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Joe Rogan Experience #2553 - Andrew Hubermsan

Andrew Huberman, PhD, is a neuroscientist, author, and host of the "Huberman Lab" podcast. His latest book, "Protocols: An Operating Manual for the Human Body," will be available on September 22. https://www.simonandschuster.com/books/Protocols/Andrew-D-Huberman/9781668032145 https://www.youtube.com/@hubermanlab https://hubermanlab.substack.com https://www.hubermanlab.com Perplexity: Download the app or ask Perplexity anything at https://pplx.ai/rogan. Get a free welcome kit with your first subscription of AG1 at https://drinkag1.com/joerogan Switch today at https://www.Visible.com for just 25/mo. Or Save $10 on your first month of Visible+ Pro with code ROGAN.

Joe Roganhost
Sep 14, 20262h 39mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:022:36

    Huberman’s 8-year book project and Rick Rubin’s “scrape it” standard

    1. JR

      Joe Rogan podcast, check it out.

    2. SP

      The Joe Rogan Experience.

    3. JR

      Train by day, Joe Rogan podcast by night, all day. [upbeat music]

    4. JR

      Hey.

    5. SP

      Hello, Andrew. Great to see you again, Joe.

    6. JR

      Good to see you, my friend. What a thick-ass book you wrote, sir.

    7. SP

      Yeah, yeah. I figure it doubles as a doorstop or a weapon. Yeah, it's, um, it's designed to be read front to back, learn a lot of science, a lot of health protocols. But you can also just decide, "I wanna get better at managing stress," go straight to that chapter, look up what you wanna do, say, "Oh, I already do that," go to the next thing, and use it sort of like a, a manual.

    8. JR

      This is a very ambitious undertaking.

    9. SP

      It took me just shy of eight years.

    10. JR

      The operating manual or An Operating Manual for the Human Body. That's a lot.

    11. SP

      Yeah.

    12. JR

      Like, just, just sitting down there and, you know, in front of the computer thinking, "I'm gonna write an operating manual for the human body."

    13. SP

      Well, it didn't start off like that. At first, it was a book about the autonomic nervous system, stress, sleep, focus. Then it evolved. Then I had a third completely new rewrite and my good friend now, I'm honored to call him a friend, but he's just such a good dude, Rick Rubin, was like, "Do you like it?" I was like, "Ah." And he goes, "Scrape it."

    14. JR

      [laughs]

    15. SP

      I'm like, "What?" And then he said, "I'm gonna get myself in trouble." He's like, "Scrape it, man. Like, what are you doing?" And I said, "I don't know." He's like, "You have to love it." And then he said, uh, "They're gonna push you to release this thing." And I said, "I already said I was gonna release it." I did, I did it again, and then I did that again. And I was going to visit him in Europe each summer, and we'd sit together and he, he goes, "Let's read some stuff together." But with Rick, what that means is you sit there and he reads you and how you're reacting to the material. So we barely read any of it. I was just talking about it and he goes, "It's not ready." I go, "What do you mean?" And he goes, "It's not ready. You're not ready." And so then this year-

    16. JR

      [laughs]

    17. SP

      ... fi- finally, but this book, I mean, we were in Europe this summer for a friend's wedding, and my team was over there, and my girlfriend and I were traveling. She was so understanding. But from... I was doing edits from like 9:00 PM until 2:30 in the morning every single night, and waking up the next morning. Like, this book has been-

    18. JR

      While you were on vacation?

    19. SP

      Quote, unquote, "vacation." Yeah. I owe her a real, real vacation now. She was working too, but she was asleep in those hours. And we stopped by Rick's and he's like, "How's it going?" I'm like, "It's there." And he's like, he just like checked in. He's like, "It's there."

    20. JR

      [laughs]

    21. SP

      Like, he can just feel it.

  2. 2:366:39

    Rick Rubin’s worldview: art “realness,” documentary work, and pro-wrestling as ‘truth’

    1. JR

      You're such a fucking weirdo. [laughs]

    2. SP

      Dude, I mean, he's, he, he has this supernatural ability to feel where people are at, but not get absorbed in it.

    3. JR

      Mm.

    4. SP

      And I have so many Rick stories. We could spend the whole time talking about Rick stories, but the, the man is just, like, he's plugged into some energetic layer-

    5. JR

      Mm

    6. SP

      ... that the rest of us aren't. And he's, all day, every day, he's connecting with people and, and trying to help them. Like, he really spends most of his time, like, looking out at the world and trying to help people with their, with their art, with their stuff. And I'm-

    7. JR

      That's really him

    8. SP

      That's him.

    9. JR

      If you know him, that's him 24/7.

    10. SP

      Totally.

    11. JR

      Like, he lives in that space. It's a very weird head space to be in because you're constantly, like, looking at other people's stuff. It's like he's a tastemaker.

    12. SP

      Mm.

    13. JR

      You know? Or that's not even a good description of him. He's just, like, an analysis of art. Like, that's his, his, his function. He anal- analyzes art, but from, like, for lack of a better term, almost like a spiritual perspective. Like, he sees whether it's real.

    14. SP

      Totally.

    15. JR

      He finds the realness. And like-

    16. SP

      Totally

    17. JR

      ... he made the Red Hot Chili Peppers record one of their albums in a mansion 'cause he wanted to hear, like, instead of a recording studio, he wanted to hear, like, the sounds of the house.

    18. SP

      That's so Rick.

    19. JR

      [laughs]

    20. SP

      There's a, you know, I, I, I didn't come here to plug this, but we should 'cause it's gonna be awesome 'cause I, I may have seen pieces of it. He has this documentary with Jay-Z coming out, like, next week, where they sit in this incredible monument structure in Europe, and they just listen to music together and talk about music, and it's so good. It's so good.

    21. JR

      It's just a documentary on them listening to music?

    22. SP

      It's really about Jay.

    23. JR

      Mm-hmm.

    24. SP

      Um, but about his childhood.

    25. JR

      So Jay's music?

    26. SP

      Yeah, so Jay's music, and they're listening to... Yeah.

    27. JR

      Mm.

    28. SP

      I think this was filmed in an abandoned post office in France because Rick liked the skylight.

    29. JR

      Hmm. [laughs]

    30. SP

      I've seen pieces of it. I'm so excited to see this.

  3. 6:399:46

    From ‘psychedelic brain chemistry’ to schizophrenia: dopamine, hallucinations, and treatment tradeoffs

    1. JR

      I've always thought that about, like, schizophrenics. Like, I wonder if that's what's happening. I wonder if they have, like, some d- dump of psychedelic chemicals that's constantly, like, leaking into their brain. 'Cause we knew, we know the brain really does produce endogenous psychoactive co- compounds like DMT.

    2. SP

      Mm-hmm.

    3. JR

      I mean, isn't it possible that you could have a brain that leaks it?

    4. SP

      So here's the weird thing about schizophrenia, and it speaks to the larger kinda ways that medicine works, for better or worse, is that for the longest time we thought that dope- dopamine, too much dopamine was schizophrenia. Why? Because drugs that reduce dopamine, we call them neuroleptic drugs, haloperidol, all these things, clozapine, would reduce auditory hallucinations. So the conclusion was-

    5. JR

      Auditory.

    6. SP

      Auditory.

    7. JR

      So meaning voices in your head?

    8. SP

      Yeah, and that's mostly what people deal with, you know, p- especially paranoid schizophrenics.

    9. JR

      Really?

    10. SP

      They're hearing voices, "Do this, do that. You're awful." I mean, it's... If you h- think about it from that perspective, imagine all day and night you're just dealing with voices in your head that feel like another person there telling you usually horrible things about yourself or the outside world all the time, and these drugs reduce those symptoms. We've known that for a long time. But because they reduce dopamine in, all over the brain and body, they create, uh, what's something called tardive dyskinesia, which is a, a suppression of the motor system. And so y- you'll see people who are doing this, like, writhing like this. You'll see them on the street a lot. Sometimes that's psychosis. A lot of times that's psychotic people who are taking their antipsychotic medic- medication.

    11. JR

      Yeah.

    12. SP

      But, you know, it gives you some empathy.

    13. JR

      It's almost better to hear the voices and tell the voices to shut the fuck up.

    14. SP

      I, I think some have auditory hallucinations and, um, s- but most have auditory hallucinations. Uh, sorry, some have visual... Excuse me. Some have visual hallucinations, but most have auditory hallucinations. And, you know, this sets in usually around mid-early 20s. And what's weird is years ago I had a, a meal with the then director of the National Institutes of Mental Health. His name was Bob Desimone, and he said, "Do you know why there's so little money for research on schizophrenia compared to, say, autism?" I was like, "Why?" And he's like, "Well, because the parents of autistic kids lobby hard, and usually the parents of autistic kids are not also autistic. But schizophrenia, even though it's not, you know, doesn't run completely through families, oftentimes the parents of schizophrenics will have schizotypal conditions or-

    15. JR

      What is that?

