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- [00:01]
Dr. Rena Malik
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- [00:52]
Dr. Alok Kanoja
So mark your calendar and shop Wayday starting October 26th at Wayfair.com Wayfair Every style, every home. Where does pornography activate the brain? And it turns out that it's like everywhere. Just about every lobe of the brain is associated with sexual arousal. And in some way, you know, you can get visual cortex stimulation, auditory cortex stimulation, imagination, emotional engagement. So every part of the brain, dopamine, is involved in pornography. And then the other thing that pornography is really good at is, is really shutting off our negative emotional circuitry. Sex is really important and so our brain is willing to push everything else away in order to have sex and procreate. So it's, it's incredibly effective at really suppressing our negative emotional circuitry. And what we tend to see in any addictive behavior is that it gives pleasure and it takes away pain. A lot of people who watch pornography don't necessarily masturbate with it. So I've had, you know, people that I've worked with that will like just be watching it while they're like doing work like on a second screen because it somehow sends those signals to the brain to like suppress our negative emotional circuitry. So it's a, it's a really weird kind of beast.
- [02:05]
Dr. Rena Malik
Welcome back to The Rena Malik, M.D. podcast. I'm your host, Dr. Reena Malik, urologist and pelvic surgeon. Today Our guest is Dr. Alok Kanoja. He's a Harvard trained psychiatrist with a tremendous psychological social media platform that reaches millions of people with online educational content. His expertise is in mental health and technology and he's co founded the Healthy Gamer platform that coaches thousands of people on healthy gaming. Today we talked about screen addiction as well as porn addiction. What is porn addiction? Who gets affected by it and how you can deal with it. We also talked about tantric or tantric sex and how it can benefit you physiologically and spiritually and what people are getting wrong about semen retention. We also talked about the challenges that young people face in dating these days, as well as the rise of artificial intelligence, particularly the future of artificial intelligent people or dolls that may impact the way we interact with society and potentially have devastating consequences. We Hope you enjoy. Dr. K Alok, thank you so much for joining us.
- [03:07]
Dr. Alok Kanoja
Thank you for having me.
- [03:08]
Dr. Rena Malik
I'm so excited to have this conversation because you bring such a unique perspective. Right. You have both Eastern traditional values that you've obtained from your life experience as well as of course, going through the medical system here in United States and becoming a physician trained in the US So I think you bring a very unique perspective. And of course, obviously mental health and the things that you deal with are so, so important.
- [03:31]
Dr. Alok Kanoja
Yeah. Thank you.
- [03:31]
Dr. Rena Malik
And your content is so valuable. So if you haven't checked out Dr. K's YouTube channel, Healthy Gamer, and on every other platform, it's very, very helpful. So, you know, when I was listening to some of your older interviews, the one thing that I remember you saying is don't take your phone to the bathroom. And I remember listening to that and being like, oh my God, like, yeah, we shouldn't be taking our phone in the bathroom. But it's like this visceral reaction, like, no, like, I can't go without my phone.
- [03:57]
Dr. Alok Kanoja
Yeah, absolutely. Yeah.
- [03:59]
Dr. Rena Malik
And so like, first of all, why are we so addicted to our phones that we have to take them with us to the bathroom?
- [04:05]
Dr. Alok Kanoja
I think a couple of things. One is if we look specifically at the phone and specifically at the bathroom. So I think one of the things that we've like lost is the ability to be bored. So if you really look at it, we try to externalize our attention and we try to have our attention constantly be on like a particular thing and be somewhat entertained.
- [04:24]
Dr. Rena Malik
Yeah.
- [04:24]
Dr. Alok Kanoja
Because if we especially look at the bathroom, it's like, what are you giving up? Right. It's not like you're doing any important work in there. It's not like you're going to be laughing really hard. Like, you know, sometimes, like, social media and technology is about, like, lots of fun. Let's watch some cat videos. And, and so really it's about sort of fast forwarding our mind, accelerating through that boredom. And, and I think what we've sort of found is that there is a device that's able to do that, to constantly externalize our attention. And even though it's super low stakes, I think we sort of see the depth of the addictive nature when we're so unwilling to give up something that's like, who cares if you're so innocuous? Yeah, exactly.
- [05:01]
Dr. Rena Malik
You don't need it.
- [05:02]
Dr. Alok Kanoja
You really don't.
- [05:03]
Dr. Rena Malik
But it's like such a. Like. Oh, that's my. Some people use it as their time to, like. Oh, they just spend more time. That can create its own problems. But, like, they spend more time in the bathroom, like, scrolling through their phone and, like, no one's gonna bother me in here.
- [05:14]
Dr. Alok Kanoja
Absolutely. I mean, by some people, like, probably all people, and especially people like young parents, you know, I think it's like, especially with how much. Because the other challenge with technology is that it invades every corner of our life. So if you're working, like, your boss is going to be texting you, emailing you, whatever. If you're a parent, like, you know, if your kids subconsciously know that if you're kind of around that they can bother you. And so sometimes the bathroom is, like, the only place of refuge where you get privacy.
- [05:42]
Dr. Rena Malik
Yeah, but it's important to be bored, right? Like, I think that's a really important part of our life that we've learned lost to some degree because of all this constant stimulation.
- [05:51]
Dr. Alok Kanoja
Yeah. I mean, I think there's so many consequences of no longer being able to be bored. So some of the things that I see is that there's just a complete lack of, like, introspection. You know, I sort of fell into this in an interesting way because for me, it was like, I want to be super efficient. So I remember when I was in med school, like, okay, it's like I wake up in the morning, and when I'm, like, making breakfast, I'm going to be listening to a lecture. Listening to a lecture. When I'm walking to the train, I'm going to be, like, reviewing something when I'm, you know, on the train. And then, like, every moment of my time is like, podcast or learning about something or being efficient. But at this, at the end of the day, it's still, like, externalizing my attention and I don't listen to myself. And if we look at it kind of evolutionarily, like, human beings used to have a lot of time with themselves. Like, we'd be like hunter gatherers and doing, like, rote work where the mind is unoccupied. So I think evolutionarily we really need that for things like emotional processing and stuff like that.
- [06:50]
Dr. Rena Malik
Yeah. And I can relate to that. Trying to be very efficient. I'm sure it's a lot of people who are high achieving or trying to be high achieving will do that. Like I will. I remember studying for the boards when I was a full time resident, working all the time, having two kids at home and being like, okay, I need to like maximize this time that I have in the car because this is like time I can get some work done. But you're right, it does lead to this sort of like go, go, go, go, go. And never taking a moment to just be like, oh, you know what? Like maybe I need to just take a second.
- [07:22]
Dr. Alok Kanoja
Yeah. So the, the really crazy thing there is that I think that a lot of people don't realize that spending more time doesn't actually improve things. So my first year of med school I struggled a lot cause everyone was like studying so much. And then I sort of realized like, this is not working for me. And so I actually started only studying like two hours a day. And that was like it.
- [07:40]
Dr. Rena Malik
Yeah.
- [07:41]
Dr. Alok Kanoja
So I'd study for two hours in the morning, I'd go to my classes and stuff like that. And then I'd be like done by 4:00pm and, and what I sort of found is that my retention actually went way up and like my focus went way up. And even now when we work with content creators, one of the big things that we're able to do is help them improve their metrics. So they'll get like 171 to like 200% increase, like view counts and stuff, sub counts, follower counts, but without increasing the amount of work that they do. So I think one of the big things that we've sort of lost is that like we don't know how to make our mind efficient. And I'm sure you've experienced this where there are some days where you're studying for boards and it like everything just sinks in and it's like a really good day. And then there are other days where you're like highly distracted and you're, you're on your third cup of coffee and it's like you're really struggling.
- [08:26]
Dr. Rena Malik
Absolutely. And I think it's so interesting when you tell that story. Is I very similar. So my husband who went to medical school also was like a studier. Like he's like always studying. So like I remember him telling me like, start studying for step one, which is a big exam we take. You know, this. But for the audience it's a big exam we take in medical school that helps determine how competitive you can be to match into residency. And so he started studying, like months earlier. And he told me, you should start studying. But I am not that kind of person. Like, I tend to do well if I do a focused amount of studying for a month or two, like, but not six, six months out. Right. And so I tried to do it and it was futile for me. And I also am the kind of person who does, like, very focused amount of, small amount of studying, but I don't tend to do hours and hours of it because it doesn't work for me.
- [09:11]
Dr. Alok Kanoja
Yeah.
- [09:11]
Dr. Rena Malik
And I think that's an interesting concept that a lot of people, yeah, they don't realize, like, spending more hours. And the first time I realized, I think, and externally was reading that book, the Four Hour Workweek by Tim Ferriss, because he talks about how much work he would get done in four hours. And it's like, yeah, if you are efficient and think about it, clearly, you can get a lot done.
- [09:28]
Dr. Alok Kanoja
Absolutely, yeah.
- [09:29]
Dr. Rena Malik
I want to talk about porn addiction because I think that's a really hot topic. And I think, you know, in terms of the mental health space, there's no real term for porn addiction. It's like problematic porn use. Right. But we see it, and in the literature it's probably like 4%. It's been described. But I think, you know, we're seeing more and more of it, particularly in the younger population, as they're sort of seeing pornography earlier. How often are you seeing porn addiction and what are your thoughts on it?
- [09:58]
Dr. Alok Kanoja
So I see it a ton and I think there are some problems in the literature. So, like, I'm not going to talk about porn addiction specifically, but just to use an analogy. So if we look at gaming addiction. So in 2010, the incidence of the prevalence of gaming addiction was about 6%. I think in 2020, it was like 9 to 11%.
- [10:16]
Dr. Rena Malik
But remember, it's pretty high.
- [10:17]
Dr. Alok Kanoja
It's very high. So 6% is around the same rate as alcohol. So, like, we're like, we have twice as many video game addicts. But then the other really troubling thing is, remember, this is prevalence of the whole population. And we don't have a lot of people over the age of 50 who are addicted to video games. So what we're really seeing is that even if you look at 10% of the population, it's not the population as a whole. What we're really seeing is like 20% of kids, which is staggering.
