Breaking the Link: Emotional Trauma & Alzheimer’s Disease

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Thank you, I’m so glad to be here.

Heather Sandison, N.D.

It’s a pleasure to have you and really wanna dive in to this autoimmune disease part of the puzzle when it comes to Alzheimer’s disease and reversing it. Autoimmune disease is kind of in the same line of thinking for a lot of people that it cannot be reversed and yet we see, you and I in our practices daily we see that that’s factually inaccurate, that you actually can reverse some of these diseases people are living with not realizing that there are answers and solutions. So what’s the overlap between autoimmune disease and Alzheimer’s.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

So you’re absolutely right that we see this all the time in our practices. People are given this sort of like sentence of, “Well, there’s no cure and here’s the medication list that we can try.” And and in my case with rheumatoid arthritis, I was diagnosed with that when I was 30 and I’m 56 now. So over 25 years ago and I was told to come back when I get worse not if. So there’s that kind of a hopelessness around autoimmune disease. And I think when I was diagnosed with RA 25 years ago, there were only a handful of known autoimmune diseases and Alzheimer’s wasn’t considered one of them. And now we have over 145 known autoimmune diseases and it’s not because we have new diseases. It’s because we have new understanding about what constitutes autoimmunity. 

So anytime you are at war with yourself and the way that conventional medicine tends to think of an autoimmune disease is by the disease name and the target tissue that your immune system is attacking. And so Hashimoto’s would be a disease of the thyroid in this conventional way of thinking, colitis and intestinal disease, MS and you’re neurological system. And so when we think about it that way, we’re actually running around in the forest, trying to move the target around as the immune system shooting arrows, instead of going to the archer and saying, “Hey, do you mind stopping that? And so there are a variety of methods that the body will use or the immune system can become hypervigilant or reactive against our own tissue. 

And so all of that being said, Alzheimer’s happens to be one of those where our immune system is attacking us. And it’s through a process. I mean, before we started talking, I had to go look this up. So I don’t wanna even pretend like I’m an expert in Alzheimer’s ’cause I am not but autoimmunity, I work with all the time. And there’s the same structure that I use to move through it, to reverse it. And with Alzheimer’s, it’s something known as pathogen mimicry. So we know that there’s this thing called molecular mimicry. And in fact, with COVID, a few of the studies that have come out, why people with autoimmunity it’s so hard is because COVID will do the same thing where there’s a pathogen related molecular mimicry, right? 

And so COVID can be an example of one of those pathogens where it actually mimics your own tissue and causes your immune system to attack you. And in this case, we’re talking about brain tissue. So it’s very interesting if you can pull out of just the thought of Alzheimer’s or just the thought of Hashimoto’s and just RA and come into this place of “Why is my immune system attacking me? Why is this going on?” Yeah.

Heather Sandison, N.D.

Right, yeah, in Alzheimer’s we think of the pathophysiology of being beta amyloid plaques and TEL proteins. And in actuality, a lot of those are produced because our brains are trying to protect ourselves, right? They’re trying to protect themselves. And so an infection or a pathogen, if there’s a big immune defense that’s in response to that, that starts to eat away the brain essentially, right? That the immune system is almost a little overactive in response to some pathogen coming in and in that way, it starts to look like an autoimmune disease, right? Like the body is trying to protect itself from something and in doing so over responds-

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

We have these little microglia cells in there that are like scissors, they go and they go, “We gotta trim that away.” “That’s extra, no.” And we don’t want those messages going to them. ‘Cause they’re like the mast cells in our immune system and the rest of the body, right? There never used to be thought to be a connection between the body’s immune system and the brain’s immune system. But now we know there is. And so this mass cell activation is the same thing that can happen in the brain with these microglia cells. And so it’s like crossed messaging, right? And then we go after ourselves and we start trimming away parts that we don’t want trimmed. Yeah.

Heather Sandison, N.D.

We need those.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

We need that please, lot’s of gray matte better.

Heather Sandison, N.D.

