Join Matt and Chris for a trademark 'short' episode as they continue to navigate the complex, occasionally controversial world of Dr. K in this second multi-dimensional episode. This time they take a look at some more recent content and reflect on whether they were wrong to identify Dr. K as such a strong advocate of Ayurvedic medicine. In their investigations, they explore the science of visualisation and manifestation, updated genomic information about the Doshas, and the power of mantras to bend the universe.But primarily they focus on the recent lively discussion between Dr. K and another famous YouTube Doctor, Dr. Mike. Their discussion touched on various topics including the mechanisms of science, the power of consciousness, personalized treatments, and the placebo effect. All good fodder for the DTG grinder even if it ends up, as it so often does, with Chris and Matt gently discussing their points of view about the nature of mind and the (alleged) mystery of subjective experience (we are sorry!).So join us for a thought-provoking ride through scientific criticism, holistic practices, and age-old East vs. West / Alternative vs Science-based medicine debates as we attempt to decipher whether Dr. K is a modern-era internet sage or a charismatic storyteller and alternative medicine advocate.LinksDoctor Mike: Debating The Value Of Eastern Medicine (Ayurveda) | Healthy Gamer Dr. KHeatlhyGamerGG: The Truth About Visualization & ManifestationHealthyGamerGG: Optimize Performance and Develop Self-Understanding with AyurvedaScience is Dope: Should we adopt Ayurveda | An Indian's response | Dr. Mike vs Dr. K
Hello and welcome to Decoding the Gurus, the podcast where an anthropologist and a psychologist listen to the greatest minds the world has to offer and we try to understand what they're talking about.
I'm Matt Brown.
Chris Kavanagh is my co-host.
He's the water to my fire, the earth to my wind.
He's my complimentary dosha.
G'day, Chris.
Oh, wow.
Yeah, that's very good.
The earth...
Or water to fire isn't a great combination in general.
That means I ghost you and, you know, I stop you from flourishing, Matt.
I put you out.
Oh, I know.
You're the paper to my scissors.
No, paper to my stone.
You're just not doing well with your analyses.
This is the problem with you.
Kappas.
You're slow to speed up.
You're top speed.
You're like Bowser, you know?
Feels like a slur calling me that.
Look, everyone is a little bit Kappa, Matt.
That's the way it works.
We learned about this.
We learned about this.
We did.
We can't say we're not educated.
But what are we learning about today, Chris?
Well, we're back with Dr. K for part two.
In our tripartite examination of his content.
And last time we looked at his outline of Ayurvedic understandings.
But that was a video from 2019, which is from relatively early in this channel's progression.
And we were going to look originally at a much more recent discussion debate he had with another doctor, Dr. Mike, which also touches...
On Ayurvedic debates, similar to what we were covering, but it's much more recent.
I thought that would be fair to see if things have changed and progressed and also in a different environment instead of outlining, you know, the Ayurvedic system from a kind of interested practitioner point of view, more discussing it.
In the context of someone who might not fully endorse all of the same things.
Might have some considerations.
But as happens, Matt, I'm a Vata person and I'm Mercurial.
And I ended up listening to more content than we were supposed to cover.
So before we get to the Dr. Mike conversation, there is a video called...
Optimize performance and develop self-understanding with Ayurveda.
And that's from two years ago.
And so this is kind of the midpoint.
And again, it's speaking to his audience, outlining things from a kind of interested advocate point of view.
But let's see if things progressed in that time.
And then, you know, we'll come right up to the present.
So first of all...
One point of concern was the degree to which Dr. K's Ayurvedic stuff is integrated to what he actually does.
Is it an additional part?
Is it the main component?
Is it not?
From the previous content, it looked like it was a substantial component.
It was at least the extra sauce that made him a lot more effective than his colleagues, as he described it.
But he also applied it in more private enterprises.
Listen to this, Matt.
Okay?
So when I go to a corporation, I'll say like, hey, I can teach your staff to be healthier and like...
Work with each other more harmoniously.
And the way that I can teach you all that is by teaching you about Ayurveda because it'll help you understand your temperament.
And once you understand your temperament, the way that your individual mind functions, it will become clear why there is workplace conflict.
Because you'll have a Vata who doesn't like structure and likes to innovate and likes to, you know, explore.
And you'll have a Kapha who's like, no, no, no, we need, like, structure.
Like, we have processes for a reason.
We are organized for a reason.
Like when you stick to the process is when you get the best result.
And the Vata is like, let's go.
Let's figure it out.
We'll figure it out.
Don't worry, man.
Like why are you so stuck up, bro?
Like what's going on?
And the Guffa is like, oh my God.
I knew it!
Those bureaucratic nincompoops always trying to interfere with me are Kafas.
Bloody Kafas, all of them.
Yeah, they just, I find it interesting that, you know, he's talking and he talks in this content about How there's some resistance to applying this kind of insight in a corporate environment because they like to think of themselves as rational and stuff.
But basically it gets results, Matt.
You identify the Vathas and the Kathas and the results speak for themselves.
Yeah, that is good.
This is an aside, but I've been involved in similar kinds of evaluations of interventions like this in an organizational context.
And my God, it is a weak area of research because they very rarely include a proper control group.
And the problem is, if you do any kind of intervention with groups of people, then you do a soft type measure afterwards, like a survey.
Did you like it?
Do you feel more cohesive?
Are you happy with this?
Everyone goes, yes.
Everything goes up.
And my name is attached to studies, by the way, which have reported on this stuff.
And I encourage the lead author to put in lots and lots of disclaimers and caveats.
The other thing I'll mention, Chris, is that this environment of corporate Consulting.
Executives love this stuff.
Do you remember that our sense makers often tend to be corporate consultancies and some of the worst psychology I have ever encountered has been highly, highly popular in the C-suite type environments.
I mean, even I think...
Outside the realm of psychology, management consultants sometimes bring value.
Sometimes they are, you know, giving information that the corporation could not generate by themselves.
But other times, they are getting paid large amounts of money to produce PowerPoints.
To jerk off and flat out fat cats.
Management.
Yeah, that's how I would describe it.
So, you know, the corporate sector is not exactly the kind of...
Cut and frost, like survival of the fittest environment that's often presented as.
No, and it's certainly not a bastion of rigorous critical thinking.
You know, I actually did my honors, Chris, in the 40-year little project you do after undergrad in leadership, organizational leadership, just a random thing that a young kid like me would select.
And my supervisor encouraged me to look at this question of transformational versus transactional.
Leadership.
Now, can you guess, Chris, which of those two is the good one?
I guess transformational.
Every leader wants to be a transformational leader.
I mean, that's not even the worst, of course.
There was like Covey's Seven Habits of Highly Effective People.
But the more I looked at this research, the more I realized like how much of it is just designed to cater and flatter middle management.
Types that want to feel like, yep, I'm a transformational leader.
I'm so special.
I bring something to this organization that nobody else can.
Yeah.
Well, now, moving on from the corporate environment, because it comes up, but it's not a big feature of it.
He does give something of a disclaimer at the start regarding the science here.
So see if this sounds a bit better than the previous content.
At the beginning of what I'm going to explain to you guys, it is very scientifically valid.
In today's teaching, the more we're going to leave science behind, okay?
So we're going to start, like, very scientifically grounded, and I'll show you all a couple of papers which I've shown before.
And then, like, the more that we get towards the corporate consulting side, I want you all to understand there have not been studies about the specificity of what I'm teaching.
It's anecdotally very useful.
People love it.
People get better.
I've certainly loved it.
I think there is science there, but the studies have not reached that point, right?
We're at the very basic level of studying Ayurveda scientifically, and it's been incredibly fascinating.
But the closer we get to application, the more we're going to leave the solid foundation
But a lot of the stuff that I'm going to teach you all towards the end, some of it has been actually verified through some personality assessments and things like that, but really we're going to leave the evidence behind and it's going to be a lot more clinically.
Okay?
So, you know, I want to just toss out that disclaimer.
Okay?
Questions?
Ooh.
I feel like we're at the beginning of a wild ride here, Chris.
Yeah.
I think what we're talking about in the last episode with the different types and the doshas and so on, now that was grounded in hard science.
But here, here we live in the reservation.
Strap yourself in.
That might not be clear, but that is indeed reflective.
Like, he's going to argue that the Doshik system is essentially completely validated by genomics, and it's the application of that in, you know, specific environments that that bit isn't on a solid ground, but the classification system is, like, rock solid.
And I also want that reference there, too.
I'm going to throw out a couple of studies that, you know, I've mentioned before.
And, you know, we saw in the last episode...
This way of dealing with studies, like you described it, like influencers like Cooperman and Dr. K. Bean.
Mike Peiss, you know, a shiny study that seems to give the result that they want.
And it's an incredibly fascinating study.
And you can flash it up on the screen and you can read off some of the technical terms and then move on.
There was a study, right?
It's science, P less than 0.05.
And yeah, that's not the best way to approach science.
Do you think it's good, then, the notion about, like, at least admitting that some of the stuff that you're going to talk about, it isn't scientifically grounded?
Like, you're flagging that up to the audience?
That is good.
He is flagging it up.
It's clinical experience.
It's anecdotal.
And, yeah, good on him.
Yeah, so about that clinical experience.
So one of the things that we try to do, so I want you all to understand this, okay, about leaving science behind.
So I'm a clinician.
So I know it sounds kind of weird, but most of clinical medicine is not scientific.
And it sounds kind of weird, but we have scientific trials, right?
So we'll have trials that tell us, okay, this antidepressant you should use first, this antidepressant you should use next, this antidepressant you should use third.
And when an actual human being comes into my office, there's a protocol of the standard of like what is...
You know, on average, the most effective.
But what I want y 'all to realize is that, like, on average, what may be the most effective is not very effective for, like, 40% of the population.
Right?
So the goal of clinical medicine is to take a scientific foundation, which is very well grounded, and extrapolate it to an individual case.
And if we want to be really precise about it, there are no randomized controlled trials about you.
There is not a single randomized controlled trial that looks at what antidepressant will be effective in you, right?
I know it sounds kind of weird.
All of the trials are what's effective on average.
But if you think about where you are and where average is, there can be a big gap there, right?
Like, you are a very different person from the average person.
I am a special person, Chris.
Yeah, different from the average.
He goes on to talk about height and saying, you know, if you take the average height and compare your, you might be like wildly different from the average.
And I'm like, I'm not sure that's a one-to-one analogy because the whole point of clinical trials is medicine that works reliably.
It is not that it only works for individuals who fall into the complete mean.
Yeah, which you cannot do by treating every single person as a unique snowflake.
On the other hand, Chris, to be generous, I think there are lots of elements of truth in what he's saying in terms of practitioner knowledge.
To a large degree, all jobs are like a trade.
You could be a nurse, you could be a clinician, you could be...
Yeah, you know, a builder.
And there is stuff that you learn from books, the stuff that you learn in terms of general principles.
And there's also a kind of tradecraft that you do learn.
And, you know, I think he's pointing at least partly to that, which I think we can acknowledge is a real thing.
Yes, that's definitely the case.
So he is that part where he describes like people taking general principles from the existing evidence and then, you know.
Based on their experience and based on other sets of knowledge and whatnot, that they work out a treatment for an individual.
That's completely true.
I do think there's a little bit of the self-serving rhetoric that we saw before of, like, science is great, you know, but actually treating people, I prefer the individual.
So, like, he's kind of saying, look, the science, yes, it gives a foundation, but, you know, the OP'd Ayurveda is what allows us to actually treat...
Yeah, Western medicine is good in general, but not for you specifically, any one person.
But Ayurveda or some other complementary and alternative medicine is portrayed as being that hyper-specific thing, which it cannot be.
As we talked about in the previous episode, it cannot be both like a system of knowledge that is consistent and coherent that you can learn and also...
Totally unique and specific to a given person.
So there is a bit of a bait and switch there.
Like you can imagine, say, a GP, right?
They've got someone who's coming in.
They're saying that they're feeling very depressed, right?
Now, on one hand, this person could be like the sort of person who's very reluctant to come to the doctor.
You know, it doesn't, you know, you remember recently they didn't even come in when they had some symptoms that were annoying them for months.
That kind of person, right?
And on the other hand, they could be like a histrionic sort of person that's always visiting, is always talking about all kinds of imagined things.
And so your knowledge of that person and their history is going to influence...
You're not just going to take this consultation and do this little checklist with what they're telling you.
You're going to integrate what you know about them.
So that is the thing, I think, about this sort of individualised practice that any GP...
Would agree with is absolutely real, right?
Yeah, yeah, yeah.
You have this knowledge of the person.
But I think you can abuse that a little bit because it leaves this wiggle room for you to inject.
These are these things that science doesn't understand.
And this is my OP power.
Yeah, yeah.
So Naima, I'm going to play a bit of a longer clip, but I think it's important.
I want to get your reaction to this.
So this is talking about...
The same topic as we covered last time, the kind of Ayurvedic classification system, but maybe offering some clarifications on that.
I want to see what you think about this.
Okay, so number one, your Dosha is not your Pokemon type.
Look, I get it.
You've found a new framework.
You're very excited about it.
You heard about a new structure for understanding the self.
And your immediate impulse is something like, as long as I can figure this out, the best way to harness my guffest strengths and shore up the corresponding weaknesses, I'll be able to solve my problems.
And maybe you will.
Whatever works, works.
And I'm not here to tell you that you need to abandon the idea for the sake of some sort of immortal truth.
If categorizing yourself as abitta somehow ameliorates your issues, What I'm trying to make clear is that the dosha concept is not some rigorous definition of individual character.
It is, like stated above, a framework for introspection.
Like many other classifications of human personality types, it's primarily useful as a tool to get the individual to look inward and examine pathways that may not be obvious at first glance.
Understanding your dosha, whatever that may be, Is not a solution in and of itself.
It's only a tool to enhance self-exploration.
More importantly, it's a tool that is only relevant to the person using it.
Your classification is of minimal importance to the people around you.
It's an entirely personal concept.
As a result, the people asking for advice on how to approach a situation as insert dosha type here are fundamentally misguided because this whole framework isn't going to provide you a solution.
There's all sorts of solutions to all sorts of problems, and trying to peg an individualized solution to a Dosha type, as though you're figuring out the best weaknesses to exploit in a Pokemon battle, is completely orthogonal to what you actually need.
Framing your personal issues purely within the Dosha framework is going to lead you astray, because introspection doesn't solve problems.
It helps you solve problems more effectively.
The resolution is ultimately on you as an individual.
The framework can't step into your place.
Well, first of all, it does feel like he's reading that out and it's like a hostage video.
Well, so just to be clear, he is reading from something there, so that's not his normal delivery.
But what about the substance?
Well, I'm a little bit confused because it does seem a little bit...
Contradictory to what we heard in the last episode there, Chris.
You know, he's portraying it there is that this stuff about doshas and stuff, it's like a Rorschach inkblot test.
It's something to kind of, you know, present you with some ideas, some more framework for you to reflect on and hopefully build upon to get some insights about yourself.
But you shouldn't read too much into it and you can't just like cite someone's dosha and think that you're going to...
You know, know anything specific about them.
But that doesn't seem entirely in keeping with what he said before.
Yeah, very well.
So I may have tried to trick you, Matt.
That is Dr. K reading out someone else's response from his subreddit where they've written a comment or somewhere on the Healthy Gamer community.
Oh, I see.
Here's Dr. K's response to that.
This is a wonderful post.
I upvoted it, right?
Love the post.
It's a fantastic post.
And unfortunately, there are huge swaths of it that are kind of wrong.
Okay. So let's take a look at this.
So this person's argument is that there are a lot of systems of let's look at this.
Okay. So, um,
Like many other classifications of human personality types, it's primarily a useful tool to get the individual to look inward and examine pathways that may not be obvious at a first glance.
So this person is correct in some of these fundamentals, okay?
And like woefully incorrect in others.
So let's try to understand what's correct about this and sort of what isn't.
I see, I see.
You tricked me, Chris.
I did trick you.
A little bit of the shit sandwich style there.
This is wonderful.
I mean, it's great, isn't it?
Also woefully inaccurate and huge shriffs of it are wrong, but it's fantastic.
It was posted and I uploaded it, right?
So this is a good use of psychology in providing feedback that you want to be received positively.
Yes.
So what did he find that was so wrong?
Oh, I'm glad you asked, Matt.
In psychology, there are certain tests, like the Rorschach or Inkblot test is the best example of this, that's a projective test.
And so the value isn't, you know, that something is objectively correct, but that we can use particular things to help people understand and serve as frameworks for introspection.
And that if you provide someone with a framework of introspection, the framework doesn't need to be objectively correct.
The value is in the introspection.
Okay?
That's what this person's case is.
And he's absolutely correct.
That in most situations of personality analysis, this happens to be true.
As it turns out, Ayurveda is actually a little bit different.
And the main reason for that is that Ayurveda is not just a system of introspection.
is correlated to your genomics, right?
So people have done studies which show that your doshik balance is not just something that you use for introspection, but can actually be genetically identified.
So if we look at the spectrum of human beings, we realize that some people are more prone to experiencing anxiety, and some people are more prone to ulcers, and some people are more prone to anger.
So if we look at human beings and we do a scientific study and we stress a hundred people out...
33 of those people will become anxious as a response to the stress.
33 of those people will become angry and irritable with a response to those stress.
And 33 people will become isolated and depressed with a response to those stress.
Now those numbers, I actually don't know if those are true or not, but the point is that we can make very real scientific observations about variances within the human population.
And as we study Ayurveda, what we discover is that these All of these variations which we can detect with people are actually correlated to their genome.
We can actually look at these people who all get anxious.
We can look at their genome and see, oh wow, all of the people who are prone to anxiety actually share common genes.
Huge, if true.
So Ayurveda is just genomics.
Genomics actually, people fit into these three categories.
Wow.
Yeah, so he's very clear there.
And I think that it would be useful for people to pay attention that he's clear.
It's not just an introspective framework.
It's something that is validated by science repeatedly.
It's essentially, if not a containing field for genomics, it's at least a hugely fertile area.
So if it didn't have that, it might be like...
The other ones.
But it has this very strong scientific grounding, and that makes it different than the other ones.
I don't remember any genomic studies that have identified this clustering in three categories.
Well, yeah, I mean, you do have them, but they're all...
Published by advocates of Ayurvedic medicine.
We covered one of them last time, but he will reference those studies.
But even those, as we saw, that was slightly overstating how significant the evidence presented in them.
So before we get out of the science component of it, Matt, there's a little bit more about the genomics and the correlations there.
So let me just play this.
So like...
Ayurvedic genomics, establishing a genetic basis for mind-body typologies.
Right?
So like, this is kind of interesting.
So there's a significant correlation between HLA type and prakriti.
That's really fascinating.
So HLA types are sort of individual receptors on some of our immune, on our cells, which immune cells recognize and stuff like that.
But it actually, that HLA types, so these are things that are sort of like blood groups, right?
That they actually correlate with vata, pitta and kapha.
So it's sort of fascinating because I do think that where I disagree with this person is that Ayurveda is simply a framework for introspection.
Yeah, I think he's right.
That is kind of fascinating.
Definitely falls into the huge if true category because what he's saying is that what we're finding is that there are these systematic genetic differences where...
It's basically sorting themselves into different clusters of people, and this aligns with ancient knowledge of people falling into these three categories that we can tell from the way they look and their personality and so on, which also infers all kinds of things about how they should be treated for various ailments and so on.
What their propensity to develop, yeah, like autoimmune diseases and whatnot, and what kind of foods they'll like.
Yeah, yeah.
So it's very exciting news, really, that the genetic evidence has found these three clusters of people who have their different advantages and disadvantages, makes them prone to certain things, and, yeah, advises for all the treatments.
Yeah, amazing.
Yeah, you say that, Matt, as somebody that's not entirely convinced.
But did you not hear there was significant...
Correlations?
Does that not matter to you, science man?
I'm actually...
Do you happen to know the answer to this, Chris?
Because I wonder what's...
According to Ayurveda, what is the theoretical reason?
Why do genes and also people fall into these three categories?
Is there a...
Like, a reason?
Is it just a fact of the universe?
I'm just genuinely curious.
Did you stumble across this?
What is the reason why there are three types of people, three types of genes?
So, that's a great question.
I mean, it's not something that I've ever heard Dr. K mention.
And, like, it's generally a thing with Cam that they don't really explain why.
You know, like, nobody explains why there are this many star signs and nobody explains why there are You know, any of the things in the cosmology of any cam.
But yeah, that seems like a question that should normally arise, right?
I just had a look and apparently it's referenced in various classical Vedic texts and it basically is discussing the creation and functioning of the universe through two fundamental principles, consciousness and matter.
The three doshas are considered manifestations of matter.
And represent combinations of the five great elements.
So it's very, you know, like four humors.
Yeah.
It comes from sort of philosophical slash theological scripture.
Yeah, I guess.
Yeah.
Yeah.
Okay.
So that's where it's from.
But yeah, so, you know, just reference to statistical significance and whatnot, as we covered last time, studies reporting that they find statistical significance between clusters of people and that you can organize things into.
Via principal component analysis or GWAS surveys, these all should be viewed very skeptically because there are mutually incompatible systems which will claim similar levels of evidence doing similar violence to these statistical tools.
I have a similar question.
He said before how they found these correlations between the genetic signatures and the doshas.
How do they know what dosha people are in?
Is there a questionnaire they fill out?
Yeah, he covered that last time.
For a questionnaire and also assessing physical characteristics and questions about temperament.
