Dr. Rangan Chatterjee (3:17)

If your whole life is spent outside of yourself getting inputs from the outside, you're not tuning into what's going on inside. The most powerful step you will ever take for any kind of behavior change is.

Rich Roll (3:34)

Welcome to la. It's great to be back with you. You're having a full court press LA experience from what I understand. You're really like doing it, aren't you?

Dr. Rangan Chatterjee (3:44)

I am. It's been great. I haven't been to LA since pre Covid. I'm loving it. I like the community here, like the things I'm interested in, wellness and health. It kind of feels normal out here. Certainly the people I've met so far and it's, it's kind of made me think that this is not real life like out here. It's so normal to be thinking about health and wellness. And it really struck me over the last 10 days that like, if you grow up around these people who are really interested in health and well being and you know, I passed more sauna and cold plunge places over the past 10 days than I've ever seen before.

Rich Roll (4:27)

But you're kind of in a self selected, you know, kind of community though, because you have contacts and friends and people and you're kind of visiting all of them. So you're hitting all the sort of hotspots. I mean, LA is a very big place. There's, I don't know, 20 million people here. So there's all different kinds. To your point, yes. Like wellness, wellbeing. These kind of principles that you speak about on your show and that you write about are, yes, like I think more embedded into the DNA of the culture here.

Dr. Rangan Chatterjee (4:54)

And I think because I don't live here and I live in the northwest of England, it is, it's a stark contrast to what I'm surrounded by. And I find that really, really interesting how much our environment influences how we think and what we deem to be important. So I've really been quite struck by that. I also feel very LA at the moment because I've got to know Gabby and LED over the last week and I've heard about their workouts Their poor workout and their pool stuff for years and they're just two of the nicest people I've come across. They're so warm and friendly and I've just hung out and I've being at their place and I'm sort of pinching myself a little bit going, this is not my real life. Like I'm in the.

Rich Roll (5:39)

This is your real life though, Rongan. This is the life that you created.

Dr. Rangan Chatterjee (5:42)

Well, it feels real at the moment, but I'll be very soon I'll be back in the northwest of England with its dark. You know, the kids I spoke to before, it's like it's dark at 4pm so anyway, but I'm having a great time. It's great to be here.

Rich Roll (5:55)

Well, it's great to see you. Is this your fourth or fifth appearance on the show? You've been on a number of times. I can't remember how many times.

Dr. Rangan Chatterjee (6:01)

I think it may be the fourth one.

Rich Roll (6:03)

But the last time was pre Covid when we were still recording in my house. So you have never even been to.

Dr. Rangan Chatterjee (6:09)

The studio and I love it. You've done a great job.

Rich Roll (6:11)

Well, it's great to be back with you. We had a nice lunch the other day with some members of the community and got to reconnect. We went to that Spotify event together the other day, which was really cool. And now we're here. We're doing the thing. It is that time of year when it does get dark at 4 o'clock in the northern hemisphere. We're sort of careening towards the holiday season when this comes out, I think at the very end of the year, it coincides with your new book coming out, which is what we're going to talk about. But it is that moment where we're all thinking about what we want this next year to look like. What are the changes we're thinking about making, how are we going to go about making them and how are we going to do it in a way that works within the complexities of our busy lives. And so I think the spirit in which I want to kind of hold this space for this conversation is around habit change, which is obviously at the crux of your new book and how you think about this time of year and setting people up to make those changes and sustain them.

Dr. Rangan Chatterjee (7:17)

Everyone wants change, right? Everyone wants change that lasts beyond a few weeks and a few months. And you know, Rich, I've been a doctor now, medical doctor for 23 years, okay. I've seen tens of thousands of patients during that Time. And for many years, it's been very clear to me from my own experience and from the scientific research that 80 to 90% of what we see as doctors is in some way related to our collective modern lifestyles. Now, I say that with an open heart. I'm genuinely not blaming anyone. I'm simply saying that the way we live our modern lives is resulting in many of us feeling sick and getting symptoms and getting diseases. And as I probably mentioned on previous episodes on your show, you know, we don't really get taught properly at medical school. I would say how to tackle that. We get taught how to tackle certain things very, very well, but we don't really understand how to create health and how to use our lifestyle to not only prevent ill health in the future, but also to help treat people when they're already sick. That's a missing piece for me. That's always been there. People say, yeah, lifestyle is really important for prevention. Yes, it is. But you can also treat people who are sick, often by making small changes to their lifestyle. So about 10 years ago, I thought, well, it's really clear to me, if it's a lifestyle that is driving our ill health, what are the key factors that we can look at? And back in my first book, I share this idea that there are four pillars to health and well being. Food, movement, sleep and relaxation. And I would say that each one of these are really, really important. Each one is going to have an impact, but you can't just do one. You have to look at all four and get balance between all four of them. So you don't need perfection in any one of those four pillars, but you do need to address all of them and get that balance. I still stand by that, that our lifestyle is the cause of most, not all, most of what we see as doctors. But I don't think those four pillars are. They are a root cause, but they're not the highest root cause because if you go even higher upstream, I think a lot of those habits and behaviors that we do are as a consequence of how we interact with the world. Right. So to make it super, super specific for people and maybe really bring it to life. I would imagine that anyone listening right now, if there are fans of your show, they generally are interested in improving their lives. Okay. In a variety of different ways. Yes, their diet, their movement, their sleep, but also their mindsets. So let's take something like sugar, for example. Most people who are consuming too much sugar for their health, I would argue in this day and age, they know that they know that excess sugar is causing them a problem. So we think that if anyone wants to make sustainable change, we think they need more knowledge. And I used to think people need more knowledge. And it's true that some people do need more information and more external knowledge. But I would argue that many of us don't need more external knowledge. We need more internal knowledge and self awareness. Oh, why, despite knowing that sugar is really. Excess sugar is problematic for me. Why, despite having done a one month detox last January where I felt great and my energy was up and my skin was better, my sleep was better, you've got the knowledge, you've got the practical experience of knowing that knowledge is going to make you feel better, yet people often revert back. So as a doctor, I've been fascinated. Why? I thought it was just knowledge a few years ago. Now you give people the knowledge, they start taking action, they start to feel better. I thought, okay, we've cracked it now give them the knowledge, they feel better, great, but people would revert back. And so this book, which is my sixth one, is really my effort to go further upstream and go. Unless you address the root causes, the way you think, the way you approach the world, the way you approach adversity, Right. You're going to struggle to make these changes that last in the long term. And I believe everyone can make changes that last in the long term. I feel I can do that in my life. I feel one of the problems with behaviour change, which is that we're trying to overcome the person who we are, the change we're trying to make is in conflict with who we think that we are. So you mentioned New Year. I think it's the energy behind the behavior that's the most important thing, not the behavior. So if your New Year's resolution comes from an energy of lack that I'm not enough, okay, I'm not good enough. And you're trying to overcome that with guilt and shame and willpower. Yeah, you can be fine for two weeks or one month or two months or three months, but you will always revert back. That's been my experience. But. But if it comes from an energy of love and abundance that hey, I actually like who I am. Right. Actually, change becomes a lot easier. And you can get to a point where change becomes effortless. I experienced that myself. Now, having tried to make changes for years that were in conflict with how I saw myself to be, you can get to that place. But I don't believe that most of the advice is getting to the true root cause. Does that make sense?

Rich Roll (13:03)

Yeah, it does. I mean, essentially what you're saying is some version of we are our own worst enemy when it comes to the struggles that we face when we try to make a behavior change. And it's not that we're our own enemy. That's probably the wrong word. It's more like we are our own biggest obstacle. And we think that those obstacles are external, but they're internal. And the solutions that we're looking for are not going to be found outside of us. They're always inside. It is an inside job. And if you want to kind of master a change, you're going to have to look inward and unpack the mechanics of why you behave the way that you do, why you have historically always done a certain thing, even though you have this knowledge and you know that it's not in your best interest. So it's sort of journeying through the subterranean landscape of your psyche to better understand what happened to you, how you adapted to whatever happened to you. Like, you have to approach it like Richard Schwartz with ifs. You have to understand these experiences that you had in your youth that wired you a certain way. Like all of the behaviors that we have that are not in our best interest, that move us in errant ways are essentially defense mechanisms that at one point in time served us behave that way for a reason. Right. And so we have to understand what those reasons are if we're going to figure out a way to address them and create kind of new patterns and neural pathways that are going to lead us on the journey towards becoming the person that we aspire to be.

Dr. Rangan Chatterjee (14:45)

Yeah. Very simplistically, if alcohol is your way of managing stress, which it is for many people, you can, on January 1st, decide that you're going to quit, and you can do 30 days without alcohol, and you could feel the benefits. But one or two things has to happen if you're going to make that change last for most people. Some people do it, and that's all they need. I recognize that, but many people can't. If stress is the underlying cause of your alcohol consumption, either you need to reduce the stress in your life so that you no longer need the alcohol to actually neutralize the stress, or you have to find an alternative behavior to alcohol to help you manage your stress. I mean, that's a very simplistic way of looking at it, but I think even within my profession, the way we tend to give public health guidelines is this amount of units of alcohol. It's okay. This amount is not this Much will impact your liver, will impact your brain, it will impact your teeth or whatever it might be. And I get that. But I feel it's very dry. There's a human level to those behaviors that we're not addressing. And I would dare say that I don't think my profession has been amazing at address the root causes of behavior change for many, many years. I think that we don't understand or we don't think about enough that every single behavior in our life serves a role. You will only change the behavior in the long term if you understand the role that that behavior plays in your life. And so when I think about behavior change, I think about it in a couple of different layers. So layer one, we can talk about healthy habits, right? How do you create a healthy habit? And I've written about this in previous books and I think, yes, it's very, very important. And there are some rules that you can follow. For example, two of the most important rules that people can follow when trying to create healthy habits is, number one, make it easy. And number two, stick on the new behavior, your desired behavior, onto an existing habit. How that plays out in my life for many years, which I think I've spoken to you about before, is I have a 5 minute strength workout every morning and I don't think I missed a day in five years. It has nothing to do with motivation or willpower. It's because I make it easy. It only takes me five minutes. I do it in my pajamas. I don't have to get ready, right? So it's super easy. And I stick it on to my coffee habits. So I make coffee every morning and therefore, in the five minutes that my coffee is brewing, I don't go on Instagram or email or look at the news. I have a kettlebell and a dumbbell in my kitchen and I just do a five minute workout and then I go on and drink my coffee. And people may say, well, that's not enough. And I would disagree with that because we understand the concept of toothbrushing that we all do four minutes a day, I hope, right? And we know that generally speaking, that will keep our teeth and our gums in good shape for life. But we don't apply those principles when it comes to our lifestyle. We make things really, really difficult. I'm not saying I don't lift heavy things at other times or go for a run or go for a walk or whatever it might be, but I have this momentum every single day that no matter how busy I am, I still found five minutes for me. And it changes the way I view myself. Right. So you can think about behavior change in terms of how do you create a healthy habit? And I think those two rules are very, very helpful for people. I've used those with patients for years. But it's still not the root of the root. Right. You can apply those principles. But if you have negative self talk, or let's say, like the whole book is about this idea that we are reliant. We're overly reliant on things outside of ourselves to feel good.

Rich Roll (18:47)

Yeah. You've created this very interesting heuristic called minimal reliance. And as somebody who thinks a lot about change, behavior change, how do you do it? What is the higher order kind of root cause of why some people struggle with this and others don't? And reflecting upon the messiness of our interior lives and trying to get a grip on the psychology of all of it, you have come up with this very elegant way in which is thinking about it in terms of the various externalities that we come to rely upon that impact habit formation and habit change. And, you know, look, I'm. I say this in a way that probably is annoying the audience because I always bring it up, but I tend to kind of see these things through 12 step. And so if you just elaborate or extrapolate on reliance and take it all the way to its extreme, that's addiction. Right. So if you're dependent on something that becomes an impediment to any kind of behavior change, that erodes your resilience and your sense of self efficacy and. And agency and the like. Right. But by identifying the various ways in which we're kind of semi unconscious of how we're unnecessarily overly reliant upon certain things in a way that keeps us stuck, I think is a really kind of cool and interesting lens into kind of this whole world.