- [10:40]
Dr. Rena Malik
That's a lot. One in five?
- [10:42]
Dr. Alok Kanoja
Yeah, probably something like that. And, and so, you know, I talked to some, like, I remember I just had a conversation with like a second grade school teacher who was like 100% of the boys in my class play Fortnite. And this is about four years ago. So if we look at pornography addiction, I think we probably have a very similar thing, because especially with the tech addictions, the likelihood that these people will enter a psychiatrist's office is very low. So men are more. Are less, Far less likely to seek mental health support. I think if you look at It Historically, about 70% of patients are women. Yeah. And so first of all, there's like a gender kind of lack of recognition there. I think even amongst patients who come in for things like mood disorders or anxiety disorders, they're very reluctant to volunteer that they have a pornography addiction. So you really have to ask. It is not a very common part of like a standardized interview. Yeah, I suspect that it's probably higher than 4%.
- [11:39]
Dr. Rena Malik
I think so. Especially with newer types of pornography. But I will say that there are plenty of people who watch pornography in a healthy manner and don't develop addictions. So what is sort of. And this can be in any field, Gaming, addiction, production. What happens to the brain that causes these addictions?
- [11:57]
Dr. Alok Kanoja
So with porn addiction, I think there are a couple of interesting things. The first is that. So this is more of a clinical practice as opposed to literature search. But what I've noticed is that prepubertal exposure to pornography seems to like, really increase the risk. Now, there could be some confounding variables there, because if you think about what kind of childhood does someone have to have to be exposed to pornography at the age of 8? So there may be like less parental supervision and other kinds of factors at play, but oftentimes these people are exposed to pornography, like, very young. The second thing that we sort of know is if you look at, like, the neuroscience of pornography, I tried to figure this out. I was like, okay, we know that alcohol addiction is like GABA receptors in the brain. So where does pornography activate the brain? And it turns out that it's like everywhere. So if you look at it, just about every lobe of the brain is associated with sexual arousal. And in some way you can get visual cortex stimulation, auditory cortex stimulation, imagination, emotional engagement. So every part of the brain, dopamine, is involved in pornography. Every neurotransmitter is involved in pornography in some way or the other. So we sort of have this kind of whole brain effect. And then the Other thing that pornography is really good at is really shutting off our negative emotional circuitry. So if we think about evolutionarily, like, sex is really important. And so our brain is willing to push everything else away in order to have sex and procreate. So it's incredibly effective at really suppressing our negative emotional circuitry. And what we tend to see in any addictive behavior is that it gives pleasure and it takes away pain. And over time, the amount of pleasure that it gives actually goes down. So as we develop some degree of, like, dopaminergic tolerance and things like that, it doesn't even offer much pleasure. And so then people really get hooked on it. From, like, an emotional regulation standpoint, the more stressed they are, the more pornography they watch. And the last thing that a lot of people are super confused by is that a lot of people who watch pornography don't necessarily masturbate with it. So I've had, you know, people that I've worked with that will, like, just be watching it while they're, like, doing work, like on a second screen, because it somehow sends those signals to the brain to, like, suppress our negative emotional circuitry. So it's a really weird kind of beast.
- [14:14]
Dr. Rena Malik
Well, and then they develop sort of. They feel even worse when they're not watching it. Right. That's a hallmark of addiction.
- [14:20]
Dr. Alok Kanoja
Yeah, so that. That's absolutely true. So. And that gets really ugly really fast. So there's all the shame from being addicted to pornography. And then how do we manage that? Sh. By watching more pornography and suppressing it.
- [14:32]
Dr. Rena Malik
Yeah.
- [14:33]
Dr. Alok Kanoja
And then when we stop watching it, all of those dormant emotions, there's almost this rebound effect, and we feel like very intense shame and things get way worse, and that's how we get hooked.
- [14:43]
Dr. Rena Malik
Yeah. You know, just on your point about children getting exposed to porn, so I actually just spoke to an expert on this who's done a lot of research. And essentially, it's the average age where kids are being seen seeing porn is like 12 or 13, but as early as 8 or 9 or 10. And often it's not that they're getting it because they're getting. Sometimes it's access to devices that there are no parental controls. But oftentimes it could be a friend's device or a friend shows them something, a picture that they don't really understand. And actually they're seeing issues of it in schools even, because they'll be talking about it and showing them things. So I think it's caution in saying that. I don't think parents are Intentionally not supervising their children. I think think that generally like there's, it's so accessible.
- [15:25]
Dr. Alok Kanoja
Right.
- [15:26]
Dr. Rena Malik
Like it's so easy to get access to free pornography now.
- [15:29]
Dr. Alok Kanoja
Yeah, that's a great point. And I think that in many of the cases that I've seen, it's even things like older siblings or friends of older siblings who are showing them this kind of stuff. Because like if you're eight, right. And you've got an older brother and your older brother is going through puberty with his buddies and they're like watching something, you're super curious about it.
- [15:47]
Dr. Rena Malik
Yeah.
- [15:47]
Dr. Alok Kanoja
And so we. Absolutely. Yeah, I completely agree with that. Thanks for clarifying.
- [15:51]
Dr. Rena Malik
Yeah. And I think. So you said like being exposed to at a younger age puts you at a higher risk, but what are some other risk factors? Like how can, if you are either with someone or your child and you're. You want to maybe catch them, not in a bad way, but like protect them from developing this addiction and you might start seeing hallmark signs or gaming addiction for that matter.
- [16:10]
Dr. Alok Kanoja
Yeah. So I think it depends on which addiction we're talking about. So, you know, we're still learning this stuff, but we're not really sure how different gaming addiction is from pornography addiction. I happen to think that they're quite different. And there's even a fair amount of research that within gaming addiction, it's not all homogenous. There are many different types of gaming addiction. That's kind of the first thing that I would say. But in terms of how to protect people from it, I think there are a couple of things to consider. The first is that generally speaking, as we said the earlier you get exposed to something, it actually alters your nucleus accumbens and how it develops. So we sort of know that marijuana is a gateway drug. And the reason it's a gateway drug is because it's alters your brain's receptivity to other dopaminergic or addictive substances. And so porn, pornography addiction I suspect will probably work in a similar way where it sort of predisposes you to certain things in terms of what we can do about it. I think sort of like having a really good relationship with your kid and even sort of talking to them about some of this stuff that hey, pornography exists. And I guess we have to start pretty young. Like I have an 8 year old and I've never thought to talk to her about pornography. But it makes me really wonder because 8 is like really, really young. Right.
- [17:22]
Dr. Rena Malik
I think I started talking to my son about sex around 8 or 9. I didn't talk about pornography until he was 10, but I definitely have talked to him about it already.
- [17:33]
Dr. Alok Kanoja
Yeah, so that's. I think you're ahead of the curve.
- [17:35]
Dr. Rena Malik
Super uncomfortable, but I've done it.
- [17:37]
Dr. Alok Kanoja
Yeah. So I think just sort of an awareness of it. And I think that a lot of parents, I think maybe, like, we're a little bit luckier because I think we sort of grew up with some technology. But I think a lot of parents really just let their children use devices, right? So there's sort of this idea, especially in the west, that, like, if you get an object, it's yours. And so this gets really problematic when, like, grandparents want to, like, give them something for Christmas. Right. But grandma or grandpa doesn't have to deal with the iPad every day after the kid gets it. They don't have to get them to, like, stop using it so that they can study and do their chores and wake up and go to bed and all this kind of stuff. So I think really being involved in your child's technological life is, like, really, really important. And especially when it comes to, like, gaming addiction, I think where a lot of parents really sort of mess up. I mean, it's kind of harsh to say, but what we found really is very effective is that, see, as a parent, we get scared. And once we get scared, we sort of have this instinct to, like, let's take this thing away. That's bad. But oftentimes what we find with, like, gaming addiction and technology addiction is that when you try to take the child's device away, they fight you. And I've heard, like, really drastic. Not heard. I mean, people have that. I've worked with really drastic stories of, you know, parents locking up power cords in the liquor cabinet. And then the kid will, like, learn how to pick locks on YouTube. And we'll go downstairs at, like, 12:30 when everyone's asleep, unlock the power cord, we'll play games until five in the morning, we'll lock it back up, and then we'll go to sleep.
- [19:10]
Dr. Rena Malik
Wow.
- [19:11]
Dr. Alok Kanoja
So if your child, like, wants to do it right, it's going to be really hard. You can try to be very controlling, but even then, I don't know if you're doing a great job of preparing them for the world, because at some point they're going to get access to technology and you're not going to be around a controller. So what we really advocate for is, like, forming a good relationship with your kid where you're really communicating with them. And that can be really hard for a number of reasons, which we can go into. And then also recognizing that people who fall into addiction do so because they're getting something from the addiction that is hard for them to get in the rest of life. So for something like pornography addiction, very poor emotional coping mechanisms in general. Right. And that's not the person's fault. It's just this. They just weren't taught this kind of.
- [19:58]
Dr. Rena Malik
Stuff and they didn't get to develop it because they developed the addiction instead of.
- [20:01]
Dr. Alok Kanoja
Absolutely right. So as you develop the addiction, your other emotional coping mechanisms start to atrophy because your brain knows. We have this thing over here that works so incredibly well at suppressing our emotions. So we usually recommend that parents will, like, talk. If you. If. If you have a kid who is addicted to video games or pornography or. Or anything, you know, at the underlying. That is going to be some kind of emotional turmoil. So sort of asking them a little bit about other parts of their life and recognizing that addiction. And there are some people in the psychiatric community that don't even believe that technology addiction is real. And these are experts who work with these people day in and day out. They think it's a manifestation of a deeper problem, which there's absolutely some evidence for. But really sort of recognizing that if you're dealing with an addiction, really trying to get to know, know your kid and asking them, like, hey, what's going on in your life? How's school going? How do you feel about romance, relationships, things like that? Because a lot of times, like adolescents and teenagers, like, you know, it's really hard for them to engage in that stuff.
- [21:02]
Dr. Rena Malik
I think sometimes they can hide it quite well in terms, and they may be irritable, and they may be sort of not chipper and happy all the time. But are there other sort of signs that maybe someone could say, like, hey, they could have something going on that I'm. Maybe I should delve a little deeper into how they're using technology or pornography or things like that.
