I wrote an article about the supplements for TBI Recovery. But What supplements are useful if you have a TBI. Well I definitely recommend getting neurofeedback. 

But what can you do if you can’t get neurofeedback? It turns out there’s a lot you can do. Listen now to learn.

No one likes to have symptoms. When we do, we tend to pop a pill of some sort to keep them from bothering us. But what if healing crisis detox symptoms are a good thing? Today on Ask Dr Gil, I discuss the benefits of detox symptoms and why they are so useful for healing. Whether it is removing senescent cells, or cancer cells, healing crisis detox symptoms are telling us something about the body. We need to (within the best of our ability), allow the crisis to abate on its own as the body’s wisdom knows it needs to remove something. And some of the treatments available are discussed too.

Mitochondria Health Supplements are something very important to our health. But why? In this podcast, Dr Gil discusses the role of mitochondria, what they do in the body and what supplements are useful for helping one improve the health of mitochondria.

Good Energy is a new book out exploring the connection between health and diet. Why is it so amazing to believe there’s a connection? What we put into our bodies affects our overall health.  In this podcast, I’ll discuss what Dr. Casey Means has to say about diet as it relates to blood sugar and how that can affect one’s mental health. The interesting things are the connections between cortisol levels (which affects blood glucose) and other factors unrelated to diet (which also affects blood sugar levels.) I’ll discuss my own experience wearing a continuous blood sugar monitor.

—TRANSCRIPT—-

Recently, I read a new book called Good Energy by a Doctor Casey Means who is from Portland, Oregon. She’s an MD who writes about the surprising connection between food and health. Which if you followed me and followed anything about naturopathic medicine, you would know that there’s no surprise about it. But let’s talk about what she has to say in the book because I actually think she makes some great points and it’s a very interesting topic. Today on Ask Dr Gil, we’re gonna talk a little bit about one aspect of the book, which has to do with blood sugar. So stay tuned.

Hello, and welcome to Ask Dr. Gil. I’m your host, Dr. Gil Winkleman. And today, I want to talk about one aspect of Dr. Means book, Good Energy, I actually think it was a really good read. And interestingly enough, I have a MD physician here that I see mostly to order blood work and that sort of thing. And he said, “yeah, that’s a good book. I ordered it. I I wanna take a look at it. I never learned anything about nutrition and medical school. “

And it’s kind of amazing when you think about it. I mean, I would argue that people know more about what gasoline to use in their car and what motor oil to use in their car as a rule in the United States than they do about what they should put in their body. And I want to talk about one aspect of the book because the book covers more stuff than I have topics and time to cover in in one podcast. And because she goes through a lot of different things. And I’ll I’ll give you a quick overview. So she talks about over nutrition, nutrient deficiency, microbiome issues.

In other words, how do you how does your gut flora work in the body? She talks about stress, exercise, the effects of medication and drugs on the mitochondria in particular, but on the body in general, sleep issues, light issues in terms of disrupting your circadian rhythms, not getting varying temperatures, which if you think about this for a minute, it’s about the ice baths and not necessarily to that extreme hot and cold therapy and environmental toxins as well. Now all of this is stuff that I talk about in my practice, not necessarily I haven’t covered everything in the podcast, but but I do want to talk about the metabolic syndrome aspects because I think that’s such a big part of American society in terms of the problems. And I’ll talk in the second half of the show about my experience wearing a glucose monitor, a continuous glucose monitor, which I tried as a result of reading this book. It was just an interesting exercise for me to kind of learn how my blood sugar goes up and down with certain things that I eat and drink and Some of the stuff wasn’t surprising and some of it was very surprising.

So we’ll get to that in a minute. But in terms of biomarkers, she talks about in the book. She talks about triglycerides and HDL and that and that they should be low, lower than one hundred, but almost equal. And this is something that you can easily get tested by your physician because it’s they’re both part of what’s called a lipid panel where they do total cholesterol. Now total cholesterol by itself is probably not very useful.

And, you know, obviously, if it’s super high or super low, that’s important to know. But generally, most physicians just look at, well, what’s your total cholesterol? Oh, it’s two hundred or two fifty. That’s high in their view, because now anything above one hundred and fifty is high. And really, you want to look at the HDL, which is the good cholesterol, and you want to make sure that that number is pretty high.

You know, approaching a hundred, although not necessarily that high, but around eighty or ninety and that your triglycerides are below that number. And so that gives us a good indication of how your body is handling fat in a sense. So and then the other numbers are the fasting glucose. You can also have fasting insulin, which is an important one, Generally, that is not ordered as standard blood work. But having that number can be helpful in terms of prediabetes.

