Prática de Shadowing: Essentials: Understanding & Healing the Mind | Dr. Karl Deisseroth - Aprenda a falar inglês com vídeo
Escolha um modo de prática
Cada modo abre uma sala de prática em tela cheia.
493 frases
Se as frases estiverem muito curtas ou longas, clique em Edit para ajustá-las.
1
Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health, and performance.
2
And now, my conversation with Dr. Carl Dyseroff.
3
Well, thanks for being here.
4
Thanks for having me.
5
So for people that might not be so familiar with the fields of neuroscience, etc., what is the difference between neurology and psychiatry?
6
Psychiatry focuses on disorders where we can't see something that's physically wrong, where we don't have a measurable, where there's no blood test that makes the diagnosis.
7
There's no brain scan that tells us this is schizophrenia, this is depression for an individual patient.
8
And so psychiatry is much more mysterious.
9
And the only tools we have are words.
10
Neurologists are fantastic physicians.
11
They see the stroke on brain scans.
12
They see the seizure and the pre-seizure activity with an EEG.
13
And they can measure and treat based on those measurables.
14
In psychiatry, we have a harder job.
15
We use words.
16
We have rating scales for symptoms.
17
We can measure depression and autism with rating scales.
18
But those are words still.
19
And ultimately, that's what psychiatry is built around.
20
It's an odd situation because we've got the most complex,
21
beautiful, mysterious, incredibly engineered object in the universe, and yet all we have are words to find our way in.
22
So do you find that if a patient is very verbal or hyperverbal,
23
that you have an easier time diagnosing them as opposed to somebody who's more quiet and reserved?
24
Or I can imagine the opposite might be true as well.
25
Well, because we only have words, you put your finger on a key point.
26
If they don't speak that much in principle, it's harder.
27
The lack of speech can be a symptom.
28
We can see that in depression.
29
We can see that in the negative symptoms of schizophrenia.
30
We can see that in autism.
31
Sometimes by itself, that is a symptom of reduced speech.
32
But ultimately, you do need something.
33
You need some words to help guide you.
34
And that, in fact, there's challenges that I can tell you about where patients with depression
35
who are so depressed they can't speak.
36
That makes it a bit of a challenge to distinguish depression from some of the other reasons they might not be speaking.
37
And this is sort of the art and the science of psychiatry.
38
Do you think we will ever have a blood test for depression or schizophrenia or autism?
39
And would that be a good or a bad thing?
40
I think ultimately there will be quantitative tests.
41
Already efforts are being made to look at certain rhythms in the brain using external EEGs to look at brain waves effectively.
42
But ultimately, what's going on in the brain in psychiatric disease is physical, and it's due to the circuits and the connections
43
and the projections in the brain that are not working as they would in a typical situation.
44
And I do think we'll have those measurables at some point.
45
Could it be abused or misused?
46
Certainly, but that's, I think, true for all of medicine.
47
I want to know, and I'm sure there are several, but what do you see as the biggest challenge facing psychiatry and the treatment of mental illness today?
48
I think we have, we're making progress on what the biggest challenge is,
49
which I think there's still such a strong stigma for psychiatric disease that patients often don't come to us.
50
And they feel that they should be able to handle this on their own.
51
And that can slow treatment, it can lead to worsening symptoms.
52
We know, for example, patients who have untreated anxiety issues, if you go for a year or more with a serious untreated anxiety issue,
53
that can convert to depression.
54
You can add another problem on top of the anxiety.
55
And so it would be, why do people not come for treatment?
56
They feel like this is something they should be able to master on their own, which can be true, but usually some help is a good thing.
57
That raises a question related to something I heard you say many years ago at a lecture, which was that this was a scientific lecture, and you said, you know,
58
we don't know how other people feel.
59
Most of the time, we don't even really know how we feel.
60
Maybe you could elaborate on that a little bit and the dearth of ways that we have to talk about feelings.
61
I mean, there's so many words, I don't know how many, but I'm guessing there are more than a dozen words to describe the state that I call sadness.
62
But as far as I understand, we don't have any way of comparing that in a real objective sense.
63
So how, as a psychiatrist, when your job is to use words to diagnose, words of the patient to diagnose,
64
do you maneuver around that? and what is this landscape that we call feelings or emotions?
65
This is really interesting.
66
People, here we have, there's a tension between the words
67
that we've built up in the clinic that mean something to the physicians.
68
And then there's the colloquial use of words that may not be the same.
69
And so that's the first level we have to sort out when someone says, you know, I'm depressed.
70
What exactly do they mean by that?
71
That may be different from what we're talking about terms of depression.
72
So part of psychiatry is to get beyond that word and to get into how they're actually feeling,
73
get rid of the jargon and get to real world examples of how they're feeling.
74
So, you know, how do you, what, how much do you look forward into the future?
75
How much hope do you have?
76
How much planning are you doing for the future?
77
So these here, now you're getting into actual things you can talk about that are unambiguous.