- [21:21]
Dr. Alok Kanoja
Yeah. So I think parental instinct really goes a long way. Like, if you think your kid has a problem, there's a pretty good chance that they have a problem. And I think what we tend to look at is like, functional impairments. Right. So is there any change in their grades or has there been a change in their, like, professional life, Physical health, mental health, relationships, including family relationships? So if you're finding that you're getting into all arguments with your kid a lot, and I think parents are very quick to, like, attribute that to, oh, this is like teenage whatever, right? It's just a phase. And that, that can be very true. It can be just a phase, but really sort of opening the door to talking to your kid and really figuring out, okay, what are you upset about? Oftentimes it is things like moodiness and stuff like that that parents will see the most of.
- [22:05]
Dr. Rena Malik
When was the last time a doctor spent an hour with you and truly focused on your goals? And when was the last time you left feeling like you really understood what was going on with your body and had a clear plan of what was going to happen next? At my practice, Rena Malik, M.D. i aim to do just that. I specialize in sexual dysfunction, bladder health, hormone health, and pelvic pain for all people. And I want to revolutionize how we take care of patients. I want to really get to know each and every one of you. That's why at my practice, when you come to see me, I'm 100% present with you for an entire, entire hour. And after you leave, if you forgot to ask me something or need clarification on something we talked about, don't worry, I'll respond to your issues and questions quickly through our secure messaging portal without any additional costs. Just go to www.renamalicmd.com appointments and schedule your visit. Today we see patients in Irvine and Beverly Hills, California and virtually for patients from California, Florida, Illinois, Maryland, New York, New Jersey, and Virginia. If you aren't located in these states, consider making an educational visit where we can talk about your conditions generally. But I can't diagnose or treat you. I can't wait to see you. When did making plans get this complicated? It's time to streamline with WhatsApp, the steps secure messaging app that brings the whole group together. Use polls to settle dinner plans, send event invites and pin messages so no one forgets mom's 60th. And never miss a meme or milestone. All protected with end to end encryption. It's time for WhatsApp message privately with everyone. Learn more@WhatsApp.com you actually became a monk, right? You went to India and you learned sort of many practices from Eastern philosophy. And one of the things I've heard you talk about is tantric or tantric sex. And so can you talk a little bit about what that is and is it something that people should be trying to achieve?
- [24:16]
Dr. Alok Kanoja
Yeah, so it's interesting. I've never gotten that question, but yeah, so we can absolutely talk about it. So in order to understand tantric sex, we have to understand what Meditation is and what tantra is and how sex can be used. This is going to get a bit technical. So the first thing to understand is that anytime you meditate, you need something called an alambana, which is a support. So usually there is a focus of meditation. So you can have something like prayer beads, you can chant a mantra, you can gaze at a candle or even like an idol or something like that. There's usually an object of your attention. So if we look at meditation, the word meditation gets translated into three Sanskrit words. And this is what confuses a lot of people. Dharana, Dhyan and Samadhi. So dharana is a focusing technique. It's a verb, it's something that you do. So I'm focusing on, let's say a candle. So I'm looking at that. And the whole point of that is if you look at your mind, it has lots of thoughts. So how do you get your mind to not think lots of thoughts? By having it focus on one thing. So if I concentrate on one point, then all of the other thoughts, as I've trained myself and I practice, all of those other thoughts will go away. Then what happens is the mind has a very natural tendency to lose track of a constant stimulus. So when we will acclimatize to a stimulus. So if I like, you know, if you step into a restaurant at the very beginning, you hear everyone talking, but then your brain acclimatizes that stimulus and it weeds it out. So what we do in meditation is we focus on one thing to push everything else away and then we're left to left with one thing. And over time we will acclimatize to that in the same way that will acclimatize. As soon as I put my jacket on, I feel it, but then my brain sort of recognizes this is a constant stimulus and it goes away. Once we acclimatize to that candle, then our all mental function stops and we enter the meditative state, which is Dion. So Dhyan is a meditative state. That is a state of consciousness. It's not something that you do. The best example here is going to bed and falling asleep. Technically, like no human being on the planet can go to sleep. We can't say I'm asleep now, we can lay down. And in the right circumstances, sleep is a state of consciousness that will happen to us. And if you're like me, it's like in biochemistry, right? So we don't want it to happen, but it happens anyway. That's how the states of consciousness happen. So we have alambanas which are like objects of focus. And then we want to enter the state of meditation. So now let's talk a little bit about sex and then we'll put them together. So, and then the third state of meditation is samadhi, which is like a more transcendent state of consciousness, which is blissful and whatever, we'll get to that. So now if we look at sex, like if we look at orgasm or sexual activity, it's a very potent draw for your attention. So if we look at kind of the neuroscience of it, like it's really easy to not get distracted when you are engaged in a sexual act. And then the next thing to understand is that people will say that the state of orgasm is like a state of Dhyan or samadhi. So it's a blissful state. And if you really pay attention to your mind and orgasm during the moment of orgasm, you actually don't have any mental functioning. You can't think about, you can't think about anything. Right? So the moment after orgasm is over, then you're like, was it good for her too? Right. And like before you're thinking lots of thoughts and after you're thinking lots of thoughts. And this is why we love sex so much. Because if you really look at when the mind is peaceful, the mind is peaceful when it's actually shut off. This is why we love drugs, this is why we love sleep, this is why we love losing ourself in a sunset. And orgasm. So there's a orgasm kind of creates that like no mind state. It's one of a very easy, accessible physiologic ways. So when we put these together, what we end up is, end up with is sex is a powerful alumna that focuses our mind. And then the state of orgasm is a very, very good way to get to samadhi or Dhyan. Then we get into some problems. So the, the whole point of tantric sex is that. Okay, so but if we want to enter that no mind state, like generally speaking, orgasm is incredibly brief if you're a dude and many women. Yeah. And so then the goal of, of tantric sex is there are certain, like yogic techniques that you can use to prolong the state of orgasm. And basically what you're trying to do is avoid ejaculation because that's the thing that triggers the orgasmic state in the brain to end. Because then we're done, right? We've done our thing evolutionarily. So some of those techniques around tantric sex are to delay ejaculation but then you can actually get this sweet spot where there's orgasm without ejaculation, which is some of the point of tantric sex. Now, there's a whole other layer to tantric sex which is even more spiritual. This is sort of more neuroscientific and technical. But during really traditional tantric sex, people are chanting mantras. And you're chanting a mantra with your partner over the course of potentially hours. And it's almost like doing a ritual or a puja or something like that, where it's like part of a religious practice and for some reason using the sexual act as like a focus and like kind of getting into these states of consciousness and chanting mantra, which is really the traditional way to do tantric sex, is. Is what it's about. And I think that's. I mean, I can go into more detail if you really want to, but there's a whole spiritual side.
- [29:46]
Dr. Rena Malik
Yeah. So then, you know, people talk. I think they've tried to adapt those things. Things in today's day and age with semen retention, they've. There's things like no nut November where people. And they don't always practice in the tantric method, but that's sort of the goal is to orgasm without ejaculation. So from an Eastern perspective, benefits in terms of doing it on a regular basis or.
- [30:06]
Dr. Alok Kanoja
Or trying to achieve that benefits of tantric sex? Well, I mean, it depends. What kind of answer do you want? Do you want like a physiologic answer, a neuroscientific answer or spiritual answer?
- [30:16]
Dr. Rena Malik
Give all three.
- [30:16]
Dr. Alok Kanoja
Okay. So this is where things get weird. And it, you know, so part of what I try to do is like, reconcile these spiritual answers with like, neuroscience and physiology. So if we start with the physiology, I'm not sure. So if you look at, like, basically every religious tradition, restricted sexual activity is part of most religious traditions. We're not quite sure why, but chances are that when you engage in sexual activity, it alters your physiology in some way. So what I've sort of found is that when I am celibate for periods of time, which is interesting, being married. And when I'm celibate for periods of time, it really enhances the quality of my meditation. So I don't know what's going on physiologically there. What I just a couple of things to theorize. So if you look at some of the yogic postures that we do when we are celibate, we'll do something called siddhasan. So in Siddhasan, you Press your heel against your perineum. So especially for men, the blood flow to your scrotum and your sex hormone production can be gently suppressed by reducing the blood flow to that area. So you're kind of like. And then you'll even get, sometimes I imagine, testicular atrophy. You do it for a long period of time, which is what yogis are trying to do. And so then if you look at, okay, if we reduce our testosterone levels, what effect does that have on our brain? It probably has some kind of positive effect for attaining transcendent states of consciousness. Okay, so we're not quite sure what of that is true. There's another layer which is that, which is a little bit more like spiritual theory. But we don't really know if it's true. And that's that. See, anytime you have sex, it creates a powerful impression. So if we think about how something enters your mind, generally speaking, the more active your mind is, the less something enters. So let's take the example of studying. If I'm in a library and library is burning down and people are making lots of noise and my mind is paying attention to all that stuff, anything I read on the page is not going to sink in. If I'm in a quiet place and I'm not distracted and anyone knows this, if you're not distracted, then you can study and then the knowledge will literally sink in. Otherwise it's like the information is bouncing out of your mind.
- [32:38]
Dr. Rena Malik
Right.
- [32:39]
Dr. Alok Kanoja
So the more no mind state we have, the more stuff sinks in. And if we look at stuff like the flow state, flow state is a very, almost no mind state. So the mind is fully focused on one thing. So you have a lot of like, whatever your studying in that moment will really sink in. So now let's look at sex. So what happens in sex? We enter that no mind state during orgasm. So in that moment, there is a very powerful impression that sinks into your mind. From an evolutionary standpoint, this is probably has something to do with like if we look at oxytocin, the oxytocin release after orgasm, which is usually induced especially by things like cuddling and he human, you know, contact. But there's something that goes on that there's a physiologic bond that forms with people who have sex. Now I've worked with people like sex workers and they have to train themselves to shut off that bond. So their natural reaction at the very beginning is to release oxytocin. But the whole point is then they try to like avoid that. So if we look at sex, then what happens is we create a very powerful impression. And then what happens is once we shut off our mind, whatever is lying in the subconscious will start to float to the surface. So when I work with patients who have a history of trauma, I don't tell them to do standard mindfulness techniques where they just let whatever is in the mind come out. So oftentimes it will trigger traumatic experiences. So if you look at the evidence based techniques around mindfulness for trauma, they're usually grounding techniques or like sensory techniques. Things like ice diving where I'm taking a bucket of ice and I'm sticking my face in it. That's not letting whatever is in my mind flow up, it's actually doing the opposite. There's lots of stuff in my mind and I empty my mind by sticking my face in ice. So whatever is in the mind will come up. And anytime we have sex, it goes deep into the mind.
