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- [00:00]
Chris Williamson
You just taught me. There are left handed surgical instruments.
- [00:05]
Dr. John Della Volpe
What's that mean for left handed surgeons? The way some of the graspers click. It's released with a maneuver where your thumb pushes something outward. For left handed surgeons, that can be sort of clunky. So they make instruments where it's outward for the left handed surgeon is actually inward towards the midline. And for the right handed surgeon, it's this way. So there are left and right handed instruments for different surgeons. Needle drivers really, where you click onto a needle and it clasps so you don't have to keep pressure on it. Then you can do your maneuver. Steak knives also have serrations that lean one way or the other. I just learned that.
- [00:43]
Chris Williamson
I didn't know about that at all.
- [00:44]
Dr. John Della Volpe
I didn't. I know. I was just looking at it because I've, I've got a buddy who's left handed and he's like pointing all this left handed stuff out in the world.
- [00:50]
Chris Williamson
Don't use that one. It's going to cut completely incorrectly. What I did learn was when you have a stake, I mean, I have to imagine this is slap bang in the middle of your area of expertise. But you want to never cut with the grain of the meat. You want to be cutting cross grain.
- [01:06]
Dr. John Della Volpe
Yeah. So that, that, that takes me to. What's beautiful about surgery is like, it's, it's not like legos. It's not like, you know, hammers and chisels. It can be with, you know, orthopedic surgeries and spine surgery. But when you have somebody who can lightly, with a, with a tweezer, a pickup, we call it, lift something up and you see some membranes that are holding two planes together. All right, let's say you have two planes of tissue and they're held together with this fine web of membranes. You lift it up and you take a scissor upside down and you just spread lightly and the membranes fall apart and the tissue comes apart, you're not really trying to tug and pull. If you do that with finesse, when the patient wakes up, they feel less injury, they feel less pain, less anesthesia, the operation goes better, less blood time. So everybody thinks surgery is all the same steps. Do these 1,000 steps. No, it's sculpting, it's art. There's a finesse to it. And at some point, when you see somebody who's good at something, it's, it's like ballet. It's like something's being released. They're not like. And now I will do this Step. And that's the part I love about it, is talent. It's more. It's more talent than smarts.
- [02:13]
Chris Williamson
I love watching people in between doing the thing that they're supposed to do. So a good example of this is drummers. If you're ever watching a drummer play live, he loses a stick or he snaps or something like that. And he'll just immediately switch, and he'll be playing with one hand, and he'll just reach over and he'll grab another one. Or if a guitarist's playing and bing, off goes a pick like that. And you'll watch him without even thinking about it, he'll do something. Grab a pick from there, roll it between his fingers and go back. And it's that liminal space. It's. I'm just so comfortable with my working environment.
- [02:44]
Dr. John Della Volpe
Yeah.
- [02:44]
Chris Williamson
And that's really cool to see.
- [02:45]
Dr. John Della Volpe
So that's an interesting word for me, liminal, because that's kind of the thing I've been thinking about a lot. It's not the easiest thing to explain to people, but I think that in nature. Let me. Let me give you an example, what I call a liminal space. I was. I used to dive a lot. I gave it up at a scary accident.
- [03:04]
Chris Williamson
Almost.
- [03:04]
Dr. John Della Volpe
Almost ran out of oxygen real deep off of Asia, Asian coast there, Palau. And it's. I was like, I've got kids. I'll do this when I'm older. Now I'm older, and I'm like, I'm. I'm. You know, I don't have the energy. But the place that I love diving the most was the cenotes of Yucatan, like, where it's all flat. Maybe the asteroid landed there and killed all the dinosaurs and that kind of thing. But they have caverns and there are river underground rivers that meet the saltwater. So when you go from fresh water to salt water in our body, salt water is a massive thing that has to do with cognition and balance. And a lot of fundamental things are controlled just by the salt in our blood and brain. And. But when you. When you're diving and you're in freshwater and then it's called the halocline, and you're now fresh waters meeting saltwater. There's like five yards. It almost feels like five meters, where it's blurry. So the transition from one state to another at chemical, psychological, it doesn't happen in a millisecond. There's a liminal state. And so when you take a look at the brain, in 24 hours, I see at least four or five liminal states when you're falling asleep, it's not a complete. I am awake, and now I'm asleep. There's a little window there about 15 minutes. Lucid dreaming, when you're asleep, asleep, and I can verify it, and you have a little return of awareness. To me, those hybrid liminal transition states give us an insight. I mean, it's hard, right? Because I'm a brain surgeon. This is. People expect everything from me to be proven, but I'm finding a lot of insight and understanding from these different liminal states. And then you can bring narcolepsy in the middle, where people suddenly fall asleep, they have interesting thought. When you wake up, a third of the world feels, you know, sleep paralysis and have. Have like these feelings of a goblin on their chest. Enough to. Where the stories are built around different cultures. So to me, those transition, hybrid states of cognition, of feeling, of experience, I think that that's where the. That's where my head is really at these days.
- [05:09]
Chris Williamson
This might be getting you out of your skis a little bit, but someone asked me this question the other day, and I thought it was such a great question. What is something that you intuit or act as if is true or might believe, but you cannot prove with evidence or science? Is there anything that comes to mind with that?
- [05:30]
Dr. John Della Volpe
Well, I mean, for me, the first thing that crossed my mind was love. It's this. You know, the term used to be ineffable and so, like, beyond explanation, but, you know, it's true. Beyond articulation, but it really motivate. Motivates you or touches you. Spiritual experiences, right? Epiphanies. A hunch. Like these are repeated experiences that people are reporting. Right. And dreams could fall into that a little bit. But there are repeated things that we are writing about through history and time. Aristotle. Aristotle wrote about lucid dreaming. Now, that sounds like. Well, come on. Lucid dreaming. But it's rigorous. So Aristotle wrote about it thousands of years ago. A return of awareness within a dream. Which sounds like, how could you ever prove that? And 20, 30 years ago, and increasingly now, lucid dreaming is being proven rigorously in sleep labs. So that I think that's one example. But when I hear that, what it tells me is don't deny those insights. Don't rely on them blindly. Don't be manipulated by somebody trying to dazzle you with those kind of things. You know, cults, sexy rhetoric. Yeah, cults catch you in a vulnerable moment. My patients are vulnerable. The sexy rhetoric isn't just, you know, that this will heal you. But I was, you know, there were, there were a lot of like stem cell clinics that, that, that were affecting children's hospitals in San Diego. Children's Hospital San Diego is real close to Mexican border of Tijuana. You know, we're in Austin, so you're familiar with that. And there, there were patients, families who were going there to get stem cell treatments that were, it wasn't that they were proven, we knew they were sham, they weren't hurting them, but they weren't helping them. And sometimes those moms and kids would choose that over therapy that was moderately effective. So I think there has to be some, there have to be some safeguards to vulnerable people being manipulated. Yet I'm fully ready to embrace intuition, hunch, those kind of things. Like where my, my dog has an instinct and hunch that comes from our limbic system that exists within us, sort of the emotional centers of the, of the brain, the deeper structures of the brain that we shouldn't deny those and creative people learn to tap into those. So the, the challenge for me is always how to liberate our understanding, my understanding, without it getting too woo woo and leading to fluff.
- [08:05]
Chris Williamson
Such a good point, man. It's such a good point. I, I really think about this a lot. The what level of rigor and skepticism should we have without closing ourselves off to alternative approaches to things? And I, I would say I lean on the rationalist, materialist kind of evidence side of stuff. I tend to have a, a real anti conspiratorial leaning to me. But that's been to my detriment a lot of the time because I think my, I've probably said no to stuff that my gut would have convinced me of saying yes to. Like my brain has overruled my intuition. And I'm kind of trying to allow that to be tapped into a little bit more. I'm trying to get that to reverse.
- [08:49]
Dr. John Della Volpe
Well, and so that's interesting. So liminal states, these hybrid states that exist in nature, deltas, where salt water meets fresh water, where a waking brain goes through our dreaming brain, that's a cognitive delta, if you will. That's a theme that I'm working on in my mind. The other thing I'm working on is what we're discussing now is that to look at our capacities as a thermostat, it's a modulation. Inflammation's bad, bad, bad. And I say that's not true. We need some inflammation to fight off bee stings and other things. But how is that thermostat set right for our lives. We fight off infections, but if the inflammation is too strong, it's like friendly fire can cause autoimmune disease. So rather than saying inflammation is bad or good, that this product is anti inflammatory. No, I actually need inflammation sometimes I need stress sometimes I need these capacities that have kept our species going sometimes. But when they're running rampant without the necessary stimulus for them, then we have to identify and use our coping strategies and maneuvers and the things that the wellness industry is presenting to bring them back into the ecological validity which is real world scenario. Where should my thermostat be? Mm.
- [10:13]
Chris Williamson
You mentioned dreams then. Is Freud totally obsolete? Did he get anything right? When it comes to dreams, he got.
- [10:21]
Dr. John Della Volpe
One thing right for sure. And before, before him, it wasn't really clear that dreams were coming from the brain. That's a cool story too because. So he's about 100, 110 years old, but before he was the one like, look, it's your desires gone wild. Your dreams are. It's just freaky time in dreams and it's. But it was coming from your brain and it was only at that time it wasn't clear that this creature, this human being lying on the ground, mostly limp, body is cool, brain must be off because they're not moving. So how could that inactive flesh, how could that inactive. Like the hibernating screen on your laptop, right? Like how could that conjure up all of that crazy wild adventures, dream state, dream experiences. So it was a guy named Berger. He was looking, he was trying to actually understand. So like the, the old school people who are trying to understand things, they were open to hunch and instinct and not to say paranormal, but something that they liked exploring things that couldn't necessarily be fully articulated. But that didn't stop the exploration, the search for the meaning in it. He felt like there was this potential for mental telepathy and in looking for that, he put stickers on the surface of patients scalps. And at that time they were just learning that like a wire to a sticker on, on your scalp didn't, didn't mean you had, you couldn't just, you could just send electricity in, but you could also record. And so he's the first one that came up with the EEG that later turned into the ekg. An EKG is the three main nerves on the surface of the heart giving you a squiggle. We're all familiar with. An EEG is 96 stickers recording. The electricity generated by 100 billion neurons are like Microscopic jellyfish, right? It's just a recording of the electrical phenomenon going inside. And when he, when he recorded that eeg, he didn't, he let it run. And at night, surprisingly, there was still electricity. And that sat for like 20, 30 years. But that was the first time people are like, wait a second. The brain is still going off when we sleep. So much so that at certain parts of the day and certain parts of when we're in our sleep, dreaming brain, the electrical activity is so strong that they call it paradoxical sleep, that while you're asleep, just based on how wild your electricity is, you can't actually tell if you're asleep or awake. It's that hot. So it's not a quiet time. And so that's what Freud did, was say dreams come to the, come the brain. And now we've come to understand that the brain is always on. It's not a 24 hours roughly cycle. You go into a cave and you get the people in the cave and they're still on a 24 cycle, right? Circadian rhythms like we're all built on this rotating planet like Venus fly traps open and close, tides open and close. We're on a 24 hour cycle. But the brain, electrically, physiologically, the amount of glucose usage when we sleep, the brain is not resting. And now that allows us to say, well, what is it doing? The most vibrant thing that the dreaming sleeping brain is doing is conjuring up dreams.
- [13:40]
Chris Williamson
Okay, why do we dream then?
