395. The Age of Anxiety & the Many Paths to Peace w/ Dr. Ellen Vora

Dr. Ellen Vora

DISCLAIMER: This podcast is presented for educational and exploratory purposes only. Published content is not intended to be used for diagnosing or treating any illness. Those responsible for this show disclaim responsibility for any possible adverse effects from the use of information presented by Luke or his guests. Please consult with your healthcare provider before using any products referenced. This podcast may contain paid endorsements for products or services.

Dr. Ellen Vora unpacks the physiologic roots of anxiety and offers simple strategies to address and develop our understanding of the emotional body and human condition.

Dr. Vora takes a functional medicine approach to mental health, considering the whole person and addressing the problem at the root, rather than reflexively prescribing medication to suppress symptoms.

She takes the whole person into consideration, focusing on everything from physical health, sleep, nutrition, digestion, thought patterns, relationships, and community, to our connection with nature, creativity, and purpose.

DISCLAIMER: This podcast is presented for educational and exploratory purposes only. Published content is not intended to be used for diagnosing or treating any illness. Those responsible for this show disclaim responsibility for any possible adverse effects from the use of information presented by Luke or his guests. Please consult with your healthcare provider before using any products referenced. This podcast may contain paid endorsements for products or services.

Dr. Ellen Vora made anxiety an art form with her mind-blowing book, “The Anatomy of Anxiety,” which offers a groundbreaking approach to understanding how anxiety manifests in the body and mind. As you'll learn in this episode, anxiety is not a mind-over-matter concept we can wriggle free from. Rather, to truly understand its nuances, one must address it as a whole-body condition. 

Together, we delve into the murky and mysterious emotion that has spread in silence as its own pandemic across the globe. We talk about how we make amends with the anxious threads that literally keep us up at night, the state of our emotion-phobic society that stifles somatic release, and the various modalities – from diet to biohacks – that can gift us with the mental timeout we all need.

07:30 — The “Why”  Behind Anxiety 

  • How Dr. Ellen fell out of sync with Western medicine 
  • Approaching anxiety beyond medication 
  • The middle ground between psych meds and holistic medicine 

23:22 — True & False Anxiety 

  • The real reason you’re anxious
  • The meaning-making mind and the human drive to create narratives  
  • Surviving in an emotion-phobic culture 
  • Crying: why we should be doing more of it
  • How trauma is held in the body 

45:46 — The Brain, Stress + Anxiety

  • A nuanced look at Serotonin and GABA
  • GABA and the gut 
  • How alcohol affects GABA levels 
  • Getting to the root of trauma with somatic therapy 
  • Finding a place for the therapeutic uses of psychedelics 

1:11:13 — Why Anxiety Has a Place In The World 

  • The Dian Fossey chimpanzee study
  • Anxiety as a superpower
  • How diet can play into your anxious state 

1:22:36 — Tech-xiety, Sleep + EMF

  • Why the attention economy does not serve our peace
  • Compare and despair syndrome
  • Reframing our relationship with technology 
  • The move to “find your seat”
  • Navigating parenthood and tech 
  • Sleep and impact on mental health

More about this episode.

Watch on YouTube.

[00:00:00] Luke Storey: I'm Luke Storey. For the past 22 years, I've been relentlessly committed to my deepest passion, designing the ultimate lifestyle based on the most powerful principles of spirituality, health, psychology. The Life Stylist podcast is a show dedicated to sharing my discoveries and the experts behind them with you. Thanks for coming by, Ellen.

[00:00:27] Ellen Vora: Thanks so much for having me.

[00:00:28] Luke Storey: Yeah. So, for those of you listening to the podcast here, we just had, as is typical, a really incredible off-the-record conversation. So, it's nice to get to know you a bit before we go on record here, and thank you for coming out and visiting us in person, too.

[00:00:46] Ellen Vora: Yeah, it's really cool to be in Austin.

[00:00:48] Luke Storey: You're enjoying it?

[00:00:48] Ellen Vora: There's a special vortex of energy happening here.

[00:00:52] Luke Storey: Yeah, I agree, because you live in New York City, right?

[00:00:54] Ellen Vora: That's right.

[00:00:54] Luke Storey: West Village?

[00:00:54] Ellen Vora: West Village.

[00:00:55] Luke Storey: If you're going to live in New York City, that's a great neighborhood to live in.

[00:00:59] Ellen Vora: That's how we planned it, yeah.

[00:01:01] Luke Storey: Yeah. I want to start with knowing like, what is the most exciting, awesome thing in your life right now?

[00:01:07] Ellen Vora: Oh, in a certain sense, it has to do with this trip to Austin. And I'm certainly in that moment in life right now where we have a good setup in New York. We like our life and we have community. It feels good. We're in a groove and we could keep going with this forever. But it feels, right now, like we're being ever so gently nudged to build something different.

[00:01:33] And that's part of why we're here in Austin right now, is to feel this out and see, is this what we're being called to do, is to build a slightly different version of how we live? With more connection to the land, with a really intentional community, just really like designing our life intentionally, thoughtfully of here's exactly what we value, here's what we prioritize, and building life around that. And so, we're feeling that out right now as we speak.

[00:02:05] Luke Storey: Well, like everyone that comes here to prospect, I always hope it works out. For most people, it does. I've only been here a little over a year, but I don't know if I can even think of anyone that came to check this out that didn't just go, "Yeah, this is it", and move here, which is really cool. And when you go out to Adrian's property, that's going to be a really—well, it was for me at least, like a really eye-opening experience of taking that building the lifestyle, speaking of building a lifestyle in Life Stylist podcast, what?

[00:02:35] But I mean, he went full on, Hollywood celebrity, Adrian Grenier. We're talking about Hollywood celebrity guy, moves to Texas, gets a huge swath of land, and is like learning how to be a farmer, you know what I mean, which is kind of what I wanted to do, but we found the house we found, and it's in a neighborhood, and it's kind of a middle step between living in a city and going kind of more off grid, but he's got a really cool thing going on out there.

[00:03:04] Ellen Vora: Yeah. I mean, that's what I think about obsessively now, like when I'm lying in bed at night, is plot of land, water rights. Like I want to start growing food. I want to feel self-sufficient or a little bit closer to that. But I think coming from New York City, we'll probably take an intermediate step first.

[00:03:19] Luke Storey: Yeah. I'm kind of glad it worked out that way for me, too, because I go out there and I'm like, oh, my God, he has to learn how to do all this stuff now, right? It's like, oh, it's a big undertaking. I think people from cities think, "Yeah, I want to be off grid and like live in the country or the mountains", and it's like, yeah, but you realize like you're septic tank backs up, and then you have no toilet or whatever. There are things like that you don't really think about until you're there.

[00:03:45] Ellen Vora: There's a reason there's been progress away from a subsistence farming life for many decades. So, now, we're at a point where it seems like this fun fairy tale of like, hey, let's get back to the land, but I don't say that cavalierly. I sort of recognize there's gravity to that. That's hard work, and things go wrong, and you don't have Uber Eats to be able to-

[00:04:07] Luke Storey: Honestly, even out here, we're in what they generally call Hill Country, which is a pretty large swath of land in this area, and one thing I noticed right away is it's very difficult to eat organic food out here. I mean, I'm so spoiled. We call, in LA, you have Erewhon deliver all your groceries, and there's a bunch of farm-to-table restaurants and organic restaurants, and out here, it's like my buddy, Khalil, is opening a sun life organic down the street next, I think actually this Friday or next Friday, and it's like a really high-end smoothie spot.

[00:04:45] I'm like, Thank God, but I'm pretty much going to be eating there every day, because there's just not that kind of opportunity here. In downtown Austin, there's a lot of great food, but out here, yeah, you learn how fortunate you've been when you switch things up like that. That is exciting. What's even more exciting is your book. Those watching on YouTube can see it right here, The Anatomy of Anxiety.

[00:05:08] Before we get into that, and there's so much that you cover in the book that I just am aligned with and inspired by that I want to just like really get into the weeds of that, but tell the audience kind of who you are, and what your background is, and your practice, and education, and all those things that brought you to be the woman writing this book.

[00:05:27] Ellen Vora: Sure. Yeah. So, I grew up in the New York area and was kind of always drawn to the brain. That was what was most interesting to me. I went to my undergraduate at Yale University, and I was an English major, and I really got comfortable with the gray areas and the complexities of the human condition. And that's what was most interesting to me. But I was still pre-med in the background and ended up going to medical school at Columbia, and while I was there, I was really tormented by the decision of what specialty to do, and I was considering a number of different ones.

[00:06:00] Somebody could have saved me a lot of trouble just telling me, "If you were an English major as an undergraduate, you're probably going to end up in psychiatry", and then just have that path laid out for me in that way, instead of considered emergency medicine, and dermatology, and all of this. But the fact is, if you want to grapple with what it means to have this human experience, and how to thrive, and feel fulfilled, and come up against our wounds, and what gives us our nooks and crannies, and our personalities, psychiatry is a pretty good landing spot, and not so much nephrology.

[00:06:34] So, I ended up going into psychiatry, and I'll just say that during my whole medical training, there were two parallel processes happening. One was a crisis of, what the hell have I got myself into? I feel out of alignment with what I'm being taught. And it was really encapsulated in one particular moment, when I was in the OR, I was on my surgery rotation, and I was standing around, we were doing an appendectomy, and I was like, this guy has probably given appendicitis a lot of thought.

[00:07:06] He stands over appendectomies for hours every day, for years of his life, so I was like, what do you think causes appendicitis? And his response to me was, "We don't ask why, we just cut". And to me, that really illustrated how I felt really out of sync with conventional Western medicine, where the value wasn't placed so much on, why is this happening? What can we be doing differently upstream to prevent this from happening in the first place?

[00:07:35] But more just accepting this happens and let's have a really good high-tech approach to reacting to it after it's happened. And I'm not going to discount that we are really good at reacting to this shit that happens, thank goodness for Western medicine, for reacting when there's a car accident or when there's a heart attack. But for me, I just know I'm drawn to that question about why. Like I'm a Jewish New Yorker, all I ever want to do is like understand the how and the why of something and ask a million questions.

[00:08:05] So, I was always thinking, why is someone getting appendicitis? Why are people getting depressed? Why is everybody suddenly inflamed? What is the common denominator of all these different illnesses that seem to be improved by something like aspirin, which is anti-inflammatory? Why is all of that happening? And so, I was really out of sync with Western medicine. I thought about quitting all the time. And at the same time, my own health was really suffering, and I was kind of going down this path of being more and more out of balance. 

[00:08:37] And I was a med student, and I thought I was doing everything right. Like I thought I knew what to do to keep myself well. And the more I applied those learnings and those skills, the sicker I got. And when I would go to see conventional docs, they would say, "Oh, take Prozac, go back on birth control pill, take this experimental medication for IBS", and their solutions. I didn't have the language yet to know that it was a Band-Aid instead of a root cause resolution, but something didn't feel quite right. I thought addressing PCOS by going back on birth control pill, I understand how that's going to give me a period back, but if I ever need to go off the birth control pill or if I want to have kids, we haven't solved the problem.

[00:09:23] The problem is still there. We've just covered it up temporarily and potentially even made it worse. So, eventually, I went on a very inefficient process of learning how to get my own body back into balance, and to practice in a way that felt in alignment for me, and they really worked together. And the learnings I experienced through my own inefficient process of learning how to keep myself well have been applicable when I'm working with patients and thinking, okay, what's out of balance here, and how can we get this person back into balance and thriving?

