Dr. Brad Lichtenstein – Mind-body Medicine

DHP’s own Ashok Bhandari recently sat down with Dr. Brad Lichtenstein, ND, BCB, to talk about mind-body medicine and how he uses it in his daily practice. Dr. Brad is a Naturopathic physician with over 20 years of private practice experience, as well as 20 years of teaching experience, primarily at Bastyr University. He’s also board-certified in biofeedback, and has a clinical focus in Naturopathic medicine, mind-body medicine and biofeedback, depth and somatic psychology, yoga and movement therapy, bodywork, and end-of-life care. Dr. Brad is very well known and highly respected in his field, has been a teacher to both the founders of DHP, and is a personal mentor to our interview host, Ashok. Clearly, we at DHP were honored to have him sit down and share his wealth of knowledge and experiences with us. (Watch this interview as a video here, or listen to the podcast here).

Dr. Brad, welcome! Let’s start with the simple: what is mind-body medicine? This term is thrown around so much now, it’s basically a buzzword in the medicine world and in the health and wellness world. How do you describe it to patients?

Great question. I could turn that back to you, but I’m not going to! NCCAM, the National Center for Complementary and Alternative Medicine – it’s no longer called NCCAM though – they define mind-body medicine as those approaches that look at the whole person. Basically, it’s looking at how our thoughts, our feelings, and even our bodies influence our health. The thing about mind-body medicine is it’s not about the treatment of disease. It’s about creating health and wellness. So, modalities that fall under the rubric of mind-body medicine are such things as yoga, meditation, hypnotherapy, exercise, even cognitive behavioral therapy, and then at the end of their long list they have the word spirituality. They just throw that in there. But it’s really how we engage in our life that influences our overall health. People who practice mind-body medicine view themselves as more of a coach and a trainer rather than the person who’s going to come in and fix. From the perspective of mind-body medicine, we’re not really looking at treating illness and getting rid of illness – as I said, it’s about creating health. So we look at health as a whole person perspective; how is this influencing everything in your life? So mind-body medicine isn’t just using the mind to fix the body; it’s also using the body to restore balance. That’s why I say yoga and exercise are also treatments to be used.

Okay, so a pretty all-encompassing definition. So another buzzword: mindfulness. Where does that fit into this? These days, everybody uses mindfulness, everyone says, “be mindful,” or “I’m doing mindfulness.” Where does that fit into all this?

Yes I think was it this year that Time magazine had a whole special edition on mindfulness and it’s been on the cover of Time several times, about meditation and mindfulness. Mindfulness is a mind-body technique, yet I like to believe that almost all these techniques are involving some form of mindfulness. The simple definition of mindfulness is awareness of the present moment without elaboration and without judgment. It does come from the translation of some Buddhist texts that were talking about a specific type of meditation. One of the problems many practitioners of yoga and Buddhism and others have with mindfulness is that it takes it out of the spiritual realm and makes it more secular. Although Jon Kabat-Zinn, he’s the founder of mindfulness based stress reduction – MBSR. But it’s been used in the treatment of many conditions. It’s really about training us on how to be mindful. But, they’ve been researching it for things like cardiovascular disease, arthritis, psoriasis, a number of things. He took mindfulness and wanted to make it secular. He said let’s get rid of the religious perspective, because it turns people off, and just teach people how to be attentive to the moment. So any technique, even exercise, if you are exercising and you’re really being aware of what you’re doing, what you’re feeling, that is a form of mindfulness. And that’s different than just exercising on a treadmill and looking at the TV screen, or as I see it the gym people are on the exercise bike and they are playing solitaire on their phone. That’s not being mindful. So mindfulness is being aware of the present moment without judgment and elaboration.

Cool. So I guess it sort of fits into the whole mind-body medicine paradigm. My next question is, when did this become a thing, to call this group of practices or this whole thing “mind-body medicine?” Was there a time at which this term was coined and then it became something where then it then played a role in patient healthcare?

