PR Brandon | Developing Resilience

 

One of the strongest demonstrations of resilience is not letting a disease take over your life. Today, Adam Markel interviews Dr. Brandon Beaber, a board-certified neurologist with a subspecialty in Multiple Sclerosis. Dr. Beaber is also the author of Resilience in the Face of Multiple Sclerosis. Dr. Beaber talks about the importance of sleep for creating and developing resilience and promoting neurogenesis. He also shares some examples of people who have made great strides and life pivots despite their degenerative conditions. Don’t miss this opportunity to become more knowledgeable about sleep, neurogenesis, MS, post-traumatic growth, healing and so much more!

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Developing Resilience For Achieving Optimal Brain Health With Dr. Brandon Beaber

I’m feeling very blessed. I feel really happy, glad and thankful that my energy has been steady. I don’t know if any of you can relate to this but typically, I’ll go through the usual cycles of having good energy, high energy, and then other places where my energy troughs a bit and I’ll think, “Maybe I need a cup of coffee or I need something to eat,” or what have you. I would say I got a good night’s sleep. It’s been consistently the case even though I’ve had a lot on my plate and it’s not quite the end of the day but near the end of the day, to want to be at my best, both from what comes through me in the microphone and all that thing. Also as an interview or someone whose message and whose work I want to feature, we wanted to have this gentleman show up and speak and be interviewed on our podcast. I want to be my best for that. We all can identify with wanting to be our best and then finding that throughout the day, maybe we’re not quite there. If we were Olympic athletes and we’re about to run the 100 meters or do something like that, we’d be much more focused on how it would be for us to be at our best and what it would look like beforehand and all that thing. Yet with our daily activities, I know on my own, I’m not always focused on running that Olympic race let’s say in everything that I do. 

I’m remarking to myself as we begin that I’m happy that I am where I am and that I attribute that to a better night’s sleep and taking good care of myself as well with a green drink and other good things. With that said, I’ve got a gentleman that was introduced to me and to our company through a mutual friend, somebody that I love and respect, Dr. Brandon Beaber. Dr. Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis. It’s through that MS work that we met through a mutual friend and other immunological diseases of the nervous system. He’s a partner in the Southern California Permanente Medical Group and practices in Downey, California, which is the Los Angeles area. He’s multiple publications on MS epidemiology and has participated in clinical trials for MS therapeutics. He is a very interesting person and has an interesting history with his own pivot stories which we’re going to explore and a little bit of a different guest for us. I’m thrilled about the fact that we can dive into some things. I’m appreciative of your time, Dr. Beaber. Thanks for being with us.

Thank you for having me on, Adam. It’s a pleasure to be here.

I always want to start with something that’s not written in the classic introduction or bio. What’s not there that you’d love for people to know about you coming into this interview?

I have very diverse interests. I like to play chess. I do some circus arts, juggling and unicycling. If you watch any of my YouTube videos, sometimes I’ll splice in five seconds of me juggling. I got back into that after many years. I have a 1-year-old and a 3-year-old. Like you, I also slept well. If you talked to me, I wouldn’t have said the same thing because I’ve had some long nights both having young kids and being on call. In the last few years, I got into the social media thing although I don’t have a particular interest in being an academic neurologist and trying to defense research and increase our understanding of the disease piece bit by bit. I have an interest in interacting directly with the community and people with multiple sclerosis and other neurological diseases and people who are interested in psychological resilience.

Resilience is definitely a topic I know we’re going to track to. We started with sleep. This is one of these things that pops up and you go, “Great. I trust that everything is always popping up.” It’s there for a good reason. It’s a question of, can we see the connection points? On Monday night, I was out in LA. I was out with my brother and with our daughter Lindsay and her fiancé and stayed out a little late. I got an abbreviated night’s sleep for a few hours and got up early. I was on the road in LA traffic by 7:00 AM and full-on bumper-to-bumper with thousands and thousands of cars on the road, which reminded me of my days when I was a lawyer and I used to commute into Manhattan. I would deal with that every day for four hours, two hours each way of traffic and how that wore me down in many ways. I didn’t sleep well. I wasn’t at my best. You do what you have to do. We’re all tenacious and I’m extremely resilient and I believe you build resilience, you create resilience before you need it. I had a reserve tank that I could call upon, but I definitely depleted it and last night, I made sure I got a good night’s sleep. My question to you is, how important is sleep whether it’s the folks that you’re working with that have some neurological challenges? Generally speaking, how important is sleep to creating resilience? 