Exactly. Another big piece of what you are an expert in is this piece around trauma. And that also can lead to this sort of hyperreactivity. You said hypervigilance. Explain the significance there and the connection.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Yeah, this is really interesting. One of the things that I write about in my book, “Solving the Autoimmune Puzzle” is a hypervigilant mind will create a hypervigilant immune system, as above so below. And this attempt to separate the mind from the body doesn’t really work very well. And we’ve had that proven to us in our medical model over and over again. So the mind is actually the part of the body and there’s no central point of mind. 

The mind doesn’t live in brain. We always think when we think of mind, we think brain. But mind is actually our perceptual field, our consciousness that’s non-local in a lot of ways of thinking. In Tibetan Buddhism there’s this thought that there are six minds not just one, each of the five sense organs, and then the synthesizing mind that it brings them from, all these, your eyes and your ears and your nose and your mouth, they’re all bringing this information. And so the bringing of the information, and then the mind that filters it is all based on a perceptual lens that we create in childhood. So we’ll be looking for things that we were trained to look for. And so then we’ll find what we’re looking for. 

So I had some sexual abuse when I was younger, when I was 10, that the hands of my vice-principal in my elementary school. So I became quite hypervigilant in looking to see if I was safe or can I trust an adult who’s in authority. And so I’ll be looking for that more than maybe somebody that’s never had a problem with somebody in authority or a problem with not feeling safe. And so my training then of my mind is really important to be able to point to, oh, that little safety thing just went off and it’s okay, you are safe. And because for every five minutes, your mind is upset, it takes eight hours for your physical structure to recover. So if you have an upset of any kind, your mind has something message now to the rest of the body that says, “Oh, we’re, we’re not safe. We can’t trust where whatever it is, not beautiful enough, not smart enough, not fast enough, not enough.” 

Then in that moment, just that nanosecond of perception, our adrenals pick that message they send out cortisol into the system, which is fine for a little while. If we do that, occasionally when we are really in danger and we have to summon everything that we need to get away from whatever danger it is and flee or fight or freeze or faint but to have that happening in perpetuity, consistently persistently, our bodies are not designed to be able to keep up with that. And so the mind’s perceptions are everything, they are everything. And we’re always trying to do this reductionist thing, like what part of the brain and what part of the brain. And it is really kind of crazy, it was just like, no, it’s actually your perceptions that trigger the entire thing. 

And this is the role trauma plays because in childhood and I’ll just define trauma, we have capital T trauma or we have lowercase T trauma and capital T trauma are the things that we tend to think of when we hear the words trauma, traumatic event, we’ll think of sexual abuse, we’ll think of domestic violence, psychological, emotional, spiritual abuse, neglect, abandonment, having a caregiver incarcerated or mentally ill or addicted to a substance or dead or violated in some kind where we witnessed it or divorced. 

So any of those things are considered capital T traumas that we can incur in childhood that then set up the way that we see the world. And from there, we react to our world for the rest of our lives until we come back around and learn how to have witness mind and shift that and kind of clip the wires to that hyper-vigilance. “Now, I am safe, I actually do live in a space where I have sovereignty and I have autonomy. Nope, I don’t have control over anybody else or anything else out here but I have control over how I respond to it.” And so those skillful means and training in those actually really affects our cytokines, our inflammation, our gut wall, our adrenal and hormone health, our microbiome, our brain health, it’s really remarkable.

Heather Sandison, N.D.

I think of this as setting someone up for risk of dementia but also caregivers, the statistics are absolutely wild. A caregiver is 60% more likely to end up with dementia. So someone who’s caring for someone with dementia is much more likely to get dementia than someone who doesn’t care for someone.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And it’s not contagious, this is the trauma part-

Heather Sandison, N.D.

It’s the trauma-

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

The hyper-vigilance, yeah.

Heather Sandison, N.D.

It’s the stress and trauma of caring for someone who has that degree of need. And you can imagine that a mother with an autistic child also kind of set up when you’re that caregiver. And so talk a little bit about processing trauma and I want this to feel empowering, right? Not that you’re set up for disease but what can we do about it? And especially if we can identify that “All right, I’m in it, I’m going through divorce” or “How do I protect my child so we can prevent the disease from happening later?”

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

I wanna circle back around and hit a point that I was making and didn’t finish about lowercase T trauma.