Well, yes. If you think about the history of medicine and you look at the way medicine used to be, or healthcare – not the health care system – but the way we delivered healthcare before 1900. There were approaches that were trying to treat the disease and there were approaches that were trying to treat the whole person. I mean if you go back to the writings of Hippocrates, which involved several people and not just one, but if you go back to the writing of Hippocrates it was really, “am I in living in relationship to nature?” You know, if the Sun comes up early, do I get up earlier? If the sun goes down earlier, do I start to go to bed early, do I eat differently at different times of the year? He talked about physis, nature, so to be a physician was to live in accordance with nature. Hippocrates was actually in contrast to some other of the schools in Greece at the time that we’re really focused on disease. You have knee pain, let’s fix your knee pain. When we go to the United States and we look at the first Medical Association in the United States, it was the Homeopathic Association, not the AMA. And I think it was one or two years later the AMA was developed. Homeopaths, herbalists; they’re trying to treat the whole person. When that started changing with the rise of the AMA – the American Medical Association – and in the early 1900’s people started to try to streamline medicine. You know, you have this disease so let’s give you this. It’s easier. I don’t have to spend so much time with you. In diarrhea, let’s just give you something for diarrhea. It takes less time than finding out how you’re living. In the 1970’s, there was a man named (George) Engel who coined the term “the Biopsychosocial model.” And there’s arguments about the Biopsychosocial model, but what he was saying is we cannot just treat one thing. We’re not treating your knee pain, you know, we’re not just treating your diarrhea, your digestive tract; you’re treating the whole person. We need to know about your socio-economic status, we need to know what food sources you have. Do you even have access to healthcare? All of this. And that was in ’71 that he started talking about this. He said that for acute conditions, the medical model, the biomedical model, works really well. And that’s what people say, you know you have a trauma to your knee, go see someone for the knee. But in chronic conditions the biomedical model often doesn’t work and so we need to look at the whole person. In the 70’s, that’s when we saw, in the United States anyway – just talking about the United States – we saw the rise of yoga from other countries coming here. We saw the beginning of meditation. Dalai Lama came over in, don’t quote me even though I’m about to say this, it was in 69 and 70 that he came over. Acupuncture; Nixon went over to China and then they started talking about acupuncture in the West. So there were these more holistic systems that came about and that’s when we saw more of a rise of the term mind-body medicine. Because it was separate from “I’m just going to treat that issue.” Now; I’m going to look at your life and so I’m going to be doing these meditations and it’s helping my whole health, and I’m going to be doing yoga and it’s helping my health, and exercise, etc. So it was in that time.

Okay, so it’s been around for a little while now, especially in the United States. And so how did you get involved? What drew you to being interested and to use this clinically?

The story I’ve told for years, I tell this all the time, is I took my first yoga class in a synagogue in the basement of our synagogue in Pittsburgh, Pennsylvania. I was seven years, old my mother was progressive. This was in the early 70’s. I was always interested in Buddhism and Taoism, However I didn’t even think I was going to go into medicine. I thought I was going to go into the arts. And then when I was in college that started to shift, it’s like I was really interested in psychology so I started a Master’s degree in psychology and counseling. Never finished that, I was just shy of that. And then I decided I wanted to go into medicine. And the reason I actually wanted to go into medicine is when I was doing psychology, I was also doing speech pathology, and I didn’t like back then that the patients that I was seeing had to see the medical doctor first before they could get referred to other treatments. I didn’t really like that. So I’m like “well I don’t want [this], I’m going to bypass it, I want to be able to do these things so I said I was going to go to medical school. And I got accepted to the University of Chicago but never went there. Sat in the parking lot for a while and just turned around and came home. And then I found out about this Bastyr place – that’s not what my friend told me. It was my acupuncturist, my mom had a 5-elements acupuncturist in the 80’s in Pittsburgh, and she told me about Bastyr and so I came out. When I came to Bastyr, I thought I was going to focus on physical medicine. I thought I was going to do sports medicine. And I thought homeopathy was crazy, and I became the chair of the Homeopathy department. And I do some physical medicine now but not a lot. What happened is I would see my patients, we would talk about the biochemical stuff, we would talk about the herbs and nutrition, and that would take about 5-10 minutes. And I never saw that being the main thing that would help them. So I just started talking to them; “how are you doing, what’s going on? How’s your orientation to your life? How are you engaged in your nervous system?” And those were the fundamental questions. Those are the things that I saw the significant changes with. Yes, I believe diet is really important, I do. And it’s not even telling patients that you need to sleep more or that you need to exercise, because how many doctors say that already, how many patients know that? That’s not the issue. What’s keeping them from doing it? What’s the pay off for their behavior? That takes a little bit more time. So when I graduated, I was doing HIV care. I worked with some HIV organizations, and this is in the early-mid 90’s. And like I said, it would take maybe 10 minutes to talk about the medications and supplements and everything, and then we’d talk about their life. And so all the stuff that I had learned in the past about yoga and meditation, I started bringing it back in with my patients. So it was really like returning back to the stuff that I already valued and knew.