Dr. Rangan Chatterjee (20:16)

Yeah. Thanks, man. I really appreciate that. I thought long and hard about this. I didn't want to just write another book that in any way repeated what I've previously put out. I wanted to see if I could come up with something fresh and original and a new way of looking at change. And I really like this concept of minimal reliance. It's not zero reliance, as no doubt we'll talk about. It's a minimal reliance. I'm saying we're overly reliant on things in our outside world to feel good. And those things are things outside of our control. So again, there's a couple of layers to this. This could be, for example, that you are someone who needs everything to go right in order for you to feel good. So you get up and your family are nice to you and the children have put their shoes away and that there's no traffic on the way to work and that your boss treats you nicely and, you know, whatever. There's no queue in your favorite coffee shop. Okay. We all like those things to happen. But if your inner well being and how you feel is dependent on those things happening, if you're reliant on those things happening, as many people are, dare I say, most people are, and how I used to be for much of my life, you're always in this very fragile state where you are like a puppet on a string. So if the outside world goes the way in which I want the outside world to go, I can feel good. And if and when it doesn't, I don't feel good. Right. So I think that's a key thing that people have to understand because you can change your reliance on those things very, very quickly once you know that they're there. So this book is about trying to bring this kind of dark side of us into the light. Go. Wow. I didn't know that I was reliant on so many things. But then there are some more bigger picture reliances that I think many of us have. In the book, I try and identify the nine key ones that I've identified in myself in my many patients over the years. And I guess one of my favorite ones is the one that I write about in chapter one, which I think is the most important chapter in the book, which is called Trust Yourself. And each chapter is addressing one of these reliances. So Trust Yourself. It's addressing our reliance or our over reliance on experts. Now, I think this is punchy and I think it's interesting to see how this lands with people because I am one of these so called experts. But I don't know about you, Rich, but one of the things I've noticed in this health and wellness space over the past few years is that we have a barrage of information. There's so much expertise out there, but people are getting confused.

Rich Roll (22:57)

And then in the midst of all of that, there is this growing distrust of experts.

Dr. Rangan Chatterjee (23:03)

Yeah. And I think there's only one way through this, certainly for me. Right. You may have this. I would find on my show that if one week I speak to one expert, they're from Harvard, they've got the right letters after their name, and they might present that this kind of diet has been really helpful in mental health problems. And they will, let's say a ketogenic diet, for example, and they will share with you evidence to support their view. I think you have a great conversation and let's say eight weeks later you speak to somebody else, like I will often do, who has a slightly different approach and goes, well, you know, I think a plant based diet is best for mental health problems. And look at these three or four studies that support my view. People would often contact me on Instagram, they send me a message, say, hey, Dr. Chatterjee, really like both of those episodes. I thought they both sounded very respectable and very trusting. I don't know which expert to trust and I think that's the wrong question. Rich, with all my heart, I believe it's the wrong question. I don't think the most helpful question is which experts should I trust. I think the more powerful question and the more pressing question is why do I no longer trust myself? And I say that as a medical expert, you know, having passed my specialist exams, my general practice exams, I have an immunology degree, I'm a professor at Chester Medical School. Right. I understand I've got all the labels of expertise, but I still will say that I don't know for sure which is the right diet for any single person who's listening to me speak right now. And what I would say to someone who gets confused, I would say, well, listen, if you like both of their messages and you trusted what they had to say, why not do an experiment for four weeks, try and take this doctor's advice, but whilst you're doing it, pay attention. This is what we don't do, pay attention. How do you feel? What's your energy like? What's your sleep like? What are your relationships like? What is your gut like? Are you bloated? Do you feel lighter? You know, and pay attention and then for the next four weeks take the advice from the other expert and again, pay attention to the same things we have as a society. Rich outsourced our inner expertise to external experts. And I've been doing this for a long time with patients and the patients who manage to transform their lives for good, not just for a few weeks or a few months. There's an inner knowing. At some point they take my guidance and the frameworks I provide for them and they go inwards and they go, actually, you know what dost you, I know you said that maybe those foods to avoid, those foods to have, but I've experimented a few times and I actually feel better when I eat like this. I'm like Great. You know that you're feeling better like this. Let me at least do some blood tests to check what's going on in your body. And there's a case in the book, right? And this may resonate with your audience. I mean, this is, I think, a powerful case study where there was a lady who came to see me. She was very proactive about how she'd listen to health podcasts like yours or mine. She'd read the blogs, she'd read the books, and she had heard a gut health expert online say that you should strive to get 30 plant foods in your diet every single week. It will improve your gut microbiome. Okay? So she's trying to do that, and every time she goes above 10 or 12 plant foods, she's getting bloated, she's not feeling good, she's getting constipated, and she feels like she's a failure. This is the problem. When we put all of our trust in external experts, we start to feel like we're a failure. So she comes in to see me, says, Dr. Chanty, I'm trying my best. I've tried to do it slowly. I've tried to do different kinds of plant foods. I just can't do it. I feel bad when I do it. And I remember saying to her, listen, the health advice you've picked up online, I'm not saying it's wrong. I'm simply saying that no piece of health advice in my experience works for every single person. Okay, let me help you discover what is the right approach for you. And so together over a few weeks and months, we experimented. And the truth is, for her, at that stage in her life, and those two things are both equally important, what she found worked for her was a more lower carb type diet, and she would have 10, five to 10 different plant foods a week. So there was lots of plants in a diet, but it was, you know, 5 to 10 that she knew she could tolerate. She felt great. She had energy, vitality. Her blood tests look amazing. And again, I think there's people out there who listen to our podcast, Rich, and I think sometimes they probably do get confused because they're like, which expert should I trust? I mean, think about the guests you've had over the years, right? You swing to everyone. You'll talk to plant based experts. You'll also talk to Peter Attia, who'll talk about the benefits of animal protein. Right. And people also who follow you, like myself, we deeply connect with your story of what happened to you and the chest pains. You experienced, I think in your 40s and how that encouraged you to change your diet. What we don't know, unless there's an element to your story I'm not familiar with. What we don't know is what would have happened if you had changed your diet to a whole food diet that wasn't just plant based. Right. Maybe you still would have got great health outcomes, maybe not. I'm not disputing. There's the compassion element, there's the ethical element. I understand that. I'm talking purely through the lens of health. We don't know that you found, I believe, what works for you. That's wonderful. And I want every single person to find what works for them.

Rich Roll (29:03)

I mean there's a lot, I mean you just, you shared a lot. So I want to tease out a few ideas in this. I mean, certainly intuition is real and important. I had a neuroscientist in here called Joel Pearson who studies the nature of intuition and how to unlock it and its powers. I've also had Kimberly Snyder in here who talked about the heart brain, this source of wisdom that we kind of don't give enough attention to. So I think I hear and appreciate everything that you have to share. And there are like too many experts saying too many different things and it's very overwhelming, especially in the social media space that leads to confusion and self doubt and ultimately some form of analysis paralysis because you don't really know like who to trust or what to do. And so yes, you should look inward and kind of connect with your heart's voice and try to pay attention to that. I think at the same time it's worth noting that we're all kind of unaware of our own biases and we have a tendency we may decry like I don't trust the experts, except here's the person who's telling me kind of what I want to hear and he's a sort of expert. And so I'm going to align myself with that person because there's a sort of confirmation bias and also it's kind of what I want to do. And now I have a reason or an excuse to do that. And I think on top of that, maybe the bigger issue. Rangan and I'm curious your thoughts on this. In order for your intuition to be trustworthy requires discernment, which I know you talk about. But on top of that a connection with yourself, like a relationship with your interior life that is mature enough so that you can distinguish impulse and reactivity from what is truly your intuition. You know, I think because we are so habituated in our reliance on so many things and impulsed by stimuli that we can confuse, like, oh, well, my intuition is that I should go get that. You know, my body is telling me it needs a Big Gulp. You know what I mean? That would be an extreme version of that. And no, that's not your intuition. That's just kind of like this impulsive thing to sate a craving or a desire in the moment. And so without that kind of maturity, to really be able to distinguish what is an impulsive reaction from what is truly intuition, I think is necessary in order for your intuition to actually properly guide you.

Dr. Rangan Chatterjee (31:50)

Yeah, I think you make a great point. And I think we have to practice. If we've spent our entire lives outsourcing our inner expertise to external experts, we're not going to be able to tune in, we're not going to be able to just hear one podcast or read this book and go, oh, yeah, great, intuition, brill, right? I'm going to start trusting myself. If you spent your whole life or many years not trusting yourself, you're not going to be able to suddenly start overnight. It's a process that you have to practice. Just like if you want to run a marathon, you're not going to suddenly just start going and running 20 mile runs. You're going to start small and half a mile and one mile, you're going to build up, develop the skill, learn what works, learn when. Oh, I thought that was my intuition. It was actually because I was feeling stressed. I wanted that Big Gulp or whatever it might be. And So I believe, 23 years into my medical career, whilst I believe that every single person needs to find the right approach for them, I believe that the most powerful daily practice for any individual in this current climate is, is a daily practice of solitude. I really believe that with all my heart. Because if you don't spend time with yourself, how on earth are you going to listen to the signals your body is trying to tell you? You're not? And so this is where routines come in. This is where things like meditation or journaling, like a period of your day where you're not looking outwards for answer, you're looking inwards and you practice. Now, I think there's a real value in routine and ritual, particularly the same thing done every day, because if you repeat the behavior each day, the behavior stays constant. So if something is different, you know, it's not because you changed your routine or your behavior, you know, it's because, oh, there's something different about you. So a couple of years ago I've always been interested in breathwork and meditation and there's this gentleman called Erwin LaCour who founded the company Movnat Lots of natural movement. I don't know if you've seen his work or not, but he's been doing this for 20, 30 years or so. And then he created a breath hold work meditation course. And I've always been quite interested in eoman's approach and I thought that sounds interesting, I'm going to do that. It was an online course twice a week for four weeks. And I remember the very first time I logged on I had just got to Stockholm because I was on a book tour in Sweden. I got to my hotel room so I wasn't calm, I just rushed on and one of the things he asked us to do was to all take an in breath as much as we can with no hyperventilation beforehand. You just take one normal in breath and then hold your breath and count how long you can hold it for. And I could do one minute. Within four weeks I was able to hold my breath for four minutes and 20 seconds. Now this is nothing like the Wimpoff technique where you hyperventilate and you blow off carbon dioxide. Actually Irwin would probably say, and he's pretty outspoken, he would probably say that doing breath hold work with hyperventilation beforehand. I think he says something like it's like doing cold immersion with a wetsuit on. What I learned in that course was how powerful your mind is. So when you're holding your breath and your body is screaming for you to breathe, if your mind is noisy, you've got to breathe. If you can learn in those moments to quieten down your mind and that thoughts use up energy and if you can just calm everything and he teaches you how to do this, you can actually go for another minute, another two minutes. It was so transformative for me, Rich, because it just showed me how much of my breath hold time. It's not about the breath hold time, it's about in that moment when your body is screaming for you to breathe. If you can master your mind there, you can master it anywhere. Right? So that practice has really helped me be. There's many other things that have helped me as well. But I would say that has contributed to me feeling pretty non reactive these days. There's very little these days that I find bothersome like genuinely and I'll explain other things that I've done to get me to that point which actually helps behavior change because we don't realize that most of our behaviors are there to soothe an internal discomfort. The emotional stress that we generate with the way we interact with the world. So going back to what you said about intuition, why did I bring up this breath hold practice? Because I do it every morning. I do the same practice every single morning. Which means on one morning, like I could do it this week and it will be, I could only do 1 minute and 10 seconds. Whereas on another day I can do 3 minutes. And it helps me tune into myself. Because if I cannot do three minutes and it's only one minute, it's because there's something going on inside me. I'm feeling tight. There's worry about something in my life. You know, there's too much stress, I've taken on too much, like whatever it might be. I'm not saying everyone has to do that practice. You can get this through a variety of different practices. If you like yoga and you have a five minute sequence or a ten minute sequence that you like doing, do the same one every morning. On some days it will feel fluid and free. On other days it will feel tight and rigid. The practice isn't changing, but your experience of that practice is different. Why? Because there's something going on inside of you. So there's many ways you can start tapping into your intuition. If you wake up and the first thing you do is look at your phone and start consuming information from the outside. And you continue doing that all day with emails. And even if you're consuming great content, this is something I've realized in my own life, Rich. Even if you're consuming high quality content, that's balanced, that's nuanced. If your whole life is spent outside of yourself getting inputs from the outside, you're not tuning into what's going on inside. That's why we can't give up sugar or alcohol or social media scrolling or online pornography or whatever it might be. For many of us, it's because we haven't spent enough time with our inner world. And we think, especially in January, we think at this time of year, we need more information. I need a new podcast to teach me new things. Sure, some people do, but I don't think it's more external knowledge we need. It's that internal knowledge. And the last time I was in LA was in March 2020 and we were due to meet up. And as you recall, everything was just starting to change. You're like, man, I don't think we can meet up. And I came here for meetings all the meetings started to get shut down. I'm a different person now, Rich, to who I was in March 2020. Fundamentally, there's a lightness in me with how I experienced life that wasn't there. And there's all kinds of things that have happened in the past five years that have led me to that point. But I've never felt this good man like I really feel this grounded calm within me, which makes behavior change actually relatively simple. I think too often we say, oh, it's hard, it's hard. Behavior change is hard. I used to say that. But if I keep saying, oh, it's hard because you want to connect with people and you want to make sure they know that you're feeling them, I'm sort of prejudging their experience. Why does it have to be hard? I believe it's only hard because we haven't got to the root. If you can help people get to the root and they can start to understand their inner world, I don't think it's as hard as we think.