- [34:29]
Dr. Rena Malik
Yeah.
- [34:30]
Dr. Alok Kanoja
And so if you sort of think about it, right, like if you meet someone once and, and you have a one night stand and then you're going to see, start thinking about them the next day. Right. So most human beings, I think will.
- [34:39]
Dr. Rena Malik
Yeah.
- [34:40]
Dr. Alok Kanoja
And so if you sort of think about it, there's powerful impressions that form. So then what happens is if we like try to meditate and you've like had sex, it becomes very hard to enter those transcendental states of mind. I don't know if that answers your question, but.
- [34:53]
Dr. Rena Malik
No, I think it's very interesting because, you know, I don't, I. What I tell people is like, if you want to practice semen retention or cell celibacy for the purposes of spiritual or betterment, that you feel better. I think it's wonderful. But I do worry that there's a lot of pressure for people to participate in these sorts of things. And they actually develop, they, it becomes so forefront of mind because they're like, when am I gonna have sex? Like I can't wait to have sex because they're so, like they're, they're trying so hard to abstain and then they also start clenching their pelvic floor and then they develop pain or other issues. And so that's sort of where I worry as a clinician who sees those patients.
- [35:31]
Dr. Alok Kanoja
Yeah. So I think those people are doing it backwards.
- [35:34]
Dr. Rena Malik
Right.
- [35:34]
Dr. Alok Kanoja
So like, let's talk about, you know, in the yogic traditions, the word for celibacy is brahmacharya. But brahmacharya doesn't mean celibacy. It means to dwell in brahman which is to dwell in the infinite. So technically, you can have sex if you're a yogi, and you can still be a Brahmachari, which means celibacy. So, so brahmacharya, what it really means is non lustfulness. So forcing yourself and struggling with yourself in the mind to not have sex still means that your mind is obsessed with the sex. You're missing the point. Right. So if you look at like a yogi, you know, when a yogi is like people. I don't know if this makes sense, but people will try to deprive themselves in order to, like, become more like, detached, Right?
- [36:18]
Dr. Rena Malik
Yeah.
- [36:18]
Dr. Alok Kanoja
So I'm not going to have sweets, I'm not going to have this kind of food. I'm not going to have this. But the mind still wants it. The mind still wants it. They're trying to basically starve their mind of the stimulus. Yeah, but the real thing is if you practice meditation for a long period of time, the desirelessness becomes natural. Right. So if I stop and I, like, look at, let's say we've got like two glasses of water here, and one is the temperature I want and one is the temperature that I don't want. And as I look at this, if I drink water that I don't like the temperature, this creates unhappiness within me. But as I. I do yogic practice and I detach from that unhappiness, then it doesn't matter which one that I have because I. The negative impact of the desire doesn't actually land. So I think a lot of these people are doing this backwards. Whereas if you practice yoga, you will become more detached from the world. Naturally, your mind will be less desirelessness. You're not bludgeoning it into submission.
- [37:07]
Dr. Rena Malik
That's so useful. Hey, guys. I'm Samantha Christine, host of the Empower podcast right here on the Pursuit Network. If you're into wellness that fits into real life with honest combos, workout tips that actually make sense, nutrition hacks that support your lifestyle, and a lot of encouragement to become your strongest self, you'll feel right at home on my show. Whether you're a busy mom in a season of rebuilding or just trying to stay consistent with the all or nothing mindset, the Empower Podcast is for you. New episodes drop every Wednesday wherever you listen to podcasts. So come hang out. I'd love to have you. Well, because I think you're right. Most people are doing it wrong. They are, like, forcing themselves into submission when it's actually the way you're Describing and tell me if I'm wrong, is that it's part of your meditative practice. Like, you continue to become free of all these thoughts in your mind through a meditative practice. And then the desire for sex goes down. And then you realize when you have sex that, oh, it's actually affecting your meditative practice negatively. So then the desire to avoid sex or abstain for periods of time is stronger. Very strong.
- [38:08]
Dr. Alok Kanoja
Well said. Right, so. So I think this is something that people don't like. So I think it's important. Sometimes you have to conquer a desire. Fine. You have to strengthen your frontal lobe and restrain a sexual impulse. Fair enough. But I think what with what you're describing, like, doesn't work, like, even in psychotherapy. So if we understand something like ocd, right. So this is a case where someone has these intrusive thoughts, which there's a wrestling with and fighting with. And the more that you fight with your mind, the less healthy you're going to be. So really good example for people who don't have OCD is think about, like, stressing about going to sleep. Oh, my God, I need to go to sleep. I need to go to sleep. I need to go to sleep. The more that you stress about sleep, the more you're like, oh, fuck, can I say it's fine. So, like, fuck it, I need to sleep. Right? And then, like, the more you stress about it, the harder it becomes to sleep. So in that same way, there's almost this weird thing that we see in psychiatry with, like, defense mechanisms and reaction formation that the more you suppress something, something, you're sort of fueling that tension in the mind. And tension in the mind and conflict in the mind will never lead to peacefulness. So what I usually have when. When I. I work with people who are interested in, like, no, not November. And we have a lot of people who have unhealthy relationships with pornography in our community is we try to teach them this kind of stuff. Right. You can try to force yourself to do it, and that can have some value, but it's way easier to sublimate your desire than it is to conquer it.
- [39:28]
Dr. Rena Malik
Yeah. Because the other thing physiologically. Right. Is your body will sometimes ejaculate on its own at night, Right. You'll get nocturnal emissions. So it's not the act of ejaculation. I think it's probably the act of being with someone and having those other hormonal connections with that person that may have a physiologic impact. But we know that people Ejaculate at night, Right? It happens. Especially the younger you are, the more testosterone you have, the more ejaculation you're going to have at night. And that's normal. Physiologic, healthy, not a problem. And so I think that people get very fixated on, like, oh, I need to not ejaculate. And then they'll have a nocturnal erection or ejaculation, and they will feel so much deep shame that they failed. And that's not the point. I think that's really important because I. You know, again, this is something that people struggle with and they really. They want permission to not do it because they're, like, hearing all these benefits. But I think, again, the thought is that you have to conquer it versus you actually have to.
- [40:23]
Dr. Alok Kanoja
Yeah, so when I work with people who are, like, really interested in. In. No, not November. Like, usually my question is, like, why? Yeah, like, what's driving your desire to like, not. Not. And usually it's like some kind of weird transmutation of something else. Like, they. It becomes a proxy battle for them where, like, I need to conquer this thing because I'm unable to conquer something else. Generally speaking, I don't have. You know, I've never worked with anyone who's, like, happy and content and is obsessed and beating themselves up over no nut November. Yeah, usually the picture that I see anyway is someone who's, like, addicted to pornography, and in an effort to conquer their pornography addiction, they're gonna do no nut November or no FAP or something like that. And then in that process, it can be good, because it's not that NoFap has all these magic, magical benefits, but if you look at the harms of pornography addiction and then you start doing NoFap and you free yourself of that physiologic cycle, that can be a net positive.
- [41:23]
Dr. Rena Malik
I think that's reasonable. What are. What are some techniques that you use for people who have porn addiction? Like, how do you help them get through that?
- [41:31]
Dr. Alok Kanoja
I think a lot of it is, like, understanding their emotions. So when I think about pornography addiction. So remember that any addiction brings. Brings pleasure and takes away pain. So if you can reduce the need to take away pain, then you're. You're going to melt away the pornography addiction. So a couple of things that are correlated with pornography addiction. So if you look at multivariate regression analyses, there are two variables that correlate very highly with pornography addiction. One of them is meaninglessness in life. So generally speaking, if you can help someone have a reason not to watch pornography and jerk off in the middle of the day, then that will help them a lot. So what happens is this is my population, but like, you know, these are people who are oftentimes young men in their 20s and they're like falling behind in some way and it's like 4pm on a Thursday. They're not really working and like what else do they have to do? So as we start building a life of meaning, like the need for pornography seems to decrease. That's one thing. The second thing is that oftentimes, remember this is emotional regulation and people will have a lot of stored emotions from things like traumatic experiences, growing up, romantic relationships, all kinds of other stuff. So as we metabolize that storehouse of emotion, it becomes easier to manage emotions from day to day. They're kind of like built up and your mind kind of stores them in the subconscious. So if we look at something like processing trauma. So I do a lot of like trauma processing for people with pornography addiction and that sort of takes some of the gas out of the tank that's fueling the addiction. The third thing to do is to reduce emotions in the present. So teach them alternate coping mechanisms that can they, they can use to manage emotions. And oftentimes it's like really life oriented stuff. So if I'm living at home and my parents are toxic, like, like learning to set better boundaries is one of the best things to teach someone who struggles with pornography addiction. Because usually what's going on is these are people that have someone in their life who is sending them toxicity, but they feel so guilty at cutting them out. This can even be someone like a romantic partner or spouse, it can be a parent. And as they're like receiving the stress, it's almost like I'll joke with some of my patients that you have an emotional umbilical cord. They're connected to someone else and another human is like transmitting negative emotions to them like a waste product. And then they have to turn to substances or pornography or whatever to like offload that emotional stuff. So boundary setting, emotional regulation techniques, processing trauma and like really building purpose in life tends to be like a pretty good, like good outcomes.