Wow. Fair enough.

And it just kept growing. I would find that the more I kept talking to patients, the clearer it got. I was part of a hospice study, where I visited the bedside of 500 hospice patients for meditation. So I would go twice a week, until they died. And they signed up for the study. During that study, I would see what would happen during just a guided meditation. I saw people’s pain decrease, I saw people’s breathing change, I saw anxiety change – significantly. And they were already on serious medications. They were on morphine and everything, and I watched that changed. I documented it. And although I already believed it, it was like, “okay, this is it.” Other things still have purpose, but if we don’t talk about how we are being present in our lives, we are missing so much.

Fascinating. So, you’ve done this for a long time now. What have you seen change, how have you seen the field evolve, as in how is mind-body medicine used in clinic now versus how it was being used back then?

So if you mean back then when I graduated, that’s a great question. I think it’s something that you already mentioned that, one: mindfulness the word is used so much now. I said I think there’s a lot more acceptance. Again, Jon Kabat-Zinn, who started MBSR, it was relatively new and in the 90’s it was still gaining more prominence. I think there’s way more studies now. I actually was on a research panel reviewing these research studies for the NIH and at that time, which was late 90’s, there were only two types of meditation that were accepted: MBSR and Transcendental Meditation – TM. So if anybody wanted to propose a new meditation style they threw it out because they said there’s not enough research. That’s not the case now, there’s more that’s coming up. So I think there’s a greater acceptance. MBSR – that specific approach, which is a six-week meditation approach; that you can find in almost every healthcare setting and in hospitals in the country. There’s a high prevalence of it. Yoga studios! Since I moved to Seattle, I mean there was a huge growth in yoga studios, there were hardly any when I moved here. So that has changed. And more research on all of these things. That said, I hear more people just talk about it but not necessarily do things. You know, so the doctor says you need to go do that. The other thing, biofeedback, which has been around for a long time, ’69 and 70’s it was coming into fruition but, as the whole field now, a lot more people are certified and using biofeedback. More neurofeedback, which just focuses on brainwaves, there’s a lot about that.

That’s perfect, because that was going to be my next question. How does biofeedback as a modality, fit into your mind-body medicine practice? You’ve said over the years there’s been an increase in acceptance and popularity, and even research studies and evidence, but did the conditions looked at or treated change? Did the assessments or tests that you use, or treatments or modalities, like biofeedback, did those change significantly? Or is biofeedback the one that’s become more prominent?

Well I think it’s become more prominent at Bastyr because I’ve been trying to teach it. And I know they do that at some of the other Naturopathic schools. Now, I have multiple answers for the way I was going to answer that. So the way I’m going to answer it is this: my perspective has changed about the nervous system, and I think that is new information that’s coming out that is shaping healthcare in general. I hope it has a potential to shape healthcare. There’s a lot of work about the neuroscience, about emotion, about trauma, how things happen. So I just want to reiterate, the way I work when I’m working with patients, is not to treat conditions – I’m not treating conditions. What I want to look at is how your nervous system is regulating. Because the nervous system is the master regulator for everything we are treating. And Naturopaths espouse to treat the whole person, not treat the condition. I mean that’s what we say correct? So if somebody has hypertension, rather than treat the cardiovascular system, how are we not looking at the regulator of the cardiovascular system: what makes the heart speed up/slow down, what causes blood vessels to constrict? So my understanding of the way the nervous system works has changed significantly from when I went to school, and how I’m teaching it has changed significantly, and the research has changed significantly about that. So I think that’s what we’re doing and that fits nicely with mind-body medicine. Because we’re saying okay if you can look at how you’re participating in your life, it will change downstream. Where biofeedback comes into play is biofeedback is just a way to give the patient more information about themselves. Because it’s that mindfulness piece, right? I want to be mindful of how my posture is or how I’m breathing. I’m not aware of all of those things. Or when I’m thinking this, when I’m ruminating about my taxes, what happens to my blood vessels or my heart rate? And with the biofeedback machine I can see that, and hopefully it helps the patient think, “oh wait, I wasn’t feeling that.” So they can begin to feel it. So I think biofeedback is just another adjunct to all these other mind-body modalities and gives it more information and helps the patient become more mindful and aware.