Rich Roll (39:52)

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Dr. Rangan Chatterjee (40:01)

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Rich Roll (40:02)

Apparel is crucial to performance. And that's why I was blown away by the folks at on's Swiss Lab. Their cutting edge approach from sustainability to precision testing for performance enhancement is next level. It is truly Swiss innovation at its best. Visit on.comrichroll that's on.com richroll this podcast is brought to you by Squarespace, the all you need, all in one platform that helps entrepreneurs and creators stand out and succeed online. It's a digital world, everybody. And having a strong presence online is not just important, it's absolutely crucial. Which is why I'm really excited about Squarespace's new design Intelligence feature. It's kind of like having a personal design expert combining decades of design know how with cutting edge AI to help you create a website that truly reflects your vision. What I find equally impressive is Squarespace Payments. This function has revolutionized how to handle transactions online. You can start accepting payments quickly and easily with options like Apple Pay and Afterpay that are built right in. And it's just perfect for those of us who want flexibility without the hassle. Also, let us not forget about getting found online. That is important. And Squarespace has addressed this with powerful SEO tools that automatically optimize your site with meta descriptions and site maps. It's all about helping you reach the right audience, especially if you're not a Tech wizard Curious. Head on over to squarespace.com for a free trial. And when you're ready to launch, visit squarespace.com richroll to save 10% on your first purchase. Within this, there's this idea that you mentioned, which is it is our inability to tolerate discomfort that creates our reliance on these behaviors or these externalities to kind of soothe ourselves. Right? And we do a lot of this unconsciously. We're not even aware that we're doing it. So first by drawing awareness to it, we're then in the position to, you know, kind of take inventory of that. And what I gather from this breathwork practice, like, obviously there's physiological benefits, there's a lot of reasons to do this, but one of the core kind of lessons out of it is that you can sit with your own discomfort and you can acclimate to that, and suddenly it's not as uncomfortable as it was a week prior and you can withstand it for longer periods of time. And that is a lesson that teaches you, like, oh, just because I feel a certain way doesn't mean that I need to impulsively do something to change it. Right? And I think within that there's freedom. So if you're looking at behavior change, you're like, oh, well, I do this thing. And then you're like, oh, I guess I do this when I'm stressed. To your point of, well, I can remove the stress, but that's trying to control something you can't control because there's externalities that are driving that stress. But you can control your reaction to that stress. And part of that is developing the capacity to kind of be in the discomfort and realize, because I think our lizard brains are like, this is going to kill us. We need to exit this situation immediately, or we need to do something so that we're not feeling this way because it. Because our brains are interpreting it as like a mortal threat.

Dr. Rangan Chatterjee (43:36)

100% agree. Whilst I have used this breath hold practice to help me and many other things, I don't think everyone has to do it. It is primarily a psychological practice for me, as you've sort of hinted at. I'm not really that concerned about the physiological benefits that it may or may not give me. I think the most important thing it gives me is this deep inner knowledge that I can handle stuff even when that primal threat of running out of oxygen is there in my body and every part of my body is saying, you need to breathe now, or this is it. Even if I can go 20 seconds longer into that, it's like, oh, I can handle that, I can handle that. And as I was writing this book, Rich, I reflected on my clinical practice over the years and I honestly feel that many patients had this low grade anxiety that was built on this foundation of fragility. Because many of our lives have become so comfortable these days and we don't do uncomfortable things in a way that we had to simply to survive several thousand years ago. I don't think that many of us believe that we can trust ourselves when things go wrong, as they inevitably will. Right things will go wrong at some point. But if you're not testing yourself regularly to know that on a deep level, you don't believe it. And so this also relates to what we said earlier about external knowledge. You can keep hearing this stuff, oh, this is important, or you need to be able to trust yourself, you need to test yourself and do uncomfortable things or whatever it might be. But I think the most important things in life, we don't learn from hearing about them. We learn through experiencing them. You experience it yourself, you know, oh, I can handle things. I know that if the going gets tough, I can handle this. And so this whole idea of discomfort, and there's a chapter called Embrace Discomfort. And it's this idea that basically, as a doctor, this is of huge interest to me because I think you can make a case that pretty much all the diseases that are bankrupting modern healthcare systems and are putting such a strain on them and all the symptoms that we're suffering from and are causing us so much heartache in our own lives, you can make a strong case that many of them are diseases of comfort. They simply don't exist in traditional societies to anywhere near the same degree, where they have pretty uncomfortable lives, right? In the sense that while you couldn't in traditional societies just stay in your camp all day, you had to get up, you had to move, you had to get the food, you had to bring it back, you had to cook it, there was discomfort built into your daily life. Humans are wired for comfort. We want to make things easier. We shouldn't feel guilt or shame about that, right? It is no one's fault that we don't want to take the stairs when they're there and we'd rather take the escalator or the lift, right? That is normal. We want to make things easy. The problem is that the balance has changed in modern society, certainly in Western society, where maybe 40, 50 years ago, until then, our desire for comforts improved the quality of our lives. We have nice houses, we have Air conditioning, heating, you know, we can go to supermarkets and buy our food. I kind of feel that the balance has tipped now, where our desire for comfort, dare I say our addiction, our reliance on comfort is now making us sick. So we mentioned cold plunge before, and cold plunge has become this really, you know, hot topic in wellness that some people love, some people say is a ridiculous fad for people who live in la. Right. That's what people say online. And the truth is, it's neither for me. Yes, we may hear about the benefits for dopamine and noradrenaline. There may well be some physical health benefits, but for me, all of these kinds of practices, the benefits are psychological. If you intentionally engage with discomfort, even when you don't have to, on a deep level, you're sending your body a message that I can handle things. When adversity happens in my life, I know I can handle it because I practice regularly. People who work out regularly, who exercise, who do ultras or whatever sort of stuff you've done in the past, you know that you can handle stuff because you've gone and proved it to yourself. And so in that chapter, I really try and make it really practical for people and say, listen, in terms of some practical take homes, you don't have to do breath holding, you don't have to do cold plunge unless you want to do these things. But you do need, in my view, a regular practice of discomfort. Now, that could be really, really simple. And I list out something called discomfort rules.

Rich Roll (48:40)

Yeah. You have this idea of replacing decisions with rules.

Dr. Rangan Chatterjee (48:44)

Yeah.

Rich Roll (48:45)

So explain that.

Dr. Rangan Chatterjee (48:46)

Look, if you leave everything up to how you feel in that moment, you're going to struggle, you're going to get paralyzed by choice, you're going to procrastinate. And if you make a rule that you internalize, okay, this is how I want to live my life. And I appreciate some people don't like the word rule, okay? They find it too restrictive. Okay, find a different word. But for me, I like that word. For me, it really, really resonates. It's like, you know, people want to make everything black and white. You know, rules are either good or bad. It's like, hold on a minute. For some people, the sort of internalization of certain rules are really helpful. For other people, maybe not. But for me, a few years ago, I decided that I was always going to take the stairs unless there was a damn good reason not to. It was a rule I made and I internalized it. Which means five years on, my default, everywhere is to take the stairs. Unless, you know, I've got like my whole family with me and four bags and both arms or whatever it might be, I've changed my default. If I leave it up to how I feel in the moment, do I fancy the stairs or ah, you know, I'll take the lift, whatever it might be. To the point where I arrived in LA about a week ago. You come off the plane, there's. I still remember it. There's, I think these. There's two long escalators and there's one staircase on the right. I, with my bags went straight onto the stairs. I think I was the only person I saw whilst doing it. And again, I'm not judging anyone, I'm not criticizing anyone. It's because I made a rule that I only take the lift or the escalator when there's an exceptional reason to do so. I also acknowledge I am able bodied and I have two legs that are able to do that and people can't. This could be for anyone else. It could be at the end of my hot shower, I just turn it a little bit cold for 20 seconds. Not like freezing cold like in an ice bath, just a little bit cold. It could be that you decide that you're going for a 30 minute walk every single day, rain or shine, right? Even if it's cold and it's wintry or whatever, you're still gonna go. It doesn't matter what it is, right? So you can even flip it. We think about discomfort as doing hard things. But I quite like this, that I wrote about this idea that in the modern world, if you're sitting on your sofa at 10pm and you've got a great box set going on on Netflix and you're really enjoying it, I would say the uncomfortable thing to do is to press stop, close the television and if you live in a house, go upstairs to your bedroom. The comfortable thing and easy thing to do is to just sit there, right, and watch another episode. And I'm sure everyone has done that at some point. Even if it's the expense of their sleep and therefore their health and their wellbeing the next day. It's very, very common because it's easier to stay there. Especially because Netflix and YouTube apply the rules of behavior change I mentioned before. Rule number one, make it easy. These guys don't run one episode into the next episode out of the goodness of their hearts. They know that if you make something easy to do, humans do it. So they do it. They're a business, they're doing what they need to do. I'm not criticizing them. I'm saying that you could have a rule, for example, that, ah, you know what? Midweek, I'm never gonna watch more than one episode. It's a rule that you internalize even if you're in the middle of a box set that you're loving. Ah, you know, I say in the week, I don't do it because it means I go to bed lately, I'm moody the next day, I have more sugar, I have more caffeine, whatever it might be. So I'm always about trying to make things accessible to people. I've worked in practice over the years. I've worked in affluent areas. I spent a lot of time in very socially deprived areas. I feel it when I come to LA and I get immersed in this wellness world that I've been in the last seven to 10 days. I love it, I'm interested in this stuff, but I know this is not how most of humanity live. And I'm always thinking in my podcast or in this book, how do you make this applicable to everyone? Right? It's not about whether you can afford the latest 10 grand cold plunge bath. If you can afford it and you like it, go for your life. I'm not anti that at all. But often we think, oh, I can't afford that. So we go, that's a load of rubbish. It doesn't apply to me. No, the principle does apply to you. The principle is if you can intentionally engage with discomfort, you will change how you feel about yourself. And that's key. What I said about New Year's resolutions before, about what is the energy behind that behavior. If you don't feel that you're capable and that everything's against you, you're going to find behavior change hard. But one of the reasons, for example, why I like that 5 minute strength workout that I do every morning, I did it this morning, right? I take my cafeteria with me everywhere. I have my coffee and a hotel room or I'm staying with a friend at the moment in la. It grounds me. It's my little ritual and it shows me every day that I can trust myself. Right? That chapter, chapter one is called Trust yourself. But I spoke rich to a body language expert on my podcast a few years ago called Vanessa Van Edwards. And she said to me, rongen, when a human being meets another human being for the first time, they're asking themselves two questions. Can I trust them? Can I rely on them? I thought it was really profound. I thought, yeah, that totally makes sense. But over the last few years, I figured out, Rich, that we're asking ourselves the same two questions every day. Can I trust myself? Can I rely on myself? I believe that one of the most toxic things we can do is say we're going to do something and not do it, which is what we all do, especially at New Year. I'm going to do this, I'm going to spin four times a week, whatever it might be, because we say we're going to do it, we don't do it, and so we feel like we're a failure. So the energy behind that change is problematic. The way to flip that is what I often say to patients, which is, make one small promise to yourself every single day and keep it. My five minute strength workout that I do each day is a promise that I make to myself. And it shows me that I can trust myself and I can rely on myself. Even if I don't like the news headlines, even if I've got loads to do at work or there's something I need to sort out with my wife, whatever it might be. I never allow that to get in the way of five minutes for myself. And I tell you, when people say five minutes is not enough, I challenge that. I have helped suicidal patients change their lives for good. And it started with a five minute habit every day. Because if you say you're going to do something and it only takes five minutes and you do it each day, you build momentum, you build trust in yourself and you change the way you start to see yourself. You're no longer someone who says they're going to do stuff and is not able to. You show yourself with real world evidence every single day that you can do it.

