In this episode, we discuss:
- What is the gut–brain connection?
- How stress and shame can cause gut inflammation and sabotage your health
- How problems with the gut can often present themselves in the form of depression, anxiety, and other mental and behavioral disorders
- What metaphysical meals are and how that mindset can help you build parasympathetic resilience
- The importance of self-compassion
- How you can heal dysfunction using somatic practices such as forest bathing
- Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel by Dr. Will Cole
- Dr. Will Cole’s website
- Articles by Chris on the gut–brain axis
- Learn more about the Adapt Naturals Core Plus bundle, or take our quiz to see which individual products best suit your needs
- If you’d like to ask a question for Chris to answer in a future episode, submit it here
- Follow Chris on Twitter, Instagram, or Facebook
- Get your free LMNT Recharge Sample Pack when you purchase any LMNT product at Kresser.co/lmnt
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Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. If you’ve been listening to the show for any length of time, you’ve probably heard me talk about the gut–brain axis, which is the bidirectional connection between the gut and the brain, where what happens in the gut affects the brain and what happens in the brain and the nervous system directly affects the gut, which is actually part of the nervous system in the modern way of looking at it.
I’m really excited to welcome Dr. Will Cole as my guest on this show because he has written a book on this topic called Gut Feelings, which explores this connection in great detail. I think it’s a very important topic for our time because almost everyone that I know either personally or that I’ve treated as a patient, students in my training programs, etc., is dealing with some level of nervous system dysregulation, whether that’s chronic stress, anxiety, depression, sleep deprivation, or just the impact of living in our busy, modern, industrialized world. I would also say that the vast majority of people [who] I’ve worked with have some level of gut dysfunction. It may not be a serious condition, but it might be some dysbiosis or disruption of the gut microbiome, [or] just the gut not functioning as smoothly as it could be. It turns out [that] there’s a very clear explanation for this connection, and research over the past 20 to 30 years has shed a lot of light on what drives this gut–brain axis dysfunction and, most importantly, what we can do about it.
There are a lot of simple and practical steps that we can take to improve the function of the gut–brain axis, improve our health, and extend our health span. Dr. Cole has written an amazing book with lots of actionable advice and insight. He approaches the topic with a lot of heart, and I really appreciate that about him. It’s not too reductionist, which sometimes discussions about the gut–brain axis can be. There’s a lot of discussion about how our relationship with ourselves and others and our connection with nature and the world around us contribute to these relationships between the gut and the brain and the nervous system. I think you’re going to get a lot out of this podcast. I really enjoyed the conversation, and I really enjoyed the book, so I can’t wait to share this with you. Let’s dive in.
Chris Kresser: Dr. Will Cole, always a pleasure to speak with you.
Will Cole: Chris freaking Kresser. My man crush. Where have you been all my life? It’s been too long.
Chris Kresser: It has been too long. We met in person a long time ago, and I feel like [we] haven’t really seen each other. We’ve just been having a Zoom relationship since then.
Will Cole: It’s come to catching up on podcasts. This is where we’re at in life.
Chris Kresser: It’s very disappointing. So, I’m excited about your new book, Gut Feelings. We share an interest in the gut–brain axis and have for many years, and I’m so excited that you wrote a book about it. I can’t wait to dive in and talk about that. But first of all, why did you write this book?
Will Cole: So, as with anything that I write about, it’s born out of my day job. My passion for my patients. Doing telehealth for as long as I have for the past 13 years, the books are always conversations that I have on a daily, sometimes hourly, basis. And when you have a conversation enough, or conversations, [as] there [are] lots of topics that I’m talking about in Gut Feelings, I just thought, “Okay, when’s the time to have this conversation with people other than my patients?” Because I almost see the patients as canaries in the coal mine many times for culture, because they are going through things, and I’m thinking, “Okay, if I’m talking to these couple of hundreds of thousands of people over the course of 13 years, they’re just the tip of the iceberg of what’s going on in society.” I feel like both the gut and the feelings are a really important thing to talk about, because it’s really a conversation about mental health. And not just mental health, but mental health plus people’s relationship with food, and people’s relationship with their body, and relationships with themselves.
I feel like the [destigmatization] of mental health in our culture today [and] the improvements that we’ve made culturally around normalizing mental health care is a great thing. But in many ways, I feel like it is an incomplete conversation because we sort of relegate mental health as this abstract thing that is separate from physical health. But as we both know, what the research is showing is that there’s a lot of physiological components to mental health problems. Why aren’t we talking about that in a mainstream way? And then obviously, the feeling side of Gut Feelings[is] the research of how things like chronic stress and trauma and intergenerational trauma and things like shame, these more nebulous things, impact our physical health. People [who] maybe don’t even see themselves as having a mental health issue. They may have an autoimmune problem, or they have chronic fatigue syndrome, or they have some sort of digestive issue. These mental, emotional, and spiritual things. They’ve maybe cleaned up their diet, [and] they’re taking the right supplements, but they don’t realize that these feeling things are actually manifesting on a cellular level. It’s a both/and conversation, not an either/or, that I think is really important to talk about. And this is my time to talk about it.
