The Doctor's Farmacy with Dr. Rangan Chatterjee

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Episode 87
The Doctor's Farmacy

Is There An Antidote To Stress?

Open the Podcasts app and search for The Doctor’s Farmacy. If you’re viewing this site on your phone, you can just tap on the

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We’re up against a chronic epidemic: stress. In fact, it’s estimated that 80% or more of doctors’ visits are due to illnesses related to stress. 

This can come in many different forms. Socioeconomic stress is a real burden for many people, as is the stress of taking care of several generations within a family, or meeting the demands of our jobs. Stress can also come in the form of bad food and poor or inadequate sleep, which send negative signals to the brain that produce stress hormones.

That doesn’t mean we’re stuck with stress though. Today on The Doctor’s Farmacy, I’m joined by my good friend Dr. Rangan Chatterjee to look at the many sides of stress and all the actions we can take to stop it in its tracks.

Dr. Chatterjee and I dive into the far-reaching topic of stress with some new and inspiring perspectives. He feels many cases of stress, or just a general state of discontent, are due to passion deficiency. When we make an effort to include things we love in our everyday lives the benefits are tenfold; we are happier, healthier, more present, and more resilient to stress.

We also have the power to change our perception of stress. Taking a different mindset about the things in life that stress us out, acknowledging what we have the power to control and what we can’t, and not giving away our personal power to others through our reactions are all major steps towards managing stress in a healthier way.

Human touch is another component of health and stress reduction that is usually underappreciated. Science has shown that touch, massage, hugging, and physical acknowledgment, in general, help us release the feel-good hormones that keep us more prone to relaxation and stronger in the face of stress.

We talk about so many really important aspects of managing stress. I hope you’ll tune in and make stress reduction part of your New Year’s health goals.

This episode is brought to you by ButcherBox and Joovv.

ButcherBox is currently offering listeners of the podcast 2 lbs of wild-caught Alaskan sockeye salmon PLUS $20 off your first box. Just go to ButcherBox.com/farmacy to take advantage of this great deal. Check out the Joovv products at joovv.com/farmacy. Once you’re there, you’ll see a special bonus the Joovv team is giving away to my listeners. Use the code FARMACY at checkout.

I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD

In this episode, you will learn:

  1. The personal experience that changed Dr. Chatterjee’s approach to practicing medicine
    (2:32 / 6:22)
  2. Why Dr. Chatterjee chose to focus on the topic of stress in his latest book, The Stress Solution
    (11:35 / 15:25)
  3. The power of identifying if there is a trigger point in your week that leads to the bulk of your stress
    (15:36 / 19:26)
  4. How stress affects your physiology and why finding meaning and purpose in your life is so important to your stress resiliency
    (20:03 / 23:53)
  5. Managing your mindset as it relates to what you can vs what you cannot control
    (32:25 / 36:15)
  6. How lack of downtime contributes to stress, the brain’s default mode network, and our toxic relationship to technology
    (34:44 / 38:34)
  7. How to create a morning routine in as little as 5 minutes
    (44:42 / 48:32)
  8. Creating new behaviors and habits
    (51:44 / 55:34)
  9. The daily gratitude exercise Dr. Chatterjee practices with his family
    (53:43 / 57:33)
  10. The importance of touch and intimacy
    (56:47 / 1:00:37)

Guest

 
Mark Hyman, MD

Mark Hyman, MD is the Founder and Director of The UltraWellness Center, the Head of Strategy and Innovation of Cleveland Clinic's Center for Functional Medicine, and a 13-time New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

 
Dr. Rangan Chatterjee

Dr. Rangan Chatterjee is regarded as one of the most influential doctors in the UK and wants to change how medicine will be practiced for years to come. He hosts the biggest health podcast in Europe, Feel Better, Live More, which Apple has announced as one of the most downloaded new podcasts of the past year. His first book, How to Make Disease Disappear, is an international bestseller all over the world and has sold over 250,000 copies worldwide in just 18 months. His most recent book, the #1 bestseller, The Stress Solution, tackles what the WHO calls the health epidemic of our time—stress. Dr.Chatterjee’s mission is to help 100 million people feel fantastic by restoring them to optimal health.

Transcript Note: Please forgive any typos or errors in the following transcript. It was generated by a third party and has not been subsequently reviewed by our team.

Dr. Rangan Chatterjee: So one of my recommendations to my patients is have a daily dose of pleasure, even if it’s just for five minutes.

Dr. Mark Hyman: Welcome to the Doctors Farmacy. I’m Dr. Mark Hyman, and that’s Farmacy with an F-A-R-M-A-C-Y a place for conversations that matter and if you’ve ever been stressed in your life, today’s conversation is right for you because I think stress matters and we’re going to talk about why and how to fix it. So our guest today is Dr. Rangan Chatterjee One of the most influential doctors in the U K in Europe, and he wants to change how we practice medicine using functional medicine. He hosts the biggest podcasts in Europe, Feel Better Live More, which Apple has announced as one of the most downloaded new podcasts of the past year.

Dr. Mark Hyman: He’s known for helping people find the root cause of health issues, and he’s highlighted these methods of functional medicine in a groundbreaking BBC show called Doctor in the House, which has been shown over 70 countries around the world. He goes into people’s homes, he transformed their lives. He shows what’s possible with the power of functional medicine to get to the root cause of disease. His first book, How to Make Disease Disappear what a great title. Is an international bestseller all over the world, so the quarter million copies in just 18 months. His most recent book, the number one bestseller, the stress solution tackles what the world health organization calls the health epidemic of our time stress. His mission is to help 100 million people feel fantastic by restoring them to optimal health. Why just a hundred million? Why not seven billion?

Dr. Rangan Chatterjee: That’s a good point, Mark. You know what? I actually-

Dr. Mark Hyman: You are like thinking small Dr. Chatterjee.

Dr. Rangan Chatterjee: I thought I was trying to think big. I actually saw this article where they said 100 million people around the world have to choose between healthcare or food, and it really struck me and I thought, wow, that’s an incredible figure. People who have to make that choice, wouldn’t it be great to impact that many people?

Dr. Mark Hyman: Well, you know what’s true. If you eat the right food, it is health care and then you don’t need health care.

Dr. Rangan Chatterjee: Yeah, exactly.

Dr. Mark Hyman: So it’s been so great to know you over the years because you’ve taken on the leadership role in the U K of bringing forth a new way of thinking about health and disease. And you’ve been an advocate for transforming how people think about medicine. And you put content out there that really helps guide people to live better lives, to incorporate the scientific principles that help them do that through your book, how to make disease disappear in your new book, The Stress Solution. So powerful. But before we get into all that, I want to talk about your personal story because I’ve heard you tell it many times and it took you from being a traditional doctor trained in traditional medicine, having your eyes open because your son was fatally ill and you figured out what was wrong with him and that changed everything for you. So tell us that story about your son.

Dr. Rangan Chatterjee: Yeah, Mark. You’re right like many conventional MDs, I went to medical school, I thought that I was going to learn all the tools that I needed to help my patients get better. And I think I always had this slight frustration that I didn’t really know why, I just thought there’s something about my job which isn’t resonating with me deeply. And it wasn’t really until my son got ill that I actually figured out what that was. And I can still remember it so clearly. So my son who was six months old at the time, he had been breastfed for six months by my wife and we went on holiday to France just after Christmas. And on the first day he wasn’t so well we thought he had a cold he was bringing up a lot of mucus.

Dr. Rangan Chatterjee: And my wife didn’t put him down to sleep as normally the evening. It’s his mother’s intuition she knew something wasn’t quite right and she just kept him with her in her arms. And we were in France and my friend Chalet and she called out to me “Rangan, Rangan you’ve got to come here he’s not moving.” And basically my son had put his arms back, he’d gone rigid and stiff and wasn’t really responsive. Now I thought maybe he’s choking, maybe he’s choked on some of the mucus that he’s been bringing up all day. And I turned him over. I tried to clear his airway. Nothing was happening. If I’m honest, Mark, I froze.

Dr. Mark Hyman: You thought he was going to die?

Dr. Rangan Chatterjee: Yeah, I froze in that moment. I wasn’t a doctor with all my experience. I was just a scared father and it was actually my wife. He said “Rangan look, we’ve got to get into the hospital now.” So we drove to the hospital, which wasn’t far, it was just two minutes down the road, although I nearly killed us on the way because it had just snowed and the French Alps. I nearly turned the car over and we got there. And what was really interesting is that the doctors and the nurses were really worried. You could tell they were worried because my son didn’t have a temperature. And as you all know, it’s not uncommon for a six month old baby to have a convulsion.
2: Febrile seizure.