[00:09:56] Luke Storey: I relate 100%. It brings me back to when I first got sober, when I was 26, which was very necessary, I had all this anxiety and depression. I mean, I was just crazy. I mean, psychiatrists don't like to use that word in the room, but I was freaking crazy. I mean, just totally unmanageable and out of control. And so, eventually, it got so bad after maybe two years that I went to a psychiatrist, really fancy one in Century City, and thinking back, knowing what I know now about my life journey and experience, it was just 100% unaddressed trauma and PTSD.

[00:10:39] But I go in and he kind of reads a list of symptoms, "Do you have racing thoughts? Do you hang on to the past? Are you constantly thinking about the future?", and et cetera? And I'm like, yes, yes, check, check, check. And he's like, "Okay. We're going to put you on this great new drug called Effexor." I was like, oh, thank God, I don't have to change anything, just take these pills, great, and they made me worse. 

[00:11:00] It was like I was on meth or something. I was super OCD, and I would be refinishing furniture for hours, and really, like, yeah, just super obsessive. But I wasn't depressed. So, that was better. But then, I became really dependent on the medication, and then it reminded me of being an addict again, because if I was running out, I would start to freak out. And then, he was like leaving medication in front of the medical building, and the bushes, or behind the mailbox, or something.

[00:11:32] I'd go over there in the middle of the night and get it, I was just like, no, this can't be it. But no fault of his. It was just the system to which he was married, and thinking back, I'm like, God, the question could have been like, hey, were you abused when you were a kid, or whatever. Let's start there. But anyway, I digress. But that's been a very parallel journey for me, too. It's like, oh, these symptoms, whether they're physical, or emotional, or even spiritual are presenting why? That's my question, too.

[00:12:05] Ellen Vora: Yeah, and I think like that's exactly it, that language you chose. I think so much of mental health, it's physical. Like physical health is mental health. That's something we haven't been appreciating, is that our brain is a fleshy organ in our body like anything else. And if our physical health gets out of balance, it impacts our brain and that shows up as mental health issues. And then, what's not physical often has a kind of psychospiritual component, and within that can be trauma, can be feeling out of alignment, can be just a little communication from within saying, slow down, pay attention, listen, like something here needs your attention.

[00:12:44] And I think I certainly don't fault the psychiatrist. This is how we're trained, and not to mention the fact that the way medicine has developed right now, what we've squeezed out of the interaction between a physician and a patient is time. That's the commodity that's been removed from that relationship, but that's exactly what you need if you want to explore trauma rather than just say, okay, we have eight minutes, please don't cry in my office, that's going to be a whole mess, and here's a script, and off you go, you're a happy camper, I'm a happy camper, and it's really just physicians surviving in such a broken system.

[00:13:18] But meds are complicated, and I have really deeply nuanced thoughts about psych meds, and I think it's important to be really upfront about it, because when I'm here touting around a holistic approach to anxiety, that can feel like for some people, for anybody watching who's on psych meds, which is many people these days, it's a huge percentage of our population, it can feel invalidating. It can come across as almost a dogmatic anti-psych med approach, and that's actually not who I am or how I approach this.

[00:13:49] I'm a physician. I prescribe medication. I started somebody on a psychiatric medication only three days ago. I don't do it often. I do it very seldom. But for me, the avoidance of meds doesn't really have to do with any moral judgment around psych meds or anything like that. For me, it's like whatever is going to help somebody get to a point where they're leading a fulfilling life, I'm on board. 

[00:14:14] And if meds are that path, that's okay by me, but I'm always still going to be thinking about, first, do no harm. And I know enough about side effects, rare adverse effects, but perhaps to me, most damning is the experience of trying to get off of psych meds, and I'm always thinking in that long-term eventuality way that I don't want to set somebody down that path. And then, I have almost a compulsive need to take an elegant approach to what's out of balance, and I don't think that depression and anxiety is a Lexapro-deficiency disorder.

[00:14:46] I don't think that that's how we're built and wired. I think that it can be anything from a state of inflammation to a B12 deficiency, to you're living out of alignment with your purpose, and anything in between, certainly, in trauma, and I want to understand, what's the true root? What's the real imbalance? Can we address that? And then, it often obviates the need for meds. 

[00:15:11] And to just sort of put the piece of tape over the check engine light, not only kicks the can down the road, and doesn't do anything to help, and maybe exacerbates the original problem, but it's completely barking up the wrong tree. It's overlooking the fact that there is, that these symptoms, anxiety, depression, which I think of as symptoms more than diagnoses, they're here to communicate and to help us understand, what does need addressing?

[00:15:36] Luke Storey: I like it. And looking back again, and not faulting that doctor, in my brief experience down that road, it's also impossible for me to know that things wouldn't have or couldn't have gotten worse, and that, perhaps, even though that was putting a piece of tape over the check engine light, maybe that's actually what I needed for that period of time, right? And knowing that sort of that method of coping came with so many side effects in my case, that it led me to actually doing deeper work and finding the root cause on my own, because I was stoked when I thought I could just Band-Aid it and was really disillusioned when I found that I couldn't.

[00:16:21] So, what am I left with? The mirror, right? It's like, okay, we've got to do some deep work. And then, here I am going to India to learn meditation or whatever that I might not have done had I not had that experience. And maybe those suicidal thoughts that I was having could have come to fruition, too. Maybe I needed that little runway for a minute there as a troubled 20-something to just kind of like get a reprieve, and then get down to the real work. So, I like your moderate approach, and also, obviously, sort of the—how do I say it? 

[00:16:58] There are so many different types and degrees of what we would call mental illness, too, right? So, to just have a blanket like all medication is satanic and you're leaving out bipolar or schizophrenia, I mean, like disorders that have much more impact in someone's life, and are much more complex and nuanced than just a kid that had a lot of trauma, became an addict, and now, doesn't have those drugs to anesthetize himself anymore, and it feels crazy as a result. It's a different animal than banging one's head on a street lamp and screaming at people that aren't there.

[00:17:36] Ellen Vora: Yeah, that's exactly right. And I think in a way, part of the problem when we think about mental illness, how we've been somewhat indoctrinated to think about it as this is a genetic chemical imbalance, and it's an identity, it's a destiny. And I think that there's, of course, a genetic predisposition, but it's a vulnerability. And like everything in functional medicine, genetics loads the gun, environment pulls the trigger.

[00:17:59] So, it's always in a dance with our environment. The genetics part, we can't completely change. We certainly have some impact on our epigenetics. We have impact on how our genes are expressed. But I think the environmental piece is where we can focus. And I think, sometimes, when somebody is really deep down a path of, they're severely schizophrenic, to me, it does not feel like non-harming. 

[00:18:28] Like to think of that as like, well, let's address this from the angle of lifestyle and let's try gluten-free, like I think there's a role for all of that, but it would be doing somebody a disservice to lead them so unable to have an intact life. And so, there, I think medication is indicated, but I think it's more on this other end of the spectrum, where somebody is saying, "I think I might be depressed, I think I might be anxious. I'm starting to", like they're in that pre-contemplation, contemplation phase of, "Maybe I'm going to get help, maybe I'm going to go see somebody".

[00:19:01] And I applaud that journey, but I think that our mental health field, as it exists, we don't catch people properly once they've taken those steps and they're like, "I'm going to get help, I'm going to go see somebody". Really, what happens is, on the one hand, it's completely unaffordable, it's inaccessible. Psychiatrists have long waitlists. There are all these issues with barriers to getting care in the first place.

[00:19:29] And then, if you're sort of lucky enough to get care, then you walk in, maybe scratch the surface of what really makes you, you, and 20 minutes, 30 minutes later, you walk out with a prescription. And I think that in certain ways, it makes things worse rather than better to not really understand what's at play with that individual and to just throw the medication on.

[00:19:53] Luke Storey: Amen. In your book, obviously, you're focusing on anxiety, and something I thought was really interesting is your delineation between true and fake anxiety. I want to get into that, but, perhaps, as we kind of go down that road, if you could give a more broad definition of this term that's thrown around a lot, I'm anxious, I have anxiety, anxiety disorder at the furthest end of the spectrum, what is it? 

[00:20:25] To me, and I'll give you my take on it, which is like kind of juvenile. But you have fear, right? Fear, to me, is more based in a reality, where like someone scary comes in the door right now, I have a natural reaction of fear to protect oneself. Anxiety, to me, would be having a fear about something that's not, in fact, real. So, I'm sitting here thinking maybe someone's scary is going to come through that door, and it's going to preoccupy my attention, and I'm going to be uneasy and stressed about something that I've totally made up.

[00:21:03] So, kind of when I'm thinking about myself and I think, oh, I'm having anxiety, sometimes, it's like, no, I'm afraid because there's a reason to be afraid. And what I find to be—and fears for me are easier to deal with, because there are choices you can make that might keep that seemingly inevitable experience from happening. But anxiety is often this low level kind of indistinguishable uneasiness around something that is kind of not a reality. So, that's as far as I've been able to kind of get with it, apart from all the stuff I learned in your book. So, how do you frame anxiety as a whole?

[00:21:46] Ellen Vora: That's better than any framing I have. I think that I get this question every single time I sit down to talk about my book and I refuse to have a good answer to it. I think that the way I think about anxiety, it pulls on a lot of different things. It draws on. There's fear, there's worry, there's stress, there's a lot of different feelings that get lumped in. It can even be muscle tension, the inability to relax racing thoughts while you're trying to fall asleep.

[00:22:15] I think where I really draw a distinction between how I think about it and what I was taught, I was taught to think about anxiety, according to the DSM, the Diagnostic Statistical Manual, and it's thinking about anxiety as these different classifications, do you have generalized anxiety disorder or panic disorder with or without agoraphobia, or is it a specific phobia, and so on and so forth? And what I think drives that, always in medicine, you're always trying to kind of, what guides management?

[00:22:43] What's going to change management? And maybe if you had panic disorder, it kind of steers you towards cognitive behavioral therapy. whereas if you had generalized anxiety disorder, it kind of steers you towards medication and therapy. And where I think it gets interesting is they're like, "Well, that is not enough. You don't check enough boxes to qualify for a clinical diagnosis of generalized anxiety disorder."

[00:23:06] And so, there's a gatekeeping that happens. And I think the idea behind it is that these interventions like medication have risks, and so we're going to gatekeep it and it's only when indicated. So, I respect that, but the way I think about it is that I don't think there really is any subclinical anxiety. I think if you're someone who's going through your life identifying with a subjective state of anxiety, to me, that's hook, line, and sinker, you're anxious in my book. 

[00:23:36] And I don't really have any interventions that come with risks, and we can talk about things like orthorexia, there's some nuance to this, but for the most part, the interventions I'm going to do are diet and lifestyle modifications. They're safe. And so, there's nothing to gatekeep. It's like it does not hurt to try any of this. And so, if you're feeling anxious, in my book, you're anxious. And however you have come to that word and that narrative about what you're feeling, I think it's all valid. And so, I really think that a better classification system is true and false anxiety.

[00:24:10] Luke Storey: Ah, yeah, false, what do they call it? Fake anxiety. That could piss a lot of people off that are like, "I'm really nervous all the time".

[00:24:18] Ellen Vora: It's fake.

[00:24:19] Luke Storey: "Don't tell me it's fake", yeah.

[00:24:20] Ellen Vora: All pretend. I mean, I think even calling it false anxiety is triggering sometimes, and I certainly don't mean it that way, the term false anxiety is not to invalidate the very real suffering, the experience of anxiety. It's to speak to the underlying cause. And false anxiety, I think of it as the avoidable anxiety, and it has some physical or physiologic basis.

[00:24:43] So, something has gotten your physical body out of balance, and typically, into a stress response. And that can be anything from a blood sugar crash to you're just on a little bit of like a stronger coffee that day, to inflammation, to sleep deprivation, and the list goes on. It could be B12-deficient, and it's gotten your body into a state of imbalance or stress, and then it creates a feeling that's synonymous with what we call anxiety or panic. And it's avoidable. 

