9UNP0132SD_Dave_ Rakel on Emotion

- My name's Dave Rakel. I am the director of the Integrative Medicine program. And I don't know much about the art of lecturing, but I always like to have fun doing this. And I think that's what I'd like to do over the next 20 minutes, is just have some fun with you, and really explore how important it is to facilitate emotions when we speak. But also to look at similarities between how important emotions are when we give a talk, or whether we're sitting with a friend who's suffering, or we're in a clinical encounter with another human being. There's a lot of similarities between good teaching and good healing. So let's explore that a little bit. The Integrative Medicine program that we started here in 2001 really focuses on how the body self-heals and how we can reproduce that. And that's much more than just the physical. 

You have to also address the bio-psycho-social and the spiritual, as well as the community. So when I started my medical training, I think I went in with a fairly balanced brain. And this is an oversimplified review of the human brain. Very oversimplified. So we have three parts, right? Oversimplified. The neocortex. That's the thinking brain. That's the part of our brain that allows us to go to the moon and cure cancer. It allows us to process data and create knowledge. 

That's good stuff. And then there's the limbic system, that emotional brain, that part that allows us to really connect with another human being. And at least in my training down at Baylor in Houston, I didn't get a lot of attention towards that emotional side of the brain. But we did have a lot of attention to the neocortex, the thinking brain, and the brain stem, because if we didn't memorize all that stuff, we wouldn't survive. And the brain stem allows us to survive. If there's a meteor coming out of the sky, my brain stem tells me to step aside so I preserve my being. So when I was going through medical school, I was cramming as much stuff as I possibly could into my brain. And if you go over here to the Health Emotions Institute, they'll teach you about this exciting new field called neuroplasticity, that what we give attention to grows. And I think that's an important thing to remember. That to which we give attention grows. 

So if I'm giving attention and memorizing a bunch of facts, that part of my brain is going to grow. And my neocortex is going to expand. Now, what we see is when we give attention to just one function, that actually expands into other functions. And the limbic system may actually atrophy. And I found myself going through this metamorphosis in my medical training, that I was cramming as much stuff into my brain as I possibly could. I wasn't giving much attention to my emotional or my limbic system. And I felt myself kind of going through a change. And after medical school, after four years, I felt somewhat like this guy. That I was really smart, you know, I could memorize a lot of stuff. But I almost had this hard exoskeleton, where I really wasn't able to connect with other human beings well. 

And I'll never forget. I was watching the -- Excuse me, I was cramming for a test. It was finals, the beginning of my second year of medical school, I was cramming as much stuff in there as possible. And I said, "I need a break." So I went down, I turned on the TV. And there was the Sound of Music. I must have seen this eight times. But when the Von Trapp family cleared the Alps into safety, I started crying like a blubbering idiot. 
(laughter)

 What's going on? 

In retrospect, I think I was suppressing my emotional side so much it was reaching out for some sort of expression. And if all we do is cram information into the human mind, we really cause atrophy of those most important attributes that we have as human beings to learn well and to heal well. So this is the limbic system. And the limbic system is probably the most important part of our being that facilitates human connection and facilitates healing. It's the main part of the brain that facilitates that L-word. Now I have a hard time saying the L-word, love, because it's not seen as scientific enough, right? It's hard to quantify love. It's hard to do a double-blind placebo controlled study on love. But it's the most important thing that influences wellness. Why are all those songs written about love? 

And all those poems written about love? When I attend at the hospital over here, I like to ask the residents, when nothing is working, you know, the patient just doesn't seem to be getting better, the surgery didn't seem to work, nothing's working, what always works when nothing else works? And it starts with an L. And they say "Lipitor." 
(laughter)

 But it's love. I can't call it love, because I'm a scientist. You know, we have to change what we call it. We call it "unconditional positive regard." 
(laughter)

 Okay, Dave if you call it that, you can research it. But this love stuff, I don't know, I don't know. So let's explore how important it is to connect with these emotions, particularly love. And we're going to talk about another forbidden word in medicine, which is spirituality. And how important these two words are in our teaching. Because if we can get people to connect with those emotions that really give us meaning and purpose in our life, that influences self-healing. That influences that a-ha moment that our learners get that creates joy in their learning and their career, hopefully. But our focus has gotten so attached to technology, which I love. I love this stuff, you know. I love the MRIs. 

