The Peter Attia Drive
#347 – Peter’s takeaways on mastering sleep, dealing with chronic pain, developing breakthrough cancer drugs, transforming healthcare with AI, advancing radiation therapy, and healing trauma | Quarterly Podcast Summary #5
Mon, 05 May 2025
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter In this quarterly podcast summary (QPS) episode, Peter summarizes his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from his discussions with Jeff English on the journey to healing from trauma; Ashley Mason on improving sleep and CBT-I; Sanjay Mehta on misconceptions around radiation and its use in cancer therapy and treating inflammatory conditions (such as arthritis and tendonitis); Sean Mackey on understanding and treating acute and chronic pain; and Susan Desmond-Hellmann on insights from her extraordinary career that pertain to the use of AI in medicine, understanding cancer, and the development of cancer therapeutics. Additionally, Peter shares any behavioral changes he’s made for himself or his patients as a result of these fascinating discussions. If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the episode #347 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Summary of episode topics [1:45]; Jeff English episode: how trauma shapes behavior and identity, and the value of understanding personal adaptations and working through unresolved emotional wounds [3:45]; Practical behavioral changes and emotional tools Peter has applied since the Jeff English episode [13:00]; Ashley Mason episode: treating insomnia using CBT-I and practical behavioral techniques for improving sleep quality [19:15]; When to seek professional care for sleep issues [30:30]; Sanjay Mehta episode: radiation therapy’s evolution, its underused potential in treating inflammatory conditions, and the cultural misconceptions surrounding radiation exposure [33:45]; Peter’s predictions and insights for the upcoming Formula 1 season [43:15]; Sean Mackey episode: the neuroscience, classifications, and treatment strategies for chronic pain, and the importance of personalized care [57:45]; Susan Desmond-Hellmann episode: how AI is revolutionizing medicine through advancements in drug development, biomarker discovery, and the potential of training models on private clinical data [1:05:45]; More from Susan Desmond-Hellmann: why cancer is so difficult to treat with drugs, the promise of immunotherapy, and the long-term hope for systemic treatments [1:14:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
Chapter 1: What are Peter Attia's main takeaways from recent podcast episodes?
Hey everyone, welcome to a sneak peek Ask Me Anything or AMA episode of The Drive Podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe.
So without further delay, here's today's sneak peek of the Ask Me Anything episode. Welcome to another quarterly podcast summary episode of The Drive. In today's quarterly podcast summary, I'll discuss what I learned from some of the recent episodes of The Drive, focusing on what I think were the most important insights, as well as any changes in my behaviors as a result.
This shouldn't be seen as a replacement for listening to or watching any of the original episodes, but this may be a great way to reinforce things that you already saw or at least point you back to an episode you missed. In today's episode, we cover interviews that I did with Jeff English, Ashley Mason, Sanjay Mehta, Sean Mackey, and Sue Desmond-Hellman.
We revisit topics around trauma, therapy, mental and emotional health, insomnia, cognitive behavioral therapy for insomnia, and improving sleep. radiology, radiophobia, common misconceptions around it, how radiation is used in not just cancer therapy, but also for treating inflammatory conditions such as arthritis and tendonitis, pain, chronic pain, and how to treat them,
And finally, discussions around oncology, cancer drug development, and how AI is impacting medicine now and possibly in the future. If you're a subscriber and you want to watch the full video of this podcast, you can find it on our show notes page. If you're not a subscriber, you can watch the sneak peek of the video on our YouTube page.
So without further delay, I hope you enjoy this special quarterly podcast summary AMA of The Drive.
Peter, welcome to another quarterly podcast summary, ask me anything episode with Peter Attia. How are you doing? Very well. You excited to be here? I am.
No place you'd rather be? No place I'd rather be. Nothing I'd rather be talking about. Even a race car?
Maybe. Okay. Well, it's good to know you're still being honest. So today we're going to cover looking back at recent episodes on the podcast. As a reminder for people, these quarterly podcast summaries, they are a way for us to talk about and gather insights from you on what you learned from previous episodes, where your behavior changed, where you're thinking about things differently.
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Chapter 2: How does trauma impact behavior and identity?
A lot of different topics, which I think speaks to who we have on the podcast, which is a variety of people, variety of angles. So I think it should be a good one. A lot of different things to chat through. Anything you want to say before we get started? No, let's dive in. Perfect. First one, Jeff English. All things trauma, mental health, therapy, etc.
Do you kind of want to walk through your insights from that episode?
This was an episode I was really looking forward to doing. As we discuss in the episode, I've obviously known Jeff for many years. I owe him a great debt of gratitude. And this is one of those episodes where between the time we recorded it and the time it came out is probably eight to 10 weeks.
During that period of time, I sent the unedited, just straight audio file of it to no fewer than 15 to 20 people. Meaning I couldn't even wait for this episode to come out to be sharing it with people. So I think that probably tells you something. I will be completely comfortable stating that that will be a record that will last for some time.
There's no scenario I can think of where I've taken a podcast before it comes out and shared it with so many people. I would say that most of the people I shared it with not only found it to be incredibly valuable, but actually wanted to sort of engage with Jeff on a professional level after that. So it's one of those podcasts where if it resonates with you, it's really important.
You're gonna share it a lot. Okay, so what was this episode about? I mean, it really was a great episode about understanding trauma And it's such a loaded word that I think it's understandable why people might have some skepticism around that. I think the word does get used a little bit too much.
But Jeff has a great definition for it, and I jotted it down right, which is that trauma is a moment of perceived helplessness that activates the limbic system. This can be a wounding event, a major event, or maybe a series of smaller events. And those typically get referred to as big tree and little T traumas.
So a big T trauma is something really obvious, being the victim of a violent crime, for example. And little T traumas are like a thousand paper cuts. A parent that was there, but just really wasn't paying attention to their kid. And those can be damaging in different ways. So
What Jeff talked about was that in trauma, too often people focus on the what happened part of the equation, but he thinks that it's more important to focus on the how did I adapt part of the equation.
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Chapter 3: What are practical tools for improving sleep and managing insomnia?
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.
As someone who, let's say, has listened to the episode and are listening to us and they're like, this is something that I've maybe been ignoring in my own life or pushed aside and decided up to this point not to deal with it. I know you also have patients who are like that.
And so when you're talking to people and trying to encourage them to take the first step and to figure out this journey for themselves, any advice you have for those people, just in case they're on the other end listening here?
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.
This is a question we get asked a decent amount to the website. So it's here as well. You in the book of openly talk podcast that you went to two centers to kind of like do in-depth work on this. Oftentimes people just ask, Hey, what are those called? So they can look them up as well.
Obviously these aren't the only two, but do you just want to state those where people are looking for a first place to start to that you found beneficial for you?
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Chapter 4: How is radiation therapy evolving to treat inflammatory conditions?
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.
And the discussion with Ashley was really a great way to kind of go through all of the behavioral changes to mitigate insomnia, which fall under the themes that are, I think, bucketed as sleep hygiene, stimulus control, time in bed restriction, cognitive techniques, and relaxation techniques. So let's just talk about each of these.
Sleep hygiene is something that listeners of this podcast are very familiar with. These include things like keeping the room temperature cold in the mid-60s, even if you need to wear socks, keeping the room as dark as possible, and using an eye mask if that's necessary. It means not drinking too much fluid after dinner to reduce the probability that you need to get up and pee at night.
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