Food, facts, and fun

One of the main reasons I devote time to this website is that I’m trying to make sense of the deluge of health information raining down through the internet ether waves on a daily basis. It’s an impossible task, I suppose. Unless you are going to take the time to read and evaluate all of the studies cited in an article or interview (and who’s kidding who, I’m not doing that!), then you have no alternative but to put some faith in an “expert” or two. Or at least put enough faith in them to inspire you to try a few life experiments based on some tentative theories. One guy who has run a shit-ton of these life experiments is the stand-up comedian/mixed-martial arts commentator/podcaster extraordinaire Joe Rogan. His podcast, The Joe Rogan Experience, has featured so many fascinating and compelling conversations on such a variety of topics that it can be hard to keep track of them all. Recently, Joe has had in-depth conversations with two nutrition experts (Dr. Rhonda Patrick and Chris Kresser) and one journalist/author (Gary Taubes) on wide-ranging topics having to do with nutrition and health science. Check them out below if you have nine hours to spare!

One of the more interesting things Patrick and Rogan talked about is the idea of “time restricted eating,” which is the practice of limiting all of one’s consumption (of anything other than water) to a 9 to 12 hour window, meaning that if you have breakfast at 7am then you do not consume anything after 7pm. Again, I didn’t fact check any of the science, but Patrick is getting her ideas on this topic from a Dr. Satchin Panda of the Salk Institute (Here are some podcast notes from a conversation between Patrick and Panda on the subject of time-restricted feeding.) It’s a circadian rhythm thing, whereby we can tune up our metabolic processes to be more optimal. It’s all based on mice studies, so who the hell knows if it truly applies to humans. But it sounds interesting and it’s easy to run some personal life experiments in order to see what might happen.

Gary Taubes and Rogan talked about the relation of sugar consumption and health problems, a topic I have been skeptical about on the (probably shaky) grounds that I’ve eaten a boat-load of sugar in my life with no noticeable ill effects. Taubes has got me thinking a lot more deeply on the subject and, truth be told, I’ve been gradually limiting my sugar intake for years based on a rationale no more complicated than “too much sugar can’t be good for you.” One thing that Taubes pointed out during this conversation with Rogan is the simple observation that it takes only a minute or two longer to scramble up some eggs than it does to prepare a bowl of cereal. I’ve been eating cereal (containing no more than 5 grams of sugar per serving) every morning for as long as I can remember, mostly because it’s quick and easy. This week I had eggs a couple of mornings, and I did notice that I was a lot less hungry between breakfast and lunch. Are eggs great for you? Again, I haven’t looked at the science myself, but Joe Rogan and his guests seem to think so, so what more do you want? (I’m confessing my ignorance here folks, so take this all with a grain of salt. By the way, is salt good or bad for you? Who the hell knows!)

It’s been a while since I listened to the conversation between Rogan and Chris Kresser, but I remember thinking it was pretty interesting, especially when they talked about the “ketogenic diet.” The big takeaway that stuck with me was that eating things, like avocados, that are high in healthy fats, is a much better practice than eating things high in carbs, like pastas and breads. Anyway, I don’t know what to tell you. Check it out if you’re interested in some interesting takes on healthy eating and living that call into question much of what folks from my generation were taught in the 80s and 90s.

Finally, for the easiest-to-digest take on dietary health of all time, there’s always good ol’ Homer Simpson.

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The role of biology in problems of thinking, feeling, and behaving

Pissing in the wind

It’s a new year, and I find myself living in a “post-fact” world of “fake news” with catastrophic failures of critical thinking everywhere on display. Happy New Year everybody! What holds true–if anything holds true these days–in the realm of politics is not fundamentally different from what holds true in other areas of discourse, like say, behavioral health. And that true thing is this: our current capacity for critical thinking cannot seem to adequately process, evaluate, and analyze the constant flow of information that is being channeled through structures designed to further agendas rather than deepen knowledge and improve understanding. That was a mouthful, I know. I just can’t help wondering though, Has all this blogging been just pissing in the wind? Have I myself been duped, or been duping myself, into a false sense of certainty and self-righteousness? Maybe. But at least I’m trying. At least I care enough to ask questions.