78
If someone says, yeah i can't even i can't even think about tomorrow i
79
i'm not i don't see how i'm going to get to tomorrow
80
that that's a nice precise thing that you know it's it's sad it's tragic
81
but but it's also that means something and we know what
82
that means that's the hopelessness symptom of depression and and
83
that is what i try to do
84
when i do a psychiatric interview i try to get past the jargon
85
and get to what's actually happening in the patient's life and in their mind.
86
But as you say, ultimately, you know, this shows up across, I address this issue every day in my life,
87
whether it's in the lab where we're looking at animals, whether fish or mice or rats and studying their behavior,
88
or when I'm in a conversation with just a friend or a colleague, or when I'm talking to a patient,
89
I never really know what's going on inside the mind of the other person.
90
I get some feedback.
91
I get words.
92
I get behaviors.
93
I get actions, but I never really know.
94
Are there any very good treatments for psychiatric disease?
95
Meaning, are there currently any pills, potions, forms of communication that reliably work every time or work in most patients?
96
And could you give a couple of examples of great successes of psychiatry if they exist?
97
Yes.
98
And psychiatry, despite the depths of the mystery we struggle with, many of our treatments are actually,
99
you know, we may be doing better than some other specialties in terms of actually causing therapeutic benefit for patients.
100
We do help patients, you know, patients who suffer from, by the way, both medications and talk therapy have been shown to be extremely effective in many cases.
101
for example, people with panic disorder, cognitive behavioral therapy, just working with words,
102
helping people identify the early signs of when they're starting to move toward a panic attack, what are the cognitions that are happening.
103
You can train people to derail that and you can very potently treat panic disorder that way.
104
There are many psychiatric medications that are very effective for the conditions that they're treating.
105
Antipsychotic medications, they have side effects, but boy, do they work.
106
They really can clear up auditory hallucinations, the paranoia.
107
And then, you know, this is a frustrating and yet heartening aspect of psychiatry.
108
There are treatments like electroconvulsive therapy, which is where, you know, it's extremely effective for depression.
109
We have patients who nothing else works for them, or they can't tolerate medications, and you can administer under a very safe,
110
controlled condition where the patient's body is not moving.
111
They're put into a very safe situation where the body doesn't move or sees.
112
It's just an internal process that's triggered in the brain.
113
This is an extraordinarily effective treatment for treatment-resistant depression.
114
At the same time, I find it as heartening as it is to see patients respond to this who have severe depression.
115
I'm also frustrated by it.
116
Why can't we do something more precise than this for these very severe cases?
117
In all of these cases, though, in psychiatry, the frustrating thing is
118
that we don't have the level of understanding that a cardiologist has in thinking about the heart.
119
You know, the heart is, we now know, it's a pump.
120
It's pumping blood, and so you can look at everything about how it's working or not working in terms of that frame.
121
It's clearly a pump.
122
we don't really have that level of what what is the circuit really there for in psychiatry
123
What are the pieces that are going to be required to cure autism, cure Parkinson's, cure schizophrenia?
124
I would imagine there are several elements and bins here.
125
Understanding the natural biology, understanding what the activity patterns are, how to modify those.
126
Maybe you could just tell us what you think.
127
What is the bento box of the perfect cure?
128
I think the first thing we need is understanding.
129
What is the element of the brain that's analogous to the pumping heart?
130
When we think about the symptoms of depression, that's maybe, you know, we think about motivation and dopamine neurons.
131
And so then that turns our attention as neuroscientists.
132
We think, okay, let's think about the parts of the brain
133
that are involved in dealing with merging complex data streams
134
that are very high in bit rate that need to be fused together into a unitary concept.
135
And that starts to guide us, and maybe we can, and we know other animals are social in their own way, and we can study those animals.
136
And so that's how I think about it.
137
There's hope for the future, thinking about the symptoms as an engineer might,
138
and trying to identify the circuits that are likely working to make this typical behavior happen, and that will help us understand how it becomes atypical.
139
We need to know the circuits.
140
We need to know the cells in the various brain regions
141
and portions of the body and how they connect to one another and what the patterns of activity are under a normal,
142
quote unquote, healthy interaction.
143
If we understand that, then it seems that the next step, which of course could be carried out in parallel, right?
144
That work can be done alongside work where various elements within those circuits are tweaked just right.
145
Like the tuning of a piano in the subtle way, or maybe even like the replacement of a whole set of keys if the piano is lacking keys, so to speak.
146
In 2015, there was this, what I thought was a very nice article published in the New Yorker,
147
describing your work and the current state of your work in the laboratory and the clinic, and an interaction with a patient.
148
So this was, as I recall, a woman who was severely depressed.
149
And you reported in that article, some of the discussion with this patient, and then in real time, increase the activation of the so-called vagus nerve,
150
this 10th cranial nerve that extends out of the skull and innervates many of the viscera and body.
151
What is the potential for channel rhodopsins or related types of algae engineering to be used to manipulate the vagus?
152
Because I believe in that instance, it wasn't channel opson stimulation.
153
It was electrical stimulation, right?
154
Or to manipulate, for instance, a very small localized region of the brain.
155
Let me frame it a little bit differently in light of what we were talking about a couple minutes ago.
156
My understanding is that if somebody has severe depression
157
and they take any number of the available pharmaceutical agents that are out there, SSRI, serotonin or chick agents,
158
increased dopamine, increased whatever, that sometimes they experience relief, but there are often serious side effects.
