Join the discussion below
Joel Kahn, MD, FACC of Detroit, Michigan, is a practicing cardiologist, and a Clinical Professor of Medicine at Wayne State University School of Medicine. He graduated Summa Cum Laude from the University of Michigan Medical School. Known as “America’s Healthy Heart Doc”. Dr. Kahn has triple board certification in Internal... Read More
Dr. Stephen Sideroff is an internationally recognized psychologist, executive and medical consultant and expert in resilience, optimal performance, addiction, neurofeedback, leadership, and mental health. He has published pioneering research in these fields. He is a professor at UCLA in the Department of Psychiatry & Biobehavioral Sciences and the Department of... Read More
- Psychosocial status and stress are as important factors in heart health as smoking and high blood pressure
- Resilience, or the ability to bounce back, can be measured and improved upon
- There are 9 pillars of resilience to learn and practice
- A daily practice beginning with self love can rewire the nervous system to a healthier heart state
Joel Kahn, MD, FACC
Well. Hello everybody. Welcome to really one of the most exciting episodes, interviews conversations of all of the dozens of conversations we’re having at the reverse your heart disease naturally summit. I handpicked the world expert on stress and resilience to discuss his research, his clinical practice, his books, his website tools that you listeners can grab onto. But I just want to preface it because you might say resilience and I’m gonna let Dr. Sideroff in a minute explain what that is. And I do want to point out just from a pure cardiology standpoint. You know, we’re really grounding this summit as much science as possible. That 20 years ago there was a massive study in 52 countries involving 25,000 subjects have had a heart attack, half were age matched gender match controls. Why do people have heart attacks?
And you know, it’s smoking? You know, it’s diabetes. The second most powerful factor were psychosocial factors. A little four questionnaire. Are you depressed? You have financial stress, you have work stress, you have home stress. People that answered yes. Yes yes. Yes. And particularly the women that answered yes did very poorly and they had this high rate of heart attacks. So Dr. Sideroff is going to talk about something right in the bullseye of avoiding heart disease and dealing with it successfully if you have heart disease. So without further ado based on so much science, Dr. Stephen Sideroff beaming in from the general area, Los Angeles because you’re a professor at U. C. L. A. Why don’t you just give us a brief bio, your fascinating background but introduce yourself and don’t be humble. You are the world’s leading expert on resilience, a very hot topic.
Dr. Stephen Sideroff
Well thank you Dr. Kahn. It’s a pleasure to be here. And I actually began my career in brain research but I wanted to not work with animals. I wanted to work with humans because I wanted to be able to ask them questions and have them tell me about what their experience was like. But I realized as I got into working in clinical psychology that the one factor the one modulator that impacted so much of people’s life was how they were dealing with stress. A person can be doing really well in their lives but as their stress mounted, their ability to cope began to break down. And this isn’t true only with individuals. It’s also true with couples, couples could be doing really well with each other but as soon as they encounter more and more stress they too begin to break down their resources and their coping abilities and the relationship can be in jeopardy. So I wanted to address stress. But the thing that people need to realize is that stress is not just bad. We all thrive actually on stress. We all mobilize to handle difficult situations that helps our bodies function better. It’s when stress is not in balance that we run into problems and that’s where resilience comes into play. So the basic is to realize that your body is your instrument and how you use, The energy of your body depends on how well your instrument is tuned and resilience is when your body is optimally tuned where the activation of your nervous system, the stress response, sympathetic arousal is balanced by its component complimentary part which is the parasympathetic that helps you recover. So you need these two to be in balance. And that’s what resilience is all about. It’s not getting rid of stress, it’s learning how to manage it, balance it with recovery as well.
Joel Kahn, MD, FACC
So if I sent you and of course we’re across the country but would telemedicine, everything is happening in a smaller and smaller uh collegial world? If I sent you the patient I saw this week in my clinic 53 years old, a major heart attack out of the blue. This guy was planning his life for the next 50 years. Not planning to be a cardiac patient, really struggling four months after his heart attack. Pretty sizable one need to take medication, need to come to visits, need to reconsider change diet, need to go to cardiac rehab. Need to reevaluate a young wife, young children and the whole thing, I mean, what kind of assessments would you put them through to conclude? You’re a highly resilient individual, your medium, your low and then of course let’s talk about other than reading your excellent books, which we will talk about what tools you would introduce. But what tools of assessment would you put them through?
