Path to Resilience: Optimal Mental Health

Introduction to Dr. Stephen Saraf 0:00

Welcome back to the Reverse Alzheimer's Summit. I'm so excited to introduce you to Doctor Stephen Saraf. He's an internationally recognized psychologist, executive and medical consultant, and an expert in resilience for optimal performance, addiction, neurofeedback, leadership, and mental health. You can see why I've invited him here today. He's published pioneering research in these fields. He's a professor at UCLA in the Department of Psychiatry and Behavioral Sciences and the Department of Rheumatology, plus the director of the Wallenberg Institute of Ethics.

He was the founder and former clinical director of the Stress Strategies program of the UCLA Santa Monica hospital and former clinical director of Immune View Treatment and Optimal Performance Center. Doctor Sit Prof. Has presented over 600 seminars and professional training programs nationally and internationally. He's helped establish innovative training and treatment approaches and optimal functioning mind body medicine and A.D.D. in the US, China, Europe and conducted cutting edge research in brain and behavior.

Doctor Cidrap has written and produced a number of self-help audio programs along with his book The Path Mastering the Nine Pillars of Resilience and Success, which has been hailed as a true Bible for living in balance and spirituality. Doctor Saraf, welcome. Thank you. It's a pleasure to be here with you. So what is this relationship between stress and resilience and aging and memory? Yes, there's many tie ins. And, you know, intuitively, we've always known that, if you're more stressed, your body's not going to function as well.

And if you're not, body's not going to function as well. You're going to age more rapidly. And, you know, if you look at before and after pictures of all of our recent presidents, you will notice in a brief period of time that that's actually true. But as you know, we now have clear evidence, that when you have a person who is under more stress, you are going to actually show actual evidence of speeding up the aging process in terms of shortening of the telomeres at the ends of our DNA, which,

Stress, Aging, and Telomeres 2:34

they hold our DNA in place. And as we as the cells divide, those telomeres shorten little by little until they get to a point where the cells can no longer divide. And there are many studies now demonstrating, showing that when you have more stress, you see greater shortening of those telomeres which indicate the aging of the cells. And we have more and more evidence now that stress literally speeds up the aging process. But there's also a colleague of yours at UCLA, Doctor Horvath, who has the Horvath clock with the methylation as well.

Doctor Carol Fitzgerald is also on this summit. So head on over to her talk if you have more questions about how to measure aging. There's a few different ways, and telomeres are certainly one of them. And so yeah, you talk about an evolutionary mismatch. How does that impact us. Well, there if you if you look at your day and you look at stimuli that either trigger activation of your nervous system, that speeds up, that activates, the sympathetic branch of your nervous system, and you look at stimuli that trigger the opposite, the recovery of your nervous system, the parasympathetic response.

You know, we have a lot that stimulates stress, but very few in our day that say, okay, it's time to relax. And you give a all of each excuse me, you give us examples of each. Sure. So you wake up in the morning and you begin by wondering what can go wrong in your day, or you're worrying about will somebody do something or is this going to happen? Those question marks in your head, that uncertainty immediately activates the stress response because your body always prepares for the worst outcome.

We're geared that way. Okay. So you're mobilized. The stress response right from the start of your day. You have an encounter with somebody and they have a strange expression on their face. And you start to wonder, did I say something wrong? Are they upset with me again? Danger. A signal of danger. So it indicates also about how our thinking can create a series of dangers throughout our day that our body is continually mobilizing to handle. Now, the mismatch that I was talking about, the evolutionary mismatch, is that we still have right now.

We still have the same fight or flight stress response survival mechanism of our hunter gatherer ancestors. Well, what are the stresses that we deal with that are effectively dealt with by either fighting them or running from them? Very few. But that's how our bodies mobilize. So we mobilize. We build up this energy in our body to handle the danger. But then we have to hold it in, because if I'm talking to my boss or a colleague, I'm not going to explode at them. Although some people do. But we hold it all in, and that's the mismatch.