159
Sometimes they don't experience relief, but as I understand it,
160
channel options and their related technology in principle would allow you to turn on
161
or off the specific regions of the brain that lead to the depressive symptoms, or maybe you turn up a happiness circuit or a positive anticipation circuit.
162
Where are we at now in terms of bringing this technology to the nervous system?
163
And let's start with body and then move into the skull.
164
Yeah.
165
So starting with the body is a good example because it highlights the opportunity and how far we have to go.
166
So let's take this example of vagus nerve stimulation.
167
So the vagus nerve, it's the 10th cranial nerve.
168
It comes from the brain.
169
It goes down.
170
It innervates the heart, innervates the gut.
171
By innervate, I mean it sends little connections down to help guide what happens in these organs in the abdomen and chest.
172
It also collects information back.
173
And there's information coming back from all those organs that also go through this vagus nerve, the 10th cranial nerve back to the brain.
174
And so this is somewhat of a superhighway to the brain then was the idea.
175
And maybe the idea is maybe we could put a little cuff, a little electrical device around the vagus nerve itself.
176
So a way of getting into the brain without putting something physical into the brain.
177
And why the vagus?
178
I mean, it's there, but, and it's accessible.
179
That's the reason.
180
the reason that's the reason yes really yeah you're not kidding i'm not kidding
181
so stimulating the vagus to treat depression simply
182
because it's accessible it started as actually as an epilepsy uh treatment
183
and it can help with epilepsy
184
but the vagus nerve lands on a particular spot on the brain called the solitary tract nucleus
185
which is just one synapse away from the serotonin and dopamine
186
and the norepinephrine so there's a link to chemical systems in the brain that make it a a rational choice.
187
Yes, it's not irrational.
188
But I can tell you that even if that were not true, the same thing would have been tried.
189
You would have done it anyway.
190
Because it's accessible.
191
I see.
192
How do you think it's working when it does work?
193
Is it triggering the activation of neurons that release more serotonin or dopamine?
194
It could be, but I would say we don't have evidence for that.
195
And so I just don't know.
196
But what is clear is that it's dose limited in how high and strongly we can stimulate. And why?
197
It's because it's an electrode and it's stimulating everything nearby.
198
And when you turn on the vagus nerve stimulator, the patient's voice becomes strangulated and hoarse.
199
They can have trouble swallowing.
200
They can have trouble speaking for sure.
201
Even some trouble breathing.
202
Because everything in the neck, every electrically responsive cell and projection in the neck is being affected by this electrode.
203
And so you can go up just so far with the intensity, and then you have to stop.
204
So, you know, to your initial question, could a more precise stimulation method like optogenetics help in this setting?
205
In principle, it could, because if you would target the light sensitivity to just the right kind of cell,
206
let's say cell X that goes from point A to point B that you know causes symptom relief of a particular kind, then you're in business.
207
You can have that be the only cell that's light sensitive.
208
You're not going to affect any of the other cells, the larynx and the pharynx and the projections passing through.
209
So that's the hope.
210
That's the opportunity.
211
The problem is that we don't yet have that level of specific knowledge.
212
We don't know, okay, it's the cell starting in point A going to point B that relieves this particular sense.
213
We want to fix this key on the piano out.
214
I'm imagining a little tiny blue light emitting thing,
215
object that's a little bigger than a clump of cells or maybe about the size of a clump of cells.
216
So we're talking about a little tiny stamp, each edge, half a millimeter in size.
217
I could imagine that being put under my skin.
218
And then I would, what I'd hit an app on my phone and I'd say, I'd say, Dr. Diceroth, I'm not feeling great today.
219
Can I increase the stimulation?
220
And you say, go for it.
221
And then I ramp it up.
222
Is that how it would go?
223
I mean, that's effectively what we already do with the vagus nerve stimulation.
224
The doctor in this case, and I have this in some of my patients in the clinic.
225
I do vagus nerve stimulation.
226
I talk to them.
227
I say how I go through the symptoms.
228
I use the psychiatric interview to elicit their internal states.
229
And then I have a radio frequency controller that I can dial in.
230
Right there in real time.
231
Right there in real time.
232
You're holding the remote control essentially to their brain, although it's remote remote control through a couple steps yeah yeah
233
and i can i can turn up i can turn up
234
the frequency i can turn up the intensity uh all with the radio frequency
235
and uh control and then it's it's reprogrammed or redosed
236
and then the patient can can then leave at this altered
237
dose in most patients i don't expect an immediate mood change
238
what i do is i increase the the dose until next level up while asking the patient for side effects.
239
Can you still breathe okay?
240
Can you still swallow okay?
241
And I can hear their voice as well.
242
And I can get a sense.
243
And you're looking at their face.
244
And I'm looking at their face.
245
And so I can get a sense, is there, am I still in a safe side effect regime?
246
And then I stop at a particular point that looks safe and then patient goes home,
247
comes back a month later and I get the report on how things were over that month.
248
That's very exciting.
249
What are your thoughts about brain-machine interface as something that's been happening for a long time now?