Chris Kresser: Great. So many places we could go there. I’ve been struck, in my experience treating patients, and also just being a resource for friends and family members and random people that somehow guess my email address and write to ask me questions. You know how it goes.
Will Cole: I know. I want to talk about that real[ly] fast because I’m always amazed by, “How did you find my email?”
Chris Kresser: Don’t worry, I’m not going to share yours on the podcast. I’m struck by the dual nature of what you said there. On [the] one hand, we’ve had sayings in our language like, “I’ve got a gut feeling,” or “I have butterflies in my stomach.” People with absolutely no medical training, just growing up in our culture, I think, have some awareness of the gut–brain connection and gut–feeling connection, even if they’ve never really consciously thought about it. Or somebody’s going out to speak publicly for the first time, [and] they all of a sudden have cramps in their stomach. Most people have had a pretty direct experience of this, and yet, in my experience as a clinician, people would come in with mental health or behavioral health issues, or I would get calls from family members or friends asking about their son or daughter or maybe themselves, and the very last thing on their mind was that it could have something to do with a gut issue or a nutrient deficiency or any number of physiological issues. It was honestly the last thing that they would think about, despite this awareness on the one hand that there is a connection there. I’ve always found that to be pretty interesting.
Will Cole: Yeah, it’s so true. And hopefully, [through] conversations like this and through the book, we can shed more light on this because we’re just scratching the surface. I think, “Okay, we’re seeing this clinically, and we are talking about these things on a podcast.” But we’re, in many ways, in our own little bubble of people that are really savvy and erudite about these topics. Then you think of all the family members and loved ones we have [who] have no idea. They just think, “This is my anxiety, or this is my autoimmune condition.” And that’s sort of it. They don’t realize that, in the overwhelming majority of cases, we wield a lot of agency over these issues to move the needle in the positive direction. In many ways, significantly so.
Chris Kresser: I love that you just use the word “erudite” in passing. I really have an appreciation for that. Let’s back up because we could assume that most people listening know something about the gut–brain axis if they’ve been listening to my podcast for any length of time. I’ve done at least 10 episodes on it over the years. But we don’t know. This could be the first episode they’ve ever listened to on this podcast. So let’s start with, “What is the gut–brain axis?” What do we know about the connection between the gut and brain and how that influences everything you’re talking about in the book? And then maybe we could talk a little bit about depression and how our view of depression has changed, given our understanding of the gut–brain axis over the past, let’s say, 10 [or] 20 years.
Will Cole: Sure. I mean, you [were] such a pioneer in disseminating this information and democratizing this information years and years ago. So, like you said, I think your listeners are very savvy. But what I want to maybe recap for people [who] are newer to this, real[ly] quickly, is [that] your gut and brain are formed from the same fetal tissue. When babies are growing in their mother’s womb, [the gut and brain are] grown from [the] same tissue, and they are inextricably linked—woven together for the rest of our life through what’s known as the gut–brain axis or the connection between the two. And there [are] many connections there, from a nervous system standpoint to a crosstalk between the microbiome of the trillions of bacteria in our gut and our brain. People may have heard this, but 95 percent of serotonin, our happy neurotransmitters, [are] made in the gut [and] stored in the gut. About 50 percent of dopamine is made in the gut [and] stored in the gut. And we know that the bacteria influence neurotransmitter expression. Different levels of dysbiosis in the microbiome or imbalances in the microbiome [and] lower levels of these beneficial colony-forming units, like different colonies of Lactobacillus and Bifidobacterium, are associated with anxiety and depression. Some of these studies are actually, especially the ones that I know about, [showing] different neurological autoimmune issues as a causative factor, meaning these bacteria actually are what’s triggering these health problems.
We have to understand that these potential autoimmune triggers, these different opportunistic and pathogenic bacteria, should be looked at as, “How is it impacting how our brain works and how our mood works? How are neurotransmitters expressed in the body, and then how [are] inflammation levels in the immune systems modulated?” We know leaky gut syndrome is not news for most people [who] listen, but these things passing through the gut that shouldn’t be able to pass through the gut are impacting things, systemically. As someone [who] can have leaky gut syndrome, they can have what’s known as leaky brain syndrome, or increased blood–brain barrier permeability, that we measure [with] labs in Functional Medicine [and] that we can see have these neuroinflammatory components to it. It’s all linked to having this gut-centric component to these neuroinflammatory problems.
So that’s sort of just the beginning of it. Then you look at the autonomic nervous system, and the vagus nerve specifically, and most of these people [who] have this dysbiosis, some intestinal permeability, some systemic inflammation, they have autonomic nervous system dysfunction and they have poor vagal tone. And this vagus nerve is the largest cranial nerve, and it’s responsible for regulating the parasympathetic aspect of our nervous system, the resting [and] digesting aspect of our nervous system, and [the] sympathetic aspect of the nervous system, that fight-or-flight, stressed, inflamed aspect of the nervous system, which is important, too. Both are important. The problem is one is just so overactive all the time. And these people, I mean, that’s, to varying degrees, the vast majority of society right now.