So there are questionnaires developed to help categorize people into their relevant primary dosha, I guess.
Cool, cool.
Cool, cool, cool, cool, cool.
Just checking.
I was just curious.
Yeah, yeah.
So the Myers-Briggs also came up last time and there's a little bit of discussion with it here.
But what's really interesting is that if you actually look at like, you know...
Papers that look at science, what you discover is that three basic geno-psychosomatotypes, or birth constitutions, have different nuclear receptors which are expected to regulate the expression of specific genes, thereby controlling embryonic development,
adult homeostasis, and human metabolism of the human organism in a profound way.
This is not a framework for introspection, my friend.
This is something that has been scientifically shown to be baked into genes.
Okay?
So this is why I emphasize Ayurveda over astrology or...
Because I've studied a lot of stuff.
Okay, guys?
I've studied, like, Vedic astrology, not so much Western astrology.
I learned how to read tarot cards.
I'm an energy healer.
I don't talk about any of that crap.
I'm also somewhat familiar with Myers-Briggs, but I steered away from Myers-Briggs.
The reason I steered away from Myers-Briggs is because when I looked for evidence for it, what I found is that there's the Myers-Briggs Institute, which publishes a lot of evidence, but there is very little independent verification of the Myers-Briggs model, which I have
been able to find, okay?
But before, Chris, in the last episode, he was holding up the correspondence with the Myers-Briggs.
As proof of confirmation of the Ayurvedic doshas.
Yeah, I think it's more that Myers-Briggs is a dirty mirror reflecting the insights from Ayurvedic medicine, but imperfectly.
So there's some relevant insights.
That's why people might see parallels.
But one thing that's notable there, again, it's not editorializing.
He is very specifically saying this isn't spiritual esoteric nonsense.
This is science.
It's all in genomic studies and this kind of thing.
But also, I just want people to note.
I've studied tarot.
I'm an energy healer.
I've looked into astrology or whatever.
So Dr. K is a bit of a seeker.
Well, I'd say it's quite a resume.
Yeah.
He is saying, to be clear, that all of those, he doesn't talk about them much because he's found the system, which actually is more science than that.
But that, I think, is worth...
No, Dean.
And also, in a different conversation, this is his conversation with the influencer, Reckfall.
He mentions this.
Like, I'd been working with gamers for years, but there's just no way that I can help, like, every person out there.
And I've got to do, like, I've got to reach people more.
And so I'd sort of set myself up to kind of be, like, the next Deepak Chopra or something like that.
I was, like, very, like, ambitious and, you know, had a lot of, like...
In this way right now, You're AOE helping people.
Absolutely.
That's exactly what this is.
It's AOE, right?
Yeah.
So I realized that I can't single-target this shit.
It's just not going to work.
Yeah, yeah, yeah.
After the AMA, I probably got hundreds, if not thousands, of requests for help.
Yeah.
So he was very ambitious as a young man.
To be the next Deepak Chopra.
The next Deepak Chopra.
He's comparing himself.
People disparaged me.
It's saying I was setting myself up as the next Deepak Chopra.
Most science-minded people don't have Deepak Chopra as a target goal.
If that is the point of a comparison, that should serve as an indicator to people that you're into esoteric, non-scientific.
Uh, stuff.
If that's the comparison that's drawn.
And just, again, Matt, one more to Gilda Lily.
This is from another episode where he's talking about visualization and him describing...
When I was practicing in Boston as a psychiatrist, I kind of developed this reputation for being into the New Age stuff, right?
I had studied for years in India to become a monk, studied Eastern medicine, and so a lot of patients would come to me specifically because they'd be interested in, like, harnessing the energies of the universe.
And they'd come to me and be like, Dr. K, Dr. K, do you believe in the power of manifestation and the law of attraction?
Can you help me, like, do that stuff?
Like, do you really believe in it?
Is this real?
You've gone and studied in the Himalayas.
And I'd be like, sorry to disappoint y 'all, but actually it's kind of a bunch of BS.
Because I looked into the science of it and I sort of was like, this is actually kind of ridiculous.
And most of this is misunderstandings from the fields of quantum mechanics.
And then I looked into the research even more and I sort of discovered something really bizarre, that visualization is actually capable of achieving things that are scientifically kind of impossible.
I mean, they're not scientifically impossible, but they sound scientifically impossible.
So today, what we're going to do is help you understand both sides of those coins and then also help you understand how to actually effectively visualize to transform your life into lots of success and bring all kinds of things that you want into your life, right?
He's blowing a little hot and a little cold there, right?
Yeah!
On one hand, it's all a bunch of BS.
On the other hand, we're going to talk about how to do visualization properly.
Yeah, so I think that this will come up in the Dr. Mike thing.
There is a benefit to presenting yourself as like, I'm not, you know, like a woo-minded person.
You know, I'm not uncritically accepting all this nonsense.
Like, I approach rings skeptically and find that there's lots of crap out there.
But the stuff that's actually good, Matt, the stuff which is true.
That stuff actually blows your mind, right?
And, like, if you present yourself as, I'm a little bit credulous, I tend to believe things that fit my approach, that's not going to make, like, everybody who promotes alternative medicine or even outright, like, pseudoscience and conspiracy theories, they all present themselves as,
like, I'm unusually skeptical, but even I was convinced by the quality of the evidence, right?
So that's, he's doing it, I think, there, a bit better.
But the main reason I wanted to play that clip was he again mentioned that he was known as the doctor that was into alternative stuff that had interest.
So that's why people would approach him to talk about the science of visualizations and stuff.
So it's just from Dr. K's own account, he is a Deepak Chopra-like psychiatrist, right?
Interested in alternative mortalities.
He studied at a complementary and alternative...
So, although he sometimes presents himself as mastering the Western method before he started to look at the East and what was there, it seems like from the very start, he was at least quite open to alternative approaches and esoteric traditions,
if not had a very strong interest in them.
Yeah, it does seem so.
And actually, in the clip you played just before the last one, when he was giving the rationale for why he's focusing on, I think, being a broadcaster and a streamer rather than a clinician, is that he needs to help more people.
And there's too many people.
AOE healing.
You know what that is, Matt?
No, what's that?
Gamer reference.
Area of effect healing.
Not the targeted at an individual, but you...
Do an area of effect.
Oh, perfect.
Perfect analogy.
Yeah, that's right.
So, you know, that is a nice rationale, right?
It has the best reasons, right?
There's too many people out there.
I need to help as many people as possible.
I'm only one man.
I can't help people one at a time.
I need to help people at a more broad scale level.
And that is a good rationale for why you should be a streamer and an influencer.
Like, just looking at his YouTube channel here.
Dr. K explores shit life syndrome.
Dr. K talks to a proud Trump supporter with David Pakman.
Why shit life syndrome is holding you back.
Dr. K talks meaning, purpose, and motivation.
Like, this is clickbait stuff, frankly, for sort of self-help with it.
Yeah, but isn't that just the...
Algorithm, you know, writing the algorithm, you have to, like, make your clickbait thumbnails and whatnot.
If you're an influencer, to some degree, this is, you know, maybe the actual content is fine, but the thumbnail and title is a bit, yeah, you know, clickbait-y.
Well, the thing is, Chris, I've listened to a bunch of these videos after reading the title, and they are pretty much what they say on the tin, and it is clickbait content.
And, you know, there's nothing...
Like inherently wrong with being a streamer or posting clickbaity stuff on YouTube.
I mean, really?
I mean, look, Hasan's a streamer.
Destiny's a streamer.
Destiny's a streamer.
Both fine people.
Both fine people.
Fine people on both sides.
I guess I was just highlighting the idea that he is presenting this choice of vocation in...
Very lofty terms.
Yes.
This will come up in the Dr. Mike stuff more.
Also, Matt, I should mention, we've jumped forward in time now.
We've moved on from the Ayurvedic outline to the truth about visualization and manifestation.
This is just from 11 months ago.
This is this year.
I know that you're a fan of quantum stuff.
So I thought you might appreciate some of this.
The key point here is that somewhere along the way, there were some revolutionary discoveries in quantum mechanics, and then there were some very common interpretations about what this means.
But if we really look at the science of it, it's kind of BS.
So I recently saw one study, for example, that the people who believe in this kind of law of attraction or manifestation in the universe subjectively think of themselves as more successful, and they also think that the reason that they're More successful is because they're like really good at attracting and harnessing the energies of the universe.
But objectively, they are more likely to be bankrupt, they are more likely to be in financial hardship, and they are more likely to be taken advantage of by other people.
So at this point, I'm pretty convinced that the best way to make money using the law of attraction and manifestation is to sell courses to other people to teach them how to harness the energies of the universe.
I think that is the most consistent way that leads to financial success.
So it's kind of BS, right?
Good.
Yeah, yeah.
I thought so too.
If you listen to this, you would think, ah, like he's not a credulous advocate.
He's like kind of realizes there's a lot of BS around quantum mechanics and, you know, common misinterpretations and whatnot.
And that the people who claim to be teaching you about visualization, the main benefit is to them.
That's true in general.
Yes, that's true.
That's true.
Don't bother manifesting people.
There's no need.
Yeah, but in any case, I think it's fair to say that Dr. K, at least in some of that content, is hitting the right kind of skeptical notes about over-interpretation of quantum effects to support visualization, right?
Which fits with his initial framing of there's a lot of bullshit around us, a lot of people peddling, like, you know, get rich.
Quick through visualization, the secret kind of stuff, and he thinks this is crap.
But he also did say, no, but the more he looked into it, the more he found out there was more interesting stuff there.
So what is on the other hand?
On the other hand, you have people like Arnold, Arnold Schwarzenegger.
And Arnold is this guy who's a big believer in visualization.
And if you listen to his talks about, like, bodybuilding, Acting or becoming governor of California.
He's like, yeah, I really believe in visualization.
When I visualize something, it like helps me achieve that thing or it happens.
And that kind of got me scratching my head, right?
Like, hold on a second.
I mean, how is this person able to be like a top tier bodybuilder, top tier actor, and actually get elected to the governor, like being the governor of California?
Like, that's crazy.
Those are three different domains.
And this dude swears by visualization.
So I looked into the research even more, and what I sort of discovered is there's some crazy stuff out there about the science of visualization.
So one of my favorite studies on this, which is kind of unbelievable, is that if you have a group of older people, so we're talking about studying a geriatric population, and they visualize exercising, okay?
They don't actually physically exercise, they visualize exercising.
It increases their muscle strength by up to 36%.
So if I take a group of old people and I tell them, hey, visualize exercising, they physically get stronger by 36%.
This is insane.
So if you actually look at the research on visualization, by the way, most of the research actually has to do with physical performance.
So they're talking about like athletes and Olympic athletes and stuff like that.
They'll do randomized trials where people are like working out physically and then working out physically plus visualization.
And the people who use visualization will actually, like, be stronger.
And the craziest thing, the reason I cite that study, it's kind of one of the weirdest ones, is that this is, like, wild, but you can be sitting on your ass at home.
And if you visualize working out, your body will get physically stronger.
The effect size tends to be stronger in older populations.
And that kind of gets complicated.
But basically, I think that even in younger populations, it seems to work, okay?
So...
Chris, this feels like the kinds of cited studies that...
You would be prone to look into.
Well, this is true, though.
I had difficulties locating this particular study because it doesn't give any information except for, you know, that figure about stronger by 36%, right?
Up to 36%, which sounds like a headline summary and a puff piece written about it.
And when I did look into similar claims, if you remember Huberman, Talking about, I can't remember the exact details, but it was, again, a similar sort of thing.
People weren't actually doing things, just told to imagine, or they were told that, that's what it was, that cleaning burns more calories.
And then, lo and behold, they burnt much more calories.
And all of this research tends to be, would you believe?
Small samples, p-values hovering around 0.05.
I'm shocked.
I'm shocked.
Shocked, I tell you.
Yeah, not pre-registered.
And in this case, like the comparison, I did find some studies and like, let's assume that the effects are real, which I think is giving them a lot of credit to begin with.
But even if they're real, the comparison is usually having elderly people do some...
Targeted visualization exercise where they sit and, you know, imagine things like during that, but during a session, right, where they're set to do something against the control.
And then at the end, the people who do the visualization report better outcomes.
Now, here he's claiming like demonstrable outcomes, like 36% higher strength.
If this were true...
It would be a huge claim because he's not talking about things at the margin.
He's talking about like a 36% improvement in people.
Now, maybe it's less with younger people, but simply by sitting on your ass and imagining doing something.
And he wants to say...
This is the power of the mind, right?
And the other evidence that he mentioned was Arnold Schwarzenegger being successful in multiple domains and swearing by visualization.
And that strikes to me that one, this tendency to cite these studies and remember headline findings, right?
And treat them as that they're definitely valid.
And the reliance on...
Anecdote.
There was a successful individual.
He was great in all these different domains and he said that visualization works.
We cannot simply dismiss that because Arnold Schwarzenegger was successful, right?
Maybe Arnold Schwarzenegger ate nothing but fish.
We seriously consider that concept of eating nothing but fish because Arnold Schwarzenegger...
You know what?
I have an interest in MMA, and I often hear MMA fighters talk about what gives them the edge, and occasionally they venture into talking about science and whatnot.
Now, of course, they're elite-level athletes, so they know how to train.
They're doing these very, very rigorous training systems.
But when it comes to their claims about medicine, much like Joe Rogan...
You just cannot trust their accounts because they will swear by magnetic bracelets or they pray to the sun god the day before and he delivered.
Athletes are some of the most superstitious people on the planet and they're very often drawing incorrect conclusions about work.
Now, they do want to do things that work, but typically The thing is that they're putting in these massive amount of hours doing this practice and they wear a special band or they have a special meditation practice and they will accredit it to often the esoteric practice that they do or visualization technique.
But I think the very, very heavy lifting is done by the hours and years of practice.
The heavy lifting is done by the heavy lifting.
Yeah, I mean, look, it's a common thing in human psychology.
Like, apparently, the people that went to war, like in World War II, American servicemen, for instance, were incredibly superstitious.
So it didn't matter if you were driving a tank, they had this thing of attaching things to their tank, and all the officers told them, you know, they looked into it, no, this is not going to protect you from the shells of the German tanks.
It's not going to do anything at all.
But in the end, apparently the top brass just decided, look, it was better to just let them do it because it was like an emotional support blanket.
It helped them do their job.
And so I think the general principle is when you are deeply invested in something, it's a really high stakes thing that you're putting, that everything is riding on it.
And it could be an MMA fight.
You could be a top tier athlete or you could be some poor bugger that's sent off to drive a tank or fly a B-17.
Then you will be.
Extremely prone to superstition very naturally because you'll be looking for anything, anything at all that might help give you a little bit of an edge.
Yeah, this is actually a research area I'm familiar with because rituals often relate to situations where there is uncertainty or...
High stakes.
Yeah, high stakes and they give...
What could be described as the illusion of control, but also they can give genuine psychological relief from anxiety, right?
So maybe you can't control the outcome of the test that you've taken, but your muller going to the shrine or the church to say the prayer, people, when you ask them about the mechanism, they'll admit that, yes, well, I don't think that God or the Buddha is actually going to go and change the results on the test.
But the point is, usually, that it gives the people a feeling.
Of, you know, relief and that they've done something.
And this is where the effect of placebos come in, right?
Because the psychosomatic benefits of that reassurance can help you drive the tank better, fly the B-17 better, do the fight better.
Because, you know, these are extremely stressful, high stakes events where being a bit discombobulated and fearful and uncertain is going to be a big liability.
So, yeah, you know, it is a difficult thing to investigate carefully.
Well, also, and this relates to some of the stuff we said last time, that actually there's been these studies, and I would say in some cases not so great studies, but nonetheless, there are studies that suggest that when you add more steps or more intricacy to ritual instructions,
that people regard them as being more effective, right?
Something with more steps, with more specificity, with more reference to higher powers lead to people ascribing greater likelihood that things will work.
There's a beautiful distal connection there with gambling research, which is that, you know, there are certain kinds of gambling games that lead themselves to delusions, like superstitious and fallacies about gambling.
And when the games sort of have a kind of complexity to them, it could be the complexity in the win schedule of a pokey machine or you get given more information about the roulette wheels come up.
This number, this number, this number, so you can see the patterns.
So you've got the raw material.
And so we've got a concept called cognitive complexity, which is if you provide the raw material for the mind to kind of operate on, then you'll have greater proclivity to generate cognitive fallacies or superstitions based on it.
See?
Overlap there, Matt.
We'll put some studies in the show notes.
And since there are studies, that means it's all true.
So on this subject of visualization, so this is kind of highlighted, right?
That he's calling out the BS, but he thinks there is diamonds in the rough there.
And in particular, he makes this distinction.
So now the question is, well, hold on a second.
Because here you are, you're saying that visualization doesn't work, right?
And there's evidence that shows that people who believe in the law of attraction, they end up being more bankrupt.
And on the other hand, you have these people like Arnold, and you have some studies which show that thinking about working out or visualizing working out actually leads to improved grip strength.
So which is it?
How do we understand this?
And there's a really simple way to scientifically understand this.
Visualization works for anything inside you.
But does not work for anything that happens outside of you.
So if I visualize the world changing, nothing's going to happen.
If I visualize myself being successful in the world, that will lead to change.
And let's understand that scientifically, because if we think about the mind, the mind doesn't have any capacity to change anything outside of me, right?
Like I can't use telepathy or telekinesis to like lift objects.
Like the mind can affect things within the body.
And when we really look at the effect of the mind on the body,
I didn't have anything to object to there,
Chris.
I think that's broadly true.
Yeah, I mean, there is an interesting thing in psychology, which is that having some irrational cognitions can be beneficial to you.
Thinking that you're kind of better looking than average, you know, have better capabilities of whatever business now, so whatever, than the typical person.
They may be somewhat delusional, but that kind of overconfidence is better on average.
It can lead to problems, but on average, it's better than being...
Having a realistic appraisal and certainly a negative appraisal of yourself?
Yeah, so we were just talking about the elite athletes or whatever.
You cannot trust the cause and effect that they ascribe to things, but they can sometimes, potentially at least, improve their...
Performance by feeling like they've managed the uncertainty of the situation via ritual or practices or whatever the case might be.
And that might be a psychological impact which goes on to affect the performance, right?
So that is sort of in line with what Dr. K is saying there.
But that bit at the end where he leans towards the mind having a lot of power over the body.
Now, there is plenty of respects in which that is true.
Although, I would want to add the refinement that the mind is...
A part of the body and the product of the body's process is happening.
So the notion that the mind affects the body, of course, because the mind is in the body and is connected to all other parts of the body.
But if you view the mind as an external thing, which maybe the body is interacting with or the brain is helping to pick up, that can be a different conception because then you can view it that...
The mind, in essence, is the actual thing which has control over various elements of the body, right?
And I think that's closer to Dr. K's interpretation, is that consciousness is the ground of reality, and matter is interacting with consciousness.
And just to give some support to that interpretation, let's listen to this clip.
And if y 'all are really interested in the more like weird spiritual consciousness manifests the universe kind of thing, check out Dr. K's guide because we go into a ton of detail about the nature of consciousness and how it interacts with the universe.
And what is the theoretical basis of like mantras and how they affect things outside of you.
Now the last thing that I'm going to talk about is going to be kind of weird because now that I've explained to you what the science of visualization is, where its BS is, where it's legitimate, and kind of like how it works, I'm going to torpedo everything.
I just said, and share with y 'all what my personal opinion is, which is that I believe that consciousness can manifest in some way in reality.
Now, this is not a scientific belief by any means.
This is just based on my experience of my own sort of meditative practice.
So, for example, like 20 years ago, now, wow, it's been 20. 20 years ago, I was given a mantra by a tantric in India.
And this was a guy who, like, gave me a mantra, and I was like, I want a mantra that will channel the energies of the universe to, like, make me spiritually successful in life and materialistically successful in life.
And he was like, okay, I will give you.
And he just, like, gave me this mantra, and he's like, just chant this mantra every day, and you'll harness the energies of the universe, and you'll be more successful than you realize.
And at the time, I was like a college dropout with, like, a less than a 2.0 GPA, and I was like, okay, like, maybe I'll just do this thing and I'll give it a shot.
And what I sort of found is that it's kind of bizarre, but the more that I do the mantra, the more that I saw it absolutely helped me spiritually.
And it also helped me materialistically in some weird way.
And I've had some sort of experiences in meditation where I sort of feel connected with other things.
And then the last thing, I don't know if this is going to make any sense, but my wife has the ability to bend the universe to her will.
So he acknowledges that he's moving into the realm of non-scientific claims and so on.
I want to highlight that, you know, you can hear the enthusiasm coming there, right?
And he said, if you come and look at the course, you can see how mantras can affect things outside of you, right?
So you know a mantra, it's just a chant.
So he's talking about magical chants that increase your personal success, not just your internal psychology, but external material success, and that there is some sort of Other consciousness that you can become connected to through meditative practices and so on.
So I feel like if that is your personal experience and you have all the beliefs that he's discussed with Ayurvedic systems and you were into tarot and Reiki and astrology and so on, the materialist scientific psychiatrist has faded quite far in the background.
I'm not sure he was ever a really strong...
Character.
Yeah, there's real want and badly with this kind of thing, isn't there?
Because the very conservative and real part of it is that the brain is obviously connected with the physical world.
The sympathetic and the parasympathetic nervous system, like you said, the brain is literally part of the body.
The hormones and neurotransmitters are constantly interacting.
So things like visualization and practices to make yourself feel calm or confident.