Okay. And that makes sense. And it segue’s nicely into what I wanted to ask about. Which is, well you kind of already said it, mind-body medicine fits in nicely with Naturopathic medicine. It fits in with how we’re trained to think about the body and think about the whole person and not just the condition. But specifically, do you find certain principles (of Naturopathic medicine) or practices guide the way you use mind-body medicine?
Okay. So if that’s the primary way in which you are looking at a patient, patient comes and sits in your office and you’re doing this work, you’re talking to them and understanding them. Pretty low on the therapeutic order? Low force of intervention?

Yes.

But it doesn’t affect the effectiveness?

What do you mean by that?

In the sense that, what I’ve noticed is that people have this misconception that if you’re lower on the therapeutic order, lower force intervention, then the effectiveness is also lower. So, the higher you go with force of intervention, the harder the therapy hits. But, that’s not necessarily true, right?

I have said this to classes, I say this to patients, I say this every time I talk about this; if you have essential hypertension – benign essential hypertension – so it’s not caused by any other physiological conditions or medications or something – all you need to do is breathe. You need to learn how to breathe. There has not been one patient who has had essential hypertension that I’ve worked with where I haven’t seen in office their blood pressure drop, significantly. Not one. The only time that it didn’t drop, the person actually had some kidney damage, and that was one of the issues I found out about afterwards. Now that’s not to say that one session did anything. If the patient does not practice breathing, if they don’t do homework, if they don’t do something every day to change and learn to breathe that way all the time their blood pressure is not going to change. And that could lead to heart disease. So if they don’t do that really easy intervention, something can happen. But yes, I’ve seen insomnia, I’ve seen seizures, I have seen hypertension, cardiovascular disease, I’ve seen IBS. I’ve worked with tons of patients with IBS who have been through Bastyr, have been to the clinic, changed their diet and all that, still had IBS symptoms. And when we did some either breath-work or some other biofeedback training, they didn’t have the symptoms anymore. I mean so it’s simple low force, but it requires practice. Some people don’t want to do that, a lot of people. And I also don’t want to do what a lot of doctors do, I hear them say, “oh the person is not ready to do that” or, “they’re not going to practice.” And they never ask or they never educated them about how effective it could be if they do that. And, help the patient understand they’ve already done practice. They know how to drive, they know how to walk, they know how to write. Some of them are athletes or play instruments or something. They’ve practiced a skill many times and excelled – it’s the same thing. So many people will say, “oh I can’t practice, I can’t do anything.” It’s like, you’ve done so many things. That’s the other part of mind-body medicine; we’re not just looking at the problems, we’re also looking at your successes. How have you actually cultivated positive things in your life? You have. Or you wouldn’t be alive. So we bring that into the fold. So yes, it’s low force, but it requires a little bit of time and focus.

Well kind of like exercise. Me personally, I know that’s always been my argument that daily life takes practice. Everything in the human experience takes practice. You have to live the experience, so why should exercise, when you’re trying to change your health, be any different? Why should nutrition or mind-body medicine type modalities be any different?