Rich Roll (56:02)

The two most important pieces in all of that are a removing decision, fatigue by making a rule or a promise to yourself, however you want to couch that, and holding yourself to that, holding yourself to account for that promise that you made to yourself is kind of the engine of self esteem. Because if you follow through on that, then with each step that you take or each follow through action, you're affirming your ability to trust and rely upon yourself, right? And that leads to self esteem and a sense of self efficacy and agency, like, oh, I did this, like, what else could I possibly do? But I think the really important piece is on the word small. I think that especially around New Year's, everybody casts their gaze way off into the horizon and they make big, bold promises to themselves that they then proclaim on social media and to their friends that they're going to do this thing and they haven't really calibrated their timeline properly and they've bitten off perhaps more than they can chew. And I think they're thinking of this change that they want to make as this giant bold statement or this broad stroke or this ambitious goal that they're finally going to go after and tackle. And they lose sight of the fact that the engine of change is the tiny little things that you do every single day. And that's not sexy and it's sort of anonymous and it's not something that you're going to post on social media media. But if you truly want to make a change, master that change and sustain it, it's all about like what are you doing in the present moment, what is the right next thing to do, what is the right next action. And generally those are very small, tiny little things that assemble gradually over time to manifest in the change that you're aiming for. It takes longer, it's just more of a slog that doesn't have giant peaks and valleys. And so it's harder I think for the human brain to get head around it. And I think within that, like to James Clear's point in Atomic Habits, habits are the compound interest of self improvement. Right. So what are these habits that you're trying to master? And I think when you drill down to very small things that you can do every day, like I'm just going to do this five minute workout, I have to do that before I have my coffee. I'm going to do this five minute breathwork, practice, whatever it is, and holding yourself to that, even if it feels like, well, what does my breath work have to do with this other goal that I have, like understanding that these things are all related, that all related, it all goes back to your ability to be present with yourself. Because as you mentioned earlier, you can't trust your intuition unless you have that connection with yourself. And if you're so distracted you're unable to be present, and if you're not present, you're most likely running a story in your mind about something that happened in the past or tripping out about what's about to happen or going to happen in the future while you're. You're kind of passively living your life, never fully present with yourself and thus not capable of seeing what's in front of you right in the very moment that you could do that would move you forward in that direction.

Dr. Rangan Chatterjee (59:19)

Yeah, I love that. Rich, you mentioned the word slog. It can feel like a slog. Can I Ask you a question?

Rich Roll (59:25)

Yeah.

Dr. Rangan Chatterjee (59:25)

Do you ever find brushing your teeth a slog?

Rich Roll (59:30)

No, it's just something that I do. But I would say that, for example, if you use the running metaphor and you're training for a marathon or an ultra marathon, basically every day you got to get up and you got to get the shoes on and you got to get out the door, and sometimes it's going to be a slog and you're not going to feel great, and you feel like this isn't moving me forward. But that's just all part of the process. So I guess that's what I'm really.

Dr. Rangan Chatterjee (59:53)

Yeah. The only reason I bring that up is because I think these small changes can actually be very enjoyable. Right. I really believe that. I'm really trying to reframe the narrative around change. I've seen patients in the darkest places Rich change their lives. Okay. You know, with your own personal journey, how you can go from down here to up here. Right. It is possible. It's more possible than people think. And I agree with you that you have to start small. Now. Why do you have to start small? Well, I believe that some people can make big changes overnight. But generally speaking, when I've seen that in my practice, it's been because there's been some seriously traumatic life event like a divorce or a bereavement, or someone's lost their house, something so massive that it's caused them to confront their life and think, no, I need to live completely differently or whatever it might be. If you don't have that driving you, I think it is very difficult to make that big change quickly. I've rarely seen it.

Rich Roll (60:59)

No pain is the lever for that. Rare is the individual raises their hand when they're in the middle of some crisis and just kind of volunteers for a dramatic life change. But I think, let me just offer this. The idea that you're getting at is this doesn't need to be a slog. It doesn't need to be burdensome. It can be enjoyable. But I think within that, and I think you would agree because you wrote a whole chapter about embracing discomfort in your life. Like, you need to raise your tolerance for discomfort and be okay with that. So if you're gonna quit sugar or, like, you know, reduce your sugar intake, you're gonna be uncomfortable because you're used to doing that thing for a very long time, and it's soothing an emotional need and making you feel good when you feel stressed. And if you stop doing that, even if you replace it with something new, that's healthy. There will be discomfort. And I think people opt out of this whole process because they can't tolerate the discomfort and they just give up or say, I can't do this. So, you know, developing that relationship with discomfort and really realizing like, not only can you kind of withstand it, but this sort of comes with the package. And I would even say to the woman who tried to eat 30 plants a week and was experiencing these issues, I probably would have told her, like, you probably haven't done it long enough. Like your microbiome takes a while to acclimate to this and the bloating is like because you're seeding it with a different kind of microbial environment and it takes a while, so for sure stay in it. You know what I mean? And maybe that's the wrong advice and I'm not a doctor, but I think it's applicable. The wisdom of that is applicable to anybody.

Dr. Rangan Chatterjee (62:36)

But hence why when I.

Rich Roll (62:37)

Because we're so comfort oriented and our culture is oriented around basically kind of prioritizing ease in everything that we do. We are divorced from that experience of discomfort. And the signal that it tells our brain is like, we need to stop or do something else and return to that comfortable place. But if we can withstand it long enough so that we can, you know, weather that period of craving when we feel like we just can't take another breath without reaching out for that thing that we're used to doing and realizing like, oh, I have the resilience to do that is an empowering thing. But I think to say you're not going to experience discomfort or it doesn't have to be that way, is perhaps on some level setting people up for disappointment rather than just saying, yeah, it's going to be this way and you can do it and I believe in you.

Dr. Rangan Chatterjee (63:30)

Yeah, I don't disagree with any of that. Right. I'm not saying it is going to be super easy that every single day that you're going to wake up and feel like doing the five minute action.

Rich Roll (63:39)

That you commit to, the smaller, the more you reduce these actions to very easy lifts so you can kind of stack tiny wins along the way, I think is a very gradual and easy way to kind of build your capacity for discomfort. And then of course the byproduct of that being like a growing resilience.

Dr. Rangan Chatterjee (64:01)

So I've got four things in my head that came up for me as you were saying that, and I'll see if I can remember them as a way of responding. Okay, so first of all that lady who was struggling with the 30 plant foods. When I brought up that example, I was very particular to say that was the right approach for her at that point in her life, which I think speaks to what you're saying, which is.

Rich Roll (64:20)

You didn't tell her to just suck it up.

Dr. Rangan Chatterjee (64:22)