Or whatever, are going to affect your performance, which are going to have an effect out there in the real world.
But there is a segue there, which I think you're hinting at when it comes to doing chants or doing visualizations and claiming that they're going to affect things in some other way in the physical world.
Yeah, and to link this to his views about science, listen to this.
And sometimes I'll even talk to my patients about this, and I'll ask them, I'll just ask them straight up, do you ever bend the universe to your will?
And if you know what I'm talking about, you know what I'm talking about.
If you don't know what I'm talking about, it's going to sound like absolute BS.
But this is where I'm a skeptic by nature, and even when science tells us that something is complete BS, the tricky thing about science is that science is the best system to learn about the world.
I think it's objectively superior than basically every other system, but it is also wrong way more than it's right.
Right. Like for 50 years ago, people in scientists thought that meditation had no mental health benefits, let alone physical benefits.
Right. That's the thing about science.
It's wrong way more than it's right.
There's quite a switch there, right?
Like, I feel that this is the rhetoric bit where you say, you know, look, I'm really into science.
I recognize science is much better at describing the world.
It gives us quantum physics.
It gives us, you know, useful drugs and so on.
But, like, I'm skeptical, so I'm even skeptical about science, right?
Yeah, it doesn't have all the answers, Chris.
Yeah, I actually, you know, this is a weird bow to draw, but...
Isn't this similar to so many of our gurus in the political sphere, of which Dr. K absolutely is not?
One of the weird things we notice is how they very much promote themselves as a progressive, liberal, rational person.
That's who they are.
And then the main thing that they're about and the thing that seems to be their main drawcard to their audience is kind of the opposite of the world that they're presenting them as.
Isn't there a correspondence there with Dr. K where on one hand he does take pains to emphasize he's a science guy, it's the best of all possible systems, citing studies and so on.
But actually the main drawcard, the thing that he's most passionate about is this other stuff.
Yeah, it does feel a little like that.
And I'll just play one more clip, Matt, before we get to the Dr. Mike stuff.
So we had two years ago, 11 months ago.
This is from one month ago, a conversation with Parrot Software, a streamer person.
And it's just a little bit, but I just want to show that these things do creep in seemingly still.
So the key thing about dharma from almost like a scientific perspective is it is that which allows you to act and persistently act outside of the variance of emotions and outcomes.
So the reason that I'm kind of asking you this kind of stuff is because I get a lot of vibes from you that track to this concept in the meditative tradition from having done a lot of meditation in a past life.
I think I've mentioned that to you before.
Because you intuit a lot of things that are normally taught.
And so when people say, okay, so if you spawn and you're level 50 as opposed to level 10, How do we understand that?
Oh, like you just XP'd up prior to spawn, and then you carry over.
When you respawn, you carry over some experience.
You're saying I'm on New Game Plus.
So the guy is kind of intuitive because in a past life, he had done lots of meditation, perhaps.
Oh, I see.
I was trying to figure out what the analogy was to gaming, but he's intuitive because just like in a game where you respawn at level 50, he's respawned, he's reincarnated.
At a higher level because he's been there before.
Yes, and this does come up fairly often in conversations with streamers about, you know, that they seem particularly attuned in some way.
Are these the same as his wife that can bend the universe to her will?
Is that connected or different things?
Yeah, maybe.
Maybe, but it's a completely different thing.
It's from a month ago.
And I think fans of Dr. K will say, well, he wears his interest in spirituality.
And whatnot on his sleeve.
Like he admits and he will acknowledge when he's going into more speculative, religious and esoteric stuff.
But I do think there's a constant framing of it as in line with science or at least in form of science.
And that when there's mention of science, it's kind of framed that, well, this isn't scientific, but that science, you know, science is catching up.
To the extent that science has been able to look at this stuff, it's confirmed all of the stuff genetically and so on that we've found.
But it's catching up.
But this is beyond science.
This is going further.
So now to get to the Dr. Mike stuff.
So all the stuff we've listened to, I think it would be reasonable for somebody that wants to have a conversation.
With Dr. K, it's specifically somebody that's talking about discussing medical topics online to general audiences as a medical practitioner around some of these issues about promoting Ayurvedic concepts, because it's clear that Dr. K does that in his content,
at least to a certain extent, right?
So this does come up in the conversation with Dr. Mike.
And here's Dr. Mike introducing...
Dr. K. Dr. K, more commonly known by his channel tag Healthy Gamer, is a popular psychiatrist who has found success online educating on the intersection of mental health and gaming.
He has a viral Twitch stream where he interviews creators about their spiritual and mental health, myself included.
Today we were planning to dive in and speak about his new book, How to Raise a Healthy Gamer, which is available now, but we actually found ourselves in a somewhat contentious discussion about Ayurvedic medicine.
Ayurveda is an ancient Indian medical system based on ancient writings that rely on a natural and holistic approach to physical and mental health.
For what it's worth, I think as an expert, Dr. K is one of the most
Okay, so that's a very positive introduction.
Yeah.
Yeah, and you got the point that, you know, there's going to be contentions, but Dr. K is a valuable, honest voice, right, that Dr. Mike respects him coming on, having to have this conversation and so on.
And now, Mike, this is not the focus of the episode, but next time when we looked about the public therapy, not therapy issues and, you know, the ethical considerations here, I just want to flag up that this also did feature in the episode.
This was like the kind of first...
Part of the episode was covering that.
And we're not going to go into that now, but you can hear just a little bit about how that topic is introduced by Dr. Mike.
It's very rare that I sit in front of someone who has significantly more experience discussing health to a huge audience online, because there's not many people doing it, period.
But to do it For the amount of time that you've done it, not just years that you've been online, but also when you stream, you spend a lot more hours in front of the audience.
For me, when I make content online, you know, we hyper-edit a fast-paced moving video, 10, 15 minutes.
Now I'm entering a little bit more into the podcast space.
How do you do it and not get in trouble?
So, you know, it's a great question.
So we'll see how much trouble I get into.
Well, let's get into troubles today.
That'll be fun.
And so I think a couple of things to keep in mind, right?
So I think just being super careful about what you say, what you don't say.
I think steering clear of like medical advice.
So I think the way that I kind of frame things is...
When I make content online, I almost think about my target audience as like residents.
So if I'm talking about, let's say, a clinical condition like borderline personality disorder, I frame it in the way of, okay, if I was teaching a group of residents or medical students or even pre-meds, how would I explain this condition?
So that's really what I usually think about.
And then I'll prepare lectures and just keeping it more educational.
Okay.
So Dr. K has a lot of respect for his audience.
It doesn't talk down to them.
It talks to them as if they're medical students.
So it's not medical.
It doesn't diagnose.
It's not medical advice.
It's educational.
We did listen to some clips where there did appear to be some thing approaching diagnosis.
But I suppose it was diagnosis in the Ayurvedic sense.
So maybe that's the loophole there.
In any case, so in the conversation, they get...
Talking about the therapy stuff as mentioned, and it moves on a little bit into talking about the difference between life coaching and spiritual guidance versus therapeutic or psychiatric care or this kind of thing.
So in part of it, they get to the issue about what was known in India or pre-modern.
Alternative medicine system versus modern medicine, right?
But in this case framed as the West versus the East.
So is like a life coaching session or a spirituality session a diluted medical treatment?
I think medical treatment is oftentimes a diluted spiritual pursuit.
Oh, tell me more.
So if you look at meditation, right?
So we use mindfulness for, you know, Clinical treatment.
But if you really look at the development of meditation, meditation was designed to help people attain moksha, enlightenment, nirvana.
This is why we developed it.
So they were not interested in treating depression or anxiety.
That's not why they did it.
They did it to attain a state of superhuman bliss, let's say.
So yeah, they're both making correspondences between clinical medical treatments and spiritual practices.
Including striving for enlightenment.
You can either think of one as a watered-down version of the other.
Perhaps that was a throwaway line.
I guess both of them are open to the idea of seeing them as basically being on the same continuum.
Right.
Although the interesting thing in this part is that Dr. K is presenting modern therapy as a watered-down version of spiritual insight, which would fit with all the clips that we've...
been listening to, which is what he was talking about when he was saying Ayurvedic is OPed versus modern medicine, right?
That's the things that work really, really well are the things that he has drawn from Ayurvedic medicine that other practitioners don't use.
I think Dr. Mike takes a slightly naive approach that gets him in a little bit of trouble, but listen to this.
I think when you look back so far, Time-wise, their definitions and understanding is going to be greatly different.
So they would never have said mindfulness is a treatment for anxiety and depression because they didn't have those terminologies.
I hard disagree there.
Really?
So you think that existed, like the idea of major depressive disorder, generalized anxiety disorder?
Oh, absolutely, right?
So we have, for example, like Ayurvedic medicine, which diagnoses mental health conditions,
I'm not familiar with this.
Tell me about this.
Yeah, so you have medical systems.
So this is the big thing, is that medical systems would diagnose things like depression, bipolar disorder, stuff like that.
And the reason that I say that meditation was not developed to treat a mental illness is because they say that it's, they're like, I invented this thing to help people attain enlightenment, get rid of suffering.
And then along the way, you will treat Your mental illnesses, but that's not the goal.
Okay, so how did he get himself into trouble there, Chris?
The issue is whenever you ask practitioners of alternative medicine or people with knowledge of historical systems and imply that in previous areas, people didn't know anything.
And actually, as we've covered, and as Dr. Kez explained, there were very complicated...
Systems of medicine and philosophy that categorize, you know, people into a whole bunch of different things.
There's early Buddhist stuff, which is dealing a lot, you know, introspective practices in general do quite a lot of ruminating about how the mind works and pathologies of the mind and so on.
So Dr. Mike saying, yeah, you know, that anybody would recognize depression as a thing.
It's basically opening up the ground for you to be corrected that you have a...
Closed mind about what people knew in the past.
But actually, Dr. Mike is right in the sense that people didn't know quite a lot of fundamental things about how the mind actually worked, but also just how the body works.
So that's what he's talking about.
Yeah.
I'm sure in almost all traditional cultures, they had some concepts which applied to, say, mental illness, schizophrenic type behavior.
But it would often be infused with all kinds of concepts, including spirits, that do not appear in a modern clinical definition of the syndrome.
And he's going to eat a little bit because he's essentially saying, you know, oh, you're saying like in...
India and stuff, that they didn't have the concept of hysterical women or this kind of thing.
And that allows it to be presented as a more humanistic and more thoughtful development than Victorian England psychology or whatever, which is probably...
True, in many respects.
But I think there's also the issue that people look back on those systems with rose-tinted glasses, because when you look at the actual history, there's lots of corresponding, you know, the misogynistic kind of descriptions and so on, including the monastic manuals.
In any case, let's hear a little bit more of that discussion.
The reason why I'm so skeptical about this is I look at how mental health was discussed in the 1900s of, like, histrionic personality disorder versus...
Hysteria in women.
Like, very judgmental, very culturally based at that time.
You're saying that didn't exist 5,000 years ago?
No, no, no.
So, dude, East and West are completely different, man.
Like, it's like night and day.
Okay.
So, let me just give you a couple of examples.
So, like, if you look at an Ayurvedic textbook, they had a super cool diagnosis for diabetes.
Okay.
They had, they say, go pee next to an anthill.
If the ants drink your urine, then you're diabetic.
So they had a lot of understanding of physiology.
What did diabetes mean to them?
Because to me, it means checking someone's hemoglobin A1c and seeing it fall in a specific range.
But if I'm trying to put myself in their shoes, I have no measurements of that.
I'm not even aware of bacteria, right?
Antibiotics don't exist.
I don't know.
I think they have certain herbs that have antimicrobial properties.
They understand the process of sterilization.
They do?
Oh, yeah.
I mean, we just did a video on the history of the first gentleman who recommended washing hands in between treating morgue patients and delivering babies in the 1800s.
That's in the West.
When was that?
1850s, yeah.
I mean, so I may have a rose-tinted glasses when I look at Eastern medicine.
I don't think Eastern medicine is perfect by any means, but they absolutely...
So yeah, a little bit of double talk there, which is quite common.
I've heard it before, where you conflate like a practice.
So it can often be the case that a folk practice or a practice that's developed in a pre-modern society is extremely effective in doing something.
I think there are so many examples, but there was one that I'm aware of, which is Indigenous people in Australia had an extremely complicated process for processing some of the foods that one could gather in the bush.
And it's a harsh place, Australia.
A lot of the foods require an awful lot of processing to take out poisonous compounds before you can eat it.
And while it's really impressive that anyone could develop that process without understanding the chemistry involved, following that process to get the result, and you can learn it via trial and error over many generations even, does not entail an understanding and having a decent model of what's actually going on and why it works.
So I think you have to be a little bit careful in saying that there was a heuristic.
Practiced anywhere.
Could be in medieval Europe or in medieval India.
That may have been effective.
It doesn't mean that they had an understanding of why it works.
And it certainly doesn't imply that the underlying theoretical model, which might be attached to that, is in any way validated.
Yes.
And there are plenty of similar kinds of examples that you can look at of quasi-diagnostic tests that people had in history.
I actually went down a bit of rabbit hole with this one and found out that, like, in addition to tasting urine, people also evaporated it to see, you know, how much sugar was left.
So Dr. K is talking about attracting ants, and this is a common...
The thing that is mentioned by advocates of Ayurvedic medicine to show, you know, they understood the principles.
But Dr. Mike is making the correct point that there's lots in ancient medicine that is observing effects of something.
But the actual underlying system doesn't understand the correct mechanism of diseases.
So it gets things wrong, right?
So you need to balance the humors.
He's also exactly right when he's saying, when I talk about diabetes, I mean...
You know, the specific medical definition that we know is the underlying mechanism.
And we have different subtypes of diabetes and so on, right?
So Dr. Case, like when he says, you know, process like sterilization, we developed that.
And that was a big change in Dr. Case.
Like, well, people knew, you know, way back.
Yeah.
And you're like, no, they did it.
They did it.
Like, you know, we have an intuitive.
Dislike of bodily waste or vomit or so on.
We're not attracted to that in general.
But that's not the same as understanding about bacteria and infectious diseases.
And India had the same trajectory that all...
Countries dead whenever modern sanitation and medicine was introduced with life expectancy and public health going up.
Yeah, that's right.
If that was already known, then you wouldn't have seen the benefit from those modern methods.
Yeah, I mean, it's very similar to the medieval theory of miasma.
They knew they could observe that people would contract contagious diseases in...
You know, underserviced, dirty kind of areas where people were close together.
They were often smelly.
So, you know, they had a theory that it was in the air, there was some kind of miasma.
It wasn't totally off track and in many cases would yield useful heuristics, but it was totally wrong and it didn't actually give you insight into the most effective ways to remediate it.
Another good example is alchemy.
I mean, people make fun of the alchemists, but, you know, they were smart, diligent.
People who were doing their best to understand chemistry in a pre-modern context.
They had a lot of practical applied knowledge, some of it quite useful, but they had no underlying correct model of atomic structure, right?
So they were never going to...
Really get anywhere.
And they indeed had a lot of superstitious, pseudo-religious aspects to their practice because, you know, it's not because they were silly or there was anything wrong with them.
They just didn't have a scientific model yet.
So they were sort of grasping at straws, I suppose, to explain the effects that they were observing.
Yeah, so there's a description, Matt, just for an example.
I don't know how to pronounce his name, but it might be Aretheus of Cappadocia.
That's definitely not it.
But it's a Greek physician from the second half of the second century.
And this is him describing an affliction.
And actually, the term that is used is diabetes.
But diabetes is a wonderful affliction, not very frequent among men, being a melting down of the flesh and limbs in the urine.
The patients never stop making water, but the flow is incessant, as if from the opening of aqueducts.
The nature of the disease is chronic, and it takes a long period to form, but the patient is short-lived if the constitution of the disease be completely established, for the melting is rapid, the death's speedy.
And there's mention in this about the taste of the urine and so on, right?
So, yes, people were getting sick, people were noticing things, there were healers and whatnot, but that's not...
The same thing.
There's a reason that, like, modern medicine and public sanitation leads to these massive improvements in length of life and chance of surviving childhood and whatnot.
On the other hand, Dr. K says this.
Dude, like, so even if you look at in Indian culture, this is how well they understood microbiology.
So in Indian culture, we eat with our hands, right?
Okay.
So, you know, we also don't have toilet paper.
So anytime...
I don't know that, actually.
So, like, if you look at, like, ancient India, like, not...
I'm just...
You know, toilet paper is a relatively recent invention.
Of course.
So how did people in India clean themselves after having a bowel movement?
They would wash with their hands.
And then this is how well they understood microbiology.
You never eat with your left hand.
You always eat with your right hand and you always wash with your left hand.
That's funny to me because you view that as like them practicing microbiology.
I view that as them...
Stereotyping and being rude to people who are left-handed.
They were aware of the bacteria, but they weren't aware that some people preferred to use them.
No, they were absolutely aware that there were left-handed people.
What they realized is, I don't care if you're left-handed, there needs to be a convention where bacteria that come out of your ass should not be put in your mouth.
And that is more important than the handedness because they literally lived in a society where there were endemic diseases like cholera and stuff like that.
So for the sake of sanitation, they would always have you eat with one hand and you never use this hand.
So Dr. K's logic there is incredibly bad.
Washing yourself with water is a very hygienic practice in my opinion.
Perfectly fine.
Toilet paper, not so great.
Good.
Just for the record.
But, you know, it's just the wrong conclusion to draw that people, you know, use one hand for one, one hand for the other, that they intuitively or naturally kind of associate feces with being dirty and not wanting to have that in contact with stuff you put in your mouth.
That does not mean that you have an understanding of microbiology.
It just means that you're a normal human being having normal human intuitions.
I don't think cavemen were walking around smearing feces in their food either.
It tends to be a fairly strong aversion to that.
So, yeah, the logic doesn't hold up there.
And Dr. Mike raises the issue about potential survivorship bias.
Like, are we just...
Remembering the hits, which is almost certainly true, but also, as we just talked about, I think that's actually maybe slightly too kind, describing this as an important hit.
But in any case, here's Dr. K responding to that and also potentially offering some criticism of Ayurveda.
This is great.
Okay, so let's look at that in a couple of different ways.
So it's absolutely a possibility of survivorship bias.
So let's also remember that there are a lot of things in Ayurvedic medicine that, Are not correct, right?
So this is where, and what tends to happen is we don't propagate those.
And then what ends up happening is a survivorship bias where the stuff from Ayurvedic medicine, like let's say ashwagandha or brahmi or meditation, these are the things that we now associate because we remove things like heavy metals in the usage of medicine.
So there's something called Rasa Shastra, in which they'll use things like arsenic, mercury, things like that as treatment.
But that is not nearly as popular, but that's absolutely a part of Ayurveda.
I think is a gross overgeneralization because there are eight branches of Ayurvedic medicine.
Some of them have scientific support.
Some of them have scientific evidence that they're actually harmful.
Now, there's even a counterargument to that, which is that they may have known something about the usage of these What do you think of that, Chris?
So, first of all, I think people would correctly give Dr. K some credit that he's willing to acknowledge that there's elements of Ayurvedic medicine which are likely wrong or harmful, so you deserve some credit for that.
But it is notable that almost immediately after...
Talking about the fact that there is branches that include arsenic and mercury being used as treatment.
Then saying, you know, on the other hand, they may have known some stuff that we didn't about how those things work.
And he immediately shifted to pointing out that it's got a self-correcting process by which it discards the things that don't work.
Yeah, so there's that.
But superficially, I think this looks like acknowledging...
The system is not perfect, but that's a low bar to say that the system of medicine is not giving perfect treatments all the time.
But in any case, after mentioning that, they go back to discussing, you know, why even if that's the case, we should be wary about dismissing the possible insights there.
So a good example of this is if you go back 60 years ago and someone shows up and says, hey, you don't need to take an SSRI for your mental illness.
You can sit there and meditate.
And what would science have said 60 years ago about meditation?
That it's useless.
Absolutely, right?
And that's what we did say.
And so they figured something out that based on our modern understanding of biology at the time was literally useless, was so antithetical to everything that there was a revolution in biological psychiatry.
We're like, this is complete BS.
And we were so confident.
And today it turns out that we're grossly wrong about meditation.
Yes.
But again, are we just pointing out the one time we were wrong and we were actually right the huge majority of the time?
That is what I think makes Western medicine the best.
So what makes Western medicine the best is we are the best at pointing out when we're wrong.
How true is that, Chris?
To what extent is meditation an amazing cure for mental illnesses?
There's this huge thing that Western medicine was totally oblivious of.
Well, there is quite a broad literature on this, right?
But it's essentially mixed in with the mindfulness literature.
And the issue there is you have a lot of studies claiming that mindfulness is very, very good and on par with other treatments for depression.
But in general, depression is a difficult thing to treat.
And in the same way, there are studies showing that...
Exercise and tango dancing or whatnot can be effective for treating depressions, but usually not the most severe types of depression.
These tend to be for lower level chronic depression.
And that literature has a lot of issues.
So Dr. K presents it that it's been completely vindicated, which is a narrative, which is very popular.
In various medical circles, and you can point to lots of meta-analyses which are showing that.
But I would say, in general, there's an issue about that being overhyped.
But I do think that for those people that are inclined towards mindfulness and introspective practices, doing that or doing Tai Chi or doing something can be beneficial in the same way that maybe talk therapy can be for different kinds of people.
Yeah.
I think it's that, you know, in general, it's a fuzzy area.
Sure.
Yeah.