    16. SP

      These are, it's, like, they now call them schizoid, schizotypal. They'll have n- un- not typical thinking, right? Um, it doesn't mean they're crazy.

    17. JR

      Mm.

    18. SP

      But-

    19. JR

      They're off.

    20. SP

      They're off. And so they're, they're, they're not bad people, but their place in society often doesn't position them to, like, sit down with a senator and say, "Hey, listen, you know, my kid's got autism, and we need more research on this." And so a lot of what, where the money goes has to do with where, obviously, the lobby is. And if you think about genetic disorders in families, and we know there is a strong component with d- uh, schizophrenia. Like, if you take two, uh, monozygotic identical twins, right, the, if one is paranoid schizophrenic, the probability that the other one will be paranoid schizophrenic isn't 100%, but it's pretty, it's much higher than in, than by chance.

    21. JR

      Mm.

    22. SP

      Much, much higher.

  4. 9:4613:49

    Stress, genetics, and stimulants: meth vs. Adderall, lab realities, and MDMA safety debates

    1. JR

      Have they ever done a study where one manages to avoid it with lifestyle choices or diet or exercise or something along those lines?

    2. SP

      Definitely, although not in a way that you could attribute it to one thing. But for instance, for a long time, active military service in somebody who has a genetic predisposition to psychosis was a, kind of an, a, an additional risk factor, a meaningful risk factor.

    3. JR

      Makes sense because of the stress.

    4. SP

      The stress. Methamphetamine use. I mean-

    5. JR

      Again, the stress.

    6. SP

      The stress. [laughs] You know? [laughs] The stress of-

    7. JR

      Also, meth heads-

    8. SP

      Yeah

    9. JR

      ... just seem fucking out of their mind anyway, so it's-

    10. SP

      I mean, there's this meth strength thing that I've never seen proven, but it do- you can find these videos of, like, meth heads carrying refrigerators down the street, and they're, they're not jacked. But they're just, like, carrying refrigerators down alleys and, you know, people talk about meth strength. Um, but yeah, I mean, methamphetamine's gonna create probably the largest dump of dopamine in the brain than any other drug, at least in the short term, and it makes people think every idea's a good idea and everything's about them and their goals. So it's the hyper-dopaminergic state, right?

    11. JR

      How much different is it than Adderall in terms of the actual effect?

    12. SP

      Oh, um, I mean, it's-

    13. JR

      Is it dose dependent?

    14. SP

      Yeah, and we don't know what addicts are taking exactly, but-

    15. JR

      Right

    16. SP

      ... yeah, I mean, Adderall is amphetamine. Vyvanse is amphetamine. Um, I actually have a f- uh, forgive me for referencing the book too many times. I- it'd be great if people wanna read it, but it, that's not my goal here is to constantly reference it. But there's a long section on all stimulants, caffeine, nicotine, Adderall, Vyvanse, modafinil, armodafinil. Every single drug that can make you more alert and focused, I talk about the pros and cons.

    17. JR

      Mm.

    18. SP

      Every single drug I talk about w- humans have always found a way to use these things to f- to find things to enhance their focus. The problem with methamphetamine is that it's also neurotoxic, right? This is actually very relevant to the conversation about MDMA, methylenedioxymethamphetamine, which is m- a variant of methamphetamine. MDMA for the treatment of trauma is looking really promising. The early studies, including one that was published in Science, show that non-human primates that are given MDMA experience neuron loss, that neurons die in the brain, and that message propagated. That paper was retracted because that laboratory accidentally injected methamphetamine, not MDMA. MDMA is d-

    19. JR

      How do they accidentally mix those two?

    20. SP

      I don't know what happened. They did publish a retraction.

    21. JR

      Why are they having methamphetamine laying around the lab? [laughs]

    22. SP

      Oh, man, you should've come to my lab when I ran a lab until a few years ago. I still teach. I shut my lab, but we had, I mean, we had all sorts of goodies in there. I mean-

    23. JR

      Did you ever worry about your students taking it?

    24. SP

      No, because, you know, with Anytime you use a federally controlled drug, you have to account for every last microliter of that. Someone's coming and checking all the time. We also worked with viruses. I mean, my lab at one point was using Sindbis viruses, modified rabies viruses, um, adenoviruses, uh, and on and on. Like a, you know... And so we had some labels on the wall, like this is a lab that works with viruses, and we also had controlled substances, and that's just kinda how it goes.

    25. JR

      This is only one way. You gotta figure out what makes what happen in the human brain.

    26. SP

      Yeah. I never had MDMA in my lab or, or, uh, amphetamine in my lab. But, uh, when I was an undergraduate, I worked in a lab where we injected rats with MDMA at a time, this was in the early '90s, when not much was known about it, but people were dying at raves, and that lab worked on thermal regulation. So we were interested in why they were dying from maybe MDMA. It turns out it was the, the hyperthermia from raves and not drinking enough fluids, and people would take amphetamines, and people were dying. That pretty much got worked out over time. People realized you need to stay hydrated. But methamphetamine and MDMA are very different. MDMA, there is no evidence that it's neurotoxic.

    27. JR

      You'd always hear those stories about people who took MDMA that had holes in their brain.

    28. SP

      Yeah, probably wasn't MDMA. Probably was more methamphetamine, maybe mixed with a little bit of MDMA. This is why it would be so great if this was finally legal and, you know, produced in ways that were reliable and administered in safe ways and all that.

    29. JR

      Right.

  5. 13:4918:56

    MDMA-assisted therapy: why FDA efforts stalled and what ‘safe practice’ must include

    1. SP

      But you know that trial, you know, the passage through the FDA failed for two reasons this last round. It might go through the next round, but it failed for two reasons. I've been very close to this whole situation. One is that the powers that be, uh, in the previous administration felt that there wasn't a good control condition. Like, you... N- wasn't a good placebo. Okay, fair enough, although a lotta drugs deal with that issue. The other was there was, uh, one, maybe two sexual improprieties of the therapist. Uh, there was a, a couple therapists that did some things they shouldn't have done with, while someb-ody was under the influence of the drug, and one incident like that can sink an entire initiative. So that was bad, obviously. Um, and so if it's gonna pass in the next few years, there's, there are gonna have to be some things in place to make sure that, you know, the way it's administered is safe. You know, 'cause the person under, you know, under the influence of MDMA is very vulnerable to all sorts of things. It's not just about their heart health, et cetera. Like, that, that can be dealt with before, it can be dealt with after. But the real issue is, you know, is the therapist operating in their best interest.

    2. JR

      Hmm.

    3. SP

      You know? And because the psychedelic community has always existed... And I'm a big fan of psychedelics for the treatment of depression, ther- uh, trauma, et cetera. But because that community has always kind of existed on the edge of other techniques, it's sort of like, well, is a foot massa- If the person's, like, saying they have all this trauma in their feet and the therapist rubs their feet, like, that's v- not usual for therapy, right? That's pretty, like, within the gray zone of, of MDMA-assisted psychotherapy done kinda rogue in the world of psychedelic therapists.

    4. JR

      Right.

    5. SP

      There, so there's really no controls on what goes with the drugs. We've, we've agreed on the basis of the clinical trials of what the dosages might be, healthy dosages, how frequent, like two, two sessions with a booster 80 milligrams in, and then a booster of, say, 50 milligrams halfway in or by body weight, spaced three weeks apart for psilocybin, maybe just once for... And on and on. All that's been, you know, looked at in various ways in these trials. W-

    6. JR

      And is it always in conjunction with psychotherapy?

    7. SP

      It should be. Uh, the, the data really show that people need therapy going in, they need therapy during, and they need therapy coming out for, for the best results. But those results are remarkable. I mean, 60, 70%, you know, significant reduction in symptoms, in some cases remission. But, you know, these, uh, you know, I, I have friends in the s- so-called psychedelic community, but I also have friends in the standard science community, and for these things to really come together, there's gonna have to be some standardization of safety, but also just practice. What are you gonna talk about? If someone's like, "I'm feeling I'm at the precipice of, like, a huge amount of pain," do you encourage them to go into that pain and purge it? Or do you tell them, "Hey, listen, you know, maybe back away from that"? All this stuff is done by feel in the psychedelic community. There's no standardization of it. But then again, talk therapy's the same way, right? There's no standardization of the narratives that you're supposed to have with your client.

    8. JR

      Right. There's a, a lot of freedom to sort of-

    9. SP

      Yeah. And you know the-

    10. JR

      Improvise.