Chris Kresser: I was going to say, by these people, you mean everyone.
Will Cole: Yeah. You mean all of us, on a spectrum. Yeah, for sure.
Chris Kresser: Almost everybody. Yeah, for sure.
Will Cole: Yeah. So that’s the state of affairs right now. You really can’t have a conversation around mental health issues, just like you can’t have a conversation around autoimmunity, without looking at the gut–feeling conversation that I think is important here.
Chris Kresser: Yeah, I couldn’t agree more. Let’s talk a little bit about inflammation, because I’ve talked about and written in the past about the inflammatory cytokine model of depression, which you’ve talked and written about a lot, as well, and the research is really pointing in this direction. I think we both agree that we can’t be too reductionistic about the cause of depression because it’s multifactorial, and there are multiple causes that will vary from person to person, but I think it’s pretty clear by now. I’m actually, in a month or two, going to have Dr. Joanna Moncrieff on the show, which I’m really excited about because she’s been instrumental in debunking this myth that depression is caused by a deficiency of serotonin or a chemical imbalance in the brain. What a lot of the research is pointing to now is that it’s caused by inflammation, and particularly inflammation that starts in the gut and travels through the bloodstream. I know you talk about this in the book. How does inflammation impact our brain and our mood, not just in terms of depression, but other mental and behavioral disorders [like attention-deficit/hyperactivity disorder] (ADHD), autism spectrum disorders, anxiety, obsessive-compulsive disorder, pretty much every mental and behavioral condition that we know of?
Will Cole: Yeah, it’s so true. I mean, we were talking about it over 10 years ago in our space, but it’s just now hitting the mainstream. And still, we have so far to go.
Chris Kresser: I do want to point out that when we were talking about it 10 years ago, we got a lot of eye rolls and a lot of incredulous stares. And now it’s a hot topic in scientific literature. So I’m just going to pat myself on the back here and then pat you on the back over there.
Will Cole: I’ll pat you on the back, Chris Kresser. Look, we weren’t just thinking this up. It wasn’t some random woo-woo thing that we thought. Researchers were talking about this. We were just saying, “Look at what these researchers are talking about.” We were just the ones publicly talking about it. I remember getting crazy troll stuff early on in social media. Even at the telehealth clinic, we would get phone calls, and [they] would say, “How dare you mislead people [by] saying inflammation?” I’m like, “All right, then take it up with the researcher because I’m just talking about the research.” And, yeah, the cytokine model of cognitive function. How [is] inflammation or cytokines impacting how our brain works? How is inflammation impacting mental health?
As you said, it’s multifaceted. Every case is going to be different, as far as the configuration of the pieces of the puzzle. Is it situational solely? Is the situational driving inflammation? Or is it the other way around? That’s sort of the gut–feeling, upstream-downstream conversation I’m having in the book. For some people, it’s the feeling stuff that’s driving the inflammation. For some people, it’s the gut things, the physiological things, that are driving the inflammation. Inflammation is the commonality, right? And my job, your job, our job in Functional Medicine is saying, “What’s driving the inflammation?” There’s something dysregulating the immune system that’s causing that. It’s impacting how the brain is functioning, it’s impacting the way that neurotransmitters are expressed, it’s impacting how certain parts of the brain are firing or not firing enough, and it’s causing a cascade of problems in the body. How many cases can we, you and I both, think of over the years where they thought that [it] was just them? That [it] was just their chemical imbalance, it was just their serotonin deficiency, and it was just genetic. Many times, what you would hear [was], “It runs in my family, and there’s nothing I can do with it.” And of course, there [are] genetic components to these things. But why is that gene being expressed in that way? Oftentimes, inflammation is the thing that’s really dysregulating the way that the body is expressing itself on the methylation side of things or whatever you’re talking about.
So it is a major facet of my work to look at the inflammation, see how it’s impacting the brain and other parts of the body, and then ultimately uncover for the individual what the pieces [are] to the puzzle [and] what’s driving up and triggering that inflammation. The gut and the feeling side of it, meaning the physiological and the psychological, are normally a both/and thing. That’s one of the reasons why at an intake for a patient, we ask a lot of questions about their childhood and a lot of questions about, “Was there sexual abuse in your childhood? Was there physical abuse? Was there alcohol abuse in the home growing up? Was there any other sort of trauma in [your] life?” We know from the studies, again, that the higher [their adverse childhood experiences] (ACE) score is, [the] more likely [they are] to have autoimmune issues triggered later on in life. Conversely, we know that the physiological stuff we mentioned [like] intestinal permeability and dysbiosis and these other stealth infections like mold toxicity also can impact things like anxiety and depression. So again, to repeat myself, it has to be a both/and conversation. But inflammation is the commonality, right? It’s the tip of the iceberg.
Chris Kresser: Yeah, let’s linger on this for a second, because there’s a lot of guilt and shame surrounding depression and other mental health disorders. You talk a lot about this in the book, and you’ve even coined the term “shameflammation.”