Dr. Rangan Chatterjee: A febrile convulsion secondary to the temperature. But his temperature was normal and you could see the doctor’s wondering well his temperature is normal, what is going on? So they put a line in his neck. I actually had to help hold him down while they put a line in his neck, which was pretty traumatic for me. He had to be blue lighted in an ambulance down to a bigger hospital because this was a very small regional hospital. We got there they didn’t know what was going on. He had two lumbar punctures and my wife and I were in a bit of a state of shock. What is going on? We’re a pretty health conscious family. Why is he having this convulsion? And we weren’t sure he was going to make it. It took a few hours before a doctor came and spoke to us and said, “Look, we know why he’s had a convulsion. He’s got very low levels of calcium in his body.” So he had a hypocalcemia convulsion.

Dr. Mark Hyman: Yeah low calcium levels is dangerous, yeah.

Dr. Rangan Chatterjee: To put it in perspective the normal range in that French hospital of a serum calcium is 2.2 to 2.6 his level was 0.97. So not just low-

Dr. Mark Hyman: And for those non doctors in the audience, calcium is super tightly regulated in the body. So any slight deviation is very serious. A little high, little low. And this is very low.

Dr. Rangan Chatterjee: Yeah. And then we’re trying to figure out, well okay, he’s got a low calcium, they can give him intravenous calcium but what caused the low calcium? And again-

Dr. Mark Hyman: And clearly he was getting breast milk, he was getting a lot of calcium.

Dr. Rangan Chatterjee: Yeah, exactly. And it turned out a few hours later after these lumbar punctures and I just couldn’t believe that this was going on with my kids and they said, “Look, Dr. Chatterjee we understand why he’s had his convulsion. He’s got hardly any levels of vitamin D in his body.”

Dr. Mark Hyman: Good for them for testing it.

Dr. Rangan Chatterjee: Yeah. And that’s why he’s had it. And then this was like, what is going on? This is a fully preventable vitamin deficiency and my son’s nearly died from that. Now look, modern medicines saved his life. They gave him a calcium infusion, they gave them vitamin D. The acute problem was fixed. But then we were discharged, five days later I was like, I was reading up about vitamin D and I was thinking, well, hold on a minute. If he’s been deficient for the last six months, if he’s been deficient whilst he was in the womb, what impacts has that had on his immune system development? Could this be why he’s got eczema? And nobody was giving me the answers to that. So I made-

Dr. Mark Hyman: Your wife also probably had low vitamin D.

Dr. Rangan Chatterjee: She got tested and she had low vitamin D. And that really drove me mad because if I’m honest, I had a lot of guilt. I thought, how did I not know this? How I used to do nephrology. That’s what I was going to do.

Dr. Mark Hyman: Where you learn all about calcium and vitamin D.

Dr. Rangan Chatterjee: I’ve got an immunology degree. I remember the word college of GPs. With all these so-called qualifications. I wasn’t able to prevent my son having this preventable vitamin deficiency and there’s a lot of guilt there and I thought, right, I’m going to get my son back to full health as if this had never happened. That was the vow I made to myself and that drove me every evening, every day I spend two, three hours on the internet in textbooks, reading, learning, researching, thinking well, hold on a minute. That’s a lot of science out there that I have not learned about as a doctor but I think is relevant for my son.

Dr. Mark Hyman: You mean nutrition science?

Dr. Rangan Chatterjee: Science on the gut microbiome, science on how our food choices impact our immune system, et cetera, et cetera. That led me to come over to America to train and study at conferences and the more I started to understand, I put it into practice with my son. He starts to get better. I started to apply this principles with myself, with my wife, with my family, we start to feel better. Then I start applying those same principles with my patients. They’re starting to feel better. And I think, well, hold on a minute.

Dr. Mark Hyman: Everybody is feeling better. It’s pretty awesome.

Dr. Rangan Chatterjee: Yeah. And I’ve got to say that yes, my son was the trigger for me. I used to feel guilty about that Mark for years. I think I had this guilt and I’m starting to let go of that because I think that helps me be the best father I can be. But now I think it was a gift what happened to my son because had he not got sick, I’m not sure I would be doing what I’m doing now.

Dr. Mark Hyman: No. Yeah. You know, often many of us who are in this field has some crisis with ourselves or family member where we wake up and we go, okay, wait a minute. What we learned in medical school isn’t the whole story that we missed a whole lot about how to create a healthy human. None of us took a class called creating healthy human one-on-one in medical school. And yet that is the most essential thing that we need to figure out so we can live healthy, vibrant, long lives. And most of the diseases we see today are actually the result of our environment affecting us. Whether it’s our diet or stress or toxins, infections these are things that we can actually modify. And that’s why I’m so excited about your new book, which is the Stress Solution. The truth is that you can’t avoid stress.

Dr. Mark Hyman: Stress is just a part of life. And the question is, how do you define stress? How do you relate to stress? How do you interact with it in a way that doesn’t control you or effect you in the way that it could? I learned that the stress is defined as the perception of a real or imagined threat to your body or your ego. So it could be a lion chasing you that’s a real threat to your body. Or it could be you think your spouse is having an affair, even if they’re not, your body has the same response as if it’s being chased by a tiger or a lion. And I think we don’t in our society have mechanisms or systems for addressing that. And not only do we not have systems, but we are exposed to chronic, unremitting stress day in day out, minute to minute from the minute we wake up to the minute we go to sleep. And we haven’t any structures in our society for really managing that.

Dr. Mark Hyman: Most cultures have had ritual, have had prayer, have had ceremony, have had meditation, have had various kinds of rituals that take a pause in life to stop and to reset and to reconnect with what matters. And we just don’t do that. So what inspired you to sort of write this book and deal with this big an often addressed epidemic of chronic stress?

Dr. Rangan Chatterjee: Yeah, Mark I think, in my first book, how to make disease disappear. I spoke about what I consider to be the four sort of pillars of health as it were. The four things that I think have the most impact on our health, but also we’ve got a fair degree of control over food, movements, which we’ve been talking about for years, but equally important sleep and relaxation. And what was quite clear to me is that people were feeding back to me that the pillar they were struggling with the most or many of them were was the whole relaxed pillar. This whole piece about stress, people will sort of thinking about their food and their movement, but they really struggled with stress.

Dr. Rangan Chatterjee: And I thought, you know what? Food gets a lot of air time movement gets a lot of air time. I don’t think stress is getting the air time that it deserves. And that’s why I thought. Well, I’m going to write a book on stress to really elevate it and in terms of our consciousness in terms of what we’re thinking about. You mentioned in the introduction, the World Health Organization right now, if you go on their website, we’ll say that stress is the health epidemic of the 21st century. That’s an alarming statement.

Dr. Mark Hyman: The health epidemic. Wow.

Dr. Rangan Chatterjee: Yeah. I mean that’s incredible. And then-

Dr. Mark Hyman: I might fight a little bit with that. I think food per food problem is big one right up there. It’s right up there.

Dr. Rangan Chatterjee: I think stress and food is linked actually because-

Dr. Mark Hyman: Actually our diet… You probably know this, but our diet, if it’s bad causes physiologic stress. So when you eat sugar and crap, it actually raises your cortisol and stress hormones.

Dr. Rangan Chatterjee: 100%.

Dr. Mark Hyman: Even if you’re not mentally stressed, it makes you physically stress

Dr. Rangan Chatterjee: Well a lot of these things actually as you know, Mark work both ways. So yeah, the poor dietary choices can send stress signals up to your brain. Good food choices can send calm signals up to your brain. This has all to do with the gut brain access, which you’ve written about before. I’ve written about in this book. But also I would say it works both ways. So if you are chronically stressed, it’s quite hard to make those good healthy food choices. Let’s take January in the U K and the U S every January, people are trying to get healthy, right? I’m going to reduce my sugar intake this year. I’m going to cut out alcohol this year. But here’s the problem I’ve seen is that people can use willpower for a week, for two weeks, maybe three weeks. But if the sugar or the alcohol was being used to help them soothe the stresses in their life, they’re never going to maintain it long term. So I actually, I agree food is a big problem but I found with some patients addressing their stress levels means they feel less of a needs to binge on sugar because they’re not feeling as stressed.

Dr. Mark Hyman: If you’re happy you’re not going to eat that bag of chips or cookies.