It allows us to do so much cool stuff. I love the medications that we've been able to develop to cure cancer. What great stuff. But that's gotten so good that our culture's almost created a deity out of the technology. That the pill is seen as the God, or the magic. I don't know if you've seen-- Do you ever watch any TV after 6:00? You're usually barraged by a lot of drug ads. I don't know if you've seen this one. Panexa. Ask your doctor for a reason to take it. 
(laughter)

 Go ahead and feed your lover the chili dog. It'll all be okay if you just take the Panexa. It's pretty much good for everything. Abdominal pain, hypertension, headaches, diarrhea, anxiety. And if you ever look at the package insert, you'll see-- And this is true-- That the side effects are the exact same as what we're using it for. 
(laughter)

 I love to use videos. There's some software called Handbrake that you need a Mac, but you can download it free. It allows you to take clips of movies and use them in your teaching. 

I haven't gotten sued yet. But I put the name of the movie up front, so we give credit. 

- What are those? 

- Valium. Quiets the nerves. 
(loud, dramatic music)

- So, everybody's expectation is that the magic pill will cure me, right? But what does Valium do? It suppresses emotion, right? 

It actually suppresses a symptom. And what is a symptom other than our body asking for some sort of change. And if all we do is suppress the symptom, we miss out on understanding what the body needs to self-heal. And these can be very effective, very good tools in our tool bag. But if we rely on these too much, we really suppress symptoms that keep us from really understanding what might be needed for that body to heal. I love kids, because kids, they don't suppress their emotions. Kids are one big emoters, you know. If they're happy, they're laughing. If they're sad, they're crying. If they're angry, they're hitting, you know. 

What you see is what you get. And it's not until we get older that our critical-analytical brain starts to cloud that. Cloud that beauty, if you will. And I would argue that we're all born with this innate beauty. That has a tendency to get covered up as we get older, as we learn things. Now, this is both good and bad. We learn things to get smarter and have better control over our environment. But as we learn things, we often become self-critical. We become more analytical. We become more judgmental. 

Sometimes someone might hurt us, and that creates a negative emotion, like anger, that covers up the beauty. And that might lead to hostility. The second cause of heart disease on this planet, behind smoking, which is number one, tied with abdominal obesity and hypertension, is stress. And the major emotion that is facilitated with heart attacks is hostility. The second most common risk factor for the biggest killer on this planet is an emotion. Because that emotion becomes physical. And that happens through our perception. We have to perceive something as stressful, or we have to perceive something as beautiful. Now the key, is I have choice. I can choose whether to see it as beautiful or stressful. 

And that's where forgiveness comes in. You can just let it go. Now, that can lead to self-doubt and judgment. I love Mark Twain's quotes. He said, "I'm an old man, and I've lived a great many troubles. And some of them actually happened." 
(laughter)

 Ain't that the truth? That if we can recognize that. Take a stand back, go beneath the surface of the ocean, look up and say, "That's why I'm judgmental, because that person hurt me when I was ten." 

And once I observe that, I let it go. And you reduce the clutter, and the judgment, and the self-doubt, and the hostility, and the anger have a tendency to go away. And we get back to our native beauty, that hopefully will then infect everything that we do. We have a course here in the medical school called the Healer's Art, which really says, how can we facilitate healing in another human being? And often, medical students want to know, "Okay, what is it that I need to say to make everything right?" What is that one word that I can say that will, you know, okay, I'm over the death of my loved one? It's all okay now. Have you ever seen Little Miss Sunshine? It's one of my favorite movies. I strongly recommend that you go. 

This guy, all he wanted to do was go to the Air Force. That was what gave his life meaning and purpose. He found out that he's color blind and his life is in chaos. 

- I don't know what to do. 

- Well, it's getting late. Maybe, can somebody stay here with him? 

- I'll stay. 

- That is not happening. 

- All right, well. I'm just worried about the time. 

Olive, do you-- Do you want to try talking to him? 

- Richard, no. There's nothing to say. We just have to wait. Honey... 

- So, Olive-- They're going across state to go to a beauty pageant for Olive. And listen to what Olive says that heals in a matter of seconds. 

- Okay, let's go. 

- She doesn't say a thing. It's her presence. 