Fasting glucose is important, though by itself, it doesn’t tell us as much as one number high fasting isn’t necessarily going to tell us as much as a hemoglobin A1C Then the other the other factors to keep in mind is making sure that your blood pressure is below one hundred and twenty over eighty, and that will stretch with age, just so you know. But you and when you take it you want to make sure that you’ve kind of rested for a minute, relaxed that your arm’s in the right position depending on if you’re using a wrist cuff or a shoulder or an upper arm cuff. And then the last one is your way of circumference. So she talks about these in terms of understanding aspects of blood sugar regulation. And It’s interesting because now the piece that I’m gonna talk about right now is still I don’t wanna say controversial, but there’s definitely evidence to support this, but it hasn’t become part of sort of mainstream scientific dogma, which is that Alzheimer and dementia may be what they’re calling now type three diabetes.

Meaning that the that the brain isn’t getting enough blood sugar and sugar into it because it’s been overloaded with sugar over a certain amount of time. And as a result of that, that’s what’s causing the destruction of the neural connections. And this is an interesting aspect of things because We, you know, some of these people that have Alzheimer’s or dementia had no issues in terms of looking at their blood sugar levels. They weren’t diabetic or so forth. And Obviously, diabetes type two and type one type one generally you’re born with.

Type two, we know this is an issue. We know this is causing problems in the body. It’s affecting people’s energy. It’s affecting people’s weight. It makes it difficult to function in the world without treatment because your body gets overwhelmed.

And and so that is clearly an issue, but this other one may be an issue that we don’t even realize because we don’t have tests for it yet by itself. So I want to, in the second half of the show, talk more about what to do to make your body healthier in terms of eating and blood sugar and so forth. So stay tuned and we’ll talk about this in the second half. Hello, and welcome back to Ask Dr. Gil.

I’m Dr. Gil Winkleman. And just as a reminder, if you like this episode or any other episode, please give us a thumbs up or a like or whatever platform you’re looking you’re listening to this on if you would give us a like on it. If you have comments, there you can make comments on the YouTube channel or on my website, and I will get notified about that. And if you just have questions and you just want to email me, you can send an email to info infoask doctor Gil dot com, a s k d r g I l dot com.

I also have a form on my website if you want to find out about scheduling and and working with me because that makes it easier. It’s nice because I’d asked for your time zone which makes things easier for me. To figure out timing. So, alright. So, we’ve been talking about Dr.

Means book, Good Energy. I really have enjoyed it and I do recommend it So the blood sugar aspects are really interesting. In terms of And I mentioned at the beginning of the show that I wore a glucose monitor, I did it for two weeks. It’s a continuous glucose monitor Generally, you need a diagnosis of diabetes to even order them. There’s a couple of companies now that are offering it to people without diagnosis.

It’s around one hundred dollars for the month. And you don’t necessarily need to do it continuously. In fact, I did it for two weeks and gave the other monitor. It comes with two monitors that last about fourteen days. So I gave one to my daughter just so that she could check it out and try it.

She was interested. And and mostly because I I got the information that I wanted. And it was really interesting because when I did it, I was actually traveling. And so I was on vacation and not really trying to eat well necessarily. And what was surprising was that the food so it was eating out a lot more than I normally do, And so the things that I expected to spike my glucose often didn’t and the things that I didn’t expect did, so let me give you a couple of of examples and then I’ll kind of pair this with what Dr.

Means talks about in the book. So one of the things that was interesting is she talks about eating low glycemic foods first. And meaning, you have protein first than complex carbs, than simple carbs. And part of that is is that your body has something to absorb the sugar with in in in a sense. It’s not so much absorbing, but in terms of absorbing the spike of the sugar.

So give you an example. So I went for Mexican food at this it’s a high end Mexican place and ordered a what’s called the skinny margarita, so it’s a low sugar margarita, and had chips and guac. And was expecting my blood sugar to spike and actually it dropped. And my theory on this is that the the alcohol helped reduce my stress. Which then lowered by cortisol, which then allowed for less spiking of glucose.

And part of the reason that I say this is I noticed this happened whenever I had alcohol. Now, I do not necessarily say you should be drinking alcohol, but it may explain some of the research that suggests that one drink a day may be useful for overall health. And this research comes from research on blue zones. And I may do a podcast about that. At some point, the blue zones are the areas in the world where there are the highest number of people living over a hundred.

And there’s six there’s now six. Singapore interestingly just joined this as a blue zone. And they, as a government, decided to make a concerted effort to increase longevity, and we’re able to pull that off. That is a whole other topic, but was very interesting. And it wasn’t just longevity, it’s quality of life.

So with blue zone briefly alcohol is consumed by all but one of the areas in moderate amounts. So moderate is less than two glasses of wine or two drinks per day. It’s usually wine in all of these areas, not hard alcohol and not beer. So and and wine definitely has nutrients in it that are good for our bodies. It may be part of the connection between diet and mental health.

I mean, respiratory, or trauma, and so forth, And one could argue that you can get that from other sources and and that can help. And also you can have other ways of relaxing yourself to lower your cortisol. So that’s why the research on the alcohol may be a little mushy, but it was interesting because this is not like these areas. They’re not like super health focused per se. It’s not like they’re you know, only eating certain things and and so forth.