Heather Sandison, N.D.

Ah, thank you.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And everybody has trauma and it’ll be in those one of those two categories. And the lowercase T trauma is what you’re talking about. It’s the one that is what we call chronic overwhelm. On the perceived stress index if you tick off all of the marks then you actually have the same change in brain architecture on an FMRI or a pet scan. Your prefrontal cortex begins to shrink in volume. Your amygdala starts to grow and volume and you start to become hyper attuned again to the environment. And you can see why a caregiver of somebody with dementia or Alzheimer’s would have that happen, right? 

So this is one of those lowercase T traumas that is creating the same exact changes in the body as PTSD does. So I wanna really make sure everyone can hear that because usually someone will say, “Oh my gosh, I had a great childhood.” And I’ll say, “Wonderful, I’m really glad, so did I.” But we all, part of the human condition is that we all have challenges. And at some point when we’re children and adults and everyone’s had this where they’re handed a challenge that they don’t think they can navigate. And when we’re kids, we’re not autonomous beings with power, we’re not empowered, we’re not supposed to be, there’s a power differential there between caregivers, parents, teachers and a child trying to learn how to be a human in a world governed by big humans. 

So we’re always going to run up against something that’s new, that we may not be able to have a caregiver next to us to help us navigate. And it can be like, I didn’t get picked for the ball team I wanted, I missed the spelling word in front of the entire classroom and the spelling bee, whatever it is. And then I come away with this belief system that I’m not good enough, I’m not whatever those things are. And then a behavior will become attached to that belief and an emotion. So in my doctoral work in 2013, I did this study called the healing unresolved trauma study. And I’m laying this background so I can say how, so I want people to be able to track it. When you first have an event in your life that you couldn’t understand, then you’re going to have an emotion that attaches to it. 

And it could be fear, a lot of times for kids it’s fear, confusion, “I don’t know what’s going on and no one’s here to tell me” then from there that emotion is felt somewhere in the body. And so sometimes we’ll have these places that we carry our stress, like our jaw or shoulders or neck or heart center or gut, et cetera. And so that got connected to that emotion a long time ago, a long time ago. And then from there you create a meaning where we’re always creating meanings in our lives. So we’re gonna create a meeting. And when we’re children, we don’t have this prefrontal cortex. So the meetings we make up are very, what we do but it’s not as fully developed as an adult head until we’re 26 and our meanings we make up are gonna be very self-centered ’cause we’re very self-centered little beings when we’re children, that’s our developmental state. 

And so then that meaning will create the belief and the behavior, the adaptive behavior response. So then on this HURT model, there are these two places you can go, the one where you heal it or the one where you continue to loop, right? You feel the feeling you, it goes off in that part of your body, you ruminate about the meaning and the belief. And then you go into your behavior. Maybe your behavior was eat Oreo cookies to feel better, maybe your behavior was to lash out at somebody, Maybe your behavior was to numb out, go jogging, whatever it is, it’s an adaptive behavior. Some of them are healthy, some of them are not. 

So when we go in at a behavior level, it’s really hard to change, we can’t because we haven’t really understood the tracking that got put in place, right? So we really have to be able to track that hurt and say, “Okay, there’s a need that’s not being met right now. What is the need?” Oh, my need for support, my need for warmth, my need for community, my need for comfort, my need for respect, acknowledgement, being seen, being heard, being understood. Those meanings if they’re not met, have a series of feelings that can happen, whether it’s anger or sadness or pain of some kind. And then we can also have needs that are met for all those things and we’ll have a series of feelings that are present when they are met, joy, happiness, warmth, right? And so you can kind of start to track like what feelings am I experiencing right now? And try and track the ones that are also warm and fuzzy. 

Sometimes we tend to really lean into the direction of what’s wrong instead of, “Oh my need for family right now is being met. My need for adventure and spontaneity and group community is not being met but my need for families being met.” And you’ll find two different kinds of feelings that go with both of those. So the what to do is really to start tracking your thought processes, your needs and your feelings for yourself. Instead of asking someone else to read you and to track you, which often as women, we do that, we caregive everybody else. And then we want our significant others or our friends to track us is not really fair. And so that’s part of the beginning of what to do. And if you find, I call it a rumination loop, if you don’t self-confront and you’re not willing to do this, what will happen is you’ll just keep ruminating on what is wrong and it leads to judgment and that leads to disease. 