It’s extremely important and a lot of resilience is taking care of your physical body and being physically strong, well-rested and having good nutrition. People have done a lot of studies on the regenerative capability of the nervous system. We historically believed that the nervous system was very static. If you have damage, maybe you get a little bit of improvement as the swelling goes down but after that, it’s very static. In reality, we have some regenerative capability. Relatively in the last twenty years, we’ve discovered the capability of neurogenesis, the formation of new neurons. One of the things that promote neurogenesis is sleep. There are all kinds of things that are going on when you sleep. You’re consolidating memories in your hippocampus. During certain forms of sleep like rapid eye movement, you’re experiencing a total relaxation of all of the muscles in your body, which never occurs even “at rest.” That is thought to be very important in terms of both the recovery of physical muscles and metabolizing certain hormones involved in stress and recuperating yourself in general.

Sleep is something that depending on who you ask, you get different viewpoints. I know there are people that are out there in social media who are pretty much influencers and they say they only need 3, 4 hours of sleep. We hear that thing if you’re side hustling or you’re creating a business or doing something that you want to be. If you’re an entrepreneur, you have to do without sleep. Even Elon Musk talks about his people. He works 110, 120 hours a week and that becomes a standard, almost an aspirational milestone for many Millennials, many entrepreneurs that they have to work even farther and more in excess of what we used to call workaholism previous to this. How important do you think sleep really is? What happens if we do without it? What if we’re getting 5 or 6 hours instead of 7 or 8? What is that optimal sleep and how important is it, do you think? 

PR Brandon | Developing Resilience

Developing Resilience: A lot of resilience is taking care of your physical body and being physically strong, well-rested, and having good nutrition.

 

Everyone’s a little bit different. There are definitely people who seem to do well on a relatively small amount of sleep, like 5 or 6 hours. Most people need closer to 7 or 8 hours. There are a small number of unlucky people who really can’t function well unless they’re sleeping a lot, 9 or 10 hours sometimes for unknown reasons. We call it primary hypersomnia. When people do very detailed neuropsychological testing of people, the cognitive function does decline a little bit when people are sleep deprived and everything that we test seems to be declining slightly when you’re sleep-deprived. Your driving ability decreases, your ability to solve math problems and to make good decisions. Obviously, I know a lot about sleep deprivation and I remember when I was a resident, there used to be a rule where you couldn’t work more than 30 hours straight, that was the maximum. You have to send the doctors home after 30 hours. I was doing a rotation, I won’t name the department because I don’t want to make anyone look bad and they abused us. We were routinely staying over 30 hours. I remember this one night on call, I had a list of patients, a bunch of checkboxes, and things I have to do and I completely forgot to see this one patient. You didn’t even see them at all and forgot that they exist. Luckily, nothing happened to them. They were stable, but mistakes get made when people are sleep-deprived. That’s the reality.

Neurogenesis, tell us a little bit more about that and things that can regenerate ourselves. Anything that we can do to regenerate ourselves not purely physical regeneration, but even our mental. Most of the fatigue I find with people these days isn’t like it was if we were working on the farm or they were out doing manual labor jobs where you were physically exhausted. It feels it’s more mental fatigue, even tech fatigue that people are experiencing. That might not be your area specifically of expertise but what are your thoughts there and where does the neurogenesis concept come in if it does?

Specifically, that is a very common complaint in people with multiple sclerosis that they have cognitive fatigue. A lot of people with MS, if you talk to them, you wouldn’t really recognize them to have any cognitive dysfunction whatsoever because their memory may be pretty good. Their intelligence may be preserved, but when it comes to things doing multiple things at once, multitasking for long periods of time, that’s when they may notice the problems. It could be something very subtle and subjective, but it’s very significant. People have a lot of problems with employment, even if they seem intelligent and smart. What’s happening is that people have a metabolic failure of the brain that you can’t keep up with the pace and if you have an injury to the brain, it’s likely to make that worse. It’s seen in multiple diseases. People who’ve had strokes and people who have multiple sclerosis and various other degenerative diseases in the nervous system.