But that’s another topic we can talk about. So I would say though that what was interesting and and so the alcohol aspect on my trip was very consistent when I got back. I was I was exercising and I noticed my blood sugar spiked during that time. So which would also track with cortisol levels because as cortisol goes up, An exercise member we talked about fight flight in the Polyvago theory podcast. With fight or flight, you’re raising cortisol, so you can act.

So you want more blood blood sugar, to be higher. And so but you don’t want that happening when you’re eating necessarily or even after you’re eating because you wanna you wanna keep keep things steady. Part of the issue with the body is that it’s not that your blood sugar goes up after you eat. That isn’t necessarily the issue. The issue is is that it goes up either too quickly and or too high, and or it takes a long time for it to come down.

And the reason is is that as the blood sugar stays high for longer periods, the pancreas has to pump out more insulin which then creates stress on the pancreas over time, and it wears out, which is why people get type two diabetes. So that’s one of the aspects of it. And what I found was, is that my glucose would generally come back down pretty quickly. The the the two exceptions would be having too much dessert. So eating more than say three bites of ice cream, in my case, was interesting.

And and I think about doctor Dean Ornish’s DASH diet, and he talks about having one spoonful of hugging does. And this is a guy who his fash diet is developed for heart conditions. So it’s kind of interesting. And when you when I thought about that, I thought about that when I I had a a bite of ice cream and it was it was like yeah, I I understand why people want more because of that dopamine aspect in terms of the sugar. And I also saw, wow, if I only had one bite or two bites, my blood sugar actually didn’t go up that much.

But once I went beyond that, then that’s what I would see the spikes. The other the other aspect of things is the liquid sugar. And there was something I had that was an energy type drink, but I don’t remember what it was. And I noticed, oh, I remember now. I had a it was a different Mexican place, a Hamica.

It’s like a Hibiscus Lemonade type thing. And I saw my blood sugar go as that was the highest it went during the two weeks. And it was really interesting because it’s like, oh, this is where things get really off in in people’s bodies. And soda, if you think about soda, you think about sugar and energy drinks, any of those things can definitely create spikes up and downs in the body in terms of blood sugar, and that’s really putting a lot of stress on your pancreas. So if you get one thing from this episode, that is if you eat drink sugary drinks to stop and that would include straight kombucha even though it’s, you know, it’s only seventy calories per bottle, there still can be fourteen grams of sugar in there.

And if you’re if you’re drinking, if you like drinking kombucha, either switch to a brand with less sugar or dilute it greatly and don’t drink as much, you know, drink one bottle over the course of three or four days type thing. Because it’s way too much sugar for our systems. So now the other things that we’re interesting in terms of of eating and so forth is that she talks about and I think is helpful is tightening your eating window. In other words, having the bulk of your calories between, say, eleven AM and six PM. And it’s interesting because I was in New York and most people don’t eat dinner until, like, seven or eight there because they’re at work and doing stuff.

But it definitely helps to to have a narrower window. And the reason I say those hours, although those hours aren’t necessarily magical, is because the the Later you eat, you want three hours between the time you finish eating and the time you go to bed. To allow the body to settle down, to allow digestion to happen, and it just helps your sleep be better. So if you’re trying to change your, you know, get eight hours of sleep and follow the sun to a certain degree, that’s why you need to stop eating by six or or in some cases seven. You know, one of the things that’s interesting is is that in Hawaii, Generally, people do go to bed with sun down and get up, at sunrise, at least the people I know, and part of that is is they’re did not sun down, but a few hours after sun down.

It it has to do with the culture. Like, people are active, they use they use the day to do things, either exercise work, and so forth. And and it’s less of a nights place than say New York City. Where people are up at all hours of the night. And it really is the city that never sleeps.

And and there’s always something happening, but that isn’t necessarily good for your system. So Okay. So a couple of other things to think about in terms of eating. Adding fiber is really important because it slows digestion, vinegar, cinnamon, chromium, those can change glucose responses so that you don’t have as much spiking of of the glucose. And the other thing that’s really important is a light exercise after eating.

And Generally, it’s it’s a slow walk. So taking a walk after you eat and I and I was able to observe this for myself was that when I took a little walk And no more than thirty minutes, but ten to thirty minutes after a meal, that helped lower my blood sugar as well. And you don’t want to overdo it. Like, you want your body to be in the rest digest mode, And so it’s not a workout. It’s more of a stroll.

That’s kind of the approach that you want to take. So there’s a lot more in this topic that we could talk about, and I may add some other stuff because she talks about mitochondrial issues, she talks about sleep, stress management. The mitochondria is an interesting topic, and I may do a separate podcast about that. But I do have a course related to mitochondria and mental health. And it covers a lot of different aspects of mental health, including methylation, which vitamins to take diet and the role of testing.