Dr. Stephen Sideroff
Well I’ve developed what I considered to be a comprehensive model of resilience that has nine components to it. And so what I give all the people that come to see me is my a questionnaire that I’ve developed and say what the item questionnaire person can take in 10 minutes and it can give them as you score it it gives them their resilience profile along these nine dimensions and from that we can identify which are their areas of strength and which are there areas that they need further development. So I would begin with that as part of my assessment.
Joel Kahn, MD, FACC
And run us through like bullet points. I think there’s three groups of three. So nine total but the pillars that are in your book, smash hit book, everybody should read called the Path steps to resilience but tell us about those nine.
Dr. Stephen Sideroff
So yes, three areas. The first is relationship and for many people, the very first component is the most significant and that’s your relationship with yourself, how you treat yourself, are you kind to yourself or as most people that come to see me after a heart attack, they can be very hard on themselves, very critical and judgmental of themselves. That’s the 1st. 2nd is relationship with other people. Do you have healthy relationships in which uh you’re with people and engage with people who are also like that, accepting or do you deal with people who can be judgmental and critical as well and being able to set boundaries and be able to say no to this type of person. The third is relationship with something greater. This could be spirituality. It is also having a purpose and meaning to your life the next level.
The other next three have to do with organismic balance and mastery. Physical balance and mastery is what most people usually think about around stress management and that is are you able to recover from stress readily or do once you have a stressful event? Your stress stays high? Are you able to calm down well and be able to go to sleep at night? Are you able to get a good night’s sleep? A very important component to having your body in balance. Next is uh cognitive balance and mastery. This is your mindset. How do you approach the world? You wake up in the day, wake up in the morning uh looking for what can go wrong or looking for, what can go right uh When you approach a situation, do you approach it as um my how am I gonna deal with this? I don’t know this is difficult or you embrace the challenges of life? The next is emotional balance in mastering.
This is about not carrying around any grievances. This is about being able to recognize your feelings, work through the feelings so that you could let them go and you’re not carrying any excess baggage, you know, if we take a look and this is very relevant for our conversation. If you take a look at someone’s heart rate pattern. If you look at somebody who’s in a positive mood, they’re in a state of gratitude and appreciation. You see this very synchronous heart rate pattern where as you breathe in, heart rate goes up, speeds up as you breathe out. The heart rate slows down. And you have this nice sinus orbital pattern heart rate. When you look at someone who’s angry, frustrated and you look at their pattern, it’s very chaotic. So here’s a direct relationship between our emotional state and our cardiovascular state. The next three and last three is how we deal with the world and that’s present. We present here are we up in our heads worrying about the future or regretting the past.
So the more you’re present, the more you can be resilient more. You can make changes in your life. The next is flexibility. And this is how well you can make adjustments if there are obstacles in your path, make adjustments in your goals, Make adjustments in the path for success. It’s also being able to put your being flexible with perspective, Being able to put yourself in someone else’s shoes, Being able to see a situation from a different angle. And then lastly, the 9th pillar is what I do is power, which I define as the ability to get things done. So the more courage you have to do things rather than procrastinate and accomplish and achieve um the more confidence you have in yourself, the more trust you have in yourself and the fewest situations will be experienced as dangerous or a threat. That’s the model. And when I work with people I look to see where their need additional training and help becoming more and more resilient.
Joel Kahn, MD, FACC
And you did comment that resilience can apply to an individual, a family. I know you’d agree, I just want to say it certainly they apply to businesses and I know you’ve been a coach for businesses, business leaders, business executives, you know businesses can be resilient or businesses can lack that. So I’ve heard, you know, a simple term resilience is to bounce back or the you know, your ability or inability to bounce back. You introduced the term flexible in one of your pillars. But these are simple ways because I think a lot of people don’t throw out the term. How’s your health and resilience is something that comes after it, even though it’s become a very popular topic, particularly during the pandemic when so many of our lives have been disrupted. I would imagine when the studies are in that people with a higher level of resilience during the pandemic thrived better and maybe because of a link to the immune system actually stayed healthier and avoided the weight gain the alcohol.
The dependency on drugs and depression and unfortunately some suicides during the pandemic from all the disruption. So it’s such a great tool. Now, going back to this 53 year old man, you do your 40 point scoring questionnaire and I believe your questionnaire is available via your website as a pdf or perhaps that’s only once somebody engages you. It’s certainly in your book the path. Talk about, you know, some of the tools, maybe those that will be quick, quick wins, easy wins as opposed to the longer term. Maybe certain people need psychotherapy or talk therapy or medication even in some cases. But what are some tools, wearables practices that you would introduce and say, you know, within a month I think we can get some patterns better for you. Mr, heart attack survivor.