Dr. Rangan Chatterjee: Because a lot of our food choices are dictated by our emotions and if we’re feeling down, if we’re feeling stress. We’ve got too much on actually that sugary chocolate bar or that bag of chips actually helps us feel good in that moment. So short term benefit but long-term harm. But you know, the other thing-

Dr. Mark Hyman: It was interesting last night I went out. I recorded my public television show for my new book and it was a very intense day and I’ve been really no sort of under a fair bit of pressure writing the script and getting it all done and performing and rehearsing and it’s a big production and everybody’s. And like at the end of the day we went out and had a celebration and I had two tequilas, which is for me a fair bet. And I noticed last night that my sleep wasn’t as good, that my heart rate didn’t go down enough, that it was really impacting me in a negative way. And today I don’t feel as sharp as I normally would because I probably did something that was counterproductive to manage the “stress” of all this stuff. And I was like giving myself a treat but actually maybe being calm, productive.

Dr. Rangan Chatterjee: Yeah. But this is a story that I think many of your listeners will be able to relate to that. If I tell the story in my book about this chap who I saw he was a busy business guy in his early fifties and what was really interesting about him is that we start to measure something called heart rate variability on him. So heart rate variability.

Dr. Mark Hyman: What is that?

Dr. Rangan Chatterjee: Basically it’s a measure of how… What is the beat to beat variation between our heartbeats. Now people will think it should be like a metronome, tick tock, tick tock.

Dr. Mark Hyman: 70, 70, 70.

Dr. Rangan Chatterjee: But that’s actually incorrect. What we’re looking for is a high degree of variability and-

Dr. Mark Hyman: Complexity.

Dr. Rangan Chatterjee: Yeah. Complexity and it shows that we’re constantly adapting and able to adapt to this changing environments around us. And what was interesting-

Dr. Mark Hyman: I mean, the worst heart rhythm is got no variability it’s a flat line.

Dr. Rangan Chatterjee: Yeah. So a low heart rate variability is actually indicative that we’ve got high stress levels in our body. And this chap actually on a Wednesday evening, he would find that he was drinking a lot of alcohol. He wasn’t sleeping well, he was having a lot of caffeine on Thursday, more alcohol on the Thursday. He was basically… He came in, he was really, really stressed. It was impacting his relationships and passing his sleep, et cetera, et cetera. The very common story. But as we start to look at his life and actually use HRV heart variability readings, we could see that everything changed for him on a Wednesday. So what happened on a Wednesday lunchtime, he had a team meeting, right? He found that incredibly stressful. We had to present to his team, it was quite a high pressure meeting and that stress would last throughout the day.

Dr. Rangan Chatterjee: So what would happen is on a Wednesday, late afternoon, when he would leave work, he had to compensate with that stress. How would he do that?

Dr. Mark Hyman: Alcohol.

Dr. Rangan Chatterjee: Alcohol. So he would open a bottle of wine, he’d have a glass, that glass one glass would turn into two, two would turn into three and by the end of the evening you’d have the whole bottle of wine. So what happens then? Doesn’t sleep well on the Wednesday night. So Thursday morning he’s feeling groggy. He needs-

Dr. Mark Hyman: Lots of coffee.

Dr. Rangan Chatterjee: …lots of coffee, lots of sugar. It’s again with through coffee in the afternoon as well, which again impacts his ability to sleep on Thursday nights. He’s not feeling good. And that cycle continues where he’s having a bottle of wine on Thursday, two bottles of wine on the Friday and et cetera, et cetera. But what did we do? We identified his trigger point was a Wednesday at lunchtime. So I could show him that on the data. He could see it very clearly. So we discussed about certain things he might be able to do on a Wednesday evening instead of alcohol. Now there was-

Dr. Mark Hyman: Do yoga class.

Dr. Rangan Chatterjee: One of it was a yoga class very near his office. So before he went home, he went to the yoga class. So what happens then? He goes to that yoga class that helps him distress when he gets home he no longer feels the needs to drink a bottle of wine. So he might have a glass, but it’s one glass and it stops there. He sleeps well. Thursday he feels fresh, he doesn’t get as stressed at work. He doesn’t have as much coffee and before you know it, all we had to do was give him a yoga class on a Wednesday afternoon and suddenly that changed his whole week. And people who are listening to this, I would really ask them to reflect on their own life and think actually is there a trigger point in my week where things start to go downhill? Because if you can identify that and change your behavior, it is incredible what you can achieve.

Dr. Mark Hyman: It’s true I mean most of us understand we need to eat well. Most of us understand how to exercise and what that means, but very few of us understand how can we actually deactivate that stress response, activate what we call the relaxation response or the healing response in the body in a deliberate, methodical way. Just like we exercise or eat well and I think those are skills we never learned that are hard for people to understand how to incorporate and yet they’re pretty easy to do and they’re actually fun and you feel amazing after.

Dr. Rangan Chatterjee: Yeah, but that’s the beautiful thing about this is that they’re not as hard as we think. They’re quite simple, most of them. I think pretty much all of the recommendations in my book I think are free. Like literally you don’t have to buy fancy equipment or fancy apps. Actually a lot of this is accessible to all of us. But just to put in context the scale of this problem, Mark, I mentioned what the World Health Organization say, but there was a paper in the journal of the American medical association in 2013, I think it was an editorial piece which suggested that between 70 and 90% of what a primary care physician like me sees in any given day is in some way related to stress.

Dr. Mark Hyman: Of course.

Dr. Rangan Chatterjee: These are remarkable statistics.

Dr. Mark Hyman: It’s either caused by or made worse by stress.

Dr. Rangan Chatterjee: 100% and I think once people understand.

Dr. Mark Hyman: I mean if you’re stressed, your blood sugar goes up, your blood pressure goes up, your blood vessels get stiff and hard, right?

Dr. Rangan Chatterjee: Yeah. I mean, I try to explain this.

Dr. Mark Hyman: You have more information.

Dr. Rangan Chatterjee: I find that when patients understand what the stress response is, I find that really engaged in trying to change it. So I say them “Look, your stress just wants is ultimately trying to keep you safe. It’s when your body thinks you’re in danger, it’s trying to keep you safe.” So let’s go back a million years ago and then you can understand what the stress response is, how it’s evolved. So you are in your Hunter gatherer tribe and a wild predecessor is approaching, right? In an instant, your stress response gets activated and your physiology starts to change. So as you said, your blood sugar goes up, which is going to help deliver more glucose to the brain. Your blood becomes more prone to clotting so that if you get attacked-

Dr. Mark Hyman: Bitten.

Dr. Rangan Chatterjee: Or bitten you’re not going to bleed to death, you’re going to survive. Your amygdala which is the emotional part of your brain becomes more reactive. So you’re hyper vigilant to all those threats around you. That is an appropriate short term response to a threat. The problem now, Mark is that for many of us, our stress response is not being activated by what predators. It’s been activated by our daily lives.

Dr. Mark Hyman: By Twitter.

Dr. Rangan Chatterjee: By social media, email inboxes.

Dr. Mark Hyman: By CNN, Fox News.

Dr. Rangan Chatterjee: To do list. What elderly parents were looking after. Two parents working in a family, one’s trying to rush home from work to pick up the kids, et cetera, et cetera. And for many of us, those short term responses that are so helpful become harmful. So if your stress is going up every day, blood sugar going up for a short period of time is not a problem, right? But if that’s happening day in day out to your email inbox, well that’s going to lead to fatigue, lethargy, type two diabetes, high blood pressure. From the stress response.

Dr. Mark Hyman: And now we have so many more stresses than we used to, right? We have the culture we live in, the stress, we have the toxic food system, we have the chronic amount of financial stress that most people feel. I think 40% of Americans can’t withstand a $500 emergency, 100 million live in poverty or near poverty, which is hugely stressful. I mean one of the studies that I found most striking a number of years ago was that more than a poor diet, more than smoking, more than lack of exercise, that socioeconomic status and a lack of sense of control about your life really stress is the number one predictor of death and disease. And I think it’s something we don’t really appreciate and we don’t as physicians really learn how to address it, how to measure it and how to help treat people.

Dr. Rangan Chatterjee: Yeah, I totally agree. And actually the first part of my book is actually on meaning and purpose. And it’s relevant to this because not having that control over your life, not having a sense of meaning, not having something to get up for every day. That is arguably the most stressful thing in your life. Even if you’re doing everything else right. If you don’t have that. A few years ago I came across this Japanese concept, the ikigai and I know you’re familiar with. I saw these four circles and it’s where these four circles intersect in the middle is your ikigai guy. When you are doing something in your life that you’re good at, something that you love, something that the world needs as something that pays you money. Yeah. And I thought-

Dr. Mark Hyman: That’s how you got that nailed, Dr. Chatterjee.