No, no, I said, okay, look, this is working, right? Let's stick with this at the moment and then let's see where we evolve this to in one month, in two months, in three months. But you're not gonna get there by trying to do it feeling like a failure, feeling that, oh, my God, I can't follow this amazing health advice out there. I am the failure. It's like, no, trust yourself a bit more. Go. Actually, you know what? At this moment in my life, this is the approach that's working for me. Great. Let's get you stable there. Let's get your stress down. Let's help you sleep better, let's help build up your microbiome, and let's see then what you can tolerate in the future. Right. It's a personalized approach. So that was one thing I wanted to say. You mentioned about the emotional stress that we might be feeling that we then soothe with sugar. And I've got a really practical exercise that. It sounds really, really simple, but I have used it with great success with myself and many patients over the years, which I'd love to share. Right. It's called the three Fs. So I want people to imagine the scenario that they're being really great in invisicoms with their choices in the day, and they're sat on their sofa at 9pm watching something in the depths of January, let's say. And maybe they're living somewhere dark and they are craving ice cream. Right? They want to have ice cream. And this is very, very common. More common than we might think. Okay, so the three Fs are feel, feed, and find. Okay? So if you're sitting there and you're craving the ice cream before you go to your freezer and get it out, think about the first F, which is feel. What am I really feeling? Is this physical hunger or is this emotional hunger? Okay, just take a pause. You may not know. Again, like going to what we said before, many people have never even taken that step. They feel, I crave ice cream, damn it, I'm going to go and get it and eat it. I'm saying just take a little pause, ask yourself, what are you feeling? And then go and get it. Right? No problem. Go and get it and have it. But by doing that first step, you are starting to build up this awareness, this intuition, this understanding of why you engage in certain behaviors. Many patients over the years, Rich would come in to see me, they don't have that awareness. Right? They really don't. So the first step is just starting to build that. And as soon as you become aware of something, you start to change your relationship with that thing. Right? People often go, well, now that I'm aware. Now what I said, okay, hold your horses. The most powerful step you will ever take for any kind of behavior change is awareness. Become aware of what's driving you, right? The next time you sit on the sofa and you're craving it, you can do it all in the first go if you want. But let's say you can't do it because you're trying to build up, you're trying to start small, do the first step, but then go to the second F. Okay, so what's the first F? Oh, I'm feeling really stressed because I just had a row with my partner. The second F is. So the first F is feel. What am I feeling? The second F is feed, which is how does food feed that feeling? Oh, so I'm feeling stressed. When I have sugar or ice cream, it temporarily at least makes me feel less stressed. Oh, right. That's why I'm going. I'm not actually physically hungry. I had a full meal one hour ago. Oh, my God. This is the way I manage stress or whatever it might be. It may be that you spent all day on your Zoom calls. You didn't take a lunch break. You've had no time to yourself. So this is your little treat to yourself. Or maybe. Which is very, very common. You're feeling lonely, right? You live by yourself. Or maybe your whole family are out. You've not seen anyone all day and you're feeling alone. And this ice cream you're going to have is going to make you feel less alone. Okay, fine. Now you're understanding what's going on. Then the third F, which you can either do that time or the next time, is now that you know the feeling, now that you know how food is feeding the feeling, now can you find an alternative behavior to feed that feeling? Right? And so this could be, oh, I'm feeling stressed. Sugar is what I go to to help me manage the stress. What else could I do? Oh, well, you know what? I really like yoga. Maybe I'll go on YouTube and do a 10 minute yoga sequence. Oh, I haven't had any time to myself. Today, because I've been on zoom calls and the ice cream is a little treat to me. What else could I do? Oh, you know what I could do? I could light a candle in the bathroom, run a bath, and I could nourish myself with a 20 minute hot bath. It doesn't really matter what it is. It's just the understanding that that behavior is serving a role. It's a really, really powerful exercise, at least in helping you understand what is driving me to this behavior. And frankly, you can use that for sugar, ice cream, alcohol, pornography. You could even use it for your alcohol consumption. You know, maybe not. If you are really advanced with your alcoholism, you want to change your relationship with it, you're starting to develop an understanding. So that 3F exercise. If anyone feels that they need help changing your behavior, I'd encourage them to maybe give that a go. And then also want to just address what you said about five minutes, Rich. Because if we look at the science, right, because I'm all about trusting yourself and tuning into your intuition, it doesn't mean that science has no value. I'm not saying that at all. I'm saying we have overdone it. I believe in society where we're so obsessed now with what the latest research says that we forget about what we're feeling or how, you know, how something might apply to us. And this is very much informed by my experience as a doctor, when I've realized that different approaches work for different people. Even if you look at the very best research paper on, let's say, I don't know, a certain medication, and you say these 100 people are not going to take this medication, they're going to be the control Group. These 100 will. Is it statistically significant, the impact that this medication is having? Yes, it is. Okay, we bring it in. No. Okay. We say it doesn't work. The problem is, even within those hundred people, even if we say it doesn't work, it would have worked for some people, but it just wasn't enough to make it statistically significant. So that's why I'm saying scientific studies are really useful and they're helpful, but they're not everything for the individual. We have to use them to help guide the individual. Now, what I was trying to say about the five Minute Health hacks, which I think could be incredibly helpful, is the science of behavior change is very, very clear on this. When you make things small, you are more likely to stick with them in the long term. Why is that? Well, there's many reasons. One of them is to do with motivation. So in January, we overly rely on motivation. We think if we want it enough, we're going to do it. But motivation never lasts. Professor BJ Fogg calls this the motivation way. Motivation goes up, motivation comes down. If you make your behavior really difficult to do, you will do it when your motivation's high. First two weeks in January, right, you'll do it. But when life gets in the way, you've had a busy day at work, you're feeling stressed, you've got to take the kids somewhere after school, whatever it might be, you will no longer do that behavior. If you said you were going to spin for one hour four times a week, you'll do it for the first two weeks of January, but you won't do it on a busy day. So if you make your behavior really easy, like five minutes, you'll do it when your motivation's high and when your motivation's low. That's the reason you've got to go small. And the second rule which I talk about is, where are you going to put that behavior in your life? Because the theme so far is small actions add up very quickly, right? So we make it too hard. Let's try and help. People say, actually, you know, what small action, what small promise can I commit to each day? People often don't think about where they're putting that behavior in their life. And it's a huge problem. Every single behavior we engage with needs a trigger, right? Of some sort. So the ice cream that we're having on the sofa needs a trigger. It's that stress that we're feeling that we're soothing with the ice cream. For me to be here with you today, I could have relied on my memory. And memory happens to be a trigger. It's just the most unreliable trigger that exists. The next best, as evidenced by the research, is some sort of notification. So a post it note or a Google Calendar notification. Oh, I've got to be at Rich's studio by noon today because I've agreed to do a podcast with him. That works. But the very best trigger for us to make a behavior stick in the long term is to stick it on to an existing habit. So an existing habit is something that we're already doing without any conscious thoughts. That's why I stick on my 5 minute workout onto my coffee at 5:30am I don't need a reminder in my calendar to make coffee. I don't need my assistant to give me a call. Say, rangan, don't forget to make Your black coffee today. It sounds ridiculous, but the reason I'm using this example is because it's real and it works. This is why I haven't missed a day for five years. I haven't missed a day brushing my teeth for five years. So why would I miss a strength workout each day? Because I've applied the same principles. It's only five minutes. So I can never say I don't have enough time. And I stick it on to an existing habit. And now it's the most natural thing in the world for me. I don't think about it. And the reason I bring up toothbrushing, Rich, is because nobody had the habit of toothbrushing when they were three years old, right? Their parents or their caregiver kept reminding them, hey, listen, you gotta brush your teeth, right? Why do we do it? Why at your age and at my age, are we able to engage in toothbrushing every day? Well, there's many reasons, but it kind of followed those two rules. It's easy. It's only two minutes. And when we go into the bathroom at the same time every day, it's easy. The toothbrush is there, the toothpaste is there. If the toothbrush was in a different room and your flossing was in a completely different room, you wouldn't do it as much. So in my kitchen, there's a dumbbell and a kettlebell that lives there. A few years ago, my wife did say to me, baby, are you gonna leave this stuff here in the kitchen? I'm like, yeah, I'm gonna leave it in the kitchen. Because if I put it away in the garage or the cupboard, it ain't ever gonna get used. So I've created an environment that visually triggers me every day, and I've applied the two most important principles. Hence, I do that. Now you can argue, yes, Strength workouts do what? They're good for my lean muscle, they're good for my brain health, they have an impact on my hormones. I get all that. I love all that science as well. But again, I think the primary benefit of my five minute daily practice is not that it's psychological. It's me showing myself with evidence each day that I can trust myself and I can rely on myself. And I think if people take nothing else from this conversation, Rich, if they all commit to thinking, okay, right, I'm struggling. I'm going to do one five minute thing a day, and I'm going to do it for the next seven days or the next 14 days. At the same time. I 99% guarantee that they will start to change the way that they view themselves and the way they experience day to day life.

Rich Roll (76:07)

The holiday is upon us. I want to make two points around that. First of all, you got to find great gifts. Second of all, you got to figure out how to eat properly, nutritiously. All of which is a way of saying, I want to talk to you about the Plant Power Meal Planner, which is our amazing digital platform where you have access to literally thousands of nutritionist and chef crafted recipes that are all customizable based on your individual preferences and needs.

Dr. Rangan Chatterjee (76:36)

You can also enjoy support from expert.

Rich Roll (76:38)

Food coaches as well as grocery lists and delivery in some major cities. It's an incredible platform. You get so much for so little. It's very affordable. And right now for the holiday season, we are offering $20 off our yearly gift cards. And to learn more, go to meals.richroll.com Two key ideas that I want to focus in on. The first is this idea of environment. And I'm glad you brought that up. Obviously, if you want to drive healthy habits, you want to create an environment that is conducive to making those habits easy and accessible. If you look at the healthiest metropolitan cities across the world, if you go to Amsterdam or Copenhagen, everyone's on a bike. Because the urban kind of layout of those cities is conducive to riding bikes. Right? Like it lends itself to making that behavior choice, the easy choice. Right. In our world, like much of our environment, is not conducive to making the healthy choice. I've spoken with Dan Buettner. He goes to cities and talks to mayors about how they can blue zone their area. And it's like, well, you gotta recreate the environment so that the healthy choice becomes the easy choice. You gotta get rid of the vending machines in the offices and the schools, you gotta create bike lanes. You gotta do all these things. Right?

Dr. Rangan Chatterjee (78:11)

Because we're wired for comfort. Right?

Rich Roll (78:12)

Exactly. Because otherwise, you know, left to our own devices, we're going to opt for the comfortable, easy choice. We can't control the environments of, you know, the cities that we live in, but we can control the environment of our home. So when you told the story about the ice cream, I'm thinking like, well, just get rid of the ice cream in the freezer. And then because like all of the things that you have to, all those questions the ask and all that kind of stuff, like if the ice cream's not there, then it's not even an option and you're forced to either sit with your discomfort or discover that healthy habit to ameliorate that stress or emotional dissonance that you're experiencing. Same thing with toothbrushing, right? How do you make the healthy new, semi uncomfortable choice, the easy choice? By creating an environment that's conducive to it. And you can do that with these rules. And you can do that with. You can make a rule like, hey, when I go to the grocery store, my rule is I don't buy ice cream. Then it never ends up in the house. Those sorts of things too, I think are super helpful. So your book, you have these eight reliances that kind of impede, get in the way of personal growth and well being. And there's health considerations, there's psychological considerations. You go into detail on all of them. We've talked about a few of them. But I sort of feel like motivation should have been the ninth reliance that we turn to, thinking that it's driving us in a good direction, where our reliance upon motivation actually is leading us astray. Because we think that we need to be motivated or inspired in order to make this change. And neuroscience says otherwise. You have to develop the reflex to take the action irrespective of the motivation or the inspiration, because it's a very unreliable energy source. So if you're sitting around going, how do I get the willpower to do this thing? You're asking the wrong question. What you need to do is figure out a way to just do the thing. And the more you kind of do the thing, these tiny little things, willpower is almost like a product of that or the more motivated and inspired you will become because you are sort of living up to that promise that you've made to yourself. And that kind of creates a deeper emotional connection to continue that journey. And with it, the kind of degree of difficulty, you become more motivated to stretch yourself.

Dr. Rangan Chatterjee (80:34)

I love that question. I love this idea that motivation should have been in there. I'm going to respond to that in just a moment. What I was going to say about what you said about the person who's craving the ice cream on their surface saying, don't bring it there in the first place. A couple of things to say on that. First of all, I completely agree. When I was changing my lifestyle for the better, maybe 10 or 12 years ago, when I really started to go, okay, my lifestyle is impacting the way that I feel and my short term and my long term health, I started with diet, I think, like many people, and I thought, well, if I don't want to eat it. I can't bring it in the house because if it's in the house, at some point one day I will be tired, I will be stressed. The cupboard will open, it will end up in my gob. And so for many years I've said to patients, and you know, we've just put a post out today on Instagram. It's 10 years since my first episode of Doctor in the House went out on BBC1 where I went into families houses who were sick and helped them reverse their illnesses in six weeks. Right. I would say to them as well, don't use up your willpower in the house. And I think that's really, really important. Now, I have posted about that several times on Instagram and there is a small group of people who will push back at that and they will say, if you truly become present with yourself and understand your drivers, you can have it there and not engage with it.

Rich Roll (81:56)

Yeah, but how many people are such a master of that? When you do it, it's sort of like, you know, not to always go back to alcoholism, but like when you're newly sober, like, you just probably shouldn't be in the same kind of like room with a bunch of alcohol later on, long term sobriety, you can be around it. It's not like doing anything to you. But like when you're at the beginning phases of trying to break a habit and form a new one.

Dr. Rangan Chatterjee (82:19)

I agree. So I think this actual issue speaks to another reliance in the book, which is chapter five, reliance on being right, which is the chapter called Take Less Offense. And it's this idea that that approach of not using a willpower in the house is gonna work for a lot of people. Now if you have gone in touch with yourself and you can literally have chocolate bars and biscuits and ice cream sitting there that you're visually seeing every day and you don't need to go for it, that is great. But sometimes I will get attacked for this advice and they'll say, that is problematic. You're not helping people understand themselves. And it's like, wait a minute, we're all at different stages on the process.

Rich Roll (83:02)

Of change that goes to the third reliance, which is this desire to be like, like, you know, okay, so what? So they're attacking you. Who cares?

Dr. Rangan Chatterjee (83:10)

Yeah, I'm good with that. I'm sure we'll get to that. So I agree with that advice at the same time. So I still, even though I feel that I'm really grounded and calm these days, and I really feel that I can pick up my emotional drivers. Now, I still don't have stuff in my house that I don't want to eat because it's just one less temptation. And you have to use that willpower every time you leave the house these days. Right. So I don't think you should. So I completely agree with you. Now, going to the second point you were making about motivation, why was there not a chapter directly on motivation? And as you were saying it, I was going, that's a really good point. Why was there not? Because I spent a long time thinking about what are the key reliances that I feel most people stroke. Many people have in society. And the reason I think motivation wasn't one of the reliances is because I think it is covered by other reliances. So what I mean by that is the whole idea in this book is that you will only make change that lasts if you really get to the root cause. Okay, so let's take. Let me take a random chat, sir. The reliance on busyness. Okay? How many people, particularly in Western society, overwork, Right. Are chronically stressed, keep pushing it. They can't switch off in evenings, they can't switch off at weekends. Okay. Where does that drive come from? And I talk about the book that this reliance on business actually, I believe is a reliance on feeling important. So all of us as humans want to feel of value to people, right?

Rich Roll (84:51)

Well, it's also. It can be a distraction.

Dr. Rangan Chatterjee (84:53)

It can be a distraction as well.

Rich Roll (84:54)

If you don't like going home or you're just uncomfortable, unless you're constantly, like, occupied by doing something, then you know that's going to lend itself to no question.