Actually, that’s what the model shows is that leads to disease, low libido disease, really discontent and unhappiness on all levels. And so if you’re willing to self-confront, really willing to start witnessing what your own mind is doing and then starting to learn skills, right? And if you get stuck, that’s where I say, you go borrow a brain and that’s therapy and it needs to be a form and a therapist that matches with you. So whenever I give talks to physicians at the Institute for Functional Medicine, I teach them this stuff and then I’ll say, “Oftentimes, you’ll hear a patient say, ‘oh, I’ve done therapy.'” But they’re still sitting in front of you with an autoimmune disease, right? And so you get to a certain level and then it might be appropriate to stop. But then once you get to your next growth edge, which is that place where, oh, I don’t think I can handle this, I’m feeling myself decelerating, I’m triggered. 

It might be time to do it again. And to find if you had a bad experience with a therapist, therapist doesn’t work for me, right? I always talk about going shoe shopping. Maybe you want a pair of really cute green boots and you go into a store and you find your pair of really cute green boots and you put them on and you walk around the store and you find that one of them pinches really badly and you think, “Oh, they’re so cute. But I wouldn’t be able to wear these all day.” 

So you put them back on the shelf and then you don’t walk out of the store barefooted and say, “Shoes don’t work for me.” You actually, if you’re really committed to green boots, you’ll keep looking and you keep wearing shoes. And so it’s the same thing with finding that good match for getting unstuck, right? Somebody that’s trained in being able to see patterns and be able to help you unstick.

Heather Sandison, N.D.

I usually recommend to patients that they make an appointment with three different therapists and see if there’s one that fits and my bias, I think it’s probably similar to yours. I basically think everyone should have a therapist that they have a good relationship with because things come up. And if you already have that person that you can call, there’s one less hurdle to finding that right fit. And so I do think that as I completely agree with what you’re seeing is that it’s not always, you don’t always find the right match the first time. And that doesn’t mean that the entire model doesn’t work.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Exactly, exactly, it means you haven’t found that, it is means, if you go on your first date and you fall in love and you get married, that’s unusual but usually you date around a little bit.

Heather Sandison, N.D.

And also that no one person can be everyone’s therapist, right there isn’t one right fit for everyone. It’s not that that therapist is bad, it’s just that it wasn’t the right fit.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And you really do need a therapist that’s gonna hold your feet to the fire not be your buddy. So this is really an important principle. You do not want to be buddies with your therapist. You’ve got to find someone that stretches you and challenges you and makes you feel uncomfortable, ’cause that’s getting you on the edge a little bit where you have to go, “Oh yeah, I didn’t wanna think about that but I see .” And then send you home with respect and love and cheerleading and you can do this and go integrate now until the next appointment. That’s really, really an important aspect of therapy. You have friends, you can go and talk to. And I always say, talk therapy doesn’t really work that well. So you really wanna do a trauma release mode of therapy.

Heather Sandison, N.D.

Right, right, yeah, there’s so much to that. Just that whole separating the friend zone from the therapist and that I think a lot of people in their minds think that, “Oh, I have lots of friends to talk to. I can air this out all over the place.” Well, that’s not actually what a therapist does, a really good therapist, you don’t get much growth out of your comfort zone, of someone making you feel better, you get it when you dive into that discomfort.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And venting is fine if once, maybe twice but you don’t wanna cement your story too deeply into that space before going in and really, really starting to release it because, yeah, we can.

Heather Sandison, N.D.

I think this is so important for caregivers who are listening to hear because there are different ways to tell the story of caregiving and some can be really beautiful, really growth enhancing, really relationship, making those relationships more valuable and more meaningful or you can go down the road of resentment. And like you said, cementing the story of the trauma and realizing that there’s that choice and that you really don’t have to change too much other than just the perception, like you mentioned.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

That’s exactly right. And resentment is the thing that I always call the most toxic chemical on the planet. And it’s not manufactured in huge tons and dumped into the air, soil and water by corporations. It’s actually manufactured in here and it’s dumped into our bodies. And so our cells are in the little hot tub, bathing in resentment, that actually makes them sicker than anything from the outside. So having boundaries with our own thoughts is one of the most important interventions for healing trauma, having boundaries with our own thoughts. So yeah.