[00:25:11] Luke Storey: Right. Yeah, it's so nuanced. But kind of in one category, like say you're going through a divorce, or your business has failed, or you're losing your job, or whatever, there's something to be anxious about, right?

[00:25:26] Ellen Vora: Yeah.

[00:25:27] Luke Storey: And then, there are all of these other sort of cofactors where you just have a general feeling of unease or disease that can't really be attributed to any circumstance in your life. You're just kind of like, eh, you're just tense, right?

[00:25:42] Ellen Vora: Yeah, but our brains are meaning makers, right? If you show us a picture that's just two dots and a line, our brain will say, I see a face. And if you give your body a stress response, and cortisol, and adrenaline, our brains are all too happy to swoop in with a narrative to explain that sensation, they'll say, well, you know what, I did get an email from my boss, it's not sitting quite right, and I forgot to text back that friend, and I'm sure she's pissed off at me now.

[00:26:07] And so, we'll swoop in and tell a story about why we're feeling anxious when, in fact, the reason, the real reason we're feeling anxious, if we could have an omniscient peek under the hood in the body, was that a blood sugar crash precipitated a stress response, full stop. And so, it's not these things going on in our life, we always have things going on in our life, but they're not the real cause. They end up feeling like a retrofitted explanation for what is a physical state.

[00:26:35] Luke Storey: I love that you touch on the meaning-making mind. So, I've been kind of, I don't know, grappling with/studying this within myself and other people for so long, but this phenomenon that we share, where you have what could be labeled a negative or uncomfortable emotion that just arrives, sensations in your body, whatever it is, and the propensity of the mind to then start creating stories around that.

[00:27:08] And it's so interesting because it's a blessing and it's a function of the mind to create a context around what you're feeling in your body so that it can then do its computing job of figuring out how to make it stop. And it's like such a fool's errand, because then you you're in not only the uncomfortable feeling in your body, but the rumination and the endless thought loops of the mind that are leading you down a lot of the time, narratives that actually have no basis in reality.

[00:27:44] It's really one of the hardest things about being a person, I think. And the only thing I've really found in a broad sense that helps alleviate that is learning how to ground into the actual feeling and sensations, and surrender the discomfort, and to do my best to resist the temptation of the mind coming in and trying to do its job, however well-intentioned it is, right?

[00:28:18] So, I might feel like a wave of grief, or sadness, or fear, or anger, and it seems to me, and I want to get your take on this, just as a lifestyle practice, that rather than repressing, or suppressing, or trying to figure out why I feel this way, is to just really feel it 100%. Like one of my favorite teachers, David Hawkins, in his lectures, people would come and say, "Oh, I just have so much anger", and he would always say, "No, you're not angry enough", and they look, they're just so puzzled, and he was getting to that truth.

[00:28:51] It's like, "No, what's making you crazy in your mind is that your emotional body or pain body, whatever you want to call it, is wanting to express anger and you're not letting it, so then your mind's trying to figure out how to make it stop, but how to make it stop is to not stop it and appropriately feel it at depth, however uncomfortable it is". And to me, this is like this golden key to unlocking that phenomenon, that sort of chain reaction.

[00:29:22] Ellen Vora: A couple of things to say on this.

[00:29:23] Luke Storey: So, what's your take on that?

[00:29:24] Ellen Vora: Yeah. So, I think a couple approaches to this. One is I really agree with the spirit of kind of like to Byron Katie, our narratives that we tell ourselves, and to make sure we're checking in and saying like, well, is it true? Is it really true? And sometimes, it really isn't true, or maybe we just don't have full evidence to support it. And then, I'm also here with a little bit of a pet peeve around the kind of cognitive behavioral therapy, very masculine, young, objective view of kind of like, don't believe your thoughts, and feelings, and emotions, like let's be reasonable, let's be rational about this.

[00:30:01] And I bristle at that. It's been a relearning for me to embrace my more feminine, intuitive, spidey senses about things, and to not just push them away as irrational, but to say like, no, there's something credible to that that's just listening to the data from a different antenna. And so, I do think it's important to suss out, is this a story that our minds are telling ourselves? Is this an intuitive hit? Is this our spidey sense? Is it a gut sense?

[00:30:30] But I think that feeling things fully, many of us have come of age in this emotion-phobic culture. And picture crying, for example, if you're sitting amongst other people, and something comes up in conversation, and you start to get misty-eyed, and you start to cry, the first thing we do is we apologize. We say, I'm sorry, and then we do our best to collect ourselves, and to almost suck it back in, and make it small, and let it pass as quickly as possible.

[00:31:02] And I think crying, we really got it wrong, and we need to rebrand it, like crying, it's a gift. It is the wisdom of our body saying, we need this release, we need ACTH, a component of our stress system to sort of come out in our tears, it disburdens us of stress in a certain way, it bonds us, and it moves us through. It keeps the energy and the emotion moving so that we fully metabolize it.

[00:31:27] And I think, now, when my patients that kind of get trained, but if I sit across from somebody, and they start to cry, and then they start to say the sorrys and suck it back in, I call them on it gently, lovingly, and encourage them to dive into it fully. Not like, "I'm too angry", like, you're not angry enough, you're not crying enough. Like make this bigger, fully have this experience, and we always feel better afterward. And in a way that we can't always access consciously, we've moved through something when we've had a good cry. I think there's wisdom in how children go through life and they have meltdowns, because they have license culturally to have a meltdown.

[00:32:04] Luke Storey: I know. I miss that.

[00:32:05] Ellen Vora: Yeah. So, I think adults need a little bit.

[00:32:07] Luke Storey: We need to give ourselves license to have that experience. That reminds me of the kind of social pressure of not crying when I was a teenager, and I was in group therapy, and I went to this weird boarding school for delinquent kids, and there was a lot of crying and screaming, and it was all this '80s kind of experimental and experiential therapy, role-playing, just all the things, pounding pillows, all that.

[00:32:36] And there was a really interesting thing that would happen if a kid started crying and another kid went up to give them a Kleenex, the facilitator or quasi-therapist would stop them from giving them the Kleenex, not to stifle their compassion, but that it was a signal to stop crying, like dry your eyes, like stop, so they would just let us sit there and [making sounds] . 

[00:32:56] Ellen Vora: Yeah.

[00:32:57] Luke Storey: Yeah. 

[00:32:58] Ellen Vora: I mean, it's interesting, also, even when there's like that pressure to applaud or the pressure to respond to somebody, I think that we all could relearn a little bit like all this etiquette around, how do you hold space for somebody having a process? And I think I don't know the answers, I just think that we want to be curious and experiment with when somebody's done, say somebody just said something that was kind of poignant or important to them, we all just kind of were like, okay, onto the next, move on. 

[00:33:30] Like when we say something like, well, that reminds me of this thing about me, all these things, which I love to do, there's no like—I think that that, sometimes, is collaborative interruption. But I think that, can we sometimes just say like, okay, like let's just stay with that for a moment or ask questions to kind of let somebody go deeper into something? And I think that that's the spirit of the don't hand the tissue. And I think there's something really beautiful about letting people have the full extent of their processes. I think we have a lot of stifled processes and I think it's not helping us in terms of our mental health, in terms of how we get along with each other.

[00:34:06] Luke Storey: Yeah. And to interrupt that meaning-making loop that gets created around it, like how much work it takes to suppress feelings, and it's like what that sort of instigate the mind to do is to dig yourself in this hole of like trying to figure out why you feel the way you feel. And sometimes, there's not a reason. Sometimes, it's energetics. I have the experience often with my wife, Alyson, who you spent some time with today, sometimes, I'll just be suddenly, unexpectedly overwhelmed with, I guess, like kind of start crying.

[00:34:43] I'll just look at her, hold her, hug her, and I don't even know what it is, but I just allow it. And it's just like love or gratitude. It's just a moment. And as a man, it's not the most natural and trained emotion to handle. But if I start to stop it, I feel instantly that I'm doing a disservice to myself, because it's kind of embarrassing, like I'm a guy, like get it together, you know what I mean? But I don't know, it's a feeling.

[00:35:17] And the more I'm able to just breathe through those moments, I don't know, there's so much healing in that. And maybe even making up for lost time, so many of us have gone through life and not given ourselves permission to just express in an appropriate and healthy way what comes up. I mean, there are stacks and stacks of past emotions that it might be impossible to identify with any logical purpose or reaction, it's just, whoa, my body's wanted to do this thing, and something needs to come out of me, and who knows where it came from.

[00:35:52] And it might not even be that productive to try to figure it out. It's just, oh, I'm feeling something, okay. And also like—I always I have a habit of talking too much of my interview, so those listening, I'm sorry, I know, I'm working on it, right? I get excited. But it's like every time one exerts the courage that it takes to just feel what you're feeling, it also has the effect of normalizing it, and identifying, I guess giving like the appropriate value to a feeling and ultimately arriving at like, what is a feeling? What is an emotion?

[00:36:38] It's just like some sensation that runs through your body. It's not going to kill you. As someone who spent decades stifling any and all feelings other than ecstasy, or joy, or the ones that I wanted, but it's like, so you have a feeling, if you can actually allow yourself to feel it, it's going to pass so fast in most cases. It's like a blip on the radar and you're back on track. It's when we stop that flow of energy that things get squirrely.

[00:37:05] Ellen Vora: Yeah. I always think the analogy is waves. And I have a healthy fear of the ocean, have many failed forays into surfing, and it's like a big wave coming towards you, it's like a big emotion, and you think like, "Oh, God, like that's terrifying, and I want to run from it or I want to resist it". But just like a wave, you're not going to outrun it, you're not going to strong-arm it. Really, in many ways, the best thing you can do is dive head on into it, let it turn you upside down a bit, but eventually, the wave is going to crest and resolve, and you're going to bubble back to the surface.

[00:37:37] And I think that that is how we want to handle our emotions. Like I have so many patients who assume if they're feeling sad, they should put on happy music, and it's just like with the anger idea, like I want them to put on sad music. And what you see on the flip side, I think Bessel van der Kolk really helped us understand this concept with his book, The Body Keeps the Score, which is really about how trauma is held in the body, which I think is absolutely spot on. But I think everything is held in the body. 

[00:38:03] And if we try to push our emotions out of awareness or resist having them, it's energy it doesn't go away, if anything, if we push it under the carpet, it just transmutes, and that becomes these epidemics of chronic headaches, and migraines, and chronic low back pain in men, and digestive issues. We've kind of pushed that emotion energy into the body and it gets lodged there. And in some ways, it behooves us to just dive into the wave and feel it in the first place. It's actually an easier way to be in a dance with the feelings that go along with the human experience, which are manifold.

[00:38:41] Luke Storey: Yeah, it's crazy, because that practice or that model, ultimately, the net result of that is you experience less pain, you know what I mean?

[00:38:51] Ellen Vora: Yeah. 

[00:38:51] Luke Storey: Because it compounds and it gets so confusing as you try to like hold it all together. It's like if you can just summon the bravery to see it through and feel it, you'll actually spend a shorter duration of time, ultimately, in that experience, right?

[00:39:06] Ellen Vora: But give ourselves grace for the fact that most of us were conditioned to not dive into our emotions, so here we are, unlearning that.

[00:39:12] Luke Storey: Yeah. I remember some of those lessons. I was mostly raised by my mom, who was super—has high empathy, and is emotional and awesome, but when I was a kid, my dad evolved so much, but yeah, there wasn't a lot of room for like crying and stuff. I think that many of us and probably more so men are just taught to not let that out. Okay. Back to some of this anxiety stuff, I'm very fascinated by the neurochemistry, like you're fascinated with the brain. Me, too. And in your book, you talk a lot about the relationship, a lot about GABA and some about serotonin. What's happening in the brain and in our neurochemistry when we're experiencing stress or anxiety?