The first Friday of every month I attend a continuing education training for mental health professionals. The training takes place in a local psychiatric hospital, and is conducted by various local leaders in the mental health profession. This last training was on the topic of addiction treatment, and I was expecting to get a heavy dose of twelve-step and brain disease dogmatism, and that’s just what happened. What took me by surprise was how starkly unscientific the presentation was–not a single reference to a single piece of research, and how uncritical the audience was as they nodded their heads to statements like “This disease wants you dead!” I felt like I was in a church listening to a sermon. I left the training deflated and discouraged. How can there be any hope of a sane, scientifically grounded approach to drug abuse (or any mental health problem for that matter) when the thought leaders, experts, and armies of professionals are all in lock-step headed in the wrong direction? Fortunately, there are dissident voices breaking through via the internet ether waves. But again, perhaps I have constructed my own cozy echo-chamber in this regard. You be the judge.

Johann Hari, he of “Chasing the Scream” and TED notoriety, wrote an interesting op-ed in the LA Times the other day called “What’s really causing the prescription drug crisis?” The piece pokes holes in the most well-subscribed narrative regarding the current opiate crisis in America, namely that Big Pharma has hooked everyone on irresistible drugs, and that what we need to do now is restrict access to these powerful life-ruining substances. The holes in this theory might not seem obvious. Even John Oliver, whose entertaining critiques usually strike the right tone, seems to have blown past them.

First of all, Hari points out that less than one percent of opiate prescriptions lead to addiction, and that super strong opiates (like diamorphine) are routinely administered in hospital settings in other countries without causing people to become addicted. So, then, the drugs themselves can’t be root of the problem, right? If it were the drugs themselves, then opiate addiction should be spread evenly across the country to match prescription rates. But it isn’t. Opiate addiction is concentrated in areas where times are the toughest, like in the Rust Belt. It’s the tough times–and their impact on people who may lack the resources (internal and external) to cope with them–that are more likely to be the root of the problem, rather than any specific numbing agent. Furthermore, how can stringent opiate restriction be the best response to the problem, when the vast majority of people who use the drugs to manage pain don’t show problematic use, and when cutting addicted folks off from their prescriptions so clearly leads them to black market heroin use? This “War on Drugs” mentality might be well-intentioned, but it’s just making things worse. In order to come up with a more effective solution, we need to fully understand the problem, which means taking into account all of the facts, which would lead us toward addressing root causes (like poverty, social isolation, poor coping skills) instead of restricting the latest, most available, most potent means of killing the associated pain.

Of course, addiction is just one category of so-called “mental illness,” and a broader argument can (and has) been made against viewing problems of thinking, feeling, and behaving, in general, as biologically driven processes best suited for physiologically focused interventions. I have been pissing in that wind for years as well, but I have not come across a more thorough critique of the predominant psychiatric paradigm than in this recent article by Phil Hickey called The Biological Evidence for “Mental Illness.” Hickey makes many of the points that I have made–ad nauseam–in previous posts (e.g., HERE), but he makes them far more meticulously and convincingly. He also grounds his arguments in research and years of clinical experience. Here are a few of Hickey’s ideas from this article that are well worth chewing on:

Depression, either mild or severe, transient or lasting, is not a pathological condition. It is the natural, appropriate, and adaptive response when a feeling-capable organism confronts an adverse event or circumstance. And the only sensible and effective way to ameliorate depression is to deal appropriately and constructively with the depressing situation. Misguided tampering with the person’s feeling apparatus is analogous to deliberately damaging a person’s hearing because he is upset by the noise pollution in his neighborhood, or damaging his eyesight because of complaints about litter in the street.

What psychiatry calls mental illnesses are actually nothing more than loose collections of vaguely-defined problems of thinking, feeling, and/or behaving. In most cases the “diagnosis” is polythetic (five out of nine, four out of six, etc.), so the labels aren’t coherent entities of any sort, let alone illnesses. But the problems set out in the so-called symptom lists are real problems. That’s not the issue. I refer to these labels as inventions, because of psychiatry’s assertion that the loose clusters of problems are real diseases. In reality, they are not genuine diseases; they are inventions. They are not discovered in nature, but rather are voted into existence by APA committees.

Both Hari and Hickey hit the nail on the head by pointing out what should be obvious, namely that addiction and other psychological problems are most often matters of adaptation, of learning, which are process that all healthy, normal brains participate in as they interact with their respective environments. How else could it be that the vast majority of people with such problems get better through such means as talking things out, rearranging their priorities, determination to change habits, and improving relationships? While it’s true–again, obviously–that every subjective human experience is grounded in some activity happening in the brain from moment to moment, it is sheer nonsense to assume that common problems faced by vast numbers of human beings are matters of hardware malfunction. This might be true for the very few. But it is only through misaligned incentives and misapplied critical thinking that the brain disease paradigm has become mental health dogma.