We mobilize. But our stress response is not really appropriate for the kinds of stresses that we deal with. And so that's the mismatch that I'm referring to that adds to the imbalance between the activation sympathetic branch of our nervous system and the parasympathetic,

Evolutionary Mismatch and Daily Stress 6:30

the recovery branch which need to be in a place of balance. And in this summit in particular, you know, so many people are struggling with this stress of either themselves starting to lose their cognitive function or memory, or a dear loved one who is in the throes of dementia. And that is stressful. That alone is deeply stressful, particularly when you've been told there's nothing you can do about it. Caregivers are at much, much higher risk of developing dementia than the regular population, and much of this is blamed on stress.

So I want to make sure that caregivers leave this conversation with us, walking away, feeling empowered to do something that helps to balance their autonomic system. Yes. Well, it's interesting you mentioned caregivers because those were the people studied in the telomere study that I mentioned earlier. They were the high stress group that was compared to a low stress group that showed a reduction in their the length of their telomeres, a quickening in the aging process. Exactly. Exactly. So, you know, if we think about cognitive behavior, cognitive performance, we can think of it in two ways.

One, in the moment, how how effective are you cognitively. And two, over a period of time developmentally. So so to speak. Okay. In the moment, stress can impair cognitive performance for many, many reasons. When you're under stress, when there's a danger or your brain, thinks there's a danger. One of the tendencies in natural tendency is for the brain to shift from the cortex controlled by the cortex, and to lower and lower, more primitive, but survival levels of the brain, where we get into more stereotypic behavior, less flexibility with our cognitive thinking.

So in the moment, it can impair cognitive performance. But long term, as we've been, as we're talking about how stress speeds up the aging process. It also has a detrimental effect on cognitive performance. Those reasons, we have all kinds of evidence of how stress impairs the functioning of certain areas of the brain, including prefrontal cortex, hippocampus, which is when a major part of our neurogenesis, the birthing of new nerve cells, takes place. And so autonomic dysregulation syndrome. Can you give us the the definition that the guts of it.

Right. So this is a term that, me and some of my colleagues have been kicking around for a number of years, either Levine or friend and colleague of mine and myself, we talking about how this, this ongoing imbalance in daily life between the sympathetic arousal, parasympathetic recovery results in the dysregulation of the nervous system. And when you have a dysregulated nervous system, there's a whole cascading series of events that take place, including some of biological perspective, perspective, for example, inflammation, as a result of this, speeding up the oxidation process.

And so you're, you're, using the energy of your body, without appropriate recovery. This is the definition of it. And then so to, to fix this, can you give me a pill? You know, you sound just like my clients. And many of mine. You know, actually, fortunately, a pill doesn't work. A pill can mask symptoms, but it's not going to address the basic mechanism. And, you know, I find with clients of mine that really want to do the work. They're the ones that benefit. They're the ones that show the difference.

They're the ones that begin to have greater trust in themselves, which is a piece of the of the puzzle.

Autonomic Dysregulation and Relaxation Practices 11:15

Trusting in yourself. That's about confidence. That actually reduces your reactions to stress because stress is really about uncertainty. And the more you trust yourself, the less uncertainty there is in your in your life. So the answer is no. There's no pill. One of the things I tell all my clients is that you really need, on a daily basis, to practice some form of relaxation exercise. If we are. Activating the sympathetic arousal so much, we have to find ways of compensating for that. And one way is practicing a relaxation exercise, because you have to really retrain your body to go into the deeper levels of, the way.

One of the ways I explain it is if we think about the range of your nervous system where you activate it to stress and danger and you recover this way, you have this balance here. When you have this, autonomic dysregulation, what happens is you shrink this range and you don't shrink it this way. You shrink it this way. We lose the ability to come down to deeper levels of calm. One of the key indications of that is difficulty getting to sleep or having a good night's sleep. The baseline creeps up.

So you need some ways of literally retraining your body to go to those deeper levels of calm. So I discussed meditation with many of my patients, and I'm sure we're going to get into that. But I can also speak from this experience personally of having the feeling like meditation isn't helping me because I can't get there. I can't get to that space where I feel calm or my thoughts are coming up. I'm stuck in my head, I can't get into my body, and so I shouldn't meditate. And really, that's when you need it most, right?