[00:39:56] Ellen Vora: Yeah, as if we know. I mean, I think that the conversation has typically centered around this one neurotransmitter, serotonin. And we've been indoctrinated with this model that's not entirely accurate, which is like anxiety or depression is like a low serotonin tank, so you take a med that kind of fills up the tank, and then you have more serotonin, and then you feel better. And it's a nice idea, it's not at all how the brain works, not whatsoever.

[00:40:20] Not to mention the fact that any time you sort of increase the level of one thing, you'll down-regulate receptors, the brain is often trying to really achieve a state of homeostasis or the original state of balance. GABA, I think, is an underappreciated dimension of the conversation around anxiety. And GABA, it's our primary inhibitory neurotransmitter of the central nervous system, which is kind of like a lot of science speak for.

[00:40:45] It's the main chemical messenger in our brain and our spinal cord that's here to say everything's okay. And in certain ways, it can feel like there's an epidemic in modern life of not enough GABA. Like we don't have enough of that signal of, you're okay, you're going to be okay, it's going to be okay. And I don't mean to invalidate the many real problems in our world. Like to be your finger on the pulse of what's not right in the world is absolutely an acceptable view, but I think that we're not helping ourselves by having a physical state of GABA deficiency and to not even be able to feel okay even when things are reasonably okay.

[00:41:26] And I think that there are so many things going into why GABA is not manufactured in adequate amounts for many of us. It starts in the gut. A lot of times, much of our GABA is manufactured by certain bacterial species in our gut flora, and that's decimated through so many aspects of modern life, from antibiotics to chlorinated tap water, to chronic stress and processed foods, and so on and so forth. So, we're missing these Bacteroides species that help us make GABA all the way up to being chronically stressed, being kind of overfed but malnourished.

[00:42:00] And then, we also have a GABA deficit related to substances, things like alcohol. And for anybody who is taking benzodiazepines on a regular basis, this also chips away at our body's ability to have healthy GABA signaling. And they work in different ways. Benzos kind of have this impact where they rush the brain with GABA, and then the brain sees all this GABA, and it thinks like that's a dangerous amount of GABA. If a leopard came around the corner, we'd be too buzzed to care and we would die, so it down-regulates certain GABA receptors, which is not a comfortable place to be.

[00:42:37] Because then, once the Klonopin or Xanax has faded, now, you just have normal levels of GABA, but lower than normal levels of GABA receptors. So, it's almost like you can't hear the GABA. And that doesn't feel good and that's why people in benzo withdrawal or trying to taper off of benzos, it's sort of the essential feeling of not okay, is that you're missing GABA. Alcohol, it works slightly differently, but it also washes the brain in GABA, and your brain sees that and tries to reclaim homeostasis by converting the GABA to a different neurotransmitter called glutamate, which is an excitatory neurotransmitter.

[00:43:15] And that's why when you've had a couple of glasses of wine at dinner, and then you have a kind of lousy night of sleep, and the second half of the night, you're tossing and turning, maybe your thoughts are racing, you have a headache, that's that glutamine effect or glutamate effect, and that's also a feeling of uneasiness. And of course, it kind of tick, tick, ticks all the way until the next night when your body's like, we kind of need our hit of GABA again to make this whole thing get back into balance. And so, we create this state of a kind of GABA seesaw just by regularly consuming alcohol.

[00:43:52] Luke Storey: Wow, that's interesting. What is it about—and you may or may not know the answer to this, but as someone who used to, I guess, "recreationally" use benzodiazepines like, I don't know if we had Xanax back in my heyday, but I used to eat a 1-mmilligram Valium like Pez, and my friends and I would always call them brain erasers, because like—I mean, we'd be drinking with them and God knows what else, but I knew that if you took those little blue pills, like you were going to have a full blackout experience and you would have no idea, like literally no idea where you were, who you were with the night before. And so, I didn't like them, but I still felt the need to take them pretty regularly. But what is it about benzos that have the capacity to just totally wipe out your awareness and memory around them?

[00:44:40] Ellen Vora: Here's my theory, I'm not sure I know this, but here's where my brain goes when you ask that, is that benzos impact our sleep architecture. It's going to impact the different stages of sleep that we go through in a night, which is an interesting fact, when people use a Klonopin as a sleep aid, it's like, yeah, you might be unconscious overnight, but that beautiful, elegant architecture sleep stages that your brain needs to move through to feel rested and rejuvenated the next day, we're not getting that same kind of sleep. So, memory consolidation happens while we sleep, and I wonder if benzos interrupt some degree of that process, and that can be why. I'm not sure, though.

[00:45:14] Luke Storey: Interesting. Interesting. Yeah, that was one thing I definitely remember. And also interesting is the, have you ever played with kava, the herb kava? 

[00:45:25] Ellen Vora: A little bit.

[00:45:26] Luke Storey: Which is incredibly relaxing and is, from what I understand, essentially a natural benzodiazepine. I don't know how its relationship to GABA, but it can be pretty profound in its ability to relax you, but it doesn't erase your brain. Like you're still cognizant, and awake, and aware, and everything's fine, and you seem to sleep okay on it. It's a really, really interesting herb, something I've enjoyed using quite a bit. Okay. So much stuff I want to talk about here. 

[00:45:57] And then, since a lot of the stuff we're talking about with anxiety in a broader sense can't really have a root cause, but what about the anxiety that is seemingly without cause but is related to trauma, and PTSD, and the overactivation of the amygdala, and keeping us in this adrenalized, cortisol fueled state, because there's something from way back that hasn't been addressed, whether it's conscious or unconscious? How does that part of the brain all work as it relates to our level of uneasiness?

[00:46:35] Ellen Vora: Yeah. So, it's such a big and important topic. I think that the way to think about trauma is that all of these responses to trauma that we see, they get a bad rap in our adult life. They look maladaptive, but they were all originally adaptive. So, anybody who's been through trauma and is like, why am I like this, why can I not trust people, or relax, or figure out the right boundaries in relationships, like this was all your sweet little child body brain doing its best to stay safe and tolerate a crazy environment.

[00:47:10] And so, basically, it was an adaptive once, and then now, in adulthood, with a different set of circumstances, a lot of those adaptations become maladaptive. And so, in many ways, what happens in the traumatized brain is it's almost like the limbic system, which it can pertain to the amygdala or threat detection center, it's scanning the landscape for threat and just trying to survive. And that limbic system almost gets stuck with like the foot on the gas pedal.

[00:47:39] It's just always in a system of like, there's a threat, things are not okay. And what we get wrong, culturally, is to think, okay, maybe like you go to therapy, and you talk about the trauma, and that can have its role, but I think that can also be retraumatizing. And in many ways, it doesn't get at the genuine root of the problem, which is not really consciously, verbally accessible. It's more on the level of the limbic system, it's more on the level of the body.

[00:48:07] And so, these trauma-specific therapies, like somatic experiencing therapy, EMDR, some of my patients do good work with things like DNRS, all of that, I think, is a better approach, where you're not just rehashing the trauma verbally, but you're accessing on the level, it's a somatic level. It's kind of reprogramming the brain to take the foot off that gas pedal in the limbic system. And it is where I think psychedelics play an interesting role and we'll put sort of like all the caveats there.

[00:48:39] Luke Storey: Yes. I always give the disclaimers when talking about psychedelics, which is, I mean, everyone kind of has—I mean, hopefully, people have that same caveat list and disclaimers, but it is real and really important. Like I've benefited immensely from psychedelics and plant medicines, and one of the most terrifying thoughts to me is just willy-nilly taking whatever substance without the context and all of the things you're probably about to say. Like literally, that would be terrifying to just one day be at a party and be like, oh, I'm going to drink ayahuasca or take mushrooms, like, oh, my God, what a nightmare.

[00:49:18] Ellen Vora: Yeah. I mean, we, as a culture, sort of like medical legal disclaimers fall on deaf ears. We think like they're just saying this for like legal reasons, but I'm saying this from a place of like I care, that nobody has a bad outcome with this. And these substances are not safe in all settings, and all indications, and all brains. And I really think people are on a spectrum where it could be so beneficial to shake up the snow globe and it can be so harmful. 

[00:49:45] To a more kind of chaos-leaning brain, I think it can be truly destructive. So, you want to go through a proper process of evaluation and make sure you're in a proper set and setting, and it's indicated, all the caveats. But basically, for somebody with trauma who kind of has an entrenched pattern or loop in their brain of like things don't feel safe, it's hard to trust, it's hard to feel that you will be okay, an aspect of entheogens or psychedelics in that, perhaps, they can help us secrete BDNF or brain drive neurotrophic factor, and promote states of increased neurogenesis and increased neuroplasticity, it gives us this window when we can change the grooves in our habits in our brains, in our neural habits, how we typically sense our reality, and perceive it, and the takeaways and the narratives that's been as a result.

[00:50:41] So, we basically have this opportunity with these medicines to have a big experience, and then, in integration, really galvanize a new way of being in dynamic with our environment. And that's where I think it's so exciting to think about this different pathway. And MDMA or ecstasy is sort of an entirely different path, where I heard it once described as like reverse PTSD, it's almost like instead of-

[00:51:11] Luke Storey: I know you wrote that in your book, I like that.

[00:51:13] Ellen Vora: It's beautiful. I wish I could credit in my memory who said it, but basically, instead of having an experience that kind of breaks your faith in humanity, you can have an experience that revives your sense of gratitude, and awe, and faith, and trust. It's a life-affirming experience because it's empathogen. And I think that's such a missing key in how, especially right now with our increasingly polarized world and how we're all kind of stuck in these patterns of, you don't understand me, I don't understand you, I can't understand how you might think this way about this.

[00:51:48] We're all so at each other, and an empathogen basically steps in and helps us see through more compassion and more understanding that everybody here has a valid perspective and that anybody who's behaving in a way that's hurtful to us, they arrived at that through a set of context that made it almost inevitable. And so, I think that just to have that awareness can do a lot to—because we're sort of so contracted from trauma and it can kind of help us soften and expand into, I don't feel so guarded against what has happened to me. It's a softening.

[00:52:27] Luke Storey: I love this concept of reverse PTSD and I like that it's framed that way, because you think about, I don't know, a lot of us, I think, think about trauma as like it was the thing that, like Gabor Mate talks about this in some ways, we think it was that thing, your core wound, they did this thing to me, and that's the thing that hurt me, but PTSD is post-traumatic, right? It's like after, how that was held within me, or the kind of support I had or didn't have around that to be able to heal it, to work with it.

[00:53:01] And those punctuation marks that some of us have in our life, whether it was an act of violence or predatory sexual behavior, whatever, like those big ones that some of us have, they leave you with that hypervigilance that you described, and so difficult to unravel it, but with some of these peak experiences in terms of the reverse PTSD, you're having as profound and impactful event or a punctuation point in your life experience that it is the converse or the reverse of a PTSD.

[00:53:37] It's like you come out of it and you are literally never the same. And rather than having a hypervigilance or any anxiety around your environment and your life experience, you have the equivalent of that in a sense of well-being, and safety, and faith, right? It's phenomenal. I mean, I've had many of these experiences, and also, I think, just spending a couple of decades in building self-awareness of what makes one tick, there are things that should trigger me now that take place and I'm kind of waiting for it, because they said this or they did that, and normally, this is how I would have reacted, and it's just like [making sounds] flat line.

[00:54:20] It's gone, like that trigger, the hook, the embedded kind of neural pathway or the groove in the record. It's just like I'm almost surprised, I'm like, oh, this doesn't bother me at all now. It's really interesting to observe that over some time. And I mean, some of it's boots on the ground work on oneself, but a lot of is just the grace that takes place when you're in the appropriate scenario with some of these medicines. It's grace. It's done for you and to you, and if one can surrender into it, you're different, you're changed. And I've had this happen in so many different ways, and it's incredible, and it's really exciting.