- [13:43]
Dr. John Della Volpe
Well, that's a massive question. You know, I mean, I would say the answer should come from the information we now have. Okay, so it's not chilling out, it's burning hot. And this one, I got to unpack it a little bit. When I just said, look, the waking brain and the dreaming brain are equally vibrant electrically, but they must be different. So one of the main things that happens when you go from the waking brain to the dreaming brain state is certain continents in our, in our brain, not like a spot, but a network called executive network. Now they're trying to call it action network, but this is a very specific part of the brain, of the prefrontal cortex. And it needs a little bit of explanation. It's called the dorsolateral prefrontal cortex. The frontal lobes are like this. It's kind of on the outside. It's the executive network. It's the conductor that coordinates it all. It's responsible for calculation, processing, quick judgment, not a lot of instinct that. And, and it tamps down other regions, such as the imagination network and Those deeper limbic structures that are our hunch are how our, my dog can tell when I'm trying to say, hey, come here, you know, like trying to give him a treat, to trap him, to put him back in his pen because we're going out for the night. That instinct comes not from the dorsolateral prefrontal cortex or of the prefrontal cortex. So when you go from the dreaming brain back to the waking brain or waking brain to the dreaming brain, that region is dampened. It's never on or off. It goes from being like 51% active relative to the imagination network to 49. So the dreaming brain has a dampened executive network and a liberated imagination network and movement regions and emotional networks. So when we see the shifts and as the executive network comes down, it's compensated by the imagination network, so you get that equivalent electrical activity. So when you think of it that way, dreams, why we dream has to be explained with what is going on with the dreaming brain. It's hyper visual, it's hyper creative, it's, it goes into tremendous social situations. And my big idea about it is it's not what others have said, like it's threat rehearsal. If you run from a woolly mammoth in your, in your dream, you're better off if you ever encounter one. Or it's a nocturnal therapist. We work out our emotions at night. It doesn't make, it doesn't fit the complexity. We have ptsd, flashbacks. So what I think is happening is certain regions of the brain that are generally tamped down for us to perform the tasks of the day are allowed to be liberated in the safe space of our temporary paralysis of our dreams. Because in the brain, if you don't use certain neurons in certain capacities, they will wither. If I patch a kid's eye for therapeutic purposes, where it lands in the occipital lobe will physically wither. And so I think we dream to maintain our emotional and creative complexity as a systematic process where, where the brain takes turns in a 24 hour cycle being executive network dominant and imagination network dominant. So all those capacities there for us for the next environmental event we're not prepared for.
- [17:10]
Chris Williamson
So if you spent your entire day as a caveman logging all of the different fruits that you'd gathered over the last week and making sure that your cave is clean and working out where you're going to go to catch the next mammoth, all of that is very executive, it's very top down. It's creative in some ways, but not intuitively creative. But you have Maybe not given yourself. The urgent always overtakes the important and the urgent is very rarely going to be a creative pursuit.
- [17:40]
Dr. John Della Volpe
Task on versus task off. Yes, task on is outward and that's the executive network. Of course, it requires a little imagination and everything to navigate. That's why it's never completely on or off. And then task off is daydreaming. Dreaming itself is the most task off thing. And the brain wants to run rampant. I mean, it's wild. If you look at some of the electrical activity, the glucose usage, it is not a quiet time. And so we can't deny that a process that makes us lie down burns that much energy, when energy is hard to get, is, and has lasted through generations and generations, is essential. So my feeling is that any collection of neurons, whether in a dolphin, like dolphins do, one brain at a time, well, half brain at a time, so they can keep paying attention. They'll, they're, they'll sleep one hemisphere at a time.
- [18:36]
Chris Williamson
Wow.
- [18:36]
Dr. John Della Volpe
Penguins do like, they do micro naps.
- [18:38]
Chris Williamson
They do like 10 flamingos do something weird with sleep as well.
- [18:41]
Dr. John Della Volpe
Well, all the creatures, they have different ways, but when you get a collection of neurons, they got to sleep. And what happens when you sleep is not rest. It's a different type of neuronal activity. The, your body might be resting, your heart might slow down a little bit. The liver's cool, body's cool, but the brain's on fire. And just to, just to put it out there, as a surgeon, when I move livers between moms to kids, you could take a piece of liver from mom and move it to a kid. I've transplanted hearts in training. We're not really reconnecting the nerves. Again, the bodily tissue is a little bit autonomous. Sleep is not really for the body. I'm not saying that sleep isn't good for you. I'm not saying sleep shouldn't be a performance goal. I'm not saying that. I'm saying when our bodies sleep, it's our brain that builds the sleep pressure. And when we sleep, what does the brain do? That's the most vibrant thing it does, it dreams. So I think dreaming is an essential feature of, of preserving a healthy brain and healthy mind.
- [19:42]
Chris Williamson
In other news, this episode is brought to you by Momentous. If your sleep's not dialed, taking ages to nod off, you're waking up at random times and feeling groggy in the morning. Momentous sleep packs. How did I miss? Both of those are here to help. They're not your typical knock you out supplement overloaded with melatonin just the most evidence based ingredients at perfect doses to help you fall asleep more quickly, stay asleep throughout the night and wake up feeling more rested and revitalized in the morning. Which is why I take these things every single night and why I trust momentous with my life or at least with my sleep. Because they make the highest quality supplements on the planet. What you read on the label, what's in the product and absolutely nothing else. And if you're still unsure, they've got a 30 day money back guarantee so you can buy it completely risk free, use it and if you do not like it for any reason they will give you your money back. Plus they ship internationally. Right now you can get 35% off your first subscription and that 30 day money back guarantee by going to the link in the description description below or heading to livemomentous.com ModernWisdom using the code ModernWisdom a checkout that's L I V E M O M E N t o u s.com ModernWisdom and Modern Wisdom A checkout is is there something interesting about the fact that we're conscious of our dreams? Because you could imagine a world in which the body shuts down, the brain shuts down and you don't have any conscious recollection of the fact that this thing happened. It was kind of. I guess what you're suggesting is there are certain capacities that the brain needs and may need in future. They're maybe not quite as common as some other pathways that we use more frequently. And dreaming is one way for us to ensure that those myelin sheaths are kept nice and lubricated.
- [21:28]
Dr. John Della Volpe
They're moving quite accessible when we need them. Yeah, they don't wither, they don't atrophy.
- [21:33]
Chris Williamson
However, the fact that we're conscious of this, the fact that we can recall it, that there is a phenomenological emotional experience of going through this. Is that bit adaptive in your opinion? Or is that some spandrel side effect like a light bulb that gives off heat as well as light? What do you think about the fact that we actually know that we have been through this thing? Because I could imagine a world in which you could retain the capacity without having the experience of being through it.
- [22:04]
Dr. John Della Volpe
Yeah, that's. It's a massive question. It's a fantastic question and my opinion is to tell a few stories about how some of these things happen. So back to liminal states. I don't think any process in the brain waking brain, dreaming brain is A is a rigid, on off process. So my, my feeling is when we remember some dreams, they're like solar flares that have leaked into our memory and we wake up, we're, we're accidentally sort of holding on to the residue of massive dreaming activity. That's my, my hunch. And, and the way to think about that is the concept of self and autobiographical memory. So when people talk about self, self worth, self, this, the, the concept of self is created by a type of memory. There's procedural memory, tying your shoelaces, semantic memory, stuff our phones record, you know, dates and stuff, episodic memory, like the episodes of our life. And that what happens is they're stitched together by a capacity called autobiographical memory. And the thought here is from people who have certain types of psychosis, when they can't separate out their dream and waking state, certain patients with schizophrenia, it becomes quite confusing for them. So I think the dreaming process is richly active in all of us. The degree of recall is different between us and different in different stages of our life. And so when we do remember a dream in the morning, or we wake up and we remember a dream, go to the bathroom, and sometimes fall back into the dream, that these are just sort of the, the residues of a vibrant dream state that is breaking into our consciousness. I don't think that it's by design. I think it speaks to the capacity that we're never fully dreaming and never fully awake. And the best example of that is not sleep entry that Salvador Dali talked about, or sleep exit. We talked about sleep paralysis. But in the middle, certain drugs that we give our patients for Alzheimer's will make them have more lucid dreams. So the awareness of the dream state can happen when you're falling asleep, when you're waking up and you're holding on to some of the dreams. And there are habits you can do to hold onto them more. But also in the middle of a dream, people can train to lucid dream. I know that sounds like, okay, there's a neurosurgeon talking about that. But it's rigorous Galantamines and acetylcholine antagonists that we give to improve certain functions in Alzheimer's patients. And they report a dose dependent increase in lucid dreaming. So I think the dream state and the consciousness state, they're like two dimmers and they're overlapping a bit. And so when we remember something in the morning, rather than thinking that it's by design, I think it's sort of like an opportunity to have an insight into Ourselves at a very emotional, very visual, very sexual time.
- [25:16]
Chris Williamson
Yeah. Why did dreams often end up being so emotionally intense, do you think?
- [25:22]
Dr. John Della Volpe
Well, because when you look at the areas that are activated preferentially in the dream state, it's the limbic system, which are the emotional centers. When you look at the, the dreaming brain, the regions that are activated, if you will, it's the visual centers, it's the imagination network. And then equally, you're dampening the executive network. So these big jumps of ideas and creativity and associations are not discarded by the executive network as it would be during the day. It allows for that. Let me give you one specific example that I thought was really fresh when, when I was asked to prepare this book was when you look at thousands and thousands of dream reports, not yours or mine, but like, mine feel wild, yours must feel wild. But you start to see that very few people report doing math in their dreams. I'm not saying like somebody's going to call in or write and say, yeah, but it's not like nightmares, 100% reported. It's not like erotic dreams, sexual dreams, over 90%, teeth falling out, being chased, flying. These are common dreams. Right. Math is very rarely reported. And what I like is, okay, if I take hundreds of years of patterns of dream reports, basically surveys, or Aristotle's comment about lucid dreams. Now with modern neuroscience, they make sense. If the executive network is, is dampened, that does calculation. It kind of makes sense to me that very few reports of math occur in dream reports like that fits. Executive network goes down, reports of math go down. Imagination network is liberated. People report creative and wild dreams. So it ties together what people are reporting for years.
- [27:06]
Chris Williamson
Why teeth falling out, falling, flying, you know, three dreams that I would guess almost everybody listening to this has had.
- [27:17]
Dr. John Della Volpe
And before electricity and after electricity from the, from the, you know, horse and carriage all the way to electric car.
- [27:23]
Chris Williamson
Yeah. And like we needed to wait for airplanes to be there to think that I could fall out of an airplane. Or for buildings to be sufficiently high that you would fall from a skyscraper.
- [27:31]
Dr. John Della Volpe
Exactly. So that. So if we're getting. Mental health is tied into certain families, nightmare one type of dream nightmares clusters in families. So nightmare disorder can happen.
- [27:47]
Chris Williamson
It's heritable.
- [27:48]
Dr. John Della Volpe
Well, or, you know, that's a complex word. I mean, you can have things cluster. I mean, you know, maybe those people are living in difficult situation, so it's hard. But there is a dream that clusters in family, just like certain mental health conditions would. And the fact that we share the same dreams with people living in wildly different cultural times, something's built in. And that. That, again, speaks to, I think.
- [28:16]
Chris Williamson
The.
- [28:17]
Dr. John Della Volpe
New understanding we're having in the last 20, 30 years as we can have people be in brain scanners and fall asleep.
- [28:22]
Chris Williamson
Have you got any idea about what makes for universal nightmare? Is this just something.
- [28:30]
Dr. John Della Volpe
I got a big. I got a big theory about it. And so. So, you know, this book was. This book was important for me. It was. I had written a few others. One was, you know, and then Penguin UK in London said they've always wanted a book that looked at dreams and dreaming from a certain perspective of somebody with a complicated life story, somebody who's had the professor chops, but also could tell a story. And I. I really took it, you know, it was. It was wonderful, actually. I. It kind of liberated me. Part of that process was me rolling around Dodger Stadium in la, going to pubs in London and sort of throwing this out because it had to be for everybody, right? It can't. It's not the question I would get asked the most, like, if dream. Wait, if dreams are good for us, why do we have nightmares? It was just sort of a. You got it. And so that was chapter two. Nightmares are. It's a tough thing to explain because it obviously, like, why, you know, if, if. Why would we. Why would he cook that up? And so the way I think about it is you have to look at the mind as something that needs cultivating in children. Just like walking and talking and so just like we're not fully formed and we have to be taught to walk and challenged to walk and talk and engaged at the same time in the mind. There are certain cognitive developments that are happening. So in. They're called longitudinal studies. They had families allow their children to be woken up for, like, 22 years and report, like, what they're dreaming about different times and like, when they were two or three, like, it's just like it's a blanket. It's. It's not very dynamic. It's not. Not a lot of movement. And then around 4 and 5, six nightmares arrive for every child. It's rare to find. I did a lot of pediatric neurosurgery, still do. I have three sons in their 20s. They have to be told nightmares always arrive in children, healthy children, unhealthy children. Some of my patients who had, you know, brain injuries. It seems to be a part of the mind's development that's built in. It arrives for everybody and then almost invariably, very few kids have nightmare disorder. It doesn't linger into the next day and ruin their day like it does for adults. So it's sort of like a wave of thinking that a species of dreams that arrives. And then around 11 or 12, you have erotic dreams that arrive. Whether kids are having sex or not or teenagers are thinking about sex or not, they arrive. And the last one I see is sort of the maturation like adolescence. The brain looks the same, but we change who we are. So I think there are three waves of sort of the development of the mind. And what happens around that age of 4, 5, and 6 is also the development of something called the default mode network. Like, until then, children have a hard time reading minds. They can't tell if smiling uncle means well or means harm. And that capacity arrives at the same time as nightmares. And so my big hypothesis, it'll be hard to prove, is that nightmares create a sense of self versus other by having these harrowing, difficult experiences. It sort of creates that the world around me is separate from who I am. And this engagement, monsters and different things creates this default mode network that allows us to start to see ourselves as separate from the world around us and to be a little bit more critical in evaluating the threats and the people and their intentions around us. That's my big thesis.
