the

24:37

first things, which are the most important, which

24:40

are effectively, if you

24:42

think about what mental illness or being diagnosed

24:45

with a mental illness from a doctor does

24:47

to us, it makes us feel powerless

24:50

to recover on our own.

24:52

And that is one of the most common things

24:54

I hear my patients telling me is that they feel

24:57

like they're stuck with this diagnosis forever.

24:59

And if they don't take the medicine the doctor told

25:02

them to take every day or the multiple medicines,

25:04

they're never going to get better. And I think

25:06

that what we're seeing

25:08

from, again, the latest research

25:11

in this area is, which is really exciting

25:13

and hopeful, is that it dispels

25:15

that concept. And so the thing

25:17

that I first tell everyone when they start working

25:19

with me is

25:21

you have the ability to heal yourself.

25:23

You

25:26

don't know sometimes what to say, and

25:29

you're basically walking on eggshells. Sometimes

25:31

it can shock people. Someone says you're having a good day. They

25:34

just expect you to say, yes, I'm okay. And

25:36

I said, no, I'm not. And

25:39

some people can get taken aback. Oh, oh, oh. And

25:41

I think it's the fear of saying the wrong

25:43

thing. You know, what do I know about

25:45

mental health?

25:48

And there is nothing more important

25:51

as a human being understanding that. And

25:53

this is taught not just by me. This is ancient

25:56

knowledge from Hippocrates and Maimonides,

25:58

some of the fathers of Western medicine.

25:59

and ancient Eastern

26:02

and tribal traditions, they all say

26:04

the same thing at the core, which is that the

26:06

source of healing comes from the person

26:09

seeking to be healed. And all

26:11

that requires us to do, to

26:14

kickstart that process, is

26:16

just to understand

26:18

that, that that's possible, that

26:20

we, even though we felt maybe really

26:23

crappy for a really long time, maybe we

26:25

don't even remember what it feels like to feel good

26:27

or feel like ourselves.

26:29

If we just remember that and then

26:31

believe in it, then we start to

26:33

know it as part of ourselves. We start to know

26:36

the part of ourselves that wants

26:38

to heal.

26:39

What have you been sick for so long with

26:41

a mental health issue that you can't remember

26:43

it? It's the same thing, because

26:46

even if you don't remember what it feels like to feel

26:48

good or

26:49

to feel like yourself,

26:50

all you have to do is understand

26:53

what the science is saying and what the science

26:55

has, and the science is saying, from

26:58

a basic understanding perspective, you

27:00

have the ability to feel good.

27:02

You have the ability to heal yourself. So

27:04

let me give you some examples of the kinds

27:06

of things that we teach people that they can do

27:09

to jumpstart that process.

27:11

So the core of all anxiety

27:13

and suffering in large part that we face

27:16

in the Western world that most people don't talk about,

27:18

and I wasn't taught it this way in my training either,

27:20

but discovered this through seeing thousands

27:22

of patients,

27:23

is the core of anxiety

27:26

and feeling uncomfortable is

27:29

that we feel out of control.

27:31

Now, feeling out of control evolutionarily

27:35

comes from feelings of uncertainty, and

27:38

that's really important that we want our stress

27:40

response system to kick on when we are

27:42

uncertain of things going on in our environment, because

27:45

millions of years ago, if we were

27:47

uncertain of stuff in our environment, that could mean like

27:49

certain demise for us, right? That could be the end.

27:52

And so we have to quickly tune

27:54

into stuff that's uncertain, but most

27:56

things, because we don't have the bears

27:59

chasing us in the jungle. We don't

28:01

have the same kinds of real survival threats we had

28:03

back then. We have the news and we have too many responsibilities

28:06

and we have too many expectations and we have kids

28:09

screaming and all these other things that are setting

28:11

us off.

28:12

And so we have to remember

28:15

that we have control

28:17

over our attention and what we actually allow

28:19

into our consciousness. And our attention is

28:21

one of our most important skills, the

28:24

invaluable skills that we have as human beings.

28:26

That's simply why every single advertising company

28:28

on the face of the earth spends billions of dollars trying to

28:30

captivate our attention because what we pay attention

28:33

to is what enters into our consciousness

28:35

and becomes part of us.

28:36

So if we spend time and

28:39

we only have so much time every day to pay attention

28:41

to anything, if we spend 70%

28:44

of that time, which I would argue is probably

28:47

about the amount the average human being spends

28:49

thinking about things that are outside of our control,

28:52

then we feel out of control and uncertain 70%

28:54

of the time.

28:57

That means that 70% of the time we're anxious and

28:59

sometimes even more.

29:01

So our fear response is kicked on.

29:03

So how do you fix that? Well,

29:05

if you understand that just spending

29:07

time thinking about things that we don't have control

29:10

over is the source,

29:12

then you fix that by spending

29:14

time thinking about the things that you do have control

29:17

over. So what do we have control over at any

29:19

moment? Our breath, our

29:22

movement, what we listen

29:24

to and what we produce in terms of sound,

29:26

song, what we say or sing, you can

29:28

produce sound, what we touch,

29:31

touching ourselves, getting touched from a loved

29:33

one consensually, holding a pet,

29:36

and then what we put into our bodies in

29:38

terms of nutrition and sleep. Those

29:40

are the six pillars of control.

29:43

And so if we focus on those things,

29:47

even just by reminding ourselves, hey, I'm noticing that

29:49

I'm thinking about all this stuff that I don't have any say

29:51

in, I don't have any control over this right now. I'm

29:54

just going to gently redirect my attention

29:56

to stuff I have control over. All of a

29:58

sudden, we start to feel more in control.

29:59

our anxiety dramatically goes down.