[00:55:07] Ellen Vora: And grace, I think, is such an interesting word there, because any time I'm going to enter into a psychedelic space, there's always that apprehension at the beginning, that nervousness of like into the unknown, is this going to be the bad one? Will this be torture, which kind of is almost always our own resistance anyway? But I think that what I learn every single time that I do these legally is that, basically, it's love, like that force, that spirit, the essence of these medicines is always love, even and especially when it's a challenging experience. 

[00:55:45] And it feels very much like the medicine almost assessing, and seeing you're ready for something challenging, and giving you exactly that learning and that gift, and you come away—I mean, often, I come away most helped by the most challenging experiences. And I think that my friend and colleague, Will Siu has a really interesting thing to say about psychedelics, and I'll maybe butcher his quote a little bit, but he says psychedelics are not just agents for healing trauma, they're also tools for making palatable spirituality in our starving Western world.

[00:56:20] And that, I think, is what's really interesting. In my book, it's like come for the functional medicine holistic approach to managing your anxiety, but like stay for the part where I kind of try to convince you to believe in God, but like not so much. I'm not attached to like how someone comes away from it, but I do think that a connection to meaning and purpose is central to how anxiously we go through our lives.

[00:56:44] And I'm certainly not here to proselytize or say it has to look like this or it has to feel like that, like I have no attachment to it, but I at least want people to bring some conscious reflection to what's their worldview, and is it more fear-based? Is it more trusting? Is it more surrendered? Does it feel infused with love? Does the world feel like a cold and senseless place? And I think this is at the heart of anxiety.

[00:57:09] If you feel like you're operating from a kind of purely random, rational, and ultimately cold universe, it's going to make this life feel pretty high stakes and it's going to make the sort of seemingly random vicissitudes of our lives when things don't necessarily go our way feel—that's very anxiety-provoking. I think it's kind of anxiety catnip to kind of always feel like, okay, I need to get my full body medical screening, because what if I get cancer?

[00:57:40] What if this happens or that bad thing? And I think that it's worth exploring a relationship to whether it's just like that there's more than meets the eye here, that there's something slightly beyond our comprehension or maybe vastly beyond our comprehension that's happening. And I find that comforting, especially when I face a steep loss or a challenge in my life and you can feel sort of hopeless or desperate, my worldview swoops in and kind of says to me, make meaning from this, trust and surrender to this process.

[00:58:20] And I really don't mean to say that like it's all hunky dory, and like peace and love, man, like I find that I'm up against this thought process, most of all, when things really are not okay, but it's a way that I move through with resilience. And I'm open to the fact that it could be wrong. To me, I don't really care if I'm completely deluded, and it turns out this is all just random, and when you die, you die, and that's the end. If that's the truth, then this worldview of feeling some degree of meaning and purpose gave me immense comfort through my life. And so-

[00:58:56] Luke Storey: Like it could be spiritual placebo.

[00:58:58] Ellen Vora: Yes, it's an amazing term. And I think that for my patients, we can't fake it. I can't give you a pill and be like, God, you will believe it now that you take this pill, I think that it has to feel true, it has to feel emergent, it has to be authentic, but at least want people seeking and not suppressing those questions the way we suppress our tears. I want people to dive into it. If they have a moment of awe in the universe, you don't need to sober up and be like, well, that's not rational. You can drop to your knees and weep at some things that are awe-inspiring about this human experience.

[00:59:34] Luke Storey: Yeah. Well, I'm glad that you have the courage to speak openly about that. And I think obviously there's much less stigma around more therapeutic uses of psychedelics and things like that, and nothing wrong with recreational ones either, it's not my lane, per se, but I mean, I know so many people whose lives have just been absolutely transformed from just getting a glimpse of divinity, of just having the veil lifted for a few hours, and after the experience, you know there's something there, right?

[01:00:13] Call it God, call it Creator, whatever, but I don't know, like when you've really had a visceral personal experience like that, there is some part of it that stays with you even when you get back into the density of the material human experience. There is like a, hmm, maybe this isn't that big of a deal. I think that's, for me, kind of the net benefit of all of it has been kind of being in this world, but still having one foot in the other a lot of the time, of really kind of relishing in the human experience, and all the ups and downs, but there's also just—it's not a detachment, it's kind of an observer awareness that this is all just drama, right?

[01:00:57] And then, I'm just kind of in an Earth school curriculum or a play, and I'm just kind of playing this role, but there still is that sort of higher or wiser part of myself that knows everything's okay, it's not that big of a deal. And I tend to get caught a lot less. I do. I'm just less attached, less freaked out, less anxiety. I always say that, especially with 5-MeO-DMT, I always say that it's literally the cure for atheists. I mean, I've had some really profound experiences apart from that, but that one in particular is just like, oh, okay, I know nothing, you know what I mean?

[01:01:39] Like everything I think I know about the universe is just completely obliterated in a 10-minute period, and then come out of that, and just go, okay, this is actually the hallucination, right? You think of these drugs, they make you hallucinate, and see things, and hear things that aren't there, but like, really, this reality, in a sense, is more of a hallucination than going totally quantum into the totality of consciousness, where there's not even a you there anymore, then when the you comes back here, it's kind of like, oh, okay, I'm going to play along with this version of the you, of the me, and there's a lightness to it that's just beautiful.

[01:02:15] Ellen Vora: That sort of my illusion of like what this is, I think, is so helpful when we get in a twist about what's concerning us and sort of like that don't sweat the small stuff, it's all small stuff. But I think to counterpoint that, I also think that this material world that we find ourselves in, this matter also matters. And I think there's also something healthy about sort of recognizing, what are we being called to do in this material world?

[01:02:42] And it's all part of it. And I think that that's sort of the counterpart to false anxiety is this true anxiety idea, which is not a kind of anxiety we could medicate away. We're not going to improve this anxiety by going gluten-free or drinking decaf instead of espresso. It's an inner compass. It's a true north, and really, a call to action. It's saying slow down, pay attention. I'm communicating to you that something's not right here. 

[01:03:09] And it demands your attention. And I think that we can be stuck in so much suffering when we're just like, "I'm anxious and the anxiety is the nuisance. It's the thing I need to eradicate." But when we can see anxiety as a communication and sort of here to help nudge us onto our path, it doesn't feel like something we want to resist so much. We want to start to see it as our ally then, and it can really help us find our path. And then, when we're sort of taking steps according to that true anxiety, it doesn't feel so uncomfortable.

[01:03:43] It feels purposeful. And so then, that urgency feels more just like a purposeful, salient feeling, and not just a, ah, this anxiety is getting me down, it's a nuisance. So, I don't know, I think that it all matters. Like I think this is absolutely an illusion and we're here with something to carry out, and we just want to kind of make sure that we're balancing those two considerations.

[01:04:14] Luke Storey: Yeah. I look at it as being in the world, but not of the world.

[01:04:19] Ellen Vora: Yeah, to be a lotus flower, yeah.

[01:04:20] Luke Storey: That's the goal. I'm always like, okay, where's the middle ground there? Right? Where you're here finding your purpose, obviously, there is a purpose. If you're in a body, I mean, it can't just be random. There are too many miracles just within the body itself. It's just such an incredible machine, a living machine. So, obviously, if my consciousness is in this thing, there's a purpose, there's something to do, what is that?

[01:04:42] And for me, it's sitting here with you. But that brings something to mind that's really interesting in your book, and that's the Dian Fossey chimpanzee study. I'd love for you to illuminate that for us because that was enlightening in the sense that certain people are just wired differently, like some of us are just very kind of parasympathetic and not easily bothered, and some of us are just Nervous Nellies. And maybe the Nervous Nellies have their place and that's what that study kind of helped me to understand.

[01:05:14] Ellen Vora: Yeah, and I think not all Nervous Nellies are sort of whether it was genetic or somewhat of like a trauma response, but yeah, we're all types of people, and I think we really all have our role. We need our parasympathetic fun folks, who are just like, I will be the pilot of the plane, I will be the surgeon. We want that level headed, even keeled person who's not viscerally connected to all the suffering of humanity at all times, like crying at the news, like we need that person, and we need our sensitive folks.

[01:05:46] And I think that this is where you'll start to hear in the zeitgeist, people referring to anxiety as a superpower, and I really do believe that. I think that, culturally, we've come of age in this life where we're calling our anxious folks, we're saying, "You're too sensitive, like get over it, like pull yourself together", and that kind of invalidating behavior, generally, not right, but we're really missing the gifts of the anxious people.

[01:06:09] They're the ones who are wired to have their finger on the pulse. They are sensing something that's just past the horizon that the rest of us aren't sensitive enough to pick up on. And there's this well-worn metaphor around the canary in the coal mine that coal mines had these sort of potentially lethal gas, and they would bring a canary in, and the canary be singing and chirping, but if the canary, was more sensitive to that gas than humans, went silent, you knew you had to get out.

[01:06:38] And I think that anxious people in certain ways are the canaries in the coal mine of modern life, and there's a lot of noxious gases in our modern world. There's a lot that's poisoning us, and like Joe Surgeon might take longer to be poisoned and our Nervous Nellie might feel the effects of glyphosate or EMFs earlier, and our culture is saying, "You're very sensitive", and we're saying that like it's a negative thing, but I think in certain ways, they're almost like our prophets here to say there is something about how we're living that's making me sick and it's coming for you slowly as well. And so, I think we really need to be honoring and listening to anxious folks and saying like, what is impacting your body?

[01:07:18] I really think of this as part of my calling, is kind of being sensitive in order to use my body as a testing ground for what might be harming my patients. And like for me, it's so crisp, clear, I know what affects my body negatively, so I can throw that out there as a suggestion for my patients, and they can put that into practice and start to feel a little bit better. And I think, culturally, we can have a little bit of movements towards, maybe we should stop doing this or that because it's impacting us. So, when somebody is really sensitive, it's not a negative thing. They're here to feel something that the rest of us might not be tuned sensitively enough to.

[01:07:57] Luke Storey: Do you remember that study that you wrote about in the book? 

[01:08:00] Ellen Vora: Yeah.

[01:08:01] Luke Storey: Would you lay that out for us?

[01:08:02] Ellen Vora: Oh, sure.

[01:08:04] I get the gist of it, but you might be better at it, because it speaks to this particular topic of kind of finding value in yourself if you're kind of leaning more toward a vigilant energy, and those of us that aren't the vigilant, sensitive, empathic type to be able to invite those in and say, hey, cool, we need you here, too.

[01:08:28] Yeah, Dian Fossey, the late, I think, zoologist or primatologist, she would study chimps. And they noticed that these tribes, these populations of chimps, there'd be some that were the more anxious types. They were more kind of wired sensitively and they would actually be the ones who weren't sleeping that well at night. They'd be kind of at the outskirts of the community, up in the trees, and they were basically looking for like, when is the elephant stampede coming? When is the storm or brewing? And they would warn the rest of the tribe like it is time to move or get to safety. And so, she did an experiment where she removed those anxious chimps from the tribe, and what they saw was that the whole community would be more likely to die. So, the anxious chimps were keeping the whole community safe.

[01:09:15] Luke Storey: That's crazy. Yay, highly sensitive people.

[01:09:20] Ellen Vora: Yeah. And we owe a debt of gratitude to our surgeons and pilots, but our surgeons and pilots owe a debt of gratitude to our Nervous Nellies.

[01:09:26] Luke Storey: Yeah, that's so cool. I love that you included that. I'd never heard about that. It was very interesting. After doing this show for going on seven years, I think pretty early on, I got bored of talking about like the perfect diet and food. I'm just like, I don't know, there's a million blogs, so I don't talk much about that, but there were some interesting points in your book that I think would be worth exploring. 