And if you want more information about that, you can check out my website, w w w dot askdoctor Gil dot com. And I have a link to it at the top in the courses. Finally, if you enjoyed this, please feel free to make a comment or like it on YouTube or Apple’s podcast, or Spotify, wherever you’re listening to this. And I look forward to connecting in the next episode, so take care.

In this episode, Dr. Gil explores what makes a good doctor patient relationship. We explore how the importance of trust, and how each person is an expert in the room. Finally, Dr. Gil discusses SEAMMS, a handy short-hand to understand your symptoms and your body.

The doctor patient relationship Transcript

Doctor Patient Relationship Full Episode (New Transcription)

On a previous addition of Ask Dr. Gil, I pose the question what makes a good doctor. I want to rephrase the question and ask it slightly differently, which is what makes a good doctor patient relationship  or doctor client relationship.

On today’s episode of Ask Dr. Gil, I want to explore some of the issues that help the relationship aspects of healing. So stay tuned.

Hello, and welcome to Ask Dr. Gil. I’m Dr. Gil Winkleman. And on today’s podcast, I want to explore some of the issues related to healing as it relates to relationship of the clinician and the patient. And I want to start by sort of discussing the whole doctor patient paradigm, because in some ways, there are power dynamics involved with this that may interfere with the ability for someone to get better. How do we approach this? Because there’s two experts in the room when we’re dealing with a doctor patient relationship in a sense.
The doctor is the expert ideally on medical knowledge, physiology, and if they’re holistic diet, vitamins, etcetera, herbal, herbal remedies and so forth. The patient is the expert on themselves, hopefully. And that’s the dynamic. Right? I mean, I have hundreds, thousands of patients over the course of twenty plus years of practice, and I understand the body in a general sense.
I can identify things. I understand if you’re having x, y, or z symptoms, it may be coming from one of a few places. But I don’t understand necessarily the person specifically. And that requires time because I don’t know, you know, someone after one or two visits, it takes a while. And from my own self, personally, So part of where this comes from, this this talk is is I have my own physician, Dr. Thom.
There’s some videos of him on my YouTube channel in case you’re curious about him. And they’re very old and and very early 2000s. But, you know, what’s interesting about my relationship with him is that I’ve been working with him for over twenty years. He’s been a mentor to me and my personal physican. He’s seen me go through lots of things in my lives, you know, my life. He’s seen me go through medical school. He’s seen me start up practice, he seen me have my children and move and all this other stuff that I’ve done.
And he knows me when I say I feel really stressed, he knows that’s serious because generally I’m not particularly stressed. I’m pretty calm, easy going person. So it’s it’s an interesting aspect, which if he didn’t know me that well, he wouldn’t, when I say something, he wouldn’t necessarily know how to interpret that. And, you know, the thing about this is, is that patients tell us things in the you know, in the intake. And and we understand certain aspects of that.
Right? But there are gaps in that. Right? There’s gaps. First of all, they can’t tell us everything in the first visit.
That’s first off. And that’s just a function of time. Right? You know, I mean, there’s aspects of things that there’s a focus. We’re focusing on certain things.
But what’s interesting to me is sometimes there are things that are not said, at least at the beginning, that are actually very pertinent to the case, but then come out later. Patients who have trauma, you know, I’ve had patients who I’ve worked with for a long time. And I have this by the way in my intake forums, but not everyone shares that. And I think some of that has to do with trust.
Right? It’s like they don’t know me either, so they don’t know what they can reveal or not reveal. So some of that requires time. For both sides. It requires time for them to say, to feel comfortable with me and say, yeah, I can share this with Dr.
Gil, or whichever doctor. And I think that that aspect of things is is also really important in terms of of a time function. The other interesting thing, and and I don’t really have an answer to this. And we’ll talk a little bit more in the second half of the program about themes which are important for understanding the body’s health in a general sense. But oftentimes, patients don’t know what is pertinent.
And by the way, that’s sometimes true for the doctor as well. But, you know, for example, I have patients who have environmental illness or environmentally based illness and don’t understand the fact that they work in an industry where they’re breathing in a lot of heavy metals, for example, is causing their illness. And so knowing that and you could say, yeah, it’s up to the doctor to ask that question. I I don’t disagree with that, but and and I’m using this as a a pretty obvious example. But there are subtle ones that show up where a patient will say something to me over time and I’ll be like, wait a minute.
Maybe these symptoms are coming from that. And it’s never easy to figure that out. So now the other piece about the doctor patient relationship that’s interesting is that sometimes patients say things that doctors don’t want to hear, like they’re not feeling better after they took x, y, or z. And and doctors say things that patients don’t wanna hear, like, you need to eat less sugar or the inflammation in your body is being caused by your diet, or you need to go to bed earlier, whatever it is, you know. And these are the things that are really interesting.
And in terms of how do people navigate that relationship? So, now, there’s really no easy answer to this. This is also another aspect of where the trust comes in because as I get to know patients better, I trust that they’re going to share the pertinent information with me. And as they get to know me better, they trust that what I’m telling them is going to help them feel better. And the challenges is sometimes this doesn’t happen right away.
You know, because because if you think about it, to get into if you have a chronic illness, to get into that state, it took more than a year for that to happen. So it’s gonna take time for it to unwind. And that’s kind of the piece to this that’s important. So we’re gonna take a quick break and in the second half of the show, what I want to really discuss is the seams. Which is a system of sort of evaluating patients.
And I think it’s important I share this with you because this is something that you can use to help yourself communicate with your physician. So stay tuned. Hello, and welcome back to Ask doctor Gil. I’m doctor Gil Winkleman. And today, we’re talking about therapeutic relationships.
And what makes a good doctor and what makes a good patient. So if you have any questions, please feel free to email me at infoasdrgill dot com, that’s I n f oas k d r g I l dot com. You can also put comments in the section if you happen to be watching this either on my website or YouTube or somewhere that takes comments. So there’s a number of factors here that we sort of have touched on, but we’d like to cover in more detail. And the first is looking at symptoms because it’s very important to understand what is going on in your body that you can then let your doctor know, which will then be useful to help figure out what’s going on.
And if there’s one thing you get out of the good doctor aspect is, in my opinion, thinking holistically. And I think one of the issues in medicine today is that we don’t have gatekeepers who are thinking in the broad scope. They’re really the problem big problem in the United States at least is we have very much overworked primary care providers that are trying to get through as many patients as possible in a short amount of time that they have. And it’s difficult to get in to see them. And I’ve had a number of patients who have expressed frustration in terms of finding a good primary care doctor to order tests or refer them to a specialist or something to that effect.
And they’re just not enough of them. A, and B, the ones that we have don’t have the time to really delve into the big picture of what’s going on with the patient. And it’s very much a very surface sort of approach. And there and I’ll do a podcast about nutrition in the coming weeks, but one of the things that’s very clear is a lot of health problems start with a bad diet. And this is something that isn’t addressed in the primary care realm.