- [32:21]
Chris Williamson
And that would make sense adaptively because before age 4, 5, 6, kids are so un. Independent that the need to be able to distinguish between I am here and that is something else is kind of pointless because you're not let out of the sight of mom or dad.
- [32:38]
Dr. John Della Volpe
Yeah, you're in the wrap still. You're very close. You're not being led. I mean, I think that's a good point. The other point is that, that it's just like every, every. Every kid has to be told it was only a. It's only a dream, only a nightmare. And that there's this. Just like we talked about liminal states in the beginning, like in psychosis, people can't separate out, you know, awake versus dreaming. And that to stitch autobiographical memory, we need to know these are awake thoughts and these are dream thoughts. And dream thoughts should not disrupt your awake thoughts. That there are these things that happen in your mind, but they're not actually the. The daily steps that link your life together. Right. That in children, I don't know if before nightmares, they know the difference between waking thoughts and dream thoughts. Like maybe nightmares inform the child it was only a dream. So it's always been a puzzle to me until then. Do they not know that what they experienced in their thoughts while sleeping was Actually not real could be discarded.
- [33:43]
Chris Williamson
I guess that the Creativity network and kids is so much more alight even when they are awake. You watch in the space of an afternoon, a child's a firefighter and a postman and an astronaut and a sports star and a rock star and asleep and then awake again and back to being a postman. And yeah, I dream of being able. I literally do dream of being able to have that level of creative access again.
- [34:08]
Dr. John Della Volpe
And I think so that nightmares are serving something fundamental because they arrive in all of us. It is the universal dream. We can all talk about what, what it, what they serve and the purpose. And the last thing I would say about that, to be a nightmare, it has to wake you up. It's not a bad dream like you wake up the next day, ooh, that was a rough night. Nightmares have to wake you up, sear your memory to be considered a nightmare. It's the, it's the dream that has to wake you up and be vividly remembered. So I think there's some mental cultivation going on with this process that we all share.
- [34:39]
Chris Williamson
We'll get back to talking in just a minute. But first, some things are built for summer. Sunburns, hot girl walks, your ex posting their Euro road trip, and now lemonade and salt.
- [34:50]
Dr. John Della Volpe
Huh?
- [34:51]
Chris Williamson
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- [35:59]
Dr. John Della Volpe
I, I think based on what I've learned, I, I think, I think it's the, it's the ultimate wellness habit that goes underutilized, you know, because first, and just to give you some examples that, you know, the sleep entry period, this liminal state where based on measurements we could show you're kind of awake, you're kind of dreaming, sleeping. I mean, people like Edison in Inception, you know, Inception, the movie was the falling chair was a concept based off of Dolly or Edison where they'd be working on some creative project and, and they had a key in his hand and a little metal basin. And when he'd fall asleep on the rock while rocking on a chair, he'll fall forward, the key would drop and then he'd write down his thoughts. He felt that there was something that could be extracted from that dream entry, sleep entry state. Lucid dreaming is something you know, we could talk about later, but that seems to be something that people report wellness with. People, athletes, people are visual, spatial, tend to have more lucid dreams. I think that's an interesting thought that we can, we can learn that ability. There's a little bit of sleep disruption about it. And then when we sleep, exit, which is a time I use quite a bit, is I have the luxury of not always hitting the alarm and I take those last five, ten minutes of thoughts and I write them down first before going on social media or looking at my email. And that seems to be an idea generator for me. I think there are sort of those practical elements that you can do. But if for me, just at a philosophical level, when my brain, with my memory, with my imagination, not somebody else's memory, not somebody else's imagination, runs in a different mode, hyper emotional, hyper imaginative, and something leaks out of that that I can hold on to. I think it's worth taking a look at. And even just the process of reflection, I, I think could hold some insight. But I would tease that out. It would be that the dreams that leave a strong emotional residue with a central image, I think it's okay to say, why did I have that dream? You know, be your own therapist in that capacity, because it's coming from your imagination and your mind. The concrete example I will give is some people who are feeling well Feeling like they're coping well will have a return, will have nightmares pop up in their lives which serve as sort of a thermometer. And so the nightmares, if they're progressive, like headaches, occasional nightmare is, is whatever it is, occasional headache is whatever it is. But if there's a progressive uptick in nightmares, that can happen while the patient is having, the person's having such a fantastic life during the day. So that can be sort of a warning sign or a signal that maybe you're not coping well. So I think we're just starting to get into those features of maybe people's dream life should be part of the vital signs. When I started training, it was like blood pressure and temperature. Now we ask about pain, we ask about wellness, we ask about living situation at home. I don't think in the world of mental health it would be a stretch to start asking and engaging people with their dream life.
- [39:23]
Chris Williamson
Dream experiences predictive of something in health. You mentioned an uptick in nightmares across the whole board. Somebody's dreaming more, dreaming less, they remember it more, they remember it less, more lucid dreaming less, whatever, more nightmares. Are there any correlations between that and someone's overall health?
- [39:41]
Dr. John Della Volpe
Good question. The dream pattern related with overall health would be nightmares. So two types of nightmares, pediatric nightmares. We talked about age 4, 5, 6, which I think are cultivating the mind. They don't really lead to nightmare disorder where the next day is ruined and then nightmares in, in adults they could happen once in a while. That doesn't seem to be a problem. But, but 4 or 5% have nightmare disorder where it disrupts the next day. And in that situation, whether it's in PTSD or whether it's in trauma or whether you're going through a difficult situation, tracking nightmares, their uptick or their improvement can be sort of a measure of how people are doing. But as far as what I've read about dream recall, dream patterns, that changes throughout our lives. So a lot of adults say they don't remember many other dreams. My cancer patients, when they get to end of life, they tend to have these genre dreams are called end of life dreams. They tend to be of reconciliation. They tend to be more hopeful than you would suspect after getting surgery and chemotherapy. So your, your dream within our lives, from nightmares to erotic dreams to the way we dream as adults, to drugs that change the way we dream and how much we remember, all the way to end of life dreams. If you don't think you have a lot of dream recall now, that doesn't mean it Won't be there for you, or it can't be cultivated. You just have to track dream experiences and prevalence throughout a whole lifetime. And you start to see that they come in waves, which I find, which is, you know, which is interesting.
- [41:21]
Chris Williamson
How real is dream interpretation?
- [41:23]
Dr. John Della Volpe
I don't think it's real at all. I mean, because I, you know, I mean, I can't do it for myself, you know, like, so what hope is.
- [41:31]
Chris Williamson
There of a lady in a shawl being able to do it on your behalf?
- [41:34]
Dr. John Della Volpe
Well, I mean, I think just we have to look at it conceptually. I think we were just talking about that. It's my imagination, it's my memory. So, like, let's.
- [41:41]
Chris Williamson
How do you know what this snake means to me?
- [41:44]
Dr. John Della Volpe
Not just what it means to me. What it meant to me five years ago. I'm not the same person I was five years ago. Like a bridge. Let's take. Let's take a bridge, for example. For some of my patients, it's, you know, they might be thinking about suicide or it could be reconciliation with a loved one. It could mean so many things within that context. How can a bridge for you and me mean the same thing but past that? A bridge for me means very different things within the context of my own life. I don't think a static symbol can reveal a dynamic mental life.
- [42:17]
Chris Williamson
Well, this would fit in with your perspective that it's kind of a gymnasium, training ground, sandbox for the mind.
- [42:27]
Dr. John Della Volpe
That high intensity training for the mind.
- [42:28]
Chris Williamson
Yeah, that we. Maybe we shouldn't give all that much credence to it. Maybe the brain is just kind of running away with itself. Because isn't it strange, people have intrusive thoughts all the time. They see somebody stood next to the edge of the road and they think, I wonder what would happen if I push them in. I mean, I'm not going to do it, but I wonder what would happen if I push them in. Oh, God, this would happen. And that would happen. Wouldn't that be thrilling? And you go, okay. Are you making some sort of inference about the sort of person that you are for having had that thought? Most people would say, no, you know, I just have intrusive thoughts that occur during the day.
- [43:03]
Dr. John Della Volpe
And you go, okay, can't go to jail for thoughts.
- [43:06]
Chris Williamson
So your intrusive thoughts when you're awake and conscious are not that indicative of the sort of person that you are. And yet you're telling me that the dreams that you have when you're not conscious are worthy of interpretation. That I've never Thought of that before, but yeah, we're prepared to give. We're prepared to dissect something which we have way less control over when we're asleep. But then on the other side, you know, the devil's advocate position would be there are very few windows that we have into the subconscious. The subconscious can often tell us things about ourselves that maybe we have repressed, not been prepared to feel. And perhaps there is some deeper wisdom to be gleaned from when we're asleep.
- [43:53]
Dr. John Della Volpe
I agree with that. But I don't agree that, you know.
- [43:59]
Chris Williamson
The lady in the shawl.
- [44:02]
Dr. John Della Volpe
I don't agree that it can be made universal. Right. I dream of a bridge. You dream of a bridge. And it's filled with emotion. It's a vibrant bridge. Okay. Go ahead and explore it. You explore it for yourself within the context of your. Your life. And I'll explore it in the context of my life. For me, it might mean suicide. For me, it might mean San Francisco, where I went to college. For you, it might mean something else. So I think the explo. The. That the dream residue being a window to our own individual at that moment. Subconscious, hyper emotional, hyper visual, hyper sexual state. Yes, but a symbol that captures it between two people, let alone between your former self. I just don't understand how that can happen conceptually.
- [44:55]
Chris Williamson
What about erotic dreams? What have we come to learn about fuels?
- [45:00]
Dr. John Della Volpe
I mean, why not? I mean, it's firing. I mean, you know, why not? That. I mean, that's. It's. This is. That was chapter three, because I remember we're talking about, like, I wanted to hit everything up, up right off the top. Why we dream nightmares. Really? Nightmares. And then erotic dreams. It's fascinating because it's another thing that happens before the erotic act. Kids don't have kids who have never seen a monster and have a puppy. They'll have nightmares that are wild. That's descending through our psychological inheritance. Erotic dreams. People have them before the erotic act. It's almost like an instruction guide. And what's fascinating to me is the. There's not a lot out there. 90 something percent. When you go from sexual dreams to erotic dreams, over 90% report having them. The terminology difference? Well, I don't know. I think it's more inclusive. So we start when you do surveys in other cultures. They're more willing to sort of say yes.
- [46:09]
Chris Williamson
Erotic dreams.
- [46:10]
Dr. John Della Volpe
The term seems to be more. It's easier for them to say yes to that.
- [46:15]
Chris Williamson
Right. Okay.
- [46:16]
Dr. John Della Volpe
Because a little less porn vibe.
- [46:18]
Chris Williamson
Yeah. And it would also imply maybe hugging.
- [46:22]
Dr. John Della Volpe
Kissing, they're not, that's not exactly, they're.
- [46:24]
Chris Williamson
Not doing it with their partner perhaps.
