Every mental health complication or diagnosis is increasing.
And I've worked with different scientists and done a lot of experimentation on myself, having grown up with multiple depressive episodes every year, to see if there are root causes that we can address.
And so I'll just throw out a few things that have been very, very helpful.
First, there's brain stimulation.
When I did this, I had months of no anxiety.
Then there's something called vagus nerve stimulation.
And one of the most heavily cited scientists in the last 30 years has seen a wild collection of benefits, So let's talk about that.
Tim Ferriss has become a performance hacking expert after speaking with over 800 influential voices on his podcast.
Now he's taking the most valuable frameworks and techniques to help you optimize productivity, health and performance.
Tim, the variety of things that you write about, talk about is so wide.
So what is the question that most people should ask you?
How do you break down complicated subjects and accelerate your ability to learn?
Because time is one of our most valuable non-renewable resources.
And so I have a framework that you can apply to any subject matter, which consists of the 80-20 principle, which is picking the 20 to focus on.
That will give you 80 of what you want.
For instance, there's hundreds of thousands of words you could learn in Spanish, but with the most frequently used 1500 words You can get to reasonable conversational fluency in almost any language in eight to 12 weeks.
And if you figure that out, you're ahead of 99.9% of the world.
And what do you think is the question most people want to ask you?
So there's a lot of questions around mental health.
And I feel like I have a moral obligation to help people because I was sexually abused by a babysitter's son on a weekly basis.
I was this close to killing myself.
And it can have a lot of effects.
But these are things that you can slowly chip away at.
And, instead of feeling like you're held captive by them, feel like you can take the pain and make it part of your medicine.
So Just give me 30 seconds of your time, two things i wanted to say.
The first thing is a huge thank you for listening and tuning into the show week after week means the world to all of us, and this really is a dream that we absolutely never had and couldn't have imagined getting to this place.
But secondly, it's a dream where we feel like we're only just getting started and if you enjoy what we do here, please join the 24 percent of people that listen to this podcast regularly and follow us on this app.
Here's a promise I'm going to make to you.
I'm going to do everything in my power to make this show as good as I can now and into the future.
We're going to deliver the guests that you want me to speak to and we're going to continue to keep doing all of the things you love about this show.
Thank you.
Tim, you're a remarkably interesting individual, in part because the variety of things that you write about, talk about, clearly have deep curiosity in is so wide that you're hard to put into any particular box.
So my first question to you is how do you think about the work you do and how do you sort of like self-define if you do at all who you are and what your mission is?
I think of myself as a self-experimenter slash student and teacher in that order.
The purpose though, ultimately is to try to find simplicity through complexity, or topics that can be complicated, and then provide some type of recipe or algorithm that people can test with low risk and hopefully, a decent amount of upside.
We're going to talk about a lot of different things today, so probably a good place to start, which is learning how to learn.
And especially in a world that's changing at such speed.
There's a lot of people that are being forced into relearning of some sort, whether it's professionally or in other domains.
So meta-learning, I've never heard this term before.
Mm-hmm.
What is meta-learning and how do I learn how to learn better?
I would love to because I spend so long, as you do, speaking to really interesting people.
I sometimes worry that some of that information is being wasted.
Yeah.
The basic idea is this that, rather than treat different subjects or fields as these silos that need to be figured out independently, how can you develop just a broad framework that you can apply to any subject matter?
And the acronym that I generally recommend folks DSSS deconstruction selection, sequencing stakes.
There's deconstruction, which is taking a fairly ambiguous goal, like learn to swim or learn Japanese.
None of those are actually very descriptive, right?
So deconstructing any one of those is taking.
Let's just use learn to swim as an example and breaking it down into constituent parts.
And you can do that very effectively with the help of an expert.
You can try to do it yourself.
But for instance, I mean, if you want to find a silver medalist from the Olympics two Olympics ago, you can probably get on a Zoom call with them for 100 an hour, maybe 50 an hour.
