ADHD Expert: How To Hack Your Brain For Better Focus | Dr. Sasha Hamdani

Dr. Sasha Hamdani 0:00 There's so many things that fragment focus. Trauma can fragment focus. PTSD, anxiety can fragment focus. So many things that impact focus, impact behavior, but that's not truly ADHD.

Lewis Howes 0:11 What would you say is typically the root cause of someone having ADHD?

Dr. Sasha Hamdani 0:15 Genetics.

Lewis Howes 0:16 It's not trauma?

Dr. Sasha Hamdani 0:17 No.

Lewis Howes 0:17 Really?

Dr. Sasha Hamdani 0:18 No.

Lewis Howes 0:19 She's a board certified psychiatrist, a best-selling author, and ADHD specialist who was diagnosed with ADHD herself. Please welcome Dr. Sasha Hamdani.

Dr. Sasha Hamdani 0:31 You can't observe emotional regulation. You can't observe these kind of difficulties and subtleties that are happening internally. We have this entire world of medication. Like, if you have an ADHD diagnosis, you don't necessarily have to be on one of those medications.

Lewis Howes 0:45 These kids almost seem like they got worse, or it was just like it didn't seem like it helped them. Why are drugs typically the first thing that most doctors or primary care individuals prescribe to someone when they diagnose them with ADHD?

Dr. Sasha Hamdani 0:58 I think when-

Lewis Howes 1:02 Your experience as a doctor around ADHD,

Lewis Howes 1:07 first off, what is the difference between ADHD and ADD, and what are the main, I guess, flags to know if you are undiagnosed with one of those?

Dr. Sasha Hamdani 1:18 Yeah. Okay. So I'm gonna blow your mind right now. ADD and ADHD, same thing.

Lewis Howes 1:24 Same thing.

Dr. Sasha Hamdani 1:25 Same thing. It's just ADD is an outdated term. So previously, ADD was really classified as more like an inattentive presentation, and now ADHD is broken into three categories, inattentive, hyperactive, and combined.

Lewis Howes 1:39 Inattentive being not, meaning not present? What does that mean?

Dr. Sasha Hamdani 1:42 Like difficulty with initiating tasks, difficulty with completing tasks, difficulty with forgetfulness and organization. Like think about the daydreamer. That-

Lewis Howes 1:52 That's me.

Dr. Sasha Hamdani 1:53 Yeah.

Lewis Howes 1:53 That's me. Yeah.

Dr. Sasha Hamdani 1:54 And then hyperactive, think about physically and verbally impulsive. Difficult staying in your seat. You have a hard time-

Lewis Howes 2:02 Yeah. [laughs]

Dr. Sasha Hamdani 2:02 Okay. So then-

Lewis Howes 2:03 I used to like shake my knees constantly in school, just like-

Dr. Sasha Hamdani 2:06 Oh, yeah

Lewis Howes 2:06 ... all day, just couldn't sit still.

Dr. Sasha Hamdani 2:09 I kind of have that now, and that's why I'm crossing my legs-

Lewis Howes 2:11 Yeah, yeah

Dr. Sasha Hamdani 2:11 ... and smooshing it down.

Lewis Howes 2:12 Yeah, yeah.

Dr. Sasha Hamdani 2:13 Yeah. So-

Lewis Howes 2:13 Focusing, yes.

Dr. Sasha Hamdani 2:14 Mm. So and then combined is obviously the combination of both. And so, uh, ADD, what it was previously called, is really more in line with the ADHD inattentive type.

Lewis Howes 2:26 So the third... What's the third aspect of ADHD?

Dr. Sasha Hamdani 2:28 Combined.

Lewis Howes 2:29 Oh.

Dr. Sasha Hamdani 2:29 So it's partially inatten-

Lewis Howes 2:30 You have both of them.

Dr. Sasha Hamdani 2:30 Mm-hmm.

Lewis Howes 2:31 If it's hard for you to focus and you're verbally and physically compulsive, is that what it is?

Dr. Sasha Hamdani 2:36 Impulsive.

Lewis Howes 2:36 Impulsive.

Dr. Sasha Hamdani 2:37 Impulsive. Mm-hmm.

Lewis Howes 2:38 Interesting. Okay.

Dr. Sasha Hamdani 2:39 Mm-hmm.

Lewis Howes 2:39 And so those would be kind of signs to see if you do this frequently, you might have that.

Dr. Sasha Hamdani 2:45 Yeah.

Lewis Howes 2:45 Is that correct?

Dr. Sasha Hamdani 2:46 And I love how you said might because e- equally important to diagnosing in ADHD is diagnosing out everything else-

Lewis Howes 2:52 Oh, interesting

Dr. Sasha Hamdani 2:52 ... that could be fragmenting focus, which is, are a lot of things.

Lewis Howes 2:55 Yeah, or just distracted or whatever. Yeah. So, so how does someone actually get diagnosed with-

Dr. Sasha Hamdani 3:01 Mm-hmm

Lewis Howes 3:01 ... ADHD?

Dr. Sasha Hamdani 3:03 There are a couple of different ways you can do it. You can do like computer or neurological evaluation where you're doing a, a bunch of tests, and you can do it with a therapist. You can do it with a primary care doctor. You can do it with a pediatrician, and they're getting information from you. If they're evaluating a child, from maybe teachers and from parents. Um, if you see a psychiatrist, a lot of time it's based on clinical interview. So you're going and you are s- talking about your entire medical history. You're talking about your entire psychiatric history. You're looking for these longitudinal patterns showing like your focus over time and how that has been impacted or changed-

Lewis Howes 3:41 Mm-hmm

Dr. Sasha Hamdani 3:42 ... by different things like hormones and life events and other things like that. And then the additional like layer to all of this is that, frankly, this is coming from my perspective, I think ADHD... First of all, I hate the name, so Attention Deficit Hyperactivity Disorder. I don't think that encapsulates everything. I think it's confusing. Secondly, I think that it's really, instead of Attention Deficit Hyperactivity Disorder, I think it's truly a regulation issue.

Lewis Howes 4:11 Emotional regulation?

Dr. Sasha Hamdani 4:12 All. I think attention is in there. I think motivation is in there. I think energy is in there, and I definitely think emotion is in there.

Lewis Howes 4:19 And so I remember being in middle school, elementary school, and there being a few kids who were like, they had ADD, right-

Dr. Sasha Hamdani 4:27 Yeah

Lewis Howes 4:28 ... back in the day.

Dr. Sasha Hamdani 4:28 We all know them.

Lewis Howes 4:29 In the '80s and '90s growing up, right?

Dr. Sasha Hamdani 4:30 Yeah.

Lewis Howes 4:32 And hearing that they were on drugs, right, or whatever it was, Rital- Adderall or something, or-

Dr. Sasha Hamdani 4:37 Ritalin, Adderall

Lewis Howes 4:38 ... Ritalin, Adderall, all these things.

Dr. Sasha Hamdani 4:39 Yeah.

Lewis Howes 4:39 Right? And it didn't seem like it helped. Like these kids almost seemed like they got worse, or it was just like-

Dr. Sasha Hamdani 4:44 Yeah

Lewis Howes 4:44 ... it didn't seem like it helped them. Why are drugs typically the first thing that most, I guess, doctors or primary care individuals prescribe-

Dr. Sasha Hamdani 4:53 Yeah

Lewis Howes 4:53 ... to someone when they diagnose them with ADHD? Why does it seem like that? Again, maybe it's not always, but...

Dr. Sasha Hamdani 5:00 I think when... So when a physician is evaluating you or when a mental health... Well, yeah, a, a physician is evaluating you for ADHD, and you've done- and you've decided, like we've looked at the medical history, we've looked at the psychiatric history. We've ruled things in. We've ruled things out. I think this is ADHD. I think the conversation really should be about the two ways you can treat ADHD, which is behavioral and like lifestyle modification and medication. And a lot of times it's the combination of both that has the best result, but there are people that do really well with just behavioral management. So as a general protocol, I think that initial conversation where you're talking about medication or you're talking about potential treatment forward, you should always-

Lewis Howes 5:43 Mm

Dr. Sasha Hamdani 5:44 ... talk about the behavioral and lifestyle, like a- at its base level, and then you kind of figure out. Now, what I will tell you is that ADHD medication, and stimulant medication specifically, can be life-changing for some people.

Lewis Howes 5:58 Mm.

Dr. Sasha Hamdani 5:58 Like some people just have incredible benefit, and it actually allows them to do the behavioral and lifestyle modification. But- We have this entire world of medication. Like, if you have an ADHD diagnosis, you don't necessarily have to be on one of those medications

Lewis Howes 6:13 And what would you say is typically the root cause of someone having ADHD?

Dr. Sasha Hamdani 6:17 Genetics.

Lewis Howes 6:18 Really?

Dr. Sasha Hamdani 6:19 Yeah.

Lewis Howes 6:19 It's not trauma?

Dr. Sasha Hamdani 6:20 No.

Lewis Howes 6:21 Really?

Dr. Sasha Hamdani 6:21 No.

Lewis Howes 6:22 So you're saying not having, having an adverse childhood where your parents are arguing and screaming and you're feeling like you have to be hypervigilant isn't a environmental cause of having some type of ADHD symptoms?

Dr. Sasha Hamdani 6:35 Now, okay, so to say something with absolute certainty is not gonna be my jam, 'cause right, I think that maybe, maybe there's something I don't fully understand about that space, but I think at a fundamental, um, baseline, I think primarily it's genetic. And I'll tell you my beef with this trauma perspective of it, 'cause I, I truly understand where that's coming from.

Lewis Howes 7:00 Uh-huh.

Dr. Sasha Hamdani 7:01 My issue is that sometimes there isn't traumatic things happening, and a parent is looking at their kid who might be experiencing ADHD symptoms, and there is actually a hesitation to get them treated, get them evaluated because they don't want to... "There was trauma here. This is your fault." I feel like there was, there was some difficulty in terms of it is a parent at fault with that trauma hypothesis.

Lewis Howes 7:30 Well, I don't think you need to blame parents necessarily on, on every case of a kid having it, right? So there's different circumstances, but I'm just thinking from what you said, you know, this book being about emotional regulation-

Dr. Sasha Hamdani 7:42 Yeah

Lewis Howes 7:42 ... and learning the skills of emotional regulation. For my... I'm speaking for myself and a lot of people I've t- spoken to, that when I grew up in a, uh, an environment that did not feel emotionally safe-

Dr. Sasha Hamdani 7:54 Yes

Lewis Howes 7:54 ... I didn't have the emotional tools on how to regulate myself.

Dr. Sasha Hamdani 7:58 Yes.

Lewis Howes 7:58 And therefore, I used strategies-

Dr. Sasha Hamdani 8:01 Mm-hmm

Lewis Howes 8:01 ... as a kid to feel safe and to protect myself.

Dr. Sasha Hamdani 8:06 Yeah.

Lewis Howes 8:07 You know, even though I wasn't physically necessarily in harm's way, emotionally and psychologically, and I felt like I was not safe, right?

Dr. Sasha Hamdani 8:15 You were in danger, yeah.

Lewis Howes 8:16 And so therefore, I used strategies to try to protect myself or stand out or do different things, and I feel like for me, that trauma, that experience caused me to act out in a lot of ways.

Dr. Sasha Hamdani 8:30 Mm-hmm.

Lewis Howes 8:30 From my personal experience, if I'm self-

Dr. Sasha Hamdani 8:32 Mm-hmm

Lewis Howes 8:32 ... uh, assessing my childhood, and I feel like that environment caused me to be hypervigilant-

Dr. Sasha Hamdani 8:40 Yeah

Lewis Howes 8:40 ... you know, vocally and physically erratic or whatever, you know, the terminology is, but I don't think it was genetic for me because I feel like I've learned the skills of healing and learned tools of emotional regulation like you talk about in here-

Dr. Sasha Hamdani 8:53 Yeah

Lewis Howes 8:53 ... that cause me to be more at peace and feel more psychologically and emotionally safe.

Dr. Sasha Hamdani 8:58 Right.

Lewis Howes 8:59 And so that's where I was asking you about the trauma side of things-

Dr. Sasha Hamdani 9:02 Yeah

Lewis Howes 9:02 ... versus genetics.