There’s, I think, a double-edged sword here. Those angry phone calls that you got to the clinic, I think, were part of people [being] told for a long time, “This is a disease in my brain, this is genetic, it’s an imbalance of chemicals, [and] there’s nothing I can do about it except for take this drug that is supposed to adjust the chemicals.” And in a way, that was really liberating for people. It took away some of the shame that they might have felt otherwise for feeling depressed, because it’s like, “Hey, I just have this chemical imbalance in my brain and it’s a medical disorder. I’ll take the drug, it will make that better, and I’ll get on with my life.” Then if someone comes along and says, “Well, actually, the research doesn’t support that that’s the cause of depression,” but there was no alternative offered, it was right back into the shame pit of, “Oh, so you’re telling me this is my fault. It’s all my fault that I’m depressed.” No, no, that’s not at all what we’re saying. We’re saying that there may be other causes that are driving it, and we should figure out what those are. In fact, many of those causes are things that you can influence. They’re not your fault. It’s not your fault that you weren’t breastfed when you were an infant, [and] that could have affected the development of your gut microbiota. It’s probably not your fault that you ate junk food growing up as a kid if that’s what your parents fed you, [or] they gave you antibiotics for acne. And everyone’s trying to do their best, generally, right? To me, it is actually empowering and liberating when people learn that depression and other mental health disorders can have physiological roots that can be identified through testing and addressed, because it gives them something to do [about it and] some actions to take.
Will Cole: One hundred percent. It’s quite the opposite. People feel judged, or they feel indicted or [that] we’re shaming them. Like you said, it’s quite the opposite. Actually, a large part of it is things that were done to you or things that you had no control over, because it happened early on in your life or you didn’t know it was happening as an adult. I always tell my patients [that] you have to know what you’re dealing with [in order] to do something about it. This is really a message of empowerment, of self-advocacy, [and] of agency over your health; not of shame and pointing the finger, at all. Like you said, “Here’s a baseline. Now let’s do something about it.” Look, you and I, we’re not anti-medication. If that’s a tool within your toolbox, wonderful. What I’m talking about, [and] what you and I see so often over the years, is that people [who] are doing everything their doctor is telling them to do and they’re still in the dark space. They’re still struggling. There’s still so much medical gaslighting going on, and these people are largely very compliant people [who] are doing things their traditional doctor is telling them to do. At that point, if they’re taking every medication their doctor is telling [them] to, or have tried it and they’re still in a bad place, what are those people supposed to do? These sort of “treatment-resistant people,” what are they supposed to do? A huge percentage of people fall under that category, where maybe they had a honeymoon period with medication, but it’s really not [working]. Maybe it takes the edge off. I hear that a lot. Or the people [whom] it doesn’t do anything for, or it [makes] them worse, [or] they had some side effects from the medication. What are they supposed to do? That’s who we’re talking about. Those are the people we need to do better for as a society. I say “these people,” but the reality is [that] it’s a big chunk of our population. And that’s where I feel like these areas that maybe they don’t want to go to in a more conventional conversation, it’s important to deal with the gaping wound we have in the form of both autoimmune issues and mental health issues.
With so much focus on what, when, and how to eat, the emotional component of eating tends to get left behind. Tune into this episode of Revolution Health Radio to learn why true health isn’t just about what you eat but how you feel. #chriskresser #willcole
Chris Kresser: Let’s talk a little bit about stress and how stress impacts the autonomic nervous system and the gut, which is, of course, an extension or part of the nervous system, depending on how you look at it. As we’ve both said, stress is inescapable for most of us, and how it impacts us, how much of it we experience, [and] how we process it will vary from person to person. But for the vast majority of us living in the modern, industrialized world, it’s just a fact of life to some extent or another. So first, let’s just review a little bit about how that does impact the gut and our mental health. Then let’s talk about some of the strategies you explore in your book [and] some of the somatic practices—forest bathing, food peace, and metaphysical meals. I love all that, and I think it’s a great way for people to get a sense of how seemingly small changes, collectively when you add them together, can make a big impact.
Will Cole: In the book, I really boiled down what the top tools [are] within the toolbox. What am I seeing being needle movers for my patients, on both the gut and feelings part of it? There’s a 21-day protocol in the book. As I say clearly in the book, I’m a clinician, [and] I know you’re not going to be dealing with healing 100 percent [of] intergenerational trauma in 21 days. But what I wanted to show them is, look, every day, like you said, there’s something I can do to nourish both my gut and my feelings. There’s something I could do every day to start to get my head a little bit more above that proverbial water. And the more you get your head above that proverbial water, the more you’re going to have more resilience and more bandwidth to do more good things that love you back and nourish you and continue your healing journey.
So the question about stress, we know stress isn’t good for our health because somatically we know this, [and] intuitively we know this. But just because something’s common doesn’t make it normal. The human body is just not used to this sort of low-grade or chronic stressing all the time. We all have different resilience capacities. We all have other variables. Some people can handle a certain level of threat [and] stress every day, and it’s not the best, most ideal thing for the human body, but they’re not noticing anything massively expressing and showing up in their health. That’s sort of the bucket analogy that I talk to my patients about. Some people have big buckets, some people have smaller buckets, and that’s their genetic tolerance for stressors. You can’t change your bucket.