You do have access to world-class talent, then they would help you figure out.
All right, there are all these different possible components.
When you get to the next part, which is selection, you're picking the 20—this is the 80-20 principle, right?
Pareto's law.
So you're picking the 20% that will give you 80% of what you want.
Let's just use language learning in that case.
Well, you can very easily find word frequency lists.
So for any given language like Spanish sure, or in English— hundreds of thousands of words you could learn.
But with the most frequently used 1500, you can get to reasonable conversational fluency in almost any language in 8 to 12 weeks without question if you approach it methodically.
But you need the right material first.
And then the next S is sequencing, putting it in the right order.
And I feel like this is the magic sauce that gets lost a lot, which is what is a logical sequence of for learning any given skill.
What do you practice first?
So in the case of swimming, for instance, forget about breathing.
Like you need to figure out like fuselage right, fuselage left and gliding, kicking off a wall in the shallow end of a pool, before you ever think about breathing.
And getting comfortable putting your head underwater, et cetera, et cetera.
So there's the deconstruction selection sequencing, and then the last S stands for stakes, which means incentives.
So how do you ensure... that you will do actually what it is you say you're committing to doing.
If more information were the answer, we'd all be billionaires with six-pack abs.
So information is clearly not sufficient.
It's necessary, but not sufficient.
Incentives drive behavior change.
So you need good intentions are not enough.
Even a system is not enough.
You need strong incentives.
So you could give $500 to a friend or $100, whatever.
The amount doesn't really matter.
And if you don't do what you say you're going to do, they donate it to like your most hated political candidate in your name, right?
That's another one that I've seen work really well.
That's it.
That DSSS, deconstruction, selection, sequencing, stakes.
And if you just check those boxes, moving that order, your ability to learn will hockey stick in a really meaningful way.
And what's also important to realize when you're trying to tackle any new skill, it doesn't matter what it is.
It will not be just a linear climb from bottom left to upper right.
But if you know in advance that those are coming, then you can have a plan for it and weather the storm.
So that's also very important.
If people expect some kind of linear incremental progress, it just ain't going to happen.
And so most people quit before they hit any real inflection points.
And how does one know what to pursue?
How do you decide what's worth pursuing?
Is there a framework for knowing what should be on the Sunday shelf and what should be today?
Today's work.
I do think about this a lot.
And I've used this for a very, very long time.
And I don't see it changing anytime soon.
I've refined it here and there.
Almost everything I do is a six to 12 month project, with lots of two to four week experiments within that six to 12 months.
I do not have and I've never had a long term career plan, five years, 10 years.
If you have a reliable five to 10 year plan.
You're going to be playing so safely within the bounds of your capabilities that I feel like you're selling yourself short.
So for me, it's projects and just going 100% into those projects.
How do you pick the project?
I pick the projects based on relationships and skills.
So new relationships, or deepening important relationships, and my learning curve skills I'm going to learn.
And there's a condition though.
Those relationships and those skills have to be able to transcend that project.
I'll give you an example.
If I have a project which is working on a startup as an advisor, that startup was StumbleUpon.
Okay, so I'm working on StumbleUpon.
Way back in the day, StumbleUpon was a huge deal.
It delivered a lot of web traffic to various websites.
It's kind of like a Pandora for websites.
A year or two into that, it didn't go anywhere.
But who was it I spent all my time with at StumbleUpon?
It was the founder named Garrett Kemp.
And I became really close friends.
I learned a ton about web traffic.
I was also able to use my own website and blog as an experimental destination, right?
So there was upside even if it went to zero for me.
And a few years later, I get a text from Garrett.
We meet up to talk about this new idea, which is solving the taxi problem in San Francisco.
And then shortly thereafter, it was called Uber Cab LLC.
And I became advised to that.
And I can give you 12 more examples like that, where I'm like The first project failed but I became friends with person A or B, learned C and D and those were applied two projects later to something that was a home run.