    11. SP

      And then, you know, in the... I've been reading a lot about the history, you know, counterculture history and stuff. Um, yeah, I joined the board of Esalen, which is this, you know, incredible place on the coast of California, and, um, the guy who started it is in his late 90s, and, um, it has a center for theory and research. It's not just about, like, yoga classes and, like, and, um, and s- it has that, but it, there's a, a serious focus on human potential there. And, you know, in the '60s, '70s, and '80s, and even in the '90s, all these somatic therapies came along, you know, and the breathing therapies. And you had psychedelic therapies too, but, you know, how much of these things to merge is, is a question. Like, maybe some somatic therapy during MDMA could be really helpful for somebody that feels really out of body or that had a, you know, bodily trauma or was raped or whatever or was abused as a kid. But then we have to ask ourselves, are we gonna let therapists touch people while they're under the influence of these really powerful empathogens?

    12. JR

      Well, why is the... Is touching people, is that normalized in the psychedelic community when they do this?

    13. SP

      Not necessarily.

    14. JR

      Like a, like a sitter?

    15. SP

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  6. 18:5621:31

    A four-step framework for resolving trauma (and where psychedelics might fit)

    1. SP

      No, not necessarily. It's just that right now psychedelic assisted therapy sits in that constellation of like somatic therapies, talk therapies, breathing therapies, emotive therapies. Like none of this is formalized. I mean, so much of what I've been interested in and why I w- you know, wrote the book aside from, you know, the compulsion to just get things out there is my hope is that as more techniques come along, different breathwork practices, different supplements, different drugs, different peptides, that people will start to understand some of the kind of principles of how things work to decide what's worthwhile or not. So for instance, for trauma, we know that it's basically four steps. Doesn't matter if you use getting through trauma, doesn't matter if it's through therapy that includes psychedelics or not. First of all, people have to have a willingness to address it, right? Second, they need to experience the painful feeling in a safe environment. There's no just kind of avoiding that. So the feel your feelings things is true, and we often just stop there. We hear that and that's it. But then there's also f- having the explicit memory of what happened, but in a state of calm, not feeling the feelings 'cause you're trying to uncouple the memory from the emotions, right? There's no losing the memory. You're trying to uncouple the emotions from the memory. And then the, the fourth piece, which is something I touch on with respect to grief and trauma therapy more generally, is there's this beautiful thing that, you know, guests on your podcast have talked about, you've probably experienced this, that at some point the shitty thing that happened to you, the awful thing, can be transmuted into some effort to create goodness for yourself or for the world. Sometimes it's public education, sometimes people, you know, the, the loss of a child for instance, like blah my God, how awful that... You know, but people will, who move through this process can get to the place where they'll like plant a tree or teach to, or talk to other parents who are in bereavement. And so they've transmuted their loss into goodness, right? So but it's four steps. So if we just say, you know, "Take your loss and go do good for the world," that's not gonna work. If we say, "Take your loss and just feel the pain of it," people get caught in that spiral. I mean, I think this is unfortunately when the millennials were in their adolescence and, and you know, teen years and 20s, there was this overemphasis on like feeling your feelings. But no one ever talked about the next phase, which is where you actually stop feeling so shitty about the shitty thing that happened. And so my goal is really to try and organize like these different practices and come up with structures so that you could imagine MDMA being very useful for that first or second step, feeling your feelings in a safe way in the right environment.

  7. 21:3134:39

    Ibogaine, DMT, ‘demons,’ and responsibility: interpreting extreme psychedelic experiences

    1. JR

      What are the studies that MAPS has done with MDMA with soldiers and PTSD? 'Cause that's been probably one of the most prominent things.

    2. SP

      Yeah. Well, the R- Rick Doblin obviously is, is more qualified to get into the specifics, but I know of at least three clinical trials looking at MDMA at dosages that are by body weight, but that are not like outrageously high dosages, that have people move through their PTSD within a matter of, you know, four to six weeks total. So with two sessions of MDMA spaced apart about a month or so, uh, talk therapy the whole way through. And of, I know of at least one clinical trial with veterans. Oftentimes these studies will include veterans, but it's not all veterans, which actually is kind of good. You, you wanna be able to compare their kind of trauma to other people's trauma. But I have to say, and I know you've covered this extensively, but the work on ibogaine has, uh, in my mind has completely revised the way that we think about psychedelic therapy because it's kind of ironic that the first psychedelic that will likely be legal for the treatment of PTSD is going to be the most intense one. It'd be like if I'm like, "Hey, I wanna learn a martial art," and you're like, "Yeah, get into the octagon and get your ass kicked," you know, and that's gonna, you know, turn you into a fighter. I mean, that's... The way people describe ibogaine is kinda like that. It is no joke. As you point out, it is not recreational. And then when they follow with DMT, I mean, you know, it seems that the outcomes are very, very good for a lot of people. I will say, and they're gonna sweat me for this a little bit, there have been a few deaths, and it seems that that may correlate with fentanyl use prior. That's-

    3. JR

      Really?

    4. SP

      That needs to be talked about if we're gonna get this legal. Yes.

    5. JR

      How many deaths?

    6. SP

      I'm aware of two.

    7. JR

      And, um, is this in those clinics-

    8. SP

      Yes

    9. JR

      ... or is this-

    10. SP

      Yes.

    11. JR

      Yeah?

    12. SP

      And they have to report them. Um-

    13. JR

      And is it, uh, heart failure? Like what it... 'Cause I know that there's heart issues, right, with-

    14. SP

      Heart and breathing, so they're linked obviously, you know, heart and breathing linked. And people are heart rate monitored. I know of many people, and they're many of your friends, like, and they've talked openly about this stuff, so DJ Shipley and Capone, you know, Marcus Capone and others, and many, many others who feel that they've benefited tremendously from these therapies. And, and there's a litany of other names there too that have benefited tremendously. I wanna be clear. There are also a few people who felt they didn't have a good experience. I know Sean Ray right now is out there talking about his negative experience this past weekend.

    15. JR

      Sean Ryan?

    16. SP

      Uh, excuse me, Sean Ray. Sean Ray's-

    17. JR

      I think-

    18. SP

      ... like a bodybuilder, right? You know-

    19. JR

      I don't know

    20. SP

      ... Sean Ryan, excuse me.

    21. JR

      I think Sean Ryan, I think he's talking about DMT.

    22. SP

      And they follow with DMT at some of those clinics, not all.

    23. JR

      But he's, uh, he said he had gone through exorcisms. Isn't that what he's saying now?

    24. SP

      I mean, I think if you If you think about my, my experience of psychedelics, I've not done ibogaine, is that there is all sorts of understanding about the brain that comes about during those journeys that leads you to understand that we have good and evil in all of us. And I could understand how it could be downright terrifying for some people to realize that we have a hypothalamus that just wants to satisfy drives, but we also have a forebrain that can suppress those drives. [laughs] I mean, that is the nature of being human, right? So-

    25. JR

      Do you think that's what these people are thinking of when they're thinking of demons? They're thinking of like inner, like drives that are a part of the, the human system?

    26. SP

      So, okay, I have a lot of thoughts about this. So neur- w- I'm not gonna spin off into a neuroscience lecture, but we think about brain function and free will and all that kind of stuff from top-down and bottom-up perspective. Bottom-up is you have a drive, you want to satisfy it, you're gonna do it. Top-down are regions of the brain that inhibit those imp- impulse circuits. Um, and so much of life is about the dynamic tension between those two, okay? I mean, the seven deadly sins, right, are all the hypothalamic structures, like, you know, rage, envy, lust, et cetera. But the forebrain can be built up. You can learn things, as the, you know, kids learn to suppress their impulses, puppies learn to suppress their impulses to get a reward or just to avoid punishment, and that's a lot of what being human is about, right? There's a, an amazing case actually right here in Austin where, I, I don't know if you're familiar with this. There was a, a kid who, um, woke up one morning, uh, wrote in his diary. Um, he's an ex-Marine, uh, this was many years ago, and then killed his wife and his mother with a knife. Do you know about this?

    27. JR

      No.

    28. SP

      Okay. Then he went to the University of Texas Austin, took a rifle, went up into the tower, and shot 14 people.

    29. JR

      Oh, that story.

    30. SP

      Yeah.

  8. 34:3951:38

    Grief, suicide, and stress regulation: why knowledge isn’t enough—and why hard things help

    1. SP

      Yeah. Yeah, and I haven't had to deal with any of those things either, so I wanna acknowledge that. I, I had a very good experience of therapeutic combined MDMA and psilocybin work, therapeutic work. Incredible, and, and I can distill it to one simple takeaway, which was d- thinking about bad things that had happened that I wish hadn't happened, like, I, I felt like I had kinda worked through that stuff in life by running, lifting weights, some therapy, [chuckles] just lifetime, you know, and worked through it. But there was a session where I was feeling the resistance to, like, feel something, and I knew what was knocking, and it was thinking about things that didn't happen that I wished had happened for me. Um, not things I, that I wish I'd got, but, you know, just basic experiences that I wish I had had. And it was incredibly sad in the moment, but then it opened, you know, after some period of time, like-

    2. JR

      Like what kind of experiences?