Chris Kresser: It also depends what else you’re putting in the bucket, too. If you get exposed to an infection that’s draining your bucket, then all of a sudden, the stress that you were able to tolerate before, which is no problem for you, becomes a problem. There’s lots that goes in and out of that bucket.
Will Cole: One hundred percent. That’s why many people will say, “Oh, I was fine, and then I had this viral infection, and it set it off the edge.” Well, was the virus the only thing in that bucket? Probably not. Obviously, the last few years, COVID[-19], for some people, triggered a whole host of different autoimmune issues. Was it just COVID[-19]? Probably not. There’s a whole host of things going on here, and it dysregulated an already very fragile, not so resilient system, in a lot of cases I’ve seen. The point is, like you said, it’s multifactorial, and there’s a confluence of factors that need to be addressed. But chronic stress is one of those things that contributes to that bucket overflow, if you’re taking it from that tipping point analogy of [your] ability to handle stressors. When we look at different methylation gene variants, or different HLA gene variants, our patients tend to have those smaller buckets, so to speak, and they tend to overflow a little bit easier [and] are a little more sensitive or having reactions [and] hypervigilant responses. We can’t change our buckets, but we can change what we put in it. And both the physiological and psychological, the gut and the feelings, can contribute to that bucket tipping point [or] that bucket overflow.
So, chronic stress is part of it, and what some of these action items that I have [are focused on is], “What’s the source of your stressor?” For many patients I’ve talked to over the years, it’s their job, it’s family dynamics, it’s stressing about their health, like they don’t feel well and that’s stressful, or trying to figure out answers about their health [and] that is stressful. So, really implementing tools there to create healthy boundaries. Sometimes if it’s around [your] job or Dr. Google and incessantly googling things that stress [you] out and cause obsession, [then] you need healthy boundaries with your phone. You need to block yourself from falling down that rabbit hole of creating more shame and obsession around your health or around whatever you’re talking about. Or it’s your emails at night, and you never turn off, and you’re constantly looking at blue light and contributing to sympathetic overactivation. There’s a lot of practices around stress that I talk about in the book for people to create acts of stillness. [That’s] how I describe it in the book. How do you create acts of stillness? Why are we doing this? Support of the parasympathetic, because that’s going to help inflammation to calm down [and] cortisol to come down. Because, what’s cortisol? It’s an endogenous immunosuppressant. So your body is saying, “I need to bring down that inflammation in the form of cortisol.” And it’s just an unsustainable sympathetic situation because, at the end of the day, your body’s going to break, proverbially. It’s going to break in the form of health symptoms, and it’s going to continue to accumulate until you deal with the whispers and then the shouts, and then the screams that your body’s trying to say, “This is unsustainable for me.”
So yeah, that’s just scratching the surface around the topic of chronic stress. But these are big topics, right? When talking about stress and trauma and shame, it is nebulous in the way that it’s prescriptive for me to say, “Well, these foods are the most likely to mess up your gut. Have less of those. Increase these foods that love you back. They’re going to help to support your gut health.” And we talk about it in the book. But these bigger topics [are what] I wanted to tackle in the book, [where] you can’t really just say, “Don’t stress or don’t have shame or don’t have trauma.” Then they stress about not stressing. I really wanted to talk about what the science [says] around dealing with these bigger topics, these feeling topics. I really think it’s an important part of the conversation.
Chris Kresser: Yeah, I want to spend a little time here. And I’m curious about your experience, but in my experience as a clinician, my patients, and I think this is probably true for you, are pretty motivated, generally. It’s not their first rodeo. They’ve usually seen a bunch of other clinicians, and they’ve got complex chronic health problems that are really interfering with their life, and they want to do something about it and get better. If I tell them to follow a certain diet, they’ll generally follow that certain diet. If I tell them to take some supplements, they’ll typically take those supplements. If I tell them to do some lab tests, they’ll typically do those lab tests. If I make suggestions to manage their stress, well, maybe not. It’s much more of an uphill battle, and people tend to struggle with that a lot more. I think there are a lot of reasons for that.
Number one, you can start a new diet and take new supplements and take lab tests without really changing much about your life and how you relate to yourself, how you relate to other people, [and] how you process the world around you. You don’t need to change any of that to do a new diet and take supplements. But managing your stress really does require that. Let’s say you’ve set some time aside to do 10 minutes of meditation, or to even just lie down and rest. If you’ve got a story that your self-worth is equal to what you accomplish in the world, then you’re probably not going to set that time aside to rest. You’re going to keep working, or you’re going to put energy into something else that feels more productive. So it’s hard. These are big changes that we’re asking of people. And yet, often in my experience, for those kinds of people who are doing everything else right, that’s going to be the biggest return on investment. Even using that term is funny in this context. That’s going to move the needle, as you said earlier, more than that final five or 10 percent of diet optimization, or that final tweak of their supplement routine. Just sitting on a cushion for 10 minutes or [lying] down and relaxing for 10 minutes would have a bigger impact. But it’s the hardest thing for people to do, often.