So that’s kind of piece of it. And I’m going to talk about symptoms a minute, but before I say that, it’s part of the issue that I’ve seen in healthcare is that patients don’t necessarily trust their physicians. And part of that is that mainstream medicine has been falling down, I would say, in many ways. And those are the people that come see me So there’s that. But also, I think trust needs to be earned and it takes time.
And this goes back to the relationship aspect of things in terms of what makes a good therapeutic relationship, and I do think trust is a big part of that. And Sometimes, trust is earned quickly and sometimes it just takes time. And, you know, one of the things that I do appreciate about the holistic approach to treatment is most of the time, not all the time, but most of the time the side effects are lower as well as less long term. And I talked a little bit about this in my neurofeedback podcast, I think, but you know, when when you treat someone using neurofeedback for example, that and you hit the wrong point as it were, the problem lasts for a day or two and then it goes away. And it’s not permanent.
And I’ve been working with people lately who have had very severe issues with pharmaceutical agents from Cipro that’s a big one. I may do a podcast about that as well because that’s an interesting one where it’s called getting flocks and there’s a couple of books out about this and what to do about it. But it’s basically an overwhelming of the inflammatory systems in the body. But also, psychotropic drugs such as well butrin and Prozac’s lexipro people of having bad reaction to those medications. And those are more long lasting.
And so that can lead to a mistrust. And it’s not necessarily the doctors fault per se. This is just the model that they’re in. So So that’s kind of piece of it. Now, here’s the thing that I’m going to tell you that can help you get healthier, faster, or at least have a better relationship with your doctor.
And that is to be able to understand your own symptoms. And so what I do is look at it from this place, I call it, the seams, sleep, energy appetite, which includes digestion, mencies if you’re a woman, musculoskeletal issues and sense of well-being. So those are, it’s s e a m m s. And knowing what your score is in all of those, will give us a determination of your overall health. Now the add on to that would be for extra credit is if you have a continuous glucose or labs can add on to that.
But labs are only part of the picture and the continuous glucose monitors are an issue because they’re not always accurate. I actually had a conversation with a patient about this recently and she said she’s been taking her she uses a GCM, and she takes her insulin tests anyway because it’s often wrong, the GCM. So, you know, and I bring up glucose because that’s related to both appetite and energy. And if your energy drops suddenly, that could be because your blood sugar isn’t being controlled and regulated properly. I mean, there are other factors with that.
But understanding your energy Do you have crashes at certain times of the day? Do you need to eat constantly those sorts of things? Sleep? Are you getting enough, you know, seven to nine hours a night? If you’re an adult, your appetite is do you have a good appetite?
Do you have good digestion? Are you having regular bowel movements? You know, Menses? Are they are you Menses are regular heavy flow, light flow? Do they alternate?
Do you have periods intermittent spotting? Those are sorts of the sorts of things that are important. Musculoskeletal. Do you just pop out of bed? Or do you have aches and pain?
Are you stiff in the morning? Do you find that if you just lift your arm or do something funny, your your backs out for a week? Those sorts of, you know, that sort of thing. And then sense of well-being is a really interesting one because that’s one that I definitely think most doctors do not ask about. And I’ve had patients who kind of like their seams were fine and then but they they kind of have this funny feeling in there.
Oh, and mood, that’s the other one. There’s two m’s in there. So mood is the other one. And But but mood and sense of well-being are not necessarily the same thing, but they’re kind of related. So mood is your emotional state.
Sense of well-being is sort of your spiritual state. And just feeling like you’re on the right path in life, that sort of thing. So people, you know, sometimes when your mood drops, or if you’re depressed, that can be a sign of inflammation. And these are the things that are important to talk about with your physician. And of course, this is why the relationship is so important.
And sometimes it seems like when there’s clinical relationship like this, it can look like two people just talking. Right? It doesn’t If I could tell you about conversations that I have witnessed between doctors and patients, over the years in my observational studies when I was in medical school and stuff, they they often aren’t necessarily around physical symptoms. And what was interesting about this is that, you know, clearly, there is rapport there and and a sense of of camaraderie, and I talked a little bit about this I’ll talk about this now is that it’s not necessarily that we want to be the expert as a physician because it’s just two people hanging out. And the person who is the on the physician role, I’ll just say it that way, will observe certain things and be able to sort of make inferences from that, and then kind of help the patient move forward in whatever way that is necessary.
So this is an intangible aspect of the healing relationship. And it’s, you know, it’s like talking to a friend about a situation that’s going on and then feeling better. And it but it’s not necessarily about the content. It’s about the connection. And this is the other piece that I think is underrated in healthcare.
Because and we’re the rushed visits trying to get through in a six minute, I think that’s the average still. Six minute session with the patient patients who feel hurt, and I’m guessing that’s part of what’s been going on here in for many people who have been coming to me. And the problem is that there’s not enough doctors doing this. Right? And the other thing in terms of the therapeutic relationship, I will say, is that sometimes healing takes time.
And it’s not like the symptoms that you have if you have a chronic illness showed up overnight in most cases. It has been something that has been building over time. And so the solution is also not going to happen overnight in most cases. Not that it doesn’t happen. Spontaneous healing does happen, but it’s not common.
And and so understanding that and understanding that this is a journey will also make the therapeutic relationship go better because then there’s less pressure on the physician to find the answer, fix it, and determine what’s going on right away. Because that’s a lot of pressure to put on somebody. Right? I mean, certainly, there is a path and most holistic doctors that I talk to will understand what the path is if they’re intelligent and good doctor. But they also understand that it’s not going to happen overnight.
And I think the role, the person in the patient role is important for them to understand that. And sometimes the doctor doesn’t communicate that very well. That’s the and this is the challenge. This is always the challenge. And communication is always an issue in healthcare because usually when the person is coming to a physician there is a level of stress and their ability to hear what the doctors saying to them sometimes is for lack of better way of saying this impaired, because there’s a stress level involved with this.
Right? I mean, it’s not easy to tell someone else about what is going on with you. Sometimes it’s embarrassing, sometimes it’s uncomfortable. Some sometimes you’re scared because you’re worried that it’s something serious. So that’s part of the issue and the challenge with with this.
So Alright. So hopefully you enjoyed that. If you have any questions or comments, please feel free to leave it on the podcast page or YouTube depending on how you’re viewing this. I also if you have questions, feel free to send me an email at info at doctor Gil dot com or check out my website, askdrgil.com. And I look forward to seeing you in the next episode.
Thanks so much and have a great rest of your day.