Dr. Sasha Hamdani 9:04 Well, let me, let me back up. First of all, love that you have, have been able, given a chaotic kind of upbringing and environment initially, that you've been able to find those skills and actually not only fine-tune them and actually make them applicable for yourself, but actually see benefit from them. So that's-

Lewis Howes 9:22 Yeah

Dr. Sasha Hamdani 9:22 ... huge.

Lewis Howes 9:22 Yeah.

Dr. Sasha Hamdani 9:23 But what I would say is that there are so many things that fragment focus.

Lewis Howes 9:26 Sure.

Dr. Sasha Hamdani 9:27 There's so many things-

Lewis Howes 9:28 Sure

Dr. Sasha Hamdani 9:28 ... that... Trauma can fragment focus. PTSD-

Lewis Howes 9:30 Mm-hmm

Dr. Sasha Hamdani 9:30 ... a huge cause of that. Anxiety can fragment focus. Thyroid conditions can fragment focus.

Lewis Howes 9:36 Mm-hmm.

Dr. Sasha Hamdani 9:36 There's so many different things.

Lewis Howes 9:37 Hormones, early, yeah, yeah.

Dr. Sasha Hamdani 9:38 Hormones. So there's so many things that impact focus, impact behavior, but that's not truly ADHD. So you could have focus fragmentation that's coming from all those things, but ADHD is a distinct longitudinal pattern that's-

Lewis Howes 9:52 Ah

Dr. Sasha Hamdani 9:53 ... usually genetic.

Lewis Howes 9:55 Well, interesting.

Dr. Sasha Hamdani 9:55 Yeah.

Lewis Howes 9:56 So I might have had symptoms or, or similarities of ADHD-

Dr. Sasha Hamdani 10:00 Yeah

Lewis Howes 10:00 ... but not ha- ADHD.

Dr. Sasha Hamdani 10:01 Yes.

Lewis Howes 10:02 How does a practitioner distinguish the difference? Do they look at your blood work and say like, "Okay, your DNA says this," versus the behavioral traits that you're using or are experiencing in life?

Dr. Sasha Hamdani 10:14 Yeah.

Lewis Howes 10:14 Because if the symptoms look the same, how do you know the diagnosis?

Dr. Sasha Hamdani 10:19 Okay. Yes. So if, you know, you're seeing these symptoms of fragmented attention kind of throughout, and if the doctor has, does a full assessment, they've looked at medical stuff, they've looked at psychiatric stuff, they've looked at the just psychological kind of environment that they're in-

Lewis Howes 10:40 Mm-hmm

Dr. Sasha Hamdani 10:41 ... and the state of affairs in terms of their life and what's happening-

Lewis Howes 10:45 Wow

Dr. Sasha Hamdani 10:45 ... and they get to a spot where they're trying to figure out like, "Is this ADHD or is this not?" Then you start looking back at patterns.

Lewis Howes 10:54 Mm-hmm.

Dr. Sasha Hamdani 10:54 Is this a consistent pattern? From birth, this was going on-

Lewis Howes 10:58 Yeah

Dr. Sasha Hamdani 10:58 ... with ups and downs, and this had been a consistent pattern. Is this really localized around traumatic things, and this is like a trauma response? Is this something that happens-

Lewis Howes 11:08 Mm-hmm

Dr. Sasha Hamdani 11:08 ... when metabolically something is different? So you're looking at context, and you're looking at kind of when these things peak and valley. You're looking at from, from early, early ages, what has this pattern been throughout?

Lewis Howes 11:23 Mm-hmm.

Dr. Sasha Hamdani 11:23 And I think it's really difficult because I also, we touched on this briefly, but like I think with ADHD, diagnostically we're at a, a very problematic spot because that initial data was done on hyperactive young males. So right now we have this diagnostic criteria that's not encapsulating so many other presentations.

Lewis Howes 11:46 But also aren't many young males hyperactive? I mean, it's like are, is it just hormones make young men more hyperactive than not?

Dr. Sasha Hamdani 11:54 I have a six-year-old young male. [laughs] He is, um-

Lewis Howes 11:59 Jumping off the walls and running around

Dr. Sasha Hamdani 12:01 ... full of energy and vigor. I, I, I think it's, I think it can sometimes be difficult to tell for sure. But, uh, but the criteria was built on observable data. There's a lot of this, especially when you're making the argument to include emotional regulation, which by the way Europe did in 2019. They amended their criteria to include emotional regulation, and the US still- ... hasn't.

Lewis Howes 12:24 Wow.

Dr. Sasha Hamdani 12:24 But when you're looking at all this, you can't observe emotional regulation. You can't observe these kind of lived experiences and these, and th- these difficulties and subtleties that are happening internally. And so now we have this, in this presentation where anyone who's having this emotional turbulence that happens with ADHD, and emotional dysregulation, uh, because of that failure in criteria, doctors are like, "Okay, well, it's anxiety. It's depression."

Lewis Howes 12:55 Mm-hmm.

Dr. Sasha Hamdani 12:56 And they're treated with antidepressant after antidepressant after antidepressant. And antidepressants, by the way, I'm not against antidepressants. I think they're great. I think they're life-changing tools if that's your diagnosis. So if you don't have anxiety and depression, you're started on, um, an antidepressant-

Lewis Howes 13:13 Oh

Dr. Sasha Hamdani 13:13 ... this cycle just perpetuates, and what happens is that I've had patients come into my office, they're, uh, they sit in the chair, they're, they've, maybe they're on their 10th antidepressant, and they're like, "I j- went to my doctor, and I asked him after seeing stuff online or, or talking to my family, I think I have ADHD." And the doctor will say, "Well, we can't even look at that until we get your anxiety and depression under control."

Lewis Howes 13:37 Shut up.

Dr. Sasha Hamdani 13:38 Yeah.

Lewis Howes 13:39 Wow.

Dr. Sasha Hamdani 13:39 So you're just in this perpetuating cycle of misdiagnosis.

Lewis Howes 13:43 That's where I feel, again, this is where I feel the medical world can be harmful if they misdiagnose and put you on 10 different antidepressants and say, "Well, we can't treat you for something else until we figure this anxiety and depression thing out." I'm not saying all medical is bad, but I'm saying it can be harmful-

Dr. Sasha Hamdani 14:02 Yeah

Lewis Howes 14:02 ... when that happens, and someone comes in your office and is like, "I've been on 10 antidepressants, and I don't know how to, like, get better."

Dr. Sasha Hamdani 14:09 Yeah.

Lewis Howes 14:09 That's, it's almost like it's harming that individual more than helping them.

Dr. Sasha Hamdani 14:13 Yeah. Well, if it's the wrong diagnosis, it is objectively harming them, 'cause you're giving a medica- a medication that is changing your brain functioning.

Lewis Howes 14:21 Ugh, man.

Dr. Sasha Hamdani 14:22 It's, it's wild.

Lewis Howes 14:24 That just makes me angry.

Dr. Sasha Hamdani 14:25 Yeah.

Lewis Howes 14:25 If someone's been misdiagnosed, been given a chemical to transform their brain in a negative way-

Dr. Sasha Hamdani 14:31 Yeah

Lewis Howes 14:31 ... that they weren't supposed to have, and then they have to live with that potential for the rest of their life.

Dr. Sasha Hamdani 14:35 I mean, look at, if you look at the, like, average age of diagnosis, for males, six to eight. For females, 35.

Lewis Howes 14:44 Of, of ADHD or anxiety and depression?

Dr. Sasha Hamdani 14:47 Of ADHD.

Lewis Howes 14:48 Wow.

Dr. Sasha Hamdani 14:48 That's when they get their di- And usually it's because they're bringing in their kid, and they're like, "Wait a second. W- this sounds just like me." And so-

Lewis Howes 14:56 So women, so moms will come in, get diagnosed at 35 when they bring their kid-

Dr. Sasha Hamdani 15:00 Yeah

Lewis Howes 15:00 ... that they, that they seemingly can't control. They don't know what's wrong with them or-

Dr. Sasha Hamdani 15:04 Yeah

Lewis Howes 15:04 ... what's going on, right?

Dr. Sasha Hamdani 15:05 Yeah. And so they'll come in and they're like, "Actually, that sounds a lot like me." And that might be the first time that they're actually getting treatment for what they should be getting treatment for. But think about all 35 years when they were having these pockets of time around puberty, around childbirth, around all of these different things where you saw big spikes in emotional regulation 'cause it's a hard world and life is hard. And, like, they're big pockets. And instead of, like, looking at what, what's a root cause of this, what, what is at the base of this, it's, it's hormonal, it's mommy brain.

Lewis Howes 15:38 Mm-hmm.

Dr. Sasha Hamdani 15:38 It's, you know, they're just getting p- it's anxiety, it's depression, and so they're either misdiagnosed or they're just frankly ignored and passed along.

Lewis Howes 15:45 Post- postpartum or whatever it might be, right? Different things. Now, how does someone know they have true anxiety or depression versus stressful thoughts that c- come and go, or anxious thoughts that come and go?

Dr. Sasha Hamdani 16:01 Yeah. Patterns. Patterns. Um, you look at intensity of, kind of, thoughts. You look at how disruptive it is in terms of your day-to-day functioning. So, like, for depression, you need criteria that is over a certain span of time, and you look at sleep, you look at interest level, you look at is this person experiencing guilt or hopelessness. You look at energy, you look at concentration, you look at appetite. You're looking at all of these different... It's not just, you know, does this person have suicidal thoughts or not. It is, you're encapsulating a lot of different things over a certain span of time versus they went through a breakup and now they're sad. This, uh, this is a, a big difference, so you're catching it over a pretty prolonged period of time. Um, with anxiety, same kind of thing. You're looking over a period of time, and you're looking, like, is this person, uh, dealing with, like, m- musculoskeletal stuff?

Lewis Howes 16:58 Yeah.

Dr. Sasha Hamdani 16:58 Are they restless? Do they have muscle tension? Is sleep getting impacted? Do they have panic, uh, attacks? Like, you're looking at all of those different pieces, but the thing that distinguishes that from a situational up and down is truly patterns-

Lewis Howes 17:13 Over time

Dr. Sasha Hamdani 17:13 ... and length of time.

Lewis Howes 17:14 Over a long period of time.

Dr. Sasha Hamdani 17:15 Yeah.

Lewis Howes 17:15 'Cause if you're gone through a breakup and you're still sad three, six, or maybe nine months later, it may not be anxiety or depression. You just maybe haven't dealt with the breakup fully yet, or the loss yet.

Dr. Sasha Hamdani 17:26 Sure.

Lewis Howes 17:27 But a lot of your book talks about rejection.

Dr. Sasha Hamdani 17:29 Mm-hmm.

Lewis Howes 17:29 And it sounds like most people in the world are afraid of being rejected or the feeling of rejection.

Dr. Sasha Hamdani 17:35 Yeah.

Lewis Howes 17:36 Whether it be a micro-rejection, meaning a comment online where someone didn't approve of their post-

Dr. Sasha Hamdani 17:42 Yeah

Lewis Howes 17:42 ... or a rejection of approaching someone, them saying no, or rejection at work, or rejection in their marriage, whatever it might be.

Dr. Sasha Hamdani 17:48 Yeah.

Lewis Howes 17:50 What is the consequence of rejection for most people in the world right now? When they experience rejection, they feel what?

Dr. Sasha Hamdani 18:01 So let's, let's back up a little bit, 'cause I don't think anybody likes rejection, right? No- you're never gonna meet someone who's like, "That was great for me," uh, after getting rejected or critici- or maybe you do, I don't know. I, but most people are gonna be like, "That was bad." But then they are able to kind of move on and, and take whatever positives they need to from that moment, or, or possibly not even do that, just forget about it and move on.

Dr. Sasha Hamdani 18:26 There is a concept called Rejection Sensitive Dysphoria, and that is a profound emotional response to real or perceived rejection, criticism, or disappointing someone. It is a neurological phenomenon that's happening. And so what I tell people is that if you are looking, you know, at where you fall on this emotional spectrum, and say-

Lewis Howes 18:51 Reject- Rejection Sensitive Dysphoria.

Dr. Sasha Hamdani 18:54 Yeah.