Dr. Stephen Sideroff
So first off, I do have what resilience assessment booklet that describes my model and also contains my questionnaire assessment. And I’d like to offer that free of charge to all of your listeners. If they email me to me, I will send them out. The resilience assessment booklet.
Joel Kahn, MD, FACC
Include me on that, I emailed you today.
Dr. Stephen Sideroff
All right, you got it. You got it. So, if someone is coming to me because they’ve had a heart attack or a significant cardiovascular event, the first thing is to help them um accept the reality of what happened. So that’s the first thing if they are struggling with that that itself is a stressor. So we have to begin and this is true for everybody. We have to begin with an acceptance of where we’re at in this moment, a lot of people come to me and they’re upset about where they’re at and that upset continues the problem. So the first thing is acceptance. The next thing is what I do is to help them believe that it changes possible because belief, you know, my fifth component cognitive balance, belief is a part of that. Yes, this is possible. I can make these changes and the change begins by starting every day with a focus on resilience. How do I be resilient today? One of the key ways is to look for times in your day, in your life where you can say to yourself, I’m safe, I’m safe. I can let down my guard at least for the moment, I can let down my guard when I sit down for lunch so that it’s easier digesting my food because when you’re stressed, you don’t digest your food as well.
Your body has competing goals. One is digest digest food and the other is to protect those are not mutually don’t work together. So to find times in your day, when you could literally say to yourself, I’m safe, I could let down my guard. To practice a 10-15 minute relaxation, exercise, relaxation, visualization, exercise, we’ve trained our nervous system to activate with all the stresses in our lives. But we don’t train ourselves to do the opposite to recover. Think of all the stimuli in your day that trigger danger and threat? Uncertainty throughout the day. But how many stimuli do you have in your day that trigger safety, relax. Almost none. So we have to bring that into the picture. And by the way it’s an interesting thing if you think of all the successes that you’ve had in your life. My guess is that almost all of them have been accompanied by stress a test and interview a deadline. All of our successes are paired with stress what that means. And I was fortunate to one of my early mentors, Donald Hebb, one of the pioneers of neuroscience and re-coined the term neurons that fire together wire together. So our brains are wired who want stress. So dress is okay as long as it’s in balance. So those would be some of the things I would.
Joel Kahn, MD, FACC
How about your experience with tools? Would you introduce a tool that a lot of the listeners know about heart math, a laptop or even smartphone based breathing biofeedback system. Have you had use and experience and good results? Everybody likes a video game. Yeah.
Dr. Stephen Sideroff
So yeah, one of the things that I do in my practice is biofeedback and neurofeedback. I’ve done research on that and those are tools that help you monitor what’s going on in your body. So a lot of times we are not tuned in well enough to our body to even notice how activated or calm our body is to biofeedback. You mentioned heart math. That’s a way of literally monitoring your heart rate pattern to master the pattern that I talked about earlier, that nice balanced way. And so it monitors some aspect of your physiology feeds that back to you because once you have awareness of it you can begin getting it under your control. So I certainly encourage people to look into that. That is very helpful. There’s a company out called Thought Technology and one of the things that we’ve discovered is that the optimal breathing rate That encourages the heart rate pattern is around six breaths per minute. So that’s 10 seconds for a full breathing cycle, breathing in and out when you go into the six breaths per minute. And people can aim for this during their relaxation practice. It helps actually modulate the heart rate pattern. They have this little cute little light that gets brighter as you for five seconds and then gets dimmer for five seconds. You can plug it into your computer and you can just have it sitting by your side and occasionally look up and then match your breathing to that light. It’s a very simple type of feedback device.
Joel Kahn, MD, FACC
Now there, you know, and that’s core technologies, correct? Is what Core technologies?
Dr. Stephen Sideroff
What is that?
Joel Kahn, MD, FACC
Is that the name of the company that has the so…
Dr. Stephen Sideroff
It’s called Thought Technology.
Joel Kahn, MD, FACC
Okay, I appreciate that. Everybody appreciates that. You know, you threw out a very fascinating quote about neurons that fire together wire together some again, listeners may know the term neuroplasticity. I mean I have been through transcendental meditation training. And the first question you ask is how does 20 minutes twice a day equate to 1440 minutes a day. Maybe I got 40 quality minutes in, but I’ve got a whole lot of others that I’m not practicing. TM I’m living life. You know, can you see sustained improvements during the rest of the day when you’re not doing your mantra, your moodra’s your heart math, your technology. I mean, talk to us about that as a brain expert.