*Mic drop*

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IHR Podcast #19: Living one’s dreams in the age of digital distraction

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In this episode of the Integral Health Resources Podcast, I reflect on what it means to be healthy in this age of digital distraction.

This is a seriously low-energy podcast. I really need to learn how to bring some enthusiasm to these things, but it’s hard to hone the ol’ podcasting skills when you only put out one every few months. Live and learn!

Here are the links to the two articles about which I riffed on:

Andrew Sullivan: I Used to be a Human Being

Chris Kresser: What is health?

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IHR Podcast #18: Neurogenesis and Holistic Health

In this episode of the Integral Health Resources Podcast, I respond to Brant Cortright’s thesis that one’s rate of neurogenesis (growth of new brain cells) may be the most important biomarker for one’s brain health.

I recently blogged about all this here.

neurogenesisdiet

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Brant Cortright on the role of neurogenesis in holistic health

neurogenesisdietI took a counseling class (Transpersonal Psychotherapy) with Dr. Brant Cortright while I was working on my first master’s degree at the California Institute of Integral Studies, way back in 1995. I liked him a lot. He had a gentle, genuine vibe about him. I can’t remember how it came to be that Dr. Cortright reappeared on my radar, but somehow I got wind that his recent work has to do with “neurogenesis” and its importance to holistic health.

Neurogenesis refers to the growth of new brain cells throughout life. According to Dr. Cortright, it was only recently discovered that neurogenesis happens beyond our 20s, and supposedly there is now sufficient research to support the notion that one’s rate of neurogenesis may be the most important biomarker for brain health. Furthermore, according to Cortright, a healthy brain will translate to optimal health at all levels: body, mind, heart, spirit. Low rates of neurogenesis are supposedly associated with a host of negative outcomes (e.g., depression, stress, anxiety, memory problems, cognitive impairments, impaired immunity), while high rates are associated with such things as robust health, cognitive advantages, enhanced memory and learning, protection from stress and depression, and high immunity. Many things that we do in life, so the story goes, unknowingly slow down our rate of neurogenesis, but we can increase our rate of neurogenesis through various dietary and lifestyle changes. Basically, we want to reduce, minimize, and eliminate the things that lower our rate of neurogenesis (and diminish brain health), and maximize and do more of those things that increase our rate of neurogenesis (and support brain health).

Some of things that Cortright recommends to support neurogenesis and brain health include the following:

  • Aerobic exercise
  • Mindfulness meditation
  • Diet (omega 3 fatty acids, blueberries, tumeric, green tea)
  • Good sleep
  • Minimize exposure to neurotoxic environments, stress, etc.
  • Much of what he’s putting forth with this “neurogenesis” spiel is consistent with my own integral health perspective, and I appreciate how he grounds the many dimensions of holistic health by focusing on how each affects brain health. Many of his recommendations are no-brainers (pardon the pun) from my perspective. Who would argue, for instance, against the health benefits of exercise, good sleep, reduced stress, and a healthy diet?

    The specifics about diet can be questioned, however. Having not reviewed “the research,” I’m not prepared to rebut Cortright’s specific recommendations. I can only say that I’ve heard other “experts” contradict many of the specific dietary recommendations he makes, and at this point I’ve almost given up on making sense of all the conflicting information out there on this subject. We all tend to inflate the importance of whatever studies support our pet theories, and to discount or diminish those that present a contradiction. Those of us who are left dizzy by the ever-shifting sands of nutrition science often end up, for lack of a more clear path forward, giving too much weight to our own anecdotal experience. For instance, I have a hard time believing all the “sugar is toxic” hype, in light of the fact that the first two-and-a-half decades of my life were spent eating (and thoroughly enjoying) a ridiculously large amount sugary foods. The quality of my life–in every way and on every level–was very, very high during those young, sugar-fueled years. And yet, I’m supposed to believe I was ingesting high quantities of poison everyday, with no noticeable negative effects?

    So, my concern here–again, keeping in mind that I have not waded through all the contradictory research first hand–is that Cortright might be too eager to accept whatever research, perhaps scant and preliminary, that supports his thesis. Neuroscience, in general, seems to be way over-hyped these days, and something about the way Cortright’s book is marketed (e.g., “Unleash your brain’s potential!”) has my internal “hype meter” bouncing around all over the place. But again, I realize that this is a pretty weak criticism, given that I have not read the book. I did, however, watch/listen to these public talks and interviews:

    I definitely find Cortright’s ideas on this topic interesting, and I will continue to explore the connections between diet, lifestyle, and brain health. Maybe I’ll even read the guy’s book, so I can comment intelligently on the subject!