The thing about neurogenesis, it’s very interesting. That’s probably the one thing that’s going to help us repair injury that has been very long-standing and appears permanent. Our treatments of MS are a lot better in terms of our ability to control the immune system because we believe MS is an immunity disease. For some people, that’s not really their problem. They’re stable. They’re not having a lot of active inflammation. At least not that we could see, but they want to repair injury that’s happened in the past. Some of that repair may be related to the myelin, which is the fatty sheath of the nerve fibers. The good thing about MS is that people may have a lot of preservation of the axons or neuro fibers, whereas they have disproportionate damage to myelin. There are a lot of novel agents, drugs, therapeutics geared towards treating that. None that are commercially available yet, but probably will be fairly soon. Some people have damage to the neuro fibers themselves and that’s where future technologies related to neurogenesis may come into play. Based on the research, the things that have been shown to increased neurogenic is getting good sleep, regular exercise, training the brain, stimulating your cognition and eating a healthy diet. There’s some evidence that antioxidants like blueberries, flavonoids and nuts are beneficial for cognitive function, for example.

Brain health, I don’t know that everybody’s thinking about it, but we need to pass a certain age, maybe it’s 40, 50 or something when you first begin to think, “I was a little sharper, a little quicker or something like that earlier on in life.” I know for me at my age, brain health is everything to me. I want to make sure that with the pace of change, the pace of everything that’s being developed all around me all the time, I want to be able to keep up. Not just keep up, I want to still be on my own growth edge, whatever the cutting edge looks like. You mentioned a couple of things that are brain health-related like the sleep you’re getting and some of the foods that you’re eating. Are there other things that people should be thinking about or looking for to determine whether or not their brain is performing optimally or whether there are some signs that maybe there’s even something that they want to get looked into?

One thing that you can do is actually test your cognitive function and there are a lot of websites like Lumosity and neuro brain, I can’t remember all of them off the top of my head and they can give you a score and you can test your cognitive function. The other thing that I should mention is chronic stress. There’s acute stress which is a natural reaction that we’re supposed to have from an evolutionary standpoint. Chronic stress is a big problem. We don’t get to rest a lot in our current society and that has very deleterious effects on our overall health and our cognitive function and probably our overall resilience.

I’m glad you brought that up this idea that people have the ability to recover is the key to much of the research to how you perform at higher levels. It is the amount to which you incorporate recovery into the rituals for whatever it is that you’re doing. With athletes for example, they have a recovery regime or routines that are built into getting back in, whether it’s in the ring or it’s on the field of play or whatever it is. They are routinely recovering. In Corporate America, we’re constantly in a do more with less cycle. The amount of work only increases, the resources to support that work usually decreases and the time that we’re given to perform things has also shrunk. There are almost no boundaries between work or business and home. Whereas 20 or 30 years ago, rest was the weekend. You have a weekend and that’s your time to rest. That’s your R and R time. These days, there is no end to the week. There is no weekend for many people.

The stress and the lack of recovery are as you say, the issue. I’d love for you to explain if you could, what does rest look like? When I asked this question to people, they say, “If I’m home, I’m not at work. I’m resting.” “What do you mean?” “I’m not on my email. It means I’m resting.” “What are you doing?” “I’m watching TV, I’m on my phone or I’m on my computer.” I said, “Is that resting?” He goes, “Yeah. Of course, it is. I’m not actively working. I’m relaxing. It’s a way that I relax.” That begs the question, is consuming content online, being on social media platforms. I won’t name any to single them out, but whatever those platforms are, watching the news whatever your brand or the news is on either side of the divide, will that equate to rest in your opinion?

People don't get to rest a lot in our current society which leads to deleterious effects on overall health and cognitive function. Click To Tweet

You make a valid point that a lot of what should be our resting time is actually a very active and stimulating time. What I would recommend is more of an active effort to specifically focus on the present and focus on rest. One of the chapters in my book is about mindfulness meditation and training your brain to specifically distract yourself from all of the troubles in the day and appreciate what’s right in front of you, what can you express gratitude for? To really try to relax your mind and relax your muscles.

We didn’t at the beginning give the name of your book, but I’d love it if you’d share that with our audience. 

It is Resilience in the Face of Multiple Sclerosis.

This is a book for someone that has MS or has a history of MS in their family, will want to check out for sure. Is it also a relevant book for people that don’t have a family history and currently don’t have MS?