Well, that's a that's a great, great, example of what happens to a lot of people. I notice that in myself. I, a number of years ago, I was doing the same thing. I was meditating, and I was thinking, well, this isn't working, and I've. And what I was doing is I was judging my performance, which is the opposite of what you need to be doing to practice relaxing. It's about acceptance and I found that when I said, okay, it's what it is I'm accepting. It's what it is. Suddenly I was able to sit and meditate, whereas before I wasn't able to.

One of the things that I do that I find is immensely beneficial in this arena is biofeedback. Biofeedback is using a device that actually monitors. So for the people that want to know, is it working? Biofeedback actually gives you the feedback that lets you know when you're successful and when you're not successful. You talk about the nine pillars of resilience, which hopefully would help us become more successful. For those of us who are interested in outcomes and getting it right. And then so it take us through those nine pillars of resilience.

Yeah. So this model that I've developed comes out of my goal of identifying everything from the psychological know, behavioral, emotional and even spiritual perspective that impacts optimal functioning okay. And so it comes in three areas. The first area is relationship. So it's relationship with your self. How do you talk to yourself. Are you, accepting or critical and judgmental. The second is relationship with others. Are you able to set good boundaries in relationship? Do you establish healthy relationships with people who can be supportive again rather than critical?

The third area is relationship with something greater. In this could be spirituality. It could be having meaning and purpose in your life. And it's about giving service. So it's a broader, horizon to the world that you're encountering. You're in in relationship with. The next area is organismic balance and mastery, and that's physical balance and mastery again. Can I relax? Can I recover quickly after a stressful event, or do I keep my my, tension elevated even after a stress is over? Because I'm wondering where the next danger is.

So it's physical balance and mastery. Mental cognitive balance and mastery. Do I focus on what's positive more than what's negative? Am I able to shift away from some thoughts that are not serving me? Do I have cognitive flexibility? So that's the second one. And then it's emotional balance and mastery. Do I am I able to recognize when I have feelings and I deal with them appropriately so I can let them go and not carry them around with me? When we have a big reaction to a situation that doesn't require a big reaction.

That's a that's a typical indication that we're sitting on unfinished emotional business. The last three have to do with how we engage in the world presence. And when we my model has two directions to presence, it's not just and present.

The Nine Pillars of Resilience 17:20

I'm noticing. I'm aware of my environment, but it's also my presence. How do I project my energy out into the world? Flexibility. Hey, we've had to be very flexible over these last two years because many of the past to success have been cut off to us. So flexibility is being able to adjust your goals, adjust your process, your patterns to accommodate changes in the world, which is happening all the time. And then finally, the ninth is our, which I define as the ability to get things done. So this has to do with having courage.

Being able to overcome your fears, to engage with the world. Persistence. These are the components of, our and being able to get things done. Because the more you get things done, the more you trust yourself, and the less in the world seems dangerous. So I think a lot, certainly, as I hear you talking, I'm like, okay, yeah, I get that. I get that. I get that. But putting it into practice is the really challenging part. Yes. Is. And I tell us about the path. Okay. So first of all, when we face all the things that we feel we need to do to become more resilient, to deal with stress, it can be very overwhelming.

There's a lot. Right? So I wanted to create some way that people did not feel overwhelmed by the process. Okay. Of all the things that need to be done. So the notion of the path is that you take certain steps during your day, and they put you on the path. And if you're on the path, you're doing all that you need to do. You don't have to look to see what's still not being done, which then creates the overwhelm or creates the sense of not doing enough. So the path. So the whole idea is goal is in all the ways out there.

You can you can achieve the goal every single day. Because all you need to do is get on to the path. And if you can get on to the path, you're going to get there. So that's the whole notion of the path is take some steps in the right direction today. That puts you on the path and you're good to go. You're oriented in that direction. And regardless of where you end up, it's going to be better than the path that you were on previously. Well, this is exactly why I created Marama and why we have the health coaching support.