Will Cole: Yeah, totally. Especially the people [who] are naturally, maybe you could say naturally, what came first, the chicken or the egg, but they are more of that type A personality. Those people also have this hyperactivation of their sympathetic thing, where there’s [typically] an aversion to [any acts of stillness], and it’s very uncomfortable to go there. The stillness can be scary for people [who have] constant mind chatter going on and their nervous system is used to going at a certain pace. There can be a lot of ruminating thoughts and a lot of incessant thoughts, [and] any quieting of that sort of distraction that they’re used to, numbing themselves with the distraction of going and educating and going and reading more or going to listen to another podcast or doing the next thing or scrolling FOMO-inducing content on social media, anything that’s going to go inward can be very scary. But those dark corners are typically where the healing resides. And I wanted to go into the dark corners that I see are the potential linchpins for people.
It’s like, “What are the roadblocks that I see [in] these complex cases? Where are they at?” You mentioned the term metaphysical meals. That’s what I called it in the book because there’s the physical meals, or the gut, and [then there’s] the feelings. The gut side is the food, the nourishing. I talk about [the Gut and Psychology Syndrome] (GAPS) protocol and the research around that. [On] the feeling side of it, what [does] the breakfast, lunch, and dinner look like, on that side of things? Almost like, use these acts of stillness as these metaphysical meals, and treat them as such. Because our patient base oftentimes, like you said, [are] super compliant with the food protocol, [and] super compliant with the supplement and the biohacking and all the things they need to do. But on the feeling side, I find that if you tell them, “Okay, if you treat this like a meal or treat this like going to the gym, and being consistent with this [as a practice] just as much as the gut stuff, that’s where you’re going to start to flex that mindfulness muscle and gain that parasympathetic resilience that I want. And it can be a game changer.
I think that you and I both probably could think of countless cases when we have the patients and clients [who] deal with both sides of that coin. They’re the quickest to heal and the quickest to move past that plateau. So I know that there’s such a need for this because there’s a sea of people. Again, there’s so much medical gaslighting around these topics and delegitimization. In some ways, because this vastly affects women versus men, [it’s] a systemic delegitimization around these topics. And it’s so important.
Chris Kresser: Absolutely. Let’s talk about some of the small changes that people can make. For me, and I think you’ll agree, that’s important. We just talked about how it’s often really difficult for people to make these kinds of changes. And in my experience, just from a straight up understanding of behavior change, if you start out and say, “Oh, I want to begin a meditation practice. I’m going to start meditating an hour a day, every day,” there’s [about] 1 percent of people that are going to be able to make that work. The good news is that it is really true that big changes are often the result of a series of small changes. I found that to be particularly the case with stress management and these kinds of things that we’re talking about. So what are the things, in your experience, that move the needle [and] you tend to prescribe for your patients, that most people can incorporate into their life, no matter what is going on [or] how busy they are, that will actually make a subjective difference for them?
Will Cole: There’s a 21-day protocol. There’s a gut action item and a feeling action item every day, so it’s 42 total practices that I compiled [that] are the most effective that I’ve seen in my telehealth clinic. On one of the days, there’s [a] self-compassion practice. You could do one a day and experiment with it. But my hope [is that] at the end of the 21 days, you will see the ones that resonate with you the most and you’ll stay consistent with, and they will be sustainable tools within your toolbox, because these things are going to take time to untangle and time to calm down depending on how severe your case is, whether it’s a mental health issue or an autoimmune issue.
Self-compassion is one that comes to mind. When [they did] research around public speaking and math, because I guess those are two stressful things for people, and people [who] had the highest self-compassion score had the lowest inflammation levels. And “self-compassion” is such an ambiguous term. But people [who] had the most grace and the most lightness for themselves, the most inner self-compassion for themselves, [tended] to be the most resilient and have the lowest inflammation levels. That doesn’t come naturally for a lot of people. [For] a lot of people, there’s a lot of shame, there’s a lot of obsession, there’s a lot of dread, [and] there’s a lot of overwhelm about these things. So I give several self-compassion practices that have been studied. One is just talking to yourself like you would a friend. If you had a tough day at work, or if you had whatever, a bad day, and you are great at giving advice but you’re not good at taking it yourself, well, one way to start to cultivate and flex that self-compassion muscle is to do this inner dialogue to yourself and sort of make friends with yourself. I find that [with] a lot of our patients over the years, there is this inner resistance and a lot of shame and negativity around their body, around foods, around wellness, all of this stuff. So self-compassion practice is really important.