- [46:26]
Dr. John Della Volpe
Well and then the next thing is when you ask and as we get into more online surveys, this is going to be great and more people are included but like 80% report infidelity and then the infidelities with a small group of people like a repugnant boss or like family. It's weird. The tribe, the characters, the characters in the, the, you know, the cast and crew is narrow, the acts are wild. And so when you take that data, healthy relationships have infidelity, dreams, unhealthy relations have infidelity. That's, those are sort of the surveys out there. And that, that leads to a lot of cool conversations. But from a neuroscience point of view, is this the part that really trips me out is, is that around the time of erotic dreams, even before, you know, the pituitary is drip the hormones that release all the hormones that cascade in our body that leads to the sort of changes of maturity is that the, the same fingertips that do touch can now do caress. And it's not like a new nerve got built in there. It's the capacity to perceive sensuality changes where the, the sensory nerves land in the brain and goes to the opposite side to a motor sensory strip in the, in the sensory region. So around the time of erotic dreams we developed the ability to have erogenous zones where a light touch on a back can be a turn on rather than just bumping into somebody in the subway. That capacity doesn't really exist at age 6 or 7 and no new nerves are being deposited. It's a perceptual change in the brain.
- [48:06]
Chris Williamson
That's interesting.
- [48:07]
Dr. John Della Volpe
Yeah. So to me, I, I, I like thinking about, I don't have an, I don't have any big answers for that. I just want people to walk away from that and say so those changes, the ability to be aroused happens around the time of erotic dreams and often it's before you're actually mature. So it just seems to me again that erotic dreams are arriving almost universally in adolescence to prepare for the act of procreation and to create the drive in our mind that we later carry out in our bodies. That's the way I see it.
- [48:37]
Chris Williamson
I wonder whether, I mean this is almost certainly going to have been the case throughout history. If you've got a particularly prudish society Victorian England, they still get it popping. Well, of course you're not going to be able to, but I, I wonder how many people that had these erotic dreams Back then would have. There would have been a real source of shame for them because I'm. My. I'm. I'm cursed. My subconscious is contravening the norms of my culture, and God is looking down on me. Especially if you're told that, you know, God is watching if you masturbate, God is watching who you're attracted to. You know, infidelity is one of the worst things that you should ever do. You should be loyal to your husband or your wife. And.
- [49:26]
Dr. John Della Volpe
And these dreams are like 80% infidelity. And it's all. With people around you.
- [49:30]
Chris Williamson
It's your mom, it's your boss. You know what I mean?
- [49:33]
Dr. John Della Volpe
It's the boss you hate. Yeah. Yeah, I think. I think it must have led to a lot of inner conflict. And so that when I. When I write about erotic dreams and you look at it in different cultures, you know, my feeling is this is a. This is a way that our just like, we learn to walk and talk. Nightmares do something, because they're a universal dream. Erotic dreams do something. They happen in all cultures. They've happened over hundreds of years. They're happening with Internet porn. They're happening in Victorian ages. And that. To really start to think of the patterns. The patterns of our dreams are not infinitely wild. And then what really teaches me is the patterns of our day are not infinitely wild. We build and break habits in similar ways. We fail in similar ways. Like, the brain is not infinite. It does have some. Some boundaries in the way it works in the dreaming.
- [50:26]
Chris Williamson
The very least. Guardrails.
- [50:28]
Dr. John Della Volpe
Yeah. Or, for example, dreams are not infinitely wild in the sense that you. You don't do math in your dreams. So there is at least one boundary. Right. And then they tend to have certain patterns. And now I'm using that to think about that. We fail in different ways while we're awake in our lives. And if you look at 10,000 people, the ways that people fail and succeed also start to follow some patterns that I think can guide us to, like, hey, our brains and minds work a certain way. And when we learn about that, then you can say, where are we in this? How is our thermostat? Is. Is a victory today, just getting out of bed or not saying, hey, wellness, I got to be. I got to feel well, or just, I got to get out of bed and get on the bus and get to the cancer center. Like, so I want to personalize that whether you're the addict, this is. This is a side rift, man. But whether you're like, there are this. There Are these people in recovery are really good with horses in the Kentucky Derby, whether you're into horses and racing or. But somehow the horses can tell somebody who's been through something and has earned and trained themselves to be calm, like they have a better rapport with the animals.
- [51:34]
Chris Williamson
No way.
- [51:34]
Dr. John Della Volpe
Yeah, yeah, it was. It was featured when it came out. And so then. And then there's like, then, you know, like I was in San Francisco and I saw this person really struggling to not use, you know, just really, just fighting that. And then I got a buddy in London who runs like this North Saharan, seven marathons in a row, you know, just to show everybody he can. And. And when he's pushing to complete that seventh marathon or that the person using is really pushing to not inject, I think it's actually the same praying processes and patterns that are working inside. And if we can learn how those work, how those can be deployed, how those falter, then we have a universal toolkit. And that's what this dreaming book, that's why I told you earlier, was like, it's really important for me is because it's helped me actually understand that if the dreaming brain follows patterns, which seems infinitely wild, right, that you brought up, then, okay, so then our waking brain, we follow certain patterns and we're not incarcerated by it. But if we learn those rules, rules of survival, rules of how our day can be empowered, or watch out for that booby trap and that falter, and watch out for this attentional magnet because it's going to trip you up. Like, you could have a toolkit, you could have a guidebook to your own mind. And that's where I want to take things going forward. And that's what the dreaming book has taught me.
- [53:01]
Chris Williamson
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- [54:33]
Dr. John Della Volpe
I don't know if it's a power dynamic, you know, or it's, you know, I, I don't know. Or the family. And I mean my idea was sometimes, yeah, the repugnant boss. But what the, the, the, the narrow list of characters. I thought a hypothesis again. There's many things we can talk about that can't be proven, but evolution at bottlenecks. Like there were times when like, it's crazy if you think about it like how many different hominid species there were at one time. And maybe Homo sapiens were down to a few hundred thousand or a few thousand at that time. And maybe it was an evolutionary advantage to only procreate within the tribe. Like that's a very hypothetical scenario. But there's, there's a field called evolutionary psychology that are. Cognitive archaeology. That the way we think was an advantage that led us to, to thrive in competition with other, other hominids because, you know, people are like, oh, bigger brain, the brain is shrinking. Stop that. Neanderthals had bigger brains, but something with our minds was the advantage. It wasn't just the size compared to Neanderthals. And this, that's why I love like evolutionary psychology. That and the way we're thinking now is something we've inherited that was advantageous hundreds of thousands of years ago. But we have to now adapt that to the modern life.
- [56:02]
Chris Williamson
Okay, so if we're thinking adaptively here. I'm also a huge EP fan.
- [56:06]
Dr. John Della Volpe
Yeah, yeah.
- [56:08]
Chris Williamson
If we're thinking adaptively the repugnant boss or the family member. Very well. Maybe we're not particularly well used to having 200,000 people available on hinge or tinder or in our local city that are Our age and hot trot, there's usually only a very, very small group of people that are here. And perhaps the sleep dream of that is. What if I test this out? How does that make me feel? What does that mean for me? Because there aren't that many other people that are available and probably should see if this is actually going to work or not.
- [56:47]
Dr. John Della Volpe
I mean, I mean, it's possible. I mean, now, as far as the characters in erotic dreams, whoever writes this book next is going to have a lot more surveys from a lot of different types of people speaking a lot more openly about these things. And then they're going to have to figure out like, you know, I mean, celebrities are part of the erotic dream. They're considered part of the tribe, like Brad Pitt or whatever. Like, celebrities show up, feel familiar, something.
- [57:16]
Chris Williamson
To do with status maybe, or familiarity.
- [57:18]
Dr. John Della Volpe
That you see them so much you feel like they are. I don't know. It's. We're just riffing. But I'm curious to see that with social media and stuff. How influencers do they show up in a similar capacity as conventional celebrities that I grew up.
- [57:31]
Chris Williamson
Let me warn you right now, you do not want the pillow talk of a podcaster in your dream or not. You know, people are gonna call in.
- [57:37]
Dr. John Della Volpe
And they're gonna write in, no, thank you.
- [57:39]
Chris Williamson
No, thank you.
- [57:39]
Dr. John Della Volpe
Look, look, you went a pugnant boss, Chris.
- [57:41]
Chris Williamson
Yeah. You slept with a podcaster. What did you expect to happen after. God, it's three hours and he's still going. He's still going on about the biggest gun of World War II. Will you shut the fuck up? Hey, look, I mean, you asked for that. You knew what into on the, on the erotic dreams thing. I don't know whether we have enough longitudinal data to work this out. I'd be fascinated to see what impact the prevalence of porn. Porn has had in changing the sort of erotic dream. Men cycling through even more partners in one sexual fantasy. Are they being influenced by what they see on screen? I certainly know that if I read.
- [58:16]
Dr. John Della Volpe
It well, if I massive book get just 10 years. Somebody just needs to rock that.
- [58:20]
Chris Williamson
I. I like to read fiction before I go to bed. And I've been. I have an admission to make. I've been getting into chick stuff, a lot of chick stuff. Frieda McFadden, the housemaid, housemaid's Tale. Alex Michaelades, who wrote the Silent Patient.
- [58:36]
Dr. John Della Volpe
It's like thrillers written by chicks, but not necessarily only for women.
- [58:40]
Chris Williamson
Really good, really, like easy, easy reading. Usually woman in her early 30s. That's kind of looked over who fixes some sort of crazy murder thing that happens that impacts my sleep. Like, fuck, dude. Like, I go to bed and I've got. But it's usually interesting. It's a particular. So you think, okay, if the thing that I read before I go to bed. I'm also watching the Tour de France Unchained on Netflix at the moment. For some reason I'm not having many cycling dreams. If these two things are happening, we have to assume that people who.
- [59:12]
Dr. John Della Volpe
The volume. Born a lot. The volume.
- [59:14]
Chris Williamson
How is that not impacting erotic dreams?
- [59:17]
Dr. John Della Volpe
I think that's the. I think that's the experiment that's ongoing and somebody younger than me will see that. That's the opportunity here to look at that. And in the context of dreams, it's super physiologic stimuli is another concept. You can't look away because it's just so. It's just like a coked up version of something. And so you may have some finesse and emotional regulation and you may be able to sort of in your own competition. It wants to be like, I'm not going to look over there because yes, I feel desire and lust for that. That image. But that pops up once or twice. But when it's just like on loop and you can't. I'm surprised porn addiction is only 5%. All right. Given just the supra physiologic stimuli that it is. But yes, the impact on dreamscape, the modern world's impact on dreamscape is as big as the. When there were rumors that when black and white television went to color that dreams also became to color. There's some urban legend about that. Like, I mean the world was in color. But when, when color magazines and color TV came out, there are small reports that our dreams were more in color.
- [60:43]
Chris Williamson
Wow.
- [60:44]
Dr. John Della Volpe
So that's. But the point is whether that, whether somebody can further explore that or not. But right now this is, this is a, this is a PhD thesis for somebody right now if they want to run it.
- [60:55]
Chris Williamson
How unsurprising that the things you consume will influence the way that your subconscious works at night.
- [60:59]
Dr. John Della Volpe
But sometimes not, right? Like it's, it's an inconsistent process of feeding your dreams. And that's what I like about it is that you think like this. You think your dreams are only going to have the thing that you're worried about and it doesn't. So it has. It's metaphorical. Like you're. You might have a lot of anxiety about something and then your dream is filled with Anxiety. But it's like. It's like Vietnam veterans when they were going through divorces, they would have their PTSD come back. They weren't. They weren't dreaming about fighting with their lovers or spouses. So dreams arise in a way that's metaphorical and requires interpretation by the person who's having the dreams.
- [61:40]
Chris Williamson
What do you think that says about where the inspiration for dream material comes from?