[01:09:52] Some of the low-hanging fruit of like the inflammatory foods, gluten or what, is probably often a lot of glyphosate or Roundup that we just think is the problem we have with gluten, but beyond that of like maybe exploring some of the things that you found to be most troublesome for anxiety-type people. But then, I like how you went into the orthorexia and like diet anxiety side of it, too, which I've explored in my own journey. And I'm just much more relaxed about food now because I found that I would be so uptight about what I was eating or not eating, that that was actually making me kind of worse in a sense, you know what I mean?

[01:10:34] Ellen Vora: Yeah.

[01:10:34] Luke Storey: I mean, I might be getting more dysbiosis from the anxiety about eating gluten and just saying, you know what, I'm going to have peace of pizza tonight, and just love it, and just imagine that that glyphosate is like the best vitamin in the world, and just keep it moving. So, maybe if you could just explore kind of what to eat, not to eat, and how to be self-caring about it, but perhaps not too extreme.

[01:10:56] Ellen Vora: Yeah, I'm in the same boat as you were like. For a while, it was fun to be like, hey, did you know you might want to try going gluten-free, and getting all these people to feel less anxious, and that was thrilling for a while. And then, I realized like, okay, like this has to be approached with a lot of sensitivity. So, these things exist in tension. And basically, I do think it starts with an understanding that mental health is physical health.

[01:11:18] And if we want our brains to function well, and feel good, and feel hopeful even when we're facing trauma, or stressors, or challenges, it just needs raw materials. It needs to not be inflamed because cytokines or inflammatory messengers are telling our amygdala like we're under threat, so we're going to feel anxious, and we need all the raw materials that help our neurons be healthy, that help us manufacture neurotransmitters, that help us repair. 

[01:11:44] All of that is essential to healthy brain function. So, it starts with reckoning with the fact that we need to be nourishing ourselves to feel good. And the fact that that needs to be said is weird, but that's the world we live in and I still find myself amazed at my field of psychiatry, where there's no acknowledgement of the role that nutrition plays. And like when we're talking about meds and therapies, but we haven't started with just like basic nutrition, we're in trouble. 

[01:12:16] And basic nutrition, it's like kind of a problem also, because if you go to see a more conventional nutritionist, you might get put on skinless chicken breast, and low fat dairy, and the Mediterranean diet of pasta. And I don't know how many people really thrive under those more conventional guidelines that have been influenced by our food pyramid, that have been influenced by industry interests.

[01:12:42] Luke Storey: The food pyramid, oh, my God. Sometimes, I forget about that and I'm like, oh, yeah, I remember that when I was a kid, like what horrible advice.

[01:12:50] Ellen Vora: And so, I think that it starts with that, but then what happens is especially for anxious, upholder, type A overachiever types is that they're like, okay, Dr. Vora said eat gluten-free and dairy-free, and have more healthy fats, and have more vegetables, and your plate should be a quarter of this, and a quarter of that, and half this, and then they do it obsessively, and then the next time I check in, they're like weighing their food, they're declining invitations to dinner parties, they're obsessing over it.

[01:13:18] And if they're traveling and they have to eat the thing at the airport, they're like, "Oh, no, I'm going to have a bad day because I'm eating this crappy food". And so then, it has become countertherapeutic. And really, what we want to remember is that the goal is not necessarily optimal health. The goal was always a fulfilling life. And sometimes, we actually need to roll up our sleeves and fix our diet a bit, because our physical health has gotten so out of balance that it's standing in the way of a fulfilling life.

[01:13:48] But then, sometimes, what happens is in trying to so perfect and optimize our physical health, it's become a part time job, and a source of obsession, and a barrier to community and connection, then the health process has now become what stands in the way of a fulfilling life. So, we just have to arrive at this balance, and fearing food or feeling fragile is not conducive to feeling less anxious. I think if we lived on what I jokingly refer to as like Whole30 Island and just the food that was available to us was nutrient-dense and non-inflammatory, I think we could be really loose and casual about it.

[01:14:30] We don't live on Whole30 Island, so I do still think we need to be mindful about how we're feeding ourselves, but like 80% of the time. And then, when we can't or when we choose not to, we need to be able to do that without looking back, without feeling fragile. And I think that's the balance, is to like approach the whole thing from a place of, "I'm not that fragile, and I enjoy my food, and I enjoy my life".

[01:14:54] Luke Storey: I like that perspective, balanced. Yeah. You can kind of see when somebody gets into natural healing, and biohacking, and all this stuff, there's like a trajectory where that pendulum swings, not with everyone, but with kind of obsessive people like me, the pendulum swings so far the other way, where it's like, for me, EMF is the thing. Like that's where I get the most neurotic and blue light, like those two things.

[01:15:21] I've always joked, like I'm driving around like Ray Liotta, in, I think it was Goodfellas or Casino, I always forget which one, but the black helicopters are after him and he's like high on coke, and I'm like, that's me with cell towers. But people get into this and go super, super extreme, and then get so tense around trying to control everything.

[01:15:40] And so, what I've done to kind of find the balance you speak of is just from time to time, just give myself permission to totally leave the reservationm, and just—I mean, I'm not going to drink a Diet Coke or something, but I mean, have a big ass pizza, and eat the whole thing, and my guts wrecked for a couple of days afterward, and it's like, you know what, it was worth it to just like not be so controlling, because I think that's really the kind of crux of it, is control. And you start to become hyper vigilant about your diet to get rid of the anxiety, but the anxiety was because of your hypervigilance. It's crazy.

[01:16:18] Ellen Vora: Ease itself is medicine. And yes, like eating gluten-free and all the Portlandia, like that's medicine, but the ease is medicine too. And our world doesn't make it easy to nourish ourselves well from a place of ease, but wherever we can kind of set it, and forget it, and make it possible, but we never want to lose that through line to the fact that we need to be doing this from a place of ease.

[01:16:43] Luke Storey: Yeah, agreed. Well, thank you for your rational approach to that. So many things I want to talk to you about here. Something I've noticed with myself and so many other people is the negative impact of technology and social media, and you have a word that I'm assuming you made up that's quite appropriate called techxiety. And I have some degree of self-awareness and I have begun to notice over the past few years how attached I am to my phone and that it's so alarming if it happens to be in the other room or forget it in the car, and I'm learning over time to train myself to see like, where's my phone? It's like, do you actually need it? No. Okay, then just leave it. But it's real sticky.

[01:17:31] And with the social media platforms and apps that are designed to give us those dopamine hits and the whole thing, I mean, the odds are really stacked against us to be able to use this technology for productivity and convenience without becoming a victim of it. And so, I love that you covered that with quite a bit of focus in your book because I think people that are meditating, eating a clean diet, doing all the right things, like most people I know in my little sphere of influence, that's the thing that's got most of us. And I'm just going to call everyone out that I know, because I watched them, and I'm like, they're scrolling and refreshing, and where's my phone? Where's my phone? It's like, what is up with that? And how does that contribute to our anxiety levels?

[01:18:22] Ellen Vora: In so many ways. Yeah. And like I used to give lectures, and people come up to me at the end and be like, okay, like I want to try to meditate, what meditation app do you most recommend? I'm like, they're all good, but the best one is throw your phone into the ocean. Like you don't really want it to be involved in your meditation. That being said, I often use a timer, but the thing is that we live in the attention economy, period.

[01:18:45] And what that means is that our attention is the commodity that very smart companies are competing for. They've done their homework. They know that they can give us reward at unpredictable intervals like a slot machine can, and will stay interested and glued. We'll want that hit of dopamine. They also know that if they prey on our fear response, or instill fear, uncertainty, or doubt, we'll rubberneck, we'll stay glued to that as well.

[01:19:09] And if there's controversy, which like the algorithm really lends itself to, because that looks like engagement, then that just helps put something in front of our eyeballs. So, these companies get more clicks and more ad revenue, but our mental health is the collateral damage. And you can be living this virtuous life and not doing any drugs, but we're kind of doing a drug without realizing it with the phone. It's lifting our dopamine, dropping it lower, and we kind of need that fix from it. So, it's leaving a lot of us kind of feeling strung out.

[01:19:39] And that's just the attention economy dimension to it. Like the fact that social media creates all this compare and despair, puts in our face when we weren't invited or included in something which impacts female seemingly even more than males, there's a lot about what happens there, even the way it's conducive to relational aggression, which I think is such a subtle factor with anxiety. 

[01:20:02] But right now, in our hyperpolarized world and the way we're kind of having the public discourse in a social media platform, there's a lot that's important there. There's a reckoning, there's accountability culture. I see value to all of that, but we do it anonymously. We do it with few character limits. And basically, it's kind of really conducive to just attacking each other. It sort of has squeezed nuance out of the conversation and squeezed the humanity of like, there's another person on the other end of this.

[01:20:35] And that's not even looking at the physiologic impact of the phone. And then, you name it, like the fact that we scroll at night, the blue spectrum light emitted from our phone screens is disrupting our circadian rhythm, suppressing our melatonin release, so we're not getting tired at the appropriate time, we're not sleeping deeply. The fact that there's no natural stopping point, that alone just means we'll keep scrolling. No one in the history of the world has ever been like, I got to the end of TikTok, I better go to sleep at this wholesome hour of 10:00 PM. And then, there's-

[01:21:03] Luke Storey: Yeah, because you can just refresh. Twitter is probably, I don't like have a following on Twitter or use it, but it's the place where I go to kind of get information about the world typically, and I'm like so disappointed when I get there, I'm like, I already read these, because I only follow a few people. So, I'll literally be like, refresh, refresh, refresh, oh, there's a new one. I'm like, dude, you're 51 years old, what are you doing? But there I am.

[01:21:28] Ellen Vora: They know. And then, there's even some, I think, mechanical issues with technology. And maybe we'll solve for this at some point as we start to implant our phones into our contact lenses, I don't know, but right now, you kind of have to have a crick in your neck to be staring down at your phone. We sort of have to bug our eyes out a little bit to stare at our computer screen. And so much of the body, there's these bidirectional communications. Something like the jaw is very keenly innervated by our sympathetic nervous system. 

[01:21:55] When we are holding these different kinds of head positions holding these eye positions, it resembles how we might look if we're ready for a fight, if we're in a stress response. And our brain is a little gullible, and all it knows is that we've tensed our jaw, and the back of our neck, and our trapezius, and we've bugged our eyes out, and it hears that signal, and thinks we're fighting, like it's on. And so, it mounts a little bit of a stress response to help support whatever challenge it thinks we're facing, but we're actually just staring at Twitter. And so, I think that in a melatonin level and a mechanical level, and compare, and despair, and attention economy, and several other dimensions, our technology is leaving us quite anxious.

[01:22:39] Luke Storey: What do we do? Like you focus a lot on sleep in your book and I want to get into some of that, but one thing you recommend, which is so smart and obvious, is to like never put your phone in your room at night, like keep your phone in there, to which, and you already indicated the primary rebuttal, which is like, it's my alarm clock, I don't use an alarm clock myself, but my rebuttal to that is like I often fall asleep to podcasts and audiobooks. 

[01:23:05] And it's like, I need a device that isn't connected to the internet, because then I'll be like, oh, I'm going to play this podcast, I'm like, well, I could check Twitter just one more time, or God forbid, I get into the hell hole of the Telegram, including my own, by the way, lukestorey.com/telegram, for all of the uncensored content. But man, if I go in there, it gets all doom porn, and now, it's like Cortisol City, but I think that, I don't know, there's got to be—I don't think there's like a fix. I ask you like, how do we fix it or what do we do?