Lewis Howes 18:55 And it's real or perceived rejection, right?

Dr. Sasha Hamdani 18:57 Yeah, you might think you're getting received... Uh, uh, think you're getting rejection.

Lewis Howes 19:00 But you're not.

Dr. Sasha Hamdani 19:01 But you're not.

Lewis Howes 19:01 It's just a fear around it too, right?

Dr. Sasha Hamdani 19:04 Mm-hmm.

Lewis Howes 19:05 Okay, sorry. So what is it? There's a scale of this?

Dr. Sasha Hamdani 19:06 There's a spectrum. There's a spectrum. So if you're looking at... And it, it's pretty intuitive, because when you ask yourself, like, "How sensitive am I? What is normal?" You look at this spectrum and, you know, that's what we go over in this book, because I don't think that was ever delineated. I don't know where, where you, you would consider normal. But where I consider normal would be when you're having a situational stressor and your mood goes up or down appropriately. Now, you look at one end of the spectrum and it's apathy, where you're having an emotional trigger and you don't really elevate up or down, it's just, meh, numb, you're there. Polar other opposite end of the spectrum, which is kind of where I live, [laughs] is where you feel things deeply and quickly and in, for a long time.

Lewis Howes 19:56 Mm-hmm.

Dr. Sasha Hamdani 19:56 And it's truly because of a difference in neurological wiring, and I would put RSD on that side of the spectrum. Rejection Sensitive Dysphoria.

Lewis Howes 20:04 How many days does it take to go from total beginner to reasonably proficient at a new skill? Well, if you practice for a focused hour a day, then about 250, which also happens to be the number of reasons to choose T-Mobile. Here's an excellent reason: they have the fastest 5G home internet according to Ookla Speedtest, which you can test for yourself worry-free with their 15-day money back guarantee. Another great reason, it's fast and easy to set up too. Plug it in and you're online in practically no time, with no appointment or technician needed. Those are just a few reasons. Find yours at T-Mobile.com/HomeInternet where you can check availability and try it for yourself. They're so sure you'll love it, you get your money back if you don't. Fastest according to Ookla Speedtest Intelligence data second half of 2025. All rights reserved. Redeem money back guarantee within 30 days of cancellation. So if you feel things deeply and intensely for long periods of time-

Dr. Sasha Hamdani 21:09 Mm-hmm

Lewis Howes 21:09 ... whether it is a seemingly horrible event that occurred to you or a friend or someone you know-

Dr. Sasha Hamdani 21:16 Yeah

Lewis Howes 21:16 ... and you feel deeply ab- around that experience, or maybe it wasn't that horrible perceived of an event, but you still feel deeply for something that's smaller.

Dr. Sasha Hamdani 21:26 Yeah.

Lewis Howes 21:26 What does that say about you?

Dr. Sasha Hamdani 21:28 I think that says that you're highly emotionally sensitive.

Lewis Howes 21:31 Yes.

Dr. Sasha Hamdani 21:32 And I don't necessarily think that's... And I mean, I want to make sure that that's not being put with a-

Lewis Howes 21:37 A bad-

Dr. Sasha Hamdani 21:38 ... good or bad label, right?

Lewis Howes 21:39 Just it is what it is.

Dr. Sasha Hamdani 21:40 It's just you're wired. Like, there are some people that process emotion more intensely. And so if, if that's how you feel really deeply, really quickly, really intensely, and it, it lingers for a long time, you're one of those people that probably does interpret emotion differently, process emotion differently, and there's a different set of skills that you use for that.

Lewis Howes 22:01 Yes. I feel like I grew up like that.

Dr. Sasha Hamdani 22:03 Yeah.

Lewis Howes 22:04 Yeah. Feeling deeply around-

Dr. Sasha Hamdani 22:05 I did too

Lewis Howes 22:06 ... lots of things.

Dr. Sasha Hamdani 22:07 Did you get called sensitive a lot?

Lewis Howes 22:11 Uh, no. Maybe emotional, but, you know.

Dr. Sasha Hamdani 22:13 Emotional.

Lewis Howes 22:13 But I would, like... I was... Yeah, I just felt very deeply.

Dr. Sasha Hamdani 22:17 Yeah.

Lewis Howes 22:17 And I would go into, like, an emotional cave at times, you know?

Dr. Sasha Hamdani 22:21 Yeah.

Lewis Howes 22:22 And either in, by myself or around other people and... Yeah.

Dr. Sasha Hamdani 22:26 It's interesting because-

Lewis Howes 22:27 And I had to, I had to learn tools as an adult on how to... Like, I still feel very deeply, but I've had to, I don't know if it's a psychological tool or an emotional tool or what it is, spiritual tool-

Dr. Sasha Hamdani 22:40 Yeah

Lewis Howes 22:40 ... on how to feel it, not bypass the feeling, but also not let the feeling take over my life-

Dr. Sasha Hamdani 22:48 Oh, my God

Lewis Howes 22:48 ... so that I can actually keep moving forward and, and focusing on, focusing out rather than focusing inward constantly.

Dr. Sasha Hamdani 22:57 So that's kind of the entire gist of this, is I wanted to make sure that people understood it's not about making you less sensitive, it's giving you more control.

Lewis Howes 23:06 Yeah.

Dr. Sasha Hamdani 23:06 So for people who do feel things really deeply, I feel like being able to utilize those skills... And it's all stuff you've heard about you. It's all stuff you know. But knowing when to apply it, how to apply it, that's really gonna help you. And I think with this book, the way it's broken up is the first part is the neuroscience of truly if you're neurologically wired to process emotion differently. Then it goes into where you fall on that spectrum. Then it goes into the tools. And then the th- last part of the book is just all real world examples, where then it breaks down, like, "This is what's happening in the brain, this is the skill you use, let's practice it." 'Cause I think going through, if you are able to do that while you're not in this dysregulated state, you're going to be able to kind of learn and build, and then when you need it, it's there.

Lewis Howes 23:54 Yeah.

Dr. Sasha Hamdani 23:54 You kind of learnt and it's experienced and you've practiced it in lower stake moments.

Lewis Howes 23:59 Mm.

Dr. Sasha Hamdani 23:59 So I think that's, that's the key of kind of moving more into that emotionally resilient spot.

Lewis Howes 24:04 Yes. If someone feels like their brain is working against them-

Dr. Sasha Hamdani 24:08 Yeah

Lewis Howes 24:08 ... and they feel like they just can't get ahold of their thoughts and their brain is kind of working against them, what do you think is actually going on inside of them if they feel like they cannot get a control on their brain?

Dr. Sasha Hamdani 24:20 Y- you have to give me more information. Do you mean, like, they f- feel like their emotions are out of control?

Lewis Howes 24:26 Yeah.

Dr. Sasha Hamdani 24:26 Yeah. I think a lot of times, like, if you go back and you actually think about the neuroanatomy of what's at play- There are two big, big things that we talk about. Number one is the amygdala, and that is that emotional threat detector in the body, in the brain. And the second part is your frontal lobe, that prefrontal cortex directly under your forehead, smartest part of the brain. Judgment, decision-making, processing, that's all that frontal lobe functioning. When you're dealing with someone who's highly emotionally sensitive, that amygdala, hyper-responsive. So now it's like taking emotional data, processing it, and it's dumping alarm chemicals like, "I am in danger. Something's happening. This is going on. This is real." And so you, and you kind of described this with this hypervigilance. You know, you're on lookout for this is happening, this is dangerous, so this amygdala spinning, dumping alarm chemicals. Then that frontal lobe, under-responsive. So when you need that guy most, where is he? [laughs] Like, he's not processing or overriding this, and the connection between the two is weak. So basically, your emotions are going to outweigh that logical part of your brain almost every time-

Lewis Howes 25:36 Mm-hmm

Dr. Sasha Hamdani 25:36 ... unless you have those skills.

Lewis Howes 25:37 Gosh. This is where, you know, I probably made too many mistakes in my past, letting my emotions get the best of me in the heat of the moment, right?

Dr. Sasha Hamdani 25:44 I know.

Lewis Howes 25:44 It's like, and you react or you say something and you're like, "Ugh, I shouldn't have said that."

Dr. Sasha Hamdani 25:48 Oh my God. I have, I have many examples.

Lewis Howes 25:52 [laughs] Many of those moments, right?

Dr. Sasha Hamdani 25:54 Many examples.

Lewis Howes 25:55 You spent years thinking something was wrong with you before you had a diagnosis, correct?

Dr. Sasha Hamdani 25:59 Yeah.

Lewis Howes 26:00 So what changed once you understood what was really happening?

Dr. Sasha Hamdani 26:04 I, I don't even think it was about the diagnosis, because my diagnostic story was a little bit weird in that I was diagnosed in fourth grade, um, did well, didn't bother me. Didn't really know that I was on ADHD medication, which was weird.

Lewis Howes 26:18 No way.

Dr. Sasha Hamdani 26:19 Yeah. I-

Lewis Howes 26:19 Your parents just gave it to you without you knowing?

Dr. Sasha Hamdani 26:21 Yeah, just thought it was a vitamin.

Lewis Howes 26:23 How do you feel about that?

Dr. Sasha Hamdani 26:23 Well, vitamin... Okay, so what, what they praised it as-

Lewis Howes 26:26 You feel tricked or lied to?

Dr. Sasha Hamdani 26:27 So they were like, "This is gonna help you focus."

Lewis Howes 26:30 Okay.

Dr. Sasha Hamdani 26:31 Okay? So I, but I never wa- z- had that sit down conversation of like, "This is ADHD. This is what you're taking."

Lewis Howes 26:38 This is a drug.

Dr. Sasha Hamdani 26:39 This is-

Lewis Howes 26:39 This is chemically changing your brain every time you take it

Dr. Sasha Hamdani 26:42 Now, keep in mind, this was... I'm not gonna... Like, it, it was a long time ago. This was very un- girls getting diagnosed with ADHD was basically unheard of. Um, I was in a school where, you know, I, number one, I was like the only ethnicity, so I already felt really othered, and I was at, like from the get-go-

Lewis Howes 27:05 You wanted to be accepted. You wanted to be... Yeah.

Dr. Sasha Hamdani 27:07 Yeah, and from the get-go-

Lewis Howes 27:08 Belong. Yeah

Dr. Sasha Hamdani 27:08 ... I f- knew I was very emotionally sensitive, and so did my parents. So I think they fumbled the bag on that one. It, like they could have handled that better. But now being-

Lewis Howes 27:18 They did the best they could

Dr. Sasha Hamdani 27:18 ... Right, but being a parent, I understand that this is where it came from, and I think that they more than made up for that, because then when I, I go through school, I do pretty well, get into medical school, and in medical school, I go through, like, it was like the first two weeks and I was like, "Did I have a stroke? What is wrong with me?" Like, why are things-

Lewis Howes 27:41 A stroke?

Dr. Sasha Hamdani 27:41 Yeah, I just felt like-

Lewis Howes 27:43 In medical school?

Dr. Sasha Hamdani 27:44 No, I didn't actually. But I was like, "Things have g- I've gone from the top of my class to the bottom of my class. What happened?" My parents were like, "Are you taking your vitamin?" I was like, "I don't know where that is." And they're like, "Okay, well, it's actually ADHD medication."

Lewis Howes 27:58 Oh my gosh.

Dr. Sasha Hamdani 27:59 [laughs] And so then, yeah, I felt extremely betrayed. I felt very angry. And, you know, this is coming from parents who well-educated, r- like the most attentive, loving parents. And I just, I, I f- was so angry, so angry.

Lewis Howes 28:19 I, yeah, I can imagine.

Dr. Sasha Hamdani 28:21 And then I was like, "Fine, I will show you." Like, I knew kids who had ADHD when I was growing up, and they weren't me. They were like kids who were, you know, doing crazy stuff and getting in trouble, and that is not me. So I tried and I tried, and I was watching all my peers, um, whiz past me, and I got into a spot where I studied so hard for an exam, so hard. I knew this neuroanatomy of the brain inside out. Like even right now, if you were to show me, I'd be like, "This is it." I know it all. I go in for this test. I do this test, hand it in before anyone else. Out the door, I'm like, "That was perfect. This, I'm gonna shove it in everyone's face. This is gonna be great." We go, and this is, I don't know if you had this. Did, did, did they ever like post grades-

Lewis Howes 29:09 Oh, yeah

Dr. Sasha Hamdani 29:09 ... kind of thing?