I talk in the book, and I always think about the esoteric level of what’s going on in the form of autoimmunity. We know on a physiological level [that] there’s molecular mimicry going on. The case of mistaken identity. You think of how the researchers even refer to it as the immune system losing recognition of self. And I think that phrase hits home more than just the physical level for many people, of people losing recognition of self. You think of the connection there, [and] what came first? It’s a bit of both, right? When your body is flared up, you lose recognition of self because you don’t know what to believe anymore, and you don’t know what’s working for you and what’s not. Food becomes your enemy, and your body is literally warring against itself. But we know the research about stress and trauma. We know the research around shame and how those things can trigger these problems, too. So self-compassion is huge to gain recognition of self for yourself again.
Chris Kresser: Yeah, I love that. I’m a big fan of Kristin Neff’s work on self-compassion. Actually, one of my teachers in the Zen tradition, Cheri Huber, is a big proponent of this. One of my favorite sayings of hers, which is similar to what you said in the beginning of this portion of the conversation, was, “If we had a friend that treated us like we treat ourselves, we would have gotten rid of that friend a long time ago.”
Will Cole: It’s so true.
Chris Kresser: It’s so true. So, yeah, sometimes it helps to think about how you would respond to a friend or how you would respond to your child, whom you love unconditionally. Often, that dialogue, the words, the tone of voice, everything is so different than the way that we tend to talk to ourselves or that tape that’s often running in our heads.
Will Cole: And we have trillions of cells that are listening to every thought, every word. So it’s huge. And [those are], again, big things to unpack because those neural pathways can be deep, and [we’re] so trained to be in those ruminating negative thought cycles. These practices take time to reprogram your nervous system [and] your limbic system, but it’s well worth it, with time and consistency.
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Chris Kresser: Absolutely. I think it’s always important to point out, as you do, that [it’s] different strokes for different folks. For some people, the starting point may not be sitting on a meditation cushion and staring at the wall in a formal, rigid Zen practice. That might be too big of an ask for someone who has a super-active mind and is hyperstimulated and just needs to take things down a couple of notches. Maybe, for that person, forest bathing is a better option. Or a restorative yoga practice, or tai chi, or Qi Gong, [or some sort of] a movement meditation. [Let’s] talk about some of the other options for creating those moments of stillness that you refer to.
Will Cole: Yeah, it’s such a good point. Everybody’s entry point is going to be different, even on a gut and a feeling side. I’m sure you’ve seen this, too. I want to meet them where they’re at, and that’s sort of the science and art of what we do. Sometimes the physical stuff, like dealing with the GAPS protocol and dealing with the gut–brain axis through nutrition and soups and stews and nourishing things, or supplements to calm neuroinflammation, that’s going to get their head above water enough to be less rattled and overwhelmed by the feeling stuff. Once you get their inflammation levels down from a physiological side, they can then move past that plateau [and be] ready to deal with the feeling stuff. [They] can actually meditate now because [their] nervous system is less dysregulated. Then, for some people, the food stuff is completely overwhelming, and [they] really just need to get out in nature. The research around shinrin-yoku, or forest bathing, [and] the research in Japan and South Korea [on] how to use nature as a medicine [and] using nature as a meditation and taking nature in with all of your senses. Both just from a visual standpoint [and] also the actual essential oils that come in from nature itself [have] a therapeutic benefit shown to help modulate the immune system in a positive way and improve mood in a positive way. It’s multi-factorial, as far as what the sensorial benefits [are] around forest bathing.
It’s definitely different for different people, but all of these practices are helpful. I would say, too, you hear sometimes people will say, “Well, meditation is not for me.” And those are typically the people [who] need it the most, right? They are the people [who] are so much in that fight-or-flight state. And they think, like you said, [there’s] just that classic, one type of meditation. But all of these practices [and] all these metaphysical meals that I’m talking about can be a meditation. Forest bathing is a meditation, but it’s just different than what you’re thinking. Even the more classic breathwork meditations or mindfulness meditation or present moment meditation or a mantra can be uncomfortable, and sometimes people need to start off low and slow. But there’s a reason why it’s called a practice, [and] it’s because it doesn’t necessarily come [naturally] to any of us. There’s the monkey mind in all of us. It’s okay to not be good at things. A lot of these type A, hyper-vigilant people, [if] they’re not good at something, they just want to not go do it because it’s supporting an area of their nervous system that is weak. And that’s why they need to be doing it. It’s like going to the gym once and saying, “The gym didn’t work for me.” You tried meditation once.
Chris Kresser: Yeah, it’s funny, [it’s] like, “I tried to bench press 300 pounds, but I couldn’t even do one rep, so I’m not going to do that anymore.” This is why I am a proponent in general of apps like Headspace and Calm for getting started. When I look back on my history with meditation, I started when I was 17. My dad introduced me to it because he had a nervous breakdown at that point in his life. And to his doctor’s credit, [because] this was [the] early days, [and] meditation was not the household term that it is now, his doctor said, “You’re going to die if you don’t do something to get your stress under control,” and recommended a meditation teacher about half an hour from where we grew up. My dad asked me if I wanted to go, and I was like, “Sure, why not?”