Dr. Rangan Chatterjee (85:05)

But through the lens of we want to feel of value to people. And I think you'll resonate with this, Rich, because it's a topic you've brought up on this show many times over the years. If we don't have a strong sense of community around us, we have no way of showing our value to others. Experiencing this kind of feedback from others that we are of value to them, we have to seek it somewhere. Now, many of us in the world today have moved away from our communities and tribes for work opportunities, for weather, whatever it might be. So we're away from our tightly knit tribes. So we don't often. Well, many of us don't feel of value. We don't feel that we're doing something that actually is helping people around us. And actually people need us and that they can rely on us. So I think some of it comes from a reliance or this need to Feel important now, what's that got to do with motivation? And I'm trying to think this through in real time, Rich. That whole chapter is about this idea that many of us are overly working, we're chronically stressed and it's making us sick. And there's loads of case studies that I talk about patients I've seen over the years who I feel stress was the final trigger for them to get their autoimmune disease, let's say, wasn't the only thing, but it was the final trigger that set it off. If you are overworking because there's this lack in your life that you don't feel worthy, you don't feel you do important things or whatever it might be, you can keep trying to use motivation to tell you, oh, my God, I need to work less. There's a statistic in the UK saying that 88% of UK workers in the past two years have experienced some degree of burnout, which is a staggering statistic and is, I think, a pretty alarming readout of the state of modern society. Certainly in the uk, I would imagine it's probably worse in the us, I would imagine the reason you're overworking, yes, it could be a distraction, but it could also be this underlying need that you have to feel important, that you don't have, you don't feel of value. Which is why the final chapter is all about community and the importance of community. And so you think you need motivation to change that behavior, but sometimes it's not that you need motivation to overcome that behaviour. You need to get to the root cause of why you need that behavior in the first place. If you get to the root cause of why you're working, working so hard, I feel you don't need motivation to overcome that behavior, and I think I can.

Rich Roll (87:37)

But don't you need motivation to even perform that autopsy? How do you get motivated to even do the inquiry necessary to get to the root cause of what it is that's driving it? And so I think that on a kind of more global meta level, it's sort of like if you're so busy and you're so stressed and you're so exhausted, you're drained of the life force, you're probably going to lack motivation. Right. Like, you're going to be like, I'm too tired to do anything and now you're asking me to do this other thing, I'm just not motivated to do it.

Dr. Rangan Chatterjee (88:09)

Yeah. So motivation, you know, is needed for anything. Right. For me to walk through this door and Sit here. I need some level of motivation, right? Because I have to want to be here. I have to have taken the taxi here. I have to walk through the door. It's not the motivation. It's not important. And yes, you can make the case that one of the chapters should have been a reliance on motivation. But in answer to your original question, I believe that motivation is weaved in throughout many of the chapters. Yes, I accept that you need a degree of motivation to do anything in life. You know, the book's called Make Change at Lasts. If you're not motivated to try and improve your life in some way, I suspect you're not listening to this conversation right now. Right. So by virtue of the fact that someone is tuning into this on YouTube or on audio, whatever, they're listening. They're probably looking for something in their life. Or maybe they love your show, they just like hearing your voice issue, whatever it is. But it's like, this is a. Your podcast is a podcast that helps people transform. It does many things, but it helps people see themselves differently in the world. And it provides hope that, oh, there is another option for me, I can live a more meaningful life, perhaps than I'm leading now. So, yes, you need it on some level, but I don't think I needed. I certainly felt when I was writing it that I didn't need a whole chapter on motivation because I think it's woven into the others.

Rich Roll (89:39)

I think it's baked into the reliance on comfort piece, mostly because you said, like, oh, I needed to be motivated to come here, I had to want to come here. But part of change with respect to the discomfort piece is doing things you don't want to do. And I think if you're reliant upon motivation in order to do those things, then you're not going to get very far. Yeah. So it's like not waiting to feel inspired or motivated, not relying. Like, motivation is great, and if you have it, if you're listening to this, you probably have some level of motivation. But I think it's the dependency on motivation where people get led astray. And the antidote to that is developing this reflex to act irrespective of how you feel about performing the action. Because if you're gonna change a behavior, there's discomfort involved, and from time to time, you're not gonna wanna do it.

Dr. Rangan Chatterjee (90:37)

Right.

Rich Roll (90:38)

And so it's like, if you don't wanna do it and you're like, well, I'm gonna wait until I feel motivated to do it, then you're doomed Right. So it's like, okay, no, but. But. And it goes to the rule piece, too. No, I made a promise to myself, or this is my rule. Like, I do this thing.

Dr. Rangan Chatterjee (90:52)

I made a promise to myself.

Rich Roll (90:53)

You are detaching from reliance upon motivation to instigate action is the.

Dr. Rangan Chatterjee (90:59)

That's the point that I'm trying to make for sure. On that busyness piece, I've got two practical exercises that I'd love to share, if that's okay, because I, for many years, would specialize in autoimmune disease. So although I was a family practitioner gp, I would see lots of patients who have chronic autoimmune problems and they couldn't get better and they were looking for a more holistic approach. And one thing I would do when I would see them is I would go through their entire lives and plot out this timeline. And I would say in 95% plus of cases within the six months prior to the diagnosis or the symptoms that led to the diagnosis, there was a major piece of stress in their lives, like huge work stress or a divorce or something massive. I can't say 100% of the time. I can't honestly say it was 100%, but it was 95% plus of the time. Right. It's very, very common. We do know that chronic stress is a huge trigger and contributor to autoimmune disease. So I have seen so many patients over my life who wish they'd started earlier, who thought they could keep pushing it and working through weekends and just pushing through just to make a little bit more, just, oh, just let me get settled in this way and then I'll be okay. And so many of them wish they'd started earlier because they were reliant on busyness. They were pushing through. And so I've had a couple of exercises that I've developed to help me and patients, and I'd love to share them with the audience in case it helps them. One of them is called Write youe Own Happy Ending. And I really thought about this exercise a few years ago, especially as I. As I was hearing about the regrets of the dying. So there's this wonderful palliative care nurse called Bronnie Ware who wrote the book the Five Regrets of the Dying. I had the most beautiful conversation with her on my podcast a couple of years ago. Like, it was a gorgeous, soulful, spiritual conversation. And she was a palliative care nurse for maybe seven or eight years. And she said, rangan, listen, people say the same things on their deathbed. Like, they all say the same things. Some version of, I wish I'd work less. I wish I'd spent more time with my friends and family. I wish I'd allowed myself to be happy. Allowed myself to be happy. That's interesting phrasing. I wish I'd lived my life and not the life that other people expected off me. These are so common. They are so universal. And even as I say them, and I've said them before and I've thought about them before, they really connect with me on a deep level. Because for me, through the lens of how do we make change that lasts? We think about what people say on their deathbed and go, well, how can we. How can we apply those tools now so that we're not on our deathbed having the same regrets? And so I do this really simple exercise that I know can be so helpful for people if they do it, not if they hear it and go, oh, that sounds really nice. And then they go on with their run or their day. You've got to take action. You've got to do something. Inspiration without action will not lead to change. You have to do something on the back of it. So the exercise is in two parts, Rich. Okay. And perhaps, you know, we could do it together. You know, see what you would say to this. So the first part is we imagine that we're on our deathbeds right now. Okay? So, Rich, I would say to you, imagine you're on your deathbed. This is your final day. Okay? This is it. Look back on your life. What are three things you will want to have done?

Rich Roll (94:50)

I've actually done them all. Like, I feel pretty good.

Dr. Rangan Chatterjee (94:54)

Okay, great.

Rich Roll (94:54)

I've said this before, too. I mean, obviously, like, you can always say, I wish I'd done this or that or, you know, there's always, like, no matter how much time you've spent with your family and your loved ones, there's always more that you could have. But I don't have a lot of regrets. And I. I've said this before, but if I don't wake up tomorrow, I'm pretty good.

Dr. Rangan Chatterjee (95:18)

Okay, so that's awesome. And you've obviously been on your own journey of transformation, and I'm sure through.

Rich Roll (95:24)

This, and I'm stressed out, and I work too much, and I get caught up in things that distract me and don't let me first. I can identify myself as reliant upon all eight of these things in different ways. So I'm not saying that I've transcended anything.

Dr. Rangan Chatterjee (95:42)

Well, let me phrase it Another way, then, it's not about regrets. I'm not asking asking. I'm saying that this exercise is called write your own happy ending. So I guess what is the dream on your deathbed? What is it that you want? You don't have to answer it, but in essence, for most people, it is the opposite of the things that we just heard. So for me, when I did this a few years ago, and I do it relatively regularly to keep making sure that that I'm still aligned with what I want on that deathbed. And again, does one exercise work for everyone? No. But for many people, they find this incredibly helpful. It has been transformative for me in a variety of different ways. So on my deathbed, I believe that I look back on my life, and number one, I will want to have spent quality time with my friends and family. Number two, I will want to have a time to pursue my own passions. And number three, I will want to have done something that leaves a positive impact on the lives of others. I'm pretty clear that those are three things I'm going to want on my deathbed to be able to say. So the second part of the exercise is that you zoom back right into the present day and you come up with three what I call happiness habits. And I have mine written down, piece of paper, like old school with a bit of blu tack on my fridge at home. So going back to behavior change, I'm being visually triggered by it every time I'm in my kitchen, right? Which is every day, multiple times a day. So at the moment, what I have written down is, number one, if I have five meals with my wife and kids each week where I'm undistracted by work, that's what I want, right? So I put down five undistracted meals with my wife and children where I'm not thinking about emails or work, where I'm fully present with them. I'm not saying I don't do anything else, but that's what I currently have. If I'm doing that regularly, I know that I'm working on those relationships. Okay, the second thing, if I have had time each week to either go for a long run or to sit with my guitar and write a song or sing, I know I found time to pursue my passions. And the third one is, for me, like you, if I release an episode of my podcast each week, which I've been doing for seven years now, well, I'm doing something that improves the lives of others. Now, why it's so powerful, Rich, is because we're living in an era now where our to do lists are never done. Like, never done. And we've got this negativity bias in our brains which has kept humans alive for so many years, but it's working against us in this modern environment. So we focus on what we haven't done. And too many of my patients over the years where they basically only fit in the important things when everything else was done. The problem is everything else is never done. You could complete your email inbox, right? You get to zero and then take a break, go make yourself a cup of tea for 15 minutes, sit down, get some sun and come back. You could have had 20 new emails in that time. There's nothing you can do about it. So this exercise says, okay, it doesn't help you get your to do list done directly, it does in other ways. But in essence it helps you focus on what is truly important. So that exercise for me means that I make sure each week, to the best of my ability, I get those three things done. If I don't, I don't anymore. Go back to guilt and shame and negative self talk that I used to. Again, the energy behind the behavior that's problematic. I go, I've been in LA now for 10 days. I go to Austin for two days and I come home. I've not hit those five meals with my wife and kids the last two weeks. Okay, that's okay. I just don't want that to become a habit. And before you know it, it's two months to do it. It was two weeks. I'll make sure I spend a lot of time with them when I get back. It's a very, very simple exercise that I challenge anyone. Listening to, do and implement it will change how you feel about your life. If that's too complicated for someone, let's make it really, really simple. So I do a few small things every morning, Rich. And again, this is another one of the exercises that I write about and make change that lasts. I ask myself three questions every morning with my morning coffee. One of them, I think, really applies to this idea that we're reliant on being busy, overly busy. And it's really the anti busyness question. I ask myself each morning, what is the most important thing I have to do today? And it's such a beautiful question, Rich.

Rich Roll (100:23)

Do you actually do that every morning?

Dr. Rangan Chatterjee (100:25)

I do it. I can tell you what I put down today if you want.

Rich Roll (100:28)

What did you put down today?