    3. SP

      You know, listen, I, I had a, a better childhood than many, much better than many, and, and harder than others for... You know, th- there were some things about my family structure that felt, um... There were times when I really, really, really needed a certain kind of support and structure, and it was gone. And so I went out into the world and found it in skateboarding, eventually in science, and, you know. Uh, I talk about, the introduction of the book, actually, I talk about why I eventually went into public health education, and it was seeing about a third of my friends from growing up dead or in jail, and that's weird for a guy that didn't grow up in the inner city, and I wasn't in the military. These are friends of mine that succumbed to drugs or suicide or mental health issues. Now, mind you, the other two-thirds did great, and some of them started companies like DC and, you know, like these weren't close friends of mine. But that community of people, of all these feral kids, in the '90s, the people who skateboarded were the ones who Didn't have parents that went to things, right? And listen, I have a good relationship with my dad now. Like we're-- I've actually had him on the podcast, and that was really bonding for us. We're great now. But there was a time when I was an adolescent and teen when I really needed structure and I really needed, uh, certain things that just were not happening, and my home life was depressing. It was really empty. It was really depressing. And so went out into the world and did way too many things way too young. Saw a lot and got involved in a lot of, uh, sex, violence, and stuff that I shouldn't have at that time, and luckily not drugs. That wasn't my thing. So I, I always knew those narratives, and I, I've always had a, like a bittersweet memory of them. Like they, they also served me well. They motivated me to, um, forage for ways to be healthy and things like that. Um, but then in science it was wild because in science, your mentors play a tremendous role in your progress and your sen-sense of safety. Science is a weird thing. It, it's different now, but when I was coming up, you would get very close to your graduate advisor. I was very close to my undergraduate advisor. He was like a father figure to me. My graduate advisor was truly like a mother to me. I knew her when she was pregnant. I knew her husband. I-- Her daughter's a neuroscientist, like incredibly close to her. She had a, a maternal way about her and a toughness that was unbelievable, and she was a serious scientist. And then my postdoc advisor similarly was very supportive. My undergraduate advisor, who I got very close with, um, k-killed himself in a very dramatic way about two weeks after I had spoken to him. Um, uh, shot himself i-in the bathtub. Um, and this was a guy who understood mental illness. I talk about him in the book. My graduate advisor died at 50 of cancer. She had the BRCA mutation, which is predisposes to cancer, and that one like devastated me. And then my postdoc advisor died of pancreatic cancer like a year into my faculty appointment, and he had a heart attack sitting across from me. You know, w-was the first indication he had pancreatic cancer. And so the joke in my field is you don't want me working for you because, uh, you know, [both chuckling] it's like, fuck. But then what's wild is that, uh, you know, I, I made it through science. I get tenure at Stanford. This kind of shit is happening in my science world. Then a colleague of mine gets addicted to OxyContin for after a back injury, and he's dead, and no one talks about it. Like everyone's like, "Oh, yeah, yeah." He was a member of the National Academy. He's a famous scientist down at the Salk Institute. Everyone's just like, "Oh, yeah, yeah," just kind of carries on with their work. And then, this is gonna get depressing for a moment before it gets light, end of 2017, three friends of mine from childhood, there's a graffiti artist, his name is... Uh, he went by Orphan, O-R-P-H-A-N. This brilliant artist, he did so much cool shit. His name was Aaron Curry. Dies of stomach cancer. My good friend John Eichelberger from childhood and my good friend Johnny Phare, fentanyl suicide. Boom. People are just going down-

    4. JR

      Jesus

    5. SP

      ... like crazy. And I'm like, "What the fuck is going on here?" And then I started to realize, this is one of the reasons I started the podcast. It's one of the reasons I started going on podcasts is like my science colleagues, they don't know how to manage their stress. They're-- They understand the science of stress, but they look like shit. Their kids are a mess. They, uh, they're have all these anxiety disorders. My physician friends, I can count on one hand the number of them that are healthy of mind and body who have healthy kids. Like, you know. And then I realized, oh, you know, the skateboarding community, the science health community, I'm at Stanford University School of Medicine, the apex. We're among, [chuckles] you know, the top universities in the world of health. And, and I'm like, "My colleagues are sick and dying and stressed." And, and I realized, I was like, "Shit, we don't know how to regulate stress." So I started studying stress and stress mitigation, this kind of thing. And then I don't want to make this even darker, but I think it, it's worth acknowledging, uh, for a couple of reasons. And by the way, I want to be really clear. I think what Veteran Solutions has done with the Ibogaine Initiative, I think what Rick Perry and what Brian are doing with the Ibogaine thing, I think it's awesome. If I highlight that there were some deaths, I want to be really clear, like n-those people might have died of fentanyl anyway. We don't know. I mean, there's... You know, we need to high-

    6. JR

      They both connect, both of the deaths are connected to fentanyl use?

    7. SP

      My understanding is they had used fentanyl prior to going to use ibogaine. So maybe in this discussion, a few people will be sensitized to like that's a potential issue.

    8. JR

      So meaning like-

    9. SP

      Yeah

    10. JR

      ... they were probably addicted to fentanyl. They were trying to get off of it, a-and they tried to do it while they had fentanyl in their system.

    11. SP

      Perhaps.

    12. JR

      Yeah.

    13. SP

      And for all we know, they might have snuck fentanyl. We don't like to think that they might have, but-

    14. JR

      Right

    15. SP

      ... who knows how closely they did it, you know?

    16. JR

      If they're really hooked.

    17. SP

      Yeah. And listen, we, you and I know, I mean, it's more from your world of, you know, martial arts and stuff, but, you know, we know people who've like, we hear they go down to Mexico, they're gonna do this treatment, they're gonna come back, they're better, and like a week later they, they don't sound so much better. You know, I'm not... I pray for these people. I want the best. Like, I'm not saying this is bad, but I'm saying these are powerful medications, and I think they are net positive. But I'll also say, you know, many years transpired between that, you know, those friends dying, the John... People will, sometimes people call me on bullshit. So Aaron Curry, John Eichelberger, Johnny Phare, best fucking kids I knew. Awesome graffiti artists. One of them was in the MoMA. Orphan went into the MoMA for his graffiti. This is a badass graffiti artist. Stomach cancer got him. Like shit can happen. My advisors didn't do anything wrong. They just, one clearly had a mental issue or otherwise he wouldn't have taken his life. The other two had cancer. So but then this last year I'm like going about my life and I'm thinking, "Okay, you know, things are pretty good." And I get a call and I hear that my good friend Nolan Williams, triple board certified MD, who took the transcranial magnetic stimulation therapies and accelerated them so that people could get relief from depression much faster. He took what was, you know, a many weeks long or months long thing and compressed it. Saved lives. Who's also doing the studies of ibogaine, took his own life. I mean, this one's still sinking in for me. Um, I, there's no reason to believe it had anything to do with ibogaine whatsoever. He took his own life. He's a colleague physician friend of mine at Stanford, and I know his wife, who's also a physician. I know his kids. He's been on my podcast. He looked like the young Jim Morrison, handsome s- uh, ma- he was a martial arts guy, did taekwondo. Like, fuck is right. Fuck is right. So what does it tell us? You know, I've had to-- I, I try not to intellectualize these things too much, but what does it tell us? It tells us that knowledge is not sufficient to take ca- to protect us. Like, like I feel like the data are in. Bold conclusion, banner across the sky, knowledge does not pr- alone does not protect us. You can understand everything about the biology of these diseases. You can know I'm messed up, I have something, uh, something's bo- and you can understand, oh, that's serotonin or whatever. People will still do these things. And it's rare, fortunately, but it tells us that the b- I believe it tells us something fundamental about humans, which is that there's always this dynamic tension between our underlying impulses and this top-down control. And suicide is a weird one 'cause it's like the whole thing gets b- you know, twisted up so that we're no longer acting in an adaptive way, right? Obviously, taking one's life is not adaptive. But it's a rage or a depression or whatever, and the, the conclusion that I draw from it is what can we do to put ourselves in the best position to be able to hold our impulses in their healthy place? You know, if I, I, I don't wanna make more of like what I did in the book or what I'm trying to do in the podcast or public education, but like let's take the ice bath, for example. I've taken a lot of shit for the ice bath thing. You have, too. We both know they don't like the cold. That's why they're talking about this. But we know for certain, and I go through the data finally, give it-- putting yourself into a high adrenaline state where your body and brain are freaking out and doing that deliberately gets you better at dealing with high-stress states, which in my mind is only a good thing. This should be basic training for children, you know, not young children, right? Why? You know, does it increase metabolism? Marginally. Does it increase cortisol? No, that's a bunch of horseshit, and we can talk about that. If anything, it reduces cortisol. It increases your ability to buffer stress. Is the ice bath a cure to mental health issues, addiction and relapse and all of that? No, of course not. But is it, does it teach you to engage in top-down control? Yes. Is it the ice bath per se? No. The ice bath is just one very efficient, low-cost way to get adrenaline to go boom through the roof. You could do it through a workout. You could do it through hot sauna that feels uncomfortably hot, provided you don't die of hypothermia. You can do it through any number of different things. The point is that the principle of learning to t- to capture your mind and think strategically, lower your state of arousal when you're in a stressful circumstance, is a life skill that is invaluable. And getting great sleep, we could go on and on about all the benefits of that. There's probably 100 benefits of that and probably 1,000 sh- things that go wrong when you don't get enough sleep chronically. A couple s- nights, no problem. But when you're well-rested, you are far less likely to harm yourself or others. Like, because your b- forebrain is more active and can suppress these impulses. And so my, you know, my kind of like, I don't like the word mission, but my, my goal is that we'll kind of move beyond the notion of like hacks or that it's this tool or that tool, and just really understand like what we're trying to do when we're teaching ourselves to be better humans. And I do think there is a generation of kids that grew up hearing that their feelings are valid. Great. We didn't hear that growing up. I just assumed like if you drank and you couldn't stop drinking, it was a lack of willpower. Now we know there's a brain circuit, but if we say, "Oh, there's a brain circuit, therefore I'm not gonna quit 'cause it's a brain circuit," well, you're still, you're still an addict, right?