Lewis Howes 29:10 Mm-hmm.

Dr. Sasha Hamdani 29:10 Yeah, not online. This is just like on a sheet-

Lewis Howes 29:12 Yeah

Dr. Sasha Hamdani 29:12 ... so we're all like huddled around-

Lewis Howes 29:13 Yeah, yeah

Dr. Sasha Hamdani 29:14 ... the next day looking, and I was like, "Oh my God, somebody got a 32%." And I was like, "Oh, God. It's me."

Lewis Howes 29:20 No way.

Dr. Sasha Hamdani 29:21 So I'm looking at my ID number, and I was like, like-

Lewis Howes 29:24 No way

Dr. Sasha Hamdani 29:24 ... "I got 100. There's no way. This must be an error." I go. I forgot to flip over the sheet.

Lewis Howes 29:30 Oh, you left the whole thing blank.

Dr. Sasha Hamdani 29:32 Mm-hmm. And so I-

Lewis Howes 29:33 So you would've gotten 100% had you flipped it over probably.

Dr. Sasha Hamdani 29:36 I was crying. I went to the instructor and I was like, "Just give it, give it to me orally. I'll do it right now. I'll show you I know it." And he's like, "You need to learn from this." And I was like, "I will learn nothing from this." [laughs] And so then I was like, that's what kind of was like-

Lewis Howes 29:51 Ah

Dr. Sasha Hamdani 29:52 ... this is a tipping point. I need... And then my dad was like, "Just come home. Let's learn about your brain, and if it's, if it's ADHD, we'll figure out what to do. If it's not, we'll figure out something else to do." So I went home, like d- did this whole library excursion. We were sitting on the floor reading articles, wr- and like learned-

Lewis Howes 30:10 Wow

Dr. Sasha Hamdani 30:10 ... everything. And by the end of it, it, I was like, "This is for sure me, and this is what..." We kind of made a plan and started working on both like the behavioral side and the medication side and trying to figure out a good path forward from there. I forgot what the actual question was. [laughs]

Lewis Howes 30:29 I mean, you learning about your parents, you know, kind of lying to you, I guess, about the vitamin being medication, and you being upset, and then you realizing, "Okay, this is- I'm gonna prove them wrong, and realizing that the test-

Dr. Sasha Hamdani 30:44 I did not prove them wrong

Lewis Howes 30:45 ... you know. Eh, that could have been a one-off, though.

Dr. Sasha Hamdani 30:47 Okay.

Lewis Howes 30:47 'Cause you were li- you proved that you knew the information.

Dr. Sasha Hamdani 30:50 Yeah.

Lewis Howes 30:50 You studied hard, and you had the answers.

Dr. Sasha Hamdani 30:52 I got a perfect score on the first half.

Lewis Howes 30:54 Yeah, so that's, I mean, in some ways you did prove them wrong, but yeah.

Dr. Sasha Hamdani 30:58 Yeah.

Lewis Howes 30:58 You forgot to flip the page. [laughs]

Dr. Sasha Hamdani 30:59 But, um, so the, uh, yeah, I think it's, it, it was just an interesting kind of trajectory. I think they, they really handled it beautifully. Like, if, i- in, in that moment-

Lewis Howes 31:13 Mm-hmm

Dr. Sasha Hamdani 31:13 ... like, going back and, and being able to... You know, my dad in particular, he was an engineer and he just, you know, was like my second brain. He was just trying to help me, and he was like, "Well, let's look at, let's look at the data. Let's look at how you answered these question. Where was the problem?" And, and really, like, without his help, I wouldn't have gotten through-

Lewis Howes 31:34 Mm

Dr. Sasha Hamdani 31:34 ... medical school, because I was learning so much about my brain and learning about how I learned and how I handled things.

Lewis Howes 31:40 Mm-hmm.

Dr. Sasha Hamdani 31:41 And I think part of that diagnostic thing is, uh, ADHD aside, I remember where the question was going, ADHD aside, the emotional regulation I figured out much, much later.

Lewis Howes 31:53 Really?

Dr. Sasha Hamdani 31:53 And it wasn't until my dad died. Yeah.

Lewis Howes 31:55 That's when you figured out emotional regulation?

Dr. Sasha Hamdani 31:57 That's when I figured out for the first time... So my dad died in 2024, um, m- relatively qui- like, he had been sick for a while with an underlying lung condition, but had been stable, and then he, we found out he had a spot, like, lung cancer. Stage one, they were like, "Don't worry about it. Like, it's not that big of a deal." He does radiation, does chemo, and then he called me and it, he was like, "Something's wrong." So I fly from Kansas City to him. I, like, he looked terrible. I was... Took him in the hospital and was like, "Do something. Do a PET scan. We need..." And they're like, "It's too early." I'm like, "Just do one. I don't care. Like, let's just figure out what's happening here." Uh, it was everywhere. Every- and he died th-

Lewis Howes 32:39 Cancer.

Dr. Sasha Hamdani 32:40 Mm-hmm. Died 13 days later.

Lewis Howes 32:41 No way.

Dr. Sasha Hamdani 32:42 Yeah.

Lewis Howes 32:43 Oh my gosh.

Dr. Sasha Hamdani 32:44 And so at that point, I think just, like, the whiplash of all of that and just how heavily emotional it was, that was the first time, Lewis, that I was like, my emotional status directly impacts my functional status. If I am emotional and emotionally overwhelmed, I can't do these things. So I was like... And I, I had seen that before with, like, breakups and, and other things like that, where it, things happened, but I didn't tie those two things together. Because, like, if it, if it's overwhelm, 'cause I have tons on my plate, I will delegate. I will hack my way around. I will figure out a skill, but I can't delegate the emotional side. And so that's when I figured out that conne- and that's when I started writing that.

Lewis Howes 33:29 Wow. Yeah, for me it was the emotional side of thing would take over my life. When I would feel too deeply or, or of the range of emotions, guilt, loss, shame, anger, whatever the emotion was, sadness.

Dr. Sasha Hamdani 33:42 But deep.

Lewis Howes 33:43 Deep, it would suffocate me. It would engulf my life, and I couldn't turn it off-

Dr. Sasha Hamdani 33:50 Yeah

Lewis Howes 33:50 ... if I was at the office or if I was... You know, I would literally just kind of just stay home by myself.

Dr. Sasha Hamdani 33:55 No, you fled.

Lewis Howes 33:56 'Cause I didn't know how to emotionally navigate those things, those feelings, for a long time. And it would, yeah, it would suffocate me. My whole life would be suffocated by emotions.

Dr. Sasha Hamdani 34:08 Yeah.

Lewis Howes 34:08 And that's when I became kind of, not obsessed, but really all in on, like, "Okay, why? Why is this happening?"

Dr. Sasha Hamdani 34:14 Yeah.

Lewis Howes 34:15 And that's where I asked you in the beginning, like, learning how to heal traumatic memories that cause the emotional avalanche to take over my life.

Dr. Sasha Hamdani 34:26 Yeah.

Lewis Howes 34:26 Once I learned emotional regulation and healing traumatic memories that were triggering the emotions-

Dr. Sasha Hamdani 34:34 For sure

Lewis Howes 34:34 ... that were causing the hypervigilance because of an emotion tied to a memory that I had yet to heal, an open wound from the past, that when you poked it, boom.

Dr. Sasha Hamdani 34:46 Argh.

Lewis Howes 34:46 My whole nervous system would just be in pain.

Dr. Sasha Hamdani 34:48 Yes.

Lewis Howes 34:48 And the bigger the, uh, trigger or the bigger the perceived abuse or perceived abandonment or whatever the wound was-

Dr. Sasha Hamdani 34:59 Yeah

Lewis Howes 34:59 ... the perception of, whether it was real or not, perceived, I didn't know how to navigate it.

Dr. Sasha Hamdani 35:04 Oh, yeah.

Lewis Howes 35:05 And so that's why I was asking in the beginning, like, when we learn, I think, the ability to navigate our emotions, and we can use a lot of the skills you talk about in your book-

Dr. Sasha Hamdani 35:16 Mm-hmm

Lewis Howes 35:17 ... um, we can come back to the present.

Dr. Sasha Hamdani 35:19 Mm-hmm.

Lewis Howes 35:20 We can hopefully learn to integrate the healing journey.

Dr. Sasha Hamdani 35:24 Mm-hmm.

Lewis Howes 35:25 We can hopefully have a moment to refocus our energy on what's at hand, whether it being present with someone, whether it being our job, whether it being whatever things we need to do.

Dr. Sasha Hamdani 35:35 Yeah.

Lewis Howes 35:36 Instead of being engulfed in the feelings-

Dr. Sasha Hamdani 35:40 Yes

Lewis Howes 35:40 ... consuming us.

Dr. Sasha Hamdani 35:41 Yeah

Lewis Howes 35:42 ... and constantly ruminating on the event that happened that caused this feeling.

Dr. Sasha Hamdani 35:48 Yeah.

Lewis Howes 35:49 And I think when we can learn those emotion regulation skills like you talk about here, um, it doesn't mean, uh, bad things aren't going to happen that-

Dr. Sasha Hamdani 35:57 Yeah

Lewis Howes 35:57 ... we have to face, like the loss of your father. It's gonna be overwhelming.

Dr. Sasha Hamdani 36:02 Yeah.

Lewis Howes 36:02 But hopefully it doesn't take years of your life away from you living in the present now.

Dr. Sasha Hamdani 36:07 And that's what it's felt like in the past. Like, when you get that, uh, hit with something so emotionally, it, it does take away years of your life. This is what you go to sleep thinking about. This is what you wake up thinking about. It's, it consumes you.

Lewis Howes 36:21 Yeah.

Dr. Sasha Hamdani 36:22 And so, and, and when you're right in the throw of it, you're just like, "This'll never end. I'm gonna feel this way forever."

Lewis Howes 36:27 Yeah.

Dr. Sasha Hamdani 36:28 It, it, it just takes up so much mental space, emotional space, having to deal with that. And, and for people who do feel deeply, they feel it obv-

Lewis Howes 36:39 Extremely deep. Yeah, yeah

Dr. Sasha Hamdani 36:40 ... more.

Lewis Howes 36:40 Right. Yeah.

Dr. Sasha Hamdani 36:41 They feel it more

Lewis Howes 36:42 When- I mean, it seems like women often get told that they have anxiety or depression for years before someone checks that it's potentially ADHD or something else.

Dr. Sasha Hamdani 36:50 Mm-hmm.

Lewis Howes 36:51 Why do you think that happens to women specifically?

Dr. Sasha Hamdani 36:54 Oh my God. Um, I think, like, if you're talking about ADHD specifically, and these are women who have been misdiagnosed with anxiety and depression, you go back and one big thing is that the diagnostic criteria, it's not built to capture women. So it's not built to capture- it's built on hyper young boys. It's not capturing adult females.

Lewis Howes 37:14 Okay

Dr. Sasha Hamdani 37:15 Like, you're not really getting that presentation. The second thing, um, that I think is a big factor in this is just the hormonal component. So hormonally, when your estrogen drops, your dopamine drops as well, and dopamine is that great regulator that kind of helps everything with mood and alertness. And so when you have that drop in dopamine, your ADHD symptoms get worse. Problem is, is that so does mood, so do all these other things. And so you're being told, "You're just hormonal. This is postpartum. It's not that big of a deal. You'll get through it." Or you get treated for anxiety, you get treated for depression, when really it's the secondary ADHD that's complicating things as well. Third thing is that I feel like women from just, like, a societal perspective, they- it's unacceptable for them to be rambunctious or m- you know, interrupting things or h- you know, get up and move around. A lot of times they learn from an early age they have to mask their symptoms.

Lewis Howes 38:14 Mm.

Dr. Sasha Hamdani 38:14 And so as time goes by, they get better and better at doing that. And it's not that the symptoms go away, it's not that the symptoms aren't impacting them, they're just really good at compensating and getting past it and blending into society better, all while taking that on as a huge toll on themselves. And so now you get, you know, 10, 15, 20 years down the line, and these women are like, "Okay, enough's enough. Let's go and get diagnosed." And then the doctor's like, "Y- you would've known if you had it before."