Dr. Rangan Chatterjee (100:29)

I genuinely, hand on heart, I put down the most important thing I have to do today is to show up fully present for coming on Rich's show. And the reason I put that down is because, you know, I've been a fan of your show for many years. Okay. So for me, I love the way you conduct your conversations. I love the integrity of your show. And for me, I'm like, yes, I've done a lot of interviews this week, but I really want to come up and deliver value and show up and be present for my interaction with you. So that's what I put down today. The reason why it's such a good question. And again, if anyone's skeptical, I say, try it. Try it for seven days. If you don't believe me. I don't want you to believe me. I don't need to be overly reliant on my expertise. I want people to be reliant on themselves a bit more. Do it for seven days and see if your life doesn't change. I know it will, because whenever I talk to people about this and they do it, they say, wow, it helps me frame my life differently. There was a bit of, I think, skepticism in your question. Do you really do it every day? I actually do, Rich. I really, really do. And when you first start doing it, usually you go, well, there's not just one important thing, right? I got loads of important things I have to do. There's work stuff. There's family stuff. I don't know if you know this or not, Rich, but when the word priority came into the English language, I learned this from Greg McKeown. When it came into the English language in the 1500s, the word priority only existed in its singular form. You couldn't have priorities, right? You couldn't have multiple priorities. It was only. You could only have one thing. So this forces me to choose now, initially, if people are struggling, I say, okay, put one thing that's important down in your work life and one thing in your personal life. But over time, it becomes one thing, and the power is that it forces you to make a decision. So in a world where our to do lists will never, ever be done, it doesn't matter. You put this one thing down, and you make sure you do it. If you specify the most important thing each day and you do it, your life will start to change. After seven days, you will have done seven things that you have identified as important and a bit like a practice of gratitude. You're sort of putting your attention there, saying, I said it was important. I did it. I'm someone who shows up each day for myself. And so the week before I came to la, it was quite a busy week because I knew I was going to be away for a couple of weeks doing my interviews. So I was trying to get stuff done. And so I think on the Monday of that, that week, it was a work task. You know, I've got to get this article back to my publishers today. That was the most important thing. It doesn't mean that my relationship with my wife wasn't important or my kids wasn't important. It just meant on that day, that was my key focus. If I did that, that was a win that day. On day two, on Tuesday, I think it was something like, oh, I'm not going to see my wife for a couple of weeks. She was away at the weekend. I must make sure when the children are in bed tonight that we spend some quality time together. It doesn't mean my work in the day wasn't important, it just meant that was the focus. I must make sure I do that. On the Wednesday I remember I was working from home. And what I put down in my journal that morning was, when my children walk through the door at just after four, when they come back from school, make sure, Ranga, that your laptop is shut, your phone is in another room so that you're fully present to listen to what they have to tell you. These things sound so simple, Rich. They are simple and they're really, really powerful. One thing I believe about myself, and again, I don't know if I would have said this a few years ago because I would have been scared as to what people would think of me saying something like this, but I, as per Chapter three, I'm less reliant on being liked these days. I don't need to be liked. I know my. My responsibility to myself is to be authentic and to talk honestly. And only I know why I'm saying something. So what I was going to say is one thing I know I'm good at is connecting with people and helping them make changes in their lives. I've done that with my patients for years. I've had, I think, very good relationships with my patients. Doctors used to say to me all the time when I was. Because I. I've created a course called Prescribing Lifestyle Medicine with the Royal College of GPs in London, where I and a colleague train doctors into all these things that I talk about because we're not taught about them at medical school. And a lot of them say, Dr. Chachi, yeah, you know, we can give patients advice, but none of them do what we tell them to do. And even the way that they're phrasing that question tells me all I need to know. Right? I have never, ever, Rich, told a patient what to do. And again, I write about this in a section in this book. I say I've never told a patient to give up, that they must give up smoking. If a patient comes in to see me and if they ask for my opinion, okay? Because I try no longer in my life to give unsolicited advice. If they ask for my opinion, I feel my responsibility is to tell them the impact that smoking is having on their lives. So I will, if at the end of that conversation, if I am confident that that patient has understood and retained what I had to share with them, and if they then say, hey, Dr. Chastity, listen, I hear what you're saying. I understand that smoking is wrecking my lungs and is causing my wheeze and whatever it might be. But I get so much enjoyment out of smoking that I'm prepared to put up with the consequences. I've never argued with him. I said, okay, fine. And the funny thing is, Rich, is what I've learned through that process is a lot of the time those same patients come back two or three months later saying, hey, doc, you know, you know what? I said, I don't want to give up smoking. I've actually been thinking about it. I think I do now. Nobody wants to be told what to do by someone else. Kids don't want to be, patients don't want to be. And that goes back to how we started this conversation. It has to come from you. You have to become the master. You have to become the expert. So this question, what is the most important thing I have to do each day? I think is a game changing question because it forces you to make a decision. And it's one of the most important things I ask myself every single day. Does that make sense?

Rich Roll (106:57)

Yeah. I mean, I think what you're doing is you're taking the abstraction of that palliative care lesson that a lot of us have heard. Like, we know these things, but we're not really wired to bring it into our present experience. It's sort of like, okay, well, that's on my mind. I know I need to do those things, and when this happens, then I will do that. And you're rooting it in the day to day to make sure that it is a priority that gets nurtured in the daily actions that you undertake.

Dr. Rangan Chatterjee (107:29)

I think one of the reasons why I actually do do these Things is because of my experience with my dad. Right? My dad came to the UK in 1962. He was an Indian immigrant. He came to the UK when they were recruiting doctors from India to fill in the gaps. And he came, like many immigrants, in search of a better life. Right? He didn't have any money, he didn't have any contacts, but he just worked. And for 30 years, my dad only slept for three nights a week. I mean, it's insane, right? I'm not exaggerating one iota. Right, I'll explain what my dad did. He was a consultant physician at Manchester Royal Infirmary and we lived in a suburb of Manchester. He drive through traffic about 45 minutes an hour to work. In the morning, he'd come back at about 6, 6:15, maybe 6:30, I can still remember. Dad would walk through the door, Mum would have dinner ready for him in the kitchen, he'd have dinner, he'd go upstairs into the main bathroom, he'd shave because I'd often go there and stand with dad and chat to him. He'd shave and then a car would pick him up at 7pm he'd go out all night doing GP house calls. He'd come back at 7am again, mum would give him breakfast, he'd go up and shave and then he'd drive into Manchester. Right? He did that for 30 years.

Rich Roll (108:53)

He'd do like multiple days in a row without sleeping. How is that possible?

Dr. Rangan Chatterjee (108:58)

I don't know. If my dad was alive now, I'd love to know, but that was my dad's life for 30 years, right? So dad had all these plans for retirement that, you know, when I retire, I'm going to see the world with your mum. I'm going to go and set up a street clinic for kids in Calcutta, which is where my family are from, in India. But he got sick at 57. He had to retire with ill health. At 57 he got the autoimmune disease lupus. He lost the sight in one of his eyes. He was on kidney dialysis for 15 years. One of the reasons I moved back from Edinburgh, where I finished medical school and was working. I moved back to the north west of England, where I live today is to help my mum and my brother look after my dad, which we did for 15 years. Okay? Highly, highly stressful time. But that experience has had such a big impact on my life. My dad's death in 2013 was probably the most traumatic thing that had ever happened to me at that time in my life. Right? I never felt that death really applied to me until that happened. And I would see my dad every day. I live five minutes away. So it was a huge hole in my life. And my dad's death was such a big turning point, like it is for many people when a parent dies. But it forced me for the first time, to stop looking out there for answers and to go inwards. And I started to ask myself these questions. You know, whose life am I leading? Is it my life or is it someone else's life? And I really feel that dad's. You know, the way I feel today is I feel that dad's death was a gift, actually. Like, I love my dad to bits, and I feel him around me more now than ever before, even though it's, what, almost 12 years since he died. A few months, it'll be 12 years, which it's nuts to say, but we get to shape our own story about anything in life. And I've chosen to see my dad's death as a gift now because the most powerful lessons I've learned in my life have come from my dad's death about myself. They've helped me become my own man and find out what is my journey, what is my story, and even what we're talking about, these regrets of the dying that we think doesn't apply to us, it's in the future. And this is why I worked so hard to create these practical exercises to bring it into the present for people. You know, I take four to six weeks off rich every single summer, right? I've done it for three years now. Now I want to acknowledge my privilege in being able to do that, right? My dad certainly, I don't think could have done that. Many families cannot do that. I accept that. But a few years ago, I realized, well, I don't have a boss anymore. It's kind of up to me when I work. And I realized through the lens of my dad's life, dad was always working. We didn't see him that much growing up, right? Because he was trying to provide for us and he provided amazingly for us. He gave me and my brother Estelle first class education. But I'm like, he went through those sacrifices and mum, for that matter. The tragedy would be, is if I don't learn from them, if I repeat the same behavior, and I have had tendencies of overworking, for sure. So this whole process that I write about in this book that I'm so passionate about is once you start going inwards and start understanding your inner world, you will start to make positive changes by asking Myself each day. What is the most important thing I have to do each day by regularly doing that write your own happy ending exercise. And reminding myself that people on their deathbed say, I wish I'd spent more time with my friends and family. I wish I'd work less. I recognize my privilege. At the same time, rich, many people who can do what I do don't. I've come to the belief that the biggest disease in society is not the disease that I can diagnose, use in my clinic. It's the disease of more. More money, more downloads, more followers, more holiday, whatever it might be, that that's somehow going to fix the hole that exists inside us. It isn't. I've tried that game. Many people try that game. So I know that these exercises helped me make that big decision. I didn't just suddenly wake up and go, I'm going to take four weeks off this summer. No, I had to do these exercises. I had to remind myself, small changes. And then it got to a point where I thought, why not? I could just stop the podcast for six weeks. I can stop and I delete all my social media apps and I see the world with my wife and kids. And I tell you, it is the most incredible experience of the year. We connect, we bond, we go on adventures together. It would never have happened if I just. I didn't wake up one day. I had to take small steps and reorientate myself about what's important. And the rich, you might resonate with this. I'd love to know your view on this. Someone in the podcast world, I can't remember who it was now, said, ranga, listen, this is a bad move for your show. I said, tell me more. And they said, listen, you've got a slot in your listener's weekly routine. I release on Wednesdays every week. Right. People go on walks on Wednesday morning or Wednesday evening, and you're the soundtrack to their walks. If you stop releasing for six weeks, you're allowing a different podcast to take that slot, right? I don't know if you've heard this advice before, but that's certainly what someone in the industry told me. And I thought about it. I thought, I actually don't care because what I'm going to gain is so much more than what I will potentially lose. And when Bronnie Ware, this nurse, came on my show two years ago, we had this beautiful conversation. This came up. I remember saying to Bronnie, I never really said this publicly before, but I said to her, bronnie, I'VE had to really think about this. If it's really true that I do this podcast to help people and it's not about my ego, then why does it matter? If people find a better show for them in the summer, isn't that a good thing? If they find a host that they prefer to me and a show that they prefer to me, it doesn't actually matter now, genuinely, that's how I feel. I've changed the way that I view the world. I understand that life is a set of experiences, and it's the story we put onto each of those experiences that determine the quality of our lives. My conversation with the Auschwitz survivor Edith Eager really taught me that on such a profound level that it's never, ever left me, that I get to shape the narrative on every single event in my life. This idea that you've spoken about before, that I've spoken about before, that most events in life are neutral. It's the perspective that we choose, and I use those words intentionally, that we choose to take on them, that ultimately determine their outcome. And I think one of the reasons that we can't make change that lasts is because we're not aware of our inner worlds. We don't understand that we're constantly generating emotional stress by the way we interact with the world, right? So, for example, I've experienced the infamous LA traffic this week that I've heard you talk about so many times on this show, right? And you see people reacting and getting het up in their cars around this traffic. Now, I don't live here, right? So I get it must be frustrating. But the reality is, if you're driving and you're running late and someone cuts you up and you decide to go on a mental and a verbal outburst on them in your car, stupid driver. They shouldn't have a license. What are they doing? You know, someone should give them an eye check, you know, whatever it might be. I've been that person before, right? So I'm not judging. But people don't realize that they don't have to react like that. That is a learned behavior. And when you react like that, it's a reliance on an externality. And the problem is, and this is one of the key secrets to behavior change for people, the emotional stress that you generate by the way you interact with that driver is the reason you're consuming too much sugar and alcohol. Because that emotional stress that you have just generated, it's not neutral. You will have to neutralize it in some way. You might go to the gym, you might Go for a run, or more commonly, you'll get to the office, you'll moan to your colleagues about that stupid driver, you'll go to the vending machine, you'll have some sugar, you'll have chocolate, you'll need an extra glass of wine when you get home from work without realizing that you generated that emotional stress by the way you interacted with that situation. And there's lots of tools in the book on helping people understand that you can change the way you interact with that situation. You absolutely can. And if you think that you can't, let me share this with you as we record this. Rich, I'm coming up to the 500th episode of my show, right? And people like I'm sure they do to you, ask you, well, what is the most impactful conversation you've ever had? And the truth is, I don't know, right? Many of them have impacted me and transformed the way I view the world. But if I had to choose, the one conversation that never leaves me is the conversation I had with a 93 year old lady called Edith Eager. When she was 16 years old growing up in Eastern Europe. She was in her house with a sister and her two parents. She had a date with her boyfriend that night and she was thinking about, what dress am I going to wear? Her family suddenly get a knock on the door. Her whole family get put on a train and get taken to Auschwitz concentration camp. When she gets there, within two hours, both of her parents are murdered. The same day, maybe one or two hours later, the senior prison guards ask her to dance for them. The senior male prison guards, because she's a 16 year old dancer, she has to dance for them after her parents have been murdered. There are things from that conversation that have never left me. Rich. The first thing she said to me that I always think about is this. She said, rongan, I never ever forgot the last thing my mother said to me, which was, edith, nobody can ever take from you the contents that you put inside your own mind. So she says to me, rich, when I was dancing in Auschwitz, I wasn't dancing in Auschwitz. In my mind I was in Budapest Opera House. I had a beautiful dress on, there was an orchestra playing, there was a full house. It was amazing. I thought, okay, this is pretty incredible. You're in hell. Literally, you're in hell and you've reframed your experience. Then she tells me, whilst I was in Auschwitz, I started to see the prison guards as the prisoners. They weren't free in their mind. In my mind, I was Free. They weren't living their lives, which is pretty remarkable given what she was seeing and experiencing day to day. And then her final words to me, Rich, which I honestly feel have become tattooed into my soul. And they have. Probably one of the reasons why I feel so happy these days is she said to me, rongen, I have lived in Auschwitz, and I can tell you the greatest prison you will ever live inside is the prison you create inside your own mind. And it just landed. It just landed in my head. I thought, oh, wow, that's what we all do each day. We're creating these stories inside our mind about the way the world is, about what people are doing to us. And then we generate this emotional tension inside us that we then need to soothe with our behaviors. We don't realize that we have the power to change those stories. And so I did a practice for years, which, frankly, I no longer need to do. Like a lot of these changes, you need to do them intentionally and consciously initially, and then they become automatic in your default behavior. So while we do this practice again, I hope by sharing it, someone's going to take me up on this and do this to improve their own life. Every evening, once my children were in bed, I'd sit down and think about, when did I get emotionally triggered in the day? Because it's easy to think when we get emotionally triggered, that it's down to that other thing, that comment we got, the way that person spoke to me, the driver who cut me, of course I'm entitled to feel, like, stressed and wound up because that person shouldn't have done that. Hey, listen, you can choose to live your life in whichever way you want. Just know that there's a consequence to having that sort of relationship with the world. I would reframe these incidents and go, oh, why has that comment bothered me so much? Why has that action by my colleague bothered me so much? Why has that email triggered me so much? What is it within me that has been triggered? It's about taking responsibility that our feelings and our emotions, they're coming from us. Nothing out there is inherently offensive. If that thing was offensive, all of us would feel offended to the same thing. But we don't, because we are being triggered by something in that comment. And once you understand that, once you've built that gap between stimulus and response, once you even know, like with that 3F exercise, oh, there is a space between stimulus and response, then you can start to change it. So over the years, I would reframe and go, oh, oh, that's because My mum used to say that to me. Oh, that's because I'm actually quite insecure. Like, one thing I've realized with having a large social media presence like you, Rich, over the years, no matter how much good we're doing in the world, we'll always have naysayers or people not liking our style or what we do. And so you'll get critical comments and people. You say, oh, you need to grow a thick skin. If you're a public figure, I don't agree. I don't think it's a thick skin you need to grow. You need to understand your relationship with criticism. But I think you can move to a point where actually you have quite a healthy relationship with it in the sense that I've now come to the conclusion that criticism only bothers us to the extent we believe it about ourselves.