Heather Sandison, N.D.

I want you to dive into the four corners of health that you described because this is part of it is the trauma and go into that. ‘Cause I think you’re creating that comprehensive sort of framework for how do I approach this is helpful not only for patients who have active disease but also for preventing disease and reversing it.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Yeah, for sure and halting it. I mean sometimes I talk a lot about like, I’ve run four reverse autoimmune disease summits. And I realized I don’t really talk a lot about, I talk about reversal and people might think, oh, reverse means all the way back. But sometimes it means halting progression and that that’s a big win. So I’m also halting, that this is a big piece of it. So long ago when I first started moving outside of just conventional medicine, which I’d been steeped and raised in. I always say, I wouldn’t have known an herb if it had bitten me in the bottom. I just didn’t know any of the thing about any of this. I was completely ICU, high intensity medicine, back in the day before I was with RA. 

And so I had to really dive in and start asking myself, “Why am I attacking myself? Autoimmunity means I’m doing this to myself. So let me really dive in and see why is that? Why do I wanna die? Because I don’t consciously want to.” And that was really important. And so in the process of reversing my own RA, which happened within about six months, I developed this framework that I call now the Freedom Framework. And I think about each of us is unique puzzles. 

So when I say all that about my own story, I don’t expect people to take that and then apply it to themselves piece by piece that this is going to be exact. I don’t even think there’s any such thing as an autoimmune paleo diet that’s right for every single person. I actually think we’re all very different puzzles. And so when we’re solving a puzzle, we dump all those pieces out. And the first thing we look to do is find those four corner pieces. And so the fourth corner pieces of any health puzzle, the way that I think about it is your own unique genetics. My grandfather had RA, it’s in my genes which is what made my rheumatologists say, “Well, here are two prescriptions, take them until you get worse and then come back and we’ll talk about switching your meds. It’s genetic, you have no choice.” 

We know that’s not true, we know that’s not true. And I could definitely get RA back because it is in my genetics. And so if I were to go back to the way that I used to be, then I could definitely have it again. So genetics is one corner piece of the puzzle. The second one is your digestive tract. so gut health really important. We know the role of microbiome now in our immune system, we know how important that leaky gut is present for everyone with autoimmune disease. We know leaky gut leads to leaky brain. We know it’s a key player in Alzheimer’s and that all of these aspects that we talk about around the gut have to actually be addressed. 

So the third one is your toxic load. Every single person’s toxic burden is going to be different because each of us has our own unique genetics again, for how we can detox, right? We’ve all been exposed to different things. The CDC says 95% of Americans have Epstein-Barr Virus. So Epstein-Barr Virus is not the key player in our disease processes but it is one of the toxins on the toxic load scale, right? So toxins, I think about as our environmental lens but also our internal thought processes, right? Any kind of toxic thoughts that you have, that’s going to contribute to toxic burden. And then the fourth one is going to be your past stress and trauma and how you’re doing with your stress today. 

So really each one of those is interrelated with one another. As I talked about earlier the perceptual filter that we view the world through and how that activates our nervous system, our fight, flight, freeze and think response. Well, if we are doing a lot of that chronically that’s releasing cortisol and breaking down our gut wall, it’s actually activating genetics to express themselves and disease states, it’s in that leaky gut process our toxic burden can go up because then if we’re more prone to small intestinal bacterial overgrowth and Lyme disease and all the pathogenic, all of it. So they all are very much interrelated. And then after we get those four corners in place, we put together the frame. And I think about these in four different Cs. 