- [61:46]
Dr. John Della Volpe
I think it's a constant. It's so. So I think during the day we are just stay with me now. If we took a brain and we flattened it out and we said they were continents, right? Thinking of the brain as this spot or that spot. Sometimes if we injure a certain spot, like a nail. I used to take care. I did a lot of trauma. Nail gun injuries. They come in with like a nail stu stuck in, you know, or they'd have a fall and a blood clot would come out. You would say, you take out a certain part and they would lose a certain capacity. You say, oh, this is. What does this. It's not like that. It's like Heathrow or London, you know, if you have an issue at lax, it's going to disrupt something globally. But it's not that LAX does flights. LAX is a hub that controls flight throughout the planet. Similarly, there are spots in the brain hubs that control broad processes throughout the brain. And what I like about it is that these injuries have informed us about how the brain works. And when you have an injury in that dorsolateral prefrontal cortex, which is these little spots here, that's the conductor of your whole brain while you're awake. Those people struggle with math. And so it's okay. It plays a role in that. And if you flatten out the brain and you have these different continents and lobes and structures, hypothetically, you have certain parts that are ramped up during the day. During Executive Network, they're not in one area. They're connected by a lot of things. Like, where's the economy? I mean, is in the cities and Wall Street. It's everywhere. But there are some hubs. So the Executive Network is one. It's like in Las Vegas, where Bellagio, where those waterfalls go up. Think of the Executive Network as those neurons and their connections. They're like 51%. They're running right now. And the imagination network is 49. And. And when you dream it, it kind of flips. You have 49, 51, hypothetically. Okay. But when you're. When the. When you're daytime and it's Executive Network, you're still pulling from imagination to run to get the task done. You're still thinking. If I went left, if I went right, it's called counterfactual thinking. If I go this way, last time I got hurt, you know, you're still imagining. Plus executive network. And what happens with dreams is when the executive network falls back. Your brain uses imagination in its own mental workspace. And the biggest example of that is dreaming. So think of the brain as always on. And there's always a balance between executive network and imagination network. And the examples of the most dominant time when your executive network is happening is under threat when you have to navigate a crisis. And the biggest example of when your imagination network is most dominant, let's say 54 to 46, is when you're dreaming. But everything in between is a dance between execution and idea. And what I like this is just a side riff. They did this thing about analyzing poetry or book cover designs and they would put these people in FMRI machines. And the idea generation is mostly imagination network. But to figure out if you came up with a good idea, you had to toggle back to dominant executive network. Otherwise you just got a bunk idea, right? And so that what I don't want people to walk away thinking that we're liminal states that we're all one or all the other and there's a thermostat in our life and how to cope. But there's also a balance of executive network and imagination Network. And there are things creative people do to bring in the imagination network. But imagination requires executive function. And really great executive function still requires imagination.
- [65:47]
Chris Williamson
What are some of the ways that people who want to activate their imagination network more effectively when they're awake can do that?
- [65:54]
Dr. John Della Volpe
Oof. All right, so I got some stories for this one. There are some examples that speak to again, a damaged executive network liberating a lot of imagination. One example is alcohol. It dampens the executive network. And some people feel that they're more creative on alcohol. And it's dose dependent, you know, not 10 drinks, not one drink. I mean, alcohol has to be really handled with care at different doses. It makes you feel different things. Number two, frontotemporal dementia that Bruce Willis has these patients in Alzheimer's clinics when they have a certain injury to that part of the brain, there are publications. If people go on and look it up, they show them and they're like artistic abilities. They can paint a lot better. Dementia and injury to the executive network leads to a liberation of hidden artistic like painting Drawing talents. So those are two examples. Some people get hit with lightning bolts. And even if it's one person, the electrical shift can release can change that executive network to.
- [67:06]
Chris Williamson
No way.
- [67:06]
Dr. John Della Volpe
Yeah, I mean they're out there for savants. So when I say this, I want people to look it up, you know, and that's also One Flew over the Cuckoo's Nest where that movie made a portrayal of shock therapy as very negative. And it generally was. But now we create, we send in electricity and create a seizure to break people out of suicidal thoughts and stuff. So there are a lot of things and those people sometimes have more creative ideation. So we know that there are hidden creative abilities in all of us. And the executive network is, is, is reining them in to get the task done. To drive on the freeway, to be on the tube. So how can we extract those? I would go back to sleep entry where that's a window where Salvador Dali thought you have good idea generation. Sleep exit is also an, is a time where the executive network hasn't fully come back online, if you will. So your ideas will. I have a lot of ideas during that time. Bad ideas, good ideas, but it's an idea generator. And then during the day, what you have to realize is you're not going to hit. Undirected thought is actually the thought you want. When you're trying to be creative, it's hard to have a triple espresso and then drop creative stuff. It's the liminal time waking up, meditating, exercising, focusing on something like a flow state partially, but not, you know, not.
- [68:34]
Chris Williamson
Exclusively driving, doing the dishes, playing pickleball.
- [68:36]
Dr. John Della Volpe
But partially engaged and then something and then some and then it. You can't demand it, you have to cultivate it.
- [68:43]
Chris Williamson
You can't liberate it, you can't white knuckle creativity. It's highly, highly irritating.
- [68:48]
Dr. John Della Volpe
Another espresso. Let's, let's.
- [68:50]
Chris Williamson
Yeah, run it back. Fuck it. Yeah, that's, that's certainly something I've found to be true. Sitting down and demanding yourself to be creative is a reliable way to ensure that you're not creative.
- [69:01]
Dr. John Della Volpe
You have to flirt with it. I mean, that's why it's not, that's why it's not a gift everyone has, but it can be cultivated.
- [69:07]
Chris Williamson
You know what you mentioned there about some of the transcranial electric stuff. As a neurosurgeon person in that world, what do you make of what, what do you make of this sort of new revolution? I know that depression, anxiety, some compulsions are being treated with this now. Yeah. What do you, what do you make of this?
- [69:30]
Dr. John Della Volpe
It's real. Right. But it's also very easy to go on Amazon and get one for four night, 4.99, where they got the little headband and being positioned in the same way. So the stuff where it's real is rigorous, it's intense. It's at massive elite centers.
- [69:48]
Chris Williamson
Usually 30 days of back to back treatment as well.
- [69:50]
Dr. John Della Volpe
Yeah. And they. And not a 30 day refund like on Amazon. Right. So every time I. Neurosurgeon. Neurosurgeon. E was a funny word. We have to be able to talk about things like instinct and hunch because that leads to the fullest capacity. Right. Smarts plus instinct. Who doesn't want that? Sports has the best thing, like, you know, under pressure, how people perform. That can't, that can't be white knuckled either. The, the brain has to be thought about in scale. You cannot answer all of these questions with the brain. Like people talk about it, it's like you can't. It's not a homogeneous organ. It's not a liver. If you dice up the liver at different areas and you put it on a magnifying glass, it's the same cell essentially for the most part. The brain has so many different cell types, so many different architectural components floating inside. You know, it's buoyant, it's floating astride liquid. It doesn't actually sit on the skull, you know, and like, so it's a, it's an ecosystem of little electrical molecular machines like tiny jellyfish that are spraying electricity and chemicals at each other. And as we talked about before with those stickers, you can record electricity, you can also deliver electricity. And that would be shock therapy. And now what's less disruptive is delivering using magnets. So for people who are familiar with physics, I'm not. I took all the classes to go to medical school. But electromagnetic magnetic fields, they, they can influence each other. So you can pulse a magnet through the skull and it can change the local electricity of a certain region. So you can actually put a magnet on the surface, no incision required, and pulse to the motor strip and make somebody's arm move. Because, because back to. It's an electrical currency that leads to dreams. You know, it's measured at night with dreams. It can be, it can be tickled. And so now at Stanford's doing some good stuff within other places is, well, what if you, what if you have obsessive compulsive disorder? Somebody else makes the diagnosis. The Term is not used casually. Let's say it's not like I'm obsessed, but somebody really is. Like, man, I turned that doorknob 120 times today. So they're looking at the. The pulse can be used to dampen the dorsolateral prefrontal cortex when it can be used to heighten. So if you pulse that area every day for 30 days and you dampen it a little bit, and at the same time, somebody gets therapy and you do cognitive reappraisal. Like the, the parts of therapy that I like are some of the ways where you're basically training yourself and you say, hey, that's not dirty. Don't. Don't worry about it, or that door is locked. You don't need to wash your hands 80 times a day. Like you. You've been struggling with that fight the whole time. People with ocd, they know they shouldn't. And now if you pulse that area, that's kind of made it, you know, difficult for them to control. That combination is leading to results that we haven't been able to find by just giving medicine. So it's real. But the thought that you can buy this and then do it for yourself.
- [73:08]
Chris Williamson
Self administer.
- [73:10]
Dr. John Della Volpe
Yeah. Or with. With the tech, with a device that looks the same but is not delivering the same technology. But that. That is the future of mental health is a combination of therapy, magnetic pulsing, occasional medicine, and that as a cocktail. Not just like three different types of antidepressants which were helpful in for people, but. But a mixture of talk therapy, a mixture of exercise, talk therapy, magnetic pulsing, all non invasive. And if you can get a 10, 20% improvement in what we're already. What's going on right now, I think that's fantastic.
- [73:45]
Chris Williamson
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- [74:44]
Dr. John Della Volpe
Yeah.
- [74:45]
Chris Williamson
What's that tell us about.
- [74:46]
Dr. John Della Volpe
I mean, this is how the. I mean, this was a story back in. I noticed in my 20s when I was in training. So. So there's this thing, you know, some. Some patients benefit from being woken up with. With their skull open in surgery.
- [75:05]
Chris Williamson
This.
- [75:05]
Dr. John Della Volpe
That's.
- [75:05]
Chris Williamson
How could you benefit from that?
- [75:07]
Dr. John Della Volpe
Because whereas this dorsolateral prefrontal cortex, we kind of know where it is, whereas the movement area, like the hand region, we kind of know where it is. You know, just based on an mri, it's consistent in you and me and others. Language is in a neighborhood. It's in the left temporal lobe right around here. And there is no. There is no specific address for it. It's different in both of us. And so to figure out where language is so you don't hurt it as you're trying to enter the deep brain through that area, you have to map the brain. And let me. And so what we're trying to do is to get to it. So the neurons, the bodies of the jellyfish, molecular jellyfish, are all on the surface, and then their axons and tentacles converge into the middle of the brain. So the cortex, the canopy, the treetops, is where all the. Where all the thoughts are happening, if you will. And so what we're trying to do is identify the parts of the treetop right here, the cortex, that when you stun the activity in this tiny little area, it doesn't lead to any. Any issues with them talking or understanding. And this is a. This isn't just like, they'll still be able to text. You can. You can hurt the whole capacity of language. So the only way to do that is to wake. Wake them up in surgery. And there's a. You numb the scalp, you put them under anesthesia, you open the skull. It's like ice fishing. Then there's a little covering on the brain called the dura matters, like a. It's like, you know, like a sort of a skydiving parachute material. You can pick it up and stitch it at the end. You open it up, and then there it is. It's beautiful. It's stunning. It's white, speckled with blood vessels. And. And then you. Then you let Them wake up slowly over 30 minutes. You know, the propofol is lightened. And then somebody engages them, and you have them count and sing and sometimes even play the guitar. Like, UCLA's got a YouTube video of somebody doing that. Like, bigger capacities, right? Not just, like, pinch your finger, but. And so they'll sing. Like, they'll sing, or they'll count, and they'll do it in multiple languages. 1, 2, 3, 4, 5, 6. 1, 2, 3,4, 5, 6. And then you'll. Then you'll take a little spot, a little electrical pen, faintest bit electricity. And the brain can't feel when it's being touched. It only feels through the nerves it sends out. So when you dissect the brain on an awake patient, they have no idea what's going on. And you tickle the. You tickle the spot, and they. And you stun those, like, collection of neurons there, maybe the size of, like, a tiny pea. And they keep counting. 1, 2, 3, 4, 5, 1. You say, okay, I can go through this little piece to the deeper brain, and I won't hurt their language abilities. So you put a little white piece of confetti on there, a number, and then you go next to it, and then you'll find areas that cause speech arrest. You'll say, It'll be like, 1, 2, 3, 4. And you'll buzz. They'll go, 1, 2, 3, 3, 3, 3, three, three, three, three. That's for real. You guys can look all that up? That's been going on for 60, 70 years. And you say that caused speech arrest. You put a little red piece of confetti. So at the end, the surface of the brain, as you're going deeper, looks like Swiss cheese. And you've. You've identified the portals through which you can dissect to take out the deeper tumor and not injure their language.
- [78:27]
Chris Williamson
Why is language such an important indicator?