I mean, like exercise is undoubtedly going to improve your mood if you can do it regularly and conscientiously.
But like you said, when you're talking about the really serious clinical levels of depression, then telling someone to go for a jog is generally not going to help.
Yeah, that's right.
I expect the same thing would be true of meditation, at least.
Yeah, I mean, but even so, I mean, even if you put all of that aside, the point that he's arguing is a relatively narrow one, which is that there could be some ideas from traditional cultural practices that you could then try out, test using scientific methods,
and they might point you in the right direction.
They might turn out to work.
Right, and they might have, in a previous area, have been...
Chauvinistically, like culturally chauvinistically dismissed as inferior or irrational and whatnot.
I think we can all agree that in previous years, some things are chauvinistically dismissed, yes.
Even today.
Well, I will say that that presentation, though, Matt, it does rankle me a little bit because it is the case that there has been dismissive views of other cultures, right?
You're familiar with colonialism, I imagine.
I have heard of that, yes.
But there is also a fairly consistent thread in Western societies, including at the elite level and amongst medical practitioners, which is very interested in any non-Western medicine or treatment or philosophy.
You can see it in the theosophist movement.
You can see it in the New Age movement.
You see it all over the place.
And just to show my cultured nature, there is a play called Juno and the Peacock by an Irish playwright, Sean O 'Casey.
It's from the 1920s.
I remember because I was forced to study it when I was at secondary school.
And there's a character in it.
Who wants to present himself as a worldly individual.
And he's constantly referencing the Brahmin and the mystics in the Orient that he's been studying, who have allowed him to understand matters.
And part of the joke in it, that he's getting things wrong.
He's kind of misusing the terms and whatnot.
But it shows that that was a common thing, that the educated people would be...
Interested in the ancient wisdom of the Orient and that this is a common trouble.
So just this notion that it was always treated like meditation.
What the hell is that?
There's no validity or use to that.
No, there's also always been a healthy fascination and the kind of exotic attraction to that from people in the West.
So I just want to point out that Dr. K in his presentation often overlooks that there is a romanticism.
Attached to those traditions as well as a dismissive aspect.
So that's just a point I wanted to make.
And if you remember, Matt, the issue about depression and there being different types did come up.
In the previous content, and this theme is continued here.
Their system of diagnosis presumes that there is not a treatment for depression.
And then what we do is we take that thing, we remove all the individuality, which is a core part of their system of medicine.
So their whole system of medicine is that, so there's even like, so for example, they believe that, you know, I'm extrapolating here based on my expertise, but if you look at like depression, there are three subtypes of depression.
So there is neurovegetative depression, right?
So difficulty getting out of bed, things like that.
Then we have anxious depression.
We recognize these as two clinical entities.
There's a really interesting third subtype of depression called depression with anger attacks, where the primary manifestation is frustration and anger as opposed to feelings of sadness.
Now, the really interesting thing is if you look in Ayurvedic medicine, they say that there are three dominant elements.
There's like the earth element, there is the wind element, and then there's the fire element.
So if you take this depressive pathophysiology and you stick it in someone who is a predominant Earth type, you will end up with a neurovegetative depression.
If you stick it in a person who's a wind type, you will end up with an anxious depression.
And if you stick it in a fire type, these are like Pokemon, you will end up with a depression with anger attacks.
So even in their literature, they have these three subtypes of depression.
And they say that it correlates with something about your alleles and how they manifest, your phenotype.
Right.
So he's linking now the...
We know what he's saying.
Yeah, we know what's going on here.
I see that there are three sort of main categories of...
Depression, as well as there being a bunch of specific sorts of types.
But I'm not sure if he described them quite correctly.
Did he describe one type as being depression with anger attacks?
Yeah, isn't that one of the subtypes that he discussed?
You remember the depression doctor that was raising that as an unacknowledged subcategory?
Yeah, according to a quick little search here, I see that we have major depressive disorder.
Clinical depression.
Persistent depressive disorder, which is a more chronic sort of version.
And bipolar depression, which is, you know, this alternating of depression with periods of mania.
Yeah.
I don't know if...
I think he might have adjusted the descriptions of them a little bit.
Yeah, he did.
So is to fit the...
Doshik.
Doshik things, yeah.
Yeah, that wouldn't be a huge surprise, would it?
But the main point I wanted to make in raising this is that the stuff that we heard in the first video from four years ago, where he was talking about this issue, about Western medicine only having one model of depression,
right, and one treatment, you hear the echoes.
Here, quite clearly.
He has a very similar view then as he does now, although at least here he is acknowledging that there are different types in modern medical systems as well, right?
Yeah.
Well, let's continue this East versus West paradigm that he's presenting.
I want it to be more accurately modern versus traditional, but he keeps framing it as Western versus Eastern.
The problem is there's such a pissing contest between Western medicine and Eastern medical practitioners that no one on the East is willing to say, yeah, this treatment sucks.
So the way, the one thing that we do really, really well, which is I think why allopathic medicine, talking about selection biases, but let's talk about, not selection biases in a, the reason that Western medicine is dominated so much is because we are so good at pointing out when our medicine is wrong.
So if you look at things like thalidomide or, you know, like that's such a great example of, oh my God, revolutionary medicine solves nausea.
And by the way, we're never going to use it ever again, right?
And so we're really good at that.
And the biggest problem in Eastern medicine is they are so hung up on getting widespread acceptance.
There's this ego battle going on between Eastern medical practitioners and Western medical practitioners that Eastern medical practitioners are not willing to say, oh, hey, by the way, this treatment actually sucks.
Is that because a lot of those treatments are less based on the scientific method and are more culturally based?
So I think they're based on the scientific method, but they don't look at the mechanism in the same way that we do.
So if we look at scientific method, what is scientific method?
It is having a hypothesis, testing that hypothesis, observing results.
So I think they did that.
Is that the scientific method?
What's the issue then?
That is the issue indeed.
Well, I thought the Indian fellow who did the very good science-based evaluation of Dr K and was very critical of these traditional methods, pointing out their problems and their dangers, he actually described the problem quite similarly to Dr K at the beginning,
which I think is true, which is that you're going to have a natural cultural affinity and have pride in your distinct cultural background.
And a lot of that Ayurvedic stuff is linked to that.
So if you're a proud Indian, if you have nationalist feelings, etc., then you're going to want to defend it to the hilt.
So I thought at the beginning anyway, Dr. K's take was okay.
He was noting that there is like a kind of ego battle between different people and that the Western slash modern medicine might be better at discarding treatments that don't work.
When it comes to this issue about science, though, I think this is a crucial issue.
So let's hear a little bit more.
But they absolutely applied the scientific method.
So I don't think that you can develop as robust of a system of medicine.
The big difference, though, is that we're really good at instrumentation.
So in the West, it's not even technically a part of the scientific method.
A child can make observations, test hypotheses, and come up with conclusions.
I mean, every time a child's learning to walk, that's what they're doing.
Absolutely, right?
But they don't use a microscope.
They don't understand anything about anatomy.
So one of the things that I think we've actually mistaken is that in the East, they use the scientific method quite robustly.
They just don't use instrumentation.
So what they did is figured out all of these correlations and causations and developed these kind of heuristic systems.
Even something like the concept of an organ is actually an abstract concept, right?
It's not, you can make an argument that there's no such thing as an organ, there's just, everything is just cells.
You can just say that about anything, about a cell.
Yeah, right?
That's like, I feel like Deepak Chopra's main thing is...
Like, what is HIV?
That's a concept that you've created in your mind.
It's like, well, wait, hold on a second.
Yeah, so I'm not quite there.
I think it's very easy to go.
So I think they applied the scientific method, but what they didn't have was good instrumentation to elucidate the mechanisms, right?
So they didn't have microscopes.
But they were still able to make observations that when you have a diabetic, they're going to have sugar in the urine.
And if you have sugar in the urine, you can test for that by if ants drink your urine.
Yeah, this is a style of argument or a line of argument that I've heard a lot, Chris.
Yeah, it's very popular and complementary and alternative medical actors, right?
Yeah, and for better or worse, science has been glorified, reified as the good thing.
You can't be anti-science, right?
So what you do, regardless of what you're arguing for, it could be...
Anti-vax stuff, it could be other therapies, it could be anything really, is that you broaden the definition of science and you describe these other things as also being science or this other thing not being real science.
And it gets quite tricksy, I would say.
I don't want to get into a long, boring discussion about what exactly science is because you can debate about it.
But it's certainly, you cannot lump everything, like a child learning to walk or...
Noticing in your own personal experience, in your own practice, that X seems to be associated with Y. It involves a lot more of a systematic procedure than that.
Modern science emerged from previous traditions, and there are elements of scientific thinking that you can find in lots of pre-scientific systems of thought.
But what they lack...
Are very critical components that make things different, right?
And it's why in the modern era, we can fly in planes or we can develop the vaccines.
And in the pre-modern period, we still had people that cared a lot about all these things.
We still had people making observations, but we didn't have the same technology develop or treatments, right?
Because there were important components missing.
And yeah, so he's not wrong.
I've even heard developmental psychologists talking about that you can think of children as like little scientists testing things and then kind of working out how the world works.
But they also come preset with, you know, intuitions about things.
But in any case, it's not like these analogies are completely foreign, but it's also the case.
That little kids are not scientists.
They're not.
So you have to be clear about what the distinctions are.
And I think, just to play a clip, Dr. Mike does do a good job of pointing these issues out.
So listen to this.
I think a lot of their scientific method approach is more so finding correlations and things that happen.
Which can be a form of scientific method and an introductory form of scientific method.
But then in order to see if your correlation is valuable, can you affect it?
Can you reproduce it?
Can you generalize it?
That is always missing.
In Eastern medicine?
Yeah.
I disagree.
Really?
So tell me more about that.
I mean, that's how they came up with these things like ashwagandha and brahmi and some of these things that we use in psychiatry, turmeric.
Yeah, so you've got the pointing to things that there is evidence that they work or have Come to be used in modern medicine.
So, like, they discovered them without using, you know, clinical trials and whatnot.
So, how would that be possible?
They must have been doing science of some kind.
Yeah.
So, that's not an accurate conclusion there, right?
Because, like, you can be, just to be clear, you can be correct and you can identify treatments of work without having the correct underlying.
Understanding of the mechanisms involved and whatnot.
I do think this is something that's very familiar if you've spent time around calm debates with medicine.
But I don't think it's something that people intuitively get.
So these arguments often sound on the face of it superficially plausible.
Especially if you yourself are not somebody that does science.
Because why would you know?
The various mechanisms that are necessary for a system to be scientific versus not.
But see if you can hear any echoes in this next clip, Matt, from the content from four years or so back.
Let's see if any of it has survived.
So when you randomize, so we view the RCT as the hallmark, right?
There's a huge problem with the RCT.
So let's say I show you an RCT that says that cholesterol, let's say like cholesterol-lowering medication.
What is the outcome for an individual patient when you prospectively give them a cholesterol med?
- You're talking about number needed to treat.
- No, I'm not talking...
Oh, you're sure.
But so if I come to you today...
- That like 99% of the time for the individual, it's not going to have an impact.
But for the general population, you will see...
- So this is really important to understand.
So our system of medicine does not make predictions about individuals.
It makes predictions about populations.
So Ayurvedic system of medicine is completely different because they don't care about populations, they care about individuals.
So their whole system, so if you think about randomized controlled trials, what we're literally doing in that trial is removing the individuality from our system of medicine, which then creates a problem of external validity.
So the basic problem of our studies is that we can do a study on 10,000 people, but you know this as a clinician.
This is why we need clinicians, because your human brain needs to take all of this data and then translate it to apply it to an individual.
So in the Ayurvedic system of medicine, they think that randomized controlled trials are the antithesis of practicing medicine.
Yes, strong, strong callbacks to the material we covered last episode.
Chris, I'm just...
Resisting the temptation to rebut this again.
Well, you can at least exercise your muscle a little bit.
A little bit.
What's just the condensed version of the issue there?
Well, I'll just remind listeners of this false dichotomy between individuals and populations.
An RCT, or in fact any statistical analysis, is making predictions on individuals.
Yes, it is assessing an effect.
Which is working on a measurably large number of those individuals such that you can detect it in the composite.
But it just makes no sense to contrast that with that kind of phenomenological point of view where you sort of translate it with your human brain, to put it in Dr. K's terms, in order to be able to apply it to an individual person.
It just doesn't make sense.
Sorry.
Well, you might feel some catharsis, Matt, because Dr. Mike is going to...
Help you out by pushing back a bit.
So let's listen to some pushback.
We're throwing away randomized controlled studies because they're imperfect to the individual.
I think we need to look at it deeper and say, right now, this is the best knowledge we have for the general public, which will ultimately be the best for you because this is the best information we have.
In the future, as algorithms, as information gets better.
I think we can better individualize randomized controlled studies so that we can run simultaneously thousands, millions of experiments to know instead of 80 patients I need to give this blood pressure medicine to prevent the heart attack, only 10. So now I'm targeting the therapy more towards the individual and less towards the general public.
But so then ideally what you would want is not even a randomized controlled trial.
You would want trials on an individual, right?
Because that's when you...
It doesn't produce perfect correlation between your scientific methodology.
Absolutely not.
Explain that to me.
Too much bias when you're treating a single person.
But isn't that what you're looking for?
You want an amount of bias that is specific to the person.
Again, this just makes no sense, does it?
How could you collect all of this data from a single person?
Let's say you wanted to test a vaccine.
How could you give the person the same vaccine 10,000 times?
It doesn't make sense.
Unless it's a special repeated measures type design, you cannot create a science of Matthew Brown and have journals and stuff like that, which with all these researchers all over the world figuring out this collective knowledge about the best way to treat Matthew Brown,
it's not going to work.
Well, and what is happening here as well is that Dr. Mike is talking about...
Like individualized medicine, which is something that modern medicine wants to get to.
You can imagine a future med bay where your specific gene is sequenced immediately and the medicine is calibrated perfectly to your system.
But as Matt and Dr. Mike are arguing, you can't get to that level of specificity without Clinical trials that would identify what genes are doing what and so on.
And you can't do that with one person.
So I'll play a clip, Matt, where Dr. Mike is trying to explain this.
If we could get to a point where that did work and we can recognize that, OK, this person has this kind of serotonin transporter gene and this kind of medication is effective.
Do you think that is that the kind of goal of personalized medicine is to create?
A system of understanding this person as an individual, not worrying about the population.
It's what are your polymorphisms so we can figure out the perfect medicine for you.
Yes, but the only way we can get there is with randomized controlled trials.
How so?
In order for us to know that this works on this person.
Oh, we have to say a randomized controlled trial that this is effective for lots of people.
Yeah, so the methodology is personalized.
And then we are doing a randomized control trial on personalized methodologies to see that personalized.
That I'm with you 100%.
So when I look at the Ayurvedic system, I think they're closer to that personalized methodology.
Don't you feel like there's so much bias in that approach, though?
Do you agree with Dr. Mike?
That Ayurveda is closer to the science of personalized medicine?
No, that's Dr. K. Sorry.
Dr. Mike is saying there's a lot of bias inherent in claiming that you're just focused on an individual and you're not trying to extrapolate out the general population's effects,
which we've already covered that they do do.
If you remember, we listened to clips from this exact conversation where Dr. K is talking about applying So if you look at our Western system of medicine,
The idea is that a disease process is independent of an individual and has a treatment.
So the whole point of an RCT is let's remove all of the individuality, all of the specificity from an individual patient because –
If we take an individual patient, we treat cholesterol in this individual patient.
We have no idea how that's going to apply to the other 9,000 people we treat because this person is an individual.
So let's remove individuality from the equation.
Let's look at high blood pressure, and let's try to isolate this disease process.
Then we run into a problem in Western medicine because you can isolate this disease process in a laboratory, but the moment that you have a real person in front of you, things get complicated.
Agreed?
100%.
So Ayurvedic medicine just looks at it from the opposite direction.
They kind of say, okay, let's start with an individual.
And let's understand what works for this person.
And then they also generalize.
They sort of also have, you know, diagnoses, right?
Which obviously means that it's not, there's diagnoses that are shared amongst individuals, but they start from a more individual lens.
We are starting at a population level and we are trying to narrow down to personalized medicine.
They start at personalized medicine and they sort of extrapolate out to a more general way.
Isn't that flawed by design?
No.
It's only flawed by design if you presume that the population base and the existence of a disease process that is independent of people exists.
I find it so frustrating because he conflates so many things in a muddled way and to come to some conclusions that are not connected with any of them.
One thing I didn't mention last episode, Chris, is that he's conflating the idea of a universal treatment.
Like a non-tailored treatment with an RCT.
There is no connection between those two things.
You can do an RCT with, say, Freudian psychology, which maybe assumes nothing and treats everyone, explores the different things and does completely different things with every individual within this abstract framework.
And you can still evaluate that with an RCT.
You allocate half the people to the Freudian method of...
Counselling some other people to Ayurvedic, get some more people and set them to a control where they get told to cheer up.
So he's conflating that with the idea of testing something that is non-tailored, that is universal, like a vaccine.
And they're separate things.
So he can argue against non-tailored treatments.
But, you know, as you said, this is not something that anything about...
Modern medicine is against.
We would love to have the information such that our treatments were tailored not just to men or women or older people or younger people, but tailored even more specifically about other information about you, like your DNA, some sort of profiling there.
So, you know, all these false dichotomies get sort of thrown up and his conclusion is that Ayurveda respects the individual and cares about and treats the individual, whereas modern science doesn't.
It just kind of ignores the individual and sort of pulls out some little aspect of them and only cares about that.
It's just annoying logically.
It's very, very calm-centered logic, right?
It's across all...
Disciplines and traditions in complementary and alternative medicine.
The narrative is always the same.
Western medicine only deals with the kind of symptomology.
It doesn't deal with the core illness and they don't really care about individuals.
They're just treating people as illnesses.
And Matt, this point about RCTs that you brought up, Dr. Mike does try to highlight that this is the wrong...
Point to get bogged down on.
So he tries to highlight this by talking about alternative designs and hierarchies of evidence.
And I thought this was quite good.
I think when you say we should do a cohort study to see if it is non-inferior, to me, that's the same thing as an RCT.
For us, an RCT is the gold standard, right?
But we have levels of hierarchy of evidence and cohorts are still up there.
It's not just mechanistic, right?
Like if you do a cohort study.
But a cohort study and RCT are two completely different study designs.
I agree.
But in terms of weight of evidence, they're high levels.
No, no.
But a weight of evidence is fine.
But what I'm saying is that the RCT as a study design is antithetical to this system of medicine.
Sure.
And I'm just using RCT because it happens to be the gold standard.
Let's take cohort.
Let's take RCT.
All the higher levels of evidence.
They're not done for Ayurvedic medicine, at least the majority of it.
So, granted, we can't do RCT, but we can do cohort.
Those things aren't done.
So I feel like we are taking what they're doing and you're seeing it as a leaning towards story, towards observation, away from the evidence-based model.
And I see it as full one-sided.
I don't follow you.
You said earlier a statement that it leans towards the story-based, the individual-based versus the group randomized controlled.
I think it doesn't just lean in that direction.
I think it's fully in that direction.
Yes.
At least in the theory, as we talked about last episode in the practice, it might well be that you get categorized according to your dosha and you get given one of the...
Things that are on the shelf.
And in fact, it's not maybe quite as tailored as the philosophy entails.
Well, I think there, yes, this is absolutely true.
But I also think that he is, Dr. Mike, that is, is talking about that as opposed to being an alternative system of medicine, it's primarily...
Like, cultural narrative, right?
It's like a non-scientific application of medicine based on building the narrative, not on testing treatments.
That's what he wants to argue, like, why the evidence matters.
Yeah, he's not talking about RCTs specifically.
He's talking about systematic data gathering and testing things properly.
And it's true.
There are some things that cannot be investigated easily with RCTs.
The link between smoking and cancer, for instance.
We couldn't get one group to smoke for their entire lives and then come back and see if more of them died of cancer in 60 years' time.
We had to do different kinds of studies there.
But the important thing is that you gather large amounts of data and analyze it rigorously.
You don't...
To take this alternative epistemology that CAM tends to endorse.
I know.
I have a good part here, Matt, that I want to get to where Dr. K provides acknowledgement of limitations.
But just before that, just to round off this point about...
Individualized versus not.
And to highlight the same use of gamer analogies and whatnot that we, you know, experienced in earlier Dr. K content.
This is, again, from the Dr. Mike interview.
Listen to this.
So we have, let's say we'll, like, use a video game analogy.
So we've leveled up to level 100 on population-based medicine.
And then the reason that we have good clinicians and bad clinicians is that the good clinicians are the ones who have leveled up to level 50 on individualized medicine.
In Ayurveda, they've leveled up individualized medicine to level 100.
But their population-based medicine is level 10. I think when you use that example, when you level up to 100 on the individual level, your data is fraught with error and bias and subjectivity.
Because you're not studying it en masse.
And there's so many mistakes that you could make when you're just treating an N of 1. Yeah.
Yeah, this is fundamentally what it comes down to.
You cannot base any kind of evidence-based practice, but on a purely phenomenological, individualized level, you can't
It doesn't even apply to people specifically.
If you're studying plants, you couldn't say, okay, I'm going to study this particular tree, not other trees, just this one, and find out what makes it unique and all the special things about it.
That is not going to give you a reliable source of information to understand anything about.
Trees in general or that species in general and so on.
You need to collect large data sets and analyze them rigorously.
It definitely sounds nice to talk about there being a system of knowledge that is based all about you or about me, Matthew Brown.
