"Why You’re Always Bored, Unhappy & Stuck" – Reinvent Your Life With This | Dr. K (HealthyGamer)

Dr. Rangan Chatterjee 0:00 Why is it in a world where people are more comfortable than ever before, have more material things than ever before, are so many people struggling and unhappy?

Dr. Alok Kanojia 0:16 Well, so it's, it's a great question, right? So the, the first thing I would ask is what is the correlation between having material things and comfort and happiness? So I think I, I basically have kind of three answers for you, okay? The first answer is we have to understand that the human body and the human mind don't wear out with usage. They actually rust without being used. So if you look at comfort, right? So if I start taking the elevator every day instead of the stairs, what will happen to my body? It'll actually start to get deconditioned. So I think what we're seeing in society is a whole scale deconditioning of certain neuroscientific circuits. So we have all of these technological tools, all of these comforts that make things easy for us. But if you're sitting at home on your couch, you're getting food delivery, you're working on your laptop, and you never have to physically move, even though everything can be brought to you, that actually makes you worse, not better. So there's a really interesting, um, mechanism here, which is if we look at serotonin production, and increased serotonin transmission is associated with improvements in depression and anxiety. We're not quite sure if deficient serotonin production causes depression or not. There's some debate in the academic community. But generally speaking, if your serotonin levels are high or your serotonin transmission is high, you feel better. So then the question becomes, what results in serotonin production? And actually overcoming adversity, doing hard work, accomplishing something, is what causes a serotonin improvement. So I think what we're starting to see a lot of is that people-- technology is basically deconditioning us mentally. We're taking the elevator every single day. We're becoming sort of mentally kind of weak, honestly. That's one of the reasons why we're seeing everyone feels like they've got ADHD. ADHD is kinda on the rise. And so as our brains are becoming more deconditioned, we're starting to struggle more.

Dr. Rangan Chatterjee 2:24 Yeah. So one, one reason is because this lack of usage is rusting our minds.

Dr. Alok Kanojia 2:34 Absolutely.

Dr. Rangan Chatterjee 2:35 Yeah.

Dr. Alok Kanojia 2:35 Right? So not just our minds, our brains too, which are two discrete things.

Dr. Rangan Chatterjee 2:38 Okay. How do you distinguish the brain and the mind?

Dr. Alok Kanojia 2:43 So, so your mind is, is the subjective experience of thoughts, emotions, and things like that. Your brain is a lump of tissue, neurons, blood vessels, astrocytes, myelin, all this kind of stuff. So oftentimes people think that the brain and the mind are the same, but that's not true. So if you sort of think about it like we can measure your brain. I can do something called an fMRI study, which measures blood flow to different parts of the brain. I can do something called an EEG study, which measures electrical activity across the brain. But there is nothing that I can do to measure a thought, right? Like, every person who's listening to this podcast right now is probably having a thought, but the existence of thoughts is not measurable 'cause they, they have no, they have no material. So the brain is sort of the, the material side. Like, it's like matter, right? It's like stuff that you can touch. It can be physically injured by a traumatic brain injury, and, and the mind is the subjective experience of, like, being human.

Dr. Rangan Chatterjee 3:49 Yeah.

Dr. Alok Kanojia 3:49 Or part of it anyway.

Dr. Rangan Chatterjee 3:51 Yeah.

Dr. Alok Kanojia 3:51 And those two things are different. And they, they connect. They talk to each other. So if you think in a certain way, it will alter your neuroscience, and if you alter the neuroscience, it will change your thinking. So there's a two-way street there.

Dr. Rangan Chatterjee 4:05 Yeah. No, I love that. Uh, g- now, going back to this idea that our bodies, our minds, our brains are rusting, I think we intuitively understand that through the lens of physical health, okay? Because that drum has been beat for many years, that we need to be more physically active, and, you know, the truth is, is that movement has been engineered out of our lives, so we've become more physically comfortable. But I think it's really interesting that we've also become more mentally comfortable as well. Now, as you were talking there, I was thinking these ideas of comfort are, are really, really interesting, aren't they? Because, uh, I mean, I wrote about this recently, that I was on a train to London, I would say a couple of years ago now. So I live in the northwest of England. High-speed, comfortable train to London, and the person I was traveling with got really, really frustrated because the app that basically allows you to order your drink from the cafe four carriages down wasn't working.

Dr. Alok Kanojia 5:16 [laughs]

Dr. Rangan Chatterjee 5:16 And I thought, "This is remarkable." 10 years ago, a service like this did not exist. You know that if you want a drink and you don't have it with you, on the train you have to get up, walk three or four carriages, choose your drink, pay the money, and walk back to your seats. Okay? No one had a problem with that back then. But now the knowledge that there is an app that can make your life easier, and then the app not working caused a friend of mine [laughs] quite an intense degree of frustration, right?

Dr. Alok Kanojia 5:51 Yeah.

Dr. Rangan Chatterjee 5:51 Which is fascinating, isn't it?

Dr. Alok Kanojia 5:53 Absolutely, right? So I think you're touching on so many things, Rangan. So the first is, like, expectations have changed.

Dr. Rangan Chatterjee 5:59 Mm.

Dr. Alok Kanojia 6:00 So there's sort of like a spiritual side to this and a neuroscience side to this. So let's talk about neuroscience first. So what are the ways in which we are, we have become mentally deconditioned?So the first thing that has become mentally deconditioned is our attention. So in the past, what would happen is when I went to school, right, I would have to force my mind. My mind wants to wander. It wants to wander over here, it wants to wander over there. I would have to force it to focus on something. I'd have to force it to focus on a textbook. I have to force it to focus on something at work. So most of the hours of the day, we had to kinda harness or rein in, we'd have to put our mind on a leash and tell it where to go. So if you look at technology, do you have to force your mind to be on TikTok? Do you have to force your mind to be on YouTube? No. So the way that, what technology has done is, is it has created so many natural pulls for our attention that we no longer have to force it to do anything. In fact, what's happened is we now have a mind that has been off the leash for so long. So when I'm on TikTok and I get bored of something, all I have to do is just swipe up, right? I, and now YouTube Shorts has a swipe function. I'm sure Instagram Reels has a swipe function. So now the second I get bored, I don't have to force my mind to do anything. It gets to run over w- whatever it wants to. If it gets bored over here, we're gonna switch over to YouTube. If it gets bored with YouTube, we're gonna switch over to Instagram. So the mind does not need its attention to be directed, and this is what people experience, right? So any time you're using technology, you tell yourself, "Hey, this is a waste of time. I need to stop." But you can't control your mind. It's like your mind has become this bear that is off the leash and runs wherever it, it wants to. This is why we create doom-scrolling, right? So, like, people are just sitting there scrolling on their phone for hours and hours. The average cellphone use is somewhere between four and a half hours to up to eight hours a day. Like, this is, like, really common for people now, and that's because our attention, the ability for us to tell our mind where to go, which is what attention is, right? Pay attention. Shift your mind from this distraction over to what you need to focus on. Our, our atte- our capacity to restrain attention is, is literally becoming weakened or atrophied.

Dr. Rangan Chatterjee 8:28 Yeah.

Dr. Alok Kanojia 8:28 Primarily through technology use. That's one of the things. Second thing that we're really getting, this is terrible, i- is emotional regulation. We are losing the capacity to regulate our emotions, which is literally wh- what we saw in this example. So this person can't get a drink delivered because of an app. In the grand scheme of the 75 years that they're on this earth, what difference does that make? They can get their asses up and walk a couple of carriages or not, and it's, like, not that big of a deal. But what's going on in this person's brain is the emotional centers of their brain have become hyperactive, and the reason they've become hyperactive is because we've relied on technology to do our emotional regulation for us. Any time you use basically a technological device, it can be video games, it can be social media, it can be scrolling on your phone, it can be pornography. All of these technologies basically suppress our emotional circuitry. So when we have something from the outside shutting off something in our brain, our brain loses the capacity to regulate itself.

Dr. Rangan Chatterjee 9:42 Mm.

Dr. Alok Kanojia 9:42 Right? A really good example of this is it's not just our brain. So let's say that I'm, I, I'm used to air conditioning and climate control 24 hours a day, seven days a week. I'm in perfect weather all the time. If I go into an environment that's a little bit hot or a little bit cold, I will feel uncomfortable. And on the flip side, there are people who live in countries where, where there aren't air conditioning, there isn't heating, and their capacity to tolerate higher or lower temperatures is way better because their body can regulate their temperature i- in a subjective way more effectively. So we're all losing our capacity to emotionally regulate. We're seeing this a ton with parents. Kids are getting, throwing temper tantrums when you take away their video games. Like, you know, everyone's kinda getting more frustrated with each other.

Dr. Rangan Chatterjee 10:31 Yeah.

Dr. Alok Kanojia 10:31 So we're, we're losing the capacity to emotionally regulate, and when we lose the capacity to emotionally regulate, we would predict increases in depression, increases in anxiety, and we're absolutely seeing that.

Dr. Rangan Chatterjee 10:43 Yeah. It's absolutely fascinating. We think about this relationship with comfort or discomfort and our physical and mental wellbeing. Couple of things came up for me there. Number one, you mentioned temperature-controlled houses, okay? Air conditioning or central heating, whatever it is, this idea that we no longer need to tolerate differences in temperature, okay? And then the first thought that came into my mind was the modern, um, what's the word? The modern kind of trend for cold plunging. Now, to be clear, I, I know there are benefits of cold plunging for some people. It can be an incredible practice. But it's interesting, isn't it, that as we've got to these more temperature-controlled lives, there is a desire with many people to experience the cold. Do you know what I mean?

Dr. Alok Kanojia 11:32 100%, Rangan, and I think that's, that's not a coincidence. So-

Dr. Rangan Chatterjee 11:36 Exactly

Dr. Alok Kanojia 11:36 ... along with the rise of, of cold plunging, we're also seeing a whole scale interest globally in meditation.

Dr. Rangan Chatterjee 11:45 Yeah.

Dr. Alok Kanojia 11:45 Right? So I, I think just like when the body is thirsty, it craves water. So what I think a lot of people are discovering, they don't necessarily understand the neuroscience and the physiology behind it, but what they're discovering is, as my mind becomes deconditioned, if I do things that are mental conditioning, my life will improve. So now what's starting to happen is people are living lives of comfort. They're living lives where their mind is easily distractible, hard to pay attention, difficulty with emotional regulation.And when people stumble into practices that fix these problems, they love it. They absolutely love it.

Dr. Rangan Chatterjee 12:26 Mm-hmm.

Dr. Alok Kanojia 12:27 Right? So if you're someone who takes the elevator, it feels a little bit uncomfortable to take the stairs, but even after you, if you go work out or you go take a walk, you kinda come back and you're like, "Wow, I like, I feel so much better. Even though I feel tired, even though I feel achy, there is some part of me that feels better because something feels a little bit more balanced."

Dr. Rangan Chatterjee 12:47 Yeah. It's interesting. I internalized this rule a few years ago. Basically, I was thinking a lot about comfort and my own relationship with comfort and discomfort. And I thought, "Okay, Rangan, you need to, or not you necessarily need to, you might benefit from putting some things in place that allow you to experience discomfort more regularly." And a very simple one that was transformative for me, and has been for many of my patients in the past, is this idea that I'm always going to take the stairs barring exceptional circumstances. So it was a one-time decision, a rule that I internalized. I've gotta say, for about five years or so, it's been life-changing. And I think the reason it's been life-changing is not just for the physical benefits. Sure, if I'm going up four flights of stairs to get to the supermarket car park with my bags, of course there are physical benefits, hormonal benefits, insulin sensitivity, et cetera, et cetera. But I honestly think, Dr. K, for me, the main benefit, or the biggest benefit is psychological, this idea that I chose discomfort when I didn't need to.

Dr. Alok Kanojia 13:58 100%. So it's more than that. So not only is it psychological where you chose discomfort, it's neurological too. So when you do that, there's this part of your brain called the anterior-

Dr. Rangan Chatterjee 14:09 Yeah

Dr. Alok Kanojia 14:09 ... cingulate cortex, which is kinda like where willpower comes from. It's where internal conflict is managed in your brain. So when you feel like taking the elevator and you choose to take the stairs instead, the anterior cingulate activates, you fight a war within yourself, and then you end up hopefully taking the stairs. So when you do that, and I see this all the time in my clients as well, when they start embracing discomfort instead of avoiding it, their life becomes way better. And the reason for that is not just because, l- as you mentioned, there's physical health benefits of taking the stairs, but you are training your capacity to do the right thing which feels bad instead of the wrong thing which feels good. And there's another really interesting manifestation of your anterior cingulate being boosted, which is in your language. So earlier when you were sharing that example, if people re- rewind, they will hear you say, "It's a rule that I made myself do." You said something like, "I need to take the stairs." And you immediately caught yourself.

Dr. Rangan Chatterjee 15:14 Yeah.

Dr. Alok Kanojia 15:14 And you said, "I don't need to. It's something that I would like to do," or something like that. Did you-

Dr. Rangan Chatterjee 15:20 Yeah, or choose. Yeah, exactly.

Dr. Alok Kanojia 15:21 Yeah, right? So what you did right here is-

Dr. Rangan Chatterjee 15:23 And, and I saw you smile as I reframed that as well, which is interesting for me.

Dr. Alok Kanojia 15:26 Yeah. Ri- right? So, so what's happening that in real time is you have this habit formed in your brain of pushing yourself, 'cause you're, you're a doctor, right, Dr. Chatterjee? And if we're doctors, good Indian doctors like ourselves push ourselves really hard, right? We have to be successful. We need to work really hard. We're sort of trained in this way. It's not just Indian doctors, right? A lot of people push themselves really hard. "I need to do this. I need to do this." And then the anterior cingulate comes in and, first of all, raises awareness to some of these, like, toxic productivity kind of habits where we-

Dr. Rangan Chatterjee 16:03 Mm-hmm

Dr. Alok Kanojia 16:03 ... we beat ourselves up. And then also, in real time what you're doing is, like, reprogramming yourself. "I need to take the stairs. No, no, no, I'm gonna choose to take the stairs. It's good if I take the stairs." And so that mental reprogramming, reprogramming your habits, also comes from the anterior cingulate cortex.

Dr. Rangan Chatterjee 16:21 Yeah.

Dr. Alok Kanojia 16:22 So it, it, it's kind of really fascinating, but j- the simple decision to choose to take the stairs on a daily basis, unless there's some kind of emergency or something like that, can actually help you program all kinds of other habits, because we are leveling up our brain's capacity to change our habits.

Dr. Rangan Chatterjee 16:41 Yeah. Yeah, I love that, and I love this idea that wherever you choose to embrace discomfort in your life, it's not only that your ability to do that thing improves. So me doing that doesn't just improve my ability to keep choosing the stairs, it has knock-on benefits into other aspects of my life as well.