Mindbody Healing is such an important topic in holistic health. But how does one get there. In today’s podcast episode, we look at polyvagal theory as it relates to therapy.

TRANSCRIPT

Last week, I did a podcast on Polyvigal Theory and I received some questions and comments about it related to therapy, today on Ask Dr
Gil, I want to go through the issues with polyvagal theory as it relates to therapy
So stay tuned
Hello, and welcome to Ask Dr Gil
I’m Dr
Gil Winkleman
And today on the podcast
I wanna go back through some of the Polyvago theory information
And this is just audio this time
There’s less visuals today
So but I wanted to kind of clarify something about what I said to start
And by the way, if you have questions or comments, feel free to send them to info info info at ask doctor Gil dot com, a s k d r g I l dot com
And I try and get back to people in a relatively timely manner
But what I noticed with this comment from people is they were asked seeing whether therapy is useful or not, because of something I had said during the podcast
And what I want to clarify is, yes, therapy is absolutely useful
And very important I think for healing for a lot of people even with trauma or non trauma situations
I think therapy can be useful to just get third party voice in our lives and understanding where there are issues and problems in the situations that are going on
But I think that what we see with I think that what can be confusing is understanding what constitutes healing as it relates to psychotherapy? And I’m actually gonna do another podcast about this in terms of what makes a good doctor, which I’ll probably do next week
This is a question though in terms of therapy that knowing and remembering something may or may not be helpful in terms of healing
And I think that’s the point I was trying to make last week because when there’s trauma, remembering the trauma can actually be more traumatizing to a person
Now, sometimes it is useful in terms of understanding what had happened to us
So for example, if you don’t remember that your father dropped you on your head when you were six
I’m just using a benign and or not some benign example
That remembering that can be useful from the standpoint of understanding that it was an accident
And so then you can have compassion for your father as opposed to thinking he did it on purpose
And I’m using a somewhat tried example just to be obvious about this
Because there’s always shades of subtlety in these situations
In But in terms of the neurology and the nervous system, remembering that may not have the impact that we would think it would have based on what modern culture is saying about psychotherapy
I mean, think about how many programs you’ve watched where people have memories of something, and that memory cures them
And maybe that’s true and maybe it’s not
And I think the the point is in terms from a neurological perspective, it’s allowing the body to reset itself that is what will allow the healing to occur
If that happens through the memory and and a recall of the event, so be it
Right? But in terms of what I’ve seen with Polyvago theory treatments, it’s more about allowing the nervous system to reset
And that is not necessary necessarily related to having a memory of an event
So for example, Peter Levinean is I think it’s in his book waking the tiger he talks about a a man he worked with who had been attacked by dogs when he was like seven years old
And in the real event, the dogs rip his pants, which is which is an important cultural fact in terms of this case because there was she related to that because they were new and it happened to be a piece of the culture
They were part of his right of passage, I believe
And he remembered his father being angry
And when he went through the event with doctor Levin, it he realizes his father was angry because the dogs attacked him
So that’s a situation where a memory can be useful remembering the event
But the healing according to doctor Levin happened when the man felt the rage that he had been holding onto as a result of the dogs attacking him
These were a pack of stray dogs
And fortunately, he had been rescued and not eaten alive in the situation
And and so he had been in a fight, flight mode
And and then when the dogs chase them down, he goes into freeze mode, not unusual, particularly for a child
In the recollection of the event with doctor Levin
And I want to be clear, the event memory was not necessary for the healing
And it’s just this case happened to have both
He felt the rage, he felt the desire to fight, and he felt the desire to flee
And I think those pieces are important as part of the healing process
So it’s it’s the parts of that that were allowing for the this man to heal And he felt the rage
He firm firmly felt the rage
And he firmly felt the flight as well
So we’re gonna take a quick break
And on the other end of the break, I’m gonna go into more detail about how the body releases this trauma or at least how we think it releases this trauma
So stay tuned
Welcome back
I’m Dr
Gil Winkelman, and this is Ask Dr Gil the podcast
And today, we’re talking about polyvagile theory and psychotherapy and different ways to treat the nervous system
And the thing about the case that I was talking about that was interesting is the way this is described
And by the way, I’ve seen this with patients as well
Is that when one is in a state of fight or flight and it goes into freeze, the healing happens when you can release the freeze and feel the fight flight response
And that allows for the system to reset
Because what’s happening otherwise is that you’re in a state of both fight and flight, fight fight and freeze at the same time
And it can look like you can’t respond to events and that you’re in a parasympathetic mode
But really, you’re in a a mode where you’re stuck
And so in this case with this man who had been chased by dogs, he started shaking
And he shook for you know, I don’t actually don’t know, but I’m gonna guess at least thirty to sixty minutes
Doctor Levin described something he he had handed the patient a role of paper towels which he tore in half