    18. JR

      Right.

    19. SP

      So the great sleep, social connection, sunlight in the morning, like these things are really designed to get us to have better control over our focus, over our impulse control. And I-- it, it almost becomes so simple at that point, and we can say, "Well, what was going on with Nolan in the weeks before?" Well, I, I have smatterings of what might've been going on. Running two giant projects in his lab, two companies, managing a family, managing a life. I'm not gonna claim he was a perfect human being, but like it's just like overwhelm. His forebrain fucking f- turned on him.

    20. JR

      Yeah, overwhelm is real.

    21. SP

      Yeah.

    22. JR

      You can only, you, you can only redline your system for so much.

    23. SP

      I mean, you know people who have done this. I mean, uh-

    24. JR

      Oh, I know a lot of people-

    25. SP

      You know people, and I've become f-

    26. JR

      ... currently doing it

    27. SP

      ... I've been friends with, uh, I've become friends with, um, David Choe.

    28. JR

      I love that dude.

    29. SP

      Fucking love him. Best fucking guy. Because he's so heartfelt now, having been through the g- meat grinder of media and life and his own tendency to self-harm.

    30. JR

      Yeah.

  9. 51:381:00:41

    Dogs, exercise, and service animals: a practical antidote to dysregulation and loneliness

    1. JR

      And I think there's a lot of people out there that are like very angry. Like, you see a lot of people on social media. I think they are living in that state, but not a state of four days, a state of 40 years of nothing, doing nothing and just letting your body just go, "Eh." You know, you have dogs, right?

    2. SP

      Yeah.

    3. JR

      You know what it's like when your dog doesn't get exercise?

    4. SP

      Yeah, he's fucking nuts.

    5. JR

      Dogs need fucking exercise.

    6. SP

      Dude, my new one has, he's part bulldog but part pit too, and I'm keeping his nuts on this time, 'cause my last dog, you know, as you know, I was like injecting him with TRT late in life, and he felt so much better. This time I'm keeping Strummer's, I'm keeping Strummer's nuts on. This dog has so much fucking energy.

    7. JR

      Yeah, you gotta throw the ball. [laughs]

    8. SP

      You gotta throw the ball. But this dude, I have him running on the fucking treadmill in the morning.

    9. JR

      Oh, wow.

    10. SP

      Oh, yeah, I take him for a walk-

    11. JR

      You got him on a treadmill?

    12. SP

      ... then I, I r- I trained him from the time he was nine weeks to run on the treadmill.

    13. JR

      Does he like it?

    14. SP

      Fucking loves it.

    15. JR

      [laughs]

    16. SP

      Dude, dude, he'll haul ass at like, right now he's up to five on a, on a, on a two incline, and he's just like at the back of that thing. He falls off, he jumps right back on. People are like, "Don't hurt his joints." I'm like, "Listen, I've raised bulldog breeds before. I'm not gonna blow out his joints, okay?" He is so stoked. He will just run and run and run, and then I'll, I tell him, "Wait," and I'll put the liver treat there, and then when he gets that thing, his ears flop. He's going like... And you can tell when he's done. It's what you're describing. He's just like peaceful.

    17. JR

      He's chill. Yeah.

    18. SP

      So peaceful.

    19. JR

      Oh, when I throw the bog, d- the ball for my dog and then we come in and sit down, he just lays on his back and I rub his belly. He's just so happy.

    20. SP

      This is Marshall.

    21. JR

      Yeah.

    22. SP

      You got another one, right?

    23. JR

      Just so... Charlie.

    24. SP

      Cavalier King, Cavalier King Charles?

    25. JR

      Yeah. Char- [laughs]

    26. SP

      They're, they're great.

    27. JR

      He's, he's amazing.

    28. SP

      Dude.

    29. JR

      But oh my God.

    30. SP

      Dude, those are great dogs.

  10. 1:00:411:06:25

    Drive vs. discipline, competitive ego, and what OCD really is (and isn’t)

    1. JR

      Yeah, the drive is an interesting thing because drive in its purest form actually replaces discipline. Like, I was acutely aware of that when I was a kid because I was not disciplined at all.

    2. SP

      Really?

    3. JR

      I was a very undisciplined kid. I never cleaned my room. I never did my homework. I, I was, I had n- very few rules growing up. I was quite feral.

    4. SP

      This was until what age?

    5. JR

      Till 15, till I started really training heavily in martial arts. And then when I got into martial arts, I still was not, I did not clean my room [laughs] . I did not do my homework. I still ... But in that one thing, I had insane drive, and I worked so hard, and I worked all day long every day. I never took a day off, and that was the difference. It was like it was the drive that replaced discipline. Because I loved the thing that I was doing so much, I found so much interest in it and so much passion in it, and, and, and it just, so, it was so exciting to me to do that I just wanted to do it all the time. And so I didn't have to be disciplined. I knew there was work that had to be done to get better at it, but it was also, I was just intensely focused on getting better. So the work, like whether it's rounds on the heavy bag or practicing specific techniques or sparring drills or whatever the fuck I was doing, I wasn't doing it, like going, "Okay, this is what I gotta do today." It was not that at all. It was just, "I can't wait to do more of this."

    6. SP

      That's so rad.

    7. JR

      I was only, the only thing that stopped me was time and sleep. I would've tried to do it all day every day. I was obsessed, but I wasn't disciplined.

    8. SP

      Hm.

    9. JR

      I had to get disciplined later on in life when I stopped competing, in particular, because then there was, like, this, this overl- this overwhelming, looming threat of physical harm if you don't stay in the gym constantly. If you, if you're not, like, 100% ready, there's this possibility that you could zig when you should've zagged, and you get a fucking shin to your head. There's a l- a lot of terrifying thoughts that are involved in that, that keep you training really hard. But I didn't have discipline. I didn't develop discipline until after I stopped competing. And then I realized, like, "Well, I should just work out because I should work out, and, uh, I should eat well because it's good for you, and I should, um, you know, I should lift weights 'cause it's probably good to be strong." You know? And it was doing things because I know they had to be done rather than I was obsessed with doing them.

    10. SP

      I mean, I'm telling a just-so story here, but there's also a part of me which [laughs] says, like, it's a mild bit of OCD, but thank goodness you didn't clean your room. Because what if you had OCD-

    11. JR

      [laughs]

    12. SP

      ... and you're like, "I'm gonna be the kid with the perfect room, and then I'm gonna be the kid that washes-

    13. JR

      Yeah

    14. SP

      ... my hands all the time. Then I'm gonna be the kid that just is all about cleanliness." Like, I think, I do think that, you know-

    15. JR

      What is obsessive compulsive disorder versus being passionate about something?

    16. SP

      Ah. So here I can, there's a really important theme to OCD. Like, true OCD, obsessive compulsive disorder, is characterized by the following: the more you engage in the behavior, the stronger the compulsion gets. And that's why it's so maddening for people with true clinical OCD.

    17. JR

      Hm.

    18. SP

      So for people that have a hand-washing thing, they're like, "Oh, I have something on my hands," they go and wash it, and it just makes them wanna wash more-

    19. JR

      Hm

    20. SP

      ... and more and more. And you know, I'm not a big fan of SSRIs in many cases. But I will say, if there's one place where SSRIs have really helped a great number of people not completely dissolve into a, a puddle of dysfunction, it's proper use of SSRIs for true clinical OCD.

    21. JR

      What, so OCD in that way, like washing the hands, what is the cause of that? Do we know?