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    IHR Podcast #17: Joanna Moncrieff and the politics of psychiatric drug treatment

    In this episode of the Integral Health Resources Podcast, I ramble on about the inadequacy of current terminology to describe “integral” mental health perspectives, and then introduce one such perspective — the critical psychiatry of Dr. Joanna Moncrieff.

    Relevant media:

  • Joanna Moncrieff – The Myth of the Chemical Cure: The Politics of Psychiatric Drug Treatment
  • Models of drug action: Brief article outlining Dr. Moncrieff’s distinction between disease-centered and drug-centered models of drug action.
  • the-myth-of-the-chemical-cure

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    IHR Podcast #16: Critical Thinking

    In this episode of the Integral Health Resources Podcast, I string together some loosely formed thoughts about the centrality of critical thinking in all walks of life.

    Related media:

    Critical Thinker Academy: Good website with lots of free resources about critical thinking

    critical-thinking

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    IHR Podcast #15: To screen or not to screen (everyone for depression)

    In this episode of the Integral Health Resources Podcast, I discuss the new depression screening guidelines proposed by the The US Preventive Services Task Force, the response to these guidelines by Allen Frances, and the perils of podcast procrastination.

    Related articles:

  • Depression screening for adults and adolescents has benefits, but don’t ignore the downsides
  • (Debate between Karina Davidson and Allen Frances)

  • Screen everyone for depression? Good intention, very bad idea (Allen Frances)
  • New depression screening guidelines outline very helpful, yet achievable goals (Harvard Medical School)
  • Do Antipsychotics Help or Harm Psychotic Symptoms? (Allen Frances)
  • Are ‘Psychiatric Disorders’ Brain Diseases? (Phil Hickey)
  • princ_rm_pet_scan_of_depressed_brain

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    NPR gets it wrong about “undiagnosed adult ADHD”

    npradhd

    I was scrolling through my twitter feed this morning, enjoying my coffee, when I came across the following headline from NPR Health News: Can’t Focus? It Might Be Undiagnosed Adult ADHD. My heart sunk. It seems even the smart folks at NPR are not above peddling the dodgy “mental illness as medical condition” narrative. This shouldn’t surprise me. Just the other day I was tuned in to NPR’s Here and Now, a show I totally dig, and I cringed hard as host Robin Young trotted out the whole “addiction is a disease, just like diabetes and cancer” song and dance. I suppose I find it particularly depressing when otherwise smart, sensitive people demonstrate such a profound and consequential failure of critical thinking. And it’s such a touchy subject to discuss. When I say something like “addiction is most definitely not a disease and is nothing like cancer,” people might think I’m saying that addiction itself is not real, or that the suffering addicts experience is not real. As a mental health professional, it is rather inconvenient that my perspective of mental health is at odds with the most prominent points of view. It is simply a fact that vast swaths of people, both in the general public and across mental health professions, buy into the medical model of mental illness, at least to a significant extent. It’s impossible to escape the language of this way of thinking, the talk of “symptoms,” “diagnoses,” and “treatments,” and all the distorted thinking and misplaced actions that follow.

    How can I point out, convincingly and with compassion, that it was wrong and potentially harmful for the hero in the NPR story, psychiatrist Dr. David Goodman , to frame his patient’s lack of attentional focus as a medical condition in need of medical treatment? After all, one of the patients (Kathleen) reported that she was completely and positively transformed by Dr. Goodman’s medical treatment, that she can now finally focus her attention, finish projects she’s started, and stop beating herself up for being a stupid or lazy person. It’s a difficult discussion to have, no doubt. But the truth matters. And the truth is that a lack of attentional focus is not caused by a stimulant deficiency, any more than drowsiness is caused by a stimulant deficiency. Yes, stimulants increase focus and alertness in most people. No, a lack of focus and alertness is not a disease or medical condition. Yes, Kathleen, your lack of attentional control might lead to problems, difficulties, and suffering. These problems are real. Your suffering is real. And yes, stimulants may help. But no, you do not “have” a medical condition, a glitch somewhere in your brain, that is being targeted, treated, or cured by the miracles of modern medicine. The truth is, no one, not even Dr. Goodman, knows why you have trouble focusing your attention. Maybe it is partly how you’re “wired.” Maybe your innate attentional tendencies aren’t a great fit in a society that values a laser-like focus of attention over other ways of taking in the world. Maybe your relationship with electronic devices can be tweaked for the better, and that might make a difference. Maybe your diet factors in somehow. Maybe a lot of it has to do with the fact that you are bored as hell with your job. Who knows for sure? Not Dr. Goodman, no matter how impressive he looks in his white jacket with a stethoscope dangling around his neck.