It's very flattering to think of everything being customized just for me, somebody staring deep into my eyes and finding out the essential Matthew-ness of me and what I specifically need without recourse to any Other people.
But while I might pander to my vanity, that is not going to help me.
Yeah.
And so, Matt, we've heard, you know, like this all sounds very familiar to the content that we've previously heard.
Focus on the individualizing thing, recognizing that there's a trade-off.
But essentially, Ayurvedic is better.
That was the constant message that we got.
There is a slightly different emphasis placed in this conversation.
So there's actually a misunderstanding here that comes into play.
So listen to this clip.
This is a fundamental problem with Ayurvedic medicine, which is that the good thing that we get, this is why I think allopathic medicine has grown so well, is because it is reliable.
Ayurvedic medicine, I do not know that it is even 10% as reliable as the practice of Western medicine.
So if you think that...
Why do you discuss Ayurvedic Medicine principles often?
Because I think there is a huge amount of utility to it.
Okay.
A huge amount of utility to it.
Sounds contradictory, but what does he mean?
Well, he's going to go on to that, but I want to make one note there.
He said, I do not know that it is even 10% as reliable as Western medicine.
That's what he said.
10% as reliable as Western medicine.
So, Dr. Mike, when he talks about this later, as it comes up, it's kind of presented a bit differently.
And it leads to, I don't know, misunderstanding or not, but it's kind of recasting what he said.
But I want to meet the point that he said...
You know, it could be 10% as reliable as Western medicine.
But to follow on from that point, listen to this.
Before this whole healthy gamer thing, my actual area of interest was evidence-based complementary alternative medicine.
So there are all kinds of problems that we haven't even touched on.
I mean, here you are saying, what about this?
What about this?
I can dismantle Ayurvedic medicine because there are fundamental weaknesses.
The first fundamental weakness of Ayurvedic medicine is that you have no way to gauge practitioner reliability.
The good thing about allopathic medicine is that at least in the United States, if you finish a medicine program, there are standards that people can expect.
If you go, you're a family physician, I'm a psychiatrist, but two people who have a heart attack on an airplane, they're going to get some comparable care, right?
Even I can handle that some.
So the biggest problem with Ayurvedic medicine is when you have this individuality, how do you judge the quality of a practitioner?
How do you know ahead of time whether this person is good or bad, whether there's biases in their patient population, if their patient population has high socioeconomic status, and this practitioner is very charismatic, so they're engaging the placebo effect, how do you even know that their treatments are working at all?
This is a fundamental problem with Ayurvedic medicine.
The problems that he sees with Ayurvedic medicine, but that does contrast with what he was saying before about it being a superpower, about it enabling him to be OP'd, I suppose.
Although part of it here, I think, is that you do have to note that one of the main issues he's drawing here is like, how do you identify the actual quality practitioners?
And that suggests that there is fundamentally very good...
If you can discern the bad practitioners from the good practitioners, then you'll be able to get to really, really effective treatment.
So it's acknowledging that there's a problem, but the problem is one of quality control in a way, not one of the underlying system.
But in any case, this returns to the 10% mark.
Dr. Mike, I think, also makes a bad framing of things here.
So listen to this.
You mentioned we need to bring some of Western medicine into Ayurvedic practice to improve Ayurvedic practice.
I view that as not an optimal use of...
Time is probably the wrong word.
I would view, based on how you describe Ayurvedic medicine, that there's a lot of problems.
90% of it has issues, etc., etc.
Why not take what works of Ayurvedic medicine, the art aspect of it, and bring it to Western medicine as opposed to bringing Western medicine and trying to fix something that is really very problematic already so far gone?
It's a great question.
So the first thing is that I think the question is sort of moot because I think both are happening simultaneously.
So I think as we...
As we progress in our scientific understanding of medicine, we are moving closer to Ayurveda.
So that's happening automatically because I think that as we're discovering more of truth, we're just moving in a particular direction of individualized medicine, which is the whole backdrop.
So Matt, did you catch the issue there with the switch?
So Dr. K said, "I don't know that it's 10% as reliable as Western medicine."
And Dr. Mike converts that to...
If you acknowledge that 90% of it has issues, right?
And Dr. K doesn't correct him here, but he didn't say initially 90% of it is bad, right?
He said 10% as reliable.
It could be 10% as reliable.
Yeah, yeah, yeah.
So this is going to, because this will now get reframed.
And I think moving forward that like Dr. K...
There is even a part where he accepts that framing, but I think it's important because that would be presented as Dr. K said.
He acknowledged 90% of it as rubbish, but that isn't what he said.
He said it could be 10% as reliable as Western medicine, and it's Dr. Mike who frames it as 90% being negative.
Right, okay.
You might not see why that matters, but I think it matters because It will be used rhetorically in various arguments, just as he is doing here.
You know, as he said, he's somebody that studied complementary and alternative medicine, so he knows how to present the devil's advocate criticism of his system, right?
And in just outlining it...
It makes it seem like you aren't adopting a strong position because you're able to see the pros and cons of both sides.
But as we've seen in the previous content and in this conversation, he is not actually taking a position which has a very balanced perspective.
He is very in favor of Ayurvedic medicine being applied.
I'm very critical of...
Western medicine.
So I feel that there's like subtle reframing going on here that it came to be slightly how this conversation was interpreted positively by people.
Okay.
All right.
Not quite following, but I'm sure it will become clear.
Okay.
But in any case, the issue that I think with Dr. Mike here is that...
When he reframes it as, like, why not take bits of Ayurvedic medicine and adopt it into, and he accepts the Western medicine framing, that sounds like a very colonialist endeavor.
Like, why don't we just...
Why don't we just appropriate a few bits and...
Yeah, and forget about the philosophical and historical context and, like, let's just take out, you know, what works and put it into Western medicine, right?
And that framing is what...
Alternative medicine practitioners always want to suggest that Western medicine is just extractive.
So, Dr. Mike is doing the rhetorical work here.
And just to highlight, Matt, that Dr. K is not...
You know, so down on Ayurvedic.
Like, listen to this.
So I think maybe I'm foolish.
Maybe I'm optimistic.
So here's where I'm coming from.
Here's why I don't think it is an unsolvable problem.
So if you look at the history of humanity, we've been faced with unsolvable problems that get solved.
So I have faith that if we were to leverage even 10% of the brainpower in scientific weight...
That we have an allopathic medicine towards Ayurveda, I think it'd be amazing what we would accomplish.
That's my gut instinct.
I don't know that that's true.
Is it potentially an unsolvable problem?
Absolutely.
So what I think, though, is that what I've seen already is that it doesn't take a whole lot.
So if we just put 10% of the brain power into Ayurvedic medicine, it will reap huge, massive rewards, right?
So that doesn't sound like...
Somebody that thinks 90% of it is crap.
No, I guess not.
But I'm not quite sure what he's wanting the scientific brainpower to do.
Is it to go ahead and test some proposals inspired by analytic practice in a scientific way and then understand the mechanisms and so on that is integrated into a modern scientific framework?
Or is it to do something else?
My cynical view is he wants more gene-wide association studies that validate the dosi.
That's what I suspect he means.
But if you take it charitably, he wants to apply critical evaluative methods to better identify treatments that work from don't.
I think in the eternal struggle between conventional medicine and complementary alternative medicine, there is...
Like a natural solution, which is to take the practice that could be informed by some traditional cultural activity or could be informed by practitioner experience.
People who work in a particular hospital notice that something works or informed by homeopathy or some other modern instantiation of CAM.
And then go ahead and test to see whether or not the effects hold up.
And if they do...
Then start to puzzle out what are the mechanisms there and understand scientifically how this thing works.
But this is not a proposal that is embraced by people from the other side of the fence because they quite rightly identify that what that approach assumes is that complementary medicine that has been demonstrated to work just becomes medicine,
right?
So what they do want to do is to carve out a place For, you know, holistic spiritual practice that sort of plays some of the role of medicine but isn't subject to the same kind of testing.
Therefore, they do not want you to unweave the rainbow and they're much more interested in sticking with those theoretical frameworks.
It could be a colour cosmology or it could be homeopathy's weird thing or you could take energy therapies or it could be Ayurveda or something else.
Philosophical, spiritual frameworks are important to the practice of CAM and important to the appeal of CAM.
Therefore, they're not going to abandon them and they're not going to submit themselves, I think, to knowledge extraction to benefit conventional medicine.
Yes, yes.
So a little bit more on this, Matt, and then we're going to get to an inflection point in the conversation that's quite important.
But here's a bit more.
And that statistic that I keep heartily known about, the 10%, 90%, it's going to make an appearance again.
So listen.
We have the starting point of randomized control data, population-based data, that we can then tailor and improve our art.
We definitely need to improve our art.
I will never not support that.
Has such a fraught foundation.
And we're like, let's bring randomized controlled evidence and all that to this fraught concept already.
Why?
I don't think that the fundamental concept is fraught.
But you said there's like 90, like 10% of it is only valuable.
Yeah, but I don't think the fundamentals are fraught.
I think the fundamentals are actually, I think the reason we practice, the more we practice the art of medicine, the closer we are to the Ayurvedic system.
Because that's what their system is.
It's an individual treatment.
But we end up there versus starting from there.
I think that's a drastic distinction.
Yeah, I think that's important.
And I think he's speaking his truth there, which is that the thing that CAM adherents like is the philosophical and spiritual foundations of it.
It is the chakras.
It is the energy.
It is the colours and so on.
They're actually not so much interested in testing whether or not turmeric or this particular thing works reliably because that's not really the basis of the appeal.
They do like the philosophical framework.
But I think what Dr. Mike is getting at there is that the framework is...
Cloudcastles built in the sky, there is no reason to think it is worth investing a whole bunch of effort into validating.
Yeah, and you've heard a little bit of confrontational tone appear in these questions.
Not very strong, actually, but just a hint.
But you're going to hear it a bit more, so just note the rising temperature in the conversation here.
So let me ask you this.
What do you think is a better system of medicine?
A system that is population-based or a system that gets outcomes that are tailored to the individual?
Let's say that I could perfectly diagnose you.
I did all the genetic stuff.
I could analyze all of your phenotypes.
I could analyze even things like your digestion, your absorption of nutrients, what kind of absorption difficulties you have.
And I understood all of this information about you.
Which one do you think would be better?
Of course, you created a perfect example, but that doesn't exist.
So the foundation of Ayurveda starts with that.
Yeah, but it's nowhere near it.
It's not even close.
Oh, that's where you've got to be careful, right?
So I think that it's way closer than what we give it credit for.
You're saying they have a perfect understanding of each individual?
They do not have a perfect understanding.
What I'm saying is that the direction that they are moving in is to focus on the individual.
So we don't even focus on the individual.
We focus on a population.
Again, with this care for individuals versus...
Abstract populations.
But you heard Dr. Mike getting frustrated, right?
Yeah, I did.
I did.
I did.
I mean, but the thing that they're talking to and the thing that Dr. K is defending is the theoretical framework of Ayurveda and saying that this is a valuable thing that deserves serious scientific investigation and validation.
And I just want to remind people what these theoretical frameworks are.
And before I describe Chris...
What the theoretical framework for Ayurveda is, just very quickly.
Let's take energy therapy first of all.
Let's see whether or not this framework is deserving of serious scientific investigation.
It proposes that there's a biofield, an energy field that surrounds and permeates the human body, that there are chakras, that there are meridians, that are pathways where life energy flows through the body.
There is a universal life force that can be channeled for healing purposes.
I'll stop there.
Let's take homeopathy, right?
They've got a theoretical framework.
It says that there's a law of similars, right?
Like cures like.
There is potentialization, right?
Where you can potentialize water, basically, by bringing into contact with things.
There is also this idea of individualization in both of those, and also the vital life force and holistic approaches, etc.
Ayurveda, very similar.
There's the three fundamental doshas, of course, that we've heard about.
That imbalance between these doshas leads to illness.
That all matter is comprised of five basic elements.
And it's these different elements that provide the vital essences that the body needs.
Digestive fire, toxic residues, seasonal patterns, and so on.
So the thing about CAM is it's not just practitioner knowledge.
Or like a traditional cultural knowledge where you'll figure it out through trial and error and intensive observation that such and such works.
It is actually a spiritual cosmology that is attached to the practice.
And that's the aspect of it that is appealing both to the people that like to use it and the practitioners.
And I think that that's the thing that Dr K is defending.
And so I'm with Dr Mike in that it is not a stable foundation.
Absolutely.
Absolutely.
And I completely agree with that, Matt.
But I also think there is the possibility of falling into a rhetorical trap here, laid by Dr. K in his framing.
And I think it relates to all those systems that you just described, because any of them can do this, right?
So listen to what Dr. Mike starts saying here.
In the way that he frames things, because he's getting frustrated, right?
So listen to this.
Why do you think in Eastern culture, we never got, well, not we, but why hasn't it moved to a labeling system, a randomized control system?
Why has there been so much disconnect between randomized controlled stuff happening in Western medicine, but that is firmly pushed against in Eastern medicine?
Why do Eastern people not like randomized controlled trials?
Yeah, like why didn't throughout time, like the way Eastern medicine is talked about now is more similar to how Eastern medicine was talked about 500 years ago than Western medicine talked about now than how Western medicine was talked about.
Why is that?
Why is it seemingly stuck in the past?
For lack of a better word.
What's the differential diagnosis for why something doesn't change over 500 years?
You see, the point I want to make there is that, so what has happened because of the constant repetition that it's Eastern versus Western is that Dr. Mike has now implied, and Dr. K helps him along saying, so you think Eastern people don't like randomized control?
And he is now essentially in the position of saying the East is backward, right?
That's what he essentially says.
They don't change, whereas Western medicine develops and what's wrong?
And it sounds bad, right?
It's a bad look, Chief, to me, suggesting that only the West changes.
And I think that's by design.
I think the correct thing instead is this is why it should be framed about modern versus traditional or scientific versus non-scientific.
Yeah, you can't overestimate the importance of that framing because it bears repeating that a couple of hundred years ago, medicine as practiced in the West was as unscientific as Ayurveda or anything else.
That is the traditional European cultural...
Health practices are largely bullshit, right?
That should be emphasized, right?
And all kinds of people all over the world endorse, practice, and receive evidence-based modern scientific medicine today.
So you really have to reject that framing that Eastern people like this and Western people are like this.
Yeah, and so, you know, when you read out those descriptions, right, Matt, it's completely valid to point out that these are pre-scientific.
They're like spiritual or metaphysical concepts that we don't have scientific evidence for.
But because of that conflation of those two positions, it can come across as Western people dismiss.
You know anything that doesn't fit within their paradigm as opposed to science has consistently shown that these systems are not correct and that's the issue I think is like that that presentation that it's like western cultural close-minded chauvinism is the like the bait and switch which happens so easily and it's really effective it's a really effective treatment because like who wants to be A dismissive Western person
who thinks that the rest of the world is stuck in the past and unable to adapt.
And I don't think like that, to be clear.
That's why I think anybody doing scientific modern medicine, regardless of race, color, creed, nationality, whatever, would get to the same things because it's a system of what?
It's not a specific culture.
No, and it's not derived from any particular culture.
That's right.
Yeah, that's what I meant to say.
It is a specific culture.
It's a scientific culture, but not a specific national culture.
And this is the issue of, I think, the Western medicine branding.
So that leads to this, where Dr. K switches to say, you know, I'm being presented as the pro-Ayurvedic person.
This is not really fair.
I feel like I'm...
I'm adopting a pro-Ayurvedic stance because of the way you're asking questions, but I don't use Ayurvedic medicine with the majority of my patients.
I use evidence-based techniques with the majority of my patients because they are reliable.
And at the same time, I'm with you that I don't know.
So if you look at this text called Jaraksamita, there's like tons of treatments in there.
I have no idea...
How many of those are effective as meditation?
We even have evidence that some of them are harmful, like Rasa Shastra, right?
So I steer clear of that because, but then the problem in the Ayurvedic system is if you go talk to an Ayurvedic doctor, many of them will not say, oh yeah, this doesn't work.
That's a huge problem.
Right?
They'll say like, "Oh, we don't understand it well."
Or they'll like kind of poo-poo.
And maybe they're right.
Maybe we're right.
I don't know.
So I'll be the first.
So my area of expertise is evidence-based complementary and alternative medicine.
So the whole point is that there's something very valuable here.
This is my belief.
Something very valuable here.
And we need to separate the chaff from the wheat.
We need to figure out what is actually really useful here.
It's very difficult to argue with someone like Dr. K because he's so manageable.
He changes his stance.
You know, dramatically from one context to the next.
So here, I guess, he's in skeptical mode.
No, Ayurvedic is just, you know, he barely uses it.
It's just some interesting ideas.
I think we should investigate it, but until then, I wouldn't use it.
But we've heard him talk about it as a superpower that does.
It's constantly validated.
It's a science.
That's the difference, right?
It's been constantly proven to be correct and the limitations of population-based medicine is something he observes constantly.
So when someone rhetorically shifts like that dramatically, then it can put the interlocutor very much off balance because it's not clear.
You know, it's like a shadowboxer.
Yeah, and also in this case, again now, there is a shift to, so Dr. K is being presented as like a non-scientific person because he's being forced by the confrontational attitude of Dr. Mike.
Oh, yes, that's right.
Dr. Mike has forced him to defend Ayurveda with his confrontational attitude, yes.
Yeah, so now I will, like, here's a bit that's in the middle, because you'll hear Dr. K admitting flaws, but also listen to him essentially say that there were miracle treatments that he's observed in Ayurvedic.
So this is somewhere falling in between both of the narratives he wants to promote.
Part of the reason that, you know, I studied Ayurveda, fell in love with it, and then I went to medical school.
Because what I saw is that I have no idea what's the quality of education I'm going to get.
I have no idea what's the reliable, what the reliability of some of these methodologies are.
I've seen things that are medical impossibilities from Ayurveda.
With my own eyes, I've talked to patients that are medical impossibilities.
Like paralysis, being able to, polio paralysis, right, which is a permanent condition.
That's not something that generally speaking gets better.
These people are able to walk.
And so when I look at that, it gives me pause.
And it says to me, there is potential here.
So what did I do?
Did I say, oh my God, there's potential here.
Let me go to Ayurvedic doctor and I'm going to indoctrinate myself.
No, I went to medical school, focused on evidence-based complementary alternative medicine, realized that in the grand scheme of being a doctor in the world today, each of us can make a contribution.
What do I want my contribution to be?
I saw something that I thought was very...
Worth?
I saw something that I saw potential in.
And I said to myself, even if 90% of is shit, I can't judge whether 90% is good, 10% is good, 50%.
I have no idea.
But there's something here that we in the West can benefit from.
And that's been what my focus is on.
I think he's been quite straightforward there.
And I believe him when he says that, you know, he's seen things and he believes that there's value in it.
And it's really just like he's expressing a personal subjective, you know, love for it, which is understandable, right?
You've given his background and you get deeply involved in this thing.
You can like it a lot and you can sort of firmly believe in your heart that there's got to be something to it.
You may be struggling a bit when it's come to backing that up.
I'd just like to say that my uncle had polio and the doctors told him he would never walk again.
And he got better.
He got better, thankfully, and walks fine.
So you saw a miracle?
I saw a miracle too.
He didn't have Ayurveda treatment.
I didn't think he had any complemented alternative treatments because it was put back in the 50s or early 60s, I think.
But, you know, if he had, and someone was around, you could observe that and go and become a lover of Ayurveda or whatever he happened to have been treated.
Maybe he was drinking vinegar, eating nothing but meat.
So people can get very misled from personal experiences.
Yes, absolutely.
But when I described it as a narrative, I mean it in both the good and negative sense of that, because I think that Dr. K is rhetorically effective and he can slip between these modes, right?
And here he is doing the, I'm an evidence-based person.
You know, I'm not an alternative medicine blind advocate.
But the framing there is important because what he said was, you know, yes, I saw these amazing things, but so what did I do?
Did I go, you know, to try and get that all endorsed?
No, I went to become a, what did he say?
Evidence-based complementary alternative medicine.
Yeah, right.
But so how many evidence-based CAM practitioners are known for debunking or for finding studies that show that CAM doesn't work?
It's almost zero.
It's almost zero because they all go and find that whatever particular brand of complementary and alternative medicine that they like just so happens that the studies almost always turned out Positive, right?
So you can be more evidence-based, but that is, in essence, a field dominated by advocates for alternative medicine, right?
You can counter this by showing me the people that have studied CAM approaches and become people that are arguing against the integration of CAM into medicine.
There's a handful of them, and they're all known, right?
So he presents it as, I was being skeptical.
But that is just being an advocate in a different variety.
So that's the bit that I want to call out.
And we went here from saying he doesn't really use Ayurvedic treatments, right?
Like they're not a really big part.
But listen to some of this, Matt.
So this might sound familiar.
What do you like about Ayurvedic medicine?
What is that part?
So I like that they focus on the individual.
Got it.
What else?
I like that they look at, so just as a psychiatrist, so like one thing that I really appreciated was this concept of like a cognitive fingerprint.
So we have this in some ways in terms of like five-factor model and stuff like that.
We have these personality assessments, but these personality assessments are usually done at the population level.
And so the translation down to the individual is not as clinically useful as some of these Eastern conceptions of cognitive fingerprint.
So when I work with a patient, doing a five-factor assessment has very little bearing on my clinical practice.
But doing more of an Ayurvedic personality assessment has a lot more utility in my limited biased experience compared to some of these generalizable personality assessments.