Dr. Alok Kanojia 17:03 Yeah. So this is where things get a bit technical, but there are three or four things that are called transdiagnostic categories in psychiatry, and these are things that contribute to basically all mental illness. So th- th- what people sort of figured out, the way this research worked is they were looking, they, they noticed that a lot of people who have depression also have anxiety. And they were like, "Why is that? Is there a root cause for both depression and anxiety? Is there a root cause for both depression and addiction?" And what they discovered were three or four things that are basically the root causes of all mental illness, and one of them is distress tolerance. So your capacity to tolerate distress. If you have a high distress tolerance, your likelihood of developing an addiction, your likelihood of developing an anxiety disorder goes way down. Your ability to set boundaries gets way stronger with distress tolerance. So if you can handle discomfort, 'cause I work with a lot of people who are addicted, and their big problem is they can't handle discomfort. If I feel anxious, I'm having trouble sleeping, I feel like I've got insomnia, let me get high so I can fall asleep. If I'm anxious, I need to, uh, get high. If I'm going and socializing, I have social anxiety, let me take a couple drinks of alcohol to calm myself down. So literally their capacity-To tolerate distress is low. And when your capacity to tolerate distress is low, you lean on things outside of you to manage your internal environment, like YouTube, like TikTok.

Dr. Rangan Chatterjee 18:41 Yeah.

Dr. Alok Kanojia 18:42 When we're, when we've had a hard day and we're feeling frustrated, what do we, what does our brain crave without even realizing it? After you have an argument, no one goes and sits quietly and ponders the nature of the argument. Everyone w- walks out of the room, pulls out their phone, and starts scrolling, and that's because our brain knows that this is going to regulate my emotions. It'll calm me down. But that's harmful over time, right? So you're, you're developing distress tolerance. It's fantastic.

Dr. Rangan Chatterjee 19:09 Yeah. It's kind of interesting that you mentioned root cause there, and one of the things that I guess I love about your online content and your videos is this blend of East and West, okay? So you're a Harvard-trained medical doctor. You've also spent time training to be a monk in India, right?

Dr. Alok Kanojia 19:32 Mm-hmm.

Dr. Rangan Chatterjee 19:32 And I think there's this beautiful balance and combination between West and East, something that I very much lean into and, for much of my career, ha- have very much tried to integrate those two philosophies together in a harmonious way. I think you do that so beautifully well. When you said about the root causes of various mental illnesses, [lips smack] I, I kind of, I thought, "Okay, well, then, it, it... There's a, there's a real issue here, isn't there, between the way we look at illness in the West and in the East?" These are very, very broad terms, okay?

Dr. Alok Kanojia 20:08 Mm-hmm.

Dr. Rangan Chatterjee 20:08 But Western medicine, allopathic medicine, tends to be, in my experience, quite reductionist and looks at all these diseases o- as separate things. We give them labels and, you know, depression is different from anxiety, which is different from, you know, something else. And the same thing with physical health. "Oh, no, you've got... Th- those gut symptoms are, um, this condition or this condition or that condition." Whereas Eastern philosophy, and I guess things like traditional Chinese medicine and Ayurvedic medicine, would be very much more holistic and go, "Well, what... You know, this symptom is a sign of some kind of systemic imbalance in the body," right? So through the lens of Western medicine, yeah, great, we're looking at those different mental illnesses, and you're saying, yeah, there are, there are sort of some root causes. One of them is distress tolerance. And I guess we could apply that same principle to a lot of physical health issues, where we could say, well, the root cause is actually chronic unresolved inflammation.

Dr. Alok Kanojia 21:10 Sure.

Dr. Rangan Chatterjee 21:10 So instead of treating these conditions as separate things, we could actually get to the root cause and go, "Okay, what's pro-inflammatory in this patient's life?"

Dr. Alok Kanojia 21:20 Mm-hmm.

Dr. Rangan Chatterjee 21:20 "How can I reduce that? How can I increase the anti-inflammatory nature of their lifestyle," for example. And I would similarly see downstream benefits in a variety of different conditions.

Dr. Alok Kanojia 21:33 Absolutely.

Dr. Rangan Chatterjee 21:34 Does that all make sense so far?

Dr. Alok Kanojia 21:35 100%, right? So we know that there's an inflammatory hypothesis for depression as well.

Dr. Rangan Chatterjee 21:40 Yeah.

Dr. Alok Kanojia 21:41 Right? So whether someone has IBS, whether they've got a- seasonal allergies, whether they've got depression, reducing their inflammatory burden absolutely improves all of those things.

Dr. Rangan Chatterjee 21:52 Yeah. So it's interesting that, you know, y- I think you said there were three... Did you say there were three root causes of mental illness?

Dr. Alok Kanojia 21:59 Three or four, yeah.

Dr. Rangan Chatterjee 21:59 Three or four. So one of them is distress tolerance. What were the others?

Dr. Alok Kanojia 22:03 Yeah, so perfectionism is another big one. So when we're, like, very, very hard on ourselves, that's one of the other trans- transdiagnostic causes. There's debate over, uh... So I... There, there are a couple that I've seen. Those are the two biggest that I think have the strongest level of evidence, is distress tolerance and perfectionism. There's debate over what the other two really are.

Dr. Rangan Chatterjee 22:25 Yeah.

Dr. Alok Kanojia 22:25 So we're not 100% sure. But some people, and this has to do with factor analysis, so if... I mean, this gets a bit technical, but when you do factor analysis, you'll basically come up with, like, four major factors. I think distress tolerance and perfectionism I think are the two that are the most significant.

Dr. Rangan Chatterjee 22:43 And those two are, of course, the two that we can make a quite simple and logical case that the [chuckles] modern world and the way we live today is ramping up, right? We no longer need to face discomfort or that boredom, which for many people is intolerable. And of course, perfectionism has been on the rise. You know, when I looked at the research of this, I thought, "Oh, this must be, uh, down to social media." But the research suggests it's from the 1980s that perfectionism has been on the rise, certainly the research I've been looking at, which is really interesting, this idea that, you know, where are these cultural ideas coming from about what it means to be a successful human. You know, the billboard idea of success and happiness, those two things are being ramped up in the modern world, and it, and of course that will be linked with all kinds of different mental illnesses.

Dr. Alok Kanojia 23:36 Yeah. So I, I think it's, it's great that you mentioned, you know, this, um, this sort of perspective on, on physical health of, of being reductionist versus holistic. If I can talk about that principle of East versus West in, in mental health for a second. So when we're talking about physical versus mental health, you know, you mentioned inflammation. So I think there's one huge difference in the way that the West approaches the mind and the East approaches the mind, okay? So in the West, our system of medicine is me doing something to you or you doing something to me, right? So our, our idea of health or the practice of medicine in the West is, like, you know, a doctor prescribing a medication. And we do this in psychiatry too, where if you are mentally unwell, the right answer is for an expert to come and fix you through something like psychotherapy or psychopharmacology.The big difference between West and East when it comes to mind is o- o- in, in the Eastern side, they were do it yourself, DIY, right? So all of the Eastern interventions for the mind, or a lot of the Eastern interventions of the mind, what we call yoga and meditation, are designed to be done by the person who has the mind. So they're, they're designed, all the interventions of the East are for you to do for yourself. In all of the interventions of the West, literally we have these, you know, gigantic research or RCTs, randomized controlled trials, on this kind of psychotherapy, dialectical be- behavioral therapy, cognitive behavioral therapy, acceptance and commitment therapy, motivational interviewing. We have all these trials on different psychotherapies to help human beings with their mental problems. The big problem with all of those things is they have to be done by a therapist.

Dr. Rangan Chatterjee 25:25 Mm.

Dr. Alok Kanojia 25:25 Whereas if you look at yoga, you look at meditation, what they did is they said, "Hey, if there's something going on in my mind, I know it sounds kinda bizarre, but no human being can read my thoughts," right? So this is a huge weakness that we have in psychiatry. This is one of the reasons why I think mental illness is getting so much worse. Because if we look at physical medicine, I can understand what's going on in your body even better than you can. I can X-ray you. I can do a CT scan of your brain and see if there's a mass in there. I can measure-

Dr. Rangan Chatterjee 25:58 Mm

Dr. Alok Kanojia 25:58 ... your blood and detect things. I can detect an iron deficiency that you may not be able to detect. But when it comes to the mind, we have no way of measuring the mind. The only way to detect the mind is through your own observation, which is why, one of the reasons that, you know, I, I'm a psychiatrist, but I, I do so much of meditation and yoga, and we can talk about that, by the way.

Dr. Rangan Chatterjee 26:20 Yeah, for sure.

Dr. Alok Kanojia 26:20 We can talk about how to find happiness and comfort and all those kinds of things in a way that anyone who's listening to can apply themselves, right? You don't need an expert to apply it, because you're the only one who can observe your mind. You're the only one who can change your mind, right? So when it comes to the level of mind, the individual is the one who actually has the most power, and in the East, their interventions of mental health have you fixing your own problems because it is technically impossible for someone else to do it for you.

Dr. Rangan Chatterjee 26:53 Yeah. No, I love that distinction. I'm totally on board. And I guess one of my biggest frustrations throughout my medical career, particularly in the early days when you're trying to fit in and you're like, "Ugh, you know what? I've been told to practice like this, or this RCT, this randomized control trial, tells me for a patient like this, this is the treatment I need to give." I've always thought, "Yeah, but I'm not sure that is the right thing for this individual with their-

Dr. Alok Kanojia 27:22 Yeah

Dr. Rangan Chatterjee 27:22 ... life experience and their preferences and their culture." And, and that, I think that's one of the reasons why I like your work so much, is it, it's, it seems to very much have this grounding in both. Because it's very easy to go, "Oh, you know, all Western medicine is not so good," or, "All Eastern medicine is not so good." And it's like, well, hold on a minute. They've all got strengths. They've all got weaknesses. In fact, let me put it to you. Dr. K, ha- having sort of studied both sides of this, what would you say are some of the strengths and weaknesses of both Western medicine and Eastern medicine?

Dr. Alok Kanojia 27:57 Speaking broadly, the basic problem with Eastern medicine is reliability. So if I go to an Ayurvedic doctor, what can I expect? I have no idea, right? So if treatment ... Le- let's say that treatment is, you're saying, like, treatment is highly individualized, right?

Dr. Rangan Chatterjee 28:13 Sure.

Dr. Alok Kanojia 28:13 Which means that w- w- I need to do one specific treatment for you, one specific treatment for your friend, a third specific treatment for your spouse, let's say. Now, if I'm a doctor and I do three different treatments for three different people, and let's say none of them get better, is the problem that their diseases are really, really hard to treat, or that I'm a bad doctor? How will we ever know, right? So the, the problem with individualized treatment is that it becomes incredibly hard to measure efficacy. It becomes incredibly hard to measure reliability. So as a simple example of this, you know, I, I gravitated towards certain things. I'm a Reiki healer. I'm an energy healer. I'm a trained energy healer. It's not something that I do as a part of my practice. And the reason for that, I almost never refer people to energy healers, because in my experience as a clinician, I've seen some energy healers who can do, I think, some medically impossible things, and I've seen the majority of energy healers who are not able to do that. So there's, there ... Anytime we are super, super individualized, reliability becomes a problem, and this is why allopathy has dominated the world.

Dr. Rangan Chatterjee 29:27 Mm-hmm.

Dr. Alok Kanojia 29:27 Right? So the reason that we have allopathic medical schools in basically every country on the planet is because there is a minimum level of reliability-

Dr. Rangan Chatterjee 29:36 Yeah

Dr. Alok Kanojia 29:36 ... with medicine. If I give you a statin and I give someone else a statin or something like that, we've even calculated, you know, the number needed to treat for a statin is somewhere between, like, eight and 40. I'm rusty on the statistics. So we know exactly, we can look at a large population. So even though there's a difference between a population and you, we can make broad predictions which, generally speaking, are correct on the allopathic side. The problem is that those, the, the, the answers that allopathy gives us will never perfectly apply to an individual.

Dr. Rangan Chatterjee 30:12 Yeah.

Dr. Alok Kanojia 30:13 Right? So allopathy is a population-based medicine. It's like we're gonna do what on average works for everybody. So what that means is i- i- it's great because, you know, if I, if I give a bunch of kids Adderall, on average, their school performance will improve. But the problem is that it's not individualized, so it will never be ideal to an individual patient.

Dr. Rangan Chatterjee 30:37 Yeah.

Dr. Alok Kanojia 30:39 I think that, uh, specifically when it comes to psychiatry, like I said, I think that Western medicine is missing something very crucial, which is that if you look at therapists, how does a therapist know what's going on in your mind? They ask you questions, right? And as I ask you questions, you give me answers, and then I use those answers as ways of trying to understand what's going on in your mind. But for you and anyone else listening, what is the difference? What is the gap between your thoughts and your words? It's huge.

Dr. Rangan Chatterjee 31:15 Yeah.

Dr. Alok Kanojia 31:17 So the basic weakness in psychiatry is that we're working on the mind, but no one else knows your mind as well as you do.

Dr. Rangan Chatterjee 31:27 Yeah.

Dr. Alok Kanojia 31:27 So, so when I practice clinically, you're spot on that I combine the two. I don't... I mean, I have seen sustained remission because, you know, we don't... The word cure is, is, is, has all kinds of problems when it comes to mental, mental illness. But I, you know, 70% of my pa- patients who come in on pharmacologic medications will be off of them and stable within 12 to 18 months. So w- I, I think there are so many things that we don't understand about how to create a healthy mind, that if you teach people these techniques, the need for medication goes away.

Dr. Rangan Chatterjee 32:00 Yeah. One of the most important pillars for our health is, of course, nutrition. But I think because of our busy, stressed out lives, so many people are struggling despite their best intentions. So many patients over the years have told me that they know what they should be doing, [laughs] but they're struggling to actually do it, and that's why I'm a fan of AG1. AG1 is a daily health drink that contains over 70 vitamins, minerals, and other ingredients that are designed to make nutrition really easy. It's been in my own life for over six years now. It's simple, it's tasty, it's convenient, and it forms a part of my morning routine. People will routinely tell me that taking AG1 regularly has improved their focus, their cognition, their energy. Some people even tell me that they drink less coffee when they're taking AG1. And there's research out there showing us that taking AG1 regularly can improve specific markers of your gut health, which is really good for your immune health. So if you're looking to upgrade your own nutrition in a simple, tasty, and convenient way, try AG1. To get a free bottle of vitamin D and five free travel packs, go to drinkag1.com/livemore. Now, I'm a huge fan of VIVOBAREFOOT shoes. I've been wearing them for about 12 years now, and one of the main reasons I love them is because when I'm wearing Vivos, I feel fully connected to the ground beneath my feet. What do we want? We want feet that move naturally, and because Vivos are wide, thin, and flexible, your foot can move in the way that it's meant to. A lot of modern shoes are stiff, they're narrow. They start to manipulate the way your foot functions, whereas in Vivos, your feet can do what they're meant to do, and that means they help your feet become stronger. There was this trial that showed within four months of wearing Vivos, your feet are around 60% stronger. Your feet are your foundation, and when you've got problems in your feet, it goes all the way up the chain. It can go to your ankle, to your knee, to your hip, to your back, and even to your shoulder and neck. And as a doctor, I have seen back pain, hip pain, and knee pain actually start to get better when people start to wear barefoot shoes. To get 20% off your first order, go to vivobarefoot.com/livemore.