Dr. Rangan Chatterjee: Hey, well look, I’m very lucky. I now have in my life, my job I absolutely love my job. That’s for sure. But what’s interesting for me is I saw that and I thought, yeah, I want some ikigai guy in my life. That sounds brilliant. I started talking about this concept to my patients and for many of them they found it a little bit intimidating. They thought, well, how am I going to find one thing in my life to tick all those four boxes? And actually when I was giving a talk in London recently on stress, this Japanese student put a hand up at the end and she asked me a question, he said, “Dr. Chatterjee, I’ve grown up with this philosophy and I’ve got to say I find it really stressful, I find that too high a bar to live to.”

Dr. Rangan Chatterjee: And what I did in the book is I created a new framework that I use in my patients. I call it the live framework. It’s a much more achievable way, I think for a lot of people to find their meaning and purpose. The L is for love, I is for intention, V is for vision, E is for engage. We probably can’t go through all of that. But I sort of, I use it with my patients to help them start to find meaning and purpose. And the first one I think is really important love, right? So the research on this is super clear. Regularly doing things that you love makes you more resilient to stress. Right? So you mentioned a lot of Americans are struggling that they don’t have control over their life. And this is the interesting thing about stress, Mark. Is that sometimes we can’t as physicians change the stressors in our patients lives.

Dr. Mark Hyman: No, no, you can’t change what’s happening out there. You just [crosstalk 00:25:30].

Dr. Rangan Chatterjee: But we can make them more resilient to that. And regularly doing things that you love makes you more resilient to stress at the same time being chronically stressed makes it harder for us to experience pleasure and day to day thing. So one of my recommendations to my patients is have a daily dose of pleasure, even if it’s just for five minutes. Can you each day give pleasure the same priorities you might give to the amount of vegetables you have on your plates or whether you go to the gym. This could be going for a walk. It could be reading a book, listening to a podcast. It could even be coming home from work putting on YouTube, watching your favorite comedian for five minutes and laughing that is very important and very valuable.

Dr. Mark Hyman: It makes a huge difference. I was in California doing my public television show and I was at the hotel and it was right on the beach and I went out to the beach and I jumped in the water, swam a little bit and I came back and I literally just laid there in the sand doing absolutely nothing. And I can’t tell you how pleasurable that was to just be unplugged for a minute and stop. And most of us just keep, go, go, go all day long and distract distraction.

Dr. Rangan Chatterjee: Well that’s obviously the nature piece there as well, which is very impactful for stress. But let me tell you about a patient I saw recently. I think you’ll find this interesting. 54 year old chap. I think he was certainly mid-fifties. He was the CFO of a local plastics company and he was in a good job, earning good money married with two kids. He came into see me and he said, Dr. Chatterjee look I’m sort of struggling a bit. I find it hard to get out of bed sometimes in the morning. I find it hard to concentrate at work. I just feel a bit indifference of things. Is this what depression is? Now I started to chat to him. We did some tests. I was looking into all aspects of his lifestyle but ultimately one thing was quite clear to me is that he never did anything that he loved.

Dr. Rangan Chatterjee: So I asked him, “How’s your job?” He said, “Yeah, its fine. You know I don’t really enjoy it, but it pays the mortgage, pays the bills, feeds the family.” I said, okay. “How’s your relationship with your wife?” “Yeah, so I don’t really see her much, but its fine I guess.” it was very, very indifference. I said the same about his kids and I said, “Have you got any hobbies?” He said “Dr. Chatterjee I don’t have time I’m always busy. At the weekends. I’ve got to do all the chores and want to take the kids to their classes and their sports games. I don’t have any time.” I said, “Did you ever have any hobbies?” And he said, “Yeah, sure. When I was a teenager, I used to love playing with train sets.” I said, “Okay, fine. Do you, do you have a train set at home?” He said, “Well, yeah, I’ve got one in my attic, but I haven’t played with it for years.” And I said, “What I would you to do when you get home this evening is get your train set out.” Now a lot more. I appreciate it. This may not be the advice-

Dr. Mark Hyman: Did you put that down on your prescription pad?

Dr. Rangan Chatterjee: Yeah, well kind of. I’m all for lifestyle prescriptions. Right, and he-

Dr. Mark Hyman: Play with train set three times a week for 15 minutes.

Dr. Rangan Chatterjee: I’ll tell you what happened, what was fascinating is the-

Dr. Mark Hyman: Refills unlimited.

Dr. Rangan Chatterjee: Exactly, but it may not be the advice that he was expecting from his daughter, but he said, “Yeah, okay, sure I’ll do that.” Then this was in a conventional medical practice. These were 10 minutes consultations in the National Health Service in the U K. We don’t get the chance to follow up all our patients. We see maybe 40 to 50 patients a day. We simply can’t follow them all up. I didn’t know what was going on with him. Three months later I finished my morning surgery and I was in the car park about to go and do my home visits and I bumped into his wife and I said, “Hey, how’s your husband getting on?” She said, Dr. Chatterjee I cannot believe the difference I feel like I’ve got the guy I married back again. My husband comes home from work, he’s pushing around on his train set. He’s always on eBay looking for collector’s items and he’s now subscribed to this magazine.”

Dr. Rangan Chatterjee: I thought, okay, that’s incredible. I still hadn’t seen him three months after that, he comes in for a well man check to my office and he comes in with this with his blood tests and I’m about to go through them with him and I said, “Hey, how you doing?” “Dr. Chatterjee I feel incredible. I’ve got energy. My mood is good and I feel motivated.” I said, “How’s your marriage?” “Marriage is great. I’m getting on really, really well with my wife.” “How is your job?” “Love it. Really, really enjoy the job.”

Dr. Rangan Chatterjee: So why is that so powerful Mark is this, did he have a mental health problem?

Dr. Mark Hyman: Or train set deficiency?

Dr. Rangan Chatterjee: Yeah or did you have deficiency of passion in his life? And when he corrected that passion deficiency everything else starts to come back online. So I want to expand the conversation about stress to go, yes, sure. Breathing nature, meditation, exercise, these things are fantastic. And of course I talk about them and I go into the science and the practical implications of people. But what about something about passion, doing things that you love? It’s just as important.

Dr. Mark Hyman: It’s true I often talk about what are the ingredients for health and one of them is meaning and purpose. And I was just shocked a number of months ago to see an article in the journal of the American medical association that people who lacked meaning and purpose had a higher risk of death and disease. I mean, it’s just striking it turns out in the research that it’s not just smoking or bad diet or lack of exercise, but lack of meaning and purpose that increases your risk of death. I mean, that’s a very striking finding.

Dr. Rangan Chatterjee: Yeah, it’s amazing. And obviously the way we look at health, we’re looking at all of these multiple inputs that play a role in someone’s health. And of course I am just as passionate about food, physical activity, sleep all these things that are critical. But we also got to think about those social pieces. Our community, the relationships we’ve got, why do we get up each morning? Do we feel that we’ve got control over our life or do we sit in traffic for two, three hours a day in a job that we can’t stand for a boss who doesn’t value us? The reality is if that is the case we’ve got to have to think about with our patients, how we tackle that. Of course not all our patients can leave that job, right?

Dr. Rangan Chatterjee: So I’m passionate and I’ve used these tips that I’ve… That the book is full of so many tips so people can literally choose the ones that are relevant for their life. But I have worked in deprived areas in the U K for many years. And these tips also work for people in deprived areas, on low incomes because the common criticism of wellness is that it’s just for the wealthy, for the middle classes. And I’m passionate to say-

Dr. Mark Hyman: No.

Dr. Rangan Chatterjee: …it is applicable to everyone. You give people these tools of nature, of passion, of a quick five minute workouts. Even if you’re living in a lifestyle that you don’t enjoy, that there are lots of stresses in your life, you can help process that stress. You really can and it can make a huge difference.

Dr. Mark Hyman: And one of the things that people don’t realize is they think stress is subjective, but it’s subjective, right? It’s the perception of how something impacts us. It’s our beliefs about something, right? So I think if that’s true, then how do we sort of create a different mindset so that when something happens it’s not stressful. I was talking to my wife this morning she’s putting on a show, a comedy show called the Conscious Show and she had some issue with the tickets and she was getting stressed about it because she thought they were on the waiting list, we’re actually giving tickets and she was kind of freaking out. And I’m like that is not really a big stressor.