Dr. Stephen Sideroff
Yeah. So. Right. And that’s the question I get a lot. Well if you’re if you’re exercising and lifting weights To get stronger, you don’t have to lift weights all day, you lift weights for about 15 minutes and that triggers an effect in your body and there’s a learning process involved as well. So if you practice relaxing for 15 minutes and you take yourself if you think of that continuum where there’s baseline and here’s activation of your nervous system and this is recovery of calmness, relaxation. We’ve lost in our lives. We actually lose the ability to come down to these lower levels of calm, that’s why people have difficulty sleeping at night. So the range shrinks, but it shrinks this way with the bottom coming up. Practicing a relaxation exercise helps you regain the ability to bring your nervous system down to those deeper levels of palm. So if you can do it and you practice it and at the end of 15 minutes you notice what it feels like. It makes it easier for you to go there during the day on your own. The more you practice it, the better you get at utilizing it at other times during the day. Yes, this is what we can call this neuroplasticity.
Joel Kahn, MD, FACC
Okay. You know, I occasionally get asked the question, you’ve been a preventive cardiologist for decades. What do you do, What do you eat, What do you work out, what do you do for sleep stress? I want to ask you as a leader in the field of stress, evaluation and resilience. I mean in your own life, what have you incorporated to chill out as much as you can knowing that there’s gonna be bumps in the road. I mean what are some one or two even practices you try and get in during the day?
Dr. Stephen Sideroff
Okay, well, I’ll begin by saying that it starts and for me it started a good relationship with myself not being hard on myself, giving myself a break, having compassion for myself when I make a mistake rather than beating myself up for the mistake. So it begins there. I make sure I take time for myself, I work hard, but when I finish working I let go of work, don’t carry it with me into my private time. So I make a clear boundary there. I do approach my day in my life looking for what can go right and it’s very important in my life and for my resilience, I feel to find times to be happy and experience joy. So I would need with some of those things and having purpose in my life.
Joel Kahn, MD, FACC
I have a sense that you have a bit of a comedic or humor aspect to in terms of appropriate, but have you found that, you know, laughing at yourself is a good first place to start, but I just got to walk out of the shower dripping wet and you only have a good laugh for most of us over 60, but is that something you’ve actually seen in practice?
Dr. Stephen Sideroff
I’m laughing because one of my clients just sent me a little clip and he said, this is what I use when I’m having difficulty and in this clip they brought 10 people together that have the craziest laughs And and it’s about a 22nd clip of these 10 people laughing and it’s like you can’t listen to it and not just start laughing yourself. So I enjoy definitely enjoy a good laugh and I love listening to a good comedian. And I find what’s humorous about life as well. You can’t be serious about so much of what’s going on today, but you have to balance that with laughter and joy.
Joel Kahn, MD, FACC
Appropriately because there are serious issues. Excellent. Excellent. Yeah. In fact, one of my favorite articles I found just surfing around reading a little bit to talk to you was a article in the American journal lifestyle medicine in 2021 with the title, kindness as a stress reduction health promotion intervention. A review of the psychobiology of caring psycho biology and just that being kind to yourself as you said, the first of your nine pillars. Before you’re being kind to others, which is obviously important, but you’ve got to be kind yourself. I think humor does come in there. So I feel a little bad. I don’t want to get towards the end of this without giving you full accolades because we jumped right on in and have talked about, you know, really important stuff. One clinical question 40 question assessment of resilience. You bring people back in 369 months. Do you see their questionnaires improving? Is that a process you go through and reinforced how miserable they were when we started and how they’re making smaller large strides.
Dr. Stephen Sideroff
Well, when I work with my clients, I’ll typically give them this questionnaire at the beginning of our work together and then again later in the process. And in my book. In fact I have the questionnaire three places in my book the beginning halfway through the book and then again at the end. And people invariably find that their scores go up as they work with me as they listen to the book. I’ve gotten a lot of feedback from people who have purchased my book who have said that um it’s turned them around in terms of how they deal with stress and their lives in general and their health. Stress is a significant factor both in emotional health as well as physical health.
Joel Kahn, MD, FACC
You know for those that are really striving. Maybe they know they have heart disease and that’s why they’re you know following this summit on reversing heart disease naturally. And of course there’s a lot of people want to get educated to avoid ever having heart disease with a major focus on stress and resilience like you’ve so well added. But for those that just wonder why I was so excited at the beginning, remained so excited at this moment. Let me just give a brief synopsis of Dr. Stephen Sideroff and of course give him a chance to talk about his books and his website by professor at U. C. L. A. In the department of psychiatry and behavioral sciences and the department of rheumatology.