Dr. Alok Kanojia 34:34 A- and even when we talk about, like, technology use, like, y- you know, we're a Healthy Gamer, which means that we're not saying you need to stop using technology. What we're saying is you need to understand how technology affects your mind, how it affects your brain, understand what's going on within you so that you can make some intentional changes, and then the, like, addictive technology usage will fall away on its own.

Dr. Rangan Chatterjee 34:56 Yeah.

Dr. Alok Kanojia 34:57 Right? That's what we see time and time again in our community.

Dr. Rangan Chatterjee 35:00 Yeah, no, I, I love that. It's really interesting because, of course, if we think about these broad terms, allopathic medicine versus more, I guess, holistic Eastern medicine, yeah, you know, allopathic medicine has more kind of robust trials saying, "On average, for this population, we're gonna see this," right? So that has a... That's a pro. Again, that same, uh, fact can also be a weakness because if you're not one of those averages, that same thing is no longer a strength, it's a weakness. Vice versa, you're a, you're a holistic practitioner. You're paying attention to the story, the unique life experiences. You understand that that trial that was published in Nature last month may or may not be relevant for the individual in front of you, yet you can't prove it. So on a kind of wider scale, when we're trying to analyze outcomes for, let's say, insurance or here in the UK for the National Health Service, then it becomes slightly problematic. So these things can be both strengths and weaknesses, the same thing, depending on through which lens you look at it. At the same time, I would say one of the other sort of through the lens of mental health and psychiatric conditions, if you, if the only way that you can feel good or get better is with that pill from that doctor, right? There is a reliance that then is created, right? So there's a dependency, which is one of the weak- for me, one of the weaknesses of, I can't say allopathic medicine as a whole, but the way it's often practiced, I should say... is that we don't always give our patients a sense of agency, right? It's like, no, no, no. The, yeah, you've got this thing.

Dr. Alok Kanojia 36:47 Mm-hmm.

Dr. Rangan Chatterjee 36:47 Let, let me tell you what's going on, and this is what you take, or this is the person you see, which, sure, may work temporarily, but in the long term... I mean, you know, I've been a, a, what is it now? 23, 23 and a half years since I qualified as a medical doctor. I would probably say that the number one thing I've learnt and I've experienced is that you have to give that patient a sense of agency before they walk outside that door. I think for me, that's always been one of the most important things. So few things there. I don't know if you have any comments on what I've just said, whether you agree, disagree, but I'd love to hear your perspective.

Dr. Alok Kanojia 37:22 Yeah. So I mean, I, I, I, I, I love what you said. I, I think I would add some nuance to it. I don't disagree. So let, let's start with this idea of, like, medication doesn't fix anything. So generally speaking, I agree with that. And we also know that, for example, SSRIs, which are a very common treatment for depression or mood disorder, um, trigger the ... Basically, all treatments of depression have one common root, which is they trigger the increase of BDNF, which is brain-derived neurotrophic factor. So one of the reasons why SSRIs, they take four to eight weeks to work. Like, you don't feel them right away. So it's not, it's not that you're becoming dependent on a pill, it's that the pill is triggering growth in your brain in some way, right? So BDNF, like, causes remodeling of the brain. It causes, like, growth of astrocytes and microglial cells and things like that. So it's almost like stimulating growth, and a lot of people who get started on an SSRI can actually be pulled off, like, very successfully given certain circumstances. So I think that there is some evidence that some medications in psychiatry you can use for a limited amount of time, and then you no longer need them. The problem is that for many people and many practitioners, they end up in the scenario that you described, which is that once you get started on a pill, th- they're just gonna keep you on it, right? And there isn't this, um, uh, there isn't this drive to sort of fix things at the root, and a really good example of this is, like, stimulant medication for ADHD, which, it, which shows that basically, like, the, the problem with stimulant medication, like metham- I mean, uh, amphetamines, like, uh, dextroamphetamine and things like that are, or methylphenidate, is that these medications make people feel way better, but their symptom improvement with ADHD is only 30%. So they feel like they're non-functional without the medication, and the medication changes their lives. There's a great, um, there, there's a great, uh, uh, p- meta-analysis that just came out, maybe in BMJ actually, that showed that basically, like, the symptom improvement from stimulant medication for ADHD is about 30%, and if you do cognitive behavioral therapy for 26 to 52 weeks for ADHD, the improvement is 69%, and the improvement from cognitive behavioral therapy lasts two years or longer, whereas the benefits of stimulant medication lasts for about six months. So we absolutely see this scenario where people will take medication. They subjectively feel way better, but they are not nearly as functional as they think they are. And if they go this more permanent route, through something like psychotherapy, if they start meditating, things like that, then they will get substantially better. So in general, I agree with your point. The one thing [laughs] I know it sounds so crazy, but the one thing that I may disagree with is you're saying empower your patients, which I'm all for. So patient empowerment is great, but if you work with a population of people who have ADHD and love their stimulants, empowering patients by giving them lots of stimulants is sometimes not the right idea. [laughs]

Dr. Rangan Chatterjee 40:37 Yeah. Well, just to be clear, when I say empowering patients, it's not about empowering them necessarily with drugs or stimulants. It's this idea that actually ... I, I have this belief, this strong belief that when a patient leaves, a patient, a client, depending on what profession you're in, right, when they leave your door, when they, when they walk out of the consultation, they have to believe that there's something they can do in their life that makes a difference. And this goes back to what you said before about things like yoga and meditation and other things that we can do to process our thoughts, to, you know, experience our mind in a variety of different ways. We have to believe, surely, as human beings, that we have some degree of agency over our lives, and that's certainly one of the things ... I'd say one of the biggest things I have tried to give patients throughout my clinical c- career, is that sense of agency and empowerment.

Dr. Alok Kanojia 41:39 Yeah. You know, when patients come into my office wanting stimulant medication for ADHD, the whole problem is if they don't get it, or if they do get it, when they walk out the door, they don't believe that there's anything else that they can do, right?

Dr. Rangan Chatterjee 41:54 Right.

Dr. Alok Kanojia 41:54 They believe this is the only thing. So even if they get the medication or don't get the medication, with the way that you clarified, in either case, they feel completely disempowered when they walk out the door, even if they get what they want.

Dr. Rangan Chatterjee 42:07 Okay. So how do you handle that? So let, let's take that as a scenario, okay? You've got this patient who wants that stimulant medication, and I know there's, it depends on the patient and a whole host of different things, but are there any sort of principles there that you kind of go through that can help us understand how, in that scenario, empowering that individual may not be the best approach?

Dr. Alok Kanojia 42:32 Yeah. So I, I think the empowerment, the way you define it, is great. I, I, I-

Dr. Rangan Chatterjee 42:35 Okay

Dr. Alok Kanojia 42:35 ... I think that's good, which is, like, helping this person understand, hey, there's something you can do. So I, I think it's ... I, I'm a little bit lucky this way because generally speaking, people come to me because they want to do more than medication.I'll absolutely get what we call medication-seeking patients who want stimulants, and I'll, I'll tell them straight up, like, you, you know, I'm happy to prescribe stimulants, but as part of a treatment plan, like a comprehensive treatment plan. And if that's what you want, I'm the right doctor for you. If you're looking for someone who just is gonna prescribe you medication and you're gonna walk out the door, and that's the kind of treatment you want, that's also okay. There are many millions of people on the planet who don't wanna do psychotherapy, don't wanna meditate, don't wanna do yoga. I just don't think I'm the right doctor for you.

Dr. Rangan Chatterjee 43:23 I wanna talk about some of these practical techniques that you've sort of hinted at. But before we get there, just a couple of words you said before which, um, sort of stuck in my head, sustained remission. I thought that was really interesting, this idea that many of the patients in your practice with mental illness, you and your team are able to put into sustained remission. You said we don't use the word cure. Now, I thought that was quite interesting, and I, I just wanted to get your thoughts on that. And I guess this probably is partly to do with the difference between physical health and mental health.

Dr. Alok Kanojia 43:58 Yep.

Dr. Rangan Chatterjee 43:59 Um, but let's say, I don't know, let's say you had a pneumonia, okay? So you, you, you, you go see a doctor, you're diagnosed with a pneumonia. It's put on your records, and you get given antibiotics to treat your pneumonia. At the end of that course of antibiotics, on the assumption that your cough and your fever and your sputum has gone, we don't say that your pneumonia is in remission, okay?

Dr. Alok Kanojia 44:31 Right.

Dr. Rangan Chatterjee 44:32 Right. Um, so the point I'm trying to get to is, is it different or do you see it differently with mental illness? Um, for example, if someone, for example, when they were 19 years old, because of a variety of different life experiences, ended up being diagnosed with depression by their, by their primary care physician or their psychiatrist, and they did a series of things. They were empowered by their practitioner, and they meditated, they did yoga, they didn't use technology the first hour of the day, and they got to know themselves better, and they never, ever had another episode again that would be classified as depression. Is it still fair to say that's a sustained remission?

Dr. Alok Kanojia 45:23 So it, it's exactly what you said. Like, your, your example is perfect, too. So let's understand. So when I say people are in sustained remission, let's understand the time point that I'm at. So someone comes into my office, right? Happened all the time, right? I was in Boston, so I'd get kids from Harvard or MIT or Emerson or whatever, a huge college town. 19-year-old comes in with an episode of depression. Three years later, there's no depression, right? So I worked with this person for three years. They're now 22. Have they been cured? Are they gonna get another episode when they become pregnant? Are they gonna get an episode after they give birth? Are they gonna have an episode when they have divorce? We don't know. So if they never have another episode for the remainder of their life, could we call it a cure? Maybe. But the whole point is that we don't know, right? So the nature of mood disorders is that they are episodic. They're not there all the time.

Dr. Rangan Chatterjee 46:15 Mm-hmm.

Dr. Alok Kanojia 46:15 So they come and they go. Now, the, it, this, it, it, it... The example that you use for pneumonia is also fantastic because we know the pathophysiology of pneumonia. We know what causes pneumonia.

Dr. Rangan Chatterjee 46:27 Mm.

Dr. Alok Kanojia 46:27 Pneumonia is caused by a certain kind of bacteria. If we eliminate the bacteria, the pneumonia will never come back. The problem with depression is that we don't know what causes it.

Dr. Rangan Chatterjee 46:39 Agreed. We know the pathophysiology of pneumonia. At the same time, there are some patients who are more susceptible to getting regular pneumonias, right? So yeah, the, the, the, the, the bacteria goes away after taking the antibiotic, but they may be the type of patient who gets two a year, right? Whereas someone else might get one every 10 years.

Dr. Alok Kanojia 47:02 To- totally with you, right? And that's where now we get into the shades of gray. So let, let's forget about pneumonia for a second. If we wanna go further gray, let's talk about asthma.

Dr. Rangan Chatterjee 47:10 Yeah.

Dr. Alok Kanojia 47:10 Right? So asthma that, uh, you know, is somewhat controlled, let's say, on, like, an inhaled glut- glucocorticoid or something like that. And then even if they stop the, the, get- getting the glucocorticoid, let's say they're off of everything, but they don't have an asthma attack for one year, does that mean that they're cured, not cured? The pathophysiology of the smooth muscle reaction that happens in their lungs is still potentially there, right?

Dr. Rangan Chatterjee 47:32 Mm.

Dr. Alok Kanojia 47:33 So there's all kinds of shades of gray, and in mental illness, too. Let's take the case of trauma, okay? So we have a whole guide to trauma where we kind of walk, uh, go into this, but so we look at trauma. Trauma has effects on every dimension of your being. The first thing that happens is your physiology becomes rewired. Your sensitivity to threat and danger increases. So there are situations in life that are not really dangerous, but your nervous system is so ramped up that it looks at a normal thing, and it sees danger there. So a good example of this is I, I did a lot of work with veterans, and, you know, if a door slams, their nervous system is wired-

Dr. Rangan Chatterjee 48:20 Yeah

Dr. Alok Kanojia 48:20 ... to pick that up and think, "Oh my God," like, "there could be a bomb going off," or, "That's a gunshot." So there is a nervous system change, okay? So one thing that we can do is we can rewire the nervous system, and that's what sustained remission even from PTSD looks like. One piece of that is your nervous system has been wired in some way, and we can rewire it. Now, once we rewire it, there's no need for, like, medications like prazosin-

Dr. Rangan Chatterjee 48:47 Mm

Dr. Alok Kanojia 48:47 ... or anything like that, right? So once we've, like, altered the wiring back to the way that it should be in a healthy range, we don't need medication anymore.It's not just that. In trauma, we also have problems with emotional regulation.

Dr. Rangan Chatterjee 48:59 Yeah.

Dr. Alok Kanojia 48:59 So this is not the central nervous system and, you know, our heart and lungs and adrenaline cor- and cortisol. This is like our amygdala becomes hyperreactive. So this is the part of our brain where we experience fear and an anxiety. So we can also do certain kinds of meditation techniques, yoga, cognitive behavioral therapy, cognitive reframing to literally increase the strength of the connections between our frontal lobe and our amygdala.

Dr. Rangan Chatterjee 49:26 Mm.

Dr. Alok Kanojia 49:26 So this is strengthening the part of your brain that allows you to calm down. So once we've done that rewiring, this is basically speaking a permanent change, or can be-

Dr. Rangan Chatterjee 49:37 Yeah

Dr. Alok Kanojia 49:37 ... hypothetically a permanent change. And then it moves up to one level. So now that my threat perception has been normalized, I'm not seeing danger in every sh- every, every corner. Now that my ability to regulate my sadness and my anger has improved, now my relationships will start improving.

Dr. Rangan Chatterjee 49:54 Yeah.

Dr. Alok Kanojia 49:55 Right? So now when I'm, when my partner doesn't text me back, instead of getting paranoid because my amygdala is hyperreactive and there's adrenaline pumping through my s- my system, I'm able to chill out, and then I can learn particular ways to relate to someone else. So trauma also changes the way that we connect to other human beings.

Dr. Rangan Chatterjee 50:13 Yeah.

Dr. Alok Kanojia 50:13 If we're traumatized by our parents, the people who love us, we get all messed up, honestly.

Dr. Rangan Chatterjee 50:18 Yeah.

Dr. Alok Kanojia 50:19 That people that we love are hurting us in this way, and then we start to fear those that we love, and our brain forms that association. So then we start working on that. And then finally, what we end up working on, and there's other dimensions to this, but the other big one is our sense of identity.

Dr. Rangan Chatterjee 50:35 Mm.

Dr. Alok Kanojia 50:35 So trauma changes the way that we see ourselves. Now, this is a persistent mental pattern that when people, when someone is physically or sexually abused as a child, they believe they are at fault.

Dr. Rangan Chatterjee 50:49 Yeah.

Dr. Alok Kanojia 50:50 Right? And that's, that's a belief that gets formed as a child that you carry with you. But once again, through things like psychotherapy and meditation, we can alter our-

Dr. Rangan Chatterjee 51:00 Yeah

Dr. Alok Kanojia 51:00 ... we can change our perception of ourselves. And once you do all of those things, you rewire your physiology, you increase your ability to, to suppress your amygdalar reactions, you alter your relationship patterns, and you alter your sense of identity. I think these people are, from what I've seen from a clinical perspective, their problems are gone.