There are some cases where those can be good, but I think that some of this stuff is quite revolutionary.
So we went from the claim that he doesn't really use Ayurvedic in his practice.
He focuses on evidence-based treatments.
But now he's saying personality assessments, like the big five or something like that, they're not really clinically useful.
But what is useful are these Ayurvedic personality assessments.
And again, there's this thing where somehow this is not a population-based classification.
When we've seen that it is indeed a very generalizing population-based classification system where you have three values, and yes, they're in different quantities, but you categorize into specific types that will be associated with specific ailments,
specific body types.
And this is only a matter of minutes from going that I don't use this in my practice to this is much more utility based on my clinical...
Practice, right?
Yeah, with Dr. K, the contradictions abound, like there's contradictions not only logically in the kinds of stuff he claims, things being, you know, ultra-individualized versus being population-based, logically inconsistent.
But at the same time, he contradicts himself from like five minutes ago.
He takes a different stance depending on the line that he's taking.
And the general impression I have is somebody who is rhetorically very gifted, is a very good speaker.
But is really focused on saying things that suit the moment, that sound good in the moment.
Yeah, so I don't quite trust what he says, I'm afraid.
Well, so one more callback, Matt.
We've had the callback to the cognitive fingerprinting, right?
And the issues with the five-factor model or that kind of thing.
Now a bit about Ayurvedic diets and the gut biome.
Also, in my clinical practice, what I've seen is if people adopt Ayurvedic diet, they're more likely to have sustained remission at lower medication doses or be able to come off of medication.
That is nothing magical, by the way.
I think they just sort of figured out gut microbiome observationally, and then now we're discovering the mechanism.
But it's really interesting that their first-line treatment for mental illnesses...
It seems to be diet, and my guess is the mechanism has got microbiome modification to support neurotransmitter precursor production.
That's my take.
And what I've seen very clinically is when I apply some of these principles to my clinical practice, that patients tend to do better.
So we've got, like, no, Ayurvedic isn't the big part, but now we also have the diet.
Adjustments coming in as like, these are more clinically effective and get people off medications, right?
So again, the contradiction should be apparent.
The other thing, Chris, that I noticed throughout is that when he makes a claim in favor of Ayurveda-inspired practice, he backs it up pretty much every time by...
This is what I believe.
This is what I've seen from my personal experience.
Yeah, this is my belief.
This is what I've seen.
And it sort of slipped in there many times.
But yeah, I mean, that's the backup he's got.
That's fundamentally the argument he has for everything he's saying.
He's not able to refer to other things because there isn't a great deal of either conceptual or empirical support there.
But it sounds quite...
Rhetorically effective, doesn't it?
When you say, Chris, I've seen things that you wouldn't believe.
I've seen things that were medically impossible and they just work.
But really, if you pay attention, he's doing nothing more than expressing his personal admiration.
So now, Matt, we heard in the clips coming up to this that Dr. Mike was getting frustrated.
And now you've had this like quite rhetorically powerful thing.
So some people might respond like, you know, positively.
But Dr. Mike's response is a little bit negative.
And this leads to a switch in the conversation.
But like, first of all, here's what Dr. Mike does.
Dr. Mike, more specifically, makes some harsh comments.
And Dr. K gets a bit angry.
Why not take the concepts of those things, like improving?
The cognitive fingerprinting of modern tools.
Focusing more on the individual approach.
And stop calling it and talking about Ayurvedic medicine.
Because it's sexy to talk about Ayurvedic medicine because people are passionate about it.
But 90% plus is crap.
And yet I feel like we're keeping it afloat.
Well, I don't know that it's crap.
And you don't know that it's crap.
Well, we know that it's crap because of how it got to where it is, because of the lack of reliability, the randomization.
No, but we don't know it's crap.
We just don't know that it's not crap.
There's a big difference.
And when someone makes a claim that this water will prevent you from dying, or this is the anti-aging water, do you know that this is not going to prevent you from living forever?
Like, do you know that I'm lying about this?
No, I don't.
Right?
You need to do a trial.
But I'm very comfortable as a doctor now saying, no, that's not happening.
Because mechanistically, it's not there.
The evidence isn't there.
And I've gotten to the point where even though I don't have the evidence.
Yeah, very important distinction, Chris.
It's not crap.
We just don't know that it's not crap.
Yeah, so that thing where he said the 90% thing again, right?
If Dr. K thought that it was 90% crap, he wouldn't be so...
Triggered, right?
By someone saying, we know like 90% plus is rubbish, right?
So this is why I'm saying, like, that wasn't what he said.
He said, you know, he said, even if it is 10% as reliable.
So this kind of annoys him because Dr. Mike is strongly saying most of it is crap.
And Dr. Mike got a bit aggressive there, but now this is the judo flip.
So here we go.
So, Mike, what frustrates you so much about Ayurvedic medicine?
I'll tell you why.
It leads to a fundamental misunderstanding of healthcare for a large percentage of patients.
It opens room for health gurus and hucksters to take advantage of people.
And it actually diverts our attention from ways that we can improve medicine.
Okay.
So now I'm understanding this conversation a lot better.
So I noticed that this was becoming very antagonistic, which was really weird because I actually agree with the majority of what you're saying.
I see that.
Yeah, right?
So I'm the first to kind of say, like, I'm the one who said, hey, like 90% of it I think could be crap.
And so I was kind of struck a little bit.
And then that's when I realized, like, I'm not talking to someone who has an open mind.
I'm talking to someone who has a mind made up.
I'm talking about it from a truth-seeking perspective.
So my mind's not made up.
If you presented some data or information here that showed Ayurvedic medicine is way more accurate than you think it is, I would have changed my mind today.
Yeah, so it's interesting.
I definitely have a bias from what I've learned so far.
So poor old Dr. Mike.
He has to admit that he's closed-minded, that he's biased.
That he has this preconception that Ayurveda is bad.
So let's dig into that, Chris, and find out why that might be.
And Dr. K, like, so there's this thing about when you make a better comment on the conversation, with that you're in, by the way, right?
Like we saw this with the sense makers.
They would say...
You know, one of them, when they wanted to position themselves as the king sense maker, they will say, I'm just seeing in this conversation dynamics, these kind of things, right?
That's right.
You're talking a lot.
You're talking a lot, Chris, and I'm listening.
And like, why do you think that might be?
Exactly, right?
So Dr. K is a psychiatrist, right, and some of her lots of experience.
So here, he kind of breaks the flow and is like, this is becoming...
Aggressive.
Have you noticed that?
Like, why do you think that is, right?
I have another great example of this.
Call back to Eric Weinstein talking to...
Oh, Mick West.
Mick West.
You know, I'm feeling...
I'm feeling very attacked or whatever he said at the moment.
It is amazing to see this in action and how effective it is.
It wasn't so effective against Mick West because to his credit, he just ignored it, which is the right approach.
But it can be a very effective form of, I guess, passive aggression where you can put the person on the back foot and get them to explain themselves why.
They are disagreeing with you.
Why they are arguing their position.
And you set yourself up for a win.
And poor old Dr. Mike here, I think, walks straight into it.
Yeah.
No, he did answer very well, I think, at the start.
He did.
When he was asked, like, why does this annoy you?
And he gave a very reasonable answer.
But the fact that he got emotional, that's it.
That's the crack.
Yeah, that's right.
If he accepts the premise that he's become annoyed.
Then obviously that's a bad thing, right?
You're letting your emotions...
But you'll see, Matt, that it doesn't entirely.
Let's see how this goes on, right?
So this is what happens next.
How is this conversation for you emotionally?
Exciting.
In what way?
So do you feel anything besides excitement?
Full excitement that we're finding a way to truth-seek together.
Because unlike many people who talk about Ayurvedic medicine in this space, I think you do it...
Incredibly honestly.
So, because I agree with you, but I think there are a couple of things to keep in mind.
So when you make a statement like, you know, 90% of it is crap, that indicates bias to me because we don't know that.
You make a very good argument that we can't, we have to be skeptical based on our understanding of things that if I say, I show up today and I say like, oh, like, here's a pyramid.
If you meditate under the pyramid, like it could work.
And then you can always make the counter argument that until you study it, we don't know they could be right.
Right.
And what I'm also detecting from you is like, I think I'm detecting this emotion of frustration because of hucksters and these kinds of people.
So I think your understanding of Ayurveda comes from these people.
And so that's why I was kind of surprised because usually in conversations, I...
Am representing your view a lot more.
Yeah.
Right?
So I'll go to these academic conferences with a lot of Ayurvedic practitioners and I'll say like, hey, like we don't know.
There are eight disciplines of Ayurveda.
We have some limited evidence of this particular thing, Brahmi, turmeric, ashwagandha, like a set of herbs.
We don't have a whole lot of stuff on this.
And so I think it's just been really interesting.
Now I understand a lot more why this conversation is going the way that it is, which is that you're asking me all these questions, which I...
I get the sense that you're sort of open to the answer, but I think you're asking questions that are not open-ended questions.
You're asking questions where you already have a hypothesis and you are asking me to reflect upon that hypothesis or even counter that hypothesis or support it.
That's fair.
Yeah, yeah, yeah.
Dr. K's skills in therapy.
Really coming to the fore here.
You can imagine someone talking to a patient saying, I'm seeing a lot of resistance here.
Why do you feel so opposed to what I'm proposing?
In other words, Dr. K isn't shy about arguing his corner, expressing his very strong views, but there's something wrong with Dr. Mike for having...
An opinion about this not being open to what the state is proposing.
And stating it so strongly.
And remember, just there again, Matt, he pointed the 90% comment.
You said 90% of it is crap.
Like, how could you make that strong statement?
But a moment ago, he was claiming he said that.
Before anyone else, like, to show that he's open-minded.
But now it's being presented as, like, that is a disqualifying comment for someone to be.
So, which was it?
This is why this thing stuck with me.
I know.
It's very close to Eric and the Flex interpretation of the Flex comment.
Yeah.
I mean, like, I think Dr. Vicky's speaking loosely, but I think in his mind, he was just restating what he thought they'd agree to him.
You know, 90% of it was not based in any kind of evidence.
Yeah, and that thing here where he says, you know, I'm usually in your position.
I'm usually the skeptic, you know, asking the Ayurvedic practitioners.
Possibly that's true.
But if so, it simply speaks to the issue, right, about the Ayurvedic community.
But Dr. K, as we've seen in the content that we've looked at, he is not...
Usually taking Dr. Mike's position in this conversation.
He has taken the same position that he has in all the other content that the Western medicine, yes, it has its uses.
It's good with instrumentation.
It's good at a population level.
But in clinical practice, what works is doshi questionnaires, finding out the diet.
This can get people to be cured in ways that they aren't.
But then...
When useful, it's just addressing it.
You know, I don't even apply these things very often in practice.
And this thing as well, we're asking people to reflect on their emotions, right?
Like, so how are you feeling?
Because there's a charge moment in the conversation.
And Dr. Mike, you know, this is best to frame it positively, but like he's also an interviewer who is now being...
Flipped round to, like, been reflecting on the way that you've been asking questions.
Have you been an open-minded interviewer, Dr. Mike?
Like, were you pushing the point of view?
Are you open to exploring new ideas?
No.
Yeah.
How well does that go with Northern Ireland, Chris, when somebody asks you to reflect on your emotions?
Yeah, let's see.
Welcome to...
Bring this approach to a right to reply if you want.
So then this also goes to this.
So listen to this bit, Matt.
I think our hypothesis is similar.
Yeah, so I think though...
And our standpoint is similar.
I think that you would benefit from studying Ayurvedic medicine.
Agreed, which is what I'm hoping in this conversation I can learn more about.
So I think just this individualized approach, it's so axiomatically different.
I think there's value to it.
Without a doubt.
So Dr. Mike has to...
I think he finds himself in a position where he needs to be a lot more accommodating, a lot less disagreeable, and to concede a bunch of things because he has sort of accepted the positioning that Dr. K took there,
which is that he's being too antagonistic.
He's being too close-minded.
Yeah, he needs to be...
He needs to...
So...
I mean, you have to respect the art, even though it's not a good thing to do.
It's been very effective in this case.
Even though, as you said, Dr. Mark's initial reply was very good, I think he took it on board.
And he's emphasising, you know, actually, we agree, right?
We're fundamentally in agreement on all this stuff.
We're, you know, basically on the same.
No, you weren't.
No, you weren't.
Like, listen to the replies.
There's a wide gulf in your presentation, but now...
The dynamics of this situation call for emphasizing, you know, and emphasizing that Dr. K, he thinks Dr. K is a very, you know, reasonable person that can see the pros and cons, right?
Like, so there's this and just to show about how much this has shifted things.
So that this is what then comes next.
So you were mentioning, you know, alternative energy systems and this way of thinking.
So they were like, oh, have you heard of meridians or nadis like this?
I've heard of them, but I don't really understand.
So there's this idea that we have this vital life energy that flows through us.
It flows through these channels.
We biologically looked for it and it doesn't, we can't find anything.
Well, we can't measure it yet, right?
We might in the future.
We might not just have the tools to currently measure it.
Yeah.
So I'm open to that.
Yeah.
So, and that's where some people are looking for it.
And one person, for example, discovered that there are interstitial channels, basically, that don't have a...
Tissue difference.
There's a change at the level of the electrical conductance, but there isn't a physical...
Atomical thing.
Yeah.
So Dr. Mike, now being a very good boy, he's agreeing that there could be energy flows throughout the body.
There could be a vital life force.
We just don't perhaps have the tools yet to measure it.
It's like with the Star Wars thing that connects and binds, Chris.
We can't measure it, but we can't say it's not there.
Yeah.
And I'm open to that.
And like, yeah, so that was Dr. Mike, you know, injecting like maybe modern medicine.
Like it's just, it doesn't have the tools to validate that.
I'm open to that.
Look how open-minded I am.
I mean, I feel sorry for him to be here.
But I think he has been successfully flipped.
And all the clips I'm going to play from now till the end are of this tenor.
So gone is the questioning and kind of pushing back.
Or even, you know, he's not about to call Ayurvedic medicine primarily crap.
Let's be clear that's not going to happen.
So Dr. K is now on his face.
So we know, for example, that yoga and tai chi...
Outperform standard exercise when it comes to things like osteoarthritis or mental illness.
There are RCTs.
You're familiar with that?
Familiar with that research?
Yeah.
That they outperform it?
I'm not sure.
Okay.
So there are some studies that show that.
So actually, let's do a quick aside.
So that's what makes me really wonder about the value of some of these traditions.
Because if we look at studies that show that yoga is superior to physical exercise.
So there's one paper from, I think, 2016, the New England Journal of Medicine on Tai Chi and osteoarthritis that basically showed that it was very effective.
So then, interestingly, from a scientific perspective, if we say, okay, like, if all that exists is physical, then exercise should be the same as Tai Chi.
The other way to think about it is that even if it's still physical, it's not necessarily that energy exists, but when you use this heuristic...
Or this concept of energy, and you develop a practice based on that concept, the physical, biological postures that you do are somehow superior to this other set of postures that is exercise.
Does that make sense, or did I lose you there?
Did that make sense for you, Matt?
Did you lose me?
Yeah, yeah.
So, first of all, do we know that?
Do we know it, Chris?
That yoga and tai chi...
Somehow, for some reason, we don't know why, it could be something non-physical, is demonstrably superior to other forms of exercise.
Well, we know that there are bound to be individual studies or even potentially meta-analyses that show that.
So that would settle it, wouldn't it, Matt?
Like if there is studies that have presented that and /or meta-analyses, well, the case goes.
Yeah, if you can find a study out there, then we know it.
We know it.
Just one thing, though, Matt, is that we are being slightly flipping because sometimes I feel that for people that aren't versed in methodologies and issues in science research, it is true, generally,
that meta-analyses are a higher level of evidence than individual studies, right?
But there's a...
Three is which a lot of people know, which is garbage in, garbage out.
And essentially meta-analyses cannot make up for limitations in individual studies.
So you have to contend with the weaknesses of the studies.
If you get a whole bunch of weak studies together, it doesn't suddenly make them strong studies.
So there are meta-analyses that say ivermectin is an effective treatment.
Bad meta-analysis, right?
So this is the issue.
You cannot simply rely on that existing.
So I might be delivering the point, but just to explain.
Yeah.
It's the kind of thing we've said before.
Yeah, so just following along with his line of argument there, which is we purportedly know that these practices are superior to these other forms of exercise.
And according to Dr. K, they should be exactly the same.
But actually, unless there's some non-physical...
Mysterious explanation, perhaps something to do with Ayurveda, but that's actually not true, right?
Like there could well be like a difference between a couple of different versions of exercise and it could just be due to like a variety of things about which yoga is different from other forms of exercise,
right?
Or Tai Chi, yeah.
Or Tai Chi or whatever, right?
So, you know, but he has jumped straight to a kind of a, all right, this...
This is a non-physical explanation.
It's a mystery.
It challenges so-called button-down reductionist science.
Therefore, Ayurveda.
Yeah, it can't be explained any other way.
And you're like, well, it can.
There's a whole bunch of much more mundane explanations.
Even if we accept that the overall finding is valid, you still don't leap immediately to metaphysics.
And if it sounds like we are...
Doing that, like being unfair, and that's not what he's saying?
Listen to this.
So, we have a study.
You can look at the paper.
I'll send you the reference.
So, Tai Chi and osteoarthritis outperforms physical exercise.
Okay, so now let's understand Tai Chi is based on this theory of vital life energy, which we have no scientific evidence about.
So then the question becomes, how do we explain this result that this practice, which is based on a non-real thing, Outperforms a seemingly comparable practice.
They're both just moving around.
So there are two explanations for this.
One, or probably more, one is that this thing does exist and is not measurable.
The second is that even if it doesn't exist, the concept of this existing and something about the way that they developed those practices based on this concept, it's still just completely biological.
But because we were considering chi, we developed this different set of movements.
And if you look at someone who just does stretching or calisthenics or whatever, these other physical practices, that there is a difference in the physical practice.
Does that make sense?
Does it make sense?
Yes, you have to think hard to follow along with his logic there.
But being charitable, Chris, the logic, I think, is that there is a practice like tai chi based on...
Sort of theoretical framework that involves energy flowing through the body and meridians or whatever the case may be.
And that if there is some benefit to Tai Chi over and above what you would normally expect from doing similar kinds of exercises, but not following that theory, then this sort of supports the idea that there is something to the theoretical framework.
I think that's what I'm saying.
Yes.
So, like, one way that you would want to check this is comparing Tai Chi with, like, slow-moving exercises that are not derived from the theory of, like, meridians and chi flow and whatnot.
And, you know, I'm aware...
And I could very easily imagine, yeah, like, a variety of practices that involve core muscles and, like, stretching and sort of tension postures and so on.
Like, I don't see that you need to have, like, a...
Like a spiritual theory of energy flows.
Yeah, though it is the case that often those things do involve some metaphysical or spiritual like layering on top, even, you know, like kind of acting postures or like the Alexander technique or whatever, like there is a kind of,
I don't know, like a pseudo-science gravity.
That comes around like a philosophical layer on top of various, you know, physical movement therapies.
I'm just saying that, like, I can imagine you don't need it, but I'm struggling to think of many examples where popular ones don't include some philosophical or esoteric framing.
Yeah, of course they do.
But in order to sort of test whether or not...
This evidence, if it exists, we have to emphasize if it exists, if there was actually like a proper, well-conducted RCTs that really showed that there was a measurable benefit to doing it the Tai Chi way versus a proper control,
which is something that involves a lot of other similar kind of muscular, physical exercises, but doesn't somehow involve the metaphysics, which is kind of hard to imagine, really.
Because it would be kind of very similar, right?
Because I don't see that you need the metaphysics in order to do the stretching.
So you can imagine some different movements, right?
So instead of like worm saluting the sun, you do Chris waving to his mate at the fish and chip shop, right?
Yeah.
It might be, in terms of biomechanics, a very similar thing, but it's just totally meaningless in terms of the spirituality and the philosophy.
So let's say there was, and I'm sure people haven't done those tests, but if they did, then...
The idea is that, okay, so we understand what's different about this sort of philosophically inspired movements.
Yeah, but I don't see the attachment of the philosophy to a particular set of practices.
Like if the practices work, I don't think that proves that the philosophy underlying it has got stuff.
It doesn't, but I feel like you're falling into Dr. Mike's trap as well.
He is saying, well, but, you know, if these work, we can just take the movements out and whatnot.
And Dr. K's retort to that is, no, you can't because the reason they work is because of the system that they're...
So even if you took the movements out and they worked in a different context, the insight was derived from the metaphysical, spiritual, biomechanical model of the body.
I see.
Right.
I see.
Now, the problem, one issue with that argument, for example, if you were taking the evidence in totality, for example, is that while Dr. K could easily find acupuncture studies, for example, which show positive results and meta-analyses,
which claim it is effective for various things, whenever studies have included sham acupuncture, which is...
Giving people healer acupuncture not on acupuncture points, right?
Just like randomly inserting them and or needles which do not pierce the skin but feel like they do.
That's the sham acupuncture control.
Invariably, acupuncture does not do better than these controls, right?
But they are rarely used.
So that would suggest that actually it isn't the meridians that are doing the work.
But, you know, in any case, it's a counter.
Point about that kind of thing, but he's talking about a specific case here, right?
Yeah.
Well, I think following along with his logic, I think I'm actually okay with it, if true, right?
Big if true, right?
If there was some mysterious benefit attached to these specific yoga practices that are inspired by Ayurveda or some other...