- [44:12]
Dr. Rena Malik
You know, so many things come to mind. But I think we're seeing particularly in young men, like we know that amounts of sex or frequency of sex is decreasing and that the even birth rates are decreasing. And so do you think this is sort of part of all of this like external stimulation that's around and then they feel sort of, I mean this is a theory for Me. Right. They feel less meaning. Right. Because they're not actually having success in finding someone or meeting someone or it's just. Just easier to access pornography. And then they're like, you know, they're still not connecting with other people. They're using pornography because they still feel bad. Of course, we talked about the cycle a little bit, but is it sort of like, are these things contributing to that?
- [44:54]
Dr. Alok Kanoja
When you say these things, what do you mean?
- [44:56]
Dr. Rena Malik
Like, meaning, are we seeing people get porn addiction because they're either having stress in their life, so say they're not coupled with somebody. Say they are trying to meet people, but they're having difficulty. Because I think the dating. The dating world has changed. Right. With dating apps and how people communicate and meet each other, it's very different from when you and I were younger. And so I think that is a very difficult, different sort of place to navigate. Like, women are looking for a certain kind of man, and if you don't fill that category, you are immediately filtered out. Right. So women are dating the top five, 10% of men are trying to aim for them, and then. And there's a lot of men who are not having success in meeting women.
- [45:37]
Dr. Alok Kanoja
Yeah, so. So it sounds like you have a theory that that's at play, and I think that's completely reasonable. So let's just play around with that a little bit. So the first thing is that, you know, this idea that women are dating the top 5 to 10% of men, I assume you're talking about, like, Tinder statistics.
- [45:50]
Dr. Rena Malik
Yeah, like those. I mean, because that's where you can filter by height and by, you know.
- [45:53]
Dr. Alok Kanoja
Yeah. So I think that there's a couple of interesting. Like, once you really look at the data, which I don't know if you have, but I'm. I'm sure you know anyone who's trained in statistics. So when. When they say they're dating the top 10% of men, there's this idea that one dude is dating, like, nine women, whereas that's not usually what happens. So if you look at something like Tinder, it's like a seven to nine men to one woman, like, ratio. So when they say they're dating, it's still oftentimes one dude is dating one guy. Or maybe people are kind of at the top, but, like, there's such a lopsided gender ratio that it's still, like, closer to one to one In. In some ways it depends on the studies that you look at and stuff like that. So I think that this creates this idea That a lot of men have that, like, oh, my God, there's like, these chads at the top that are, like, banging lots of girls.
- [46:40]
Dr. Rena Malik
Yeah.
- [46:41]
Dr. Alok Kanoja
I don't think the reality is quite like that when you really look at the statistics. So that's one piece. But I think another thing to really consider that. That I think you kind of hit the nail on the head is that it is harder for men and women to find a good match.
- [46:54]
Dr. Rena Malik
Yeah.
- [46:55]
Dr. Alok Kanoja
There are many reasons for that. I think one reason is that. So if we look at, like, what women want in partners, and this is generalizations. So you can look at statistics. Right. So, like, the idea of a dating a dude who lives at home at the age of 28 is like, I don't want someone who's living with their parents. But 50% of people under the age of 30 who are adult adults still live with their parents. Men and women both.
- [47:18]
Dr. Rena Malik
Yeah.
- [47:19]
Dr. Alok Kanoja
So the economic situation is changing. So the idea of, like, an independent man at 28 just doesn't apply to 50 of the population.
- [47:26]
Dr. Rena Malik
Yeah.
- [47:27]
Dr. Alok Kanoja
Another good example of this is most women, I want to say, like, statistics are historically, somewhere around 70 to 80% of women will want to date a man who makes more money than they do. But 60 of college graduates are now women.
- [47:39]
Dr. Rena Malik
Yeah.
- [47:40]
Dr. Alok Kanoja
So what we're starting to see is as equal quality of income increases, that expectation becomes harder and harder to fill. So whatever the reason is. And there's all kind of challenges that women have as well. They get tons of dick pics and all kinds of other things. Yeah. So it's definitely making it harder for men to date. Now, that's just on the gender side. But there's a whole other set of things that's like screwing up dudes, too, which is that, you know, as men, like, we have very poor emotional regulation skills. We're not really taught how to express emotions beyond anger. We're unlikely. It's, like, hard for us to engage in psychotherapy, which I don't think is a weakness of men. I think there's some systemic biases in psychotherapy that are against men. So if you look at studies on couples counseling, like you ask. Ask men, why don't you want to go to couples counseling? And what they. What happens is they feel outgunned. So anytime they go see a couple's counselor, their female partner, assuming a heteronormative relationship, knows how to articulate their feelings, and the man doesn't know how to do that. So the. The wife is, like, articulating, like, he does this. And this makes me feel this way. And the therapist kind of like gets on their side. And so men sort of feel like outmatched. And I think that there's a good reason for that. So men are really struggling right now. I think there's a lot of this dating stuff going on.
- [48:59]
Dr. Rena Malik
On.
- [48:59]
Dr. Alok Kanoja
There's a lot of expectations that are changing and then there's a lot of like, distortions. So if you look at, I recently saw a paper on incels where their beliefs about what women want are quite divorced from reality. So there are these ideas that, oh, like, you know, the top 10% of dudes are dating all the women. So they assume that. Okay, like what that means. Right. We can sort of like apply. The transitive property is that this woman I'm talking to is only interested in a dude who's in the top 10%. But if you actually ask women, like, who are you interested in and who do you date? It's much more wide and accepting than most men understand.
- [49:35]
Dr. Rena Malik
You know, it's interesting because in the same breath, I don't disagree with you, but I want to kind of push back a little bit because you said it's not cute to date someone who's living at home, whatever. Right. You're like, that's sort of a turn off. And so that's half the male population who's living at home with their parents. Right. And then. And you want people who make more than you. And women are more often graduating college, getting higher degrees, getting higher positions, and the average salary of a man is $45,000 in the US so it sort of seems like there are. I mean, maybe they're not dating the top 10% of men only. Maybe they're just not dating. Right. Yeah, you know, I think that's part of it too.
- [50:10]
Dr. Alok Kanoja
So I'm. How is that a pushback?
- [50:12]
Dr. Rena Malik
No, no. So my point is like, so. So meaning that there is. The large majority of men are not finding matches is exactly what you said. But they're not finding matches is because women are choosing not to date because their expectations are not being met. Which is sort of what you said. But it is. I mean, so they're not wrong in the sense that this woman wants something different than what I have to offer. But they're wrong in saying they only want the 10% of men. They just want something different than what I can offer.
- [50:35]
Dr. Alok Kanoja
Yeah. So I think that there's like both can be true. So I think the challenge now is that, like, see, we used to need partners, so now what's happened is our society has become so independent that a man is not even competing against another man. A man has to add value to a woman's life more so than the stress or annoyance that he brings. And that's true for both genders.
- [50:59]
Dr. Rena Malik
Yeah.
- [50:59]
Dr. Alok Kanoja
So like this is what's going on is like now it's just easier for me to live by myself than it ever used to be. And so now really what, what both genders are competing against is like, is this other person's life better alone or with me? There's also other interesting statistics, like if we look at like men under the age of 30 and stuff like that. So if you look at like there's also a gender, I mean, sort of an age gap issue. So if you look at women who are 28 and you compare them to like men who are 28, that's kind of a mismatch. But if you look at like, I forget what the statistics are, but there's like a interesting statistic about people under the age of 30 and like, I think maybe like 50 to 70%. I'm rusty on the statistics of men are not dating or don't have, aren't partnered under the age of 30. But that number is lower for women. And the reason for that is because they're dating older men.
- [51:47]
Dr. Rena Malik
Yeah.
- [51:47]
Dr. Alok Kanoja
So it's very common. So that skews the statistics in some way too.
- [51:52]
Dr. Rena Malik
So the younger generation is having less sex, they're less often dating, they're less often than having children. And that leads to the possibility of our difficulty in perpetuating our population. Having a aging population that's not really replaceable.
- [52:07]
Dr. Alok Kanoja
Okay. I think it's important to remember that globally this is a trend in some places. Right. So basically developed nations are seeing this way more. So I remember talking to a colleague of mine in China and so basically like, you know, China had this one child policy for a while and I heard recently that they have this new policy, well, they. Where they will subsidize your third and fourth child. So what's going on in parts of China, in South Korea, in Japan, less so in the US is exactly what you're describing. Which is that for every. I think we're having like the lowest birth rate is like 0.67. So they're not even having one to one.
- [52:43]
Dr. Rena Malik
Yeah.
- [52:43]
Dr. Alok Kanoja
So this is a very scary from an aging population. But there are other parts of the world, like if you look at like South America or areas of like the Middle east or Africa where people are having still lots of kids and So I don't think the species is going to die out. I think what's going to happen is like in developed nations they're going to have this huge problem of like not having enough young people to support the old people. Yeah, so that I agree with was there. I'm sorry, I forgot your question.
- [53:08]
Dr. Rena Malik
No, I think that's the issue. And so like my question is like, what can we, like this is an issue, right? This is a, is more societal issue than an individual issue, but it's a problem. And so what do you think? Like are there things that you think that we should be addressing?
- [53:22]
Dr. Alok Kanoja
Yeah, so I think that I don't focus on societal issues. I know it's kind of weird. So despite the fact that we have this, this like large scale approach, I still at my heart am a clinician. So when I work with men who are struggling to date or working with women who are struggling to date, what I always focus on is the individual. And so I think what we really need to do, like what I would love to do is like make a school for crappy boyfriends. I don't know if I could do that for crappy girlfriends because I don't know what it's like to be a crappy girlfriend. Like, but I think that there's a lot of like skills training that we're seeing. So like what should we intervene in? I think social skills atrophy is huge. So what's happening when we start to use technology is like as you know, any part of your brain that you don't use, like rusts. So if you don't speak a language, you'll forget it because your brain is like, hey, we don't need this. So as we move to like text based communication, what started to happen is our empathic circuits have started to atrophy. So we're seeing a rise of social anxiety. And why is that? That's because when I sit with you, I see body language, I see facial expression, I interpret it. And so this part of my brain works well. But now the more that we text, then when we meet in person, I'm going to feel incredibly anxious. So we're seeing a rise in social anxiety in both genders. So that's really what I think we need to target is like how can you be a more emotionally available partner? How can you be like more confident in yourself? We're seeing like low self esteem problems, a lot of shame, you know, and social skills atrophy. So these are the things that I kind of focus on and like how can you, whether you're a man or a woman, we have everyone in our community, like, become just a better human being. And then I think as you become a better human being, what we tend to see is that the relationship kind of like comes pretty naturally. But this is not a societal program. I'd love to make it one.