So the first edge pieces along the side of the frame is going to be uncover your root causes, which will be in your body, your mind, your heart, your spirit and your story. This is why I was talking earlier and you pick that theme up, how you tell your story is really important. And then the second edge piece is going to be confront your data from whatever data that you’re collecting. So it can be what’s on your scale when you stand on it, it can be your energy level as you assess it when you wake up in the morning and throughout your day, your libido level, your relationship satisfaction and all the functional medicine laboratory testing that’s so important to do when we’re asking the body what it needs, always test don’t guess. 

And then the third edge piece of that framework is going to be to connect the dots between the data that you got at the top there and your lifestyle choices. And then after you’ve really solved for those three, then you go to that fourth edge, which is going to be to create the life that you want with intention now, instead of from factory default settings from childhood. And so now you can really, instead of believing myself unsafe, I can actually shift that, really click the wires in my nervous system and move into a space using lots of different techniques, whether it’s deep breathing, vagus nerve stimulation, making sure that I can connect, I always keep this picture next to my computer with my little child part that I’m actually really attaching to her. 

I have really insecure attachment disorders when I was younger because I have a birth story that went to that. And so being able to reattach to myself, to my inner core and to be able to know that I’m not leaving me, is that’s the foundation I stand on and I’m connected to the sacred and to the divine and that that never leaves. So all of these are practices that have to be done with consistency and dedication and love. And so then that actually in the middle of the puzzle are the five Rs that we think about when we’re healing from a functional medicine paradigm. And so it’s going to be different for every person.

Heather Sandison, N.D.

Right and it takes hard work but it’s so worth it, right? If the alternative is to live sick and miserable versus doing the hard work, I mean, it’s such an invitation, right? Our symptoms are communicating with us. That’s our body communicating that something’s out of balance and it’s this invitation to walk through that threshold and do the work so that you can experience life more fully and more easefully, get more joy out of it because you’re not in pain, you’re not suffering. You can remember those great memories. So such a beautiful invitation and such a great way to organize yourself around it, ’cause it can feel overwhelming, especially if you’re starting from being pretty sick and having been through the gamut of the conventional system.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

My grandfather who had RA lived quite a bit of time, deformed in a wheelchair and he died at the age I am right now. I mean, they didn’t know any of the things that we’re talking about today. I mean, what an amazing time to live in right now that we have access to all of this, that we can really know ourselves so deeply if we just tune in and do it, like we have it. And that wasn’t, none of this stuff is anything anyone would talk about in my grandfather’s generation. So yeah.

Heather Sandison, N.D.

So you are getting a master’s degree in divinity, is that right? So this is fascinating to me because I was reading your bio, we’ve met before and I’m always impressed by the number of certifications and degrees that you have. And I’m like, “Where do you find the time?” But you really exemplify being dedicated to just lifelong learning. And we know that that is so good for your brain. Can you talk a little bit about how that influences your brain and also the science?

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Yeah, I always used to say that if somebody came into my office and stump the chump, the chump would go back to school or something. It’s like, “Oh, I need to learn that.” And so these things built up over the years, never was there a place where, and this is part of the privilege that I live in and then I’m going to identify. Like I really locate that privilege that I have and feel very grateful for the fact that nothing in my mind stopped me or said that that would be impossible. I could actually just go learn whatever I wanted to learn. And I feel really grateful for that. So that’s what I’ve done my whole life. 

And my parents role modeled that, when I was 12, they went back to school. My dad left the Navy and they went to nursing school together. And I think that that was really nice role modeling for me that my parents seemed very old at that time to me. I was 12 and they’re 18 years older than me, which is not at old. But it was quite ancient to this little kid, right? And I thought, “Wow, you can still, you can.” So I already had that in place. Like there’s no age that you can’t go back to school and learn. And so, yeah, whenever I’ve been curious about something, I’ve decided I wanna do a study about it or go learn if it’s not available already. And in this case, I went back to school for a masters of divinity because this idea of perceptions and the mind training. Tibetan Buddhists really have this nailed down. 

And I thought, “I really wanna go learn from them like how they have identified.” The Buddhist psychology is so much deeper and more intricate than Western psychology, it’s really rich. And the more I learned about it, I thought “I need to go train with these guys.” So that’s what I’m doing and what it does for my brain at the age of 56 is, I mean, there are piles around me of research papers and I’m devising a study right now to answer a question about how to reduce death anxiety in our culture and to really alleviate what they call terror management and how our culture just does not talk about death and dying. And therefore it lurks back here and people with Alzheimer’s have to confront it, so do their caregivers. 