Dr. Rangan Chatterjee 51:22 Yeah.

Dr. Alok Kanojia 51:22 Like, unless there's some other kind of trauma, maybe I'm wrong there. Maybe, 'cause I don't know the benefit of the future. Maybe 10 years from now, the stuff will come back. I don't know.

Dr. Rangan Chatterjee 51:29 But isn't that the-

Dr. Alok Kanojia 51:30 It just seems the same

Dr. Rangan Chatterjee 51:30 ... isn't, isn't that the same for most things in life?

Dr. Alok Kanojia 51:32 Yeah, absolutely.

Dr. Rangan Chatterjee 51:34 Yeah.

Dr. Alok Kanojia 51:34 100%. That, so this is the answer, right? So here's what people don't understand in psychiatry. So if we're... See, the biggest mistake people make is they'll start on an SSRI, and then six months in they say, "I'm feeling better. I'd like to come off of the medication. I don't need the medication anymore." And then what oftentimes happens if you pull off of the SSRI in under a year, without certain circumstances, which we can get into if you want to. Um, there's basically like a serotonergic diet and things like that that you can start that will allow you to come off of an SSRI. But, so if someone says, "Okay, now I'm ready to stop because I feel better," oftentimes the depression can come back. And what a lot of people don't understand in psychiatry is your mental health today, just like your physical body, is a product of what you put into the mind.

Dr. Rangan Chatterjee 52:25 Yeah.

Dr. Alok Kanojia 52:26 So if I sit on my ass all day long, I eat processed food, I'm gonna get back pain, I'm gonna get pedal edema, I'm gonna get all kinds of problems. If the, the body is responsive to its environment. If I go and inhale toxic fumes, I'm gonna have a lung problem. If I go breathe fresh air, I'm not gonna have a lung problem. So this idea of a disease as being independent of your environment is wrong.

Dr. Rangan Chatterjee 52:53 Yeah, agreed.

Dr. Alok Kanojia 52:54 This trips people up so much in psychiatry because now that I feel better, I'm gonna stop meditating. Now that I feel better, I'm gonna stop going to therapy. Now that I feel better, I'm gonna stop taking medication. And in doing so, they recreate the circumstances that led to-

Dr. Rangan Chatterjee 53:14 Yeah

Dr. Alok Kanojia 53:14 ... their system being out of balance and manifesting as a particular mental illness.

Dr. Rangan Chatterjee 53:19 Yeah.

Dr. Alok Kanojia 53:21 Right? So sustained remission, is it gone forever? I think there's a certain amount of, and this is where things get a little bit tricky, because I think there's a certain amount of, like, rewiring, which is semi-permanent.

Dr. Rangan Chatterjee 53:32 Yeah.

Dr. Alok Kanojia 53:33 So once you correct the physiologic wiring of PTSD, it doesn't just come back if you stop eating healthy. But there are all kinds of things. If you enter into a bad relationship, if you go back into a literal war zone, all of that stuff can get re-triggered.

Dr. Rangan Chatterjee 53:49 Yeah.

Dr. Alok Kanojia 53:50 And so the big mistake that a lot of people make is that they think, "Oh, I'm cured, so therefore I can open the door to all of my bad habits again because this problem is cured."

Dr. Rangan Chatterjee 54:01 Yeah.

Dr. Alok Kanojia 54:01 And that's what separates people who get chronic pneumonia from people who get one-time pneumonia. So for anyone who's listening to this, so that your audience, I, I think is quite health-focused, right? So how do you understand your health? I think think about it like a karmic perspective. It's, it's not a, a... I don't think it's just a technical discussion-

Dr. Rangan Chatterjee 54:18 Yeah

Dr. Alok Kanojia 54:18 ... between doctors. I think it's like, how do you approach your health? Is cure possible? And it's kinda like depending on what you reap, I mean, you're, you're gonna s- depending on what you sow, that's what you're gonna reap. There's some amount of buffer you can buy yourself, right, if you're very healthy and y- you've lost a lot of weight and you exercise every day and you no longer have Type 2 diabetes. You can have a, a piece of cake or two. It's, like, no big deal. But if you start engaging in those wrong behaviors again, those health problems will reemerge.

Dr. Rangan Chatterjee 54:47 Yeah. Yeah, no. Okay, in terms of practical things that people-

Dr. Alok Kanojia 54:52 Yeah

Dr. Rangan Chatterjee 54:52 ... can do, um-

Dr. Rangan Chatterjee 54:56 You mentioned meditation and why it can be such a powerful practice for a whole variety of different conditions, whether it be mental or physical for that matter. And I think there's lots of misconceptions about meditation. So a lot of people hear, "Oh, I should meditate." They try. They often say, "Oh, it's not for me," or, "It didn't work," or a whole host of other things. So Dr. K, from your perspective, what is meditation and how can people start to engage with it in their lives?

Dr. Alok Kanojia 55:29 It's a great question. So this is where I think the biggest problem with meditation is that we use one word to describe what is up to eight different Sanskrit states or more. Probably, there's probably 20 or 30, maybe even 100 words for meditation in the Sanskrit language, and they each describe different mental states or states of consciousness. So here's the most important distinction. There are two words that loosely get translated as meditation. One is dharana and the other is dhyana. So dharana means focusing technique. So dharana is a verb. So when I say, "I sit down to meditate and it doesn't work for me," there are two things we're talking about. One is an action and one is an effect. Does that make sense?

Dr. Rangan Chatterjee 56:20 Yeah.

Dr. Alok Kanojia 56:20 So when some people sit down to meditate, they say, "It doesn't work for me," what are they talking about? They mean, "My mind is scattered. I have no peace. Everyone's talking about peace, everyone's talking about stillness, everyone's talking about a no mind state. I, I can't do any of that. It's not working for me." So not working is an effect.

Dr. Rangan Chatterjee 56:34 Yeah.

Dr. Alok Kanojia 56:35 It's different from an action. So the best analogy for this, so dhyana is a state of mind, of a certain state of consciousness which is very, very positive. We'll get to that in a second. But dharana is sitting down to meditate, and dhyana is the state of consciousness that if you are lucky, you achieve while you are meditating. The best example of this, so you're a doctor, right, Dr. Chatterjee?

Dr. Rangan Chatterjee 57:00 Correct.

Dr. Alok Kanojia 57:02 Um, I'm having difficulty with sleeping. Can you teach me how to sleep?

Dr. Rangan Chatterjee 57:08 Yeah, it's a great one. No, of course I can't teach them how to sleep, but I can teach them-

Dr. Alok Kanojia 57:12 I'm confused. Are, are... Have you never slept before?

Dr. Rangan Chatterjee 57:16 [laughs] Yes, I have slept before.

Dr. Alok Kanojia 57:19 Can you teach me how?

Dr. Rangan Chatterjee 57:21 I can teach you some of the things that you may want to focus on, some actions that you can do which may lead to the outcome of sleep, but I can't actually go and take you directly to sleep.

Dr. Alok Kanojia 57:33 Great. So what are some of the actions?

Dr. Rangan Chatterjee 57:35 Okay. So again, it depends on you as an individual, but it could be that I start off in the morning and talk about the importance of natural light first thing in the morning to help you with your circadian rhythm.

Dr. Alok Kanojia 57:46 Great.

Dr. Rangan Chatterjee 57:46 I may talk to you about when do you stop drinking caffeine. Okay. You enjoy-

Dr. Alok Kanojia 57:51 Great

Dr. Rangan Chatterjee 57:51 ... caffeine, great, but there's a long half-life. Maybe you wanna just stick to it in the morning. I may talk about your mind being overly stimulated in the evening and help you understand is there some sort of shut off time where you can move from work time to relaxation time. And-

Dr. Alok Kanojia 58:07 Beautiful

Dr. Rangan Chatterjee 58:08 ... light exposure, the time you have your last meal, et cetera, et cetera.

Dr. Alok Kanojia 58:12 Great. And if I do all of those things, will I fall asleep?

Dr. Rangan Chatterjee 58:15 I can't say that for sure, but it's gonna increase the probability.

Dr. Alok Kanojia 58:19 There we go.

Dr. Rangan Chatterjee 58:20 [laughs]

Dr. Alok Kanojia 58:21 Right? So that's the first thing to understand is that meditation is not about sitting and breathing. I can wake up at 5:00 AM, I can stop caffeine, I can have zero caffeine during the day, I can meditate, I can exercise, I can have no blue light exposure to my pineal gland before, you know, a couple hours before sleep, and then I can still not fall asleep. So meditat- first thing to understand is meditation is the same way.

Dr. Rangan Chatterjee 58:47 Yeah.

Dr. Alok Kanojia 58:47 There's the action that you take, and then there is the state of consciousness that you achieve. When people say, "Meditation doesn't work for me," they are not able to attain the state of consciousness. They're not able to fall asleep. They can do all the right actions, but they don't get the result. So this, this is the first thing to understand.

Dr. Rangan Chatterjee 59:05 Mm.

Dr. Alok Kanojia 59:05 Second thing to understand is as you beautifully said, right, when you're trying to help someone sleep, it depends on you. So the biggest problem in the world today with meditation teachers is that we've started having trained meditation teachers. We've started offering certifications for meditation. Do you know historically how many years it took to become a meditation teacher?

Dr. Rangan Chatterjee 59:31 I don't, but if I was to guess, I might even say 20 or 30 years.

Dr. Alok Kanojia 59:39 Excellent. It's 30.

Dr. Rangan Chatterjee 59:40 Right.

Dr. Alok Kanojia 59:40 That's the average, the average amount of time to become an accomplished meditation teacher, to become a Zen master, to become a swami, is 30 years. Right? So I, I, I know you're Indian, but if, if y'all are familiar with Indian culture, you know, where there, there used to be this caste of people who were priests, they would start training at the age of, like, five, and then by the time they're 30, that's when they graduate. It's a 25-year education.

Dr. Rangan Chatterjee 1:00:06 Is this similar with yoga where people are doing a weekend course and becoming yoga experts?

Dr. Alok Kanojia 1:00:10 Absolutely.

Dr. Rangan Chatterjee 1:00:11 Yeah?

Dr. Alok Kanojia 1:00:11 Absolutely. Right? So, so now what, what's started to happen is we have very poorly trained teachers because our system of training is, like, very, like, factory oriented. The other thing, and this is what really is wild, so what used to happen in the Zen tradition is you could train for 30 years, but if you have not achieved the right states of consciousness, you don't become a Zen master. There are some people who will go to swami training. Not everyone graduates. Whether you graduate or not depends on your spiritual achievement, but the idea of doing a 30-year PhD and then not getting your degree at the end is completely foreign. I paid my $600. I want my damn certificate.So we have very poor quality meditation teachers. The other reason that we have very poor quality meditation teachers, in my opinion, is that people are not taught the roots of meditation, they're taught a technique, right? So what happens is I'll train with this person. I became a certified tradit- teacher in this tradition, which means I know one technique. There was a guru or a spiritual master who, like, understood a lot of t- me- meditation, and then they taught their disciples, who taught their disciples, who then taught their disciples.

Dr. Rangan Chatterjee 1:01:29 Mm-hmm.

Dr. Alok Kanojia 1:01:29 But the tradition is dead. It's basically copy-pasted, right? And so think about this as a doctor, like, if there was someone 150 years ago who treated a patient with pneumonia with this medication regimen, and then they taught that medication regimen to the person after them, who taught that medication regimen to the person after them, who taught that medication regimen to you, and then you give this person a treatment and they don't get better, what do you say as the meditation teacher? You say, "Try harder. Keep practicing, keep practicing, keep practicing. It'll come."

Dr. Rangan Chatterjee 1:02:00 Mm.

Dr. Alok Kanojia 1:02:01 Because meditation teachers are not trained in a variety of techniques.

Dr. Rangan Chatterjee 1:02:06 Mm.

Dr. Alok Kanojia 1:02:06 They're trained only in their tradition. So if you look at this ancient Indian Hindu text called Vigyan Bhairav Tantra, it's a conversation between Shiva and Parvati, which are two gods. We don't have to get into that. It's just a conversation between a meditation teacher and a meditation student. And the meditation teacher says that there are 112 fundamental types of meditation, and for every person on the planet, their brain will resonate with one of these types of meditation. And these types are very, very different.

Dr. Rangan Chatterjee 1:02:39 Mm.

Dr. Alok Kanojia 1:02:40 So the other problem that I, that I have, and this is what I've found as, uh, I mean, people arguably I'm a successful meditation teacher. You know, I've, I've taught literally millions of people how to meditate, and the reason that I'm effective is because I don't just teach one technique.

Dr. Rangan Chatterjee 1:02:53 Yeah.

Dr. Alok Kanojia 1:02:53 What I try to do is understand, at least with my patients, what is your diagnosis? What is going on in the mind? What is the right technique for you? A simple example of this is when I have patients, everyone tells patients with ADHD, "Slow down, slow down. Your mind is moving too fast." It is a terrible idea. With ADHD, we wanna have the mind move as fast as possible. So their meditation involves intense cognitive activity, because, I don't know if you have kids or not, but I'll offer something that I think most parents will agree with, which is if you want your kid to sit still, tell 'em to run around, right? Go get your energy out. Go run around, play at the playground for 15, 20 minutes. Go do jumping jacks. If th- if, if we want, if there's a hyperactive mind, there's too much energy in the mind. How do you get something that is hyperactive to, to calm down? You e- engage it. So what I'll tell my patients to do is go outside. This is a hard one. It doesn't work for most people. There's an easier version of this. Go look at a tree and count the leaves. Count the leaves as quickly as you can. Count every leaf on a tree. So the mind is moving incredibly rapidly. Their, the cognitive strain is a lot, and then the mind becomes exhausted, and they enter a meditative state. Another really good tip for people with ADHD, everyone says meditate with your eyes closed. Terrible idea with m- uh, with ADHD. AD, people with ADHD require some degree of stimulation to achieve stillness of mind. So if you tell a kid to close their eyes and sit still, if they have ADHD, they'll start wiggling. They require some kind of interoceptive stimulation. So meditate with your eyes half open or open. Meditate listening to music. It all depends on matching the technique to the brain.

Dr. Rangan Chatterjee 1:04:41 Yeah.

Dr. Alok Kanojia 1:04:41 So if meditation doesn't work for you, you need to figure out, try to find a competent teacher, and try to find an array of techniques.

Dr. Rangan Chatterjee 1:04:48 Yeah. God, that's, that's just so interesting. I guess if we draw an analogy with, uh, movement, right? We, we would never say, "Oh, movement doesn't work for me." We'd, we'd understand that we need to find the right form of movement [laughs] that we enjoy doing, right?

Dr. Alok Kanojia 1:05:03 Well said.