Dr. Mark Hyman: I mean it’s your belief about it. It’s not a big deal. Like there are things to really be worried about. And I think for most of us we get caught in this vicious cycle of stress and worry about things that are not really worth worrying about. And I think it’s our beliefs about it that make it seem so, and I think there are real things to worry about. If you have income issues, if you have real trauma in your family or I mean there are real things that are going on that are stressful. Like my dad died last summer and I was very stressful for me. But I think there are ways of looking at changing our mindset. So can you talk about how that works?

Dr. Rangan Chatterjee: Well, I think there’s a couple of things to say there. I think when it comes to stresses I think we need to think about what we can control and what we can’t control. Many of us I have for years spent time and energy worrying about things I have no control over. And that’s something that I’ve changed a lot in my life. I’ve really had to work hard on that. And once you get into that mindset, it’s amazing how your stress levels just come down because so many of those things like traffic, I can’t do anything about traffic. I just don’t let it worry me anymore.

Dr. Mark Hyman: You don’t get road rage Dr. Chatterjee?

Dr. Rangan Chatterjee: If I’m honest, seven, eight years ago when I was a care for my dads, when I was working a busy job, when my kids were very young and wasn’t sleeping very much. You know what, if I was driving to work and someone would come in front of me or cut me up, I would probably get quite agitated if I’m honest. But now I just don’t, I’m like, they’re probably having a bad day if they’re sort of screaming at me from the window and I’m just a lot more chilled and relaxed.

Dr. Mark Hyman: I mean, you give your power over to other people if you let them effect you that way.

Dr. Rangan Chatterjee: Yeah, for sure. But it’s something we have to work on. And I think the reason why many of us struggle with this is because of time. Now, I’ll explain what I mean by that, I think one of the biggest stresses in the modern world today, in the 21st century is our lack of downtime. So the modern world has stolen downtime from us. It’s gradually being eroded out of our lives. I’ll give you an example. We’re here in Santa Monica, right? In California. I bet 10 years ago, if we were here and we went into a local cafe to buy coffee, I bet people will be standing in line. They’d be looking around. They might bump into a friend, they might be looking at all the sweet treats and they might be thinking, which one am I going to have? There’ll be daydreaming a little bit. Now if you guys in the café what’s everyone doing?

Dr. Mark Hyman: They’ll be on their phone, computer.

Dr. Rangan Chatterjee: Look to be clear, I’m not criticizing. I will do that as well a lot of the time. Okay. But my point is-

Dr. Mark Hyman: Is to be. This lack of time. It’s fascinating I just went to a give a talk at the CIA, the central intelligence agency and it’s a highly secure building in Langley and there’s no technology allowed so you can’t bring in a phone, computer nothing, not even a Fitbit. And what was striking to me is it everybody was present. I gave a lecture to 300 people and nobody was on their phone. I was in a room giving a talk to 30 or 40 doctors and health professionals. Nobody was on their phone and everybody was focused in paying attention. It was the most remarkable thing. It was like going back on a time machine.

Dr. Rangan Chatterjee: But only a time machine of 15 years.

Dr. Mark Hyman: Yeah.

Dr. Rangan Chatterjee: And that’s how quickly things [crosstalk 00:36:16].

Dr. Mark Hyman: 2009.

Dr. Rangan Chatterjee: And I don’t think we’ve realized how toxic that is. Because you may say, well why does that matter? What’s the problem on that we’re using this downtime to get ahead, we’re sending an email, we’re quickly updating our Instagram. Well, I’ll tell you the problem with that. There’s many problems with that, but we used to think that our brain went to sleep when we switched off. Right? When we stop focusing on a task in front of us, our brain went to sleep.

Dr. Rangan Chatterjee: Neuroscience shows us that’s not the case. When we stop focusing on a task in front of us, there’s a part of the brain called the default mode network or the DMN that goes into overdrive. Now what does that part of the brain do? But there’s many things, but two things I think listeners will find really interesting is that part of the brain helps us solve problems and helps us be more creative. So this is why so many of us get our best ideas when we’re out for a walk, out for a run or we’re in the shower. I don’t know if it’s just me or you do you get… I get my best ideas when I’m in the shower.

Dr. Mark Hyman: Totally. When I go for a run or a bike ride and I can just wonder of my head

Dr. Rangan Chatterjee: And this is because Mark, our brain is trying to solve problems for us. If we give it the downtime to do that. And I think showers are one of the few places still where our phones haven’t… I don’t know about you. I certainly don’t take my phone into the shower with me. I’m sure that will change very soon.

Dr. Mark Hyman: Yeah. Now the new phones, they go down to four meters underwater.

Dr. Rangan Chatterjee: Yeah. I mean this is why I’m with you trying to swimming actually cause I think swimming is again, one of those sports now where you can still do without technology. Even in the gym now people are posting selfies of them doing their workout, updating their feed. And the DMN is a really important part of our brain. And I go into a lot of companies now to talk some about employee wellbeing. One of my top tips for them is take a tech free lunch break.

Dr. Mark Hyman: Digital detox.

Dr. Rangan Chatterjee: Even if it’s just for 15 minutes, take a tech free lunch break. And last year actually I made, actually was earlier this year I made an ITV documentary on stress and we got to take three or four people. We got to measure their stress levels minute to minute throughout the day for three days. And one chap in particular, he was a manager if his local company he took his job seriously. He wanted to lead by example, but he was complaining of stress. He was thinking… He was complaining that he was drinking too much alcohol, his relationship with his wife was under strain and he was always tired. Now we measured his stress levels, his HRV heart rate variability and we could see that actually on his work day, his stress levels would climb throughout the morning. At lunchtime he would work through his lunch and they’d keep climbing and all afternoon as well. They would just constantly elevate it.

Dr. Rangan Chatterjee: He would go home late, he would drink alcohol to unwind. He wouldn’t be present with his wife. That would cause issues. He wouldn’t sleep well and the cycle would continue. All I changed within Mark was I said, Okay look, I want you to take a 15 minute break at lunchtime. I want you to leave your phone in your draw and go outside for a walk. He was very lucky he had a river nearby and we can maybe touch on why nature is so important. So all he did was for 15 minutes at lunchtime, he went for a walk in nature without his phone. Now when we re-measured his data objectively, his stress levels were right down, but subjectively, what did he say? He said “Dr. Chatterjee I feel like a different person. I’m more creative in the afternoon. I enjoy my job more. I’m leaving early now rather than late. It’s not just on time. I’m leaving early, I’m drinking less alcohol and my relationship with my wife is improved.”

Dr. Rangan Chatterjee: So this is what I call the ripple effects. One small thing.

Dr. Mark Hyman: It’s powerful.

Dr. Rangan Chatterjee: When we say that wellness is for the middle classes. Well, hold on a minute. Who doesn’t have the ability to have a 15 minute tech free lunch break. That is free.

Dr. Mark Hyman: That’s not asking a lot. It’s true.

Dr. Rangan Chatterjee: I’m not trying to underplay this, but I’m very-

Dr. Mark Hyman: It’s powerful. I mean, I think the whole digital detox movement is really growing and for my wife, for our anniversary, I got her a little box and I said, “Here honey, here’s your anniversary present.” And she’s like, “Oh, this is such a nice little box.” I said, “No, no, that’s not the present. The present is I put my phone in the box Friday night and I don’t take it out until Sunday night.” And she’s like, started crying like that was the best present I could give her to be present with her. The present of presence. And then I did it and I thought, Oh, this is for her. But my experience was so transformational. I was like laying on the carpet, playing with the cats, listening to jazz, just daydreaming, relaxing, not grabbing my phone every second. And it was the most wonderful experience for me. I love it. And it’s like a regular habit now we leave our phones at home to go for dinner. We don’t.

Dr. Rangan Chatterjee: On Sunday mornings, my wife and I will go out with our kids and we’ll both leave our phone at home. And I’ll do it for the whole day, but often it’s like four hours, four, five hours. And what’s incredible is that you come home and I feel like I’ve been on holiday. We don’t realize how much this constantly checking our phones is draining us. And I got caught out by this by my daughter. She is a few years ago. I was playing with her in our living room and I can’t remember what was going on. But I kept nipping out into the kitchen to keep checking my phone and she said to me, “Daddy, you’re not really here, are you?” And that really, really struck me. I mean, kids really can teach us how to be presence and live in the moment.

Dr. Rangan Chatterjee: And I thought, wow, she’s right. I’m not really here because yes, I’m in the room playing with her, but my mind is actually not quite there. It’s thinking about what’s going on my phone. And that really changed my behavior.

Dr. Mark Hyman: That will get you.

Dr. Rangan Chatterjee: That did get you that got me big time.

Dr. Mark Hyman: Right out of the mouth of babes. Right?