- [78:30]
Dr. John Della Volpe
Ooh, that's a big question. I mean, I think it's. I think it kind of makes us who we are. I mean, it was sort of a differentiating thing for. For mammals is language, and then all the complexity that comes with language. But it. It is housed in a neighborhood. And unlike the frontal lobes, there's not a lot of redundancy. So the motor strip is the same. Apes, you know, humans, the same language. It's kind of a fuzzy address. One frontal lobe can be injured with a spike, with a tumor. And people are mostly fine. I mean, they go home, they drive, they go to work. So there's a maximum redundancy in these. The prefrontal cortex is a. It's a. It's an important word. It's front of the front. It's the things that, that pushed our foreheads forward. And it has three very interesting components. The dorsolateral prefrontal cortex, which is mostly out here, dorso up, lateral. It's just fancy. Then there's an orbital frontal cortex, which just sort of sits above the eyes. And that does a lot of. Like, when people are injured there, they can't change their political views or they don't get, like, social faux pas. Like, there's a lot of complex social things that happen up here with a lot of redundancy and then language and feelings of spirituality and stimulating here where people, like, have nightmares, smell burnt toast. That's temporal lobe, and that's, that's a fuzzy area without a lot of redundancy. And then the motor strip is a very precise area. So there, there are different regions you have to learn how to dissect around and through.
- [80:13]
Chris Williamson
And some of them can have a little bit of damage and you still function relatively well. And some of them, even a tiny bit of damage and it's. It's wrecked. Yeah, that's.
- [80:21]
Dr. John Della Volpe
And that's the, that's the craft is how do I get to the deeper brain? How do I.
- [80:26]
Chris Williamson
Which without damaging anything that doesn't have redundancy.
- [80:29]
Dr. John Della Volpe
Yeah.
- [80:30]
Chris Williamson
How do dreams differ in people that have got brain injuries or really severe trauma?
- [80:36]
Dr. John Della Volpe
That's a good question. The. The range of injuries vary. The range of drugs vary. I couldn't, I couldn't figure out, like, the dreams on drugs was just so wild. I couldn't find a pattern. I mean, you know, people smoke weed, they don't remember much. Are they having fewer dreams or fewer. Less dream recall. And then there were stimulants and antidepressants and all the different combinations. I couldn't find a consistent pattern for it to become a chapter. I think that'll be for the next author. And similarly, in brain injury, there. There wasn't really a consistent pattern, with exception to one. The, the thalamus is sort of like this. The pineal gland that they talk about being the third eye. We, we remove that, melatonin goes away, we remove that, the patients are fine. So I'm not saying that people shouldn't believe in the. That concept and Descartes and third eye, but the pineal gland is essentially a vested. It's like the appendix, but the central. Like the size of an egg. There's something called the thalamus which is sort of the gate for all the sensations coming up and it refines the movements going out. When you have injury in that area, they tend to have a lot more lucid dreams immediately afterwards. So like, like it's, it's almost like there's too much arousal permitted in the sleeping state because the thalamus is injured. Right.
- [82:03]
Chris Williamson
The gatekeeper has stopped keeping the gate.
- [82:05]
Dr. John Della Volpe
Right. Because the gate is again, nothing is ever off. If there's an alarm that goes off or you smell smoke, you're going to pop up out of your sleep and dreams and that what is let through. And they used to do all kinds of weird things like have people sleep and they put their hand in a glass of water or a bucket and see what that changed. The point there is a thalamus is, is the gatekeeper that lets certain things through. If that part is injured, let certain things through and says, time to wake up. There's an alarm. If you injure that part, you get a more, more lucid dreaming awareness seems to creep into the dreaming state a little bit more readily.
- [82:43]
Chris Williamson
Could you see in some ways the thoughts that people have in their dreams being more real or more accurate to their sense of self than their waking thoughts? They're unencumbered by the executive network, tamping everything down. Their sense of self, the story that they have arced together. This is who I am and this is what it means to be me. I had a conversation with Dr. David Spiegel about hypnosis and it sounds not too dissimilar that maybe in some ways we're liberated. So, yeah, I wonder whether, yeah, some of the thoughts we have in dreams could be more real than the ones that we have when we're awake.
- [83:17]
Dr. John Della Volpe
Well, I don't know. But I will tell you that some dreams require no interpretation. Right. You're stressed out about giving a talk. You show up naked at the podium. Your end of life dreams, those tie up. But as we discussed earlier, let's not hold dreams to a standard. We wouldn't waking thought. Like we have all kinds of junk thoughts and thoughts that we don't want to hold on to. Thoughts that don't reflect who we really are. And I think similarly for dreams, it's. It's a wild landscape. What it is is your brain in a hyper emotional, hyper visual, hypersexual, hyper imaginative state. That is creating experiences at the neuronal level, not at the. You're paralyzed, so you're not living them out, but it's from your memory, it's from Your life story, right. It's drawing upon all that imagination that's liberated from the bank of memories and experiences you've had. And I think in that way it's personal, it's individual and maybe doesn't give a truer insight, but it gives a different insight. So you got to think about your life when you're awake, when you're waking up, when you're falling asleep, hold on to that dream that. That stuck along, stuck around a little bit longer and just use all those portals to put to stitch the story of are you liking where you're at and maybe you need to change or maybe you need to be at peace with yourself.
- [84:42]
Chris Williamson
I think the main thing that it makes me think is that it's a reminder we have way less control than we think we do.
- [84:48]
Dr. John Della Volpe
I love that.
- [84:48]
Chris Williamson
I think that's the main thing that shit is firing.
- [84:51]
Dr. John Della Volpe
We are not driving. I mean, and during the day too, right? I think that goes back to the. But if we learn the ways in which. At this time I have less emotional regulation. At this time I have more emotional. Like if we knew. It's not that we have a lot less control, but it's almost like riding. It's like the stream of conscious. Like there are some boundaries and you are sort of riding on a river. You're being tossed around, but you have some. You can drop a hand and control and pivot and move around a little bit. So I think if it allows for failure not to be permanent, allows for triumphs not to be permanent, and allows for us to say that it's okay to not have a linear goal of self improvement and growth. Mindset, like to me it's cyclical. There's the winter in our life, victory. Sometimes just getting up victories, sometimes not. You know, just not falling apart if you get a cancer diagnosis or your child gets ill. So I'm trying to come up with universal ways of understanding how our brains and minds work. So it applies to the elite 900 running 100 mile athlete or the person saying, you know, I don't want to use this OxyContin that I got after surgery, that I'm trying to give this up. You know, that it's the same universal processes at play. It takes the judgment out of it too.
- [86:13]
Chris Williamson
Going a bit more broad than just dreams. Someone that spent a lot of time looking at the brain. What are the myths that are widely held about the brain that annoy you the most? What do you wish people would stop believing?
- [86:27]
Dr. John Della Volpe
That's a great. I wish they would Start, stop talking about it as the brain, as if it's a homogenous singular entity. The brain, the heart. And I think it's, I think it requires just one level more. And the way I would say is, I'd love for people to have a sense of scale in their explanations and podcasts and stuff. Is it at the neuronal level? Is it at the network level? Executive network or imagination network? Is it at the lobe level, the anatomical level, temporal lobe and language? Is it at the global electricity level? Seizures, dreams? And so when people say, well, the brain prefers this, the brain thinks this like the. It doesn't make sense to me because it's not descriptive of the tremendous diversity in this ecosystem in our skull. So I would, I would love to see one more level of, not proof, but a little detail of precision, depth of explanation that goes beyond the brain, as if it's like muscle or liver.
- [87:40]
Chris Williamson
Yeah, yeah, yeah, yeah.
- [87:41]
Dr. John Della Volpe
Right. So that, then that way you'll know if people have really thought it out. That's one. And then the number two is this myth that we only use 20% of our brain. No, I mean the whole brain lights up, but to do one thing, we may only use 20% because it's really an energy hog. So the brain wants to be efficient and fall into patterns. And the last one is that it's limitless. You know, your body's limitless, your mind is limitless. Actually, no, it's. I, I think you can be closest to limitless in your behavior if you realize that there are patterns and proclivities and tendencies that all human brains and minds have and to try to identify when somebody does it well, what are their coping strategies when somebody's struggling, the way in which they falter with their goals. Maybe I don't, I'm not falling apart now. But there are, there's a lesson there for me because I don't know what's down the road. I haven't gotten knocked down yet. And that's called ecological validity where it has to constantly be tested in real world scenarios. So to me, the learning that the brain is not limitless and the brain creates a mind that is reciprocal. Brain makes the mind. Mind can change the brain a little bit. And then the biggest conundrum is why the mind doesn't always translate to behavior. You're like convinced, I'm not going to do this or I'm going to do this. You just can't get it done. That bridge between mind and behavior is also another. An area that I'm looking at. And that's where the coping strategies go. Rather than saying, oh, don't drink, don't smoke, it would be nice to say, when the thought of smoking a cigarette comes in your mind, these are the processes going on. Break it at the cognitive level with step 1, 2, 3. Avoid the intentional magnet. Do this. Don't look at it. Definitely don't let that smell come into your nose. Okay, now it's in your body. You had a whiff of smoke that your partner's having. Now your body's jonesing for it. Your hair is sticking up. Bring in these strategies here. Somatic therapies. Deep breathing. Like to know the ways in which we falter and then to apply strategies. Because the brain is not limitless. It falters in a certain way, triumphs in a certain way. So a little bit more prescriptive to the way. What stage in your, you know, failure or triumph you're at would give a little bit more precision to. Rather than. Because it could. It can get overwhelming. I would never tell my cancer patient, like, you know, just be well, or you can do it. They have to be coached through the process. So I'm trying to come up with a universal toolkit to understand this is what I'm feeling. This is the way most brains and minds and people falter when at this stage of addiction, of desire and at this step, I want to use these strategies. Okay, now I'm going to get the cigarette. Okay, now I want to use mitigation. Give away the pack, you know, like. But not to just give a global strategy. Don't smoke. Don't smoke. But if you're being pulled in that direction, here's the game plan. That's what I want to build a universal toolkit.
- [90:54]
Chris Williamson
Do you think the neuroscience industry is overselling some of the new tech that's coming along? Fmris brain scans of all different types. We can detect onset of Parkinson's, CT scan with contrast, all of this stuff. Are we. Are they making promises that the sort of insights can't cash?
- [91:20]
Dr. John Della Volpe
I think so. It started, like, 20, 30 years ago. We needed these scans to do surgery, to do brain surgery. So I'll tell you, this is another story. My professors, they. When you had a blood clot, they would see like somebody's eyeball was, you know, pupil was big. And they would call it exploratory trephination with a hand drill. Just start with the patient's family's consent. Thirty, 40 years ago, there were no CT scans, and they would just make random holes Till they hit blood, like drilling for oil. Then a CT scan came out and changed everything. You could see which side the blood clot was on. It's fantastic, right? They're coming out of hospitals for neurosurgery. Then we try to figure out, like, function. And that's where FMRI started. And because MRIs don't have radiation, you can elect to be in there. You can get MRI every day. CAT scan has radiation. And so neuroscientists started putting people in there. And what I would say is what's happened is the term is being thrown around brain scans, but the information, nobody's explaining it, that this area is activated. But what if you activate the area that, you know, stops a function? That's different than activate an area that grows a function. Right. So there's a modulation of the brain. Not all activation is good, not all inhibition is good. Right. And so those nuances are not getting out. But the term brain scan can be used by any author now. And I'm not saying that. I mean, everybody's an expert in the brain, right? Because we have one. So I'm not saying that we should limit that. But the question should be one step further. And what, what is the meaning of that? A brain scan shows this. And the way to understand, in my opinion, what the meaning is is to ask how is that experiment set up? Right. Like just to say, so you have a thousand people who think of puppies in an fmri, and then you have a thousand people who don't think of puppies and think of snakes in fmris. And then you're looking at the differences, puppies effects on mental health versus snakes effect on mental health. That experiment can't be set up because you can't stop the person thinking about puppies thinking about snakes, and you can't really control the person thinking about snakes thinking about puppies. There's no way to set that experiment up. So when it says brain scans show this, I think if I were an interviewer, I'd say, well, how is that experiment set up? And I think that way we would get past some of the fluff that's out there. Because it has. There has to be an experiment that justifies the answer. And then just throwing out brain scan I don't think is enough.
- [94:08]
Chris Williamson
What role does lifestyle really play when it comes to cognitive decline?
- [94:13]
Dr. John Della Volpe
Massive.