And yet there’s not a great permission in our culture for it, like even if your thought about dying, like how do you feel when you… That’s just not something people usually will come head on with, right? And so what that does for my brain is it keeps it really active and vibrant. And we know this and research with Alzheimer’s science is brain science. And then when we look at Alzheimer’s to prevent it, if we can use as many different parts of the brain as possible and not do the same thing day in and day out, like really stretch ourselves, move over, “Oh, I don’t do crossword puzzles. 

Maybe that would stretch me over here, play Scrabble but if I do that a lot then maybe I need to do something with numbers. And if I do that a lot, maybe I should do something a little bit different, like from the temporal low with spirituality.” So they’re just music, something that stretches from what you do already all the time, so that you can keep those connections and those bridges moving between the parts of the brain and firing. So the microglia don’t deem them unnecessary and cut them away.

Heather Sandison, N.D.

Another thing that I think our society doesn’t really discuss is aging itself, right? We think about, “Okay, I’m gonna save for retirement maybe,” but that retirement in our minds is, “Oh, we’re gonna get a second house in the mountains or at the beach or go on cruises.” And it doesn’t, we don’t really discuss, “Okay, well, what do I wanna do if I’m debilitated? What does it look like if I am demented, if I can’t remember if somebody else is in control.” And the lucky among us put something into place, there’s a power of attorney, there’s plenty of savings and that doesn’t get depleted, however-

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Not that lucky among us, it’s the ones who are planning.

Heather Sandison, N.D.

The ones who are planning, right?

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

That’s pretty important.

Heather Sandison, N.D.

And talking about it. And I think there’s so many of us that think, “Oh, that won’t happen to me. So I don’t need to plan for that.” And yet opening up these conversations around death, dying and aging allows for us to plan. And when we take away the stigma or this assumption of that’s not gonna happen to me, I think the other piece of that is that we’ve taken those people out of society, right? They live in homes separate from us. And so we don’t have to be confronted by it. They die in hospitals, they die in homes, not with us, not around us. And so we don’t end up having those conversations in advance.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

I started having these conversations years ago with my parents and my children. I have four children who are now no longer children, they’re in their 20s and I have a 30 and a 32 year old too. And we at Thanksgiving would start, we started having around the dinner table, any updates to your plan that you wanna listen to in terms of music, if you’re ever comatose or you want read to you, is there anything different than what we have already? And everybody has that has expressed it. 

And I’m a conscious dying doula. And so I have like a little care plan and everything that I put together for everyone and a notebook has it all. And my dad died in February and it was quite suddenly after a second COVID vaccination. And he had a brain bleed and he died overnight really fast. And he was on the ventilator and we were keeping him on the vent until my brother could get there. And the nurse kept coming in and trying to tuck his feet in in the covers. 

And I said, “He’s gonna to haunt you if you keep doing that.” I’m the one that keeps on doing it because he’s told me for years, “If you take my feet in, I will haunt you.” And he had Jazz playing next to him on the pillow with his phone, a playlist that he’d put together already because I’d asked him to. So we knew as much as we could, we implemented of all the things that I knew about what he wanted, we knew what the memorial was to look like. He died on a, he went down on Valentine’s night. We took him off the vent at noon the next day. And then we picked up his ashes on Thursday of that week. And we had his memorial on Saturday. It was like so smooth because we all knew what to do.

Heather Sandison, N.D.

You were all on the same page. And I would imagine that brings him so much more peace. He’s not sitting there incapacitated unable to voice his wishes. And you’re on the other end going, “I know I’m doing what he wanted.”

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Exactly.

Heather Sandison, N.D.

Questioning yourself, every decision.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Exactly, there was no drama trauma about any of it because we all knew and so.

Heather Sandison, N.D.

My mom was like, “There’s a key. And in there is all the passwords and you’ll be okay.”And that’s as far as it goes and then I go, “I don’t wanna know, I don’t wanna hear it. You’re gonna be here forever.” Like I’m totally in denial.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Don’t do that, Heather.