250
Devices, little probes that are gonna stimulate different patterns of activity in ensembles of neurons.
251
First of all, it's an amazing scientific discovery approach.
252
As you mentioned, we and others here at Stanford are using electrodes, collecting information from tens of thousands of neurons.
253
Even separate from the Neuralink work, as you point out, Many people have been doing this in humans as well as in non-human primates.
254
And this is pretty powerful.
255
It's important.
256
This will let us understand what's going on in the brain in psychiatric disease, in neurological disease, and will give us ideas for treatment.
257
I see that as something that will be part of psychiatry in the long run.
258
already with deep brain stimulation approaches we can help people with psychiatric disorders.
259
And that's putting just a single electrode, not even a complex closed loop system where you're both playing in and getting information back.
260
Even just a single stimulation electrode in the brain can help people with OCD, for example, quite powerfully.
261
One of the questions I get asked a lot is about ADHD and attention deficit of various kinds.
262
I have the hunch that one reason I get asked
263
so often is that people are feeling really distracted and challenged in funneling their attention and their behavior.
264
But, and there are a number of reasons for that, of course, but what is true ADHD and what does it look like?
265
What can be done for it?
266
And what, if any, role for channel options or these downstream technologies that you're developing,
267
what do they offer for people that suffer from ADHD or have a family member that suffers from ADHD?
268
Yeah.
269
This is a pretty interesting branch of psychiatry.
270
There's no question that people have been helped by the treatments.
271
There's active debate over what fraction of people who have these symptoms can or should be treated.
272
This is typically Adderall or stimulants of some kind.
273
Yeah, for example, stimulants.
274
That's right.
275
So ADHD, as its name suggests, it can have either a hyperactive state or an inattentive state.
276
And those can be completely separate from each other.
277
You could have a patient who effectively is not hyperactive at all, but can't remain focused on what's going on around them.
278
So their body can be still, but their mind is darting around.
279
That's right.
280
Or they can be very hyperactive with their body.
281
Yeah, it happens both ways.
282
Probably rarely is somebody hyperactive with their body, but their mind is still.
283
I notice I have to think complex, abstract thoughts.
284
I notice I have to be very still.
285
So my body has to be almost completely unmoving for me to think very abstractly and deeply.
286
Other people are different.
287
Some people, when they're running, they get their best thoughts.
288
I can't even imagine that.
289
My brain does not work that way at all.
290
I have to be totally motionless.
291
which is kind of interesting.
292
How do you go about that?
293
I sit much like this.
294
I try to have time in each day where I am literally sitting almost in this position,
295
but without distraction and thinking.
296
And so it's almost meditative in some ways, except it's not true meditation, but I am thinking while not moving.
297
You're trying to structure your thoughts in that time.
298
Yeah.
299
Interesting.
300
Yeah.
301
So, but everybody, as you say, is, is, is very different.
302
And so with, with ADHD, you have, the key thing is we want to make sure that this is present across different domains of life,
303
school and home to show that it really is a pervasive pattern and not something specific to, you know, the teacher or the home situation or something.
304
And then you can help patients.
305
It's interesting that, that ADHD is one of those disorders where people are trying to work from quantitative EEG-based diagnoses.
306
And so there's some progress toward making up a diagnosis with looking at particular externally detectable brainwave rhythms.
307
So skull cap with some electrodes that don't penetrate the skull.
308
That's right.
309
And this can be done in an hour or two hour session.
310
That's right.
311
Has to be done in the clinic, right?
312
Yeah, in the clinic, right.
313
You have to have the right recording apparatus and so on.
314
But that's in principle, as increasing confidence comes in exactly which measurements one could even imagine moving toward home tests,
315
but we're not there yet.
316
Amazing.
317
I think one of the reasons I get asked about it
318
so much is a lot of people wonder if they have ADHD.
319
Do you think that some of the lifestyle factors
320
that inhabit us all these days could induce a subclinical or a clinical-like ADHD?
321
Meaning if I look at people's phone use, including my own, and I don't think of it like addiction, it looks to me and feels to me more like OCD.
322
And I'll come clean here by saying when I was younger, when I was a kid, I had a grunting tick.
323
I used to hide it.
324
I actually used to hide in the closet because my dad would make me stop.
325
And I used to, I couldn't feel any relief of my mind until I would do this.
326
And actually now if I get very tired, if I've been pushing long hours, it'll come back.
327
Interesting.
328
I was not treated for it, But I will confess that I've had the experience of, I always liked sports where I involve a lot of impact,
329
fortunately not football, because I went to a high school where the football team was terrible.
330
Maybe that would have avoided more impact, but things like skateboarding, boxing, they bring relief.
331
I feel clarity after a head hit, which I avoid, but I used to say that's the only time I feel truly clear for a long, and then eventually it dissipated.
332
By about age 16, 17, it just disappeared.
333
Um, so I have great, uh, empathy for those that feel like there's something contained in them
334
that won't allow them to focus on what they want to focus on.
335
And these days with the phone and, and all these, uh, email, et cetera, I, I wonder, and I empathize a bit when I hear people saying like,
336
I think I might have ADHD or ADD.