- [94:13]
Chris Williamson
I'm seeing a lot now. I'm big behavioral genetics Stan as well. I think that heritability has got a big fettered past. But it's real important. And I Think that more people should learn about behavioral genetics than do. I think it's. There's a lot being laid at the feet of. Of lifestyle because it's something that we do have control over in a meritocracy where people feel like they want to be able to author their own life. This idea that you are being puppeted by some stuff that happened literally before you were born, like as you were conceived, is very disempowering as an idea to a lot of people. But I also think it's super informative. And if you can kind of get past the initial discomfort of ha. There's some stuff that I didn't choose that I'm at the mercy of, but on the flip side of that lifestyle as well. So talk to me about cognitive decline and its contributing elements. Lifestyle, genetics. How do you come to think about it?
- [95:13]
Dr. John Della Volpe
DNA is not destiny, especially when it comes to the brain in mind. Like, I mean DNA might be destiny for like heart attacks and stuff like that, or certain. There are certain medical conditions that are very linked to genetics, epigenetics. But whether you have a proclivity or tendency to have Alzheimer's or dementia or not, whether you want to stave that off because you don't want to know based on a new Alzheimer's test, or whether you've been given a diagnosis and you're trying to work through it. The treatment is all lifestyle and behavioral. The medicines are limited. They exist for early diagnosis and Alzheimer's, but the treatment is all lifestyle. The way I think about it is five key things to do, or a handful of key things to do is one, you got to keep the arteries open. We've been talking about the beautiful brain. You have four arteries coming up. They get into this beautiful branching pattern. It's exquisite. Parts of a loop over each other. Looks like a chandelier. We call it the candelabra. And they get narrower and narrower so you got to irrigate the flesh. So whatever is good for keeping heart arteries open and kidney arteries open is also good for keeping brain arteries open.
- [96:32]
Chris Williamson
Exercise.
- [96:32]
Dr. John Della Volpe
Yeah. Or taking the anti cholesterol pills that are long established and mostly saved. Like pretty safe, you know. So exercise. Yeah, but exercise does a couple of them. So you got to keep the plumbing open to irrigate these neurons. Number two is you have to eat a certain way. And I know there's a lot of diet stuff out there and that's a whole theme. But the thing that over decades has been proven to preserve or even increase cognitive health, cognitive function is is the mind diet, which is the closest thing to it is pescatarian. It's mostly plants, fatty fish. And the reason? Fat. So I like to take it one step, one step deeper. The reason it's fatty fish and omega 3s is. You mentioned the word myelin before. And so the little, the, the neurons and the axons, the way they make the electricity communicate faster is that the cable is wrapped with a fatty sheath that's called myelin. And then the electricity actually jumps across the little gaps they have and it goes faster than if it is not myelin coated. And thought can actually deposit myelin, preferring that thought to happen again. That myelin sheath is made from Omega 3s, so there's a specific fat that's needed for myelin and that's omega 3s. And fatty fish you can get in flaxseed and other things too. So keeping the plumbing open, giving the brain the material it needs. Now we're at the, at this scale level, right? Okay. And then you, then you go in a little deeper. The timing of eating is interesting. I, I do think there's some pretty strong neuroscience evidence of intermittent fasting. I know there are a lot of diet things out there, but skipping breakfast, if who, if you have the luxury of skipping breakfast, skipping, going 16 hour windows will, if you don't eat, you're not going to just drop dead. And the brain, the brain is a, a hybrid vehicle. The brain can live off of neurons, can, you know, thrive and, and use glucose or ketones. And so after 16 hours, your liver will, will churn out ketones if you haven't eaten. So that's how you live past, you know, the 16 hour window if you don't consume anything. And that switching back and forth in intermittent fasting. The cognitive test now, now we're getting from flesh to mind. People seem to have more focus, people seem to have more. It's not about weight loss, but intermittent fasting. It's letting the brain have glucose and ketones a couple times a week.
- [99:16]
Chris Williamson
That's interesting. So your suggestion here is that all ketones, someone that's doing a full ketosis or carnivore style diet, or somebody that's doing a classic sort of omnivore style diet, which when you're grazing, typically you're not going to drop into ketosis unless you forget to eat carbs for a couple of days or something, you're suggesting that there is a principled brain benefit and neurological benefit to the switching between these two fuel sources.
- [99:43]
Dr. John Della Volpe
Correct.
- [99:43]
Chris Williamson
That's interesting.
- [99:44]
Dr. John Della Volpe
Weight Loss is separate.
- [99:45]
Chris Williamson
Yeah, yeah, yeah. And autophagy and.
- [99:47]
Dr. John Della Volpe
Yeah, but, but also, I mean, there's a lot of ways to lose weight, but this, this is. We're talking about how to stay sharp, keeping the flesh healthy, keeping the plumbing open those arteries, you know, vascular health, exercise could do that. What we eat, giving your brain the right materials and the. Mostly plants will clear out the sludge and the Antioch. You know, the plants work because they got, they have antioxidants and tannins in these things that clear the sludge that these little molecular machines called neurons make. Right. That's why plants are good for your brain.
- [100:21]
Chris Williamson
Are there any that you prioritize in plants?
- [100:24]
Dr. John Della Volpe
Yes, I don't think it really matters. It's hard. Again, I can't find the experiment where they got a thousand people eating spinach and they got a thousand. But I can tell you over 30 years whether it's blue zones or the Mediterranean diet. Now specifically called the mind diet. It's Mediterranean diet. And those people, they get a lot less Alzheimer's than people who don't. So I can't distill it down to that. But Michael Poland, you know, he's great. Mostly plants and some fish and then the indulgence of the burger or the caviar or the, or the vegan, you know, burger patty. So it's all up to you, but the staple is pescatarian. Then we talked about the timing of eating, what to eat, the timing of eating. And then I think the other one.
- [101:11]
Chris Williamson
That'S just on the timing of eating thing, outside of the intermittent fasting thing, is there anything else to say on that? It's primarily at some point, a couple of 16 hours.
- [101:22]
Dr. John Della Volpe
Like ketones.
- [101:22]
Chris Williamson
A couple of 16 hour fasts per week is probably a good idea.
- [101:25]
Dr. John Della Volpe
Yeah. And relatively easy to do. You can have black coffee in the morning.
- [101:30]
Chris Williamson
I feel great. When I do. When I fast, I feel really, really great.
- [101:34]
Dr. John Della Volpe
Yeah. And, and that's another, another theme I'm trying to tie in. Like things that have worked for the ancients, you know, whether it's again, back to Aristotle or fasting and different things. Again, for people who have the luxury of this right. Most, there's a lot of food insecurity. I'm just giving you the conceptual answer. And then the, you know, the, the fourth thing is, is movement. So exercise is movement. But, but for my patients, what we've seen is that when you're vertical, like people think like it's gotta, you know, you gotta have, you gotta have the gear. You're out there, you're just. You look like you're auditioning for the Equinox commercial or whatever. Like, that's great. I'm not knocking that. But for most people, just standing. For my patients, the trajectories of patients who can stand and get up from a toilet and stand and get to the couch is so much better. Being vertical requires postural muscle activity. So what I would say is walking and movement are also cognitive protective. You mentioned exercise now. So exercise and movement does a couple of things. One, it keeps those arteries open that we talked about as far as the food. Number two, what to eat pescatarian. Third, and mind diet. People can look all these terms up. Third, when to eat, intermittent fasting for ketones. And the cognitive benefits. Thinking benefits, not structural. Fourth is exercises that it. That this ecosystem requires nutrients, not neurotransmitters that are being sprayed between neurons. But. But in the milieu, in the garden, if you will. And there are things like growth factors, obviously. BDNF is a popular one. I had a grant from the Department of Defense studying it. I'm familiar with it. What I want people to know is when you exercise, it's not like it's released from, you know, like your thigh muscle and swims up to your brain and says, hey, I'm helping you out. Now that these chemicals are housed in the brain and exercise is the cue, is the signal for your brain to release them on themselves. BDNF is released from the brain for the brain when you exercise. And I think that's. I think that's powerful. Outside of the cardiac and weight loss, I'm just talking about a little bit of movement a couple of times a week, and all of a sudden it starts to feel like, hey, I could do these things.
- [103:57]
Chris Williamson
Yeah, they're pretty low bowels to entry, but.
- [104:00]
Dr. John Della Volpe
But high, high impact and proven. And then the last one is, you got to think, man. You got to challenge yourself. I mean, if, you know, if Usain Bolt you. You know, you ask them how to run faster. Say you train.
- [104:11]
Chris Williamson
You're.
- [104:12]
Dr. John Della Volpe
You train your biceps. I mean, it's. It's a thinking flesh. If you don't. If you don't push it to the next level of complexity and thought and challenge. Not too hard where you quit. Just like video games, if it's too hard to get to. If. To level up, we tap out. If it's too easy, we're not engaged. So finding whatever you're engaged in, from puzzles to complex conversations, that needs to be challenged with thought, with ideas. With creativity, with reading those novels you're reading at night. So the fresh content that's engaging and requires you to think, think differently, think wildly, think in ways you haven't before. I think that's an essential part of also. That doesn't mean everybody who was a professor lived longer, did better than, you know. People are just rocking out, not approaching it that way. But creative ideation, I think, is as valuable as just raw processing power. It's not all about doing math and puzzles. I think challenge yourself to be creative is an intelligence in itself.
- [105:23]
Chris Williamson
What about the impact of stress on brain aging?
- [105:26]
Dr. John Della Volpe
Well, I mean, this is a big question now. So this whole thing about cortisol is like, okay, I don't have an answer for that. I know people who live in a constant stress. It seems like bathe constant stress is bad for you in a lot of ways. I also know thrill seekers, surgeons, athletes. Every time they do something exciting, cortisol is up. Okay. And they don't have accelerated brain, you know, brain aging. So I don't have an answer for whether cortisol is doing it, whether stress is doing it, whether it's just a rough life, whether it's struggling with thoughts you can't control, which revert back to your brain and injure your brain. I don't have an answer for that. But I think with the story I would tell you about that is there's a tumor called pheochromocytoma, and it sits on top of the kidneys and it releases all this, all these what basically look like you're extremely stressed out.
- [106:28]
Chris Williamson
And is that how it feels as well?
- [106:29]
Dr. John Della Volpe
That's the essential question, my man. They don't come in like, ah, that is the essential question, my man. That's a banger. That's total. I don't have the answer, but I'm leaving you with things. I hope I want to know the answer. But the brain contextualizes all of this surge of stuff that's happening.
- [106:47]
Chris Williamson
Interesting. Do you know Rick Hanson? You familiar with Rick? Neuroscience guy. He wrote Hardwiring Happiness. I read that and spoke to him, and he became a good friend. And then the more neuroscientists that I speak to, the more I realized that a lot of the stories that we tell ourselves are kind of repurposing mechanistically what's happening in the mind. But the weird thing is nobody talks about the story you tell yourself about your knee injury, right? You know, someone snapped their acl, and it's not about thinking your ACL back into contact. We understand that there's a mechanism that's going on in here and that that really needs to be fixed and that there's a pretty well established process that you go through in terms of rehab and it's progressive overload and tendons really love to be under time and attention. So you're going to do this and you're going to get range back and there's a combination of stretching that you get with strength and the more range that you get, the less you know all of this. It's mechanistically very well understood. But the thing is, there is no massively phenomenological sense of having an acl. There is one for everything that happens in the brain. And I really got into psychology, human nature, you know, Angela Duckworth or James Clears of the world, Morgan Housels, you know, a lot of people that write very astutely about human nature and about psychology and are going to evolutionary psychology, which is even maybe one step further removed, right? That's like the source code and that a lot of accusations have, just those stories and things like that. And that's really cool and compelling. The more that I spend time thinking about this stuff, the more I try and come back to mechanistically what's happening in the brain. Because it really does feel like, for instance, with gratitude from Rick's understanding here, he basically sees happiness as your ease of access to being grateful about what's going on. And he has a very simple process that is well understood and just reflects the mechanism of what goes on in the brain, of have an experience, enrich it and absorb it. And it's just this little acronym that you go through. I thought that's so great. That feels to me one of the problems that a lot of people have when they read stuff to do with human nature and psychology is it feels so fucking wishy washy. You're like, I, I give me something to grab onto.