And then also I'm at home courses because this is an approach to reversing cognitive decline, much like you described the pillars of reason of resilience. It's challenging, it's complicated. And it can feel like an exceptionally heavy lift, particularly if you or your loved one has cognitive decline already. You have, you know, even for people with full cognitive capacity. This can feel really hard. And so we get that and we get you. And we're here for you. And I think Doctor Saraf and I both are united in this idea that there are ways to take small steps that have big impacts.

So I'm curious, where are you usually have people start. What's the first step on the path. Okay. Well very good question. So the first step is to do an assessment. So I've developed a 40 item questionnaire. And what I want to say is I has a resilience assessment booklet. And if anybody who's listening to your podcast, would like and email me, I will send it to them free. And my email very simple is sit across@ucla.edu inside our office at UCLA digi edu. And I'll send you my resilience assessment booklet which describes my model.

Each of the components. And it also gives this 40 item questionnaire that a person can take in 5 or 10 minutes. Self score. And then you get your profile of of which of the nine pillars is your strength or your strengths and which areas you need for the development. But to answer your question, it's it's doing the assessment, seeing where you're at. And the key the biggest key is acceptance of where you're at. Most of us do not accept where we're at. Most of us feel we should be further along than we are.

And I like to, in my earliest training as a psychologist is is still therapy. I learned, that is what's called the paradoxical theory of change. Have you ever heard of that? No. I'm so curious. Okay, so here you are, on this path through life, and you're somewhere here. Let's say you're over here. Most of the time we're here. We feel we should be here. So we're in the middle. And we feel like we should be a little more advanced for anybody who can't see your fingers. I want to make sure they kind of know where we are.

And space. Okay. Yes. So I'm moving my finger along the path, but we feel we should be further along the path. I should have done that better. I should have known. I shouldn't have made that mistake. And the answer is no. Here's where you are. You cannot be two places at the same time. If you're here, you can't be over here. So the best way for your growth and development is to accept where you're at. If you keep misplacing your keys, you don't say, well, I should have known where they are. No. Right now, stuff is going on in your life,

The Path, Assessment, and Acceptance 23:35

in your head that's so distracting to you. And you don't notice when you place your keys down. So you're not going to remember where they are. Except that right now. So acceptance where you're at on these nine pillars, your profile. The first step is accepting the next step. In my book, The Path I actually have in each chapter. Step one. Step two. Step three. Make it very clear. Go to step one and do that now. And so to be on the path it involves some, effort on your part. But I guarantee if you get onto the path, if you take those steps, you're going to become more resilient.

You're going to handle stress a lot better. It's just about taking those first steps. You mentioned Gestalt and the. I'm curious about the primitive gestalt patterns that you mentioned and how they can you can feel kind of out of control. Yeah. So primitive gestalt patterns is something that I've written about that really talks about the lessons of early childhood and how they become the patterns that we are tied to as adults. So you're in your earliest years of life and you're trying to what's the most important thing?

Survival. How do I survive and be on the good side of the people who I'm dependent on? Usually mother and father, whoever our primary caregivers are. So the key here is we don't go out into the world as a little baby, as a 2 or 4 year old, and sample hundreds of families to determine what's really right. Our primary environment to us is the whole world, and we adapt to that environment. And then unfortunately, our adaptation freezes to that environment. And the more stress in the environment, the more our pattern adapts and freezes to it.

Unfortunately, if so, as adults, we don't know that this is a pattern. These are unconscious driving forces as adults. And the way I refer to it is we develop an internal parent, which is the voice we hear 24 seven and that's what we listen to. If it's critical, we believe it's the way to be. If it's hard on us, we believe that's the way that puts us down. Well, it's the truth because it's all we know. And in my work, I contrast that with what I refer to as a healthy internal parent. And the healthy internal parent comes from a place of love, compassion, acceptance, support and care.

And so part of being on the path is being aware of when you're talking to yourself in an inappropriate way, because that takes you off path. And if you notice that by asking yourself one question, am I on the path or off the path? And if you're off the path, there's steps you can take to get back on, including finding that healthy voice and talking from that healthy perspective. So it sounds like there's this early imprinting that happens that really impacts the way we show up in adulthood, regardless of whether or not it serves us.