    22. SP

      Well, we know, so there's a woman who was at NIH for a long time. She passed away this last year. Her name was Judith Rapoport, a real pioneer in this whole field and brain science more generally. And she found that there's an area of the brain called the basal ganglia. These are circuits that we all have that are involved in generating action, go and no go. You have two, basically you have an accelerator and a brake on action, and the basal ganglia have these ... You know, they, it looks a lot like a gear system in a car when you really, you know, just, you know, draw it out. The people who have true clinical grade OCD have an enlargement, for whatever reason, of subregions of this circuit, and they basically feel the impulse to do this thing all the time. Now, what is the thing? The, the thing is based largely on inputs from structures like the hypothalamus that are in, related to very, uh, primitive adaptive behaviors. Like, you know, getting infections out and, and getting, um, you know, dirt away is, you know, adaptive in a, in a, when it's done in a healthy way. You know, there are all these people, and there's actually a paper, I hate this paper, but it's a real paper, that, like, um, watching zit popping, like, stimulates dopamine. This is why people do z-

    23. JR

      [laughs]

    24. SP

      I can't watch these things. It's like, you know, but people like-

    25. JR

      Shout out to Dr. Pimple Popper [laughs] .

    26. SP

      There seems to be, someone sent me this paper. I'm like, "Oh, God, this is gonna be like..." And I look and I'm like, "Oh, this paper, someone actually ran this study, and now this explains a lot of the Internet, uh, the stuff on the Internet."

    27. JR

      [laughs] Cysts.

    28. SP

      There must be, there's, there's a component in, in all of our brains that, um, gets some sort of satisfaction from the removal of infection, right?

    29. JR

      Hm.

    30. SP

      Um, from relief from infection. And-

  11. 1:06:251:16:27

    Inside awake brain surgery and the promise of AI in medicine (and its failures elsewhere)

    1. SP

      ... you know, germs are bad, but, you know, worrying that much about germs is, is obviously, uh, not good. So again, we're talking about primitive brain circuits and these circuits that can go awry. You know, some people, they just, for reasons we don't understand, they have overactive areas of the brain. Um, actually, I have a, a, a positive tale that you may like 'cause it has to do with jujitsu, of which I do none. But I have a, a close childhood friend. His name's Eddie Chang. He's the Chair of Neurosurgery at UCSF. Brilliant guy, bioengineer. He's figuring out the speech system in the brain. He's a member of the National Academy. He's been my friend since we were seven, and he's like this amazing physician. And he called me, very, very calm guy, um, and he called me and he said, um, he calls me Andy, which is unfortunate, but he goes-

    2. JR

      [laughs]

    3. SP

      He goes, uh, he, he knew me when I was a little kid. He goes, "Uh, Andy, uh, I've got a patient who, um, wants you to come to the surgery." And I go, "What are you gonna do?" And he goes, "Well, he's got a tumor, and, uh, but he's really into jujitsu, and he really admires, like, Joe and Jocko, and, you know. Would you, do you think you'd come up?" I was like, "Yeah, a chance to go see my childhood friend do brain surgery?"

    4. JR

      Yo.

    5. SP

      So I go there. I meet this guy. This guy has a, uh, a tumor that needs removing from the frontal lobe. So-

    6. JR

      You're in there for the whole thing?

    7. SP

      Eh, right up there. Right up there. I mean, you know, um, so I'm in there, and it's, they keep patients alive for this, so they locally-

    8. JR

      Awake.

    9. SP

      Awake. Excuse me. [laughs]

    10. JR

      Yeah.

    11. SP

      They definitely keep them alive.

    12. JR

      [laughs]

    13. SP

      I love that you don't edit this show, so you like [gurgles] uh, this proves why I misspeak so many... He's definitely alive going in and coming out. He's alive today. I spoke to Eddie this morning. And they basically remove, you know, they remove the skull. They go in, and the way they decide what tissue to take out is, and what tissue to keep, because the tumor is, you know, is embedded in functional brain areas that are required for speech, for movement, et cetera. You can't just start scooping brain tissue out. And what I learned is that these tumors don't look different when you just look at the brain. They, they feel different to the, to the instruments of the highly trained, uh, uh, surgeon. So he's in there, Eddie's in there mapping, stimulating different areas of the brain while this guy is awake and reporting what he's feeling, okay? His hand's moving, and I'm going back and forth talking to this guy, going back and forth and seeing the tumor getting removed little by little by little.

    14. JR

      [gasps]

    15. SP

      Put into a plate, go- goes off to biopsy, but this guy is awake the entire time. Incredible. And as they're doing this, because the patient agreed, they're mapping what areas of the brain are involved in mathematics. What are areas of the br- he's doing math problems while he's, uh, in this surgery, while this, this, this patient is doing this. He's also saying, "Oh, you know, I felt that in my toe," or, "I felt that in my face." And so, you know, Eddie's getting these functional maps of the brain that we've never had before, and his lab has discovered incredible things about how speech and language are organized in the brain. He's taken people who have full locked-in syndrome, completely paralyzed, who could just blink to communicate, and that's it. He has a, this has been written up in the news. He had a patient, Pancho, who Eddie's figured out there are areas of the brain that prepare for speech, not just generate speech, created through AI and bioengineering, because he's also a bioengineer, of course. He created ways that this patient can now speak, and the first thing Pancho ever said was, "Hello." And you say, "How are you doing?" He said, "Doing well." And the AI is learning his speech patterns. It's taking what would normally be sent to the pharynx and larynx, right? Because after all, speech is just an exhale that's controlled by the pharynx and larynx and the tongue. And the AI gets better at understanding what this person wants to say, and now he's got patients literally, they're still in wheelchairs, right, wheeling around with a iPad next to them of their face speaking according to what they're thinking.

    16. JR

      [laughs]

    17. SP

      This patient who got the, the tumor removed is amazing. I asked Eddie this morning in case this happened to come up, "How's he doing?" He goes, "Great." I think, and we filmed all this, by the way. Um, the team at UCSF did this. Um, he'd like you to come to a jujitsu class, so we may put this out there. I think he's really into... He's 60. He's, uh, from what I understand, he's serious. He, like, rolls, like, five or six days a week. He's, like, really into this, and he's now rolling jujitsu. This tumor, which would have killed him, is out. He's, yes, alive. He's thriving. And you know, we hear a lot about the negative aspects of AI, but I asked Eddie, "To what extent is AI critical for this kind of technology to evolve?" And he's like, "Absolutely critical," because it can take all these neural signals and figure out what the brain was doing exactly when the person said the word for or the or my name is blank and blank. You know, you can't sink that many electrodes into the brain before you start destroying brain tissue. So you have to collect a lot of different signals, and, and AI is, is greatly facilitating our ability to decode what the brain is trying to do. And I said, "So where else is this gonna go?" And he said, "Well, this obviously is what Elon wants to do with Neuralink and taking paralyzed people out of a paralyzed state." It's like, what's the intention to move? What does that look like neurally? And then convert that into signals that maybe it's prosthetics, maybe it's actual muscles and nerves can respond to accurately. There's, so the takeaway here is that, like, we hear a lot about the bad stories of medicine, the stuff that's on the edge, and we still need to figure out, like, the psychedelic stuff [laughs] and... But I, I have to say with respect to AI in medicine, I am super, super excited about people walking again, seeing again. I mean, this stuff is starting to happen. Having brain tumors removed that do not encroach on areas of the brain that are critical. I said, "If you were a quarter centimeter or less into this other margin where you recorded that the guy says, 'Oh, yeah, my hand. I felt it in my hand.' If you were to nick that," he's like, "He'd completely lose b- uh, hand function." Now, mind you, he's one of the best surgeons in the world. I'll go on record saying that. He is, like, may you never need his help. In fact, there's one of our public-facing health colleagues, I'll tell you this because he, uh, he's been public about it, uh, who got a stem cell injection into the disc down in Mexico, and it got infected.

    18. JR

      I've heard of people doing things like that.

    19. SP

      And was paralyzed, and was in a hospital here in Texas. Okay, this is no, you know, I'm not casting any judgment on Texas, but what happened was they didn't realize that he had a egg-shaped, egg-sized infection there, okay? So there was, this surgery had gone awry. It got an infection, and he was paralyzed, and they said they were gonna have to sever the spinal cord to get this infection out when they finally discovered it I contacted Eddie and I said, "Listen, here's what's going on." He said, "Get me in touch with his doctor. Get me his charts." He was airlifted to UCSF, and it wasn't Eddie that did the surgery, but it was someone in his department that removed this egg-sized infection. And Eddie called me from the surgery, okay? And he said, "We're triple masked in here, and I can smell the infection." It turns out that bacteria had never been identified in the, in the United States, so there are bacteria that exist in other places that we're just not exposed to that frequently, so it was very virulent in this case. They got the infection out.