I’d like to think so because what inspired me to write the book is that I specifically tried to interview people who have a lot of problems. Multiple sclerosis is variable. There are many people who are marathon runners or high powered CEO’s and you wouldn’t know that they have MS by looking at them, but I tried to interview people who have MS. They have a lot of disability related to MS, both the salient kind that you can see like a physical disability, abnormal speech, clumsiness and also invisible symptoms like fatigue and pain that you wouldn’t readily see but have a profound impact on people’s lives. I found to my surprise that a lot of people live great lives in the face of MS or sometimes even because of MS. I’ll give you an example of that. One of the people I interviewed is Sandra Orozco and that’s actually her real name. She’s a fairly well-known political activist in that Tri-City area in South LA. In the past, she was a healthcare administrator and she was lively and ambitious. She loved her career and she developed very aggressive, multiple sclerosis quickly and was severely disabled within weeks or months. If you saw her now, it would blow your mind because even though she has a lot more disability, she’s using a wheelchair for many years. She’s happy, enthusiastic and productive, but at the time, she was severely depressed and it was even institutionalized. She was institutionalized for depression and she’s slowly recovered from that.

As you would say, she made a pivot in a different direction and she wasn’t able to go back to work, but she became a political activist and she found that she had new strengths, new abilities and new interests that she never even considered before. There’s a whole area of research related to this that they call post-traumatic growth. One of the researchers is named Tadashi and he studies a lot of people who experienced traumatic events like losing a spouse, losing a job or coming back from war. We all know about the negative things and we know about posttraumatic stress disorder. We know about depression, flashbacks and all the horrible things that can happen, but it turns out that a lot of people experience something different, what they call posttraumatic growth. It’s where people realized that they had abilities that they didn’t have before. Sometimes they appreciate the little things in life more like their relationships with other people. Sometimes people experience a difference in philosophy or even a new religion or new importance of religion in their life, for example. It’s like what you experienced when you were in the emergency room with chest pain and everything like that.

Posttraumatic growth, this is a term I’ve never heard before. In real terms, what this means is that there’s something that’s happened, you’ve gained meaning, something that you might call negative or something that’s hit you. It could feel like the loss of a job, it could be a cancer diagnosis. It could be any number of things that have happened at times in our lives, but there’s a tendency toward resilience being created. Is that the growth that you mean?

Exactly. I’m not saying that multiple sclerosis is good or that this adversity is good. Of course, it’s bad and it may severely limit some of the things that you’re able to do in life and change your plans. You may be able to find something good in it or to use it to be more flexible in life and to develop new skills and to go in a direction you never would’ve gone in otherwise. With Sandra, she got interested in politics and she started going to city council meetings. She’s very personable and she made relationships with people. She was actually able to really help her community. She was pretty famous for a period because she was protesting the City of Bell scandal. I don’t know if you were in Southern California at that time, but it was a huge scandal involving city council members in the City of Bell stealing money from taxes, basically pocketing it. She did all great things for our community and she’s such a happy person, productive, and fulfilled in life despite having MS.

PR Brandon | Developing Resilience

Developing Resilience: Sleep, exercise, brain training, eating healthy diet, and cognition stimulation promote neurogenesis.

 

I want to change the trajectory a little bit. We often will talk about other people’s pivots and they’re very instructive obviously to look at how something’s gone in someone else’s life. What’s something that’s happened in your life where the principle of posttraumatic growth came into play? Is there something like that that is relevant to you?

When I read your story, it makes me think I’m glad I didn’t go into law because it’s funny, every lawyer I talked to is very unhappy with a few exceptions. Generally speaking, I’m happy with my career and don’t get me wrong, I’ve definitely had some rough times. Not everything about my career is positive. I’ve realized that I don’t want to be just a clinician, I want to be an author, I want to write multiple books. I want to be active on social media, interact with people and contribute to the community of people with MS in that way. I’m not going to do something like you where I try to make it my career. I’ll primarily be a multiple sclerosis clinician. That’s what I’ll do for a living for the rest of my life, I believe. I want to have this separate thing on the side that gives me a lot of fulfillment. It’s been an adventure. I enjoyed the whole process. You talk about in your book, you turn the ship five degrees over a long period of time. It makes a big difference in you’re very far from where you would have been otherwise.

We often will tell ourselves and I know I’ve done the same thing. There’s a sunk cost in doing something for a length of time, whether it’s to be in a job for a long time or to be working a particular business plan or business model for some length of time and thinking, “I’ve got so much invested already. It’s almost impossible for me to change or to turn the ship.” Those small changes make a big difference. Part of what all of us are looking to do is to return to a place that feels balanced in our lives. I’m not a big fan of that concept of balance, personally. I think of it more like harmony and how do we return ourselves to a state of harmony when often we’re walking around with those more prehistoric reactions happening inside of us, it’s cortisol pumping through us. We feel as though we’re in fight or flight and even to the point where we’re not recognizing that some of those things are being triggered within us and that disturbs our peace. It disturbs our sense of well-being. It disturbs our sense of being grounded.