Dr. Rangan Chatterjee 1:05:03 Whereas as you say, we think meditation is this kind of one thing. "Oh, I tried it. It doesn't work." Which, yeah, and it, it also makes me think of this, again, bringing up this kind of broad terms East v. West, right? This idea, like, that we've sort of weaved in throughout this conversation, this idea that actually the allopathic model, the randomized control model, tells us what is the best thing for the average pers- for, for most average people, right? So we then try and apply that to everyone-

Dr. Alok Kanojia 1:05:36 Mm

Dr. Rangan Chatterjee 1:05:36 ... and it works for some, and it doesn't work for others. Diet is a prime example, right? Whereby, again, if you think about this through an Ayurvedic, uh, medicine lens, they have understood for thousands of years that actually there are different constitutions in-

Dr. Alok Kanojia 1:05:52 Mm-hmm

Dr. Rangan Chatterjee 1:05:52 ... individuals, and depending on your constitution, you're gonna benefit from a different flavor, a different balance in your diet. And it's the same kind of principle, isn't it? In meditation, it's like you're saying there's 108 or 112 different forms. I don't think that is, not I don't think, I know that is not common [laughs] knowledge with most people, certainly in the UK and the US.

Dr. Alok Kanojia 1:06:16 Yeah. People think they understand meditation, but the, I mean, it's very deep, right? So there, there's, uh, literally hundreds, thousands of texts. There's lots of different spiritual teachers, lots of different techniques, and I think if someone says, "Meditation doesn't work for me," I think that's actually okay. That doesn't mean that you're doing it wrong. 'Cause this, the other thing that I, I find is crazy is like, you know, when there's a teacher and a student and the student is struggling, it's usually the teacher whose responsibility is to, like, get the student, you know, on, uh, to succeed. And, and so if, if meditation doesn't work for you, I would say find a different teacher.

Dr. Rangan Chatterjee 1:06:53 Mm.

Dr. Alok Kanojia 1:06:53 And, and this is what we try to do, so understanding this, right? So we'll have, you know, I, I, I've taught probably over 100 different meditation techniques. It's not, it doesn't map onto the 112, by the way, but-I- I've taught over 100 different meditation techniques, if not more, uh, y- you know, in various YouTube videos, guides, whatever. And, and what I've sort of found as a psychiatrist is, like, this is wh- the research that I was doing at Harvard as I was developing meditation programs for particular mental illnesses. So there's a particular regimen for trauma, there's a particular regimen for anxiety, there's a particular regimen for depression. And the really wild thing is, like, you know, trauma's a really good example of people will say, like, "Empty your mind," right? Th- like, people will say, "Do mindfulness." I think mindfulness is terrible for trauma. So in trauma, we have a mind that has employed all of these psychological defense mechanisms to keep things suppressed, to keep things walled off. And when we create a vacuum in the mind, the trauma comes rushing up and then can oftentimes overwhelm us. Which is why even if we look at evidence-based protocols for treatment of trauma, they do not have mindfulness in its traditional sense. They have something else called grounding techniques. So a really good example of this is something called ice diving, where you take a bucket of ice, you fill it with water, and then you dunk your face in. So these are the kinds of meditation or grounding techniques that people with a history of trauma will use, because their problem is not that they're, they're, m- you know, they don't need to empty their mind. They need to shut down their mind. They need to sort of achieve some degree of peace or balance. They need to break the cycle of, like, a panic attack or a thought loop or something like that.

Dr. Rangan Chatterjee 1:08:37 On that point, when you said mindfulness, can you just clarify-

Dr. Alok Kanojia 1:08:39 Yeah

Dr. Rangan Chatterjee 1:08:39 ... what, what, what, what is it you mean by the term mindfulness in that context?

Dr. Alok Kanojia 1:08:45 Yeah. So oftentimes wha- so that's a great question. But, uh, oftentimes when people say mindfulness, they just mean, like, just observe your thoughts, right?

Dr. Rangan Chatterjee 1:08:52 Okay.

Dr. Alok Kanojia 1:08:52 So there's a great definition of mindfulness by Jon Kabat-Zinn, who's like, you know, it's, um, nonjudgmental awareness in the present moment, I think is what he causes, uh, calls it. The problem is that nonjudgmentalness for people with anxiety or a history of trauma is, like, not really achievable early on.

Dr. Rangan Chatterjee 1:09:10 Mm.

Dr. Alok Kanojia 1:09:10 So what I find works way better is particular meditation techniques that activate the parasympathetic nervous system in a very, very focused way. So once you activate the parasympathetic nervous system, the mind will be more calm, and nonjudgmentalness will then be possible.

Dr. Rangan Chatterjee 1:09:27 Mm.

Dr. Alok Kanojia 1:09:28 But you can't just, like, sit and not judge your thoughts if you have a history of trauma. It becomes incredibly difficult.

Dr. Rangan Chatterjee 1:09:34 Yeah. One of the practices I've heard you talk about before is where you sit in complete stillness for, I think, five minutes.

Dr. Alok Kanojia 1:09:47 Mm-hmm.

Dr. Rangan Chatterjee 1:09:48 And one of the things I, I love when I've heard you, uh, describe that practice in various conversations and interviews that I've seen is that you talk about this idea that at some point it gets so uncomfortable that the most luxurious and pleasurable thing in the world becomes your breath. And I thought that was a really beautiful and evocative concept for people to get their heads round, the, the, the kind of the beauty of the breath, as it were, in the sense that a lot of the time, you know, we get told to focus on our breath, but it's like, "Oh, yeah, I don't wanna focus on my breath. Like, you know, it's a bit of a pain, but I know I heard it in a podcast that they said focus on my breath." But you kind of flip it with this sort of practice where actually you get to the point where you want to focus on the breath. So I wonder if you could explain what that practice is. Does it come under the umbrella of meditation, or is it separate to meditation? And who might wanna consider trying it out?

Dr. Alok Kanojia 1:10:46 Okay. Great, [laughs] great question. So the practice is something called Gayasthiram, which means s- like, holding the body still. So when you hold your body perfectly still, it's gonna be okay for a little bit, and then it's gonna quickly become not okay.

Dr. Rangan Chatterjee 1:11:06 So when you say still, do you mean literally you're not moving a muscle?

Dr. Alok Kanojia 1:11:10 Well, you're gonna have to be respirating.

Dr. Rangan Chatterjee 1:11:12 Yeah.

Dr. Alok Kanojia 1:11:12 But try to keep that to a minimum as well. But if you have an itch, don't itch it. If you feel like shifting your leg because your leg is falling asleep, don't shift it.

Dr. Rangan Chatterjee 1:11:20 Mm-hmm.

Dr. Alok Kanojia 1:11:20 Uh, you know, so over time what'll happen is you're not used to sitting still, so you're... And you won't be sitting, like, perfectly balanced. So over time, muscles will, will... Muscles are contracting to hold you in place, right? That if we have to sit up, we're contracting our back, we're contracting our trapezius, our shoulders. There's all gonna be all kinds of sensations that over time get worse. This is the point. So don't do it to the point where you're, like, you know, hurting yourself. But it, it'll feel uncomfortable, intensely uncomfortable. And as it becomes more intensely uncomfortable, you'll be sweating. It'll require your full attention to hold it, right? So a, y- a good example of this is if you sit, uh, against, a sit on the wall. I don't know if you, you know what that means, where you're kinda, you know, just sitting against the wall.

Dr. Rangan Chatterjee 1:12:04 Yeah, yeah, yeah.

Dr. Alok Kanojia 1:12:05 Yeah, right? So it's a good abdominal exercise. But, like, if you hold an uncomfortable position, it becomes painful. And the way that I was taught meditation is by understanding the principles. So people say focus on the present, focus on your breath. These are things that you don't have to focus on. You can do a certain practice where you have no choice but to be in the present.

Dr. Rangan Chatterjee 1:12:28 Mm.

Dr. Alok Kanojia 1:12:29 As you engage in Gayasthiram, the longer you are still, at the beginning you can think about, oh, I'm gonna eat. I have this meeting tomorrow. But as the int- as you continue being perfectly still and the itch on your nose becomes so unbearable, you will literally not be able to think about anything else. And then the only relief that you will have is your breath. And then you will start to breathe. Because it's all of these sensations. Your somatosensory cortex is gonna be going wild. It's gonna be sending you all of these signals to move, move, move. The only way you can distract yourself from those signals is to breathe.Some people figure it out, some people don't. I'm kind of giving y'all the answer. But you'll sort of figure it out on your own, is the only way to tolerate it is to breathe. And the more deeply you breathe, the more you will be able to tolerate. And then you will fall into the breath. Breath will feel like it is like you're, you know, it's like you're, you're starving, and then you're getting this, this one breath of air that is bringing you some degree of peace. And the feeling is truly ecstatic. And it'll take five to 10 minutes. Your only refuge will be the breath. And so the beautiful thing about this practice is everyone says meditation is hard. I can't focus on the breath. I get bored. I get distracted. I can't be in the present. My mind is running all over the place. That's because no teacher has taught you what to do so that these things come naturally. They're not to be forced.

Dr. Rangan Chatterjee 1:14:01 Yeah.

Dr. Alok Kanojia 1:14:02 Right? So it's about figuring out a technique that naturally puts you in the present, naturally has you focusing on the breath, and this is the cool thing. Just like we talked about over an hour ago, this carries over. So once your brain knows how to find relief in the breath-

Dr. Rangan Chatterjee 1:14:20 Mm-hmm

Dr. Alok Kanojia 1:14:21 ... it will start automatically finding the relief in the breath. When you feel anxious, when you have difficulty sleeping, when you feel sick, you will take a deep breath and you'll be able to work a little bit better. You may notice that my voice is a little bit hoarse right now. I'm sick. And yet some of the practices that I engage in on a daily basis, you saw the meditation cushion at the beginning, allow me to be more functional because now my body knows, right? Like, I know how to r- maintain focus and things like that. So all of this being present focused, all of the stuff about sort of finding relief in periods of hardship will increase your-

Dr. Rangan Chatterjee 1:14:57 Yeah

Dr. Alok Kanojia 1:14:57 ... distress tolerance and will allow you to tolerate the difficulties in life, manage the difficulties in life way easier.

Dr. Rangan Chatterjee 1:15:06 Yeah. Amazing. Thank you for sharing that. Sorry to interrupt. To make sure you are taking action after watching this video, I have created a free special guide to help you improve your sleep and reduce fatigue. Now, in my clinical experience, most people who are struggling to sleep are doing something unconsciously in their day-to-day life that is negatively impacting their ability to sleep at night. So in this free guide, I share with you five of my very top tips, tips that I have seen transform the lives of many of my patients. So if you wanna get ahold of this guide, all you have to do is click on the link in the description box below. Um, secondly, with, with respect to that practice, it's a really, it's a really thought-provoking practice I think for, for many people listening right now I imagine, because you're right. Too much of the attention is on... You know, it's like what we said about meditation before. You know, we think meditation's gonna give us a clear mind without understanding, no, no, it's an action. You take the action. You may get that secondary outcome. You may not. But take the action. And I, I love this practice whereby instead of saying, "Oh, I must focus on the breath, I must focus on the present moment," you will be left with no option but to do so within a few minutes. With that in mind then, and with what we said earlier in mind, this idea that many of us now have been conditioned for comfort or conditioned away from discomfort, it feels to me as though that is a practice that could be applicable to anyone. Is there anyone... I mean, I, I, I mean, I'm already keen to go, "Well, I wanna try that tomorrow morning. I wanna actually give that a go and see what happens when my muscles feel tense, or my nose wants to be itchy," or whatever it might be. Is there anyone who shouldn't do a practice like that? Or do you think it's quite a fun or, or useful experiment for most people to try at some point?

Dr. Alok Kanojia 1:17:10 Yeah, I mean, I, I, I think it's useful for most people to try at some point, right? But so generally speaking, Gayush theorem should be done sitting up straight. So if you've got spinal problems or back problems or things like that, like we don't wanna, you know, trigger, like, muscle spasm or things like that, so you always wanna be careful. Talk to your doctor. But generally speaking, I think Gayush theorem is a great practice for someone to try. And go into it is beautiful. It's, like, so easy to do. Just go into it recognizing this is gonna suck for me. Let's see how far I can go. Now, you have to be a little bit careful there because ego can come in, and you can just be like, "Oh, I'm gonna go longer. I'm gonna go longer."

Dr. Rangan Chatterjee 1:17:44 Mm.

Dr. Alok Kanojia 1:17:44 "I'm gonna go longer." If that's what happens in your mind, you're doing the practice wrong because now think about what's happening in your mind. It's about going further, going further, achieving, achieving. You're not paying attention to the present. You're not focusing on your breath now. The breath isn't a relief. It's very, like there's a conquering energy to it of, "I wanna be hardcore." That'll lead to ego, so you have to be a little bit careful about that.

Dr. Rangan Chatterjee 1:18:06 Yeah.

Dr. Alok Kanojia 1:18:07 And there's, there's all kinds of nuances, but generally speaking, I'd say, you know, if you're listening to this, find a safe place if you don't have any health conditions or anything like that, and try to sit still for 10 minutes without moving a muscle. If you fail, it's okay. That's not the... Failing or succeeding is not the point. Even if you fail or succeed, the issue is that during the practice itself, there will be such an intensity of experience. Your brain will be doing all kinds of stuff. Even if you fail, for the three minutes that you were suffering and succeeding, your brain is wiring for distress tolerance.

Dr. Rangan Chatterjee 1:18:41 Yeah.

Dr. Alok Kanojia 1:18:42 The next time you don't get your drink on the train because the app is broken, you've managed this Gayush theorem for three minutes and that was torture, you're gonna have no problem with not getting your drink.

Dr. Rangan Chatterjee 1:18:56 Yeah.

Dr. Alok Kanojia 1:18:57 Life will literally become easier.

Dr. Rangan Chatterjee 1:18:59 Yeah. One of the practices that I was taught a few years ago now, it, I, I mean, there, there's a chap called Iwan Lacor who founded, uh, MovNat. He's a natural movement guy. And he has this thing called breath hold work meditation, okay?And, you know, he, to be clear, he's not, you know, he, he doesn't attach it to any religion or spiritual practice. He's like, no, he, he just, he teaches this as a standalone practice. And I did his course, and it's bas- basically a breath-holding, um, practice. But it doesn't have hyperventilation like the Wim Hof technique, for example, which I know comes from thousands of years ago anyway from, from, uh, other traditions. But in, in essence, without doing any prep work in terms, in terms of hyperventilation, you hold your breath, and you know, you just take a breath in, and you hold your breath. And, you know, from day one to four weeks later, and it was just a course that was twice a week, I was able to increase my breath-hold time from one minute to four minutes and twenty. And my physiology did not change. My, my, my carbon dioxide tolerance did not change to that degree in three to four weeks. What I learnt on that course through his guidance was that the quieter I could make my mind, the, the stiller I could become internally, the longer I could hold my breath for. So I'm summarizing, you know, a lot of teaching from him, but in essence, the point I'm trying to, uh, get across and share with you is that I learnt through that practice, and I do it regularly still today, that when your body is screaming for you to breathe, and you learn how to control and quieten your mind, and then suddenly you can go for a minute longer. You, you literally think, "I have to breathe now or I'm gonna explode," and he helps you understand how you quieten everything, your muscles, your mind, your thoughts. I, I, I said to my wife, you know, uh, uh, I think a few weeks after that, like if you can master your mind when that primal urge to take oxygen is, is overtaking your body, most things in life are easier than that. It's a similar principle, right?