    20. JR

      So this was just like a clinic with a dirty needle?

    21. SP

      This was a bad clinic with a bad practice of some sort.

    22. JR

      Oh.

    23. SP

      They screwed up. Some- some- someone screwed up along the way, okay? And this f- this guy happens, the patient happens to be a physician in this case. This guy is walking, talking, exercising.

    24. JR

      How's his back? [laughs]

    25. SP

      Great.

    26. JR

      The, the, the-

    27. SP

      Yeah

    28. JR

      ... injection helped? [laughs]

    29. SP

      Oh, I do not know. So I asked, so [laughs] you know, so w- what, what... I said, "What was it that allowed you guys to do this that, you know, another clinic might not have been able to do?" You know, because I, like you, am very interested in what makes for good doctors versus so-so doctors versus lousy doctors ver- versus superb doctors. And he said it's two pieces. It's the training and the skill of the physician, obviously, their willingness to constantly update their models with new understanding of what's out there, new technologies, and it's also these incredible bioengineering and AI technologies that can make estimates about where the margins of error are in real time.

    30. JR

      Mm.

  12. 1:16:271:37:26

    Neuroplasticity explained: attention, frustration, sleep, and why ‘error’ drives learning

    1. SP

      Because Eddie came up through a lab by the, a guy by the name of Mike Merzenich, and I actually talk about this in the book in the chapter on learning. You know, until the early '90s, people thought you couldn't learn after age 25, that there was no plasticity.

    2. JR

      Into the early '90s?

    3. SP

      Yeah. And then basically three guys, it was Mike Merzenich, a guy named Michael Kilgard who's down in Dallas, or maybe it's Houston. He's here in Texas. And, and a guy named Greg Recanzone, who is this brilliant scientist. They did these studies at first in monkeys and then in humans, which showed that if you take adult monkeys or humans and you have them pay really careful attention to a task, that the brain changes, and the, the experiment is very simple. It's like this. So they had monkeys, or a human can do this, feel a little, like a rotating drum, and the drum's got bumps on it like braille, okay? And they're recording from an area of the brain that responds to touch. And the monkey's job is to, to basically press a lever any time the bumps go from coarse to more fine. So think big bumps, small bumps. The monkey plays this game, and every time they get it right, they get some juice. Monkeys like juice. Press the lever, press the lever, press the lever. These are adult monkeys. They come back some time later, and the brain area representing the fingers has expanded. It's, the brain has changed. There's plasticity. It learned. But what I didn't tell you is at the same time they're doing these experiments, there's a sound in the room, okay? Now they do a different experiment where the monkey is still feeling the bumps, but the m- monkey is trained to listen to changes in the sound, subtle changes in the frequency of the sound, high to low or low to high, and if they get that right, they press, if they press, they h- think they went from high to low and that's the task, they press the lever or they pull the joystick and they get some juice. Under those conditions, the area of the brain responsible for hearing changes. Now, the key thing here is the experience is the same in both cases. They're hearing and touching in both experiments. But the key difference is what they're paying attention to. The brain of the adult does not change just because of passive experience. The brain of the adult, and this is true in humans too, changes because of what you attend to. And when we start talking about neuroplasticity and learning, everyone would like to think, "Oh, my brain is different at the end of this conversation than before." You don't learn from passive experience. You learn from focusing and the friction that's accompanying trying to do things right and sometimes getting it wrong. The error signal is what instructs the brain to change.

    4. JR

      Mm.

    5. SP

      I'm sure you know this from martial arts. I'm sure you know this from other areas of life, too. If your brain Can do something, there's no reason for it to change. No rewiring is needed.

    6. JR

      [smacks lips] Right.

    7. SP

      But if you're trying to do this, I, I don't know martial arts well. I mean, I did a little bit of Thai boxing when I was younger. I boxed in my 30s, which was really dumb by the way, as a neuroscience professor. I'd spar on Wednesday nights in San Diego, where you got all these Marines and all these, like, team guys. It was so dumb. I'd come home, like, all busted up. My girlfriend was like, "What are you doing?" I was like, "Ah, you know, I, I like it." She's like, "You don't get paid to do this," you know? But it was a lot of fun. Like, you learn, I think you learn a lot from sparring.

    8. JR

      I wish it wasn't bad for your brain.

    9. SP

      I wish it wasn't bad for your brain. I will say this, I'm not encouraging anyone to box, you know, un- unless they really want to. But I also learned a lot about how to stay calm when you're getting your ass beat, and how to think clearly.

    10. JR

      Yeah.

    11. SP

      And it's also, I think Sam, uh, who's the guy who wrote A Fighter's Heart? I love that book.

    12. JR

      Sam Shepard?

    13. SP

      Sam Shepard. He also talks about, like, it's like an intimate thing to spar with somebody.

    14. JR

      Mm-hmm.

    15. SP

      Like, what does he say? He's like, "You're sharing bodily fluids with somebody. [laughs] It's like a one-night stand."

    16. JR

      Yeah.

    17. SP

      That's not wh- y- like, you, you develop a closeness with the people that you spar with, a respect. And I wasn't fast enough. I don't think that my timing was really good.

    18. JR

      [laughs]

    19. SP

      I eventually learned that I'm, my, I have a long reach. That could help me. But I realized I, I can't be doing this, not as a neuroscience professor. But I really enjoyed it.

    20. JR

      It's not something that you really get excellent at if you learn late in life, unfortunately.

    21. SP

      Yeah.

    22. JR

      Unless you're a very unusual athlete.

    23. SP

      Yeah.

    24. JR

      Most, uh, people who get good at striking, striking in particular, they start out very young.

    25. SP

      Yeah.

    26. JR

      And that's how they get good at it. There's a level that they-

    27. SP

      Yeah

    28. JR

      ... reach that someone who starts out late in life, even if you're a good athlete-

    29. SP

      Yeah

    30. JR

      ... you'll probably never reach that level.

  13. 1:37:261:53:03

    Addiction susceptibility, kratom’s ‘leaf vs. isolate’ problem, and bioprospecting from plants

    1. JR

      But y- h- I wanted to ask you this about, um, addiction About, is there a biological component to addiction? Um, and one of the reasons why I ask is, uh, I, 'cause I, I take these, uh, Tucker Carlson sends me these ALPS. I like these. Um-

    2. SP

      They taste different than the other ones I've had.

    3. JR

      I think, I don't know.

    4. SP

      I've tried Athletic Nicotine, Zyn. I've not tried the ALPS.

    5. JR

      I like Athletic Nicotine.

    6. SP

      Mm-hmm.

    7. JR

      That's probably my favorite, like, the threes, 'cause it's mild.

    8. SP

      Yeah.

    9. JR

      The little 3 milligrams. My point is, uh, I do it all the time, and I take them before shows. I like to suck on them before I go on stage. Um, but when I went on vacation for 10 days, I didn't bring any on purpose. So I was like, "Let's see what this is like." Nothing. And I've heard so many people say that they, they have horrible cravings. They can't tolerate it. They go nuts. They just need a d- they need nicotine. And I'm sitting there, like, on day two, like, waiting for it to come on. Nope. Nothing. I just, I'm not on nicotine.

    10. SP

      I mean, you're a bit of a mutant too, you know?

    11. JR

      I don't know what it is. It is-

    12. SP

      Like, I mean, just 'cause y- you're so, it sounds to me like you're so familiar with discomfort. You may not even register that, like, a mild, tiny bit of withdrawal. But it is interesting, you know, because if I don't drink caffeine, like, life is a lot less interesting to me, and I've been drinking-

    13. JR

      [laughs]

    14. SP

      ... I've been drinking a shit ton of caffeine. I mean, I've got a picture. My, I'm half Argentine, so there's a picture of me on my grandfather's lap drinking mate from a gourd when I'm, like, three years old in my Spider-Man pajamas. You know, I, people on the internet, they go, "Oh, I, I don't believe it." I probably drink 800 milligrams of caffeine a day, and I'm fine. But if I don't drink caffeine, I, I'm just like, "Oh, man." I, I'm, I don't know if I'm addicted in the classic sense. Like, I'm not gonna go rob old ladies to get caffeine. I'm not, I'm not, uh, you know, I'm not k- you know, gonna harm myself with it. If anything, it shows that it can offset dementia. I mean, the, the new data basically say up to about 400 milligrams per day, it, caffeine's great-

    15. JR

      Mm

    16. SP

      ... for the brain, for the body. You know, it's, people have anxiety, it can be problematic, but you just might not have, um, I mean, you may just naturally make a lot of acetylcholine, and so when you don't take nicotine, maybe you just rebound really fast.

    17. JR

      I don't know if that's it. I, I mean, I do take nootropics. That might have an effect on it, but I d-

    18. SP

      Oh, definitely

    19. JR

      ... but I didn't bring any with me when I was on vacation.

    20. SP

      Amazing.