Sort of traditional philosophy.
And you came up with a bunch of other good controls, like you just described, right?
Biomedically identical.
And you even gave people, what you have to do is actually make up, because of the placebo involved, in terms of the sort of benefits that people perceive in their being, sort of a rich philosophy attached to why they're saluting the sun in this particular fashion.
You just make one up, right?
One that's plausible, but not real and kind of random.
And if you ran that kind of study, I would be gobsmacked if you could show a difference.
But if you did, if you did, then I would hand it to Dr. K. I'd go, yep, you know, I think we've shown that there is something in those insights.
Yes, again, this is going to sound like biohumbug, but it's important.
But it wouldn't be impressive if you showed that in a single study because you could randomly find the effect just from random...
Noise, right?
Like in a study.
It would all depend on how well-powered the study is and whatnot, but like what you would want to be able to show is that you could consistently find this effect.
Different research groups could find this.
Indeed.
So on, right?
So, yes.
Yes, right.
It takes more than one study to demonstrate this, of course.
Yeah, you say you would be gobsmacked.
I wouldn't be gobsmacked by a single study.
I wasn't referring to a single study, Chris.
I was referring to the outcome of a program of research by critical researchers from different labs and so on, right?
I should have given you more credit.
Yeah, give me more credit, man.
But returning to Dr. K, I think the way he said it, though, sounds very...
Plausible, right?
He sets up these two things.
There's only two explanations.
There could be other ones.
And, you know, the sort of intuitive thing to do is to agree with him, right?
Yeah.
And he talks about the issues with publishing and how they kind of misrepresent this.
So listen to this.
So the moment that we remove that spirituality from it, I think we lose that value-generating aspect.
Why?
Why do we have to lose that?
Like, for example, you took the principles of those breathing practices of slow the mind or energize the mind, and you adapted them to modern medical defined conditions.
Yeah.
Why in this scenario do you feel like you're losing the spiritual connection?
Because when we publish papers about it, the more that I include that information, which is really where I got my answers from, right?
The more that I include that, the less likely it is to be published.
Why?
Because people don't publish that.
Why?
I don't know.
Because it's not scientific.
But the science mechanisms, theories are not scientific in nature.
Yeah.
So I could have a thought today that I would put up for scientific testing.
How in the world would a company not want to publish something if something works simply because the beginnings of it weren't scientifically valuable?
If you look at the studies, the evidence-based studies, right?
These are studies that are published.
So if you look at like New England Journal of Medicine thing on Tai Chi, you'll find...
Almost no.
You'll see a small section in the background that Tai Chi is an ancient practice based on this theory.
You won't have a single line about what is actually happening to the Chi in your body when you do this kind of thing.
Correct.
So there is a strong publication bias against this kind of stuff.
I don't know why.
I mean, you have to ask the journal editors.
What is the value of including the history of it?
It's not history.
What I'm talking about is they have a mechanism, right?
So they have a theoretical mechanism with which they develop a practice.
And we know from RCTs that the practice is quite effective.
Just a small thing there, Chris, before you reply to the substance, because at the beginning he alluded to his studies and his publications on this topic.
Whenever people do that, I always look them up on Google Scholar.
And just from a very brief search, it appears that he may have co-authored two studies.
He may have written one Okay, so you're just pointing out that he's not exactly a very prolific published researcher on this topic?
Which is not a crime, but he did imply that When he publishes on this or tries to publish on it, I guess big science has stopped him from publishing.
Just a small note.
Yes, that is true.
The implication you would get from the comment is that he's often publishing things about this or trying to, but yeah, that wouldn't seem to be the case.
But also, I think that the discussion there is saying like, you know, it's hard to include stuff about...
We believe it's working because of the way that the chi flows and this kind of thing or because of the Ayurvedic dosha system.
And he's correct that that would be hard to get published in mainstream journals because it's not scientifically evidenced.
So it would be like getting a result that is positive and then attributing it to the worship of the...
The sun god Amaterasu, right?
Like, you might have a system of exercises that are based around, you know, the history of believing in this particular god.
But it would be odd for a scientific journal to include a thing saying, so, you know, we cannot rely that the sun god is making the process more effective.
Yeah, I mean, this is entirely normal, isn't it?
You could write a paper, for instance, you might have genuine evidence regarding, say, difficult gaps in the fossil record in a pre-Cambrian shale somewhere, right?
And it might be perfectly legitimate, and you could publish that.
But if you then go on to talk about how this is evidence for intelligent design, then you probably will have difficulties publishing it.
And you might say, oh, it's because research is prejudiced against...
Intelligent Designs.
It's a perfectly good theory, just like any other theory for why we're seeing the gaps.
But actually, it's not.
It's not a good scientific theory.
And that's probably why you don't really see it.
And the other thing I would note is just that there's a line in it where Dr. K is saying that when we publish papers about Ayurvedic or this kind of thing, it's difficult to include the information about where they really got their answers.
From, right?
So the point for me is that, you know, that is suggesting that the fundamental basis is the Ayurvedic system, right?
And yet, again, in this conversation that was presented, that isn't even really what it uses in the practice.
So, yeah, just mixed messages again.
But this follow-up, because we did actually hear a bit of doubt, CPN, again, from Dr. Mike.
you know, why can we not just remove things from the context and see if they work?
And we get the conversation being steered back to Dr. Kaysley.
So neurons, blood flow, firing, creating action potentials are all the same, right?
Like you're...
Okay, so...
You having a thought right now?
Yeah.
Where's that thought coming from?
My brain.
Okay.
But is there any other thing in the causal chain that is creating that thought?
Is there anything else in the causal chain creating the thought?
Sensation, receptors, etc.
So the simple idea.
So one of the places that...
Thoughts in our brain come from.
This is based on the yogic concept.
So sure, it's translated through the brain.
But we know that our sense organs are a source of thoughts.
This is why advertising is a thing.
If I show something to your eyes over and over and over again, it will trigger certain thoughts.
It will trigger certain desires.
Agreed?
Okay.
So where else do thoughts come from?
So we can also have thoughts.
I'll speed run this.
You're welcome to question it.
Memories, etc.
So we've got the introduction of the mystery of consciousness, Chris.
This is one of your favorite topics.
Yeah, perennial fever.
But you can hear Dr. Mike trying to give the answers.
He kind of senses a trap, right?
But also, often when I see Dr. K do this, he does this with streamers as well.
It is somewhat like people haven't given this.
Much consideration.
You know, like, I guess this is what Sam Harris, why he thinks it's mind-blowing as well, like to say, you know, you are not your thoughts.
Like, you know, like, but to me, this is a kind of rhetorical technique where you start to say to people like, well, what caused you to think about that?
Where did that come?
Did you?
Did you decide that you were going to say this sentence?
Wasn't there other causes that are not related?
Do you know everything that is motivating you to say something?
And the ultimate thing is to kind of point out that what you thought of as your agentic control is actually embedded in these processes and caused by very different things.
And you can use that for different purposes.
You can use it to...
Suggest that there's no true agency, that we're living in a deterministic universe.
Or the other thing is to problematize the notion of consciousness that people operate around.
And so that's what Dr. K is doing here.
Yes, indeed.
There's a very specific point that he's wanting to get to with this.
And it's interesting because it appears like a very long leap, right?
He's leaped from defending...
I guess, spiritual, holistic, intangible processes as being an important part of what should be an extension to science, something beyond science.
And he's looking towards the mystery of consciousness.
You can't explain consciousness if you struggle to say where your thoughts come from, if you struggle to say, am I something else apart from an agglomeration of cells, then you've made some space for the mysteries, I suppose.
Yeah, so this is a little bit further on, just to see where this line kind of goes.
So, but how do we know that cognition exists?
Because we can test it.
How can we test it?
By asking someone a question, by giving them a command, and seeing an outcome.
Right, but so then what are we actually measuring?
We're measuring words and actions.
Correct.
We can't detect a thought.
So for all you know, so like, am I thinking right now?
Like, to me, the definition of a thought is a signal.
So you have an experience of thoughts, right?
Correct.
But we don't have...
So we can do EEG, we can do fMRI, but this measures electrical activity.
It measures blood flow to the brain.
We can observe the impact of thought, but we actually have no...
And maybe someone will prove me wrong.
I've been asking this to a lot of neuroscientists and psychiatrists.
We don't have any proof of the existence of thought.
We just can't measure thoughts, right?
So I can't detect thoughts.
I can't verify for you that thoughts exist.
I mean, he's right.
I mean, he is right that subjective consciousness is not something that is the experience of it, by definition, right, is not something that one can objectively measure.
I don't want to get into a discussion of consciousness, but I just want to say this is a very familiar thing.
Once people start talking about consciousness and the mystery of consciousness, I feel like Dr. K here is at his most Deepak Chopra-esque because you can create this, you know, this fascinating mystery of consciousness, open the door and go, well, there are things that science can't explain,
Chris.
Why not?
Why not spirits?
But, you know, yes, you cannot hook someone up to the...
Brain image atomizer and have their thoughts projected on the screen where Fred Flintstone is running around or whatever.
We cannot do this.
But we can't measure thoughts.
Aren't thoughts just part of cognitive activity which we can measure and show that it's going on?
I think the key thing there, Chris, is that by definition, so his definition of thoughts there.
It's not any of the physical manifestations of thoughts, right?
Like neural activity, things you say, things you might describe about your experience.
None of that is the thing.
The definition that he's working to is the subjective experiential thing, which if you think about it is by definition.
Unmeasurable because it's a subjective experience.
You and all the people keep saying that, and I just don't think it's true.
Because, take for example, Matt, there was a study done where they had the tree in this kind of software, right, with like brain activity interface on people looking at various images and the brain activity, right?
And they were able to get the thing to reproduce the image that people were looking at.
Do you know about this?
Like they spelt out the word neuron.
So what's that?
What happened there?
Those are just the signs of consciousness, aren't they, Chris?
So those people were looking at a word which the software was able to reproduce, like a visual image of it.
So is that visualizing the subjective experience of thought?
But how is that different from me saying, hey, Chris, right now I'm looking at a word that says bunk.
I'm giving you a sign, a measurable, tangible indication of what.
I'm subjectively experiencing, which is what that experiment's showing too.
So I'm not disagreeing with you, really.
I'm just saying that the trick here, it's a bit of wordplay, right?
It's how you define it.
You define it in a way such that it is unmeasurable.
Yeah, I get what he's up to, but I'm asking you.
You're a wordplay.
Okay, Dr. K, get out of the way.
This is between me and Chris now.
I'm not going to be tricked into another discussion about consciousness, Chris.
I will not do it.
Just that's one thing.
So you said you cannot measure the subjective experience of, like, thoughts.
But what I just described, assuming it's a true description, is it not measuring the subjective experience?
You're saying you could tell me, but you don't need to, because the Brien user interface has shown me on the screen what you...
So, how is that not measuring the subjective experience of someone?
Because you don't know that that person is subjectively experiencing it.
They could be a p-zombie, right?
That just has a bunch of neurons that's encoding it, right?
They could be like a large language model that can perfectly comprehend the word and you could probe it and go, "Oh, look, I know what the large language model is looking at.
It's looking at this word, right?
Because you probed it."
They're talking about the subjective experience of the thing, which by definition is not something you can probe.
What if it is?
What if it's the CMRs that?
What if there isn't an extra special source, like the experience of doing that with that kind of brain is that?
What if there is nothing else apart from the signs or the measures or indications of conscious experience?
No, no, no, no.
It has to be...
We will cut all this out.
But I'm just going to say, it's like saying, the eyes work like this.
We know how the cones and the stuff register the light signals, and we understand how the brain can reinterpret those signals to produce a visual system, right?
You know all about that.
But we don't know what it's like.
We can't tell that everybody's eyes, that they actually produce an image.
That's the classic thought experiment about qualia, right?
Which is that we don't know that your experience of red is the same as my experience of red, like seeing the color red, right?
Yeah, but why would it be different?
We both know that we point to the same objects and go, that's red, right?
Yeah, yeah.
But your experience of it could be completely different to mine.
Right, but why?
But that's the thing.
Why would it be different?
It could be arbitrary.
A lot of things in neurodevelopment are kind of arbitrary, like the way things get wired up.
It could be that redness for you is a different kind of experience.
All right, we'll never resolve it.
I mean, I'm with you.
I find it incredibly frustrating and I don't like it.
This is why I don't want to talk about it because I think it's just, this is philosophical fucking, you know, navel-gazing.
You can't investigate it, so you can't answer those questions.
I'll just remind you that Kevin Mitchell said that I was right.
He might have said you were right about something stupid.
It doesn't matter.
Okay, okay.
So after that sidetrack into consciousness, which...
We've been exercised from the podcast.
So, yeah, the thing is that Dr. Mike is pointing to various signs that we can indicate that people are thinking and are having thoughts and whatnot.
And Dr. K is constantly saying, but those aren't actually the actual individual experience.
So, that doesn't really matter.
And you can play that game all day.
Like, the same thing works again with saying, you know, who are you?
Well, I'm a, you know, I'm...
An Irish man.
Oh, like, so you are, you know, like, just going down through categories till you get to Adams or till you get to...
Who are you really, Chris, once we strip away these layers of the onion?
Yeah, you didn't invent Irishness, so you inherited a bunch of...
You can do this deconstruction of conceptual categories in so many different ways.
And Dr. K is doing one version.
Of it here.
And yeah, so it gets to this, which is where it was always going to go.
There's a bunch of spiritual practices that are designed to dissolve the ego.
And in that process, once you dissolve your sense of self, then you get access to transcendental states.
So some of this stuff we know is scientifically correct.
Some of this stuff we have some scientific theory of mechanism, like default mode network, psychedelics, ego, death, and meditation.
And then even beyond that, though, the transcendental stuff, we have no idea what's going on there.
What is going on on a practical level?
Like, maybe not on a measurable level, but how would you describe it to me?
So I would describe it to you as the nature, the basic unit of existence is consciousness.
And consciousness coalesces into energy, and energy coalesces into matter.
So we can affect things in the material world by working on the level of matter, or we can access the consciousness level, which will then dribble down into manifestation in the real world.
And I'll be the first to admit that that makes no scientific sense.
I think it does.
Why not?
People incorrectly saying...
This coming from you, Mike?
What?
Wait, why?
I just expected the staunchest...
That's why you think I'm a disbeliever, but I'm not.
I think...
Also, you have to remember, I'm not an allopathic physician.
Oh, that's your deal.
I'm an osteopathic physician.
Well, I'm with Dr. K here.
It is incredibly unscientific.
I understand his worldview, and it's one that he shares with a lot of other people, that consciousness...
There's a spiritual energy and it's like a mind-body dualism thing, right?
Where you can affect the world.
Ideas like manifesting arise from this.
And, you know, even you and I disagree about some of the subtleties here.
So I think it's understandable that people get confused.
But it is really a wrong way of trying to understand the world and a very unscientific one when you posit that the consciousness is like a fundamental building block of the universe.
At the other end, you've got atoms and electrons and so on.
The idea being that this conscious essence affects the world and the world can affect the consciousness and that they're interacting with each other.
And it's just a road to nowhere intellectually.
But it's a common belief that he's got.
Yes, well, that's true.
But I think that one issue there is that people will read that as you say.
This is a mysterious topic, whatever.
However, that's definitely bullshit.
That worldview is just nonsense on stilts, which I think people might read as dismissive.
And I would say that, like, you know, he thinks consciousness is a thing.
I think consciousness is a thing.
I just don't think it's a special separate thing from the material world and universe that we exist in.
He thinks, as you said, like there's a dualistic Or maybe more.
But in essence, the stuff that modern medicine is dealing with is matter.
But people are composed of matter and mind.
And a proper holistic practice just deals with both of those things.
And that's what I think is a road to nowhere.
I recognize there are interesting philosophical debates at the margins.
But that worldview, that dualistic worldview, is a waste of time.
Sorry.
Well, I think you can hold that worldview all you want, but if you hold it, you have to acknowledge it's not supported by science, which, to his credit, he does say there.
But this is why I think it's worth understanding that Dr. K's content is based on this worldview.
All of the stuff that we've heard, all of the clips are about tapping into this power.
Of consciousness and spiritual practices, which then allow the BS medical stuff to be supercharged.
So, counter to what he said, that this is just the, you know, frosting on his evidence-based practice.
No, you can see now, where he's more comfortable, that he's fundamentally highlighting this is the basis.
This is why he thinks that Ayurvedic is OP.
This is why he thinks manifestation.
Kind of occur in different ways and so on.
So like it is not an incidental fact, you know, he might believe in heaven and hell or he might believe in doshas.
No, no, no.
It is more like a Christian scientist who their metaphysics and philosophy strongly impacts how they perceive, you know, what is effective in medicine.
That's why it's important, I think.
Yeah.
And the reason why I say it's a road to nowhere is not because I think the mind isn't interesting, the consciousness isn't interesting, that we shouldn't be thinking about thoughts and complex systems and so on.
It's rather that when you hold that kind of worldview, what you do is you carve out this region of things which are measurable, things that you can investigate using scientific practices, and then you carve out this other section, which is spiritual,
which is metaphysical consciousness, whatever you want to call it.
But the important point for me is that it's ineffable.
Like, it's unknowable, except through some sort of revealed kind of experiential thing.
And he often gestures towards his personal experience and he just knows this.
He's seen it.
You know, he can feel it.
And that's what people do because it can't be investigated any other way.
You can't unweave that rainbow.
And so the reason I think it's not a useful path is more that it...
By design, it can't be investigated.
Well, but I think that is the trap that Sam Harris and Dr. K will set for you, because their counterargument to that, and the counterargument of all people involved in those kind of practices, yes, there is a way that you can investigate those centuries-old programs of very rigorous...
Introspective practice, is that what you're going to say?
Introspective practices that understand...
The mind and these systems.
And if you did it, if you did those practices, you would be able to reliably produce the same outcome.
So it is a science of the mind.
It's just one that you have not investigated and that science doesn't properly comprehend.
Okay.
Well, that's a lovely trap, but I'm just going to leap straight over it with a great big hop because the simple rejoinder is that isn't science, right?
Just like we said before, like a child learning to walk, it's very amazing.
It's very cool.
It's not science, right?
Science is about documented methods, replicable things about actually objective measurements.
It's not about, hey, I personally did this thing and it really worked for me, so trust me.
But their argument isn't that.
This is the thing.
Their argument is exactly all the criteria that you just said, that you do this and you will produce replicable results reliably and consistently and that you can document it, is what introspective practice is.
But they will say that you can't untangle it.
You can't understand the reasons why.
The reasons why are kind of intangible, right?
Like you said before, they would object to you sort of carving out saying, oh, this kind of yoga seems to work really well.
Let's figure out exactly the reasons for that.
And you said before that they would say, no, no, no.
It makes no sense to do those things without embracing the entire spiritual kit and caboodle, which can't be investigated.
You and Dr. Mike, you will get in trouble with Dr. K because they will say, yes, we do have a system that explains why this happens.
We just outlined it.
It's meridians or it's the doshik.
But you can't measure those things, right?
You can't measure doshas.
You can't give questionnaires.
I give up.
You win.
All right, you and Dr. K win.
You tell me.
How do you argue against this?
I don't know.
Well, you don't say that they don't have...
Clearly nonsense.
No, no, no, no, no.
You do not say that they don't have systems that are...
Giving explanation for these observable findings that they have.
The issue is that the claims, like there's so many incompatible systems claiming the same thing.
Like if you follow the set of introspective practices that you will confirm the reality of these competing energy descriptions, which are not the same, which are based on mutually incompatible systems of metaphysics, but they're all relying on the same claim.
You're on sounder grounds map when you say it's the same.
As like the revealed truth of prophets from a religious system, which it is, but they have a system, right?
So you don't say to people who reveal truth that, well, but you don't have any system to explain why you got revealed truth or what your revealed truth comes from.
They do.
They've got complex theologies.
No, I appreciate they have a system, right?
Like people that believe in extraterrestrials have a whole cosmology, you know, a whole elaborate Baroque.
System of explaining why things happen.
As we've heard through this episode and the last one, there is a resistance, a kind of in principle resistance to disentangling that system and isolating the components and measuring the components and figuring out what does what.
And that, I think, is what makes it ineffable and uninvestigable.
Well, correct.
Things will come up where the intentions of the researcher matter and various other things.
The effect will disappear if there's skepticism applied.
Yeah, exactly.
But you have to be careful.
Let me give you an example.
Hypothetically, because I've seen different versions of acupuncture, and I've seen at least one version where what they're targeting are lymph nodes or perhaps nerves.
I could be getting mixed up, maybe both.
I've seen explanations like that, and I've also seen explanations where the tap being actual energy, you know, more intangible energy lines and centers and so on.
Now, the latter one, you just can't investigate because this thing is not, you can't point to it.
It is a religious kind of concept.
But on the other hand, if they are basing it on, say, targeting nerves or lymph nodes, then you can actually test it.
And see, okay, well, if they're targeting this live node, you can see whether it's having an effect on that.
You can understand the mechanism.
Oh, it's releasing toxins or not toxins, but you know what I mean?
Something from this thing and actually figure out why, if there is an effect, why there is an effect.
So it's investigatable in principle.
But, you know, from what we've heard, there is like a resistance to that.
There is...
Very quickly are gesturing out, no, you can't unweave the rainbow.
You can't disentangle these little things.
Many of them are on a different non-physical level, and that's what Dr. K is constantly speaking to, which is that, you know, this is why he brought up consciousness, because he wants to point to the importance of the realm of the non-physical, which is, in principle, not measurable.