Dr. Alok Kanojia 1:21:22 Yeah. So there's so much that you're touching on.

Dr. Rangan Chatterjee 1:21:24 [laughs]

Dr. Alok Kanojia 1:21:24 So first is this idea of, oh, I, I need to breathe, I need to breathe. No you don't. Not necessarily, right? So my favorite example of this, I don't know, uh, how things are in the UK, but here in the United States, you know, we have long distances that we drive, and then we, we sometimes need to go to the loo, as you call it, right? So you, you stop at a gas station, you go to the bathroom. And it's really interesting because, you know, when you feel like you need to pee, y- you pull over, you walk into the restroom, and you're ready to pee. But if you walk into the restroom and you see that there's a line, and you can't go to the bathroom right away, the intensity of needing to urinate becomes so strong. You're like, "Oh my God." You start to panic. The moment that you walk into the restroom, your intensity, your desire to urinate shoots through the roof. And if there's a line, then it becomes torture. It becomes absolute torture. But if the gas station were five minutes further away and there was no line, you'd be totally fine. Does that make sense?

Dr. Rangan Chatterjee 1:22:25 Yeah, for sure.

Dr. Alok Kanojia 1:22:25 So it's not, it's not a physiologic signal. You're 100% right. It is in your mind.

Dr. Rangan Chatterjee 1:22:31 Mm.

Dr. Alok Kanojia 1:22:32 So now the question becomes how do we understand that, right? So you're saying if you train this. So I'm gonna give y'all... So I, I know you mentioned a technique that I've taught elsewhere. I'm gonna give you a fresh one-

Dr. Rangan Chatterjee 1:22:42 Okay

Dr. Alok Kanojia 1:22:42 ... that's never been taught before, okay? This is a really fascinating technique that can u- be used to erase any bad habit. It's so simple. So if we understand what a habit is, a habit is a desire or a natural inclination to move in a certain direction, right? I have a habit for caffeine. I have a habit for alcohol. I have a habit to, I don't know, pick my nose, whatever. We have all these kinds of bad habits. So I know this is gonna sound kind of weird, Rangan, but like if I wanna stop drinking alcohol, what do I need to do?

Dr. Rangan Chatterjee 1:23:19 Okay. Well, there's a number of ways you could tackle this. Okay. Um, oh, okay, very simply, all you have to do is not put the alcohol in your mouth.

Dr. Alok Kanojia 1:23:29 Perfect. If I wanna stop picking my nose, how do I do that?

Dr. Rangan Chatterjee 1:23:34 Just never, ever put your finger in your nostril.

Dr. Alok Kanojia 1:23:37 Perfect. Right. So here's the crazy thing. What skill is that? How would you group together all of those things?

Dr. Rangan Chatterjee 1:23:50 You set an intention and you take action. You say, "I'm no longer gonna pick my nose," and you no longer do it. You say you're always gonna take the stairs, and you always take the stairs. There's an alignment between your intention and your action. Uh, certainly that's one way I would look at it.

Dr. Alok Kanojia 1:24:08 Yeah. So, so it is a way of looking at it is right in one sense and 100% wrong in the other.

Dr. Rangan Chatterjee 1:24:12 Okay.

Dr. Alok Kanojia 1:24:12 Because what we're talking about is not taking action, right?

Dr. Rangan Chatterjee 1:24:16 Of course.

Dr. Alok Kanojia 1:24:16 How do I not pick my nose? It is practicing inaction-

Dr. Rangan Chatterjee 1:24:20 Yeah

Dr. Alok Kanojia 1:24:21 ... to break any bad habit, right? So a bad habit is an action, right?

Dr. Rangan Chatterjee 1:24:25 Yeah.

Dr. Alok Kanojia 1:24:26 So you're right that it, it, very similar, right? So if, if you're trying to build a good habit, then you set an intention and you take an, a, an action. If you're trying to break a bad habit, you set an intention and you don't take an action. Like literally.

Dr. Rangan Chatterjee 1:24:39 Mm.

Dr. Alok Kanojia 1:24:39 Very simple. So now the question becomes how can we practice inaction?

Dr. Rangan Chatterjee 1:24:47 Okay. So can I just work this through with an example?

Dr. Alok Kanojia 1:24:51 Yeah, 100%.

Dr. Rangan Chatterjee 1:24:51 Yeah. Okay. So let, let's say snacking, right? Because snacking is something that a lot of... Or sugar. People struggle with this, right? So, um, let's say someone's sitting there or I'm sitting there, and I have an urge to put a cookie in my mouth, okay? And I've decided that this is a habit I want to break. Okay. So okay, so I feel an urge to pick up the cookie, but as you've just illustrated with that needing the toilet example, all these urges are temporary. They don't last forever. They come and they go.When I get that urge, I'm practicing inaction. At that point, I'm going, "No, I'm gonna sit with that urge. I'm not going to pick it up and put it in my mouth." And I guess through a process of observation, you'll find that actually after a short period of time, that urge actually vanishes and it's no longer there.

Dr. Alok Kanojia 1:25:45 That is fantastic, right? A couple of things. One is we use this technique in addiction psychiatry called urge surfing-

Dr. Rangan Chatterjee 1:25:51 Okay

Dr. Alok Kanojia 1:25:52 ... which is this idea that urges will come and go, right? So the, the whole problem with human beings is that things don't last forever. My happiness from my wedding day does not last for the rest of my life, right? Like, we don't need a perfect wedding day because it's only one day, but a lot of people get caught up in it.

Dr. Rangan Chatterjee 1:26:09 I completely agree with you, and I've said that many times as well. I'd rather have a poor wedding day and a great marriage.

Dr. Alok Kanojia 1:26:15 Right. Okay. So urges are temporary. There's a problem though, Rangan, which is that since I have trouble with snacking, when I get the urge to eat a cookie, I can't control it, right?

Dr. Rangan Chatterjee 1:26:28 Okay.

Dr. Alok Kanojia 1:26:28 That's the whole problem.

Dr. Rangan Chatterjee 1:26:28 Yeah. Okay.

Dr. Alok Kanojia 1:26:29 Very simply. So now the question becomes how can we practice inaction? And when an urge comes, sometimes the urge is overwhelming. This is the struggle that everyone has with their vices every single day, and we usually fail, right?

Dr. Rangan Chatterjee 1:26:42 Okay. Before you give me the answer then, can I, can we keep working this through, 'cause this is really interesting for me.

Dr. Alok Kanojia 1:26:46 Yeah.

Dr. Rangan Chatterjee 1:26:46 Okay.

Dr. Alok Kanojia 1:26:46 Absolutely.

Dr. Rangan Chatterjee 1:26:48 So here's another way that I've been looking at it with patients for years, okay? So people who tell me, um, "Dr. Chatterjee, you know, I'm, I'm really trying to cut out sugar," okay? And they say, "I'm really, in inverted commas, good in the day. But I have my dinner, and the kids then go to bed, and then I'm in front of the television in the evening on my sofa, and I feel like having ice cream." Okay. So I came up with this exercise that I used to call, well, I do call the three Fs, the freedom exercise, and I, I'm, I'm, I'm gonna share it with you because I suspect you'll have some comments on it, and the three Fs are feel, feed, and find. So I said, "Okay, next time you feel an urge to have Ben & Jerry's at 9:00 PM in the evening, I want you to just pause, and before you get up from your sofa and go to the kitchen, I want you to ask the first F, 'What am I really feeling? Is this physical hunger, or is this emotional hunger?'" Okay? Uh, and I won't go into all this in detail, but essentially just try and get them to have a little pause and start to create an awareness of what is actually really going on internally here that's making me feel, oh, you know, I've had a row with my partner. Oh, the kids' bedtime went on too long. Oh, I've been on Zoom calls all day, and I feel a little bit frustrated. Okay, great. Then go and have it if you want to. Then I say the next time do the first F and go to the second F, which is, okay, now that I know the feeling, stress, how does the ice cream feed the feeling? So the second F is feed. Okay. Oh, the ice cream helps me at least temporarily feel less stressed. Okay. And you can, you know, there can be all kinds of other things that it does, but let's just use that as an example then. The third F is find. Now that I know what the feeling is, internal stress, now that I know how food feeds the feeling, temporarily reduces stress, now can I find an alternative behavior to feed that feeling? And it, I, I found it very helpful for many patients, at least in the short term.

Dr. Alok Kanojia 1:28:50 100%. Okay. So as a psychiatrist, I love it. There are so many mechanisms that you have stumbled into, like creating a gap, raising awareness, finding cognitive reframing, finding alternatives. It's brilliant as a psychiatrist. As a meditation teacher, I'm asking you a simple question. So on a simple sense, this is why meditation is so transformative, because it's not a tailored solution to a specific problem. It is a fundamental that once it clicks for you, it will change the way that you live your life.

Dr. Rangan Chatterjee 1:29:22 Okay.

Dr. Alok Kanojia 1:29:23 So how do you practice inaction?

Dr. Rangan Chatterjee 1:29:25 Sitting there in stillness and observing-

Dr. Alok Kanojia 1:29:28 That's it.

Dr. Rangan Chatterjee 1:29:29 Yeah.

Dr. Alok Kanojia 1:29:30 That's it, right? So here's the thing. When the cookie is there, it's like trying to s- learn to swim in the ocean. Terrible idea. The urge is so strong. This is exactly the problem that people have. They try to fix their problems, which is not [laughs] how you do it. If your goal is to swim in the ocean, you don't practice by swimming in the ocean. You practice by swimming in a swimming pool.

Dr. Rangan Chatterjee 1:29:56 Yeah.

Dr. Alok Kanojia 1:29:56 So literally to sit still and to practice sitting still. Just sitting still. Just sitting still. That's it. Don't say anything. Don't do anything. Even if you want to do Kaish theorem, you can do that. If you want to wiggle a little bit, that's fine. But to cultivate the ability to not act is one of the most powerful techniques to break any habit. The strength of a bad habit controlling you depends on your capacity for stillness, and the crazy thing about this principle is that there is overwhelming scientific evidence-

Dr. Rangan Chatterjee 1:30:33 Mm

Dr. Alok Kanojia 1:30:33 ... that this works. If we look at treatment for OCD, if we look at treatment for trauma, if we look at treatment, uh, uh, for anxiety, what we find is literally the evidence-based treatments, techniques like you did, which I love, three Fs are fantastic. So in OCD, there is literally something called exposure and response prevention. That is the treatment for OCD. We expose ourself to the thing that triggers our OCD, and then we prevent the response. That is the cure for OCD.

Dr. Rangan Chatterjee 1:31:09 Yeah.

Dr. Alok Kanojia 1:31:09 The cure for OCD is to sit still and do absolutely nothing. In trauma, we have two examples of this. We have something called EMDR, which is eye movement desensitization retraining, which is when we discuss the trauma, we are focusing on something else. We're moving our eyes. So the trauma is not triggering.

Dr. Rangan Chatterjee 1:31:30 Yeah.

Dr. Alok Kanojia 1:31:30 So once again, we are training non-responsiveness.

Dr. Rangan Chatterjee 1:31:34 Yeah.

Dr. Alok Kanojia 1:31:34 Literally, these are the, the evidence-based treatments that we do. We teach people to sit still in clinical protocols that are specific to a particular thing, which is what your three Fs is.

Dr. Rangan Chatterjee 1:31:44 Yeah.

Dr. Alok Kanojia 1:31:45 So literally, if you practice just sitting still, practice inaction, what you will discover is that bad habits will become way easier to manage, and something really cool happens. Which is that most of the problems that you have in your life are going to be because you react.

Dr. Rangan Chatterjee 1:32:04 Yeah. No, I love that. Absolutely love it. You say it's the root cause of a lot of mental illness. It- to me it seems to be the root cause of everything, the root cause of f- you know, much of our habits that lead to physical health problems, mental health problems, and unhappiness, right? When you can sit still with yourself... Certainly this has been my experience, and I imagine yours as well, though I don't want to assume. The better you are at solitude or just sitting there doing nothing without the need for stimulation or distraction, the easier every aspect of life becomes. Would you, would you agree with that statement or would you frame it slightly differently?

Dr. Alok Kanojia 1:32:45 Yeah. So what we're... Absolutely. So let me say, now we're gonna go back to East versus West for a second. Let's understand something. The more specific the problem, the more effective a targeted technique is. That's what Western medicine is really good at.

Dr. Rangan Chatterjee 1:33:00 Mm.

Dr. Alok Kanojia 1:33:00 You've got pneumonia? Take this antibiotic. This Eastern perspective is much more global-

Dr. Rangan Chatterjee 1:33:08 Mm

Dr. Alok Kanojia 1:33:08 ... but is way harder to implement in the moment. Requires a ton of investment.

Dr. Rangan Chatterjee 1:33:14 Mm-hmm.

Dr. Alok Kanojia 1:33:14 You need to practice sitting still every single day, right? So it's, it, it's a great example, contrast of one isn't better or worse, it's do you want a global benefit that is, because it's so simple, is actually way harder to do. I said it works. I didn't say it was easy.

Dr. Rangan Chatterjee 1:33:32 Yeah. I don't know if this, if this is a relevant example, but it, but it feels... You know, let's say people... Uh, uh, and I'm, I'm sticking with food because that's just something we're talking about-

Dr. Alok Kanojia 1:33:42 Sure

Dr. Rangan Chatterjee 1:33:42 ... and of course something that many people struggle with. One way to reduce your consumption of sugar or snacks or ultra-processed foods, one way or one thing that can be helpful is to not keep that stuff in your house, right? So when you're tired and stressed one evening, you come back from work and your willpower's low and you're like, "I just feel like something," if it's there and easy, you're gonna have it. If you have to get in the car, drive 10 minutes somewhere to go and get it, it's just a little bit of friction between you and that behavior.

Dr. Alok Kanojia 1:34:13 Mm-hmm.

Dr. Rangan Chatterjee 1:34:13 At the same time, that's not the root, right?

Dr. Alok Kanojia 1:34:16 Yeah.

Dr. Rangan Chatterjee 1:34:16 That is a management strategy that is helpful. Really, you wanna get to the point where you're not dependent on your external environment being a certain way in order for you to engage in helpful practices. And I, I, I think you're right with that, this sort of East/West perspective. I love that because it's not easy, but it's much more effective, long-lasting, and beneficial for a variety of different things than the short term. And so for me, and, and presumably for you as well as a clinician, it's what, what, what does that patient necessarily need at this moment in time? Or what do I believe is the most helpful thing? I need a strategy to help them reduce it right now.

Dr. Alok Kanojia 1:35:04 100%.

Dr. Rangan Chatterjee 1:35:05 And so sometimes you do a short-term recommendation whilst, like you say, sometimes you'll give the stimulant or you'll give the medication as part of a wider program.

Dr. Alok Kanojia 1:35:17 That I think is the best strategy.

Dr. Rangan Chatterjee 1:35:19 Agreed.

Dr. Alok Kanojia 1:35:19 Right? There's the long-term-

Dr. Rangan Chatterjee 1:35:21 Yeah

Dr. Alok Kanojia 1:35:21 ... more permanent change, and then there is the immediate thing that you need, which totally makes sense.