[01:23:36] But the only way out, I think, is either you just denial technology and don't have it, you have an '80s Nokia flip phone, which no one's going to do, very few people, you go off grid, that whole thing. It's almost like each of us has to develop the discipline, and I don't know, going through the withdrawals of like kicking the way that we use it and putting stopgaps in place, leaving the phone in the car on purpose, or like in LA, I had a microwave, but I didn't use it, and I would put my phone in there, and for some reason, just mentally, since I knew that I had put it in a special box, I was less likely to walk in there and go get it, because then I would kick myself in the ass and be like, dude, you promised yourself you were going to get some deep work done, and not be on your phone, and here you are opening the microwave, and it was somewhat easier if I put it in there.

[01:24:27] If it was just a mental game I played with myself, like you could put it in a safe, or in a closet, or somewhere where you're not tempted, but I'm like, still, that is kind of disempowering, because it's like, do I really lack the discipline to just not pick up my phone when I'm sitting there trying to be in someone's presence, or do some work, or whatever?

[01:24:47] Ellen Vora: I just connected two dots that it's never occurred to me before, and now, I'm kicking myself that this isn't in the book, but let's kind of build a little analogy here. So, I mean, just to answer your concern, listening to podcasts while you fall asleep, if you must, which we can talk about how that's—but I think you're probably not going to want like an Alexa device listening to your life and emitting all the EMFs, but something that can just be kind of projecting it from elsewhere.

[01:25:12] I don't think it's a perfect solution, but it's true that at least when it comes to bedtime, setting up our phone in another part of the house, setting up the charger elsewhere, kissing your phone goodnight like 9:30 PM, and then going into your phone-free bedroom, certainly, at least helps with that doom-scrolling that happens at bedtime. Here's the analogy. So, in my book, I talk about a Brené Brown.

[01:25:35] She brought this up in an interview once I believe, where she talks about how there are the abstinence-based addictions, where it's like, okay, you're just going to not ever drink alcohol again, and then the sort of non-abstinence-based addictions like she was struggling with overeating. And she's like, the abstinence-based, you have a tiger in a cage in your living room, and all you know is that if you ever opened that cage, that tiger would eat you alive, so you just keep the cage closed, the tiger never comes out and you get by. 

[01:26:04] With something like overeating, with struggling with food addiction, you have to open that cage three times a day, so how do you stay in recovery? And I had that experience. I was a binge-eater. I was overeating. Absolutely, food was my drug. It was an addiction. In med school, it was really quite severe. And I was doing all kinds of weird pathological practices around it and creating so much suffering in my life. And what I realized, for me, not saying that this is applicable to everyone, but for me, I had to recognize that it wasn't all food that was behaving like a drug in my body, it was certain foods. For me, it was gluten, which has this kind of gluteomorphin opiatelike quality-

[01:26:46] Luke Storey: I feel the high already.

[01:26:48] Ellen Vora: And then, it was dairy, which also has casomorphin.

[01:26:51] Luke Storey: That's why pizza, pizza is like the heroine of food, I've always said that.

[01:26:54] Ellen Vora: It's brilliant. I mean, if I had been asked like, we're going to invent a food, that's a circle of dough, and tomato, and cheese, and people are going to love it, I would've been like hard pass, that sounds gross, but it turns out it's the ultimate drug. So, gluten and dairy were behaving like drugs for me, sugar, and then that kind of Franken food flavor crystal that's added to processed foods to engineer them to be addictive, whatever that is. And so, those were the foods that were behaving like drugs in my body, and I couldn't eat just one Pringle, as the slogan goes, which the joke is on us.

[01:27:27] If I started down any of those foods, I was going to binge, I was going to overeat. And this worked in tandem with the fact that I was feeling really disconnected. I wasn't getting certain fundamental human needs met, so I was really out of balance. I was not fulfilled in my life, and this was my drug that came in to kind of self-soothe all of that unmet need. And what I figured out to do was to abstain from those foods, so I still ate, I just didn't eat gluten, dairy, sugar, or processed foods.

[01:27:57] Luke Storey: Are you still that way?

[01:27:59] Ellen Vora: I have more wiggle room now, absolutely, but I still very much have an eye on that. Those are still triggers for me. I'm not going to binge anymore, because I am so fulfilled in my life, my needs are so met, so I'm not going to kind of go deep down that path, but a Milano cookie will still lead to a whole bag of Milano cookies for me.

[01:28:19] Luke Storey: Oh, my God, yeah.

[01:28:20] Ellen Vora: And so, I abstained from those four foods and still ate everything else, and that was actually an exit ramp from binge-eating for me. And so, this connects back to technology, in that I think that what we really want to get to a point with technology is that we use it and it doesn't use us. And do we have a way of being in a non-abstinence-based recovery with it? Can we use Google Maps, and Google Calendar, and whatever is sort of really serving our life while not engaging with the druglike qualities of the food, of the phone? And that's maybe more like social media apps or games and things like that, the gluten, dairy, sugar, and flavor crystals of the phone that we know will take us down a binge.

[01:29:01] Luke Storey: Yeah, easier said than done.

[01:29:04] Ellen Vora: Yeah.

[01:29:05] Luke Storey: But yeah, I mean, in recovery I've heard it called, I think, something like riding the tiger kind of thing with us. You're right. With abstinence-based stuff, it's just black or white, like you do that or you don't do that, that's how I am with alcohol and a number of different drugs. And when you get into sex, and food, and things that are kind of part of normal human life, it's much trickier. And the technology would definitely be that way. I don't know.

[01:29:30] I feel like I am finding, just as I become more aware of how habituated I've become and the negative impact, I am finding it a little easier to just kind of wean off, and it's not a black and white, on or off kind of thing, but for people whose livelihoods are more integrated with social media and things like that, like mine is, I mean, I could hire someone to do my own Instagram, so I just never—I mean, have people that help with it, that do some of the posts and stuff, but just to totally take my finger off that pulse and like have someone being me isn't—I don't know, it isn't logical. It's just like you can't do that, I don't know, maybe you can.

[01:30:16] Ellen Vora: I feel you. And I think social media not only is that how someone like us, like we're trying to understand the zeitgeist, and like where people at, and where is the suffering so that we can be of service to it. And it's also a rapidly evolving language that happens on social media, which is fascinating. I think it's kind of a beautiful aspect of the internet, is the way we kind of have an emergent language that changes constantly, but I think that we do want to at least, I think the term find our seat is helpful.

[01:30:48] And to me, that speaks to not needing the phone to be a distraction or to take us out of the moment. We approach it consciously, eyes wide open, wide awake, like I am going into Instagram right now in order to understand the zeitgeist, and to participate with whatever I've put out there and engage with comments, or whatever it is, but then if I have a moment where I'm bored, I'm on vacation, I'm sitting at dinner alone, I'm waiting for an elevator, whatever it is, we all have this reflex of just like, check it, and it instantly takes us out of the moment.

[01:31:23] And can we at least just like be curious about what does it feel like to sit in boredom, in stillness, in our feelings, in the absence of other things, and actually really relish that? To find your seat is also to sit in stillness and silence, is delicious. And we think like you have to fight willfully to not need this distraction in the phone, but actually, like there's something that feels really nice about being with ourselves.

[01:31:52] And we, of course, have to be comfortable with ourselves. We have to be able or willing to do some shadow work. We need to be able to sit in the middle of the storm of what comes up. I'm biased. I'm a psychiatrist. I'm like bring it on. But I think that maybe just as having a goal is running towards finding our seat and being able to be in stillness.

[01:32:11] Luke Storey: I like that approach, rather than having an aversion to the negative consequences and putting so much energy on what we don't want, is our attention being preoccupied with these devices, is like transposing that attention onto what we do want, which I actually did that this morning. I took the dog for a walk, and usually, I'm like, I got to put on a podcast. God forbid, it's silent for 10 minutes. It's like, really? How much can my brain take? All these conversations and I listen to podcasts all the time.

[01:32:42] But anyway, I was like, I'm just going to leave my phone in here, and it was really actually nice having that walk, and just like, oh, I heard a couple of birds, I would have never heard those birds if I was listening to some podcasts, like, no, I need more information. So, I like that. Like going toward what you want more so than trying to quit something, because then there's like that part of yourself that's like, I don't know, it feels good, I don't want to quit, it's like you don't want to be told what to do, that sort of defiance characteristic that many of us operate from will come up and it's like, I'm going to do what I want, man.

[01:33:13] Ellen Vora: And we were talking about this off the record earlier about how this has an impact on parenting. And I have a six-year-old daughter and I realize, like right now, her brain is pruning and growing, and it's doing the synaptic connections that wire her socially. And as her mom and the person she looks to constantly as a reference point of like, well, how do you react to this? Is this stranger safe? What do you think about this?

[01:33:37] Like she's constantly looking to me, and the best thing I could possibly do is be attuned to her. It doesn't have to be perfect. It just has to be good enough. But if I can be in the world physically with her, and attuned to what she's encountering and how she's reacting, it helps her wiring process and she learns how to pick up social cues appropriately. And I think part of what's happening right now, and I got the memo, I'm really trying, but I'll often notice that she's looking at me and I'm looking at my phone, and that little love triangle is not so good.

[01:34:09] And so, I think our kids are seeing these parents, it's got to do something to both their sense of worth and like how—like I heard this once, part of what we need to do as parents is let our children know that they're a miracle and teach them how to self-regulate. And I think that maybe you feel a little bit less like a miracle if your parent is like, yeah, yeah, you're great, but Instagram, that's got my attention.

[01:34:35] And so, I think we really want to be able to put our phones away when we're with our kids so that they can just see our face looking at them. I think it just needs to be that, that we're on the ground physically in the world with them. And I do not say this from a lofty seat of I do this exactly right, I notice how I do this exactly wrong a lot of the time, but I'm worried about the impact of it.

[01:34:58] Luke Storey: I like that. I'm going to put that in my box of tools for when I'm a parent. But actually, it's another good reason of that thing, going toward what you want, right? It's like you want to be present with your kid. There's just a part of your brain that like gets the sticky hits from your phone, but if you really are introspective, I'm sure you'd be like, oh, my God, this is so much more rewarding than this temporary little hit that I'm getting, just observing your daughter doing something for the first time or whatever, a beautiful interaction she has with another kid, or her curiosity, or whatever it could be is ultimately like so much more valuable. Yeah. Super cool. Okay. I want to talk a bit about, and then I swear I'll let you go, but you did it, you wrote this freaking textbook here. I mean, it's like there's so much information in this book that there's just a lot for me to go over.

[01:35:50] Ellen Vora: I had to cut like tens of thousands of words.

[01:35:52] Luke Storey: Did you really?

[01:35:52] Ellen Vora: Oh, yeah. 

[01:35:53] Luke Storey: Oh, yeah. I have a feeling I'm going to be that kind of a writer. I'm In the beginning stages of it and I can already see like, oh, you can't, that's too long, like my podcast often are. But I do want to cover, I think a good ending point would be sleep and within that blue light, because when you got to that in your book, I'm like, thank God, so many people kind of miss that point. It's just they think, oh, it's just a trend, people are hung up on the blue light, and I'm thinking, circadian biology is massive. This is a huge deal. And you also talk about getting in the sun safely.

[01:36:26] And I was like, alright, a woman after my own heart. I think that sleep is becoming more popular in the kind of health and wellness circles, which is very cool, but to your average person, it still sounds boring and something that does not warrant that much attention, focus, and determination. In my own life, being the age that I am, it is an extremely high priority, because when it's not, my life tanks. I cannot function without good quality sleep. How to sleep pertain to anxiety in our general sense of well-being, and what are some tips that you might give us, like you wrote in your book?