Right, but the whole discipline of evidence-based CAM research exists to counter that.
And say that, well, but even though you cannot unweave the rainbow, you can't demonstrate that these practices are effective.
So this is why I just think you have to be careful about any sweeping statements because that would immediately be pushed back.
Well, I don't care about evidence.
I'm on the board of journals that are based on examining the evidence in clinical trials for...
This kind of thing, right?
So I think when you look at the statements that we've looked at, you can see that there is a constant like flipping back and forth between those modes.
But that's why I think in the same way that Dr. Mike finds himself tied up at times from saying something about like people don't investigate this or this kind of thing.
That's all I'm saying.
I take your point.
I take your point.
Well, look, fortunately, I don't really care about winning arguments.
I'm just giving my opinion here, Chris.
Yeah, I'm just preparing you for the right reply.
Consider me your Mickey.
So just to bring it back, Matt, we heard earlier in the earlier content about manifestation.
And again, I want to point out that...
All the stuff that we heard in the earlier content, you hear echoes of here in this discussion with Dr. Mike.
So it wasn't that this was, you know, isolated things where he's talking like kind of loosely about the ideas.
And when he's in more lockdown mode, they don't apply.
Like, listen to this.
So what I mean by that is you take something called a Sankalpa or a Resolve.
So whatever Sankalpa you use during Yoga Nidra.
It gets implanted into your mind and then starts populating your mind during your regular time.
So when I use this with patients, for example, who have a history of trauma and have self-esteem problems.
So like, you know, we came up with one sunkulp, which is like, I deserve to be whole.
So it's not that I am a good person.
I'm going to manifest things in the universe.
And there's interesting science on manifestation and stuff, which we can get to.
And it's just this idea that if you literally look at a patient who is struggling.
Their mind will have a hundred thoughts over the course of the hour.
And there is a particular practice that allows us to add 10 thoughts of whatever we want.
So this is sort of the spiritual value of a sankalp.
And even there's even more non, even psychological benefits to it.
There's spiritual benefits and transcendental benefits and all this kind of stuff, which is really what a sankalp is about.
A sankalp?
Is that what he said?
Sankalp.
Sankalp, sorry.
So this would highlight that conjoining.
You know, this is just a way to interrupt negative thought spirals and, you know, get people to break cycles by focusing, you know, on like reciting something or something like that.
And plus there are transcendental spiritual things, which is what it's really about building up.
But, you know.
Yeah, no, I see what you're saying.
It's like a foot in both camps where you get to on one hand go, look, it's very scientific.
It actually accords well.
And, you know, science is now rediscovering and finding, confirming this result.
At the same time, it's magical.
There's a whole bunch of extra stuff going on.
I'm interested in the manifestation thing, Chris.
Is there more on this?
Well, there is what we heard.
There's a whole YouTube video about the science of manifestation.
And you can imagine how it would be reframed here, right?
That, yes, I agree that all that stuff is bullshit.
But actually, there are really good studies showing that you can grow extra muscle and stuff just from thinking about doing exercise and so on.
Speaking of YouTube shorts, Chris, I don't think I'm...
Did I mention this?
I stumbled upon a fun YouTube short from Dr. K, which I think is on a similar vein.
Science proves enlightenment.
And it was set up at the beginning of he's going to run through some of the scientific evidence for enlightenment.
So I thought this would be interesting.
But actually, no, no.
He didn't cover any of the supposed scientific evidence for enlightenment.
But it was actually how to become enlightened with five tips.
And it was things like avoiding coffee.
Not using your device before you go to bed.
It was very YouTube shorty.
Yeah, it was fun.
I can imagine that.
So the claims often outstrip the evidence.
But after these kind of conversations with Dr. Mike, he's essentially got him to largely agree that they're in agreement.
And Dr. Mike is eager to make this point as well.
I think you and I see eye to eye on this topic really.
Pretty much one-to-one, maybe 99.9% of the way.
I think we see eye-to-eye and Ayurvedic stuff almost.
Yeah, that's what I was like, really, really close.
My question is, when you're doing that practice and you're doing the informed consent, and you're doing it before the evidence hasn't caught up to it yet, how would you feel if when you, let's say,
a patient comes into a doctor's office and the doctor says, hey, look, this medicine, Has never been proven to work for your condition through scientific rigor.
But I'm going to give it to you anyway.
Just trust me.
Do you have an issue with that?
That's a good question.
But I like the framing.
Oh, and one thing.
So, you know, you heard at the end of the clip that Dr. Mike is an osteopath.
He agrees he's not allopathic.
And, you know, as we covered before, allopathic is the denigrating name that holistic doctors use for.
Mainstream, modern, mainstream medicine.
Yeah.
Yeah.
So, I mean, by that stage, he's also at the point of saying, you know, why would I oppose that, you know, mystical energies can come down and affect matter?
So he's fully swapped the role from skeptic to, you know, like open-minded seeker.
But yeah, I thought that's just interesting that he wants to highlight, you know, I'm not purely allopathic.
I'm not.
Yeah, no.
Well, okay, well, putting aside the fact that Dr. Mike is rolling over to have his tummy rubbed, you know, he asked a good question, which is that, is it fine, from your point of view, to be practicing therapy or practicing medicine based on things that do not have a scientific evidence base,
you know, based on your personal convictions rather than an evidence base?
And that's a good question.
That's a good question.
Do you want to know what the answer is?
Here's a fascinating study by a guy named Ted Katchuk.
So he's a placebo researcher out at Harvard and was a mentor to my PI.
So he did a super interesting placebo study.
He said, "I'm going to give you a placebo.
This is a placebo, but we know that placebos work."
And he said, "I think this will help you."
And turns out that the placebo helps even if people know it's a placebo.
So, I think that, you know, off-label prescribing, as long as you do it with informed consent, and the doctor has some kind of rationale behind why they're prescribing it, I think that's reasonable.
It's an interesting defense, isn't it?
It's an interesting defense.
Yeah.
We know there's a placebo effect, and like, also combined with...
Off prescription, which is a different thing, right?
Because that is that there is an effect, but it's not the one that the drug is originally approved for.
That's right.
So a placebo is not the same.
It's not equivalent to any kind of treatment for which there is not an evidence base for its efficacy for a particular thing.
Oh, is it that, Matt?
Maybe I have one more clip just to send that off.
Here's what I think could be going on with neuroscience, with this, with this.
And then I'll put it to the patient and let them decide.
Right.
Aren't you just giving them a placebo and calling it a placebo by doing that?
What is a placebo?
You're giving them something that is unproven so far by our Western methods and saying there's no evidence for it.
So you're saying it's a placebo.
You're admitting that to them, to the patient.
But you're saying you think it would help.
What is a placebo?
To me, the description of placebo is something that we do not feel like would help the patient through a mechanism by which we understand.
Yeah, so here's how I would describe placebo.
Placebo is things that work that we just don't have mechanisms for.
Yeah, right?
And that's where I would say, here is the hypothesized mechanism, but I think we have to do it.
I wouldn't call it a placebo, but you could absolutely make the argument that you are engendering the placebo effect.
But I think that that is absolutely necessary.
So they're both giving incredibly misleading descriptions of the placebo effect, aren't they?
And what a placebo is, right?
So he's saying that a placebo...
Is anything that works for which science has not yet understood the mechanism for how it works?
That is not a placebo.
That is a vastly broader range of things.
A placebo is something that we know with a strong degree of confidence has no inherent therapeutic value and it's something that is useful because it can mimic the real treatment that we give someone.
And therefore, it's useful as a control in medical research, randomized control trials, so that you can take into account the fact that people often say they are feeling better or think they're feeling better or even maybe experience some kind of improvement when they believe that they are being taken care of and being treated and so on.
So it's a useful control.
So by conflating those two things...
He's mounting an interesting defense of non-evidence-based medicine, isn't he?
Yeah, because he's essentially saying, you know, it's a bit like the Arthur C. Clarke quote, you know, any sufficiently developed technology will seem like magic and any sufficiently mystical medical treatment will be labeled a placebo.
That's kind of what he's going for.
But yeah, you're right that that's like kind of muddying.
The definition of placebo?
Like, if placebos actually worked, right?
Like, there was some placebo, unless there was a sugar pill, but it turns out that sugar was exactly what this person needed to, whatever, reduce the symptoms of such and such, then it would be a bad placebo, right?
It wouldn't be, actually wouldn't be a placebo because it's actually a different...
Effective treatment for the condition.
I mean, it's not complicated.
I don't want to make it so complicated because it's not.
No.
So, like, I think the bit that could confuse people is you can be on a placebo treatment and get better.
But that doesn't mean the placebo worked.
Worked.
No.
Right.
Like, it's not the effect of the placebo.
And it's not necessarily also your mental.
I think this is another mistake that people make.
It can simply be...
Regression to the mean or, you know, just normal variation.
So like when you get the cold, what eventually happens?
You get better.
How many people have eternal colds?
Very few, right?
Some unlucky people, but everybody gets better.
And then if you took something that was a pill, you might also get better.
And then if you were in a study, this could be attributed to a placebo effect.
But actually...
You could have just got better from regression to the mean.
And there's actually a literature around this, around the placebo fight versus...
It turns out that the, you know, perhaps before we thought that those mental effects were stronger than they were because we're confusing what you said, which is reversion to the mean when you take a measurement, but you selectively take your initial measurements when things are particularly bad, because that's when you get a treatment,
right?
And then, as you said, things that are bad, If you're feeling really good one day, you'll probably feel worse the next day.
And if you're feeling really bad one day, you'll probably feel better the next day.
So that selective sampling leads to an effect.
So that gets conflated with placebo effects.
But, you know, the important thing here is that that's a terrible defense of non-evidence-based medicine.
First of all, saying that, hey, it's the same as a placebo.
As long as people believe in Ayurveda, then it's the same as believing in a sugar pill.
That isn't actually a very complementary thing to whatever your non-evidence-based treatment happens to be.
And the second thing is that there's a total mismatch because he's claiming that actually these alternative treatments for which there is not currently evidence actually do work.
We just haven't discovered the mechanism for why they work.
And that isn't the same as a placebo.
Not at all.
Yeah.
So just to round off this point, Matt, this is where it ends up.
Are people engendering the placebo effect?
Almost certainly.
And this is where there's even a, I'm in a worse position for this, to kind of support your point, which is that there's a huge selection bias of people who come to my practice.
So people who come to my practice are looking for...
They already have a preset idea of, okay, this guy's going to teach me something special.
I give something special, it fulfills their expectations, and they see a clinical benefit.
The clinical benefit is, the reason people come to me is because people have been to 10 psychiatrists before.
I'm not trying to toot my own horn or anything.
A lot of people will come to me and they've tried other things.
I mean, I even started a consult service at MGH where the majority of my patients were from other psychiatrists because they wanted to learn this stuff.
So there's even a selection bias, which I absolutely have to consider.
My take, though, is that there is a very real mechanism to this.
So I don't think, and that could still be placebo.
Yeah, my question is, how do you, you're so honest with this, and I love this, so I have to give you huge props to this, because I can't tell you how many doctors will claim, I've helped 10,000 people, and I'm like, but selection, like the people who are coming to you.
No, I have a bigger placebo problem than the average person.
Amazing that you're taking that into consideration.
So now the question is, how do you decide or decipher between what you're doing being truly beneficial versus is this a placebo effect or does it not matter?
So I can't decipher.
And does it matter?
Is it important to decipher?
In a theoretical perspective, absolutely.
I mean, you know, on one hand, at the beginning there, that was, you could think of it as being like a good degree of insight.
Mea culpa.
Yeah.
Yeah, mea culpa.
It's kind of disarming, isn't it, to sort of forthrightly acknowledge things.
He's certainly right.
Selection biased.
Selection biased.
When enthusiasts go to a particular alternative therapy, they're super keen on it.
They want to believe.
They are all set up for walking away happy, basically.
But then I feel like...
He's sort of disarming Dr. Mike there with this sort of frank honesty before shifting to the conclusion, which is, but despite all that, I have complete confidence in what I'm doing and I believe that it's true because I've seen the results, I've seen that it works, my clinical experience,
etc.
Yeah, this is the behavior of a seasoned CAM advocate.
You acknowledge limitations and you get praised for doing that by Dr. Mike who's like, this is incredible that you can be so open.
But it doesn't fundamentally alter any of the things that you're claiming.
And also, just again, Matt, so throughout this, there's this double step of I'm not really focused on this thing in my practice.
I'm offering evidence-based things.
I'm very critical of Ayurveda.
I see lots of issues with it.
I'm very concerned about all of these science-y and methodological things.
But...
And then it switches to that unequivocal confidence.
But also, I'm renowned for having this approach.
And people seek me out because they know that this is the thing I'm going to offer.
I thought it was just a small bit of the treatment study.
That's the bit where it really depends on what suits the given argument.
Whether it's a core part of the practice which distinguishes what he does and he's seeing the effects versus it's just a small...
I'm not actually pushing on anybody or suggesting.
It's just I found some benefit in this.
Here, it's that he's well known as this figure that can cure people through these practices that other people don't have.
That suggests it's a core differentiating factor in your practice.
I know how you feel that inconsistencies, Chris.
I'm very upset about it.
I'm very upset about it.
So that's the Dr. K and Dr. Mike conversation.
And I think if you listen to it, you don't see this big distinction from the other material that we looked at.
It's just presenting the same kind of arguments from manifestation to, you know, the scientific basis of doshas and so on, along with some recognition of limitations and issues with the evidence base.
In Ayurvedic medicine, but he's still a very strong advocate for it.
And the judo flip that he does psychologically on Dr. Mike, I think is very effective.
And that's more in line with the last part that we'll look at, the kind of therapeutic stuff.
Yeah, I think the judo flip was very effective.
And I think the other rhetorical techniques we saw...
For instance, this bringing in consciousness into the equation, running the argument, there are things beyond our ken, things that are difficult for you, science men, reductionists, to explain.
Therefore, maybe there are other things we don't know that we can't measure that are having an effect on our health and on our world, cosmic, mental things.
And, you know, the mea culpas, the recognitions, like positioning himself as a critical...
A critically minded person who recognizes the limitations of it.
Those are usually stated as a point from which to springboard to the opposite point of view, which is like having a great deal of confidence in these things, which, as you said, is represented in his practice and all the other things he said.
So I feel like a lot of rhetorical techniques were used effectively.
But it doesn't wash with us, Chris.
It doesn't wash with us.
It doesn't.
And there's a video called Ethics, which will come up in the next episode.
It's more about whether he's practicing therapy on stream or not.
But after all the stuff that we've heard, you know, from two years ago, from 11 months ago, from a month ago, from the Dr. Mike video from one or two months back, let's see how this compares with what he states here.
about the stance he takes on Ayurvedic medicine.
HG has gotten to where we are today because of the feedback from our community.
So I'll give you all just one simple example of this.
In the past, I had talked a fair amount about Ayurveda.
Generally speaking, when I talk about Ayurveda, I talk about it more from a personality analysis standpoint.
And as part of the support for Ayurveda, I cited a couple of scientific papers.
Seven months ago, someone in our community made a post sort of questioning the veracity of the research that we were citing.
And it turns out that they made really, really good arguments.
So we talked about it on stream, addressed their criticism.
Turns out that a lot of their criticisms were actually really good.
And for the last seven months, we haven't said a word about Ayurveda.
Internally, we're going through the process of reviewing a whole body of Ayurvedic research.
My point here is that sometimes at HG, we'll say particular things that We believe are correct and we'll even do some research and we'll cite papers and stuff like that.
But no scientific paper is perfect.
And as members from our community will point out those kinds of things, we will absolutely adjust our behavior.
So one of the things that we really value and hold ourselves to a very high standard about is actually accepting feedback from our community, which is really, really helpful and is actually really responsible for the impact that we've been able to achieve.
Chris?
Just a bit of a meta-observation.
Yeah.
It feels very corporate, doesn't it?
Like those sorts of statements, like it's carefully honed, it's carefully crafted to minimize, you know, detrimental blowback.
It seems like it's crafted by a public relations team.
And I just, it's just a feeling that I have with Dr. K that a lot of what he says is very carefully modulated to min-max public perceptions.
Well, certainly when he's responding to criticism, as that video is, right?
And in this case, he's, one, pointing out that they're willing to correct things, you know, when they find out that there's issues with it.
But I would just say this video is before pretty much all the content that we played, especially, you know, before the Dr. Mike video and stuff.
So I don't know that I would agree that there's no more...
Real mention of Ayurveda on Healthy Gamer GG.
I've certainly detected that here and there in the material that we just discussed, you know, like the visualization or the discussion with Dr. Mike.
No, Chris, everything that's said about Ayurveda is based on the research.
They're carefully reviewing the research.
The research isn't perfect, and sometimes there will be studies that are a little bit subpar.
So, you know, naturally, not everything they say about it will necessarily be true, but they're committed to going back through the research and correcting their mistakes.
It's really very admirable.
They're doing the work.
They're doing the work.
Yeah.
So, you know, opinions may vary on the extent to which that is a core component of the content or sprinkling on it.
I do want to say that it is perfectly possible, and I know various people who have commented that, you know, while we've been making this series, that they have been helped by Dr. K's material and that they don't focus on the Ayurvedic part.
It's not an important focus for them.
And I think there is a whole host of material.
Out there that you could consume where it wouldn't come up or if you noticed that it would just be here and there, like additional references.
But I think when you look at Dr. K's output in totality, it is not a minor part of his output and it is not an insignificant feature for the way that he approaches.
The topic of therapy or medicine in general.
Now, Chris, I mean, on that note, I agree with you.
I think it is an important aspect of his brand.
But like you said, a lot of his content doesn't have that stuff injected into it.
I stumbled across another thing that he'd posted, which was, again, it was very YouTube-y, click-baity, top five, ten tips to do whatever.
But it was about how to say no and how to...
How to basically not be aggressive or submissive, set boundaries, that kind of thing.
And I watched that and I thought, well, these are all good tips.
Yes, it's pop psychology, but it's not bad advice.
So that stuff does exist too.
I think we want to acknowledge that.
Yeah, yeah, yeah.
So, you know, we'll see if the final thoughts to the last episode, which is about the therapy.
Or non-therapy, the online in-depth interviews with streamers and discussing trauma and so on, or life experiences and philosophies and whatnot.
So that will be the last stage of the Dr. K episodes.
Then we're out of the Dr. K market.
So thank you for indulging us.
This two part is basically like that previous content from four years ago.
It was like an in-depth, overt advocacy for Ayurveda.
But all the content that we've looked at now is more recent.
And I think there are very obvious through lines in the arguments being presented and whatnot.
And in a lot of ways, it's bog standard CAM, but it's actually quite skillfully done in a way that I haven't seen so much in kind of mainstream.
So that's why I thought it's interesting to look at.
But I think it would be hard to argue that was a part of his output, you know, a couple of years ago, but he doesn't really do that anymore.
Like, no, I would dispute that strongly.
Yeah, and all of this is actually entirely separate from the issues that we'll look at next time, which is around the conversations that he has with streamers.
You could be doing those with a completely different...
Metaphysical or therapeutic approach.
And the issues would arise that do.
So that's all.
I'm just justifying our three-part structure, I think.
But that's...
You don't have to justify it to me, Chris.
It's fine.
We can do that.
Good.
Okay, part two done.
Looking forward to part three.
Yep, yep, yep.
And lastly, Matt, lastly, I'm just going to thank a couple of our patrons.
The people that are there supporting us, keeping us afloat.
when times are hard and skies are grey.
Colin Fardy, Andreas Hawkenins, Edison Yee, James, Sean Carmody, Patrick Browse, Connor Carey, Anna Jay, Sam Mountjoy, Sam McLeod,
Minotaurus Rex, Jacob Lincoln, Dr. Wallabong, Ethan Blythman, Zed, Joshua Davies, Marcin Junxy Diamond, Carly Nightart, Jack Gibbons, Dina Cruster, Jake Lawrence, Saeed Polat,
Jameson Shipley, Ethan Milne, Oh No, Joe Rimmel, Ryan Nestledroth, Anna Mae, Chris Can't Pronounce, Bobby Lamont, Privateer, Jeannie HB, Oh my god.
Well done.
That's a lot of patrons.
Thank you.
Thank you for supporting what we do.
People have missed.
Are we catching up, are we?
People you've missed, Chris.
Yes, that's true.
People I've missed.
Brienne, possibly, unclear which theater that they're in, but they all receive the Galaxy Brienne shout out.
We tried to warn people.
Yeah.
Like what was coming, how it was going to come in, the fact that it was everywhere and in everything.
Considering me tribal just doesn't make any sense.
I have no tribe.
I'm in exile.
Think again, sunshine.
Yeah.
That's me.
I'm everywhere and in everything.
That's...
That's my tag.
Yeah, you're all around.
You're much like the consciousness and the Doshik Vedas.
They connect and bind us, Chris.
They do.
So we'll be back for another episode with Discussions of Consciousness.
Shortly.
We need to do a guru that doesn't talk about consciousness, but that's actually hard.
That's actually hard to find.
You need to exercise some self-control and not to talk about it.
Or you just avoid saying extreme things and then saying, but we're not going to talk about that.
Your own rhetorical sleight of hand.
No, I'm just speaking common sense, Chris.
That's it.
Speaking the truth, the power.
Well, we're almost out of the Dr. K mini season.
But one more time.
One more time to the grindstone.
But we might take a break in the middle with another guru popping in.
