Dr. Peter Attia
speaker
5,258 appearances
36 recordings
6 series
first heard Jan 2024
last heard Jun 2025
Dr. Peter Attia’s voice in public audio — every appearance, attributed to the second.
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So for example, for many people, meditation is a great tool to increase the probability of responding as opposed to reacting when something happens. learning the language of I statements, basically taking ownership for what you think, what you feel, what you do, working through this triad that he describes as the triangle of vulnerability.
So sadness, shame, and fear, and trying to be curious about where you are on that triangle and being more responsive to your own emotional vocabulary around these things, noticing what your coping skills are. Again, I talk and often joke about some of mine that still exist to this day. E-shopping is an enormous coping skill for stress.
I just can't stop buying stupid things online when I am stressed out. I feel fortunate in some ways. I'm really glad that it's not drinking too much alcohol, but it's still a distraction. Even if the worst thing it does is set me back a few dollars, it's preventing me from connecting and it's preventing me from accepting and dealing with what it is that's happening.
I think there are other things, but I think those would be a great place to sort of start. And obviously we talk about so much more in this episode.
I just can't say enough about it. It's one of the things I enjoy talking about with patients more than anything, because even though patients come to our practice because they want to improve their lifespan, they also care about healthspan. And it's easy to forget that emotional health is a piece of healthspan.
And I think when a person is sort of caught in the vicious cycle of what's often the response to and the adaptation to traumatic events, not necessarily exclusively as children, but often as children, they're not living this connected life that Jeff talks about. And I can just share from personal experience that being disconnected versus being connected is all the difference in living.
And it's not like you flip a switch and everything is fine. It's a process. It's a journey, of course. But I've never met a person who's addressed their negative adaptations and come out on the other side and said, I wish I didn't do that.
Yeah. The first place was called the Bridge to Recovery. I went there in 2017. That's actually where I met Jeff English. We talk about that a lot in the podcast. The second place I went in 2020 was called PCS, Psychological Counseling Services. And I would recommend both of those places very, very highly. And I think PCS focuses on more than just trauma, but it's very trauma-focused.
The Bridge is really a trauma-based residential program. And again, I'm sure there are others out there that are maybe equally wonderful. I know that for many people, obviously, I've encouraged a number of people to go to these locations, and many have. Everyone acknowledges, as I did up front, like, are you kidding me? How about I just keep working with my therapist for an hour? twice a month.
That can work, but sometimes it doesn't. And sometimes you actually need to undergo immersive therapy.
I mean, truthfully, and this is obviously just terrible rationalization. I think most things I buy in my eShopaholic bursts, I'm pretty happy with them. Not all of them. I have bought some really stupid things. And what I tend to do is give them away so that I don't see them again, which is actually counterproductive because I should keep more of those things as a reminder of my bad behavior.
In other words, I should surround myself with more of the consequences of those actions. That's a great answer. Spoken like a true shopaholic in that.
Right. It's this horrible selection bias. I keep the things that are awesome. I give away the things that are not awesome. It's awful.
Yeah, boy, Ashley is a force of nature. We had sketched out a lot of things we were going to talk about, but we never got out of insomnia and CBTI because I felt like it was just too important to stay there and gather all that information. So yes, definitely we'll have to have Ashley back. So I learned a lot. Honestly, what I came away with is thinking that
Okay, I feel like I almost know enough to help people through part of the CBTI playbook without even having to refer out to CBTI. And I think that the takeaway from this episode should be that you can do a lot of CBTI on your own. which is not to say you shouldn't reach out to a practitioner if you're struggling. But the good news is so much of the heavy lifting was covered here.
So first of all, let's just start with the semantics, right? So insomnia must persist for months. It must interfere with life and it must cause distress. This isn't just a few nights of bad rest. So we don't want to over pathologize this. So we're really trying to focus on a meaningful reduction in sleep.
CBTI or cognitive behavioral therapy for insomnia is one of the most effective tools for addressing serious insomnia. 50 to 60 people who utilize this achieve a complete remission and 70% show improvement.
so there are lots of contributing factors to the development of insomnia so you have predisposing factors like genetics past experiences you have precipitating factors such as a life crisis divorce enormous stressful experiences at work and then you have perpetuating factors or coping strategies like what you do when you are in this state of insomnia Now, CBTI only focuses on the latter.
It does not concern itself with what your predisposing factors are, doesn't even care what the precipitating factor is, and doesn't try to stratify people based on those things. It basically says, you're here, you're having significant insomnia, what are you doing to cope with it, and how do we address that? So in that sense, the treatment is independent of the first two.
Of course, I should just say this before we go on. You do need to address any sleep pathology like restless leg syndrome or sleep apnea before engaging in this. So you have to rule out that kind of stuff. Okay. So CBTI is really about addressing this triangle of thoughts to feelings to behaviors. So picture a triangle, thoughts, feelings, behaviors, where each one is influencing the next.
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