This is a term that came up from me some time ago and I want to bring it up and get your thoughts on it, which is homeostasis. This idea that from a physiological standpoint or even a medical standpoint, that there is a balancing within our bodies or return to something called homeostasis. Can you share a little bit about what’s your understanding of that and how important is it that we ourselves are returning back to a state of, I’ll say homeostasis instead of balance? If you could give us your take on that, it’d be very helpful.

You have a certain amount of mental energy and if you’re trying to put excess demands on your mental energy. You’re not able to fill that tank by doing things like programming and rest and you’re doing things that you enjoy, giving your body good nutrition and exercising regularly, then you’re probably not going to be able to keep up with that demand. Some people are stronger than others, but everyone cracks under enough pressure. You have your chest pain story and a lot of other people have stories like that, but it may not necessarily be something dramatic. It may be that your productivity is less at work over a long period of time. You don’t have a passion for it anymore and you don’t enjoy it anymore. People underestimate how important happiness with what you’re doing is in terms of something like success in your career or an entrepreneurial venture. For instance, if you had gotten into a More Love Media thinking there’s a niche for transformative speaking in the business world, but you had no particular interest in it. I don’t think that you would be able to sustain the passion for it and put in the work and sacrifice over time to make it successful. A lot of success in business and entrepreneurial adventures are doing something that you love, that you care and you’re passionate about. In my book, I talk a little bit about different schools of psychology and how they contribute to overcoming resilience.

One psychologist that inspired me is this guy Dr. Martin Seligman. You know who he is of course. To those who don’t know, he criticized the world of psychology because it was too focused on the negative. It was focused on treating depression, anxiety and schizophrenia. What about improving the lives of ordinary people? He called this positive psychology as opposed to negative psychology, treating something bad. According to his research, there are different things that really contribute to happiness. One of those things is simple hedonistic pleasure, maybe this would be watching TV or eating delicious food. It’s something that instantly causes gratification that we can all understand.

He argued that this actually contributes to a small amount of happiness and that other forms of happiness are more important. One of those things he calls engagement, which is basically being immersed in an activity. It could be that you’re playing chess or a video game or reading a book that you really enjoy or spending time with someone that you care about and time seems to pass very quickly. As soon as you know it several hours have passed and you weren’t even thinking about it. This isn’t necessarily through your profession. It could be many things, volunteer work, some intellectual or artistic works. The last thing that he talks about is meaning, doing something that you know is valuable, where you believe in the cause and that’s going to make you more passionate and more productive in the long run even if a little bit of pleasure, a sacrifice in the short run.

When we think about how it is that we create greater resilience, Seligman is a great example of that. If I’m recalling, he talked about a way that we talk to ourselves that we’ve all got our own way of creating a story or creating meaning for ourselves. The difference between somebody that looks at the world and sees the glass is half full versus the person that might see it otherwise. It has to do with the way that we look at what’s happening in our lives and whether we see those things as being permanent, pervasive or it might’ve been personal. There are people who look at things that are happening in their lives and they make meaning out of it. Some think that what’s happening is permanent. There’s something that they’re experiencing that they can’t change. They’ve lost a certain amount of control that some people think that what’s happening is a part of a pattern or a history that always happens. This is my luck. This is my life, my lot, this is what happens all the time to me. People that also believe it was personal, where they assume that there’s something that they’ve done personally that’s invited this thing into their life. In each of those cases, we have this choice that we can make in terms of how we frame that story and what we take away from it. What you said is very important. We have this opportunity when we’re making meaning of things, to tell ourselves that there is meaning in it. 

Some people are stronger than others, but everyone cracks under enough pressure. Click To Tweet

It’s Man’s Search for Meaning and the idea in Viktor Frankl’s book that there’s meaning in everything. In fact, he created meaning therapy out of his experiences as unfortunately surviving or being in a concentration camp and fortunately surviving that. Part of how he survived where other people didn’t was that he was thinking while he was there, that someday there would be something good that could come out of it somehow, inconceivable as it was and without even clarity about what that might look like. He felt there would be some meaning. Ultimately if he could share that meaning that maybe things would be better for someone else. The idea of how we look at the story that we’re not necessarily seeing things as being permanently wrong or pervasively wrong or personal like we deserve it or we are being judged or something like that. Rather seeing that anything that’s happening is on some level happening to our benefit and potentially to the benefit of many other people. That seems to be a concept that’s more on the mindset side. I’d love to get your thoughts on the work that you do with people who have been diagnosed with MS, for example, how much of it is mindset? How much of it has to do with the thinking versus what’s actually going on inside of their physical bodies?