337
Do you think it's possible that our behaviors and our interaction with the sensory world, which is really what phones and email really are, could induce ADD or reactivate it?
338
Yeah, this is a great question.
339
I think about it a lot.
340
And you mentioned this tick-like behavior in yourself.
341
It's very common that people who have ticks have this building up of something
342
that can only be relieved by executing the tick, which can be a motor movement or vocalization or even a thought.
343
and people do, I think these days, do have this if they haven't checked their phone in a while they do have a build up, a build up, a build up until they can check it and relieve it
344
and there's some similarities there's a little reward that comes with the checking
345
but the key question in all of psychiatry what we do
346
is we don't diagnose something unless it's disrupting what we call social or occupational functioning You could have any number of symptoms,
347
but literally every psychiatric diagnosis requires that it has to be disrupting someone's social or occupational functioning.
348
And these days, checking your phone is pretty adaptive.
349
That pretty much helps your social and occupational functioning.
350
And so we can't make it a psychiatric diagnosis, at least in the world of today.
351
I'd love your thoughts on psychedelic medicine and putting them into patients and seeing tremendous positive effects,
352
but also tremendous examples of induced psychiatric illness.
353
In other words, many people lost their minds as a consequence of overuse of psychedelics.
354
I'll probably lose a few people out there, but I do want to talk about what is the state of these compounds?
355
And I realize it's a huge category of compounds, but LSD and psilocybin, as I understand, trigger activation of particular serotonin receptor mechanisms may
356
or may not lead to more widespread activation of the brain more that one wouldn't see otherwise.
357
But when you look at the clinical and experimental literature, what is your sort of top contour sense of how effective these tools are going to be for treating depression?
358
Well, you're right to highlight both the opportunity and the peril that is there.
359
And of course, we want to help patients.
360
And of course we want to to explore anything
361
that might be helpful and but we want to do it in a safe
362
and rigorous way but i i do think we should explore these these avenues these are um agents
363
that alter reality
364
and alter the experience of reality i should say in in
365
relatively precise ways they they do have problems they can be addictive they can cause lasting change that is not desirable
366
now
367
that said uh even as these medications exist now as you
368
know there's uh an impulse to to use them in very small doses
369
and to use them as adjunctive treatments for for the therapy of various kinds
370
and i i'm also supportive of that if done you know carefully
371
and rigorously of course there's risk but there's risk with many other kinds of treatment
372
and i'm not sure that the risks
373
for these medications vastly outweigh the risks that we normally tolerate in other branches of medicine.
374
Why would they work?
375
I mean, let's say that indeed their main effect is to create more connectivity,
376
at least in the moment, between brain areas.
377
So psychedelics seem to be a trajectory not too far off from the dream state,
378
where space and time are essentially not as rigid.
379
And there is this element of synesthesia, of blending of the senses,
380
you know, feeling colors and hearing light and things of that sort.
381
You hear these reports anyway.
382
Why would having that dreamlike experience somehow relieve depression long-term?
383
Do we have any idea why that might be?
384
We have some ideas and no deep understanding.
385
One way I think about the psychedelics is they increase the
386
willingness of our brain to accept unlikely ways of constructing the world, unlikely hypotheses, as it were,
387
as to what's going on.
388
The brain, in particular, our cortex, I think, is a hypothesis generation and testing machine.
389
It's coming up with models about everything.
390
It's got a lot of bits of data coming in, and it's making models and updating the models and changing them, theories, hypotheses for what's going on.
391
And some of those never reach our conscious mind.
392
And this is something I talk about in projections in the
393
book quite a bit is many of these are filtered out before they get to our conscious mind.
394
And that's good.
395
We think how distracted we'd be if we were constantly having to evaluate all these, you know, hypotheses about, you know, what kinds of shapes or objects or processes were out there.
396
And so a lot of this is handled before it gets to consciousness.
397
What the psychedelics seem to do is they change the threshold for us to become aware of these incomplete hypotheses
398
or wrong hypotheses or concepts that might be noise
399
but are just wrong and so are never allowed to get into our conscious mind.
400
Now, you know, that's pretty interesting and it goes wrong in psychiatric disorders.
401
I think in schizophrenia, sometimes the paranoid
402
delusions that people have are examples of these poor models
403
that escape into the conscious mind and become accepted as reality and they never should have gotten out there.
404
Now, how could something like this in the right way help with something like depression?
405
Patients with depression often are stuck.
406
They can't look into the future world of possibilities as effectively.
407
Everything seems hopeless.
408
And what does that really mean?
409
They discount the value of their own action.
410
They discount the value of the world at giving rise to a future that matters.
411
Everything seems to run out like a river just running out into a desert and drying up.
412
and what these agents may do that increase the the flow through circuitry
413
if you will the percolation of activity through circuitry may end
414
up doing for depression is increasing the the escape of some
415
some tendrils of of process of forward progression through through the
416
world that's a concept it's how i think about it there are ways we can make
417
that rigorous we we can indeed identify in the brain by recording we can see cells
418
that represent steps along a path and look into the future
419
and we can rigorously define these cells and we can see
420
if these are altered on psychedelics and so that's one of the reasons
421
that we're working with these agents in the laboratory to say
422
is this really the case are these opening up new paths or or representations of paths into the future.