You know what’s so interesting is when you look at the studies on anxiety or depression, many of them came out of the University of Miami. But one’s that looked at exercise, group therapy, cognitive behavioral therapy, and the impact on anxiety and depression, exercise always seems to reign supreme. Now, when you compare exercise and yoga, yoga seems to be a little better. And I can show you those specific studies. But the thing that it seems to be is that with exercise, you could be doing it and not really paying attention to yourself. With yoga, you’re really focused on the breath and the posture. But it’s movement. Movement was the main thing. And I have so many people say “you know when I did that I felt better.” But then the next day, they didn’t do it. But that’s my job: to help them find how they want to do that.

Right. Okay so I know you said, like a lot of Naturopaths say, we don’t treat the conditions we treat the patient and we treat the whole person. But how does somebody know that they should be going to someone who does mind-body medicine without knowing the conditions that you can treat? So are there some common conditions? Or, what are the most common conditions that you do see that patients walk in suffering from or dealing with to your office, or that you see most often studied with mind-body medicine modalities?

Okay, I’ll answer the first part, that at Bastyr Center for Natural Health and in my private practice, the main conditions that I see people coming in with are anxiety, PTSD and trauma, hypertension, and IBS. Those are the main things that I have seen. Others include insomnia, depression, chronic pain, I should say that just chronic pain in general and not necessarily specifically low back pain. Migraines, TMJ – so that can fit with the pain thing. I think those would be the main. And so when we get into the main conditions and efficacy for mind-body medicine, we have to look at which modality we’re talking about. Are we talking about biofeedback, are we talking about MBSR? Mindfulness meditation, transcendental meditation, autogenic training, which is a different type of modality, hypnotherapy, I mean all of those. And there’s a lot of studies out there. For instance, there are some studies that show mindfulness is helpful for hypertension, and it does nothing for hypertension. The problem with those research studies is they’re looking at an approach, mindfulness based meditation, to fix a condition when mindfulness is about really creating awareness. It’s not about any change of condition. In fact, the primary goal of mindfulness meditation is not to change anything, just to be present with it. What’s interesting in the studies where they show that mindfulness does help with hypertension, we can make an association; they start to say, “the way I’m viewing my hypertension or my life is creating more tension and resulting in my blood pressure going up.” With that said, we could use any of these mind-body techniques to alter our relationship with our symptoms, so I find that they’re all effective in some way, not necessarily in eradicating or getting rid of the condition, but helping manage the condition or even help our mood in relation to the condition. And remember, I’ve worked with people who all were in a hospice study and they were all dying. The goal is not to prevent them from dying. I mean, that would have ruined our data too! The goal was to see if it improved their quality of death, the quality of life they had before they died. And I believe we saw that. So it really does depend on what we’re really looking at.

Okay. So if we were to do a little comparison, in simple terms, you know we see that a lot of these conditions that you listed off and obviously it could take forever to talk about them, but the common conventional treatments for a lot of these conditions; how do they compare? How does the conventional treatment and care compare to the Naturopathic or mind-body medicine modality equivalent as far as force of intervention, or therapeutic order?

Well you already sort of mentioned that. That they are lower force interventions. But for instance, in many of the biofeedback studies, what a lot of the biofeedback studies – just to be clear, biofeedback being a process where you’re getting information about the physiology. So they hook you up to sensors that measure muscle tension, your heart rate, your breathing, temperature, sweat skin conductance, brain waves. A lot of the biofeedback research studies that look at post concussive syndrome, that look at headaches, hypertension, pain, even IBS and some other things, the difference in approach is you come in and you are following up, coming in weekly for sessions for maybe anywhere from six to twelve to twenty-four weeks. So if you talk about level of intervention: that’s time, that’s money… it’s time. Since you are learning new ways of either breathing or holding your muscles or relaxing, coming in weekly is really important. It’s no different than hiring a coach if you’re an athlete and you’re on a team and going to practice every day. It’s no different than having a coach to tell you what to do. So it’s really important. The studies on PTSD for example, and hypertension, they’re about six-week studies. That’s it. Six-week studies of learning how to breath a certain way and you see changes. So, if you go see the doctor and get a medication, or get an herb, and then come back in a month and check in on how you’re doing, and this is the way we follow you for six weeks, I believe the outcome is better. Because what I most often see is that since we’re not treating the end organ – we’re treating the whole person – I teach someone with hypertension six weeks of breath-work, not only is their blood pressure lower, they’re sleeping through the night, their GI tract is not upsetting them anymore, and we did one thing. Which is a huge thing. So I don’t need to give an herb for this, an herb for that, adjust this, or fix that. I’m working on “this” to work on their whole nervous system, and that branches out to so many different areas. So if you want to talk about cost effectiveness, compared to conventional care, you don’t have to see the gastroenterologist, the cardiologist, the sleep specialist, etc. So I think that it is more effective.