Dr. Rangan Chatterjee: Yeah. But I think it’s a very powerful lesson for all of us. And I think people need strategies because these things are designed to be addictive. So I will not charge my phone in my bedroom anymore. If I bring that phone into my bedroom. I can’t resist it. I simply cannot resist. It’s too addictive. So I charge it in my kitchen. And so I say to people, you need to try and create a better tech free time in your day. Sure, lunch break is a great time to do it, but if you can’t have some time, ideally a golden hour in the morning and a golden hour before going to beds, if a golden hour is too much, start with five minutes in the morning, five minutes before you go to bed.

Dr. Mark Hyman: Or if you can’t figure it out how to do it for five minutes, there’s definitely a bigger problem in your life.

Dr. Rangan Chatterjee: Yeah, there is. But also when people are commuting, right? That’s a time when often people who are on the train on a bus. What you want to do then is instead of trying to catch up on those emails, use that as a way of unwinding. Listen to some music. Do 10 minutes on your meditation app like [crosstalk 00:43:24]

Dr. Mark Hyman: Listen to your podcast.

Dr. Rangan Chatterjee: Listen to an inspiring podcast that feels good like my one or your one or anyone that they like, right? Use that time. Really value your mental space. What information are you feeding it? If you watch the news and you’re putting toxic information right into your brain the whole time, that is going to impact the way you feel or your stress levels. I say take the news app off your phone. Another tip I say to people and this probably one of the most impactful things-

Dr. Mark Hyman: Notifications.

Dr. Rangan Chatterjee: …notifications take them off your phone.

Dr. Mark Hyman: How did, I guess.

Dr. Rangan Chatterjee: Hey, it’s one of the most powerful things. But Mark, I would challenge anybody listening to this podcast for seven days to switch off their notifications, which simply means, if someone likes your Instagram post, you’re not going to get a notification. If you have a new email, you’re not going to get notification, et cetera, et cetera. Try it for seven days. If you don’t feel better, fine, go back to it.

Dr. Mark Hyman: And then people are on their phone so much they don’t realize. There’s a new screen app where you can look on your iPhone and see how many times you picking up your phone. And I was sitting next to this friend of mine, we were at a lecture and she was picking up her phone, doing Instagram, whatever. And I’m like “Give me your phone.” And I grabbed her phone and I’m like, showed her like she picked up her phone a thousand times in a day. And I’m like, “That is a lot of time picking up your phone.” So let’s talk about some of the strategies that you put in the book. You talked about the importance of a morning routine because yes we know the harm of stress and we can go into that more, but I think people get it.

Dr. Mark Hyman: What are the three M’s you talk about that you can practice every morning to start your day and actually kind of get ahead of the stress?

Dr. Rangan Chatterjee: Yeah, so I call these the three M’s of morning routine. The first M is mindfulness, the second M is movement and the third M is mindsets. So I say, look, I’m a huge fan of morning routines because they give you a period of calm in the morning. That’s just going to make you a bit more resilient to cope with those stresses that will come up in your day. It’s not if they’re going to come up, they will come up. But I think the three M’s provides a very valuable structure to help you think about what are you going to put into your morning routine. And it works if you have an hour in the morning, it works beautifully well if you only have five minutes. Like some of my patients, it can still work really well. So the first time mindfulness can be meditation, it can be breathing, it can be a practice of mindfulness.

Dr. Rangan Chatterjee: Whatever you want can go under that umbrella with mindfulness. I personally, currently I’m doing the calm meditation app. So first thing when I get up in the morning, I’m plugging into the calm meditation app. I put my phone on airplane mode so I can’t see any of the incoming noise that might be on there. And I do 10 or 15 minutes meditation. Some days Mark, I hit the zone and I feel really, really calm. Other days I just go through my to do list. But what I’ve learned to do is not beat myself up about it. On those days where I’m going through my to do lists, I’m accepting that, Hey, you know what? My mind’s a little bit busy today. That’s okay. Whereas even 18 months ago, I would get slightly frustrated, I can’t switch my mind off. I can’t clear my mind. So I think that’s a great practice for people to do.

Dr. Rangan Chatterjee: Then I move onto movements. Again, movement can be anything depending on what you like. I do a lot of hip stretches, maybe some yoga moves, maybe some workouts on a step, maybe some press-ups, whatever I feel like for five or 10 minutes that is all I do. And then I’ll move on to mindsets. So mindset can be anything to put you in a positive frame of mind. So it could be reading a book that you find very uplifting for a few minutes with a cup of tea in the morning. It could be doing affirmations and actually like many people listening, I’ve got young kids, right? So my daughter who’s currently six has a sixth sense when daddy is up. So I try and get up before them and get my morning routine done, but she can sense when I’m downstairs doing it. And often she’ll creep down in.

Dr. Rangan Chatterjee: Often it’s in my second M in my movement, which is fine because she just does the movement with me. But if she sat with me for the third M, which is mindset, I’ll do affirmations with her. So we’ll sit there together. I’ll hold her hand, she’ll hold my hands and we will say for about two minutes I’m happy, I’m calm, I’m stress-free, I’m happy, I’m calm, I’m stressed. And we’ll just repeat that for two minutes and the end of those two minutes, she’s got the most peaceful smile on her face. I feel totally relaxed and calm and that calm continues throughout the day. That’s the beauty of it. It’s not just in the moment. I’m more resilient to the stresses in my life. Now for people who are thinking, I don’t have time for that because I’ve got a lot of patients who are single moms who might be working two jobs. I manage to persuade them to give it a go even for five minutes.

Dr. Rangan Chatterjee: And one of my patients simply does this. She does her morning routine with those three M’s in just five minutes, she gets up and for one minute she’ll do deep breathing. She does a breath. I taught her, called the three four, five breath. When you breathe in for three, hold for four and breathe out for five. Okay? She does that for one minute. Then she does two minutes of some yoga moves that she learned on YouTube. Right? So this is super accessible. She didn’t have to go to a class, even though I recommend yoga classes. She learned some moves on YouTube, which he likes. And then for the final two minutes she’s got about three or four books that make her feel good and she’s literally for two minutes, she reads three or four pages from that book and she has reported back that actually that has really, really helped her.

Dr. Rangan Chatterjee: In fact, she thinks it’s helped her eczema get better, which is remarkable because there are many things that can cause eczema. Eczema, we know ultimately is a slight dysfunction of the immune system. Stress impacts the immune system. So for her doing that morning, we’d seen, she feels is helping her with her skin. For somebody else, it may not do that right? But I just want to really get across how powerful these small, intentional moments of calm are. So again, I hope people listening think, maybe I’ll try that three M morning routine for about seven days or so and see how you feel.

Dr. Mark Hyman: Yeah, I know. It’s so powerful. It’s just building the structure of that into your day. And I think when I do it, it makes a huge difference. Like yesterday again I was preparing for my show and I’m like, I got 300 emails and I’ve got this to do and that to do. And I’m like, no, no I’m just going to stop. I’m going to do a little meditation in the morning. I went to work out a little bit, I went to the beach and just sat on the beach. Went into the ocean for a little bit and my mind was clear, I felt calm. It was like and it set me up for an amazing day, which often don’t give myself that. I mean, I usually meditate in the morning for 20 minutes and well exercise when I can.

Dr. Rangan Chatterjee: Can I ask a question Mark?

Dr. Mark Hyman: Yeah.

Dr. Rangan Chatterjee: Do you ever feel how important meditation is for you in the morning. But do you like many of us sometimes feel I’m too busy today. I don’t have that 20 minutes. I just want to get ahead with my emails. And if you do that I think it’d be interesting for people to hear that is do you fall prey to the same pressures that we fall into.

Dr. Mark Hyman: I absolutely. And I’ve got the stuff I’ve got to prepare for. I don’t have time. I’ve got to finish this, I got to do that and yeah, but I’ll usually fit it in somewhere else. And I think, it’s probably a false notion. It’s probably not even true that if I did it I’d feel better. And when I do it, especially when I do it regularly, like twice a day, I don’t feel stressed about anything. Like I’m resilient, I’m calm, I’m more productive, I’m more focused. And it’s like, well, how do you have that much time every day to meditate? Well, it turns out I don’t have the time not to because of the impact it has on the quality of my life, the quality of my happiness, the quality of my experience, the quality of my relationships and my overall wellbeing and in my productivity. So I think I’ve learned that it’s something that’s essential and it’s not just an add on. It’s as important as eating well and exercising.