- [55:08]
Dr. Rena Malik
What I think, I think if you did it on an individual level through, for many, many people at scale, it would help society overall. Right. Like, because I think you're right. Social skills are definitely less, less robust. Right. In the, in the age of technology, I worry about how our kids, I mean, I sort of force my kids to like, communicate with people. We go out, like you have to have a conversation, you have to learn those skills because otherwise, you know, they'll be looking at their phone or looking at devices or, I mean, they don't have a phone, but like, they'll be looking at some TV or something else or trying to get a dopamine fix through something else. And so that is, you know, a real problem, I think, in society today, in our, at least in the developed countries where there's lots of access to these things.
- [55:49]
Dr. Alok Kanoja
Absolutely. And I think now that I realize it, so. So we have lectures on those topics. So even at scale, I know I sort of said I work with individuals, but what I've sort of done is like we did two lectures on communication and relationships and we have two lectures coming up on like, how to make. Build meaningful connections. And so there's a lot of science that we can really utilize and once we understand how connections form. So I think like a good example of this is people don't realize what leads to attraction. So the science of attraction is like, really fascinating. And the interesting thing is that Tinder does. The data points that Tinder collects don't correlate at all with attraction. So your interests and things like that don't actually govern attraction in the brain. So it's interesting things like shared emotional experiences. So there's a super fascinating study where they had people go on first dates on a rickety bridge or a stone bridge, and on the stone bridge it's stable and it was like, whatever. But when you have people meet in the middle of a rickety bridge, your sympathetic nervous system is activated. Both people are a little bit scared and anxious. And when there's an. A similar emotional experience, it can even be negative. This results in like some kind of bond being formed emotionally. So there are some of these things, like you have to, you know, keep your date under 75 minutes. Because something happens in terms of, like, attraction and stuff like that. There's a lot of stuff that we can actually teach people to help them kind of like compensate for the social skills atrophy.
- [57:15]
Dr. Rena Malik
That's interesting. That's really fascinating. Are you loving the Rena Malik, MD podcast? Well, I love each and every one of you, and I'm truly honored that you choose to spend a bit of your day or a bit of your week with me. Did you ever hear the actual story of why I started making content online? Well, when I was a resident, I remember having a patient who had bladder cancer. And in order to treat her bladder cancer, we had to remove it and then reconstruct a new bladder called an Indiana pouch. Now, with this new bladder, she would have to catheterize herself through a stoma or an opening on her abdomen in order to empty her bladder. So after surgery immediately, she did great. She went home and no major issues. But subsequently, over the next couple months, she started getting readmitted over and over again to the intensive care unit, and we were really wondering what was going on. Eventually we figured out that she didn't truly understand that she now had to catheterize herself to empty her bladder. Just the simplest thing that was so pivotal. She didn't understand that. And it was then that I realized as a urologist, I could do the perfect surgery. But if my patient didn't understand the consequences of that surgery, then I failed as their doctor. And once I started practice, I realized that I couldn't teach people everything they needed to know in the 15 or 30 minutes I saw them in my office. And that's when I started creating all my Rena Malik MD content to offer free education to people around the world. And I can tell you that it has been truly one of the most rewarding experiences in my life. And in order to keep providing free content, we need your help. If you are getting value out of this podcast or my other content, I encourage you to join our premium membership. As a member, you'll get early access to the audio and video of the podcast completely ad free transcripts of all the episodes, and exclusive access to Ask Me Anything episodes that occur once a month. And during those episodes, I answer questions that are asked only by premium members. So join us today@renamallick.supercast.com can't wait to see you there tonight. Turn down the noise of the day and focus on the rest with agz, the nightly drink for winding down and resting up. New from AG1AGZ supports your body's natural sleep cycle with clinically studied key herbs, adaptogens, and minerals in amounts supported by research. And no melatonin. Helping you wake feeling rested, wind down, rest up with Agz. Learn more@drinkagz.com I wanted to go back to you mention something about when you have sex with someone, you create a bond with them, right. And so how does that work in terms of casual sex? Like, in terms of the brain, like you're having casual sex with multiple partners. How does that affect you in your brain and how you see future partners or see yourself?
- [60:18]
Dr. Alok Kanoja
Yeah, so that's a great question. Let me try to approach it from a couple different angles. So the first thing that I found is that I think it is natural in the sense of from an evolutionary perspective to bond with someone that you have sex with. That being said, what we're seeing is different kinds of behaviors now in which that doesn't happen or happens in different ways. So I was like, just looking at research on polyamory, for example. And the research on polyamory shows that people who are polyamorous and in relationships are relatively happy. But I think there are some biases in the research because they're doing research on people who are in polyamorous relationships. They're not studying the people who were in a polyamorous relationship and are no longer one. So all of the research on polyamory is biased towards the success cases. And no one is looking at people who tried to open up their relationship and fell apart, which I suspect is the majority of people. So anytime you have sex with someone, there is a tendency to bond. And what I tend to find is that with people who are having more and more casual sex, we are seeing more and more emotional suppression. So this is from technology. So we're just numbing out our amygdala and limbic system on the whole, which I think makes it easy. We're also seeing a lot of dehumanizing behavior. So the other thing that people that allows people to have casual sex and not bond is like burnout. So the more burnt out you are, the more your empathic circuitry is exhausted, the harder it is to form a bond. And when I have patients who are in relationships where they have, like, casual sex, I oftentimes find that as we do, like, emotional healing, casual sex becomes more difficult. That being said, there are absolutely people who are able to have casual sex and can even form, like, somewhat of a healthy emotional bond. That does not necessarily mean, like, romantic ownership. You can still oppress Appreciate someone and like acknowledge them and like bond with them. And if you look at studies on polyamory, you actually find that there's like very strong positive, emotional. They're able to have emotional connections without it sort of resulting in ownership. So polyamory is a good example of like, it's not actually casual sex. There's like emotional parts of it that they're able to manage.
- [62:34]
Dr. Rena Malik
It's ethical non monogamy, right? Yeah, yeah, sort of. Or consensual non monogamy.
- [62:41]
Dr. Alok Kanoja
Yeah, so. So. And people like to think it's ethical. But you know, I've been on the flip side where I see people who oftentimes feel trapped because if their partner says like, I want this and it's like the in thing to do and I want to be supportive of my partner, even if it's emotionally hurting me, I've seen that a lot. I just don't think that that gets advertised very much.
- [63:00]
Dr. Rena Malik
You know, I will share this with you. I just interviewed somebody about choking in during sex, rough sex. And apparently it's. It's a very vanilla thing to do these days with the younger. Maybe you know this, but it was news to me. I didn't know that it was so commonplace. And again, there was a lot of sort of in these qualitative interviews of like, yeah, well, my partner likes it, so I do it and I accept it. And I wonder why, you know, of course, when you're young and your brain is developing, but like why you would as a, as a species where asphyxiation is essentially dangerous, that you would accept something like that if you didn't like it.
- [63:37]
Dr. Alok Kanoja
Yeah, So I mean, I think there's a physiologic aspect.
- [63:39]
Dr. Rena Malik
Right. So.
- [63:40]
Dr. Alok Kanoja
So the asphyxiation does something to the neurochemistry of the brain. And even if you look at it like, even meditative states that are induced usually by very low respiratory rates. So we'll have like a respiratory rate, like, you know, the average respiratory look like 12 to 14, but in some states of meditation, you're having one breath like every five minutes. And so we know that for some people there's a physiologic change in the brain that intensifies the sexual experience once you add asphyxia.
- [64:10]
Dr. Rena Malik
I understand why people like it, but I'm saying people who self proclaim that they don't really like it, that they don't, they don't find the pleasure in it, but they do it because their partner likes it. That's sort of where I think It's. It's. It's a little murky because it's. They may not be getting that benefit from it.
- [64:25]
Dr. Alok Kanoja
But when you say these people, like, they do it because their partner likes it, or are they the ones doing the asphyxiating?
- [64:30]
Dr. Rena Malik
No, they're the ones getting asphyxiated.
- [64:31]
Dr. Alok Kanoja
Oh, so. But. But then the. So the partner wants to asphyxiate them. Yeah. That's weird. Most of most. I mean, I'm not trying to judge people, but most of the people that I've worked with who enjoy asphyxiation, they're the ones getting asphyxiated.
- [64:47]
Dr. Rena Malik
Yeah. No. And so it's the other way around. And again, this is not the standard. Not everybody, but the majority of the in heteronormative relationships is the male doing the asphyxiating. And they are sometimes asking for it or saying, let's try this. And then the partner says, yes, doesn't really like it. And then they're like, oh, but it's okay that my partner likes to do it.
- [65:08]
Dr. Alok Kanoja
Yeah. So I think that's, like, weirder. Yeah, I mean, like, not to be judgmental, but, like. So. So I think that there's. Why weirder? I mean, there is more to it than a simple physiological induction of a neuroscientific state that enhances sexual pleasure.
- [65:21]
Dr. Rena Malik
Is it a way that we feel like we have to appease our partners? Is there like a, you know, psychological explanation for that?
- [65:29]
Dr. Alok Kanoja
Absolutely. Yeah. So, I mean, like, let's start with the psychological explanation of why I would want to choke someone who doesn't enjoy it. So this is.
- [65:35]
Dr. Rena Malik
Well, they may not realize because the person is saying, yeah, it's good. Right. Because they want to please their partner. So they're not realizing that maybe there's a lack of communication. Maybe the partner's doing it because they think the partner. The female partner likes it. And the female partner saying, yeah, it's good because they want to please their partner, and they're sort of this miscommunication. But whatever the case is, if it is truly that the male partner likes it and the female partner doesn't, but she's saying yes to appease them. That's sort of where my questioning is.