Dr. Rangan Chatterjee 1:35:28 Yeah.

Dr. Alok Kanojia 1:35:29 Now let's go to happiness.

Dr. Rangan Chatterjee 1:35:31 Yeah.

Dr. Alok Kanojia 1:35:31 So what is happiness, Rangan?

Dr. Rangan Chatterjee 1:35:36 Inner peace.

Dr. Alok Kanojia 1:35:38 What does that mean?

Dr. Rangan Chatterjee 1:35:40 Okay. Um, okay. There's two ways I'd like to answer this, okay? Um-

Dr. Alok Kanojia 1:35:46 Great

Dr. Rangan Chatterjee 1:35:46 ... the first way is that I believe that happiness is a skill that can be cultivated.

Dr. Alok Kanojia 1:35:53 Okay.

Dr. Rangan Chatterjee 1:35:53 That happiness is not something we directly go for. The model that I use for happiness, or have used, is there are three components. There's alignment, when your inner values and your external actions start to match up. Uh, contentment and control, okay? A sense of control. Not controlling the external world, things that you can do that give you a sense of control, okay? So if you work on those three things, and there are practices you can do to work on those three things, the side effect is that you're gonna be happier more often, okay? So that's the practical way that I view happiness, but when you asked me what is happiness, 'cause I think about this all the time.

Dr. Alok Kanojia 1:36:34 I can tell.

Dr. Rangan Chatterjee 1:36:35 I think this is a state, I say inner peace, but I guess to expand upon that a little bit more, I mean the state of minimal reliance where I am no longer or not dependent on the world around me, the people around me, the comments around me, to be a certain way in order for me to feel a certain way. So it's this minimal reliance on the external world, and I guess in many ways maximally reliant on myself. It also echoes with what you were saying about this ability to just sit in stillness. Inner peace to me is if you can sit in silence for an hour and not get frustrated and not necessarily need to distract yourself, I would argue that you are, you know, quite a bit on the way to getting-

Dr. Alok Kanojia 1:37:27 Okay

Dr. Rangan Chatterjee 1:37:27 ... that inner peace.

Dr. Alok Kanojia 1:37:28 Okay, great. So here you are with these, like, three things, like alignment, autonomy, or agency. So the key thing is that you figured out a method that if you apply this method and you cultivate these skills, you will get some result, right? But here's the thing. The skills are not the happiness. The happiness is the result of the application of the skills, right?

Dr. Rangan Chatterjee 1:37:50 Yeah.

Dr. Alok Kanojia 1:37:51 Okay. So let's get rid of all the skills, because that's not what happiness is. I asked you what is happiness, not how to achieve it. You're already giving me how to achieve it, which I don't disagree with at all. There's a ton of research that I'm sure you've done. If you haven't, I can back up everything that you said with piles and piles of research about why it's effective, how it's effective, what happens in your brain, what happens in your psychology. It's a fantastic methodology, I mean that. But that's not what happiness is. What is the end result of all of that? Ideally, happiness. So let me ask you a different way. How do you know you're happy?

Dr. Rangan Chatterjee 1:38:26 I love these questions. Okay. I absolutely love them. How do you know when you're happy? Okay.

Dr. Alok Kanojia 1:38:31 Yeah.

Dr. Rangan Chatterjee 1:38:33 Okay.

Dr. Alok Kanojia 1:38:34 But what?

Dr. Rangan Chatterjee 1:38:35 A la- okay, a lack of desire.

Dr. Alok Kanojia 1:38:37 Okay, great. So now let's look at desire. So the moment that I have a desire, I wanna eat a cookie. Am I still happy? If I'm ordering something from the train car app and I'm not getting it, am I happy?

Dr. Rangan Chatterjee 1:38:51 No.

Dr. Alok Kanojia 1:38:52 No. I have a desire that is unfulfilled, therefore I am unhappy, right?

Dr. Rangan Chatterjee 1:38:58 Yeah. Okay. [laughs]

Dr. Alok Kanojia 1:38:59 So people go through life wanting things and not getting them, and they are unhappy. Correct?

Dr. Rangan Chatterjee 1:39:08 Correct.

Dr. Alok Kanojia 1:39:09 And this is what we see with technology, right? You said that in the '80s, perfectionism was on the rise. So in the '80s, we started getting these billboards. Beautiful. These billboards of people who have stuff that we don't have. The advertising industry wants to teach us that there are things that we don't have, that if we got those things, we would be happy, right?

Dr. Rangan Chatterjee 1:39:29 Mm.

Dr. Alok Kanojia 1:39:29 Body dysmorphia is on the rise because of social media and fitness influencers. There are all kinds of unhappiness that is... We, we are literally as a global population becoming more unhappy, and our unfulfilled desires are going up. So when a human being has a desire, how do they achieve contentment again? So the dude at the train wants the cappuccino or whatever, beer, whatever he's drinking, water. How does he... What does he think will lead to his happiness?

Dr. Rangan Chatterjee 1:40:04 He thinks that getting that drink is going to lead to happiness.

Dr. Alok Kanojia 1:40:08 Right. And why does he think that?

Dr. Rangan Chatterjee 1:40:11 One of the reasons he thinks that is because he's thirsty.

Dr. Alok Kanojia 1:40:15 Okay.

Dr. Rangan Chatterjee 1:40:15 So therefore, I have the drink, I'm no longer thirsty. So that's-

Dr. Alok Kanojia 1:40:19 There we go. Right? So what percentage of human beings chase their desire? 100%.

Dr. Rangan Chatterjee 1:40:25 Yeah.

Dr. Alok Kanojia 1:40:26 Right? 100%. This is not bad societal conditioning. I would argue that when 100% of human beings and basically every animal on the planet chases its desire, the reason for that is because the satisfaction of our desires brings us happiness. So this is the key thing. The reason that everyone chases desire is because chasing desire works.

Dr. Rangan Chatterjee 1:40:53 Yeah.

Dr. Alok Kanojia 1:40:53 Right? But that's why we do it. Now, here's the key thing to understand. When you, when you satisfy a desire, what happens to your internal state?

Dr. Rangan Chatterjee 1:41:07 It changes, uh, from discontent to content.

Dr. Alok Kanojia 1:41:14 What is the nature of contentment? How do you know you're content?

Dr. Rangan Chatterjee 1:41:19 Because you no longer want for that thing. I did want that thing. I got it, and I no longer want it.

Dr. Alok Kanojia 1:41:25 Okay. So let's say I'm sitting in a state of contentment. How do I become discontent?

Dr. Rangan Chatterjee 1:41:31 Your internal state changes.

Dr. Alok Kanojia 1:41:33 And what is the nature of that change?

Dr. Rangan Chatterjee 1:41:35 Some internal dis-ease.

Dr. Alok Kanojia 1:41:38 What was the nature of the dis-ease?

Dr. Rangan Chatterjee 1:41:40 Oh, you get a feeling. You, you have a, um, emotion, you have, um, an urge. Like, there, there's something, something internal comes up for you.

Dr. Alok Kanojia 1:41:52 So would you argue... So let's say I am walking down the street and I am content, and I see you eating a cookie, and then suddenly I am discontent. What do you think the nature of my discontent is?

Dr. Rangan Chatterjee 1:42:08 In that scenario, envy, comparison.

Dr. Alok Kanojia 1:42:14 Great. Whatever, right? Something. There's some activity.

Dr. Rangan Chatterjee 1:42:18 Yeah.

Dr. Alok Kanojia 1:42:19 Inner peace is stillness. Inner peace is a lack of activity. The moment that I have a desire, there's activity in the mind. I want it. Oh, I shouldn't eat it.

Dr. Rangan Chatterjee 1:42:30 Mm-hmm.

Dr. Alok Kanojia 1:42:30 If I eat it, I'm gonna get fat, right? So there's activity in the mind. Oh, there's an advertisement for a, a video game I don't own. Now I am dis- Now my mind has activity, and it is grasping for things. When I, when the mind receives what it grasps for, the mental activity disappears, right? Now I'm content.

Dr. Rangan Chatterjee 1:42:53 Yeah.

Dr. Alok Kanojia 1:42:55 So happiness, here's the crazy thing. So w- here we are, but our default state is actually happiness. Our default state is when we're c- when there's nothing going on, when there is a complete absence of whatever, and this is why people love sleep. This is why people love drugs. Drugs give us neutral mental activity.

Dr. Rangan Chatterjee 1:43:16 Mm-hmm.

Dr. Alok Kanojia 1:43:16 They remove mental activity. Ketamine is so addictive, it's a dissociative agent. It allows us to unplug. So this is the crazy thing. Happiness is actually our default state. Desire comes and ruptures our connection to happiness by creating some kind of activity, and then when we satisfy the desire, the desire goes away, and once the desire goes away, we're back to happy. Does that make sense?

Dr. Rangan Chatterjee 1:43:44 Ag- yeah, 100%.

Dr. Alok Kanojia 1:43:47 Right? So this is where a lot of people think that fulfilling your desires is the way to happiness, but it's not fulfilling it, it's restoring your o- original state of balance. I really need to use the restroom. What would restore me to balance? That urge going away.

Dr. Rangan Chatterjee 1:44:02 Yeah.

Dr. Alok Kanojia 1:44:02 Right?

Dr. Rangan Chatterjee 1:44:02 Yeah.

Dr. Alok Kanojia 1:44:03 So the way that I, I... This is, it's kind of a, a, a, it's an interesting shift, and I'd encourage everyone to think about, is that instead of thinking that fulfilling your desires causes you a- achieve to happiness, your desires interfere with your connection to happiness.

Dr. Rangan Chatterjee 1:44:19 Hmm.

Dr. Alok Kanojia 1:44:20 Because even if I have a desire for a cookie and I see you eating a cookie, the moment my desire for a cookie goes away, whether I satisfy it or not, the moment the desire goes away, then I'm happy ga- again. Agree or disagree?

Dr. Rangan Chatterjee 1:44:36 Yeah, I agree.

Dr. Alok Kanojia 1:44:38 So it's not that you... And the only... The, the thing is that the simplest way for us to make a desire go away is to satisfy it. But as you astutely pointed out, it only goes away for a little while. And now what we've done is trained our neurons to deal with desires in a particular way, which is to satisfy them. And then we have a huge problem, because our brain develops tolerance.

Dr. Rangan Chatterjee 1:45:06 Mm-hmm.

Dr. Alok Kanojia 1:45:07 So no amount of indulging our desires will ever bring us lasting happiness, because the first hour of video game I play, I enjoy it a lot. Hour number five and hour number six, the whole problem in life is that whatever we do to make us happy has diminishing returns. So the more we do that crap, it stops working. And then we're kinda stuck to square one. That's why s- fulfilling the desire of the cookie never really works. And then there's the other problem, which I kind of alluded to, which is that we're training our brain to seek, uh, uh, we're, we're teaching ourselves that the only way to be happy is to fulfill our desires, which is technically not right. The reason that our fulfilling our desires makes us happy is because it removes the desire. It is the removal of desire that makes us happy.

Dr. Rangan Chatterjee 1:45:55 Yeah.

Dr. Alok Kanojia 1:45:55 And fulfillment removes it, right? It's just one of the ways to remove it. You with me?

Dr. Rangan Chatterjee 1:46:00 100%, yeah.

Dr. Alok Kanojia 1:46:01 And now we get back to where we started, which is technology. So what technology does is we, we have a disrupted state of mind. I don't feel good about something. And then when we, when we get bored with one TikTok, why do we s- swipe? The moment we get bored, there's an increase in mental activity. Now I'm thinking about this, now I'm thinking about that, now I'm thinking about this. Why do we love binge-watching a show? Because when we're binge-watching a show, we become absorbed in it. When we become absorbed in it, when we meet... When you met your wife and you guys went on your first date, and you were just with her, and you guys l- uh, lost all track of time, why does that feel so blissful? Because you're m- there may be some degree of mental activity, but the key thing is that there's, like, kinda one-pointedness of the mind. There is peace within you.

Dr. Rangan Chatterjee 1:46:54 Yeah.

Dr. Alok Kanojia 1:46:54 There's not a longing for anything else.

Dr. Rangan Chatterjee 1:46:57 Yeah.

Dr. Alok Kanojia 1:46:59 Now you, one last thing that I wanna mention is you mentioned emotion. Emotion does not destroy our happiness. So I don't know if you know this, but there are movies that are sad. Did you know that?

Dr. Rangan Chatterjee 1:47:12 I did know that, yeah. [laughs]

Dr. Alok Kanojia 1:47:14 Isn't that wild? Why would someone pay money to feel sad?

Dr. Rangan Chatterjee 1:47:18 Yeah.

Dr. Alok Kanojia 1:47:19 So when I am caught up in a sad movie, I love it. Feels so good to cry. But once again, that's because of the state of peace.

Dr. Rangan Chatterjee 1:47:29 Yeah.

Dr. Alok Kanojia 1:47:29 I'm absorbed in it. It is one-pointed. Emotions don't destroy our happiness. It is the associations with emotions that destroy our happiness. The, the reason sadness destroys my happiness is why am I sad? Oh, I'm sad because I don't have a girlfriend. I don't have a boyfriend. I'm alone. It, there's a desire with your emotion. Any time you experience desire with an emotion, the emotion will be painful. But otherwise, when we're watching a movie, we're crying, "Oh my God, I'm s- it's so sad. It's heartbreaking," and I'm loving it because there's no desire. There's no wanting with the emotion. This is what so many people miss out on. And so the cool thing is that as you develop a sense of inner contentment through practices, through sitting still, whatever you wanna do, whether you're meditating with your eyes open, whatever, as we start to recognize that your base default state is happiness, and the more time that we spend sitting in that space, even negative emotions will no longer touch us. We will be able to feel the full breadth of emotion that life has to offer, and we will be peaceful.

Dr. Rangan Chatterjee 1:48:39 Yeah.

Dr. Alok Kanojia 1:48:40 And once we are peaceful in the face of negative emotions, our reactivity goes down. We can see things clearer. We are happier. We can, uh, we can lose a loved one and recognize that their life was a beautiful thing.

Dr. Rangan Chatterjee 1:48:55 Yeah.

Dr. Alok Kanojia 1:48:55 We can feel that grief and that loss. The problem with grief and loss is that we want them to be alive again. It's not that we lost them. Pay attention very clearly to yourself. You'll discover all of these things.

Dr. Rangan Chatterjee 1:49:07 Yeah.

Dr. Alok Kanojia 1:49:09 And so the problem with technology and mental illness today is that it is moving us towards more desire, more desire, more desire, more activity of the mind. What is boredom? Boredom is your brain trying to calm itself down. It's m- boredom is so painful. I'm thinking this, I'm thinking this. Uh, my mind is all over the place. When we're bored, we're not still. We're the opposite of still. We are seeking stillness-

Dr. Rangan Chatterjee 1:49:31 Yeah

Dr. Alok Kanojia 1:49:32 ... through some kind of activity that will quiet me down.

Dr. Rangan Chatterjee 1:49:37 Are you happy?