[01:37:05] Ellen Vora: Yeah. So, sleep is my absolute favorite thing to treat, partly because I really hold us to be self-evident that our bodies know how to sleep, they want to sleep, and the reason so many of us struggle to get enough sleep are these seemingly innocuous, subtle aspects of modern life that disrupt our circadian rhythm and make it hard for us to sleep deeply. And so, it just requires a little bit of an ancestral perspective of thinking, well, what are the conditions under which we evolved, and getting strategic about how our modern life is really divergent from that, and how can we sort of approximate that in modern life?

[01:37:41] And that's the whole idea. And I agree with you, like you see sleep specialists and all these experts, and they're very focused on like sleep hygiene, and cognitive behavioral therapy for insomnia with sleep restriction, and they sort of make sure that your sleep efficiency is better, and I don't know. I think it has its place, but it overlooks what, to me, is like right in front of our eyes, which is the modern environment has disrupted our circadian rhythm, and it, most of all, centers around light.

[01:38:10] That's where it starts. And the whole thing here is just that our body, evolution really kind of designed us pretty brilliantly to be like, how are we going to make the humans feel awake during the day, and tired at night, and whoever stood up in that boardroom and was like, should we use light? Because then, when it's light out, it's, by definition, daytime, and we can have cortisol be secreted, and make the humans feel awake and alert, and then when it's nighttime, it's going to be, by definition, dark. 

[01:38:37] And so, that darkness will suppress the cortisol, and allow the melatonin to be released, and then they'll feel sleepy, and they'll sleep deeply. I think that was a brilliant design. Bravo. Hats off. And I don't blame them for not anticipating the fact that we were ultimately going to invent the lightbulb, and then eventually Netflix, and eventually Tiger King, and nobody was ever going to sleep again. So, here we are, and our evening environment is what's most disparate from how we evolved.

[01:39:03] The morning is not amazing, either. Like if you are working from home and kind of in a windowless room during the day, that's also pretty disparate from how we evolved. We were outdoors in sunlight during the day. But the most stark contrast is what happens after sunset, where in the proverbial savannah of evolution, we were going to experience this transition of light, and then true darkness with the only interruptions to darkness basically being fire and moonlight, stars and maybe a little bio phosphorescence.

[01:39:32] So, here we are, and after sunset, it's a psychedelic light show, and we have the overhead lighting on, and now, it's LED lightbulbs, and we have the TV, and we share the couch with a laptop, and there's a spreadsheet open, and we bring our phones into the bed with us. So, we're surrounded by blue spectrum light and it's just tricking our poor little brains. The blue light goes through our eyeballs. It travels along the optic nerve to the suprachiasmatic nuclei in the brain, and it basically says, good morning, the sun is rising.

[01:40:01] And so, our brain thinks, okay, let me help out here, suppress the melatonin, release the cortisol, help us feel awake and alert, and meet the challenges of the day. And that's fine at 8:00 AM, and that's really problematic at 11:00 PM. And that's why so many of us struggle to feel sleepy at night to sleep deeply. And the solutions include anything from putting software on your computer screen like flux and night shift mode on the phone, but I think a much more impactful intervention, short of living off the grid and not having any artificial light after sunset is-

[01:40:33] Luke Storey: Going camping.

[01:40:34] Ellen Vora: Camping is a great reset, but I like blue-blocking glasses.

[01:40:38] Luke Storey: Me, too.

[01:40:38] Ellen Vora: I think that it's my favorite kind of intervention. It's something that is non-invasive, inexpensive, high-potential benefit. The only thing that's like that is the Squatty Potty, totally separate conversation, I like that, too. But basically, it makes sense that if we just block the blue spectrum light from getting into our eyeballs after sunset, it protects our melatonin release and protects our sleep. So, that intervention has made enormous impacts for so many of my patients and it helps them fall asleep at night.

[01:41:08] And I think that we have a cultural attitude around sleep right now, which is that if you have a mental health issue, if you have depression or anxiety, we see it as, well, I'm not sleeping, but it's the depression causing the insomnia, it's the anxiety causing the insomnia. And I don't deny that these issues do contribute, they play a role in how well we sleep, but even more undeniable is that the quality of our sleep plays a role in whether or not we'll manifest with depression or anxiety. Certainly, with bipolar. And so, sleep has an impact on absolutely every mental health condition, and it's the easier entry point.

[01:41:47] This is not seven years of therapy on the couch or a medication, this is just fixing our sleep. And so, if we can protect our body's ability to sleep well, sometimes, through an earlier bedtime to avoid getting overtired, sometimes, through blocking blue spectrum light, maybe making the bedroom colder or darker, maybe being a little bit more strategic about our relationship to caffeine, or alcohol, blood sugar, all of this can protect the quality of our sleep, magnesium has a role in there as well, and then we protect our sleep and a lot of our mental health issues improve.

[01:42:17] Luke Storey: I like that relationship between like which came first, the chicken or the egg, with the mental health issues and sleep, it's like the thing that came to mind was like when the town sheriff is after the town robber, but the town robber is the town sheriff. It's just like [making sounds] the cyclical thing that you're never going to get out of. And I'm so fanatical about blue light. Actually, I don't know if you know this, but I made my own blue-blocking eyewear line, because I mean, there are other great types out there, I just wanted super cool frames, so I did it myself.

[01:42:49] But that has had a huge impact not only on my sleep, but just, I would say, my wellbeing. I've been doing it for years, and pretty much, every night when the sun goes down, everything goes red and it's that way until I go to sleep. I've changed different light bulbs in my house, like in our new house, I paid extra money to put extra like one of those recessed lights in different rooms on two switches, so I have like the red switch and the blue switch, and I went pretty fanatical about it, because I don't always like to wear something on my face at night.

[01:43:19] It is kind of nice to just be able to have all orange or red lights on, too. But yeah, I can't emphasize this enough, and I'm glad when people like you—I mean, you're probably going to reach so many people with this book that are totally unaware of that or it's just kind of some fringe thing they saw like—because like Tom Ford and these major designers have like blue-blocking glasses, but they're kind of fake. They're still clear, they don't really block the right spectrum of light. So, that's an important part, too. Might help with computers and things, but not with sleep. So, thank you for including that. And also, the sleeping cold. Yeah, that was probably the number one thing that helped my sleep.

[01:43:57] Ellen Vora: It's not rocket science. This is all just trying to approximate the proverbial savannah of evolution. What did our genes evolve to expect, and that decrease, that drop in temperature that inevitably happens after the sun sets cues our circadian rhythm, it cues us to think like, okay, this is nighttime. And I love the data that shows that different remaining hunter-gatherer societies around the Earth that still exist in places like Venezuela and certain parts of Africa, they have somewhat of an agreed upon consensus bedtime. 

[01:44:28] And it's not because they're learning about it from each other, like they are literally off the grid, but it's around three hours after sunset. It's so interesting because it varies by geography and time of year, but it makes sense that the sun sets, you kind of have some time around the fire, there's a hearth, people connect, and eat, and celebrate, and then there's that drop in temperature, and it gets very dark, and it feels like it's time to go to bed.

[01:44:52] Luke Storey: Yeah, the thing I have is called an OOLER. They made the Chilipad, and then they made the OOLER. It's just a little more high tech. Dude, I've traveled with that thing, like I've packed it in suitcases, and it's a huge, heavy thing. I'm like, I went to Spain a few years ago, and it was a hot season there, and I'm like, there's no way the hotel is going to have cold enough AC for me, and I've brought it with me. I mean, that's how fanatical I am about it, but it really, really helps, especially if you run hot. I do a lot of ice baths, so I'm just always hot, I think, as a result.

[01:45:21] Ellen Vora: It's interesting. Heavy luggage is a small price to pay to keep your sleep going well when you travel. I bring a travel Squatty Potty, like digestion always get screwed up when I travel.

[01:45:31] Luke Storey: Do they like to fold up or-

[01:45:32] Ellen Vora: Yeah.

[01:45:32] Luke Storey: Oh, really? I didn't know that. That's a great idea. That's a great idea. I love the Squatty Potty, too. Okay. Well, listen, I think—I mean, Jesus, if we didn't—there were other things, okay, but we'll do another one. I don't want to exhaust you or the audience. I think my idea was to like, lay out the problem, and then kind of offer solutions, but I think within this conversation, you've illuminated many solutions and strategies for this thing that we face as a species, especially now. So, thank you so much for coming on to talk about your work and all the stuff that you've done. I think you're just amazing and brilliant, and I really appreciate you being here.

[01:46:09] Ellen Vora: Luke, thank you so much. Thank you for this gift of your podcast, too, which I think impacts so many, so beneficial. So, thanks. It's an honor to be here.

[01:46:17] Luke Storey: Yeah. I mean, what else am I going to do? I'm not a good enough guitarist to make a living at that, so I got to do something. I got one last question for you. Who have been three teachers or teachings that have influenced your life that you'd like to share with us?

[01:46:31] Ellen Vora: Oh, that's right. I meant to prepare this. Okay. So, let's think about it. I think that I might not even try for a cool answer, I'm going to probably just give you a true answer.

[01:46:42] Luke Storey: Good. Even better.

[01:46:43] Ellen Vora: So, I do think that—let me make one category of like Ram Dass, Alan Watts, even Michael Singer with Untethered Soul, like the people that actually got me to finally understand what it means to be present in this moment, and to be available for the present moment, and not miss it, and to connect to the fact that I am loving awareness, like I needed that spelled out for me with brilliant analogies and metaphors, and those three really got me there.

[01:47:19] And then, I owe a debt of gratitude to our national treasures of Glennon Doyle and Brene Brown, and I think that to help us understand the role of vulnerability and leading a wholehearted life, and to understand our conditioning that has kept us very tamed, especially for women. So, I've learned a lot from them. And then, here's like the least cool, but really true answer for me, is I actually really connect to Beyonce.

[01:47:49] Luke Storey: Really?

[01:47:50] Ellen Vora: I know it's a random one.

[01:47:51] Luke Storey: That's a first. Go on. I'm interested.

[01:47:53] Ellen Vora: But what I see when I see her perform is somebody that, basically, I think that she is so connected to the divine, and I think that she has figured out how to make herself a channel, and to let the miraculousness of divine source energy move through her and create art with it. And I really get inspired by that, through the whole like labor of love of writing this book, when I would get into the doldrums and the trenches, and just be like, I can't go on, I can't do this, I would just put on a Beyonce video and I would see how she channeled it, and I'd be inspired by that. 

[01:48:33] And I'd think there's something about this book that needs to be birthed, I feel like I'm the right combination of perspective, and background, and education to be the one to write this book, and so I just tried to open myself up and be a channel for what needs to be shared. And so, Beyonce really helped me get that, sort of that synaptic connection would happen when I'd be inspired by her.

[01:48:54] Luke Storey: I love it, and it's a novel answer, too. But I know what you mean. I have that experience with some artists, I'm super into music, and there are just certain people like a Stevie Ray Vaughan, for example. You're just like, this dude's not even human, like there's something supernatural going on here. It's that channeling sort of quality, or yeah, they practiced a little bit, and I'm sure she like does her vocal warm ups, but there's something else coming through. I appreciate that.

[01:49:23] Ellen Vora: There's a secret ingredient.

[01:49:24] Luke Storey: Yeah, there's a secret sauce that maybe they don't even know. And then, where can we find, obviously, The Anatomy of Anxiety, is your book? By the time that this podcast comes out, it will be out, I'm sure, where all books are sold, what about website, social media, anything else you want to share?

[01:49:40] Ellen Vora: My website is my name, ellenvora.com, and then I'm at Ellen Vora, MD, on all the different social platforms.

[01:49:46] Luke Storey: Awesome. Alright. Those listening, make sure to follow her. And with that, I'm going to let you go.

[01:49:52] Ellen Vora: Thank you, Luke.

[01:50:20] Luke Storey: Thanks for joining me.



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