Alright, that’s awesome. I think we touched on everything that I wanted to talk about to get a little bit of an introduction to what exactly mind-body medicine is. Now this next part, this is a little bit more for you to get on your soapbox a little bit. So I’m going to ask you to just list, something I like to call our 3 Top 3. So first, the top three things that you would say people should avoid to optimize health and wellness.

The top three, and this is my soapbox? Okay. Social media. Yes, as I say that on here. I had a friend who was going through educational technology, a degree program at UW. And this was in the 90’s, and we were talking about emails and everything and I was saying “oh this is so bad.” And he said, no. And this is the argument, right? No thing is really bad, it’s how we use it. So I’m not going to say social media is bad. I’m going to say, no social media, no cell phone, no phones in your bedroom, no social media after a certain time. Really maybe those are two different things. But limit your social media. There is so much research showing that the more friends you have on Facebook, and not from a business perspective because they know people use it that way. But the more friends you have on your personal Facebook page, the more unhappy you are. I see people constantly worried about that. “Did I get like, it was two seconds after I posted it.” So really limit the use of social media and do it for what you want: to engage. But what we find is people who use social media for social support, feel a lack of a social support because there’s no one around them. Put down the social media and go and do something. So I would say that’s 1. It has its place, you can use it, use it effectively, use it for the way you want to connect with people but actually connect. Nothing, I mean nothing, can replace connecting with people live. So don’t use social media as a substitute. 2: get off your computer and your phone hours before going to bed. It will disrupt your sleep. Most Americans, I don’t know about the Canadians, (Yes, Ashok is Canadian) but most Americans have sleep deprivation problems. Lack of sleep and poor sleep changes all your hormones. It affects everything. Don’t do that. All those sleep hygiene things they say, yeah do that. Okay do I have another one? Hmm, to avoid? The only thing that came up was McDonald’s, or fast-food. Yeah I don’t know what else, those two are the biggest ones. Umm, going to a doctor? My patients in the end-of-life study who lived the longest were the ones that said I never listened to anything my doctor said. So, oh! Don’t search the internet for your health conditions! Okay there, yeah I tied it together. McDonald’s? Yeah, sure. Those first two are really important to me.

Okay. So what about 3 daily practices to encourage balance in health, on a daily basis?