Lewis Howes 38:44 Hmm.

Dr. Sasha Hamdani 38:45 That you're doing too well. And so it's just- it's- it's a system that wasn't built for women.

Lewis Howes 38:51 Interesting. Do you think just modern society life is causing a lot of anxiety, depression, and ADHD versus, I don't know, living on a farm and working hard with your family unit back in the day or something like that? Like, is it just modern society is causing so much overwhelm of the brain and the emotions to be able to navigate all the- all that's happening?

Dr. Sasha Hamdani 39:14 I think right now is hard. We're living in a really hard world. It's har- it's a hard every which way you look at it, um, which is why I think, uh, uh, discussions about emotional regulation are especially important right now, but I think d- like does this increasingly, like, digital overwhelming world, does that cause ADHD? No. Does it worsen ADHD? For sure. So I think there is an exacerbation of all of these things just because we're living in this extremely chaotic timeline with so many things happening, so many... Like, I have an eight-year-old girl, and she sees me on my phone, and she was talking about like, "I want a phone, too," and I was like, "No, never." [laughs] And she's like, "Well, why? That's not fair. Why do you have a phone?" I was like, "There's literally nothing good that lives in my phone. I wanna throw it into the sun." Like, I-

Lewis Howes 40:11 Oh

Dr. Sasha Hamdani 40:11 ... like the phone, I feel like I- that's where I'm fed. Like, a lot of times social media is so dark and difficult and, like, it just- it wears on you just being a human right now-

Lewis Howes 40:26 Yeah

Dr. Sasha Hamdani 40:26 ... from a psychiatrist's perspective.

Lewis Howes 40:27 So just modern society is hard in general-

Dr. Sasha Hamdani 40:30 It's hard

Lewis Howes 40:30 ... like everything's happening. Yeah, I kind of feel blessed that I didn't get a phone until I was, like, 17 or 18, so I kind of missed that window of being on screens really.

Dr. Sasha Hamdani 40:41 Mm-hmm.

Lewis Howes 40:41 I guess I played, like, maybe a little bit of, like, video games, like maybe, but I was more-

Dr. Sasha Hamdani 40:45 Like Super Nintendo?

Lewis Howes 40:46 I think s- I mean, I was more into, like we wouldn't- we didn't have enough money to have a Nintendo until years later, but I would, like, go to the arcade.

Dr. Sasha Hamdani 40:53 Oh, yeah.

Lewis Howes 40:54 And like, but it was like a set amount of time, and I didn't have enough money to be there for hours.

Dr. Sasha Hamdani 40:57 Yeah.

Lewis Howes 40:57 So, like, how many quarters do you have? But I was more in the sports world where it was just like, after school I'm playing in the playground, I'm doing sports activities, so I was always out playing.

Dr. Sasha Hamdani 41:07 Yeah.

Lewis Howes 41:08 And then I'd come home at night, have dinner, and it was like maybe later I had like a little bit of time, but I wasn't really interested in playing video games when I was older 'cause I wanted to get better at sports.

Dr. Sasha Hamdani 41:19 Right.

Lewis Howes 41:19 So I kind of missed that window of being a kid in this generation where you got phones early or your parents had a phone and you're playing the games with them or iPads. I kind of missed that.

Dr. Sasha Hamdani 41:28 Yeah.

Lewis Howes 41:29 But as a parent of two, uh, you know, twin girls right now,

Lewis Howes 41:35 what advice would you have for me around iPads, iPhones, screen time, uh, cartoons-

Dr. Sasha Hamdani 41:45 Yeah

Lewis Howes 41:45 ... movies for my kids or any parents for their kids if they wanna have healthy young kids that have fewer chances of getting anxiety, depression, and ADHD?

Dr. Sasha Hamdani 41:58 So I don't think screens are going to cause ADHD. I think they could worsen an underlying ADHD for sure, and screens do fragment focus. So in that early developmental period from zero to two, that's really when you're still so neuroplastic. You're- you're learning things. Even though you're not up and about doing all of those things, you're learning kind of the flow of the world. You're learning how to encapsulate attention. You're- you're building all of that gray and white matter and trying to figure out what your brain is doing, how it's gonna be wired, right? So I am never gonna be the person who's like absolute- my mom is that person. My mom's a pediatrician, and she is like, "Don't do screens." And I was like, "I literally grew up on a TV."

Lewis Howes 42:44 Literally.

Dr. Sasha Hamdani 42:45 You know?

Lewis Howes 42:45 Yeah, yeah. Sitting in front of the TV, yeah.

Dr. Sasha Hamdani 42:47 Sitting in front, like this far away from the TV, yeah. Um, and so I, it was, you know, I, I know that for a lot of parents, screen time is truly a tool so that the parent it- or, or his or herself can take a break-

Lewis Howes 43:03 A peace, yeah

Dr. Sasha Hamdani 43:03 ... and do, yeah. And really-

Lewis Howes 43:04 Have an hour to themselves.

Dr. Sasha Hamdani 43:06 Yeah. So-

Lewis Howes 43:06 Can make dinner, can do the laundry, can just go to the bathroom, yeah.

Dr. Sasha Hamdani 43:10 Totally. So I, I don't think, like, i- if you have an excessive amount of, like, guilt and shame about stuff like that, I do- like, it's all about moderation to me. I think if there is a way that you are able to minimize screen time, use more, like, integrated play and, and d- movement and other interactions that are screen-free, your kid is more likely to kind of grow up and need that less. So I... But if you still have screens, and I will tell you, my kids had screens, um, not of their own, but, like, they were exposed to it at different points in their lives and there are still times where I'm like, "Okay, [laughs] like I need to finish this last patient, and if, if I, i- if you guys are around and I'm trying to play with you, there's no way I can do that. Here's a show. It's 26 minutes long."

Lewis Howes 44:05 Yeah, yeah.

Dr. Sasha Hamdani 44:06 You know?

Lewis Howes 44:06 Yeah.

Dr. Sasha Hamdani 44:06 I, so I think it's, it's all about moderation.

Lewis Howes 44:10 Mm-hmm.

Lewis Howes 44:11 If someone is, you know, they don't have ADHD, they don't have anxiety and depression, but they are just feeling overwhelmed a lot, and they feel like they don't know how to reclaim, reclaim their thoughts, their emotions, but they're not diagnosed with one of these things.

Dr. Sasha Hamdani 44:29 Yeah.

Lewis Howes 44:30 What's an emotional tool that you talk about that people could use if they're just feeling like, "Life is so hard right now."

Dr. Sasha Hamdani 44:37 So hard.

Lewis Howes 44:37 "I'm overwhelmed. I'm overworked. I'm feeling stressed. I can't reclaim my focus." Like, what's an emotional tool they could use right now to help them?

Dr. Sasha Hamdani 44:45 So I, again, a lot of the tools in this book are stuff that you've heard about or probably have been told. Like for example, a- any time I was in this, like, spirals of overwhelm or things like that, "Take a deep breath. Go..." And I'm like, "I, I... Like, get out of here with that. I don't want to hear that from you." But if I arrive to that conclusion myself, I somehow think it's, like, the greatest breakthrough of all time. But I think one of the best things is the way we talk about emotional sensitivity and dysregulation and overwhelm is also understanding that it can present very differently.

Lewis Howes 45:22 Yeah.

Dr. Sasha Hamdani 45:22 Like, there are times where I feel very overwhelmed, and my initial impulse is to be a recluse and to withdraw and be quiet-

Lewis Howes 45:31 Me too

Dr. Sasha Hamdani 45:31 ... and go into the... Then there are times where I'm emotionally overwhelmed and I am pacing, and I'm, like, talking out loud and I'm, like, trying my best to kind of work through it. If I am in a spot where I'm, like, by myself and withdrawn, I probably do have the capacity where I could be like, "Okay, let me take a deep breath. Let me do this," because I'm already kind of on the quiet side and I'm by myself and I'm... I can... I m- may be more likely to do that. If I'm pacing around, telling me to slow down and take a deep breath-

Lewis Howes 45:59 That-

Dr. Sasha Hamdani 45:59 ... feels so much harder.

Lewis Howes 46:00 Yeah.

Dr. Sasha Hamdani 46:01 So that time when my nervous system is literally on fire, I lean into it. Like, I need to use movement. I need to somehow push that oxygenated glucose into my frontal lobe so I can think my way out of this. So this is, like, I... I'll give you an example. Being on this press tour and, uh, for this book, it's, it's just, first of all, writing a book about rejection, then going on a press tour-

Lewis Howes 46:27 Yeah

Dr. Sasha Hamdani 46:27 ... 0 out of 10 would not recommend. But, um, I had, you know, these podcasts lined up, and one of the podcasts pulled out two days before I was supposed to film, and I-

Lewis Howes 46:38 How did it make you feel?

Dr. Sasha Hamdani 46:39 God. It was like trash. So I was just like, "I am just not a big enough deal, and that's why they canceled. I- they feel like I'm bad for their brand. They don't want to talk about emotional sensitivity. The book is stupid. I'm stupid." Like, it just, it went from 0 to 60 really quickly, and I was sitting on the couch with my husband, and I just started getting up, and I started pacing around, and he's like, "Hmm. Okay. [laughs] Something's happening." And then I remembered, like, "Okay, I know what's happening. My amygdala is spinning out of control. I'm dumping alarm chemicals. I need that frontal lobe to kick on, but I... it, it's hard because I can't think my way out of this. I can't even think about an alternative to what's happening, 'cause I'm so convinced this is happening." And so I had seen, like, a couple of days prior to that, like, you know, someone was talking about, like, the, um, benefit of doing squats, like, for, like, longevity and, like, uh, muscle health and brain health, and I was like, "Great." So I'm, like, going from pacing to all of a sudden doing squats in front... And my husband is just like-

Lewis Howes 47:44 "What are you doing?" [laughs]

Dr. Sasha Hamdani 47:46 And so I'm doing squats, and, like, it, it's, like, less than two minutes, and I'm like, "Okay." I stop, I sit down again, I reread the email, and this time I'm like, th- this is the first time that I reread the email, and I saw the words "due to a family emergency." Did not even read that the first time. And I was like, "Okay, that I can, that I can stomach."

Lewis Howes 48:09 Uh-huh.

Dr. Sasha Hamdani 48:10 And then two hours later, I get a thing where they're like, "They wanted to float you this different date." And I was like, "Okay."

Lewis Howes 48:17 Right.

Dr. Sasha Hamdani 48:18 Well, so I mean, I think it's all about, like, understanding how you present, working with your body instead of fighting against it, and just using y- knowing when to apply the tools.

Lewis Howes 48:28 Sure. What's happening in the brain, in simple terms, when someone feels a small moment of rejection as overwhelming pain or anxiety?

Dr. Sasha Hamdani 48:38 Mm-hmm. So I think basically from that fundamental perspective is that emotional threat center of the brain, the amygdala, is very hyper-responsive. It freaks out. It starts sending alarm chemicals to the rest of the body, telling you, like, "You are in danger." And it's very much this fight or flight response. "You're in danger. Something is wrong. You need to either get ready to throw hands, or [laughs] you need to get out of here, or you need to freeze," because those are your options that you have. And- All while this is going on, your frontal lobe is supposed to help you do checks and balances and be like, "This actually isn't totally accurate. You can, you can calm it down a little bit." But that is under-responsive, so you're not getting that checks and balances. So really, you're at the mercy of this emotional cascade slowing down. So unless you have those skills to help that happening, you just gotta ride it out, which it seems very unfair.

Lewis Howes 49:34 Yeah, that's tough.

Dr. Sasha Hamdani 49:35 Yeah.

Lewis Howes 49:36 So you need the skills.

Dr. Sasha Hamdani 49:37 You got the skills.

Lewis Howes 49:38 You need the tools.

Dr. Sasha Hamdani 49:38 Yep.

Lewis Howes 49:38 You need the tools. Um, what's the most damaging piece of advice people

Lewis Howes 49:43 with RSD get from well-meaning friends or family?