423
MDMA, ecstasy, is a unique compound in that it leads to big increases in brain levels of dopamine and serotonin simultaneously.
424
And I realized that the neuromodulators like dopamine and serotonin often work in concert,
425
not alone the way they're commonly described in the more general popular discussions.
426
However, it is a unique compound, and it's different than the serotonergic compounds like LSD and psilocybin.
427
And there are now data still emerging that it might be,
428
and in some cases can be useful for the treatment of trauma, PTSD and similar things.
429
Why would that work?
430
And a larger question, perhaps the more important question is psychedelics, MDMA, LSU, all those compounds,
431
in my mind, there are two components.
432
There's the experience you have while you're on them, and then there's the effect they have after.
433
People are generating variations of these compounds that are non-hallucinatory variations, but how crucial do you think it is to have,
434
let's stay with MDMA, the experience of huge levels of dopamine,
435
huge levels of serotonin, atypical levels of dopamine and serotonin released, having this highly abnormal experience in order to be normal again.
436
Yeah.
437
I think the brain learns from those experiences.
438
That's the way I see it.
439
And so, for example, people who've taken MDMA, they will, as you say, they'll be the acute phase of being you know on the the drug
440
and experiencing the this extreme connectedness with other people for example
441
and then the the drug uh wears off and
442
but the brain learned from that experience and
443
so what what people will report is yeah i'm not i'm not in that state
444
but i saw what was possible you know i saw yeah you can there don't need to be barriers
445
or at least not as many barriers as i I thought I can connect with more people in a way
446
that is helpful.
447
And so I think it's the learning that happens in that state that actually matters.
448
And as you described that, that sounds a lot like what I understand to be the hallmark feature of really good psychoanalysis, that the relationship between patient and therapist
449
hopefully evolves to the point where these kinds of tests can be run within the context of
450
that relationship and then exported to other relations. Is that?
451
And that probably, I'm assuming, is still the goal of really good psychiatry also.
452
It's a part of intimacy, really.
453
It should be.
454
When we have time, I think all good psychiatrists try to achieve that level of connection and learning.
455
Try to help patients create a new model that is stable, that is learned, and that can help instruct future behavior.
456
One of the things that I took from reading your book, in addition to learning so much science and the future of psychiatry and brain science was,
457
you know, amidst these very many, many kids, very tragic cases and sadness and a lot of the,
458
the, the weight that that puts on the clinician on you also,
459
that there's a, that there's a central cord of optimism that where we're headed is not just.
460
possible but very likely and and better yeah
461
and um you know it are you an optimist i am
462
and this this is by the way this was a really interesting experience in writing projections
463
because i had a a dual goal i wanted it to
464
be for everybody literally everybody in the world who wants to to to to read it
465
and yet at the same time i wanted to uh stay absolutely rigorously close to the science,
466
what was actually known.
467
When I was speaking about science, when I was speaking about the neurobiology of the brain or psychiatry,
468
I wanted to not have any of my scientific colleagues think, oh, he's going too far, he's saying too much.
469
And so I had these two goals, which I kept in my mind the entire time.
470
And a lot of this trying to find exactly the right
471
word we talked about was on this path of staying excruciatingly rigorous in the science
472
and yet letting people see the hope the the where things were have everybody see
473
that we've come a long way we have a long way to go
474
but but the trajectory and the the path is is beautiful
475
and so that that that was the the goal i i think uh you know of course
476
that sounds almost impossible to to jointly satisfy those two goals, but I kept that in my mind the whole way through.
477
And yes, I am optimistic, and I hope that it came through in the book.
478
It certainly did, and at least from this colleague, you did achieve both.
479
It's a wonderful, it's a masterful book, really, and one that as a scientist
480
and somebody who is a fellow brain explorer hits all the marks of rigor
481
and is incredibly interesting and there's a ton of storytelling.
482
Definitely check out the book.
483
There are other people in our community that of course are going to be reaching out on your behalf,
484
but it's incredible that you juggle this enormous number of things.
485
Perhaps even more important, however, is that it's all in service to this larger thing of relieving suffering.
486
So thank you so much for your time today, for the book and the work that into the book, I can't even imagine, for the laboratory work
487
and the development of channel ops and clarity and all the related technologies
488
and for the clinical work you're doing and for sharing with us.
489
Well, thank you for all you're doing and reaching out.
490
I'm very impressed by it.
491
It's important and it's so valuable.
492
Thank you for taking the time and for all your gracious words about the book.
493
Thank you.