When people come to see me, they’re most interested in the medical side of multiple sclerosis. What diet should I consume? What medication should I take? How often do I need an MRI scan? That’s typically what people want to talk to me about when they come to see and visit. Of course, that’s only one side of having multiple sclerosis. Another side is, are you open with a diagnosis with people or do you keep it a secret and not make it a major part of your identity? What are you doing at work to try to stay productive? Are you on disability? Is that the best option for you, for example? How is it affecting your personal relationships? It’s a little bit hard to talk to people about everything. I truly try to give people some words of encouragement the best that I can. Everyone’s situation is a little bit different but I do think that’s a very important part of it. That was the point that I was trying to make with the book, the correlation between disability or severity of MS is not necessarily highly correlated with overall happiness life. That’s one aspect of life. It may make things more difficult but it’s amazing. People are incredibly resilient and they find a way to have a happy life.

To give the example of Sandra, for her to get up and go to a city council meeting is very difficult and she has a lot of physical disabilities. She has a lot of fatigue and it’s hard for her to get through a whole day. She wants to take a nap in the middle of the day. It’s a big deal for her even to do that, but because it’s meaningful to her, she cares about her community and it’s very important. Even those painful tasks become somewhat of a pressure because they’re part of the pursuit of success. I’m sure there are aspects of what everyone does that are not maybe the technical aspects of producing a podcast for instance, but you get excited doing it because you know what the end result is going to be and you care about the product. For me maybe writing the book, a lot of technical aspects of the editing and stuff are difficult, but you get excited about it because you want to see the finished project and you love to see how it rests. That’s what it’s all about.

Our mutual friend is one of the most positive people you’ll ever meet. He’s got nothing but energy and enthusiasm for the work he does. He’s going to be delivering a TED Talk pretty soon and part of what I know is on his heart when he delivers that talk is this message about your mindset. It’s this message about how you approach things. It’s like a counselor. You didn’t answer my question. Not so much, is there a correlation? I don’t think anybody disputes this correlation between your mindset and what’s showing up physically for you. There are still some people that go to a doctor and go, “If there’s something wrong with me, I want you to tell me what I can take or what I can do, what procedure, what medication, etc.” If you say to them, “You may not want to hear this, but the best work you could probably do for your condition is to examine how it is. What’s your process for thinking through things? What’s going on inside your head during the day? How often are you spending time in the judgment of yourself or others? How much time are you not in peace? How much time are you angry? Why are you still rehearsing the grievances of the past or feeling guilty or feeling resentment or any of those things?”

I don’t suspect that’s something that’s really addressed in medical school that much. I know there were too many things to count that weren’t addressed in law school that didn’t prepare me to do which is what I ultimately learned how to do as a lawyer. I learned on the job in managing many aspects of the client relationship. I’m asking you the question, what do you think is true about the connection between the mind and in what people are presenting in their bodies? 

There is definitely some evidence that chronic stress is related to chronic diseases and there’s a plausible physical basis of this. When you have chronic stress, you have chronically high levels of adrenaline. This has various effects on the body, on your fat metabolism, a function of the immune system and so forth. Very directly, it is a factor. It’s a little bit unclear from the science how much chronic stress is contributing to multiple sclerosis versus other genetic or environmental factors? Even aside from that, you have to be a strong person to do all the things that you need to do to take care of yourself. To eat a healthy diet to exercise regularly, even to comply with a medication regimen, to show up to all of your appointments and get your MRI scans and do everything that you need to do. Life is complex enough and to have a chronic disease makes it even more complex and you really have to be mentally strong to deal with all of that. You’re right in medicine that we don’t dedicate a lot of resources to that but we have other people to help us. We have counselors, we can make referrals, give us a little bit of extra time and attention to those areas.

Meditation and mindfulness, you cover that in the book as well, right? You talk about mindfulness.

I do. I talk about managing stress and to ground yourself, but that’s very valuable for a lot of people.