Dr. Sasha Hamdani 49:47 Oh my God, can I tell you the one I hate the most? [laughs]

Lewis Howes 49:50 Hopefully I haven't done this. [laughs]

Dr. Sasha Hamdani 49:52 No, and if you have, straight to jail.

Lewis Howes 49:54 Yeah, right.

Dr. Sasha Hamdani 49:54 Um, "Just calm down." It's like, "Oh my God, thank you so much. I never thought of that."

Lewis Howes 49:59 Yeah.

Dr. Sasha Hamdani 50:00 Like, that doesn't help me at all.

Lewis Howes 50:02 And this is with someone has Rejection Sensitive Dysphoria.

Dr. Sasha Hamdani 50:06 Yeah, so if I'm already feeling like my m- my entire brain and body are responding to this rejection or threat or criticism, and I recognize in real time this is a huge response and it's overwhelming, now you're telling me to calm down. It's like I-

Lewis Howes 50:25 Or relax or whatever, yeah

Dr. Sasha Hamdani 50:26 ... I like, I-

Lewis Howes 50:27 So what can someone say when they see a friend, a loved one, in their mind looks like they're freaking out over nothing.

Dr. Sasha Hamdani 50:34 Yeah

Lewis Howes 50:35 You know? And to the person it's a big thing that's happening.

Dr. Sasha Hamdani 50:38 Yeah

Lewis Howes 50:38 Whether it's perceived or real.

Dr. Sasha Hamdani 50:40 Yeah

Lewis Howes 50:41 But in the friend's mind, like, this isn't that big a deal or it's all gonna be okay. Chill out. Relax. What can that friend say or do instead?

Dr. Sasha Hamdani 50:48 So this is something my husband does so beautifully, and I think it, it was just intuitive for him, but maybe it's be- it was since they-

Lewis Howes 50:58 You trained him also maybe. [laughs] You've trained him.

Dr. Sasha Hamdani 51:01 But in those... Like, for example, when I was pacing around and then just randomly doing squats in front of him, he was sitting on one end of the couch. I go and sit on the other end of the couch. He moves closer to me, and he was just like, "What happened?" [laughs] And I, you know, I think, number one, he entered it from curiosity.

Lewis Howes 51:20 Right

Dr. Sasha Hamdani 51:20 It wasn't what's wrong. It wasn't j- that was crazy. It was, "What, you know, what's, what's happening right now?" I go through this kind of thing that happened from like, "Well, I read this," and then I started like... It just ever... I, I, uh... The way I explained it was like everything felt so hot. I felt like I was just getting so hot. That's how I describe it to my husband. And then I just started getting a- like, and he's like, "You were pacing around." And I, like, I didn't even realize I was pacing around. I knew I got up, um, definitely knew I was doing squats, and then I was like, "Yeah, I tried to, like, kind of calm things down 'cause I was feeling really restless," um, and then I went back and read the email, and I realized it was a family emergency. Um, and so then that neutral kind of I'm just sitting-

Lewis Howes 52:09 Yeah

Dr. Sasha Hamdani 52:10 ... and supporting you, letting you regulate your nervous system real time... 'Cause I think for a lot of people who are dealing with this fear of rejection or criticism, especially if it's in the context of that person that you're receiving it from, if they storm off or if they tell you to calm down, you feel even more unheard. You feel even more rejected. Sometimes him just sitting there, being with me, knowing like I can, uh... It, it immediately regulates my nervous system.

Lewis Howes 52:39 Mm-hmm. I think it's a powerful thing when someone can do that, and I think it's-

Dr. Sasha Hamdani 52:45 Yeah

Lewis Howes 52:45 ... in general, I would say it's hard for most men that I've known to learn that skill, to be able to sit peacefully when something is chaotically happening, which seems like nothing happened and you're overreacting, right?

Dr. Sasha Hamdani 52:58 Yeah.

Lewis Howes 52:58 This is the seeming situation for a lot of people, and if men haven't learned the skill of emotional regulation themselves, which most men haven't learned that yet-

Dr. Sasha Hamdani 53:09 Fair

Lewis Howes 53:09 ... they can't handle someone else, what seems like a freakout around them-

Dr. Sasha Hamdani 53:14 Yeah

Lewis Howes 53:14 ... if they don't know how to, you know, navigate it, so it's hard for them. So this is the challenge. Like when... I'm not saying, you know, some men aren't able to do this, but there... n- then there's challenges in relationship breakdowns when the woman doesn't feel seen or heard and the man feels like, "Well, you're just acting crazy," or whatever the terminology is, and that's a challenge. That's why I think when both individuals, or all individuals, can learn emotional regulation, hopefully it's less heated by one person, and the other person has the skills to be able to meet them and see them and f- and hear them and hold that space. But that just takes very present people who are actively trying to improve themselves.

Dr. Sasha Hamdani 53:55 Oh my God, teach it in the schools. Like, uh, j- like, g- give me something, man.

Lewis Howes 54:00 Yeah

Dr. Sasha Hamdani 54:00 Like, th- this is w- these are things that I think really would benefit. Like, I think everybody could, uh, benefit from emotional literacy.

Lewis Howes 54:07 Yes

Dr. Sasha Hamdani 54:08 Like, you know? But I think, like, if you start integrating, like, the way you experience emotions is neurological. The way you talk about emotions, the way... Like, you just... I feel like this world specifically, people are so careless with that component of it.

Lewis Howes 54:24 They are. They are.

Dr. Sasha Hamdani 54:25 Yeah.

Lewis Howes 54:27 What is something you wish you knew when you were growing up that you now know now?

Dr. Sasha Hamdani 54:32 The emotional regulation part. Like, if I had, if I had understood that the emotional side of things would so directly impact my ability to be productive and move forward in a pathway, I would have spent that time, instead of shoving down my emotions or compartmentalizing them or... 'Cause I felt like that was my default. Like, anytime I felt something big, I'd be like, "Not right now. Go away." And I... And it would show up later in the weirdest kind of ways. So I, I just never figured it out, and it was truly until I was like, "Oh, these two things are connected," that I felt like- This deserves me going into and learning how to manage things. And my life has exponentially improved since then, and it's made me a better parent, it's made me a better partner.

Lewis Howes 55:24 Mm.

Dr. Sasha Hamdani 55:24 It's made me a better doctor, it's made me a better person because of that emotional regulation.

Lewis Howes 55:29 Yeah.

Dr. Sasha Hamdani 55:29 Mm-hmm.

Lewis Howes 55:31 How can someone who feels like they're overly sensitive turn that into a strength?

Dr. Sasha Hamdani 55:35 Number one, by recognizing that it's neurological. Like this isn't a quirk.

Lewis Howes 55:39 Mm.

Dr. Sasha Hamdani 55:39 This isn't your personality. It's not something that if you're born with it, you're [beep] of luck. Like you just, you are... This is something, the brain is just so incredible, that we have this capacity and this agency to rewire our brains. I think that's so... It makes, it makes psychiatry feel so hopeful.

Lewis Howes 55:58 Mm.

Dr. Sasha Hamdani 55:59 And so I think that it, if you feel, "Yes, I get overwhelmed all the time. This is really hard for me, and it's, it's difficult for me to navigate through life because I feel like I'm constantly responding to these triggers," I think it is possible to kind of move on from these things, to learn your patterns, to learn what your triggers are, to learn how to manage them in real time. And you said this previously, and I loved how you phrased it, is you still want to feel things. You just have to navigate it, and I think that's what's the takeaway is. It's, it's giving yourself and trusting yourself enough to be able to navigate without feeling like I'm always gonna be sucked under.

Lewis Howes 56:41 Mm. As a parent of two kids, what's your biggest fear over the next 10 to 15 years for them, based around what's happening in society and, like, the overwhelm that a lot of youth are feeling and things like that?

Dr. Sasha Hamdani 56:54 I have so many fears. I don't know where [laughs] to go. The one that I most recently was, uh, thinking about, and it kept me up like three days ago, is thinking about, like, how increasingly digital our world has gotten and how isolated we all are. Like we, we're all kind of operating, like, you know, I, uh, what, what triggered this is I walked into, um, a coffee shop and I was waiting for my order, and I looked around. Literally every single person sitting-

Lewis Howes 57:25 On their phone

Dr. Sasha Hamdani 57:25 ... on their phone. Sometimes there were two people sitting at, to eat with each other. They're both on their phones, and I'm guilty of that at times. I'm checking my email and trying to multitask. But that's the world that we kind of are in right now, where everybody is so in their own universe that it makes me think about, like, what's, what's 10 years down the line gonna be?

Lewis Howes 57:47 Yeah. As a parent though, and as a doctor, how do you ensure that your kids have this emotional regulation at an early age?

Dr. Sasha Hamdani 57:56 I think some of it [laughs] , some of it is honestly in our house, I think because I've been figuring this out in real time. I've also made it a point to talk it out loud. So when I'm feeling big things, and especially with my dad where I was like I, I really can't explain my way around it. They're seeing it. Like, I don't, uh, we just have to talk about it. Talking about those kind of emotional moments and letting them in on h- how can we make this better, how can we... And having honest discussions. I think one of the most wonderful things that came out of that is that it really made me less afraid, and it made them less afraid of emotion.

Lewis Howes 58:38 Mm.

Dr. Sasha Hamdani 58:38 'Cause like, it, it, you know, I could not stuff this down.

Lewis Howes 58:42 Yeah.

Dr. Sasha Hamdani 58:42 And so, and they were seeing that, so it's like how do we navigate this kind of as a family? And we're talking about it and we're talking about emotion, and I don't remember ever doing that as a kid with my parents or-

Lewis Howes 58:53 Talking about emotions.

Dr. Sasha Hamdani 58:54 No.

Lewis Howes 58:55 When something challenging would happen in the family or-

Dr. Sasha Hamdani 58:57 I mean, maybe intermittently, but not like, not like, "This is where sadness is coming from in the brain. This is like, when you feel this way, what's the difference between, like, feeling sad and feeling scared?" And you know, things like that. We're, we're really talking about emotion a lot more. Um, and like, you know, if we are, uh, if we see something on TV, like my husband [laughs] watched The Goonies with them the other day, and I was like, "All right. Great." But like talking to them about, like, "Okay. Look at this. What do you think they were feeling at that spot?" So just, like, talking about and integrating emotion into the conversation.

Lewis Howes 59:36 Yeah. I think that's powerful.

Dr. Sasha Hamdani 59:38 Yeah, I do too.

Lewis Howes 59:39 So like if you don't talk about... And I think maybe there's, you know, what is it called? Gentle parenting or something, where it's like maybe there's too much-

Dr. Sasha Hamdani 59:47 Yeah

Lewis Howes 59:47 ... emotion every day long talking about it. But I think having those moments where you talk about your feelings or your emotions at different times I think help kids realize it's not like something to stuff when you can't have emotion.

Dr. Sasha Hamdani 59:59 Yeah.

Lewis Howes 1:00:00 Um, and I think there's an extreme the other side where you're talking about it all day long every day. It's too mu- like, "How are you feeling?" and "Tell me more," and you know, I think it's maybe too much.

Dr. Sasha Hamdani 1:00:08 I, I-

Lewis Howes 1:00:09 I haven't gotten to that point yet 'cause they're still young, so.

Dr. Sasha Hamdani 1:00:11 They can't talk. [laughs]

Lewis Howes 1:00:12 Yeah. They can't talk yet.

Dr. Sasha Hamdani 1:00:14 I feel like with gentle parenting, and my mom's a huge-

Lewis Howes 1:00:16 Gentle parenting. Yeah, yeah.

Dr. Sasha Hamdani 1:00:17 Yeah. We talk about this all the time, and I feel like, I, I mean, in my, in my brain I thought as a parent, like my Pinterest version of myself was that I would be a gentle parent. I'm not at all. Um, but I think that sometimes it's, it's a fine line between emotionally validating and, and kind of letting the child figure out, but also giving that firmness and structure, 'cause I think-

Lewis Howes 1:00:41 Boundaries

Dr. Sasha Hamdani 1:00:41 ... kids really need that. Yeah.

Lewis Howes 1:00:43 Boundaries.