- [66:02]
Dr. Alok Kanoja
Yeah. So what exactly is the question there? Like, why does that mean.
- [66:05]
Dr. Rena Malik
So, yeah, why do people. It doesn't have to be asphyxiation, but why do people do things to appease their partner when. I mean, this one is an example. Because it could be dangerous, right? Like, you could actually have injury. So that's why it sort of gives me pause and alarm to hear about that.
- [66:20]
Dr. Alok Kanoja
Right, Me too. But I mean, I think if we ask, like, you know, like, you know, I hope it's okay. You're married, right?
- [66:25]
Dr. Rena Malik
Yeah.
- [66:26]
Dr. Alok Kanoja
And there are things that. We're not talking about sex here, but there are all kinds of things in a marriage that a partner does.
- [66:31]
Dr. Rena Malik
That's fine. I get that. Right.
- [66:32]
Dr. Alok Kanoja
That's fine.
- [66:33]
Dr. Rena Malik
But I'm wondering, like, why you would. Why? Because it doesn't make sense evolutionarily that you would put yourself in harm's way to appease someone else if you didn't like it. Maybe you don't realize it's harmful, but your body should give you some signal that that's not feeling very good.
- [66:44]
Dr. Alok Kanoja
Yeah. So. So, I mean, I think that what I tend to see is like, I don't want to standardize and I can't hypothesize on these people. But generally speaking, what I've worked, what I've seen in my patients is that when someone. The more willing someone is to appease their partner in an unhealthy way, the more disturbed their attachment style is, the more likely there is to be a history of trauma. Oftentimes these people don't feel comfortable communicating and it's not even necessarily, like their partner's fault. So I. I'm like thinking about one particular patient that like, never fought with their partner. And like, that's not healthy for anybody. Right, right. So. So this person was just grew up in such an environment where they like, learned very, like in a very conditioning way that I'm not allowed to express any kind of, like, discomfort or disagreement or something like that. And so I think that the more extreme your survival signals should be going off because someone is joking you.
- [67:46]
Dr. Rena Malik
Yeah.
- [67:47]
Dr. Alok Kanoja
The stronger that psychological conditioning problem probably has to be.
- [67:51]
Dr. Rena Malik
Yeah.
- [67:51]
Dr. Alok Kanoja
But I think one thing I learned as a psychiatrist is that, like, once you get someone in your office, the reasons that someone does or doesn't do something is actually way more vast than you would realize.
- [68:02]
Dr. Rena Malik
Yeah.
- [68:03]
Dr. Alok Kanoja
But I think there may be something trauma related, which is like a good safe guess if we're talking about like a board question. Like, that's what I would circle.
- [68:10]
Dr. Rena Malik
That's really interesting. So what do you think? You know, I've been thinking about this a lot lately, and I don't know the answer. But now with VR, Arkansas being able to, like, feel like you're in a erotic film or potentially the future of like, sex dolls that are realistic and AI what do you think that's gonna do in terms of our mental state and how we bond with people.
- [68:35]
Dr. Alok Kanoja
Okay, so this, I think. So you were worried about, like, you know, the lack of birth rate or whatever. Like this I seriously think could like end the human race.
- [68:44]
Dr. Rena Malik
No, I'm worried about that.
- [68:45]
Dr. Alok Kanoja
So. So I think this is what's going to happen. Okay. So someone is soon going to figure out. So if we look at the trend in technology, addiction. Okay, this is what's going on. So first we had a video game, and then a video game activated our dopamine. And then we had like, friends lists, we had communities, we had guilds, we had massively multiplayer online RPGs. And so over time it.
- [69:08]
Dr. Rena Malik
What.
- [69:09]
Dr. Alok Kanoja
What has happened is gaming scratches different itches in the brain. So we're getting more whole brain effects. And the more of a whole brain effect you can create, the more likely someone is to play a video game. So we look at relationships. Something weird, right? Which is that sometimes you're dating someone or you're married to someone or whatever, and like, even though there's drama in the relationship, somehow the drama pulls you in.
- [69:30]
Dr. Rena Malik
Yeah.
- [69:31]
Dr. Alok Kanoja
And so I think what we're going to see is like AI girlfriends that start, start. Or boyfriends that start, like having drama. Like, they're gonna start like getting mad at you and they're gonna start having fights and someone is. Is gonna figure out from an algorithmic sense what is the right amount of denial of reward, which I'm sure you understand, right? Random reinforcement schedules. And like gambling. They're gonna start inputting gambling mechanics into virtual systems.
- [69:55]
Dr. Rena Malik
We're so.
- [69:56]
Dr. Alok Kanoja
We really are. We really are. And then this is going to add more. And then as these virtual AI like girlfriends or boyfriends or whatever become more and more robust as they become like, more, as you mentioned, like, they're going to get integrated into sex dolls and like, physical sensations and things like that. You're going to have emotional connections where they're going to be like, activating emotional circuitry. You're going to. And then like, the crazy thing is that after she, like, denies you, she's going to come and apologize and then that's going to make you feel really, really great. Right. And so the closer we get to approximating a real relationship, I think the more pulled into this we're gonna get.
- [70:32]
Dr. Rena Malik
Yeah. So my hope was that they would be at least the. And I'm sure this is correct, that the initial ones will be very, like, acquiescent. Like, they will just be very nice. And they will do. They will say yes. To everything. There won't be that. That negative sort of random reinforcement sounds like that. That won't. People won't like that forever. But if they do evolve to what you're saying, we're totally.
- [70:52]
Dr. Alok Kanoja
Absolutely. So I think that's what's going to happen. Right. So. So unless someone stops it, and then we're going to. We're going to slowly add other qualities to AI girlfriends, adding the physical dimension, like, who know. Like, I. I don't know exactly what's going to happen, but then, like, you know, they're. They're going to evolve and to do.
- [71:09]
Dr. Rena Malik
Everything you would want a real person to do in the perfect way. Actually, the perfect amount of way. Like.
- [71:14]
Dr. Alok Kanoja
Yes. So what I would say everything. They're going to be so perfect that they do things. Things that you don't want them to do.
- [71:20]
Dr. Rena Malik
Right. Because. Because we need that.
- [71:21]
Dr. Alok Kanoja
We need that.
- [71:22]
Dr. Rena Malik
Yeah. That is. Oh, my gosh. Okay.
- [71:25]
Dr. Alok Kanoja
Scary.
- [71:26]
Dr. Rena Malik
So if you were Surgeon General and you could put in any policy that you want to, like, to. To better the universe right now, what would you do?
- [71:35]
Dr. Alok Kanoja
If I was Surgeon General, I would resign and make Vivek Murthy. I would tell him to take my place. So he's a fantastic answer. I'm not trying to kiss his ass. It's just like, honestly, like, so. So I mean, if I could put any policy in place, probably what I would do is create a mental health training curriculum as part of our core K to 12 education.
- [72:00]
Dr. Rena Malik
Yeah.
- [72:00]
Dr. Alok Kanoja
So in ancient India, like, we taught kids, like, mathematics and how to meditate. So we taught kids how to control your desires, how to train your attention. So if we look at some of this, like, you know, this work that we do with, like, ADHD and stuff like that, we train people how to control their mind. And I think that, like, everyone needs to learn this, because what's going on right now is that we don't know how to control our mind, but the people who develop technology are getting better and better and better at it. So literally, what is happening is that psychiatry is the only field of medicine where we are losing the war. So, I mean, maybe this is untrue. I don't know about your logical outcomes, but I would bet money that over the last 50 years, urological outcomes have improved.
- [72:43]
Dr. Rena Malik
Yes, yes. But I think that comorbidities have gotten worse because of other things, and that's overall made urologic outcomes, like, you know, more prevalent. So erectile dysfunction and cancers and those sort of incontinence, all the things that we see Sort of more common even.
- [72:58]
Dr. Alok Kanoja
Then I would say that that is losing, that's a loss on psychiatry. So what we're, what we're seeing is we're not able to, to control human beings behaviors, right? And so even though our technology and urology, cardiology, things like that, we've gotten better at PET scans and MRIs and whatever, our science has improved, but we're losing the war on mental health. And I think the reason for that is because we have stopped learning how to utilize our mind. And then on the flip side, we have people like app developers, which like, I don't think they're all evil, but there's like two groups of people who call their users users, drug dealers and app developers, Right? Otherwise it's like clients or patients, but they're users. And so what's happening is all of these people are getting more sophisticated. And as they get more sophisticated, they know how to prey on your brain. And they're even like scientific studies on something called the attention marketplace, where you have people who are now neuroeconomics, economists who are studying like human behavior and trying to figure out like, you know, this is way beyond advertising and marketing, like, how can I control someone's mind so that they buy something. We see this a lot. There's actually like a sports betting epidemic right now. And a big part of that is that we now allow people to place bets at 2am when their frontal lobes are completely exhausted and they can't like control what they do. So technology is getting better at exploiting us. And so I think what we've seen, at least in our community, is thankfully, if you learn like yoga and meditation, all this kind of stuff, if you learn how to train and control your mind, it can help you control technology addiction, pornography addiction, video game addiction, all that kind of stuff. So that's probably what I would implement.
- [74:37]
Dr. Rena Malik
Yeah, I mean, I think education at a young age needs to be revamped to include a lot of things. From my perspective. I always talk about how sexual education would do leaps and bounds because there's one so much misinformation. Two, people don't know anything, right? They don't. They learn how to put on a condom, they learn basic consent, they learn how to avoid STIs and pregnancies. That's it. And they don't learn what the anatomical parts are. They don't learn how to. And their parents aren't talking about it enough. So they're learning about how to pleasure someone through pornography, which is not reflective of real life. Right. It's actually 1 in 4, like 1/4 of teenagers are learning through pornography based on data that we have. And so just one fourth, well, at least that's a few years old, but yeah, I mean, it's probably more than that. Right. But at least 1/4 admit to it, whatever survey they did. So that's a lot like, like, and so if people knew what sex should be like and what actually female partners, like, what male partners like, I mean, there's on both sides, right. Men have a lot of expectations of her performance. Women are expected to enjoy penetration immediately and orgasm within minutes. Like, none of this is accurate. Right. And so if they were taught what is normal function, what is normal anatomy, what is pleasure, I think people would be so much happier because you know just as well as I do the devastation that comes with difficulties in the sexual domain.