Dr. Alok Kanojia 1:49:39 So this is what I would say. I have periods where I'm connected to my peaceful self and periods where I'm not connected. And even in the periods where I'm not connected, the more I can look at that and say, "You know what? I'm unhappy right now"-

Dr. Rangan Chatterjee 1:49:53 Yeah

Dr. Alok Kanojia 1:49:53 ... the more peaceful I become. So what? Of course I'm gonna be unhappy at times. What was I expecting? [laughs] Right?

Dr. Rangan Chatterjee 1:50:01 Yeah.

Dr. Alok Kanojia 1:50:02 So this unhappiness is part of my life. Whatever. If I'm unlucky, there'll be a ton of it, and I'll have a ton of suffering. So be it. That's my karma.It's some amount of random chance or my choices or whatever. Whatever crap life sends my way, whatever amount of discontent, whatever amount of failure, whatever amount of crap I deal with, the... What, what was I expecting? If it sucks, it sucks. So be it.

Dr. Rangan Chatterjee 1:50:28 Do you have less desires today than you did 10 years ago?

Dr. Alok Kanojia 1:50:34 100%.

Dr. Rangan Chatterjee 1:50:35 Yeah.

Dr. Alok Kanojia 1:50:37 And way less... I, I, um, w- I have 1% of the desire that I had when I was a freshman in college and decided that I wanted to be... I was pre-med, and I was gonna, I was gonna be one of the best doctors on the planet. I wanted to go to Harvard Medical School and promptly failed out of college. And then let go of all of that desire, went to medical school. It was embarrassing. One of my mentors called me at 7:00 PM on a Friday and said, "Where are you? We're at the awards ceremony. I'm here to present an award for you. Like, no one's seen you." And I was like, "I didn't realize I was getting an award." I didn't even check my grades. I didn't kn- I mean, I knew I hadn't failed because someone would've told me, but I never even looked at my grades in med school. So the, the really paradoxical thing is as we let go of our desires, we become more productive, we become more content. Our best self comes forward. We're able to apply an undisturbed mind to the problems of our life.

Dr. Rangan Chatterjee 1:51:38 Yeah. No, I, I, I, I, I mean, I love it. I'm in, I'm in total agreement. And the, the, the reason I ask is just out of pure interest. W- the reason I answered your question on what is happiness, a lack of desire, is because I've thought about this a lot over the last couple of years. How, how do you, how do you know when you're happy? 'Cause I know that I've never felt this content and calm, uh, and connected in my life. I haven't, and I, I've shared that journey on this podcast for a, for a number of years now, so I don't need to repeat all the things that I've necessarily done over that time period. But one of the things I've noticed is I just, I don't have a desire for things anymore. I live quite a simple life. Yeah, sure, I, I, I like spending time with my wife and my children and going to see my elderly mother and recording my show each week and, you know, I, I enjoy these things. But I can't put my finger on one... You know, the internet wants to know, what was the one thing you did that got rid of your lack of desire? Well, it, it wasn't o- certainly for me, I can't put my finger on one thing.

Dr. Alok Kanojia 1:52:50 So you asked me am I happy, and what was my answer? How would you describe my answer?

Dr. Rangan Chatterjee 1:52:55 Well, you said some version of, "I have periods where I feel connected with my inner peace. Other times where I'm taken away from that, but even when I'm taken away from it, I'm able to, I guess, be a little... quite detached and observe that and not sort of get-

Dr. Alok Kanojia 1:53:10 Beautiful

Dr. Rangan Chatterjee 1:53:10 ... caught up into it."

Dr. Alok Kanojia 1:53:13 On a good day, I'm content with being unhappy.

Dr. Rangan Chatterjee 1:53:18 Yeah.

Dr. Alok Kanojia 1:53:20 You with me? 'Cause the moment that you are okay with being unhappy, you don't have to chase happiness.

Dr. Rangan Chatterjee 1:53:27 Yeah.

Dr. Alok Kanojia 1:53:28 Now, here's the problem with everyone who asks you that question, "What is the one thing you did to be happy?" That in and of itself is a desire. Their desire for happiness... Remember-

Dr. Rangan Chatterjee 1:53:40 Yeah

Dr. Alok Kanojia 1:53:40 ... desire gets in the way. If you have a desire for happiness, you will never be happy because it is the very thing that is blocking your happiness.

Dr. Rangan Chatterjee 1:53:48 Yeah. And it relates to what we said before about discomfort, right? A lot of people find the feeling of unhappiness uncomfortable, but you just said-

Dr. Alok Kanojia 1:53:56 Yes

Dr. Rangan Chatterjee 1:53:56 ... "I'm, on my good days, I'm okay with being unhappy. I'm okay with the discomfort, with the uncomfortable emotions that are there within me." And it's a subtle difference, but very, very important. I'm in a really introspective space at the moment. I've just come off, uh, a crazy six months that I chose. I've launched a new book, a book I'm very content with, and I believe to be my best work yet. I've then done a national theater tour around the UK talking about a lot of these ideas. And I'm now in a period where I've realized, actually, you know what? The last, um, six to eight months have been very outward focused. Some elements of my life I've felt pretty content throughout it, to be fair. But now I want... Not that I want, I'm now looking forward to a few months of, um, more structure and routine and not traveling and just, you know, getting deep into my movement practices and things that I enjoy doing. Not that I don't enjoy my work, okay? And what's really interesting is that, you know, you, you do all these tours and, you know, you, you, you, you meet all these, um, these other influencers, right? When I was preparing for this conversation, I've noticed that you've been on some of the big podcast shows, and it's very clear watching that some, certainly from the way I could see it, have this insatiable quest for more, which you picked up on and you sort of unpicked with some of the hosts, which I found really interesting because it, it feeds into this, I think one of the kind of seductive lies of the modern world, that many people and many children growing up today in this digital world end up believing in such a big way, that more things, more downloads, more so-called external validation driven success is what's gonna make me happy. Whereas, like, I don't know, it was quite interesting to see how many hosts probe you on that, because these are a lot of the time the people that people are looking up to, thinking, "I want that life."

Dr. Alok Kanojia 1:56:07 Yeah.

Dr. Rangan Chatterjee 1:56:07 But it's, it's like, are you sure you want that life? You may not want that life, that insatiable quest for more. Which I've been there before, right? So I know what that feels like, and I, I certainly feel I've mostly come out the other side. Any comments on what I've just said?

Dr. Alok Kanojia 1:56:23 Yeah, so I, I, I think, so a couple of things. O- one is y- you're spot on that this is what our society values.

Dr. Rangan Chatterjee 1:56:29 Yeah.

Dr. Alok Kanojia 1:56:30 Okay? And are you sure you want that? I think the answer is yes, because you can be chasing small desires and be financially not so successful, or you can chase big desires and be financially very successful, right? So I, I think that people aspire for these things-

Dr. Rangan Chatterjee 1:56:47 Yeah

Dr. Alok Kanojia 1:56:48 ... because I think if you are rich and powerful and good-looking and have an impact on the world, if you have autonomy and agency and power and can, can, uh, there, there, uh, the things that you talked about earlier, I think many of these very successful people align with that. So if you're someone who is full of desire and unsuccessful, is it better to be someone who's full of desire and successful and rich and powerful? Sure, why not? And you are settling on something else, which is what I found. So I work with broke gamers and I work with billionaires, and the reason that I work with both of these people is because there are some fundamentals of the human condition about the nature of desire, the nature of contentment.

Dr. Rangan Chatterjee 1:57:34 Yeah. Are these lessons that can be learnt without having gone through it, right? Do you have to g- you know, I, I love what you said about, you know, satisfying all those desires first before you come out the other side, you know? H- I mean, how do you think about that with your own children, for example, if, if you, if you're willing to share?

Dr. Alok Kanojia 1:57:55 Yeah, yeah, yeah. So why would you want to get to the other side without the experiences?

Dr. Rangan Chatterjee 1:58:02 I wouldn't.

Dr. Alok Kanojia 1:58:04 Right? So I, I, I think the, the problem once again is in the question. So why do we, why do we place so much value on the other side? So w- w- uh, the, the experiences in my case were really difficult. So there's this natural idea of, "Okay, can I jump ahead? Can I avoid all this pain and suffering," right, "and get to where I am now?" And what I've come to realize is there's no pain and suffering and pain and suffering. You can't know that until you go through the pain and suffering, right? Uh, I don't know if that kinda makes sense.

Dr. Rangan Chatterjee 1:58:33 Yeah, yeah, yeah.

Dr. Alok Kanojia 1:58:33 But, but, like, it, it, and I mean, there is pain and suffering and pain and suffering too, but, uh, I, I think that this idea, and if you think about it, there's a grasping. That's the problem, is that you want your life to be different. You want your life to be optimized. You wanna skip steps. That thinking in and of itself will never get you there.

Dr. Rangan Chatterjee 1:58:54 The quick fix, the hack.

Dr. Alok Kanojia 1:58:57 The, yeah, all that stuff is like all this bypassing, and people can try to bypass. And I'm like all f- I'm fine. If you wanna be efficient, be efficient, but accept what comes. Accept that, so what, what I do with my kids is I'm not their guru. I'm no one's guru, and I'm not sure I'm an influence or whatever, but, like, I'm their dad. So my dharma, my duty to them is to be their father, to pass along what I have to share, but they're not my students. I've tried to make them my students. They're not interested. So then I realized, oh, this is about me. This is like, here I am, you know, get watched by 15 million people a month, and my kids don't wanna learn from me. Like, people come from all over the place to, like, learn meditation from me, and my kids kinda don't wanna learn meditation from me. So be it. Like, that's fine.

Dr. Rangan Chatterjee 1:59:46 Yeah.

Dr. Alok Kanojia 1:59:47 I'm gonna spend my time playing Dungeons & Dragons and teaching them how to play Monster Hunter on PS5. That's what they want from me. That's what I'm gonna do. I'm gonna pay their bills. I'm their dad.

Dr. Rangan Chatterjee 1:59:57 Mm.

Dr. Alok Kanojia 1:59:57 Right? There's thousand other people. They can watch your podcast. Let them learn from you.

Dr. Rangan Chatterjee 2:00:02 Mm.

Dr. Alok Kanojia 2:00:02 That's fine.

Dr. Rangan Chatterjee 2:00:03 Yeah. Uh, I, I love that. And, and at various times throughout this conversation, you've mentioned these documents that you've created, these, these, um, for trauma you mentioned, I think you mentioned for something else. I think you may be new to a lot of my audience, and first of all, your YouTube channel is just phenomenal and full of wisdom, brilliant videos about a whole variety of different topics. I would tell people to, don't get distracted with the name HealthyGamer. It is, to me at least, it is for everyone. There's, you know, I d- I can't imagine anyone will go on there and not learn something about life and themselves. But for people who wanna learn more from you, um, where would you have them go?

Dr. Alok Kanojia 2:00:47 Yeah, so I, I think the YouTube channel is a great place to start. So basically what they're gonna find on YouTube is exactly what they heard here today. You're right, it's not so much about gaming. It's about weaving together the modern problems of the digital age, understanding them through neuroscience, psychiatry, psychology, and spirituality. Um, and then, uh, you know, this, so go to the YouTube channel is great. The other thing that I did mention is we, we do have, so I've built certain guides to mental health, which is my take on common conditions like depression, anxiety, ADHD, and they're full of basically, uh, similar stuff to even what, what you described. So there are all kinds of meditation techniques in there. My understanding of these conditions in a way that we discuss this stuff, right? So it's like, it's not just the, these are the diagnostic criteria. It's like, what is depression? Is depression normal for some people because their life is genuinely bad? What are the different ways in which trauma shapes your physiology, shapes your brain, shapes your psychology, shapes your identity, shapes your relationships? So we kinda go into a lot of depth and detail on those kinds of things. And then the last thing, it, since we talked about kids some, is it's interesting because I, I wrote a book that was not for my target audience. I wrote a book about parenting so that we can equip parents with the skills to teach their children how to develop a healthy relationship with technology. So I, I wrote a, it's kinda weird, but I, I wrote the book that I thought the world needed, which is that there's a whole generation of kids who are spending way too much time on screens. Parents are struggling.Because parents are up against like Google and Meta who have all of these engineers that are designing all of these applications to get your kid to be on a, uh, on a phone. How can you compete with that? So if people are interested in, in parenting stuff and, and sort of helping their kids-

Dr. Rangan Chatterjee 2:02:45 Yeah

Dr. Alok Kanojia 2:02:45 ... 'cause it's the most common problem I hear about. So definitely check out How to Raise a Healthy Gamer, which is a, a book.

Dr. Rangan Chatterjee 2:02:52 And, and where, and these guides, where do they find them? Is it on your websites?

Dr. Alok Kanojia 2:02:56 Yeah. So you can just go to healthygamer.gg-

Dr. Rangan Chatterjee 2:02:58 Yeah

Dr. Alok Kanojia 2:02:58 ... and then it'll be, it'll be there.

Dr. Rangan Chatterjee 2:03:00 Yeah. Amazing. Hey, I can't tell you how much I've enjoyed today's conversation.

Dr. Alok Kanojia 2:03:05 Yeah. This was a blast.

Dr. Rangan Chatterjee 2:03:06 It was so much fun. And just finally, for that person who has, has been listening and they've heard something that's just sparked something inside of them, it sparked something where they feel, "Yeah, you know what? I'm, I'm kind of, I have been feeling lost. I have been feeling a little unmotivated. I have been feeling as though I'm someone who's full of desires and I can never satisfy them all," and they're looking for some kind of final words of wisdom from you, what would you say to them?

Dr. Alok Kanojia 2:03:43 So if someone's listening to this conversation, you feel a spark, "Oh, this resonates with me. I'm too full of desires. I'm uncontent. I'm, I can't control my mind. What should I do?" Nothing. In the past when you've had this feeling and you've chased this feeling, where has it gotten you? See, the moment we feel discontent and we feel a longing to act, and then the discontent goes away, and then we no longer follow through. So oddly enough, what I'd encourage everyone, like, I mean, so if you're listening to this, examine your own life. And when you feel a little spark of something, what do you usually do? You usually chase it, and then it fizzles. So don't live your life based on these sparks. I mean, should you pursue something? By all means, go and learn, read a book, whatever. I'm not saying practically don't do anything. But don't do it reflexively. Take a moment and just do nothing. And interestingly enough, that may help you 'cause if chasing your sparks has not led you to where you wanna go, try not chasing them. Try being still. Try doing absolutely nothing and see where that leads you.

Dr. Rangan Chatterjee 2:04:58 I love it. Dr. K-

Dr. Alok Kanojia 2:04:59 [laughs]

Dr. Rangan Chatterjee 2:04:59 ... it has been an absolute pleasure. Thank you so much, and I, I really hope we get to do this in person at some point in the future.

Dr. Alok Kanojia 2:05:07 Yeah. Looking forward to it, man.

Dr. Rangan Chatterjee 2:05:08 [upbeat music] If you enjoyed that conversation, then I think you are really going to enjoy this one.

Guest 2:05:13 We live in an age of rings and pings and dings and app notifications, social media alerts. We're rewiring our brains. Technology's a tool for us to use, but if technology's using us, then, then we become the tool, right?