    Yes, it may be comforting to externalize your problem as a “treatable disorder.” But you don’t have to choose between “I have the disease of ADHD. It has nothing to do with how I live my life.” and “It’s all my fault. I’m stupid and lazy.” The truth is that psychological problems are complicated. The truth is that ALL behaviors and experiences are rooted in the brain and body, and yet our neurophysiological processes are also constantly being influenced, fashioned, and shaped by what we do in the world, by the actions we take, by the quality of our interpersonal relations and other psychosocial engagements. So go ahead and take the Ritalin, if it helps. But consider the potential side-effects and health impacts first. And don’t buy into to false notion that Ritalin is curing some illness that you have. Buying into that false notion shuts down consideration of all the psychosocial factors that are well worth considering.

    The same goes for the vast majority of psychological problems faced by the vast majority of human beings. Are there neurodevelopmental and genetic anomalies that affect some people? Of course! Can the tools of modern medicine be brought to bear on these and other problems? Of course! But if the medical model of understanding mental health problems was effective in addressing the more common concerns of the general population (as it has been with say, vaccinations for various infectious diseases), then we should see a reduction in the severity and rates of mental illnesses as our medical treatments are being increasingly applied. But we don’t see that, and that’s because the vast majority of psychological problems experienced by the vast majority of human beings are not best understood using the conceptual tools of the medical model.

    I know a kid, about ten years old, who takes the antipsychotic medication Risperdal to help control his behavioral outbursts. The meds are helping, no doubt about it. Fewer explosive outbursts. Fewer trips to the hospital. Better grades in school. This kid’s problems are real. His suffering is real. His parents’ suffering is real. But this kid doesn’t have a “disease” that is being “treated” by the Risperdal. He’s not suffering from a Risperdal deficiency or from brain damage in some hypothetical neural circuits that Risperdal might be affecting. Perhaps smoking some marijuana every day would help control his outbursts as well, but that would say nothing about the “cause” of his problems. The truth is, no one knows why he is the way he is. It’s complicated. But thinking of his problem as a “brain disease,” however comforting that might be to him and/or his parents, is bad thinking, wrong thinking, and potentially dangerous thinking. That thinking pushes his parents to accept the often severe side effects of Risperdal, the unknown effects on the child’s developing brain, and to close the door on exploring the many other interventions (e.g., physical exercise, dietary changes, parental-style adjustments, creative outlets, behavioral modification strategies) that may also help to control the child’s outbursts. And psychosocial interventions have the distinct advantage of being side-effect-free, while also building skills and positive behaviors that can shape both subjective experiences and neurophysiological structure in enduring ways.

    So, going back to the NPR story that started me on this rant, I’m happy that Kathleen is able to focus her attention in a way that’s more to her liking. But I’m not happy to see NPR falling into the same traps of poor thinking that have been keeping the broken mental health model in place for decades. Decade after decade we apply the same medical model to the problems of mental illness and addiction, and decade after decade we scratch our heads wondering why everything keeps getting worse and worse.

    What are some alternatives, you might ask? There are plenty of them. Check out, well… anything on this website, for starters!

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    IHR Podcast #14: Thoughts on Integral Theory and the associated community

    In this episode of the Integral Health Resources Podcast, I discuss my current perspective on Ken Wilber’s “Integral Theory” and the associated community, especially in light of the recent New York Times article on Marc Gafni, a known sexual predator who is unconscionably endorsed as a leader in the integral community.

    Related media:
    Brief description of the “Four Quadrant” model of Integral Theory
    – “A Spiritual Leader Gains Stature, Trailed by a Troubled Past” – New York Times article on Marc Gafni
    Blog post by Judy Rogers, one of Marc Gafni’s victims
    Articles critical of Gafni, by William Harryman of Integral Options Cafe
    – My blog post on Ken Wilber, “Has Ken Wilber jumped the shark?

    Screen Shot 2015-12-28 at 3.03.35 PM

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