- [109:08]
Dr. John Della Volpe
It's like my puppy's example. But let me just jump in right there. I like that. And what really just gets me jacked in a positive way is when I see that our behavior and our minds work in a way that's actually reflected at the neuronal level, you know, so like if you stress stem cell reservoirs just enough, they'll make one of themselves and release a new neuron. So they're always replenishing them. They never. They're inexhaustible in that way. Right. They're stem cells. But if you stress them out too much, they'll Go into senescence or they'll die. And then you start to realize, wait, that's kind of how life is, right? Then you. Then I like to take it all the way to like, International Space Station. There's not enough gravity. Those bone cells in space, in our thigh bone, when they come back on the ground, they got a rehab for a week or two. The lack of gravitational stress leads to withering of osteocytes for astronauts. And so the same concepts in bone cells in space or stress in the human brain, that there is a necessary amount of stress that leads to growth, but if it's too much, we fracture. If it's not enough, we don't blossom. And I. And I like to take those concepts to then coping. And so, for example, like, this thing about resilience was tripping me up for a little while. Like, what does that mean? You know, like, be resilient. Like, I always try to think, like, I got to be able to say this to my sons. I got to be able to say to a newly diagnosed brain cancer patient. And, and what I learned from that is it's sort of this systemic and processive resilience, which is basically like the resilience you bring to the fight, you know, the strength you bring to the fight. And then the process, what the fight reveals in you. And what I like about that is that each cell, each person, each human is in their own individual path and has accumulated a set of experiences. And my hope is universal coping skills. And they're ready to engage the world in front of them. And that could be a lottery, that could be falling in love, that could be being diagnosed with cancer, and they're coming equipped with some skills. And in that cyclical nature of stress and growth that happens repeatedly in our bodies, like, that's actually what's happening in our lives. It's a cyclical nature of a springtime in our cells in our body, a winter in our cells in our body and life. And that there is no, like, linear trajectory towards wellness or a moment of arrival or a final clarity because you just don't know what the challenge or the gift in front of you is.
- [111:58]
Chris Williamson
Well, certainly one thing that I can say with almost absolute certainty is that you do not develop capacity to deal with things while you're dealing with things. Your capacity to deal with things is almost always developed in advance and revealed during. So there's one of the best justifications for mindfulness, that mindfulness is preparing for the worst day of your life. That's what meditation is. Meditation is preparing for the worst day of your life. It's the day that you lose your job and your dad passes away on the same morning. It's the day that your partner gets a cancer diagnosis and you find out that you're no longer employed or whatever it might be. If you're in the thick of it right now, I've been in the thick of it for a good bit of the last 18 months. You're doing your very best to not go under.
- [112:49]
Dr. John Della Volpe
Yeah.
- [112:52]
Chris Williamson
And then you fight, fight, fight. And then when you get a break and it's really. Actually, this is interesting. It's only difficult times that reveal to you, holy fuck. I couldn't really make much progress during that. I was just trying to survive. The urgent outweighed the important so much that all I could do was kind of try and hold it together. Okay, so what's the implication of that? When you do not have something that's super urgent in front of you when you're not putting out fires? It's a really, really, really good time to develop some more psychological resolve. Yes. That's the time that you try to get your meditation habit in. That's the time that you work on.
- [113:30]
Dr. John Della Volpe
Your health, you refine, you're training for the fight that has yet to come. Yep. With the toolkit that I'm trying to. I'll never finally make. But, I mean, that's what I'm trying to get at. And back to the cells. Cells go through a period of dormancy and at that point, not dying is. Is actually the victory. And then there's a springtime, just like in nature. And this happens in our biology and I think it happens in our psychology that you're talking about. And that those moments, there's a temporal nature. There's like reflection and going back and saying, okay, what are the lessons I learned? How would I handle it better? Forward. I love all that. I'm actually trying to come up with. When you feel like you're dry drowning or about to fall apart in that short temporal window, are there things we can do at that time?
- [114:18]
Chris Williamson
How do we interject right then?
- [114:20]
Dr. John Della Volpe
Yeah, the time sensitive maneuvers.
- [114:22]
Chris Williamson
Yeah. I very much like being able to step in on stuff that's acute. It's all well and good talking about building up your resilience and all the rest of it, but if you're in the fucking fight, you go, hey, I can't go back six months ago and start a meditation practice. Practice. Tell me what to do right now.
- [114:36]
Dr. John Della Volpe
Right. And so what I would say is, if you Know, the. I would say is that urges that hijack the body are very fascinating to me. When the. When the thought is now recruits the body. There's a whole new fight now, whether that's addiction, whether that's desire. Because now there's a feeling that if I don't go in this harmful direction, that I will feel ill. So now you're not just trying to stop a thought. Let's take the example of having a cigarette again. It's not just, I don't have a cigarette, don't have a cigarette. It could cause cancer down the road. It's bad. It's bad. You promised everybody you wouldn't. They might smell it on you. Whatever you're thinking, don't look at it. Look at those shiny boxes of the gas station, right? But then when you have that waft and it goes from the nerves in your olfactory bulb to your frontal lobe, and now you're just like, oh, man, that reminds you of so much. People will have physiologic changes. So now the fight is controlling your mind and body. And I believe the maneuvers are different when it goes from your mind to your body. And the management of bodily urges requires bodily techniques. Breathing techniques are the same ones I use in surgery sometimes when I was learning. And you feel like that, oh, around that corner, that tumor is going to run away from you. I mean, you gotta. You, you gotta not. You gotta. It's gonna. Either you're gonna freak out. You're not gonna freak out. And the simplest thing I can tell you is, like, when you hyperventilate, it creates a feeling of anxiety. Well, you got to take it the other, other way. The first maneuvers just control your breathing. Nobody knows. The room is just like, da, da, da, da, da, da. And you're just like, whoa, whoa, whoa, whoa, whoa. You know, this could. This could run away from me. And so I have my own maneuver that I do in that moment is just stop talking, you know, Or. And there's something I call out, I say, I need 15. And they're like, okay, everybody pay attention. Back to. Back to your positions. That he might say, I need this from the wall. I need this from the wall. And the whole thing is just. Just get that. Get that breathing paced. I'm not talking about one nostril. I'm not getting into all that. I'm just trying to tell you physiologically, if I pace my breathing, I can slow down this swell of fear and panic that's in my guts when things run away from me. I try to Use the same thing with a lover and with a conflict. But that's a specific toolkit that has a physiologic basis that I can explain that the ancients use is, is in the acute moment. And I'm hunting now, you know, the next year or so, but are there other maneuvers that, that we're all equipped with that can work while you're, you know, while you feel like you, you're falling apart or you're drowning or you're struggling, you know, at that moment? Not in rearview, not in the future. I will. Right now, right now, what do I do?
- [117:29]
Chris Williamson
Is there anything you've ever seen in surgery that shook your belief in signs?
- [117:40]
Dr. John Della Volpe
Not in surgery. Surgery is a physical performance, is ballet. But I have had, I have had patients in the psychological sciences. I've had patients where I just look, I'm like, I don't know the, the, I don't know how the great majority of cancer patients get dressed, come in and are ready to get the worst news of your lives every three months when we do the scans. It's come back or didn't go away. I mean it's just, it's just so heavy. And the, the what the fight brings out in them or the coping skills it brought and it's inconsistent. I'll get to the, the more philosophical question. It's inconsistent. Somebody comes in, they've got the wellness techniques, they're the CEO, they get hit with that C word, it's you don't know what you're going to get. And then somebody comes in, they're struggling with something, they look disheveled, you're like, this person's not going to handle as well. It brings out something in them. So I think this feeling that, that arrival in some sort of wellness and achievement or clarity, understanding of life is misguided because we don't know what's coming next. I think it's cyclical. Develop your skills, time sensitive skills in the review, being prepared for being what's forward. That's the way I've been approaching it. And as far as shook my belief in science, I would say something recently has liberated my view in science that it's through science we can have understanding that we might not. So there are these near death experiences, those electrodes are being recorded. People in Canada and studies starting to come out that when the heart stops for the first few minutes afterwards, the brain just deploys all its chemicals and electricity. So whereas other organs whimper to death, like the brain is struggling, the heart stops. And then if you Measure the electricity because you can actually have a dnr. You could say, look, if I have a heart attack, don't touch me. Do not resuscitate. And they're still monitoring. You still get a live feed of the brain electricity. So you would think the heart stops, then the brain electricity stops. But it goes for a minute or two afterwards and it's wild, fierce. It's not like it's a sir. So that's a measurement. What does it mean? That's for everybody to explore. But to me that's like, okay, so there's, there'll always be just amazing neuroscience information coming from hospitals and patients that's a little bit more than just scanners. Right. And when those people are resuscitated and why do they all universally say, I saw, it's a film strip of my old life. And you know, there's a consistent pattern of what happens. And if you drown or if you have a near death experience and are resuscitated in whichever manner, they come back reporting the same thing. Film strip of their life. Wide stories. They saw loved ones. And when you look at the electricity, it's very consistent with dreaming and memories. So to me, I love the fact that now we might be able to explain why near death experiences are a consistent perception or experience for people. So I love seeing that stuff come out. Yeah.
- [120:52]
Chris Williamson
I'm interested in what working with terminal patients has taught you about living life.
- [120:58]
Dr. John Della Volpe
Well, everything. Yeah, everything. You know, it's thousands now. I mean, 52, massive experience. About three adult sons, massive life experience. But since 25, I've been taking care of some of the sickest people in the hospital. Brain injury for 10 years off your life? Yeah, I was a kid when I started. You know, I mean, I look at my, I look at people in their 20s. I'm like, I was like 26 or 27. I wrote about it for a Vice article. I would drew care. I mean, I helped families land their patients, I mean their family members and remove the breathing tubes and say their last rights and wishes and all the different cultural elements that come into it in ICUs. I was 27 years old and I started to see there were patterns in the ways the brain and mind respond when the finish line comes closer. It's not trauma. You're gone. You don't know it. It's okay. Three years, two to five, seven. You can't quantify, but you know it's coming now. It's in, it's in sight. And they had a universal. All of them say the Same thing again when that finish line comes into view. And it's the lessons I think everybody else talks about, but they have a similar thing about reconciliation, forgiveness, about having spent more time with their children. Usually it was like busy, busy dads at that time. My 20s, you know, and I, and I incorporated that. I had a lab, I raised my kids, didn't take them just to the baseball games, but the practices spent a lot of time to them and that they seemed unencumbered, they weren't. So the little things don't get to them as much. And the question then becomes, how do we take those lessons without actually having, you know, if hypothetically, the finished, God willing is 25 years away from me, how can I actually live it like it's five years from now. And that's the lesson that my cancer patients have taught me is one, start now with what you would if you had, you know, that you do five year curves. And two, build your coping skills. Because the ones that I saw do well, they had techniques. I mean, I'm just coming, coming back to this and like I learned one from one like every three months. The scans, let's just imagine brain scan two, three hours, six hours, who knows what it's going to. You show up in clinic, it's another hour to wait to hear it for somebody. And they, so they would do this thing where like, look, the 11 weeks in between, I can, I can hold on to myself and say, this is not the time to be stressed, but I need to have a week when I'm just completely losing it. Like, you can't just not be stressed about that. But they were able to compartmentalize it to have like 11 good weeks and then another shitty week because, oh my God, I got another. Get a brain scan and see Dr. John de All. And so I started to see those techniques they were using to make the most of their cancer journey. Support network is nice, but the support network can be surprising. It's not always who you think it is. You know, once that cancer word arrives, relationships break up, surprising relationships form. And so, you know, no triumph is forever and no tragedies forever. But if you come equipped with your own personal and psychological toolkit, you know, we make the most of this run.
- [124:36]
Chris Williamson
Heck yeah. Dr. John DL Ladies and gentlemen. Why should people go, you're going to want to keep up to date with everything you've got going on.
- [124:41]
Dr. John Della Volpe
Just, I don't know, I just, just, you know, I'm a surgeon at City of Hope Cancer Center. I think that's the easiest thing is look up Dr. John DL at City of Hope and then, you know, things will pop up. But appreciate you having me on.
- [124:53]
Chris Williamson
I appreciate you too, man. I get asked all the time for book suggestions. People want to get into reading fiction or non fiction or real life stories and that's why I made a list of 100 of the most interesting and impactful books that I've ever read. These are the most life changing reads that I've ever found and there's descriptions about why I like them and links to go and buy them. And it's completely free and you can get it right now by going to ChrisWillX.com books that's ChrisWillX.com books.