That's right. You're describing this opportunity to choose a different, imprinting. And so how how do we it sounds like it's going to take a lot of practice, because especially if we're talking to somebody in their 60s or 70s, this this is a long these I think of like wagon wheel ruts in the mud. And you talked about biofeedback maybe neurofeedback. Are, are there places again I, I'm, you know societally trained to be like, well what's the pill. How do I what what's the good quick shortcut to replacing that imprinting with love and compassion and acceptance and support and care.

Well, you know, I had the good fortune early in my career to be a colleague of Donald Hebb, who wrote the very first. Really neuroscience book in 1947, actually. And, he coined the phrase neurons that, that fire together, wired together. Okay. And that's why when you say wagon wheels in a rut, what the real translation is, is that we've developed neural circuitry based on the lessons of our childhood. And so we have two very, very important factors running our lives. One, which is the primitive physical patterns.

I was talking about how our neural circuitry developed based on those early lessons. Unfortunately, the other is neuroplasticity. And neuroplasticity is the brain's ability to rewire itself. And that's we want to emphasize that that's where we want to put our efforts. When you get on to the path, when you're engaged in looking for the old patterns and correcting them, you are literally, causing old patterns in the brain to fall

Neuroplasticity, Aging, and Lifestyle Integration 29:25

by the wayside and develop new patterns in the brain. It's literally a half hour impactful experience such as this interview and literally begin shifting neural circuits, but you have to be consistent with it. That's the key. You have to be focused in on making sure you do this on a daily basis. And when you do, the changes literally occur. And I am sure the return on investment there, right? If you're investing a 30 minutes a day over the course of six, eight, 12 months, you're going to get huge returns on that, right?

That that your experience of the world, your experience of life, your interactions with all of those nine pillars, really will be impacted at a at a fundamental, foundational level. Definitely. So I'll give you one case example. Okay. So I obviously hopefully follow my model of resilience. Right. Because I believe it's the key to slowing the aging process. And then all the other benefits that benefits that follow. So couple of months ago, I did one of these methylation studies like Horvath. And that actually gives you your biological age.

So last month I turned 75, but my biological age came out as 55. High five. So what? I was so impressed. But, it's a case example. I followed my model or I developed my model based on what I know and how I live my life. But anybody can do that. Anybody can do that. Anybody can achieve those. Certainly improvements on what's going on right now. And then I mean, you talked a little bit about this, in the nine pillars of resilience, but do you put this in the context of diet and exercise and sleep and, and these other sort of foundational, aspects of health?

Definitely. Definitely. You know, Rob Lufkin, good friend of mine who does his podcast on longevity as well. And he was a guest of yours. We we sort of like these dueling dueling scientists who does the a metabolic aspect of it. And I do the psychological aspect of it, but it's an integration of the two. It's an integration of the two. They both play an important part, physical part in this process. And I think those two have it all covered. The, the, the both aspects really have the optimal aging covered.

And of course, when we talk about optimal aging, we're talking about the optimal functioning of the body. Right. And that yeah, that virtuous cycle, even that starts to happen when we take care of both the mind and the body. Right? Is as our mental health is better as you work through these pillars of resilience and the path, then you make better decisions around exercise and diet and prioritizing sleep. And then your resilience gets better and you can see how, you know, we sometimes we talk about these downward spirals that people will get on.

And there's an opportunity to take advantage of it. And upward spiral a virtuous cycle. Definitely, definitely. And that's what we are encouraging data center of. It's been an absolute pleasure. Again, people can reach you at CET or off at UCLA. Edu do you also have a website? I do, the website is Doctor Stevens sitter off.com. That's Dr. step and s idr offer. I actually have an audio relaxation visualization download that people can get for free. I also have a resilience challenge where people can answer nine questions and it gives them a sense of their resilience, plus a lot of other oh my, a lot of my research, is on my website as well as, as well as, some of my audio products as like one, it takes people step by step through a six week program.

Fantastic. Thank you so much. This has been an absolute joy of a conversation and, really a pleasure to have you. And I'm so grateful for your wisdom and experience and and really sharing your, your firsthand experience, not only as a clinician, but, what you've experienced personally. So valuable to our listeners. Thank you. Thank you. Also great questions. Thank you. For.