Dr. Rangan Chatterjee: Now, thank you for that. I mean, I find that when I don’t do my morning routine, when I think that I’m too busy, I feel it later. I get stressed at things, things take me longer than they would’ve done. I’m not perfect, but I’ve certainly trained myself to actually do it. And I find it the more you can do it at the same time, every day the easier it is to create that new habits. Again if people are listening to this, I’d say if the last few months I’ve been really delving into behavior science in terms of what is all the best science and behavior change say about how we create a new behavior. And research from G University suggests over 50% I think it was 56% of what we do in any given day is habits.

Dr. Rangan Chatterjee: It’s not a conscious thought, its habits. So the way to create new behavior is to stick it on to an existing habit that you are already doing without thinking. So for example, in the UK and then it was the same here. But a lot of people like to put the kettle on in the morning and make themselves a hot drink, whether it was a coffee or a cup of tea. So with many of my patients, I start simply that. I said, “Look, how about when the kettle’s on? What do you do?” “Oh, I normally flick emails or go on social media.” I said, “Okay, why not when the kettle’s boiling, why not for that one minute, do some deep breathing.” And it’s amazing how powerful that is because they don’t need to find time in their day because many people say they don’t have time. They’re already going to be born in that castle. So they’re using that time productively to get that one minute of deep breathing in.

Dr. Rangan Chatterjee: And again, breathing is one of the simplest and fastest ways to switch off your stress response. Breathing is information for your brain. It’s information for your body.

Dr. Mark Hyman: It’s true. You know, we were talking earlier about BJ Fogg, who’s a behavioral scientist, and he talks about behavior change. Having to be broken down in something that’s you have an intention to do, you have a desire to do, you have the ability to do and you have a trigger to do it. And so for example, I really wanted to do more pushups because I’m getting older, I don’t want to lose muscle. It’s important. And I’m like, Oh, I’m so busy, but I know it takes like 30 seconds or a minute for my shower to heat up in the morning. So I basically have the trigger, which is I turn the shower on and I dropped down in the bathroom floor and I do my 30, 50 pushups and then I’m good. And it’s so simple. And at that time, I don’t know what else I would be doing here. They’re just sitting there waiting but I’m looking at my phone. So simple behavior change habits that you can integrate in your life that make the biggest difference.

Dr. Rangan Chatterjee: So powerful and gratitude. For example, you’ve spoken about gratitude before I write about it in this book. If you want to make a gratitude practice, regular simple things you can do if you want to do it before you go to bed, to really put your mind in a positive frame of mind. Leave a journal that you like, that you’ve bought, that you really desire, you want to write in, leave it next to your bed on your bedside table with a pen just makes it a little bit easy. Every time you put an obstacle in the way of doing a new behavior, you make it less likely. Keep it there you’re going to go to bed and it’s just going to prompt you to go, Hey, I’m just going to write those three things down. There’s a lovely gratitude practice I actually do with my kids every day that I wonder if people might find useful.

Dr. Rangan Chatterjee: It’s something that the strength coach shoot, unfortunately the Olympic strength coach who tragically died last year, Charles Poliquin, well he told me about this a few years back that he did this with his daughter and it really resonated with me and it’s at our dinner times when I’m at home. It’s a big thing for us. We’ll all sit around the table to have dinner together and when all our devices and what we do is we play a little game and everyone has to go around the table and answer three questions. What have I done today to make somebody else happy? What has somebody else done today to make me happy and what have I learnt today? Now Mark, if I’m honest, I thought this going to be a great exercise for my kids. It’s going to be really going to help them teach them about the importance of putting them into a positive frame of mind. But I’ve got to tell you from my wife and I as well, it’s the most incredible practice.

Dr. Rangan Chatterjee: And because we do it over the dinner table, I have not had to find time in my day to fit it in. It’s not another thing I have to fit into an already busy day. Well, I’m going to sit down and have dinner anyway. And what it helps you do is it helps connect you with the people around you and it will be a peaceful way. I sort of finding out things from my children and my wife that I wouldn’t have otherwise found out. I can ask my kids how was school today?

Dr. Mark Hyman: And then fine.

Dr. Rangan Chatterjee: What did she get out to? Nothing. Okay. And you can’t really go down that road, but you play this game. Like my daughter, recently said, “Hey daddy, you know Annabel opened the door for me on the way out to the playground today at lunchtime. I thought that was really nice.” And I feel as though I’m helping to teach them from a young age how important it is to look for those little bits of positivity that happen every day. And the research is powerful. We know that gratitude is good for our physical health, our psychological health, our emotional health. And it’s such a simple process. It goes back to what we said at the start stresses endemic in our culture. We can’t always remove the stressors that are there, but we can put into practice with these simple, accessible things that all of us have got access to. I think it’s that important.

Dr. Mark Hyman: What’s so beautiful about your book, The Stress Solution, because it’s filled with really practical tips that are achievable. It’s not like, Oh, you have to go to a monastery and meditate for three months and then come out. Right. And one of the things you talk about, which I thought was really interesting and kind of novel and also a little bit challenging in the me too era, is the importance of touch and intimacy and the physicality that actually helps to reduce stress. I remember reading a study that in neonatal ICU if the babies were picked up and touched and massage, that they would heal better, that they would get out of the ICU faster, that they wouldn’t need as many medications and was really objective scientific data showing the power of touch to accelerate newborn babies healing.

Dr. Rangan Chatterjee: Yeah. I think this is the chapter I’m most proud of in this book actually, because I do think it’s new. I think it is challenging a lot of people’s perceptions and it’s giving priority to probably the most neglected of all our senses, which is human touch and-

Dr. Mark Hyman: [inaudible 00:57:40] big hug and it was awesome.

Dr. Rangan Chatterjee: It changes the whole dynamic. But there is such good science on this. So the reason I wrote this chapter actually is because I was filming a BBC one show last year called holding back the years. And as part of that, we went to Liverpool, John Moores University and I met someone called Professor Francis McGlone, who’s one of the world’s leading researchers in touch. Yeah. And he says that human touch is not a sentimental human indulgence. It’s a biological necessity. And he has spent his life the last 20 years researching touch fibers, the nerve fibers.

Dr. Rangan Chatterjee: And I think this is super, super interesting. So we think of touch as, someone touched me in my forearm touch is just there to tell me that somebody has touched me on my forearm. But it’s not true. So there are two types of touch nerve fiber. There’s the fast one and there’s a slow one and they do different things. So it’s very much like pain. So it’s probably easy to understand that we start with pain. So if you, for example in your kitchen there’s a hot pan on the stove and if you touch it and it’s really hot, instantaneously your hand will come off it. That’s the fast nerve fiber that’s told you there’s something hot on your hands and you move away. There’s no emotional quality to that pain that is simply telling you what’s happened. A few seconds later, the emotional part of that pain comes. You start to feel really offended. You feel upset that that’s just happened to you.

Dr. Rangan Chatterjee: Kids are a great example of this. Like when my daughter was four and if she would fall over, I remember once in the garden, she fell.

Dr. Mark Hyman: It would take a minute for her to figure it out that there was.

Dr. Rangan Chatterjee: Initially right. She rubbed her knee because she knew her knee had been touched and she’d be a bit bemused. Three or four seconds later she started to cry. So it’s a delayed response because the slow nerve fiber communicates something different. It communicates the emotional quality of that pain rather than just the geographical location. It’s the same or touch. Same thing with touch. He’s got this, these experiments set up where he’s found that actually there’s a type of nerve fiber on your skin called the CT [Afri 00:59:55] nerve fiber. The name doesn’t matter so much.

Dr. Rangan Chatterjee: What’s important about this nerve fiber as it is optimally stimulated when you stroke it three to five centimeters a second. Now when you stroke your wife or your kids Mark, you don’t calculate. I’m going to stroke that now with three to five centimeters per second, no. But when you watch mothers stroke their children, they automatically lock into that speed. Why? Because that CT Afri nerve fiber doesn’t tell you where you’ve been touched. Those nerve fibers go up to the limbic system in your brain and there’s an emotional quality. We know that when you stimulate these nerve fibers, it lowers your heart rates and increases oxytocin. It lowers your blood pressure, it increases the amount of natural killer cells in your body. Natural killer cells are part of your body’s innate immune system. They help us to fight off things like viruses and infections.

Dr. Rangan Chatterjee: All of these things get influenced by human touch and we have neglected this and you mentioned the me too era. We have become a touch averse society and I totally understand the rationale for that. I totally understand that there has been a lot of inappropriate touch in society, but I think that has come at the expense of safe appropriate touch. Mark as a doctor I can tell you 10 years ago if I was giving one of my patient’s bad news I probably would’ve come in close. I would’ve put my hand on their shoulder and really sort of delivered that information in a hopefully a caring and compassionate way. Now I feel scared to do that. it feels in this era we now live in, I think we have got-

Dr. Mark Hyman: I still hug all my patients.