Which is an incredible feat of strength, but also it just shows the level of rage this person was holding on to as a result of this situation
And before this session, he was unable to really move forward with his life, which is no wonder he was stuck
So this is where I think the therapy require some kind of somatic work to be able to engage with that sense and then release it
Now, this is an issue and you may be wondering this
How does one get in contact with that feeling when they’re disconnected? And this is the magic of psychotherapy
This is where a good psychotherapist can definitely help
And there are techniques to do this, by the way, some of which work for some people and others work for other people
And if you were to ask me, hey, do you think this will work for me? The answer is going to be, I don’t know
Because clearly, there is a lack of understanding in terms of what therapies work for who win
And sometimes therapies work for someone at a particular time in their life and not at another time
So what are some of these therapies? Well, neurofeedback is one of them
I’ve talked about neurofeedback in previous podcasts
Basically, in the therapy, the practitioner hooks the person up to electrodes
It’s usually it’s touching parts of their head, sometimes it’s the ears
And and there are different types of neurofeedback
But basically, there is either signals going to the brain or there is a reward system to the brain to be in a particular state
And The thing about neurofeedback is that certain types of neurofeedback, I won’t say all of them, but certain types of neurofeedback are helping the body release the stuckness, if you will, in the nervous system
But it’s doing it at the neuronal level
And so it’s going from almost like a top down perspective, if you will
Now there’s also heart rate variability training, heart, mouth
I believe I’ve done a podcast on that
That’s kind of going from a bottom up perspective in a sense because you’re calming the heart space down
Now, What’s interesting about that is as we slow down, a lot of times the sensations start to come to us
And that’s where a somatic therapy would work from is that it’s gonna work on helping you be in your body and experiencing what it is that you are feeling in this moment
So for example, if you have, say, I’ll use a personal example
I had tightness in my shoulder, and it came on from actually, it came on after a long airplane flight
But I surf a lot so I could have had shoulder tightness
Well, as I allowed that to let go, I felt this sense of that I was raising my shoulder to protect my neck
And and so I I felt into that
And it’s you know, this is not an intellectual process, just so so we’re clear
So I just felt the feeling of protection in my body
And so eventually that let go
And and sometimes it will move to another part of the body, you know
It could have moved down my arm
And so then I would feel that
So it’s an experience of what am I feeling right now in my body? And I don’t push it away and I don’t try and make it go away
I don’t try and I don’t judge it
I don’t do anything except observe it and allow it to be there
And as you observe, something shifts and that shift is what you’re looking for
Now, I’ve had patients who’ve done this and they break in tears as a result of that
And one of the somatic therapies, by the way, is trauma and informed yoga
A lot of times there’s a yin yoga aspect to this where you’re holding poses for a long time
And particularly when when you get into the hips, because people store a lot of emotion in their hips and their pelvis, people will break down crying in the middle of a class
And I say this not because it’s a bad thing
I say this because oftentimes people are afraid of feeling the experience or breaking down in front of other people
And so be aware that that is a possibility that that can happen
And there are other forms of therapy real quick that I will talk about brain spotting in EMDR, which are kind of related, but they’re using the eye movements and the position of the eyes to access the experience and the feeling
So if you look up and to the right, for example, that will give you insight and memory into a particular place, whereas looking down into the left may give you a different experience
It’s not so much that you’re trying to figure out where a particular memory is as much as what’s going on in that moment when you look in that particular direction
And EMDR is a little different in that
It’s a little more guided, there’s definitely more structure to the EMDR situation
So anyway, I hope this is helpful to help you understand and I guess if I would say if there’s one thing about polyvagal theory and somatic therapies that you get, it’s understanding that the body can go into a freeze mode and that freeze mode usually is preceded by a sympathetic dominance of fight flight event
And after that, you are still in the fight flight experience, even though you aren’t experiencing yourself as in fight or flight, you’re experiencing yourself as seemingly relaxed, but it’s really freeze
And one of the things about freeze mode, I didn’t mention earlier or in the other podcast is that a lot of times when we go into freeze mode, we’re releasing a lot of indoor phones and natural opiates because that’s how our body the mode is designed to make us not realize what is happening
It’s a dissociative event
And so you can have the really good feelings related to that, but you are actually dissociated from yourself
And so the question then is how do you come back into it? And that’s where the somatic therapies
That’s where a good somatic therapist will have you sit, be in your body, experience what it is that you need to experience in that moment
So I I hope this is helpful
And if you have questions or comments again, please feel free to reach out
It’s at info at us doctor gail dot com
And remember that I have the course on my website at askdrgil.com which doesn’t so much go into this other than to talk about the physiology because this issue with the fight flight freeze is affecting inflammation, nephylation, mitochondria, and is a big part of the issues with disease in modern society
So thanks again for joining me, and I look forward to seeing you on the next podcast.