PR Brandon | Developing Resilience

Resilience in the Face of Multiple Sclerosis

The visualization component of the healing process or the process of turning around some physical challenges that people are having medically, do you believe that visualization is a helpful tool?

It’s a helpful tool in that it’s relaxing. It will give you that optimistic attitude and that can only be good for you.

There are a number of people out there that talk about being able to turn around some pretty serious physical injuries through the visualization process. I don’t know if it’s something that you’ve had any experience with or seeing good results from, but is it more than something that can’t hurt, in your opinion?

I don’t think it’s going to cure everything, but I don’t think it can hurt. If it gives you a positive mindset and makes you more vigilant about other things that you could do then it’s a good thing. I wouldn’t say that I’ve seen anything extraordinary for people who do this, but it’s not necessarily a very common thing that people do on a regular basis.

When it comes to resilience, it’s important for me to have rituals that help me to take better care of myself like being kind to myself and all the things that I know will work short and long-term for me. What’s a ritual or some of the rituals that you are engaged in for yourself and how do you see that contributing to your ability to do more of what you want? You’ve got a full medical practice, but you also have this passion for writing books and reaching people in a different way.

One thing that I do is at the end of every day after my kids are asleep, I try to take a few minutes instead of moving onto the second phase of my day doing whatever chores I need to do. I try to take at least five minutes to take a break and separate the two sections of the day and relax and sometimes do mindfulness meditation also. The other thing that I do is once a day I take a look at my electronic calendar and not just about what I want to do now, but also what are my long-term goals? What am I trying to do this month overall and what is going to sustain me through the month? Maybe this month, I can get a little bit more exercise or spend a little bit more time with my wife or kids or do meditation more regularly, as an example. I try to do that on a routine basis so I don’t forget it.

Do you calendar pretty much all those things? Are you wanting to put your meditation time on a calendar?

I don’t put the meditation time on a calendar. I try to do that at a set time like after the kids are asleep

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I find that I have time for everything that I can put on a calendar these days. It’s probably more of a time management tool or priority management tool than anything else. It really helps me at a point where I used to calendar almost nothing. I didn’t want to live by a calendar. It was restrictive. It would restrict my freedom somehow or my creativity. These days, it is helpful. I find that the things that we want to ritualize so that we can eventually habitualize those things that are good for us when they’re on the calendar, I do them. When they’re not on the calendar, I might do them, but I also might forget about them because there are many other competing things going on in our world. The time for waking is an important time in our lives every day and we’re lucky because it’s a new beginning. We’re planting a seed with those early things that we do first thing in the morning. What’s the ritual that you do upon waking? Do you have one that you do consistently?

Unfortunately, I have to say that my mornings are quite a commotion on the weekdays. I generally eat and shave in the car on the way to work, sadly. On the weekends, if I’m not working, I take a little time and make some breakfast, I make some coffee, I spend a little time with my kids off while my wife is sleeping and I do get some quality time there.

You’re a young guy and you’ve done a lot in your life and you still have that very youthful appearance. I know I took myself for granted for a long time. I’m not making this assessment of you, but I say it’s early morning and eating in the car or shaving, I never shaved in the car, but eating in the car, I’ve done it many times. We absolutely can put ourselves, and I want to say last, but we’ll put other things or make other things a priority. For somebody like you, if you’re going to give the advice to you or some version of you and it says, five days out of the week that you’re heading to the office and you’re eating in the car, you’re shaving in the car and you’re taking on so many things. What small change could you make to that to your own schedule if you are not you, but you’re giving that advice to someone else? What would you say to them that they could do to create a new ritual so that maybe they had a little more time for themselves or a little more peace and quiet or a better diet even to begin the day?

Sometimes you have to program in creative solutions. To give an example of myself, one thing that I wanted to do for a long time was to actually get a treadmill desk at work. I had used a standing desk for years and there are all kinds of benefits to standing up and getting that low-level exercise throughout the day is very beneficial. That’s a creative solution without taking any extra time to get a little bit more exercise. Some other thing that I do is I try to get to work a little bit early than necessary. Take a little bit of time to slow down and plan out my day and not be in such a rush at the very start of my day.

For you, part of the creative solution there, the creative opportunity is to be in the office a little early so then you can maybe ground and slow down before you have to speed up, is that right?

Yes. Generally, I’m not in a rush to see my first patient because I’m there long before and I have plenty of time to review my calendar, review the charge and feel I’m ready to face the day once the first patient is there.