Rich Roll (123:39)

Well, the criticism that bites. It bites because there's some truth in there that incites you. And so your point being that. And it's true, like, what triggers you, that's the juice. Like, you need to go towards that, and you need to go, that's the juice. And not only that, that's your opportunity for discovery and healing.

Dr. Rangan Chatterjee (123:59)

Where Edith helped me, because it's easy to get caught up in our own lives, right? So if I'm in my life and I cannot reframe an event, and I'm trying to convince myself that the way I feel is down to the other person, I'm struggling to reframe what I would do. I would go, hey, Rongan, you know what? Edith could reframe events in Auschwitz. You, in your pretty comfortable life here, can probably reframe this. I've taken her story as inspiration. Now, listen, when the student is ready, the teacher appears, right? For whatever reason, I was ready for that message then. And there have been significant things in my life that have changed how I view the world. But understanding deeply that I create the story on every single thing in my life has changed me. It's completely changed me. I don't get triggered anywhere near to the same degree. If I do, it's usually because I'm overworked or underslept. And I'm saying this to you. I've come to America maybe two weeks after this election, right? And looking on the outside, it looks like, you know, so divisive. When I spoke to Vivek Murti, the current Surgeon General, six months ago when he was in London, he shared with me back then that 1 in 6Americans are not talking to another family member because of A difference in political views. I shudder to think what it might be at the moment. And I'm not trying to get into the ins and outs of policies. That's not my bag. What my bag is is health, happiness, living meaningful lives. And the relevance of what Edith has experienced in Auschwitz is that that's relevant to each and every single one of us. We create the narrative. Another phrase, Rich, that has really helped me, and I'm sharing it in the hope that it's going to help somebody else who's listening. The phrase I think about a lot is, if I was that other person, I'd be behaving in exactly the same way as them. Sure, I know it sounds trivial.

Rich Roll (126:06)

Every man is right from his own perspective, and every behavior demonstrated by every human being is a product of everything that preceded it.

Dr. Rangan Chatterjee (126:15)

Yeah, but why it's so important is people go, what are you saying? That that behavior is acceptable? No, I'm not. What I'm saying is if you start to judge other people's behaviors before you start, before you try and understand them, we're never going to make change in the world. We're always going to have. Have black and white coming up against each other. You were probably the first person to have John McAvoy on your podcast, right? I had him on pretty soon after that in the uk. And I remember John came to my house, and I think in that first conversation, we went for two hours and 40 minutes, and I was just spellbound the entire time. It was like a Hollywood story. For people who don't know John. John, at that time or previously, was one of Britain's most wanted men. Having been locked up as an armed criminal were two life sentences. I remember after hearing John's story, he left my house and I went into the kitchen and my wife, Edwards, and said, hey, babe, you know what? If I had John's upbringing, I think I'd be in jail right now. Like, I really had that. Oh, my God. I don't. I get it. I get why you've ended up where you are now. He's turned his life around. He's a free man. He's the loveliest man. I would leave him home alone with my children. Like, he's utterly amazing. But these experiences, like John McAvoy's story, has taught me that if I was that person, I'd be doing the same as them. Edith Eger in Auschwitz has taught me you get to create the narrative of any story you want. And if she can do it in there, I can do it in my Life. These are the things that move the needle. This is the reason, Rich, why habit change is not lasting, even with the rules of, you know that I'm saying make it easy, stick it onto an existing behavior. These are important. And there's so many habit change books out there. What I think change that last does that. I don't believe I've seen a book in this health and wellness and happiness arena do before is really try and go one step further and go what is upstream from this? How is it that we view the world and interact with the world that is making changes? It inevitable that we're going to engage in problematic behaviors. So I'm really, really passionate about it because I've seen the changes with my patients and quite frankly, I kind of feel it in myself. Like I don't find behavior change hard anymore and I deeply, deeply want to share these tools with people because I know that if you keep looking outside for answers, you're going to struggle. I've heard that some people in the US now are not having people over family members for Thanksgiving because they voted a different way from them. Now, to me, I'm not an American, but I find that confusing. I'm like, this can only happen to me at least if you're stuck in your own stories, right? Step outside, understand why does your auntie think differently about the world to you? You don't have to agree. In fact, in that chapter on taking less offence, I say, if you believe every single person in the world is going to agree with you on your views, it's quite an arrogant approach to take. There's 8 billion people on the planet. Not everyone's going to think the same way as you. I don't always agree with people, but by interacting with them with compassion, first with, why do they think? Like, over the summer we had problems in the uk, right? I was away in Kenya and my wife and I were starting to get text messages about some of these kind of, I won't call them riots, but there was a bit of racial disturbance going on in the UK and people getting attacked, right? And I was like, oh, wow. I'm like in another world in Kenya at the moment. And I text my brother to say, hey, is there anything going on in our town where we live? He said, no, there's nothing here. But those incidents. I love these kind of more extreme incidents in a way, I don't love that they happen. They really help me test out these views. I go, can you apply this even in an extreme situation? And so I honestly would say if someone was being racist to me, of course, if I was in danger, that would be different. I would obviously take action to make myself safe. But if I see a comment online that's maybe a bit racist or discriminatory, my first approach now is not to judge. It really isn't. It used to be, it's not to judge. My first approach is, why does this person think like that? What has gone on in their life? What have been the inputs into their brain? What did their parents say? Were they bullied as a child? You know, what was the toxic first workplace they were in? If I was them, I would be thinking about the world in exactly the same way. Rich, this is the stuff that changes people. We can tell people about exercise, about food. These things are important. I've been teaching my patients those for years. I've been doing them for years. But when you get to this level and you start to alter how you think and understand that actually, you know what, my behaviors are driven by my beliefs. And my beliefs weren't with me when I came out of my mother's womb. My beliefs have been formed based upon my experiences. Just as I form these beliefs, I can unform these beliefs if I want to. If I spend a bit of time with myself each day, listening to the signals, tapping into my intuition, that's the secret to behavior change that lasts, in my view.

Rich Roll (131:42)

I think that's a good place to end it for today. I think that's a solid way to kind of deliver the message and kind of inspire people with some really actionable tools to carry into the new year. So thank you. Appreciate you coming here today.

Dr. Rangan Chatterjee (131:59)

Thanks for having me, man.

Rich Roll (132:00)

Yeah, and good luck with the book. You did a great job, man.

Dr. Rangan Chatterjee (132:04)

Thanks Rich. Appreciate it.

Rich Roll (132:05)

Yeah, welcome here anytime and more to come from my favorite general practitioner. Thanks, Rangan.

Dr. Rangan Chatterjee (132:13)

Thanks Rich.

Rich Roll (132:13)

Cheers. Peace Plants. That's it for today. Thank you for listening. I truly hope you enjoyed the conversation. To learn more about today's guest, including links and resources related to everything discussed today, visit the episode page@richroll.com where you can find the entire podcast archive, my books Finding Ultra Voicing Change and the Plant Power Way, as well as the Plant Power meal planner@meals.richroll.com if you'd like to support the podcast. The easiest and most impactful things thing you can do is to subscribe to the show on Apple Podcasts, on Spotify and on YouTube and leave a review and or comment. This show just wouldn't be possible without the help of our amazing sponsors who keep this podcast Running Wild and free. To check out all their amazing offers, head to richrole.com sponsors and sharing the show or your favorite episode with friends or on social media is of course awesome and very helpful. And finally, for podcast updates, special offers on books, the meal planner, and other subjects, please subscribe to our newsletter, which you can find on the footer of any page@richroll.com today's show was produced and engineered by Jason Cameolo. The video edition of the podcast was created by Blake Curtis with assistance by our Creative Director, Dan Drake, portraits by Davey Kramer Greenberg, graphic and social media assets courtesy of Daniel Solis. And thank you Georgia Whaley for copywriting and website management. And of course, our theme music was created by Tyler Pyatt, Trapper Pyatt, and Harry Mathis. Appreciate the love. Love the support. See you back here soon. Peace Plants Namaste.

Dr. Rangan Chatterjee (134:18)

It.