30:02

And the Apollo is a very powerful tool

30:05

to help people do that, because all of those

30:07

techniques bring us back into our bodies,

30:09

and our bodies are always present in the moment, our minds can

30:11

be anywhere. So it's these kinds of practices

30:14

combined with the modern understanding of

30:17

the way we feel and how we can control

30:19

that, that regardless of whether you remember

30:21

what it feels like to feel like yourself or not, you can

30:24

restart that process of healing at any

30:26

moment.

30:27

It's really just about taking control over your attention.

30:29

I love it. It makes

30:31

so much sense. And to have another

30:33

tool in the toolbox is super

30:36

important.

30:37

Finally, what gives you hope?

30:39

What gives me hope is that the, in

30:43

the same vein of what we're talking about, that

30:46

we have long been taught that mental

30:49

illness is something we're born with. There's like

30:51

a genetic thing that causes

30:53

an imbalance of neurotransmitters in our brains that

30:56

results in us

30:57

getting diagnosed with mental illness and getting sick. And

31:01

what is really hopeful is that

31:03

all of the latest studies of this

31:06

topic have shown

31:07

that there is no significant evidence

31:09

to support

31:11

that there is a genetic reason for

31:13

over 99% of mental illness.

31:15

So think about that for a moment, right?

31:18

That means that if we

31:20

might have been taught that we were born with a neurotransmitter

31:23

imbalance in our genes that is causing

31:26

us to be sick and causing us to be sick

31:28

in the longterm,

31:29

what the data now shows is if you look across

31:32

the board, there is no significant or reliable

31:34

evidence to support that theory.

31:36

And so that means

31:39

what is actually responsible, we can ask

31:41

the question, right? What is actually contributing? Why

31:43

do we have mental illness?

31:45

It's unprocessed, unresolved trauma. And

31:48

that's what all the studies are showing. And

31:50

if we know that that's the case,

31:52

then we know that we

31:54

can reverse it because trauma

31:57

is one or multiple intense meaning.

32:00

full experiences that we've had, that we perceive

32:02

as threatening or fearful, that we haven't

32:05

been supported through. And

32:07

if you look at the psychedelic medicine work, if you look

32:10

at the work of what we're doing with Apollo, what

32:12

you can see is people can

32:14

get better, even if

32:17

other things haven't worked. And

32:19

when you look at the MDMA therapy results with

32:21

just completed phase three clinical trials with the

32:23

FDA, just three doses of MDMA

32:26

and 12 weeks of psychotherapy

32:28

were resulting people, 55% of

32:30

people in the phase two trial are no

32:33

longer meeting diagnostic criteria for PTSD

32:36

after having PTSD for 17.6 years with no

32:38

relief. 55% of

32:42

those people are no longer meeting diagnostic

32:44

criteria for PTSD two months out.

32:47

Then you follow those people to one year out

32:49

with no additional treatment that was administered

32:51

by the study group. They could do whatever they want. There

32:53

was no additional treatment.

32:55

That number of 55% goes up to 67%.

32:58

We have never seen anything

33:01

like that in the history of psychiatry,

33:04

like literally never. It is the most paradigm

33:07

shifting, phenomenal finding that we have

33:09

ever seen thanks to Rick Doblin and the maps

33:11

team.

33:12

So you think about how that's working.

33:15

We're seeing people get better after treatment

33:17

at stop even better. And

33:20

that is probably the single most hopeful

33:22

thing that we can all take with us

33:24

into the future of the way we think about mental health.

33:27

It allows us to potentially think about using

33:29

the cure word for the first time, which we've never

33:32

been allowed to use in mental illness.

33:34

Well, Dr. Dave, you give me hope. Thank

33:36

you for all you do and for being a part of the podcast.

33:38

Absolutely my pleasure.

33:48

I want to start off my talk with a quick

33:50

disclaimer. I

33:52

am very excited to be here, but

33:55

I'm also incredibly terrified. I'm

33:58

speaking about

33:59

mental health and mental illness. So

34:03

that means I'll be talking about a subject that you

34:05

all know is taboo and something that society

34:07

doesn't really like mentioning. And

34:09

while I'm not afraid of people's judgment anymore

34:11

because of what I have been through, I

34:15

am afraid of the consequences that come out of that

34:17

judgment. I'm

34:19

afraid of being isolated. I

34:22

am terrified of

34:25

feeling like something's my fault when it

34:27

wasn't.

34:28

And I'm also

34:30

afraid of being ousted

34:33

for going through something that's completely normal.

34:48

The mental health crisis

34:51

we face in America will take innovative

34:53

thinkers and the courage to break through

34:56

our own biases if we want

34:58

to overcome it.

35:00

It's gonna be hard. Not only

35:02

are the challenges in our laws making

35:04

it hard for breakthrough treatments like

35:06

ketamine to reach the patients who so

35:09

desperately need them, but they are deeply

35:11

woven into the very culture.

35:15

Our language, for example, makes free

35:17

use of words like crazy

35:19

or insane to describe events

35:22

which are out of the ordinary. We

35:24

often shun those who struggle, treating

35:26

them as a

35:27

burden. It will require

35:30

us to be our best selves to

35:32

break down barriers of politics,

35:35

class, and culture.

35:37

I believe we can do it.

35:40

I hope you'll join me in trying.

35:47

Sorry Not Sorry is executive produced by

35:50

Elisa Milano. That's me. Our

35:52

producer is Ben Jackson, audio editing

35:54

and engineering by Maciej Lewandowski,

35:57

and music by Josh Cook, Alicia Eagle,

35:59

and...

35:59

Milo Bouliari. Don't

36:02

forget to rate, review, and spread

36:04

the word. Sorry.

36:06

Not sorry.