And we’ll have to ask him why he’s the director of the Wallenberg Institute of Ethics founder and former clinical director of the stress strategies program at U. C. L. A. Santa Monica hospital of course Dr. Sideroff is based in the L. A. area, the book, the path mastering of the nine pillars of resilience and success and a new book the resilience response. So we can go on and I just have to ask you, I know you have a history of being personally uh an athlete was at high school, was at college, what sports was it?
Dr. Stephen Sideroff
So I was a four wall handball player and I was my college. I won my college championship three years in a row even when in the last year I was not the best player and that’s because of mental strength as well. That allowed me to do that. I’ve also part of my work in the past I’ve worked with Olympic and professional athletes and peak performance. And I really believe that resilience is the backbone of that as well and to motivate your audience, gonna motivate them now because I follow the principles of my model of resilience and we now have markers of biological age. In fact I’m going to do a study looking at the relationship between resilience and biological age. But I’ve taken that test on myself and last March I turned 75 and the month before that it took this uh just kind of swab a little bit of your saliva and send it in. But they can look at cell methylation and determine your biological age. And mine turned out to be 55.
Joel Kahn, MD, FACC
Wow. Congratulations.
Dr. Stephen Sideroff
Thank you. Thank you. So that’s what people have to look forward to. If he become more resilient.
Joel Kahn, MD, FACC
Right? And that’s indeed a test called your Epigenetic age test of which a fellow professor U. C. L. A. Dr. Steven Horvath is one of the world leaders. Maybe you did the Horvath age Saliva methylation test. I’ve done that too. But I think you’re a little younger than me. Unbelievable. And how and you have, I was gonna ask you, you have coached athletes, you’ve coached business executives. What was 15 years as a assistant to a shaman does something you saw in linkedin.
Dr. Stephen Sideroff
Ah No it was far from linkedin. Yeah. Yeah but again flexibility is to be able to go to different places and states and learn from different perspectives more about indigenous cultures and the wisdom that they have to offer. And so you know an integrated approach is one in which you find some truth everywhere you look.
Joel Kahn, MD, FACC
All right. So you have a book that’s been out about half a dozen years called the path about the nine pillars. Just give us a minute, minute and a half. And if you have the book they’re wonderful. The nine pillars of resilience and success. And although it’s a little shiny we can see your name at the bottom. Tell us about the new book and then your website where people can find you because I know they’re gonna flock to your website. It’s a great website, I’ve been all over it, but tell us about the new book.
Dr. Stephen Sideroff
Yes. So the website is DrStephenSideroff.com. The new book is called The Resilience Response. Many years ago, there was a book out called the relaxation response, which showed the importance of just practicing relaxation. And this shows the importance of the of my nine pillars of resilience and success. And the new book takes people daily on a daily path in which you wake up in the morning, you read five minutes of it and it gives you something to focus on that actually enhances your resilience. And so it’s like a personal coach that you have on a daily basis, helping you address all the stresses and all of the challenges of the day.
Joel Kahn, MD, FACC
Is it written with 365, many chapters? Is it a daily ritual?
Dr. Stephen Sideroff
Yes, it is.
Joel Kahn, MD, FACC
It’s a deal. Look forward to that.
Dr. Stephen Sideroff
Each, each day is a little bite size taste of resilience that you can do and learn and I, we’ve lessons of the nine pillars throughout the book.
Joel Kahn, MD, FACC
And just in case hundreds of thousands of people are rushing to the web to look up your website. I want to make sure people know it’s D R for Dr Stephen is the ph version. S T E P H E N S I D E R O F F dot com. So you want to get there and you want to look at the courses and the other responses uh materials that Dr. Sideroff has developed over this long and glorious career. So I will just say it’s been fascinating and I think, you know, it’s easy to talk about broccoli and, you know, high intensity exercise and sleep therapy. And these are all critically important. But sometimes the psychological and the caring and the resilience aspects are just not emphasized. So, we’re all very grateful. And I wish you a wonderful day ahead since you’ve done so much for so many people listening and thank you very much.
Dr. Stephen Sideroff
It’s been a pleasure and a great conversation and you’ve asked just the right question, So thank you very much.
Joel Kahn, MD, FACC
All right, we’ll be in touch and I know you’re gonna help so many people from this.
Downloads
Download Transcript