I know that if I were giving advice to someone like you, I’d probably say, “Is there a way to go to sleep a half hour early?” I know this is always a challenge for most of us especially when the kids go to bed, you read them a story and now it’s after bedtime. It’s the first time of the day where it might be you time or you and your wife to actually look at each other, have an adult conversation and now you’re first going to unwind only to find that it’s 45 minutes later we ought to be in bed and getting ready to go to sleep. If it’s possible to go to bed a half-hour earlier so you can wake up a half-hour earlier and potentially that breakfast can be had at your table before you get in the car. Those things can happen earlier.

I’m always curious about the little changes and even as you were making reference to my story from the book or from the TED Talk, that’s really our concept of what pivoting looks like. That pivoting is about making small changes because we’re convinced that we have to do something drastic, like quit our job or move someplace or any of the other big investment types of changes. It brings up a lot of fear anytime you feel you’re pushing all your chips into the table. You talk about the triggering of our medulla to feel where our lives are at risk, that’ll stop us often. The antidote to that, if you will, I find is to chunk it down into what’s the tiniest little step? What’s the tiniest little domino that might start things on a different trajectory?

Waking is a big deal and what you do when you wake. My ritual has been the same now for more than ten years. Sometimes I feel it can seem trite even because it’s so simple. It’s so basic and yet I’ve found that it not only has paid great dividends for me personally but a lot of people who still write to us and on Facebook or in other communities, let us know that it works is the first words you say upon waking. What are the first words that come out of your mouth? For some of us, it’s like, “I’m late.” They pick up their phone right away and the first message that they see is the thing that triggers their mind going in a certain direction.

I keep my phone far away. I don’t even bring it upstairs anymore. I keep it downstairs plugged in. I turned it to grayscale. It was another little small change I made. I got rid of the color and I can always bring it back. It takes some getting used to, but it’s made my phone a lot less attractive in grayscale mode. I don’t turn that phone on usually until after I’ve eaten something or I’ve had something to drink and that’s a concoction or a green drink. I will look at my phone after I’ve put something in my body. The words that come out of my mouth, I feel they’re the first seeds of the day. Those words are, I love my life. They’re simple but yet really powerful words. I get to ask you this, Brandon, do you love your life? 

PR Brandon | Developing Resilience

Developing Resilience: People are incredibly resilient, and they find a way to have a good a happy life.

 

I do. I love life. There are some difficult parts but I really love my life. You reminded me of something when I was a medical student, I was doing my surgery rotation and it was a brutal rotation. We were up at 4:30 AM and worked long hours and doing frequent calls. One of the guys who was rotating with us whenever we were going for lunch, he would say, “Let’s eat some delicious food.” I remember food tasted better after he said that somehow. Having that attitude, I do think it makes a big difference. I’ll work on getting to sleep earlier. That’s definitely good advice.

Let me know how it’s working for you.

I will for sure.

I have enjoyed this conversation a lot and you can find more about what Dr. Beaber is doing. Brandon, as I called him, is such a good guy. I want to put out his website, CalorieDense.com, is that correct?

I don’t actively manage that website. That’s a website on nutrition. If you want to check me out, you can follow me on Twitter @Brandon_Beaber or you can search my name on YouTube. I make videos about multiple sclerosis. They are a little more technical, but if you’re interested, check it out. You could certainly check out my book, Resilience in the Face of Multiple Sclerosis on Amazon and other booksellers.

Thank you for filling in that blank for me and for our community. We love to get your comments. I’d love to find out if you’ve got questions that you would have asked if you were in my shoes. I’m coming to that now but there are so many places we could’ve gone with this interview. Anything that you would’ve asked Dr. Beaber, please feel free at AdamMarkel.com/podcasts. Leave a comment. Let us know what you thought about the conversation. If there were questions you would’ve wanted to ask him, who knows, maybe we can collect those questions and have a part two. You never know. That would be fun. There are many things yet to discuss and I’ve enjoyed the time together, Brandon. Thank you so much.

Thank you for having me on, Adam.

For everybody else, I’ll say ciao for now. Remember tomorrow, do the same thing. Wake up and think about the first thing that you want to put into the soil of your mind. What thought and what words do you want to express out in the universe? I will remember the story of you and medical school and that friend of yours saying, “Let’s get some delicious food.” I’m going to get some delicious food.

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About Dr. Brandon Beaber

PR Brandon | Developing ResilienceDr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles).

He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.