(laughs) Avoid social media, turn off your phone. 1: get up and move. And that doesn’t mean you have to exercise. I mean that would be good, but get up and move. Do not be sitting for more than 20 minutes. And I’m at fault for that, what do I teach at school. We have classes for 2 hours, 3 hours, I could talk forever. Get up. I’m telling the students now, I’m trying to put that in the syllabus, to get up and move. Don’t sit in these chairs. I could say your education system is causing poor health, they’re doing it to you by requiring you to sit. So no, every 20 minutes move. I think that’s really important. The other thing is to have some time of silence. And when I mean silence I don’t mean like radio silence, I mean internet silence. We could call it silence, but sometime to just reflect and be present to what we’re experiencing. That’s where all the mind-body techniques come in. It could be yoga, it could be meditation, it could be prayer, it could be eating mindfully, whatever. It is some time where you just sit so you can really reflect on what you’re experiencing and feeling without being bombarded by other noise. And this is not just at the end of the day before you go to bed and then you fall asleep. It’s throughout the day. We switch gears so many times so quickly, the mind can’t really multitask. There’s no multitasking, it’s switching back and forth through different things, and some people think they excel at that. The problem is if you hardwire your brain to excel at that, you don’t know how to turn it off. And that’s going to cause all these health things downstream. (points to the right) This is my downstream area over here, this is where all the diseases are. I hear people say “well I can’t sit, I get antsy.” Because their nervous system is not used to it, they feel like they have to be looking at something, they’re on guard for something. Spend some time to cultivate time in silence. Tt doesn’t mean you’re sitting with people and not talking, you need to reflect, breathe, you know your walking can be doing that too. So I think that’s so fundamental. And then the third thing that I think is really important is social connection. I know there are people who you know live certain places so they’re not connected, but how do you form social connection? So many people are isolated from that. I truly believe, and we didn’t go into the nervous system specifically, that social engagement – not via Facebook, not through email or texting – but real social engagement. The voice is better than nothing, because if you’re on the phone you hear someone’s voice, you connect with their intonation, that does something to your nervous system. If you’re Face-timing you know, I’m telling you put down the screen but if that’s the only way to get social connection, you can see facial expressions and hear the voice, that’s useful. But there’s nothing better than being in the presence of somebody. And if you are isolated and if you feel you can’t, get a pet. Because that will help. It regulates our nervous system. It’s the master regulator, being with people, like-minded people who support us. So if you find all day you’re around people who are critical and picking on you, yeah that’s not necessarily helpful for your nervous system. Too often I hear people say I’m too tired, I don’t want to go out and do that. And then when they do go and spend some time with people they feel energized and they feel better. Social engagement. So the second one, when I’m saying be silent with yourself and spend some time, that’s actually self engagement. That’s engaging with ourselves and the other is engaging with others. So that’s what I really think, our daily practices [should be]. Move, which means you engage your body and you have a relationship with it, be silent so you can engage with your emotions, thoughts, and feelings, and then engage with others. That will that can heal a lot.

Alright. So the last three I will ask you for are just 3 tips for optimal health. Doesn’t have to be daily practices, just three general health tips.

Those were they, those were the ones. I think that the daily practices are the tips. I don’t think there’s one thing to do like a one-time, one-off. It’s like these are daily things that will really change your health. It takes dedication and practice. If you think of it, like if you want to learn to play piano, you practice your scales. You’re not even practicing that major concerto, you’re practicing your scales. Everyday, no matter how many years you practice. And you keep doing it because it reminds you of how you want to be. I think Dali Lama said, and I think it was in the art of happiness, something about how he gets up really early every morning and meditates for hours. And that’s the first time. And when asked why do you do that, he said because it reminds me how I want to be that day. So I think these little things have major consequences. so I’ll say that to optimize health, maintain your daily practices. And don’t beat yourself up on the days you don’t. Practice self compassion.

Okay. Dr. Brad, this was wonderful. I want to thank you very much for joining me, talking with me, and entertaining some of these questions I had. But, before I let you go, I know people will watch this, and they’re going to be like, “that’s so cool!” Because I’m fascinated by it, you’re obviously fascinated by mind-body medicine and how the body works and treating the whole person. Where do people go to learn more about this or to learn more about you? How can they follow what you’re doing and what you’re talking about? You know, do you have social media?

I do have social media, that I struggle with doing at times. But I do have a website. It’s www.thebreathspace.com. And on that I actually have some of my guided meditations so people can download those for free, they can listen to them. I have some of my articles that have been published. Now, I do have an Instagram thing (@breath_space) and some other stuff. I’m not as good on “the Facebook” and the Instagram. I also have a private practice, so you can find that through www.thebreathspace.com. Other places people can go, I mean I’m excited because I’ve helped train a number of practitioners out there. the Bastyr Center for natural Health has a mind-body medicine shift so people can go there. If they’re interested in mindfulness specifically, several hospitals in the area offer free or really low cost mindfulness based stress reduction programs, so they can check that out. MBSR. And then there’s just so many other techniques, there’s a number of biofeedback practitioners that are Naturopaths that got certified. People can find out about that on the www.BCIA.org website, and find a practitioner. That’s the Biofeedback Certification International… Alliance? I should know that one! So you can find a practitioner in your area and can find somebody who’s board certified. Psychotherapists, physical therapists, Naturopathic doctors. You don’t have to be certified to do biofeedback, but that certification is just another indication of level of proficiency. You can always look there if you’re interested in that.