    21. JR

      I just brought vitamins.

    22. SP

      No cigars.

    23. JR

      Nope, no cigars. No nothing.

    24. SP

      Man, what kind of vacation was it? [laughs]

    25. JR

      It was fun.

    26. SP

      Yeah.

    27. JR

      I enjoyed it.

    28. SP

      Yeah.

    29. JR

      It was just v- family vacation.

    30. SP

      Nice.

  14. 1:53:032:23:57

    Peptides, GLP microdosing, medical gatekeeping, and AI’s double-edged future (ending with God)

    1. SP

      But we don't hear about all the others. The interesting thing about peptides is that this is the first time that we are bioprospecting from the body. These are things that the body makes, and I, I, I can't take credit for that understanding. That's really, that distinction, uh, which I think is a key one for people to understand, is Dr. Abud Bakri, this, you know, MD, who, uh, you and I are familiar with, who in my mind just really understands the biology of peptides. And because he's a practicing physician outside of peptide biology, I think he's an intensive care, uh, guy, um, or critical care, he, he can kind of see the picture now. Yes, insulin's a peptide. It came from the body. But all these peptides, now pharma companies are like, what is the body making? Like in the case of GLPs, when you increase GLPs two-ford, twofold, fourfold, you can see some relief from Type 2 diabetes. Some, but not much weight loss. That had been happening for a decade. But when you increase it a thousandfold, wow, people don't want to eat. People don't... They... Okay, we could talk about the, the ramifications of that, but pharma companies are now thinking very seriously about finding all the peptides in the body and which ones are gonna be potent for... There's a new one for increasing bone density, for osteoporosis, and then all the, you know, people are thinking about biohacking with this as well. There's pinealon, which I'll occasionally take, and you get three hours of REM sleep that night, and on subsequent nights, your REM sleep is enriched. Interesting. You know, um, we all, we know GLPs obviously. BPC 157 is the one everyone seems to kind of go to, but I think that there are a lot of interesting peptides that we've known about for a long time, like kisspeptin, which is involved in, uh, resetting the reproductive system. It's involved in puberty, but it's being used to reset the reproductive system. All these peptides, I think the next few years it's gonna be a bonanza of peptides. And I get shit for saying it, but I'm super excited because my physician friends who are super standard physicians, they're calling me like, "Hey, man, my knee, is this BPC 157 stuff gonna work?" And I go, "I don't know. You can try it. I know some clean sources of it." And then they'll come back a week later and like, "Why isn't anyone selling this, studying it, talking about this?" I'm like, "Well, they are, but your community doesn't like to talk about this."

    2. JR

      Well, there's a lot of people that dismiss it, and the way they dismiss it is very, it's very gaslighty. They, they're, they're bullshitting you that all these anecdotal stories aren't significant, that all these professional athletes that using it don- or that are using it with, with great benefit don't know what they're talking about.

    3. SP

      It's threatening to them. I mean, they-

    4. JR

      Yeah

    5. SP

      ... they... I mean, as my, I feel like I'm quoting my dad today for some reason.

    6. JR

      It's threatening because of compound pharmacies.

    7. SP

      And it's threatening because these, a lot of these physicians are gonna lose their standing in the field as these pe- there's something to, important to understand about physicians, and again, there are many excellent ones. I referenced a few today, right? Um, many excellent ones, but they, there's a guarding of knowledge that existed in the science community up until a few years ago when podcasts hit. It wasn't just me. You know, Bob Sapolsky was a pioneer in getting out there and teaching the public, and every scientist who's gone out into the public eventually gets this pushback, like, "Yeah, our field doesn't really take him or her seriously." It's be- and sometimes that's legitimate, um, criticism, although not in, in Bob's case. In, in many cases it's because you've taken their thing, it's their baby, it's what gives them value. I know. I grew up around scientists. It's what gives them their value, their knowledge that no one else has. It allows them to be interesting. They now have to have people coming up to them and going, "Oh, did you see this podcast with so-and-so talking about this thing in anthropology on Rogan?" And they're like, "Oh my God," like, "that's my field." Like, you know? And they're, they-- it's a self-worth issue.

    8. JR

      Mm-hmm.

    9. SP

      They're not like, "Oh, anthropology's getting publicity, yes." Or the good ones are, the secure ones are. But the physicians who are like, "Wow, if there's a compound that's making patients feel better really quickly, what's that gonna do to my practice? And then if I embrace it, my... Here's the key thing. If I embrace it, my colleagues won't think much of me. And if I don't embrace it, maybe I'm gonna lose my standing, my validity as somebody of authority." If I've got patients coming to me and saying, "I have this friend that took this thing and it really helped. Could I explore that?" And I don't do that and they go elsewhere, word spreads fast nowadays. So I like scientists and physicians. I also understand scientists and physicians. I g- my father's a scientist. I grew up around them. Uh, in my town, most kids were children of engineers or scientists, and you see the full array. The secure ones, the ones that are really on the cutting edge, that learn, that embrace the new technology, they do great. But the other ones, they're, they're like dying, they're a dying breed because their whole practice rests on them having the knowledge and you not having the knowledge. So much so that they're saying, "ChatGPT, bad." They're saying it's bad because patients are coming in and they're like, "Hey, ChatGPT says that what you're recommending is, is perhaps not the best thing." They're freaking out right now. And so they're l- so they're saying AI's bad for medicine. But the good scientists, the good physicians are like, "Great. It's gonna help our practice." They're genuinely interested in helping people. You see two, it's two camps. So when I hear people saying, "Oh yeah, this BPC, no trials." Okay. Are, are there any adverse events we need to know about? Not that I'm aware of. And Abud says, you know, the, the lethal dose is, like, super high. No one's even come close to achieving it. I'm sure someone will figure it out. But I get excited because I think, all right, now the general public finally has some agency in understanding what's going on with them, thanks to AI, thanks to podcasts, thanks to the internet. And it can go awry, certainly. But man, I had a, a shoulder thing a week ago, and I don't never have this shoulder thing. It-- and I like, "Yeah, fuck it." Put two injections of BPC. Gone. Gone. Now, could I have put saline in there and it would've been the same? Maybe, but all I know is it's gone. And-

    10. JR

      I don't understand that argument of putting saline. Does, is that a common thing where people have a severe shoulder injury-

    11. SP

      Oh, no. Sorry-

    12. JR

      ... and they put saline in it?

    13. SP

      Just running a control experiment. I could have put it in.

    14. JR

      Right.

    15. SP

      Like, maybe if some-

    16. JR

      But I've heard people say that. That's why. I've heard people say that in argument. You know-

    17. SP

      Maybe

    18. JR

      ... oftentimes people have, uh, similar benefits injecting saline. And I'm like, where-

    19. SP

      Mm-hmm.

    20. JR

      Who's done that? Why aren't, why aren't people injecting saline instead of getting cortisone shots in their shoulders?

    21. SP

      I mean, this is how they talked about creatine. This is how they talked about TRT. This is how they talked about-

    22. JR

      Yeah

    23. SP

      ... women's hormone therapies.

    24. JR

      Right.

    25. SP

      It's very interesting, you know, because, uh, because for legitimate, you know... There, there are legitimate complaints about the fact that for a long time science and medicine did focus mainly on men, and the women's hormone trial basically was a mess because they said there were all these adverse effects, and turns out it's when you started the hormone therapies. And, and we now know that if those therapies are started early enough, they're immensely beneficial. So there's more kind of acceptance of, of hormone replacement there a- across the board. I think TRT now is kind of a broadly accepted thing, although I think a lot of guys are doing it too young. They don't even know why they're doing it, you know, like in their 20s or something. But-

    26. JR

      That's not TRT really, right?

    27. SP

      That's not TRT.

    28. JR

      That's really, they're just doing juice.

    29. SP

      Yeah, they're just doing juice. The, but when it comes to the peptides, I think my prediction is it's gonna slot in right between prescription hormone therapies and what we think of as supplements. I think there's gonna be this third middle category where, sorry, practicing physicians, people are gonna find the safe sources. There'll be US-made sources soon, I hope. Um, there'll be reliable people who can educate on this. People will understand the risk profile of these things, and people will be buying them and taking them legally. I, I think that's gonna happen. It's that also now people aren't afraid of needles. The GLP industry was so genius in taking this thing, needles, everyone, needle phobia, needles, what am I gonna do? And they made a pen. Ta-ta-ta-tic. It's still a needle. The pens have gotten rid of everyone's needle phobia. So now m- my sister, people are like, "Oh, what about peptides?" They go, "You have to inject it." They go, "Well, do they have the, like, the little needles with the pen?" "Yeah." [laughing] "Cool." No one's afraid of a pen, even if it has a needle on the end. But no one likes... So it turns out it was the syringe that scared people.

    30. JR

      Mm. The plunger.

Episode duration: 2:39:59

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