Baixar aplicativo
Tudo o que você precisa para falar fluentemente
Pronúncia com IANota em cada frase
Prática de IPADomine cada som
VocabulárioMonte seu banco de palavras
Jogo de vocabulárioAprenda brincando
Mesmo canal
C11,316
Why Reading (Books) Makes Us Better at Speaking
Daily ConversationUniversity StudentsWorking Adults
C18
Build Muscle Size, Increase Strength & Improve Recovery | Huberman Lab Essentials
Daily ConversationWorking Adults
C13
Essentials: Neuralink & Technologies to Enhance Human Brains | Dr. Matt MacDougall
Daily ConversationUniversity StudentsWorking Adults
C157
Why Women Over 30 Should Consider Freezing Their Eggs
University StudentsWorking Adults
C13
Your Memories & Emotions Impact Immune Status
Daily ConversationUniversity StudentsWorking Adults
B2Dr. Arthur Brooks: The 3 Macronutrients of True Happiness
Business EnglishUniversity StudentsWorking Adults
C14
How Foods & Nutrients Control Our Moods | Huberman Lab Essentials
Business EnglishUniversity StudentsWorking Adults
C13
The Science & Treatment of Obsessive Compulsive Disorder (OCD) | Huberman Lab Essentials
Daily ConversationUniversity StudentsWorking Adults
C129
The Cure for Addiction
Daily ConversationUniversity StudentsWorking Adults
C134
Welcome to the Huberman Lab Podcast
Daily ConversationUniversity StudentsWorking Adults
C117
You Can Learn New Habits Very Fast: Brain Circuits Rewire Faster With Urgency
Business EnglishUniversity StudentsWorking Adults
C13
Essentials: Science of Mindsets for Health & Performance | Dr. Alia Crum
Daily ConversationUniversity StudentsWorking Adults
C12
Food & Supplements for Brain Health & Cognitive Performance | Huberman Lab Essentials
Business EnglishUniversity StudentsWorking Adults
B21
Tools for Managing Stress & Anxiety | Huberman Lab Essentials
Daily ConversationWorking Adults
C11
Essentials: The Biology of Slowing & Reversing Aging | Dr. David Sinclair
Business EnglishUniversity StudentsWorking Adults
C12
Essentials: How to Assess & Improve All Aspects of Your Fitness | Dr. Andy Galpin
Business EnglishUniversity StudentsWorking Adults
C12
The Science of Making & Breaking Habits | Huberman Lab Essentials
Business EnglishUniversity StudentsWorking Adults
C121
Tools to Improve Your Focus & Concentration | Huberman Lab Essentials
Business EnglishUniversity StudentsWorking Adults
C14
Essentials: Micronutrients for Health & Longevity | Dr. Rhonda Patrick
Business EnglishUniversity StudentsWorking Adults
C120
Tools to Set Your Cortisol Rhythm
Business EnglishUniversity StudentsWorking Adults
FOR YOU
Vídeo recomendado
C13
69 frases
Steven Pinker: Linguistics as a Window to Understanding the Brain | Big Think
IELTS PrepTOEFL PrepUniversity Students
C12
28 frases
How Depression Affects The Brain - Yale Medicine Explains
IELTS PrepTOEFL PrepUniversity Students
C12
510 frases
Anna Lembke on Pleasure, Pain, and Recovery in a Dopamine-Driven World
IELTS PrepTOEFL PrepUniversity Students
C13
21 frases
Dr Joseph Kwan | Cleveland Clinic London Neurological Rehabilitation
IELTS PrepTOEFL PrepUniversity Students
C19
120 frases
Intro to Psychology: Crash Course Psychology #1
IELTS PrepTOEFL PrepUniversity Students
C12
221 frases
Masking in ADHD & Autism: The Hidden Cost of Looking “Fine”
Daily ConversationUniversity StudentsWorking Adults
C13
63 frases
Your brain doesn’t detect reality. It creates it. | Lisa Feldman Barrett
IELTS PrepTOEFL PrepUniversity Students
![Who Shares The Blame for the Mental Health Epidemic? - Will Self [2014] | Intelligence Squared](https://img.youtube.com/vi/pT_7MXawaZU/mqdefault.jpg)
C222
233 frases
Who Shares The Blame for the Mental Health Epidemic? - Will Self [2014] | Intelligence Squared
IELTS PrepTOEFL PrepUniversity Students
C11
746 frases
Blindboy discovers the link between gut health and mental health
Daily ConversationUniversity StudentsWorking Adults
C11
259 frases
Talk Back: Why Arguing With Yourself Can Help You Flourish
Daily ConversationUniversity StudentsWorking Adults
Vocabulário e dicas de fala para esta lição
Esta aula de conversação de nível C1 usa o vídeo “Essentials: Understanding & Healing the Mind”. Este vídeo tem 493 frases e 6352 palavras para praticar shadowing. A fala dura 38:29. O falante fala em ritmo natural, cerca de 165 palavras por minuto, próximo de uma conversa do dia a dia. 83% das palavras estão entre as 3.000 mais comuns do inglês; vale a pena estudar o restante antes de começar.