I started with a teacher. I got involved with Zen practice, [and] as some people may know, Zen traditionally has a formal student-teacher relationship. And I’m not saying that you have to have a teacher to learn meditation, but one of the things that can be helpful in having a teacher is that they can disabuse you of some of these misunderstandings about what meditation is supposed to be like. One of those, like you said, was, “I’m supposed to sit down and just have a completely clear mind for the next half hour with no thoughts.” That happens to exactly nobody. Even the most seasoned teachers who had been meditating for 30 [or] 40 years, who in turn had teachers who were famous Zen practitioners, they’re sitting down and thoughts are going through their mind the entire time they’re sitting. They might have moments. Any seasoned meditator will have moments of relative calm and the thought process slowing down. But the real difference is how we’re relating to those thoughts as they’re passing through the mind. And that’s something that anybody can learn to do—to shift that relationship to what’s happening in the mind and cultivate that witness perspective, where we’re not like a pinball in the machine bouncing around, hooking, grabbing onto one thought and hanging onto that like it’s a bumper of the car flying by, and the next car comes by, and we reach out and hang onto that bumper and get dragged through the road. So yeah, I love that you brought that in because I think the number one misconception about meditation is that if you’re having thoughts, you’re not doing it right.
Will Cole: Yeah, exactly. Like you said, how can we create that witness? How can we realize we’re not our thoughts and emotions, but this is our observing presence of them, as Eckhart Tolle says? I think that is just paramount. And I find, to repeat myself, clinically, the patients I see [who are] not the [necessarily] best at it [but are] the most consistent with it, are the ones [who] tend to modulate their immune system, i.e., lower inflammation levels and increase that vagal tone that we need, so much better [and] so much more unimpededly over time, [and] so much more effortlessly. Because they are doing this both/and approach, this gut and feeling approach that I think is just paramount. And again, the entry point can be different for different people, but these are all practices. I talk about different somatic practices in the book, too. Yoga is a somatic practice, and you mentioned these movement medicines. [For] some people, that is a great entry point, [things] like yoga or tai chi or drumming. I give a tapping practice in the book to sort of metabolize that trauma or metabolize that stress in that way.
Chris Kresser: Yeah, it’s great to have these different options in your toolkit, so to speak. For me, I have a pretty consistent sitting meditation practice because I’ve done that for 30 years. And it’s, in some way, like brushing my teeth. There’s nothing special about it. I mean, it’s incredibly special, in one way of looking at it. On the other hand, it’s nothing special. It’s just part of my routine. But then there are times [when] I’m feeling a lot of anxiety or stress in my body, and I feel like I just need to move. In that situation, I might do some tai chi or yoga or even dance, or get outside and take a walk in the fresh air. It’s great to cultivate familiarity with your own internal compass and then have different options to go to, depending on what’s happening.
Will Cole: Yeah, exactly. And intuitively, no, it’s not a failure if you go to something else and pivot. The way that I verbalize it to my patients [and] that I wrote about in the book is exactly what you said, making the mundane a meditation. Making your life a meditation. It’s not this big thing. Sometimes there [are] big meditation classes where it’s a formal thing, where you’re learning the deeper science and art of these ancient traditions that have a lot of exciting science that it talks about. But sometimes it’s making tea. The rich tradition of just tea making and using that as a present moment awareness of grounding yourself. It can be anything that you do. For me, I consult patients online all day long. So how am I making that a meditation? How am I really making the person I’m talking to the only person that’s there, and having their presence, even virtually, be an anchor for me in the present moment? That’s nothing fancy. That’s just being rooted in the present moment and using the present moment as an anchor for us. It doesn’t have to be some deep, esoteric, unattainable thing. It’s just, in many ways, in my opinion, how to live life in a sane way, because the madness of the human mind sometimes can be so dysfunctional. How can we live life in a more sane way? I think that these meditation practices are a way to do that.
Chris Kresser: Absolutely. [I] love the book, Gut Feelings. It’ll be out by the time this podcast goes live. Will, where can people learn more about the book and follow the rest of your work?
Will Cole: Thanks, my friend. DrWillCole.com. We have all the links to the books there. You can buy Gut Feelings on Amazon, Barnes & Noble, [and] Target. Support your independent bookstore, as we all know, if you have one locally. We have a lot of preorder stuff going on around the release of Gut Feelings. I have a three-week mastermind with me and a few psychiatrist colleagues of mine around this topic. And this is not in the book, but at DrWillCole.com, I adapted a questionnaire that we ask patients. I adapted it for online and [created] a quiz, because people like quizzes, to see what the Functional Medicine perspective [is] on the microbiome mind bidirectional relationship and measuring your shameflammation, if you will, and seeing how your gut–feeling connections are. I brought some ACE aspects, like the adverse childhood experience aspects and some other questions that I ask patients, for people to see and maybe have an aha moment of, “Oh, I thought I was alright here, but I have a lot of [issues] to deal with.” You have to know what you’re dealing with to do something about it. So it’s all positive.
Chris Kresser: Fantastic. I love the book [and] highly recommend it. [I] love your work, Will, and loved this conversation. Thanks for taking the time to join us. And thanks, everybody, for listening. Send your questions to ChrisKresser.com/podcastquestion. We’ll see you next time.
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