- [75:57]
Dr. Alok Kanoja
Do you have a good resource for what you consider, like, what they should be taught? Like, is that something that you put together at some point?
- [76:03]
Dr. Rena Malik
I haven't yet. I'm going to. I'm going to work on it. There is actually, I just learned of today, there's a website called Make Love Not Porn, where that's essentially what this person is trying to do. And it's fascinating because she couldn't get any funding and, and like, from anyone because nobody found it worthy of investing. Whereas, like, you know, you can think about all the other things that are sexually oriented that get lots of funding and lots of, you know, lots of advertising that allows them to offer it for free. So, yes, I'm going to work on making a sexual education course that hopefully schools will use. But, you know, I think the same. I think in terms of digital media, they're doing digital media education in, like, Australia now, and probably in some schools here they're trying to start implementing that, but I think it's super important.
- [76:47]
Dr. Alok Kanoja
Yeah, yeah, absolutely.
- [76:49]
Dr. Rena Malik
Is there anything we didn't talk about that you want to talk about?
- [76:51]
Dr. Alok Kanoja
Nope. I think this was great.
- [76:53]
Dr. Rena Malik
Okay, well, I have a few questions I ask everybody. Just sort of like more about you than your expertise. But what's something, you know, now in your life that you wish you knew earlier?
- [77:00]
Dr. Alok Kanoja
You know, that's interesting. I mean, I hope this isn't annoying an answer, but I'd say nothing. One of the things that I've come to appreciate is, like, ignorance earlier in my life has helped me, like, kind of become the person that I am. And like, there are certain things, like I failed out of college, for example. And so, like, there were times in my life where I wish I could go back and change that, but I really wouldn't because if I knew different things, then I would have acted differently and then I wouldn't be where I am now.
- [77:24]
Dr. Rena Malik
Yeah.
- [77:25]
Dr. Alok Kanoja
And I'm really happy with, with where I am now.
- [77:26]
Dr. Rena Malik
That's great. I mean, that's really great. Yeah.
- [77:28]
Dr. Alok Kanoja
And it's not a BS answer. I know it sounds like a bs.
- [77:30]
Dr. Rena Malik
No, no. But I mean, I think, I really believe that strongly is that your journey is individual to you and, and if one thing was different, you wouldn't be where you are. Right. So like, if you hadn't almost failed out college, you wouldn't have gone to India, you wouldn't have learned all the, all the, you know, Eastern traditional things that have influenced you and perhaps gotten into medical school later and, and pursued psychiatry and all the things.
- [77:52]
Dr. Alok Kanoja
Absolutely. So I'm, I'm happy with where I am and like I'll take all the decisions and all the ignorance.
- [77:57]
Dr. Rena Malik
That's great. What is a non negotiable for you? Something you have to do every day?
- [78:01]
Dr. Alok Kanoja
I mean, aside from like physiologic functions.
- [78:03]
Dr. Rena Malik
Yeah. Like, not like people say sleep a lot, but I'm like, okay, everyone has to sleep.
- [78:07]
Dr. Alok Kanoja
I mean, I don't, I don't, I don't know that I have a non negotiable. I think the clo. The thing that I enjoy the most is like oftentimes watching esports while I have like a cup of coffee or tea in the morning, that is the thing that I, I enjoy the most and was like the one thing that I try to hang on to. But really after like being in an ashram for a while, like there's not.
- [78:25]
Dr. Rena Malik
You don't need anything.
- [78:26]
Dr. Alok Kanoja
Yeah. That's what you learn is that we think we have all these non negotiables. But like, you know, if you don't have what, like, can I ask you, like, what's one?
- [78:33]
Dr. Rena Malik
I don't have one.
- [78:34]
Dr. Alok Kanoja
Yeah. So like, like if you oftentimes parents learn this the hard way is like you had all these non negotiables before you became a parent.
- [78:41]
Dr. Rena Malik
Yeah.
- [78:41]
Dr. Alok Kanoja
And then like your kid gets rid of that and it's like, it's not that bad.
- [78:45]
Dr. Rena Malik
Like you don't like. I would love to say I have to go outside every day and I would love to say that I could do that, but there's some days where I just can't. I can't, I can't literally. Maybe I can step outside for a couple minutes, but I can't. Like, do a walk in nature, like, I would love to, or I can't meditate every day. And I think that's okay. But I always find it really inspirational when people are like, yeah, I have made it my, like, my thing to do this XYZ every day, and it's helped me in some sort of way.
- [79:08]
Dr. Alok Kanoja
Yeah, yeah.
- [79:09]
Dr. Rena Malik
But what's a health hack or life hack that you would share?
- [79:12]
Dr. Alok Kanoja
So, one is that meditating twice a day is exponentially better than meditating once a day.
- [79:17]
Dr. Rena Malik
Can I ask how long?
- [79:19]
Dr. Alok Kanoja
Yeah. So I will meditate for 20 to 30 minutes twice a day. So if you look at most of the studies, like, probably around 18 minutes is what you need to shut off ACTH production and reduce cortisol and things like that. Most of the clinical studies on mindfulness or meditation show clinical benefits with, like, 20 minutes of meditation. But I think this is where there's a big difference between physiologic benefits and spiritual benefits. And what I found is meditating twice a day for 20 to 30 minutes, the first time you meditate is going to give you physiological benefits. But if you really want to accelerate your spiritual growth, you need to meditate twice a day, because it's that second day where you clean out all the physiology stuff and then you're really, like, primed for, like, spiritual growth.
- [80:00]
Dr. Rena Malik
That's fascinating. And is it, like, certain times of day or any. Any two times?
- [80:05]
Dr. Alok Kanoja
No, I mean, so any two times will work, but generally speaking, dawn and dusk, and there's, like, interesting stuff about our circadian rhythm and things like that. So even if you look at, like, visual acuity during dawn and dusk is, like, the highest, which is why sunsets are so beautiful. So dawn and dusk are the two best times to meditate during the day. So if you can do that, great.
- [80:24]
Dr. Rena Malik
And what's your second thing?
- [80:25]
Dr. Alok Kanoja
The second thing is this concept in Ayurveda of Sattvik, Rajsik and Tamasik. So, see, a lot of people, like, I don't know if this kind of makes sense, but on some days, you're sluggish and it's, like, harder to get yourself to do the things that you want to do. And then there are other days where it's, like, easy for your body and your mind to listen to you. And so basically what the Yogis figured out a long time ago is that there's a way to balance your mind by making it sattvic. And Raj sick means overly passionate or active, and Thomasik means, like, inert. But there are certain Things that you can do, like food that you can eat and things like that. So eliminating most if not all psychoactive substances will help you over time. So the main kind of life hack is what can you do today that will put you in a better frame of mind tomorrow? So if you like drink even like a glass of wine at night, that will interfere a tiny bit or with your REM sleep overnight, which can affect you the next day. So what I really try to tell people to do is do like whatever you can today. And it's not about today, it's like set yourself up for like a good day tomorrow.
- [81:31]
Dr. Rena Malik
Well, that's like also impinging on delayed gratification, which is tough for people. Right. Like you are sort of looking for.
- [81:37]
Dr. Alok Kanoja
So that's what I mean. So your ability to handle delayed gratification depends on how so thick your mind is. Yeah, so that's, that's, it's kind of like the linchpin is like. Yeah, you're absolutely right that it's hard. But that's the whole point is like once you get started on that path, once you sleep a good night, it's easier to delay gratification tomorrow. And then you do the next thing. And then you do the next thing. And this is sort of from the yogic literature, like being sattvic. So you're doing mind body practices, changing your diet, eliminating psychoactive substances. All that stuff is really good.
- [82:10]
Dr. Rena Malik
That's great. I'm going to add one more question because you've been in the Eastern medicine, sort of Eastern philosophy. There's a lot of sort of ayurvedic medicine, herbal supplementation. Are there certain things that you've taken from that that you recommend your patients take?
- [82:25]
Dr. Alok Kanoja
Oh, I mean, so I started a consult service at Mass General that was evidence based, complementary and alternative medicine. So it just depends on the patient. So I know we're seeing good evidence for things like Brahmi, Ashwagandha, Turmeric sometimes is an anti inflammatory. So it depends on the condition. So I don't, I don't recommend that everyone.
- [82:45]
Dr. Rena Malik
There's not like one thing.
- [82:46]
Dr. Alok Kanoja
Yeah. So the closest thing I would say is probably meditation. So we have clinical trials on meditation for all mental health issues. And so that's like the one thing that seems to be like a panacea. It's kind of like exercise where it helps everything.
- [83:00]
Dr. Rena Malik
Yeah. Okay, awesome. Well, thank you so much.
- [83:03]
Dr. Alok Kanoja
Thank you.
- [83:04]
Dr. Rena Malik
Thank you so much for tuning into the Rena Malik, MD podcast. If you're enjoying this content, please be sure to go onto YouTube, subscribe to our channel and go to Apple and Spotify and leave a rating or review. This really helps us reach more people and it's a free zero cost way to support the podcast and I will greatly appreciate you. Also, if you like my content, feel free to follow me on social media. My handle is renamed Malik MD on most platforms and as always, I'm gonna take care of yourself because you're worth it. Start the season with Etsy and make your holiday traditions extra special on Etsy. You'll discover original pieces from small shops that will help you celebrate your way. Shop Etsy for holiday decor that makes you feel seen. Special starts on Etsy. Tap the banner to shop now. Hey guys, I'm Samantha Christine, host of the Empower Podcast right here on the Pursuit Network. If you're into wellness that fits into real life with honest combos, workout tips that actually make sense, nutrition hacks that support your lifestyle, and a lot of encouragement to become your strongest self, you'll feel right at home on my show. Whether you're a busy mom in a season of rebuilding or just trying to stay consistent with the all or nothing mindset, the Empower Podcast is for you. New episodes drop every Wednesday wherever you listen to podcasts, so come hang out. I'd love to have you.