It's her ability to connect emotionally, and provide compassion and empathy that heals like that. And if we can do that in our teaching, if we can connect a little bit deeper below all the facts, that can have tremendous impact. She does a great dance at the end, too. 
(laughter)

 All right, I want you to look at this and tell me if you see any movement. I had to take some Dramamine the first time I saw this. It moves. It's not really moving. But it moves because our mind is multi-tasking. Our eye is trying to focus on all the different almonds. 

And in doing so, it creates this optical illusion of movement. But now focus on one almond. Focus on just one. What happens to the movement? It becomes still. As we focus on one thing well, and get our mind out of all the clutter and multi-tasking, we see things as they truly are, not as we are. I think this is so important. If we can clear the clutter of what we teach, and really get a little bit deeper to really touch that emotion, that will sink in a lot deeper. And we'll be able to see things as it truly is, instead of how we are. I like to use this analogy. 

Have you ever seen one of these balls, you know a snow ball? I got this at the airport. There's usually something beautiful on the inside. This one has a cow. 
(laughter)

 I got it here at our airport. But I can't see the cow, right? I can't see it. You know, there's stuff cluttering it up. What do I have to do to see the cow? 

You got to sit, be still, clear the clutter. And then you can connect with the beauty. And if we can do that, that's when you feel the hair on your neck stand up. When you feel that, that's an emotion. And when we can do that, that's that a-ha moment. Whether you're with a patient, or with a student, or a fellow human being, that is some of the most powerful influences on health. In healing-oriented medicine, we talk about spirituality. Touching that with which gives life meaning and purpose. This was a hard thing for me to do initially, because I thought, you know, I shouldn't go there. Spirituality, let's leave that to the experts. 

But in actuality, we're all experts on spirituality. Actually, I'll show you how I felt. Put your hands together. I won't make you pray, so don't worry about that. But put your hands together. How many people have their left thumb on top? How many have their right thumb on top? It doesn't matter if you're right or left handed, but now switch the thumbs. How does that feel? Ooh, that's weird. 
(laughter)

 That is weird. It's only weird, because we're not used to it. We haven't trained our brain to feel comfortable this way. But if you sit like this for ten minutes a day for the next month, this will start to feel pretty good to you. 
(laughter)

 So what I'm asking us to do in our teaching is really touch on that which is somewhat fearful. And if we're brave enough to kind of go to the love or the spirituality, that is some of the most rewarding things in our work. And if we can clear the clutter and help our student match their learning to what gives them meaning and purpose, that's that a-ha moment. So we define spirituality as an inherent aspect of every human being that relates to the absolute, that domain where values and meaning exists. 

There's no one absolute. There's your absolute. There's my absolute. I can't tell you what your absolute is. All I can tell is what my absolute is. And when I do this, I need to define what my absolute is, so I don't project my absolute onto you inappropriately. That's the beauty, is that everybody defines this for themselves. And it's not my job. It's actually malpractice if I try and project my absolute onto your absolute. Our job in medicine, to facilitate healing, is to understand, "Okay, what's your absolute, so I can help you define it that helps you connect with those things that give your life meaning and purpose?" 

If we can do that, that's key. So three words. A connection with that which gives life meaning and purpose. So sometimes you get it, you know, sometimes you're lecturing and you can see, you know, in the eyes, can see the little hairs stand up. Those are the good days, you know. The light is shining through the windows, and you know it's like one good golf shot, it will keep you coming back. It doesn't happen very often, but when it does, it is very exciting. Now, those are the good days. Now, there's polarity in everything. And a lot of times, our students or our patients may make us feel like this. 
(laughter)

 But you know what? We learn from that. We don't beat ourselves up. We learn from it. We go back the next day and try and do it a little bit better. So in summary, I'd like to just focus on three things that I found to be helpful in doing this with other people. Is number one, touch hearts as well as minds. That if we can really get in and touch that heart, that emotional place that gives us meaning and purpose, that's good stuff. Don't neglect the science. 

If we can have the science and the data, along with the humanism, boy, that's good stuff. Love what you teach. You can talk about dirt on your shoe. And if you're passionate and excited about it, you will engage the listener. The topic doesn't matter as much as your passion and your love of what you're talking about. And connect to meaning and purpose. How can we help the students match what we're teaching them that gives them a sense that, you know what, I can use what you taught me to cure hunger, or to reduce global warming, or reduce all the war and fighting on this planet, you know? If we can connect our teaching to those goals, that absolute of our students, beautiful. All right. My time is up. 

I'm going to pass it on to Steve, and anxious to hear and learn from Steve, as well.