Heather Sandison, N.D.

I know, you’re absolutely right, I’m glad we’re having this conversation. And yet there’s so many people who do. My experience is probably more than norm. And I mean, thank you for modeling these alternatives for how we can think about this. And certainly as I spend more time with Marama, the residential care facility for the elderly. And when we took that over it was a hospice facility. So I did have the privilege of watching three people transition there and just holding space for them in that. 

And I would say that the families who had loved ones with us who were transitioning, their experience was closer to mine than yours, right? It was a lot of question, a lot of siblings that didn’t know what does she want? Well, I want this, well, the grandkids, my kids want this piece. And a lot of internal, of course, the grief and the processing but the questioning. And then the tension between the people who are left.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

And that will sometimes happen. My grief process after my dad died got arrested about a week later ’cause my brother just all of a sudden got angry at me about something that he won’t even tell me. And we’re having a lot of drama right now. Sometimes people go sideways if they don’t have enough mastery over their own mind. And so I just have to just let that be what it is. I was very attached to never having family drama after death. I was very adverse to it ’cause after years of hospice I used to see those things too. And so I did everything I could to make sure everything was smooth with all family members but you can’t control how someone’s going to do their grief, you just can’t. 

And so all you can do is in my situation, I just have to like, let that go. “Okay, there’s family drama, I tried everything I could not to have family drama and here we have it.” And have boundaries with it, send him compassion not get myself tormented about it, which is the most important part because then my body will start to deteriorate faster and I’ll create resentment and I’ve already had a disease that goes with that and I don’t need to do it again. And so he’s become my greatest spiritual teacher for patience and forgiveness and compassion. And it’s like really doing my work. 

So we can’t control the people around us. And sometimes the stuff does happen, it’s quite common with a death. So for some kind of family fracturing to happen. And it’s so sad, so sad but if it does then the other component of that is, is to be able to engage in radical acceptance for what is not fight about it inside of yourself, they should be doing this, I can’t believe, not ruminating ’cause on that HURT model that’s the left hand side of the model where it leads to disease, rumination, judgment, anger, pain, those cause disease. So it’s really important that we keep ourselves clean and clear as much as possible.

Heather Sandison, N.D.

Yeah, I loved what you said, again, it comes back to this perception of like, are we focused and ruminating on what they’re doing wrong? Or are they your greatest spiritual teacher?

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Right, spiritual teacher.

Heather Sandison, N.D.

Amanda, who works with me, she always says, she’s like, “They’re our sandpaper, they rub off our edges and they make us even smoother.” And so just having that perception and even when you can that gratitude, right? Like what is this here to teach me? And I’m so grateful I get to learn this lesson and become a more full version of myself because I’ve had the experience.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Yep, we don’t learn anything in the times of contentment. We don’t, we enjoy a lot more, it’s really nice. It’s like swimming in the lovely bubble bath and it’s nice. But then the growth part always happens with the pain if we’re willing, if we’re willing to do the self-confrontation work, we can grow through the painful parts, otherwise we just wind up getting sick from them, so.

Heather Sandison, N.D.

Dr. Keesha, this is such a valuable, meaningful, really important conversation to have. And I personally have gotten some inspiration from it. So thank you so much for joining us. I wanna make sure our listeners and viewers of the Reverse Alzheimer’s Summit know where to find more about you. I know Dr. Keesha.com is one place. Where else can they find out more about your programs, your summits, everything you have to offer?

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Yeah, D-R-K-E-E-S-H-A.com, that’s the best. And then reading, “Solving the Autoimmune Puzzle.” I’m finishing a book called, “Healing Trauma Through the Chakra System” right now. But that book really has a lot of what we just talked about, solving the autoimmune puzzle.

Heather Sandison, N.D.

Thank you so much for all of the contributions you’ve made not only to this summit but to medicine in general. And just to really giving people the tools they need to resolve trauma and reverse disease. It’s so meaningful and I’m so grateful, I’m really privileged to know you.

Keesha Ewers, PhD, ARNP-FNP-C, AAP, IFM-C

Thank you and you, bye everybody.