Dr. Sasha Hamdani 1:00:43 You need boundaries, and you need, like, uh, the kid can't navigate the... Because then you get your whole slew of other things going on. Like, it's really difficult for them to handle disappointment later. It's really difficult for them to understand-

Lewis Howes 1:00:57 Rejection

Dr. Sasha Hamdani 1:00:57 ... like how to be, yeah, how to be resilient.

Lewis Howes 1:01:00 If someone doesn't have the ability to handle rejection, what type of life will they live?

Dr. Sasha Hamdani 1:01:06 I don't know. They'll be a, a psychiatrist on social media, I guess. [laughs]

Lewis Howes 1:01:09 [laughs]

Dr. Sasha Hamdani 1:01:11 No. I, I feel like rejection is just such a normal part of the human experience, and it, a lot of times- Rejection is just redirection, right? It's, it, it kind of pushes you into a different pathway. Um, I think what's important-

Lewis Howes 1:01:26 But if you never learned how to navigate and handle rejection, small or big, what happens to your body, to your life, to your mind?

Dr. Sasha Hamdani 1:01:34 I, I mean, I think you get consumed by it. Like, a lot of times, sometimes you see rejection, um, and, and people trying to avoid that or potentially, um, deal with it in a different capacity. You see a lot of compensation behavior, so you see a lot of perfectionism. You see a lot of people pleasing. You see a lot of different pathways that, yes, initially may f- feel advantageous. This is, people aren't criticizing me. I am always top of my game. I'm getting validating comments. This is great. But, like, in terms of sustainability, what is that doing to the quality of your life? What is that doing over time to you? What happens when you are normal one day and everyone's like, "Are you sick?" Like, "What's happening to you?" And so I think it's, it's just a balance of trying to understand yourself because if you never really get on top of how to navigate rejection, how to navigate criticism, you're going to find other maladaptive ways to do it.

Lewis Howes 1:02:36 Yeah, and I think also if you never learn how to do it, you may never go after what you want-

Dr. Sasha Hamdani 1:02:41 Yeah

Lewis Howes 1:02:41 ... 'cause you're afraid of the rejection happening. So you never-

Dr. Sasha Hamdani 1:02:44 Totally

Lewis Howes 1:02:44 ... go for the career you want or launch the project you want or do, you know, go for the relationship you want because you're afraid of the potential rejection that may or may not happen.

Dr. Sasha Hamdani 1:02:54 Yes.

Lewis Howes 1:02:54 And how to navigate the feeling of not being good enough if and when that happens.

Dr. Sasha Hamdani 1:03:00 And, and just, like, anticipating that acute pain I think is so hard. I've had many patients who come into me and, you know, you're, you're talking about just their overall history. You're talking about medical stuff going on. You're talking about psychiatric stuff. Then you just break into, like, kind of socially what's, uh, what's happening in your life, what's your life structured like, and they talk about within relationships how that's a thing that they really, really want. I, I, I s- my parents have had a 35-year relationship. They're so happy. I want that. I want kids someday. I want all of these things, but I can't get past that initial point, or if-

Lewis Howes 1:03:40 Yeah

Dr. Sasha Hamdani 1:03:40 ... we get into a conflict, it gets so hard and I back away. And so it's, it's difficult, and I feel like in my 20s, you know, I, I tell my husband, like, I've never been broken up with because I would leave. I like-

Lewis Howes 1:03:53 You would leave

Dr. Sasha Hamdani 1:03:54 ... things would get a little hard and I'm like, "Ah, ah, ah, ah, ah, ah, ah."

Lewis Howes 1:03:55 You're like, "I'm out." Wow, so no one ever broke up with you.

Dr. Sasha Hamdani 1:03:58 No.

Lewis Howes 1:03:59 You broke up with them or you left.

Dr. Sasha Hamdani 1:04:00 Yeah, I would just be like, "This is scary. I'm out of here." And I, and I would use the excuse of like, "I'm in medical school. I don't, like, I-"

Lewis Howes 1:04:07 You're busy.

Dr. Sasha Hamdani 1:04:07 "I'm too busy. I'm too busy." And so it would be me running away from that, and I feel like my husband kind of snuck past the guard on that one because we were long distance.

Lewis Howes 1:04:18 Mm.

Dr. Sasha Hamdani 1:04:18 So I didn't have... I wasn't constantly reading his tone or his body language. We had, you know, we were communicating via text and phone call and all of the stuff, and it would just, it felt so easy and comforting. And by the time we were in the same spot, it, it-

Lewis Howes 1:04:34 Did you try to run at one point? Were you like, "Ah, it's too much conflict"?

Dr. Sasha Hamdani 1:04:39 He's pretty easy to be around.

Lewis Howes 1:04:41 He's peaceful. He sounds like, "Hey, what's going on? Why are you feeling this way? What's-"

Dr. Sasha Hamdani 1:04:44 He's such joy.

Lewis Howes 1:04:45 That's amazing.

Dr. Sasha Hamdani 1:04:45 He's involved.

Lewis Howes 1:04:46 Yeah, yeah. He, uh... It's good. You got lucky.

Dr. Sasha Hamdani 1:04:49 He had two older sisters, and I think they just, like-

Lewis Howes 1:04:51 Yeah

Dr. Sasha Hamdani 1:04:51 ... beat it into him.

Lewis Howes 1:04:52 Yeah.

Dr. Sasha Hamdani 1:04:52 Mm-hmm.

Lewis Howes 1:04:52 It's good.

Dr. Sasha Hamdani 1:04:53 Mm-hmm.

Lewis Howes 1:04:53 I have two older sisters as well, so.

Dr. Sasha Hamdani 1:04:55 Yeah. Okay. Well, probably-

Lewis Howes 1:04:55 It's probably why I was too sensitive and also emotionally like, "Hey, what's going on?" You know? It's like [laughs]

Dr. Sasha Hamdani 1:05:00 Yeah. You can tell.

Lewis Howes 1:05:02 [laughs]

Dr. Sasha Hamdani 1:05:02 [laughs]

Lewis Howes 1:05:03 That's interesting. So there was not enough conflict for you to feel like, "I'm out," once you got close?

Dr. Sasha Hamdani 1:05:08 No. Believe me, there was plenty of conflict, but it wasn't-

Lewis Howes 1:05:11 For you to feel like you're out, though.

Dr. Sasha Hamdani 1:05:13 At one point we did break up, but it wasn't conflict on his and our part. I think it was-

Lewis Howes 1:05:19 Did you end it? Oh, so yeah, d- you still haven't been broken up

Lewis Howes 1:05:23 with. Yeah.

Dr. Sasha Hamdani 1:05:23 I did, but I think that that was, like, from a cultural perspective, we couldn't figure out-

Lewis Howes 1:05:29 Uh-huh

Dr. Sasha Hamdani 1:05:29 ... how to blend those two.

Lewis Howes 1:05:30 Is he a white guy?

Dr. Sasha Hamdani 1:05:31 Yeah.

Lewis Howes 1:05:31 Oh, wow.

Dr. Sasha Hamdani 1:05:32 Um, and so I was like, "I don't..." And, like, my family, it, it, I mean, it just, like, historically has-

Lewis Howes 1:05:38 Uh-huh

Dr. Sasha Hamdani 1:05:38 ... had arranged marriages.

Lewis Howes 1:05:39 Uh-huh.

Dr. Sasha Hamdani 1:05:40 This i- this was, like, so out of the norm.

Lewis Howes 1:05:42 What do you mean? You have love. Yeah, what is this? You're allowed to love someone? Yeah.

Dr. Sasha Hamdani 1:05:45 It's crazy because my parents were so in love. They were truly-

Lewis Howes 1:05:51 Wow

Dr. Sasha Hamdani 1:05:51 ... meant for each other, and so w- I had this, like, expectation like that's what it's gonna be. There's no... And then, you know, it just, it, it blossomed into this wonderful relationship, and then I was like, "Wait, but that's not what we're supposed to d- I'm, I'm not supposed to do that. My family doesn't want that." And, and then we had to-

Lewis Howes 1:06:09 So why waste your time with someone if you weren't supposed to do that?

Dr. Sasha Hamdani 1:06:13 I don't know.

Lewis Howes 1:06:13 [laughs]

Dr. Sasha Hamdani 1:06:15 I don't know. It, it, uh, it happened and-

Lewis Howes 1:06:16 Everyone goes through the phase, and then they're like, "All right."

Dr. Sasha Hamdani 1:06:19 He was so handsome.

Lewis Howes 1:06:20 Well, there you go.

Dr. Sasha Hamdani 1:06:21 [laughs]

Lewis Howes 1:06:21 There you go.

Dr. Sasha Hamdani 1:06:22 So I mean, it's, it's like given that opportunity, 10 out of 10 times-

Lewis Howes 1:06:25 Yeah

Dr. Sasha Hamdani 1:06:25 ... I'm gonna take that opportunity. But I-

Lewis Howes 1:06:27 But your fear of either rejection from your family-

Dr. Sasha Hamdani 1:06:30 Yeah

Lewis Howes 1:06:30 ... or society or the culture was like, "Oh, I'm not doing it the way it's supposed to be."

Dr. Sasha Hamdani 1:06:35 Mm-hmm.

Lewis Howes 1:06:35 And so part of you was afraid of that rejection feeling.

Dr. Sasha Hamdani 1:06:38 I don't wanna let down my parents.

Lewis Howes 1:06:40 Right.

Dr. Sasha Hamdani 1:06:40 I don't want to. And, and, um, since that time it's been, like, such a beautiful blending and everything has been great, but that initial period, I, I think-

Lewis Howes 1:06:51 Wow

Dr. Sasha Hamdani 1:06:51 ... it was too scary.

Lewis Howes 1:06:52 How long were you together for before that breakup?

Dr. Sasha Hamdani 1:06:56 Like three years.

Lewis Howes 1:06:57 Wow.

Dr. Sasha Hamdani 1:06:58 Too-

Lewis Howes 1:06:58 So didn't you know, though, going into it, like, "This isn't gonna last if the fear of rejection, I'm gonna back out eventually because it's not an arranged marriage"?

Dr. Sasha Hamdani 1:07:06 Okay, can I tell you though, because it was such a cute story that I was like, "It's fate. It... Clearly this has to w-" Like, we, we, I, we ended up seeing each other, and I saw him from, like, across a restaurant, and I was like, "Awesome." And so, like, I went and immediately talked to him. And he had been sent from across the street because the bartender across the street was like, "Go and talk to that girl. You'll like her." And then later I found out that my best friend's parents had been trying to set us up on a blind date for two years, and I kept saying like, "No, I don't wanna, I don't... Like, just show me a picture," and they wouldn't. And I was like, "The guy's gotta be a dog. Don't, like, no."

Lewis Howes 1:07:41 Wow.

Dr. Sasha Hamdani 1:07:42 And so I was just like, there's so many.

Lewis Howes 1:07:44 But then you had the fear after three years that like, "Ah, we can't do this. It goes against-"

Dr. Sasha Hamdani 1:07:48 It, I think it became so real because we're like, "Well, what do we do here?" Because I'm ending school.

Lewis Howes 1:07:53 Mm.

Dr. Sasha Hamdani 1:07:54 Like, I, like we're, we have been together. We love each other so much. Do we get married? Do we cut, like do we cut ties? Like, this is such a transitional spot. And then I was just like, [laughs] "Too scary. Too much." And like a- at that point, I was just like my parents were just s- had such a hard time with it that I was like-

Lewis Howes 1:08:16 Yeah

Dr. Sasha Hamdani 1:08:16 ... I can't... Yes.

Lewis Howes 1:08:17 For three years they had a hard time with it?

Dr. Sasha Hamdani 1:08:18 Oh, they didn't know for the first part.

Lewis Howes 1:08:20 Oh, wow. Wow. So the first couple years they didn't know.

Dr. Sasha Hamdani 1:08:24 I mean, not-

Lewis Howes 1:08:24 So you're also afraid, you're also afraid of the rejection from your parents that you weren't even telling them.

Dr. Sasha Hamdani 1:08:30 Yeah.

Lewis Howes 1:08:30 For a couple years.

Dr. Sasha Hamdani 1:08:31 But yeah.

Lewis Howes 1:08:32 Long distance.

Dr. Sasha Hamdani 1:08:33 Oh my God.