In this simulcast, Dr. Gil explores the healing power of neurofeedback. He explains what neurofeedback is and how it works. Neurofeedback is a powerful system to heal the brain of various issues including, TBI, migraine, anxiety, OCD, insomnia, depression and others. Neurofeedback measures amplitudes and frequencies to determine the best way to retrain the brain. The procedure is painless and efficient

You can hear more about this and there is a video at https://www.youtube.com/watch?v=I7WS4NryiB8

In this simulcast, Dr. Gil explores post concussion symptoms and treatment. Whiplash and concussion symptoms are more common than most people realize. Delayed concussion symptoms are a real problem. And you don’t have to hit your head to have a TBI. Studies have shown contra coup injuries occur as a result of the brain slamming into the skull. This is a big part of why people do not receive appropriate treatment. As a result, people do not connect their symptoms with the injury. Post concussion symptoms include cognitive, emotional, and physical ailments including emotionaly lability, brain fog, attention issues, problems reading, migraines and headaches and other issues. Learn more about this and the treatment.

You can hear more about this and there is a video at https://www.youtube.com/watch?v=I7WS4NryiB8

In this first simulcast, Dr. Gil explores the basics of polyvagal theory. He discusses the different branches of the automomic nervous system and how to allow the energy to release from your body.

At the end of the podacst, Dr. Gil talks a bit about his new online courses that are available.