Vocabulário principal deste vídeo
As 15 palavras mais avançadas do vídeo, com pronúncia e significado:
| Palavra | Pronúncia | Significado |
|---|---|---|
| psychiatry substantivo | /saɪˈkaɪ.əˌtɹi/ | psiquiatria |
| symptom substantivo | /ˈsɪm(p)təm/ | sintoma |
| psychiatric adjetivo | /ˌsaɪ.kiˈæt.ɹɪk/ | psiquiátrico |
| stimulation substantivo | /stɪm.jʊˈleɪ.ʃən/ | estimulação |
| dopamine substantivo | /ˈdoʊ.pəˌmin/ | dopamina |
| serotonin substantivo | /ˌsɛɹəˈtoʊnɪn/ | serotonina |
| electrode substantivo | /əˈlɛk.tɹəʊd/ | eletrodo |
| psychedelic adjetivo | /ˈsaɪ.kəˌdɛl.ɪk/ | psicodélico |
| schizophrenia substantivo | /ˌskɪtsəˈfɹiniə/ | esquizofrenia |
| hypothesis substantivo | /haɪˈpɒθɪsɪs/ | hipótese |
| neuron substantivo | /ˈn(j)ʊɹɑn/ | neurônio, neurónio |
| stimulate verbo | /ˈstɪm.jəˌleɪt/ | estimular, incentivar |
| projection substantivo | /pɹəˈd͡ʒɛkʃən/ | projeção |
| activation substantivo | /ˌæktəˈveɪʃən/ | ativação |
| autism substantivo | /ˈɔːtɪzəm/ | autismo |
Phrasal verbs que você vai ouvir
| Palavra | Pronúncia | Significado |
|---|---|---|
| turn up verbo | aparecer | |
| come back verbo | voltar | |
| check out verbo | verificar, sacar só | |
| come up with verbo | pensar (em), alcançar | |
| get out verbo | sair | |
| go down verbo | descer | |
| go up verbo | subir | |
| make up verbo | /ˌmeɪk ˈʌp/ | compensar |
Frases que vale a pena repetir
Frases curtas e completas do vídeo que você pode usar na conversa do dia a dia:
- How much hope do you have?
- How much planning are you doing for the future?
- How do you think it's working when it does work?
- Can I increase the stimulation?
- Can you still breathe okay?
Gramática neste vídeo
As estruturas que o falante mais usa, com as palavras exatas do vídeo:
| Estrutura | No vídeo |
|---|---|
| Present perfect continuous have/has been + -ing — uma ação que começou antes e continua | that's been happening · have been doing · I've been pushing |
| “Used to” used to + verbo — um hábito ou estado do passado que não é mais verdade | used to hide · used to say |
| Voz passiva be + particípio passado — o foco está no que acontece, não em quem faz | is built · being made · be abused |
| Orações relativas who / which + oração — informação extra sobre uma pessoa ou coisa | own, which can · lecture, which was · therapy, which is |
Pronúncia para ficar de olho
O falante usa 99 contrações e formas reduzidas, como don't, I'm, you're. Diga-as na forma curta, do jeito que você ouve.
- Os sons de “th”: hypothesis /haɪˈpɒθɪsɪs/, rhythm /ˈɹɪð.əm/
- Os sons de “sh” e “zh”: stimulation /stɪm.jʊˈleɪ.ʃən/, projection /pɹəˈd͡ʒɛkʃən/, activation /ˌæktəˈveɪʃən/, occupational /ɑkjuˈpeɪʃənəl/, measurable /ˈmɛʒəɹəbəl/
- Palavras longas — acerte a sílaba tônica: psychiatry /saɪˈkaɪ.əˌtɹi/, psychiatric /ˌsaɪ.kiˈæt.ɹɪk/, stimulation /stɪm.jʊˈleɪ.ʃən/, serotonin /ˌsɛɹəˈtoʊnɪn/, psychedelic /ˈsaɪ.kəˌdɛl.ɪk/
Sons difíceis para falantes de português:
- Consoante final — sem acrescentar um “i” depois: psychiatric /ˌsaɪ.kiˈæt.ɹɪk/, electrode /əˈlɛk.tɹəʊd/, psychedelic /ˈsaɪ.kəˌdɛl.ɪk/, stimulate /ˈstɪm.jəˌleɪt/, innervate /ɪˈnɝˌveɪt/
- /l/ final — a língua toca o céu da boca, não vira “u”: cranial /ˈkɹeɪ.ni.əl/, occupational /ɑkjuˈpeɪʃənəl/, atypical /eɪˈtɪp.ɪ.kəl/, measurable /ˈmɛʒəɹəbəl/
- /h/ — um sopro suave, diferente do “r”: hypothesis /haɪˈpɒθɪsɪs/, hyperactive /ˌhaɪpəɹˈæk.tɪv/, hearten /ˈhɑɹtn̩/
Como praticar com este vídeo
- Ouça o vídeo inteiro uma vez sem falar e anote as palavras que você não conhece.
- Comece na velocidade 0,75×, faça shadowing frase por frase e volte à velocidade normal quando ficar fácil.
- Grave a sua voz e compare com o original, prestando atenção a palavras como psychiatry, symptom, psychiatric.
O que é a Técnica de Shadowing?
Shadowing é uma técnica de aprendizado de idiomas com base científica, originalmente desenvolvida para o treinamento de intérpretes profissionais. O método é simples, mas poderoso: você ouve áudio em inglês nativo e repete imediatamente em voz alta — como uma sombra seguindo o falante com 1-2 segundos de atraso. Pesquisas mostram melhora significativa na precisão da pronúncia, entonação, ritmo, sons conectados, compreensão auditiva e fluência na fala.