Lewis Howes 1:08:33 Wow. So you had a fear around-

Dr. Sasha Hamdani 1:08:34 Around this idea

Lewis Howes 1:08:35 ... the rejection from them as well.

Dr. Sasha Hamdani 1:08:37 Big time because I, I knew my expectation. What my expectation was is that you finish your educational kind of background and then you go into this next season of life, and at that point your parents know you so well, they find you a partner that-

Lewis Howes 1:08:51 Right

Dr. Sasha Hamdani 1:08:51 ... it's, they, you, and you date them for a while. If you like 'em, you get married to that person. If you don't like 'em, you try again. But it's someone that your family has vetted, and they know the family, and they know everything about them, and it's like it, it's like it's not even like just your parents. It's like you have this like-

Lewis Howes 1:09:07 Oh, really?

Dr. Sasha Hamdani 1:09:08 Yeah. You have like the weigh in from all these people of like, "I think that's gonna be a good match." So I just kind of assumed that was my trajectory. And so I was like when we got to this point where I'm like, oh, God, I, like this... I fell in love with this beautiful, beautiful person and my whole-

Lewis Howes 1:09:26 Emotionally evolves, beautiful, kind

Dr. Sasha Hamdani 1:09:29 ... and like-

Lewis Howes 1:09:30 And I'm gonna say no to him?

Dr. Sasha Hamdani 1:09:31 ... family. I mean-

Lewis Howes 1:09:32 [laughs] Oh, my God

Dr. Sasha Hamdani 1:09:33 ... we, I just... And everything-

Lewis Howes 1:09:35 I swear, when I hear, when I hear stories like this where people are watching or listening and like you found a dream man, and the other way would to be like, "What are you doing?" You know? It's like, how could you say no to this?

Dr. Sasha Hamdani 1:09:44 It, it's ins- and like, Lewis, you lay eyes on this man and-

Lewis Howes 1:09:49 Handsome guy, huh? Even I would be attracted. [laughs]

Dr. Sasha Hamdani 1:09:51 Yes. It's impo- like he will get stopped in public, and I'm like, "I'm right here."

Lewis Howes 1:09:57 Mm-hmm.

Dr. Sasha Hamdani 1:09:58 It's... But it is one of those things where I was so terrified of what does this mean? What does this mean for my relationship with my family?

Lewis Howes 1:10:08 Wow.

Dr. Sasha Hamdani 1:10:08 What does this mean? I cannot... I have to let this go. And so I think that was hard. And then, you know, it was-

Lewis Howes 1:10:17 So how did you get back together then? How did you overcome the fear of rejection from your whole community?

Dr. Sasha Hamdani 1:10:22 Yeah.

Lewis Howes 1:10:24 Your parents, your family, your extended family, everyone judging you, making you wrong for making this choice. How did you overcome that fear?

Dr. Sasha Hamdani 1:10:31 Now, keep in mind that even though all of this was kinda happening, I truly understood even, even as this was happening in real time, and I... He understood, too, which was incredible, that this is so culturally driven. This wasn't, this wasn't-

Lewis Howes 1:10:48 Yeah

Dr. Sasha Hamdani 1:10:48 ... that they hated him. This wasn't that they didn't trust me. It... Although I had a terrible track record. So, like, thi- this was, "This is what we do culturally."

Lewis Howes 1:10:58 Yes.

Dr. Sasha Hamdani 1:10:58 "Your mom and I are so happy. We want that happiness for you."

Lewis Howes 1:11:01 Yeah. Yeah. Yeah.

Dr. Sasha Hamdani 1:11:02 So after a month of us, when I told David, I'm like, "We can't talk 'cause it'll break my heart. You can't do that," this man calls me. I was in a call room in Phoenix, um, and I was on call, so I pick up the phone, and I was like, "I told you not to call." He calls me and he's like, "I will wait as long as it takes. If you have to... And I will move on when you get married." And I was like-

Lewis Howes 1:11:24 Holy cow

Dr. Sasha Hamdani 1:11:25 ... "I can't pass that up."

Lewis Howes 1:11:26 Holy cow. So what?

Dr. Sasha Hamdani 1:11:28 So then I was like, "All right. Then let's do this. Let's do it." And so then that next day I was like, "This is what's happening to my family."

Lewis Howes 1:11:35 Wow.

Dr. Sasha Hamdani 1:11:35 And it was a rejection. It wasn't... It was a cultural clash and they were like, "This can't work. Like we... This, this isn't... Like, he doesn't come from the same cultural background. How are you gonna raise kids together? Like, it's going to be a blend. There's gonna be too many barriers. We're so scared about this process."

Lewis Howes 1:11:53 Wow.

Dr. Sasha Hamdani 1:11:54 D- and it was difficult because for a while they weren't even... Like, the two parties weren't even interacting with each other because my parents were like, "Just m- m- make this go away." [laughs] I'm like, "We'll figure it out." And then we got all the way until, you know, we're, we're getting married and we're doing all these things. It, it, it, it was really after kids where it was just like everything kinda clicked into place and then my parents were like, "Oh, I get it." [laughs] Like, and it, it was just like that fear of me, like, not following cultural things. They could see then in, in their own way and their own conclusions that this is such a loving, supportive person who truly, like, cradles my whole life.

Lewis Howes 1:12:49 Wow.

Dr. Sasha Hamdani 1:12:49 Makes it so easy.

Lewis Howes 1:12:50 Wow.

Dr. Sasha Hamdani 1:12:51 And so, I mean, once they saw that and once they saw him as a father, once they saw him as a... It just, like, everything. And towards the end of my dad's life, my, uh, my husband's mom died of brain cancer, and so he knew this process. He was there like every second tending to my dad.

Lewis Howes 1:13:09 Oh.

Dr. Sasha Hamdani 1:13:10 I know.

Lewis Howes 1:13:10 My gosh.

Dr. Sasha Hamdani 1:13:11 I know.

Lewis Howes 1:13:12 I wanna give this guy a hug.

Dr. Sasha Hamdani 1:13:13 He's... You should. He's great.

Lewis Howes 1:13:15 How long have you guys been married now?

Dr. Sasha Hamdani 1:13:16 We just had our 10 year in October.

Lewis Howes 1:13:17 Holy cow.

Dr. Sasha Hamdani 1:13:18 Yeah.

Lewis Howes 1:13:19 Two kids, 10 years married, and you haven't run away.

Dr. Sasha Hamdani 1:13:24 No.

Lewis Howes 1:13:25 So-

Dr. Sasha Hamdani 1:13:25 I don't think I'm going to. I'm tired.

Lewis Howes 1:13:26 And so it's, and so it's like you've shown that like, hey- It doesn't have to be this cultural way to be the only way also.

Dr. Sasha Hamdani 1:13:34 Yeah.

Lewis Howes 1:13:35 Even though they rejected it or were not fans of it and pushed it away for a long time, it took time for you guys to face that together, but it seems like a beautiful love story.

Dr. Sasha Hamdani 1:13:45 It was... It's my favorite love story.

Lewis Howes 1:13:47 Wow.

Dr. Sasha Hamdani 1:13:47 But to be honest, I think that the cultural kind of expectation of an arranged marriage, really good for someone who's scared of rejection. I'm like-

Lewis Howes 1:13:55 I guess

Dr. Sasha Hamdani 1:13:56 ... this is already-

Lewis Howes 1:13:57 Yeah

Dr. Sasha Hamdani 1:13:57 ... this is already set for me.

Lewis Howes 1:13:58 But isn't it part of a human being's experience to have to overcome that fear of rejection rather than saying, "All right-

Dr. Sasha Hamdani 1:14:07 Yes

Lewis Howes 1:14:07 ... just take care of it for me and I'm gonna stay a kid forever because I'm gonna let my parents always do things for me instead of have the courage to face potential rejection."

Dr. Sasha Hamdani 1:14:17 I, I don't necessarily think having an arranged marriage, like I, I think there's so many people who do that and are perfectly-

Lewis Howes 1:14:24 Sure

Dr. Sasha Hamdani 1:14:24 ... evolved and they're, they're w- whole. For me, myself, if I had gone down that road, it was simply because I would be too scared to step out of that cultural lane.

Lewis Howes 1:14:36 Yeah.

Dr. Sasha Hamdani 1:14:36 And it was truly because he was so wonderful that I was able to, and it, like wonderful in a way that like most people would have, if there is a family that's like, "We don't want you." [laughs]

Lewis Howes 1:14:47 Yeah. He still stayed

Dr. Sasha Hamdani 1:14:47 ... still would want. Yes.

Lewis Howes 1:14:49 This guy.

Dr. Sasha Hamdani 1:14:50 It's like-

Lewis Howes 1:14:50 This guy's a saint.

Dr. Sasha Hamdani 1:14:51 I'm telling you.

Lewis Howes 1:14:52 This guy's a saint.

Dr. Sasha Hamdani 1:14:53 I'm telling you.

Lewis Howes 1:14:53 That's great. Uh, Sasha, I gotta get to the end here. I got a couple final questions for you. Before I ask them, I want people to check out your book, Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply.

Dr. Sasha Hamdani 1:15:04 Yeah.

Lewis Howes 1:15:04 I wish I had this book when I was a teenager.

Dr. Sasha Hamdani 1:15:06 Me too.

Lewis Howes 1:15:06 It would've helped me a lot. Um, this is a question everyone, I, I ask everyone at the end called the three truths.

Dr. Sasha Hamdani 1:15:11 Okay.

Lewis Howes 1:15:12 Hypothetical scenario, you get to live as long as you want on this earth, but it's the last day for you in the future.

Dr. Sasha Hamdani 1:15:18 Oh.

Lewis Howes 1:15:19 And you get to create and experience life on your terms, all your dreams come true. You write tons of bestselling books. It all comes true, you do.

Dr. Sasha Hamdani 1:15:29 Yeah.

Lewis Howes 1:15:29 But on the last day, you have to take all your work with you, and no one in this world has access to your content anymore. But you get to leave behind three truths, and from everything you've learned in life, everything you've learned in your work, family, relationships, you get to leave behind three truths, three lessons you would leave with the world. What would those three truths be for you?

Dr. Sasha Hamdani 1:15:53 Okay. The first one are... The, the first one is don't be scared of your emotions. Like lean into them. I think that's, that's a really important one that for me, even sometimes I'd be scared by the highs I would feel by something 'cause I'm like, "It's gonna go away." So just, like be able to feel them, be able to process them. That's one. The other truth is I think there's nothing more precious than time with loved ones.

Lewis Howes 1:16:28 Mm-hmm.

Dr. Sasha Hamdani 1:16:29 I just feel so strongly about that, and I feel like it, it takes, like if you're lucky enough to have those relationships where you can continue to cultivate and grow them and spend that time and energy, um, with that quality time, there's nothing better than that. And the third truth is to lead with kindness even when the world expects you not to. 'Cause I think the world is a hard place, and I think you just need to infuse more of what you wanna see.

Lewis Howes 1:17:06 Mm-hmm. That's beautiful. I wanna acknowledge you, Sasha, for the journey you've been on. I know it's not been easy, from the marriage stuff to your dad passing and all the things you've had to face in your practice. Um, and people need this work more now than ever. So I acknowledge you for putting this book out there, for sharing your content online, and for having the courage to face rejection yourself as a great example for other people as well. So I acknowledge you for that. Um, my final question, Sasha, what's your definition of greatness?

Dr. Sasha Hamdani 1:17:40 Greatness is truly understanding and being able to work with your brain. 'Cause I think that that lives in s- in us, and it's just a matter of understanding how your brain works and how to unlock that potential.

Lewis Howes 1:17:54 Hmm. Sasha, thanks for being here. Appreciate it.

Dr. Sasha Hamdani 1:17:56 Of course. Anytime.

Lewis Howes 1:17:58 Amazing. Powerful.

Dr. Sasha Hamdani 1:17:59 Yay.

Speaker 1:18:00 People will say to me, "Dr. K, I, I have no motivation." That's incorrect. You have a ton of motivation. You have a ton of motivation to stay home. You have a ton of motivation to play video games. There is such a powerful drive to return to the couch. So identity shapes motivation.

Lewis Howes 1:18:15 He is a psychiatrist, a Harvard trained physician, and founder of Healthy Gamer, one of the fastest gr-