Dr. Rangan Chatterjee: Hey, but that’s awesome Mark. But what I’m saying is that many of us feel that we can’t touch anymore and I’m talking about safe, appropriate touch. But Hey Mark look to put it into perspective, basketball teams in the NBA had been shown in a study that if the teams who touch more at the start of the season or the teams who end up higher at the end of the season, which is incredible.

Dr. Mark Hyman: Touch each other, you mean?

Dr. Rangan Chatterjee: They touch each other more, yeah. So there’s more human touch there. If a waiter comes to give you the bill in a restaurant and they tap you on the shoulder, you tip more than if they don’t tap you on the shoulder. So if there’s any waiters or waitresses listening that’s a tip on how to get more tips. But what does this tell us? It tells us there’s something primal about human touch and we’re not… We need to touch more essentially. And I will say that some people find it quite hard to be touched and often that comes down to experiences as a child, whether they were touched enough or not.

Dr. Mark Hyman: Or touched inappropriately.

Dr. Rangan Chatterjee: Exactly. And I do recognize that and I think we’ve got to be very sensitive about that. But a lot of the time with my patients, I ask them to keep a touch diary, find out how many times in a day or in a week they’ve had safe, appropriate touch. And I say within two weeks try and double that. Right? When you see a friend, I say to guys instead of just-

Dr. Mark Hyman: Or giving eight hugs a day to be healthy, I heard.

Dr. Rangan Chatterjee: Yeah. But there ways. I have literally summarized all the top science in this and my chapter one touch to really get people-

Dr. Mark Hyman: So this isn’t actually a feeling it’s actually science.

Dr. Rangan Chatterjee: That’s the beauty of this stuff. There is real science behind it. And again, look, I think it’s about giving people tools that are relevant for them. Some people may be listening to that and go, I’m okay on that area that’s not something I need to worry about. I’m like, okay, fine, focus on another area. But maybe someone listening to this will resonate with that and go “You know what? I think that’s me. I think I could probably start to increase the amount of safe, appropriate touch I have in my life and give it a go.” And again, I’ve heard so many stories of patients who’ve done this.

Dr. Mark Hyman: I ask hey can I give you a hug or you just ask permission and I think it’s not so bad people I’m really craved more connection, affection and touch and intimacy it’s part of our nature.

Dr. Rangan Chatterjee: I guess the extension from that is you asked me about touch and intimacy I also wrote a chapter on intimacy because this was in the whole. The book is split up into four parts and there was one quarter is on relationships. And I think relationships are very important because one of the best ways to distress is to have close, nourishing relationships in our life. But at the same time, too much stress makes it very hard to have those close, nourishing relationships. It works both ways, like all of these sayings. And I feel that it really sort of plays into this idea of technology and how much it’s now impacting us and bleeding into all aspects of our life. I sort of make the case in my book, it’s slightly controversial, but I say that many of us are now having IFS with our phones in the sense that we now know the curvy console’s off our iPhone more than those of our partners.

Dr. Rangan Chatterjee: I said it slightly to be provocative, but really to make people start to take a look at themselves. And the cliche now is that a couple goes to bed at night, right? They’re in bed together and they’re physically together in the same bed, but they’re actually in their mind a million miles away because they’re both on their devices, in their customized worlds of emails or the right feed on Netflix. Frankly, a human being is going to find it very hard to compete with that. This is a highly curated, personalized feed to basically have you. And so I say, look, we really need to prioritize those relationships, get more intimacy. And I was inspired by my mother in law actually about something called the three D intimacy greeting. I used to work very near to my wife’s parents and sometimes I would drop in for some foods. Which is great because I got this peaceful home cooked meal at least once a week.

Dr. Rangan Chatterjee: It was incredible but what I noticed when I was there is when my father in law came back. If I was there eating and he came to the door, my mother in law would go and give him this huge hug, say some really kind words. And when you look him in the eye its incredible after 30, 40 years of marriage, they’re still doing that and that really informed what I call the three D intimacy… The three greeting, which is greet your partner or your friends in three dimensions with touch, with voice and with eyes. It sounds a bit forced, right? It sounds a bit cheesy, but I guarantee if you try this for a few days for just 10 or 15 seconds, it will transform the fabric and the dynamic of your relationship.

Dr. Rangan Chatterjee: It’s something my wife and I try to do every morning because otherwise you get together, you’re in the kitchen trying to get the kids ready for school. You’re checking your emails. Yes, you’re physically together but you haven’t really connected and it’s just about giving them a hug, looking them in the eye and saying something really kind or something nice to them. And actually since the book’s been out, it’s amazing how many times on Twitter on Instagram people have said to me, “Hey, Dr. Chatterjee I’ve tried that through the intimacy greeting with my husband. He doesn’t actually know I’m doing it. And he’s just like a different person. He’s kinder, he’s warmer. We’re much closer.”

Dr. Mark Hyman: And it’s so easy. It’s so simple. And I think it’s one of those things in the book that I think is so simple to do. It’s so important and it not only is good for the other person to receive that, but it’s good for you to give that because it actually connects you as well. And I think most of us don’t take the time to really stop. And I think my relationship it’s so important for me because it’s easy to be distracted. You’re in the middle of something. But when my partner walks in a room, I stop what I’m doing, I get up, I give her a hug, I look at her, I greet her and I say something nice. And I think it’s the most powerful thing.

Dr. Rangan Chatterjee: Mark, that sounds so simple. And in many ways people might be thinking, why does a doctor have to tell us this stuff? But the reality is this is where society is today relationship problems are driving a lot of health problems as well. And we’re not present in our relationships, we’re distracted. It’s not uncommon for one person to come home now the other person is still stuck in that computer and you barely say a word. I have done that in the past. Right. I am not saying that I’m whiter than white on this. I also do these things, but I’ve recognized the problems that causes. But you mentioned another important thing which I think is really important to focus on. And that is, I mentioned the research of when you are strokes, when you are touched, what that does for you. Well, actually the research also shows that the giver of touch also receives benefits, right? And that could be for your pets as well. If you give your pets a cuddle, you stroke your pets, you also get a benefit. So it works both ways.

Dr. Mark Hyman: Of cause, it’s a virtuous cycle

Dr. Rangan Chatterjee: It really is and so… I really wanted to put this relationship section in the book because as important as meditation, as breathing, as working out as all these things are I get that we’ve heard those things before. It’s important to emphasize them, but I think this whole piece around relationships really needs emphasizing particularly today.

Dr. Mark Hyman: Yeah being connected, being present, intimacy, touch. There are things that we forget about because we’re so distracted. And the book I think is such a big contribution to us understanding the relationship of all these things to the quality of our life and our happiness and the happiness of our relationships, our productivity at work. I mean it is essential issue of our time and nobody really talks about it that much. We’ve had many shows on meditation and stress, but I think it’s such an important book and it’s such an important topic and I just want to thank you for bringing that in the world for teaching us the simple things and this the little bite sized pieces that are really doable. The one minute breathing exercise, the three D greeting. I mean these are simple things that are brilliant and easy and if we do them, the power to transform ourselves, our lives, the quality of our experience, our level of stress is just fantastic. So thank you Dr Chatterjee for being on the doctor’s Farmacy.

Dr. Rangan Chatterjee: Mark, thank you for having me. It’s great to catch up.

Dr. Mark Hyman: And if you’ve loved this podcast, please share with your friends and family on social media. Leave a comment. We’d love to hear from you and subscribe wherever you get your podcasts and we’ll see you next time on the Doctor’s Farmacy.

Dr. Mark Hyman: Hi everyone. It’s Dr. Mark Hyman. So two quick things. Number one, thanks so much for listening to this week’s podcast. It really means a lot to me. If you love the podcast, I would really appreciate you sharing with your friends and family. Second, I want to tell you about a brand new newsletter I started called Mark’s picks. Every week I’m going to send out a list of a few things that I’ve been using. Take my own health to the next level. This could be books, podcasts, research that I found, supplement recommendations, recipes or even gadgets. And I use a few of those. And if you’d like to get access to this free weekly list, all you have to do is visit doctorhyman.com/picks That’s doctorhyman.com/picks. I’ll only email you once a week, I promise and I’ll never send you anything else besides my own recommendations. So just go to doctorhyman.com/picks. That’s P-I-C-K-S to sign up free today.

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