And should everybody at every stage in their journey have the same framework?
Because if you think about the different things one could acquire from resources reputation knowledge skills network,
If I'm 18 and broke, should I be aiming at the same things as if I'm Tim Ferriss?
My instinct is to say yes.
And the reason I say that is that Lady Fortune has a lot to say about what happens.
There's so many things outside of your control that whatever game you choose to play requires a system that allows you to survive a string of very bad luck.
Everything snowballs over time and compounds and it's really hard to lose long-term as long as you are not over indexing and betting too much on any one project, say financially.
It's like you need to be able to withstand, as a team or as an individual, a period of very bad luck in order for the law of big numbers and statistics to work in your favor, with a system that gives you a slight edge.
So that's just my lens on the world in general, at least professional choices.
And I would say you mentioned a couple of other things, right?
So like reputation and so on.
I feel like a lot of those are second-order effects.
They happen automatically if you are optimizing for the relationships and skills.
So this comes back to the sequencing, right?
So it's like which is the lead domino?
So if you have 12 dominoes, you kind of have to decide in which order you're going to stack them.
So you knock over the small domino, knock over the bigger domino, then the bigger, then the bigger, then the bigger right.
And over time.
If you're thinking about doing two projects a year, let's just say if they're six months each, that's going to add up.
It's going to add up.
So you can afford to be long-term greedy instead of short-term greedy.
Is that what people call passion?
Are you using the same... I...
I like energy over passion for a couple of reasons.
Because you could have passion between the bed sheets.
You could have the passion of the Christ.
You had a different type of passion.
I don't like imprecise terms.
Energy for me, very simple.
It's like, are you more awake or are you sleepy?
Do you feel like you can do this for another five hours?
Do you feel like you want to stop in 15 minutes?
These are almost biological questions.
That's biological state questions.
So it's pretty intuitive for people to get to a yes or no.
One of the subjects I've been thinking a lot about recently.
Why have I been thinking about this more recently?
I don't know.
Just a series of conversations I've had on the show which have kind of pushed me closer to trying to answer.
This question is about meaning and purpose and, I guess, religion.
Because actually it's only in recent history that we've had so many answers to some of these bloody questions like the.
Solar eclipse, we now know what's going on there.
It's not God testing us so that the Vikings are throwing their spears at it.
We know what it is now.
So not believing, atheism, agnosticism, is that a fairly new construct?
And are we not meant to know so much?
Well, I think that humans need certainty.
They need something to believe.
And if your belief is that non-belief is the way, well, guess what?
I mean, that's a belief.
So I would say that my experience is if you want to experience self-transcendence, which I think is critical for mental health, you don't need religion per se.
You can have, I think, a very wonderful life without religion.
I don't think it's possible to have a wonderful life without awe and wonder.
And those are things you can architect.
Those are things you can very much architect and engineer and schedule in your life.
Why have veganism and CrossFit done so well?
They're religions.
I mean, effectively.
They may not have a god per se, but certainly they have thought leaders, glassmen before his fall from grace, and so on, various athletes and so on.
But it's like clear rules, community values, Self-enforcing.
Describing life's sports.
Yeah.
I mean, it's like, this is religion.
Just goes by another name.
It's a lot of the behaviors, collective behaviors and tenets of religion just lacking the R word.
What do you worship?
I knew that was coming.
I think the risk for me is that I feel like I have a moral obligation to which can turn into a bit of a savior complex because of a lot of the pain that I've suffered in the past.
I feel like I am not necessarily uniquely suited, but I have the experience and the perspective that allows me to be credible when talking to people who are experiencing certain types of pain.
And that can become a huge unhelpful, self-imposed burden where I feel a moral obligation to do things at the expense of my own mental health or physical health.
So I would say that's something that I have very clearly on my radar as of a few years ago.
When did the first domino fall in that regard?
In terms of, you mean just general challenges personally?
Well, I might as well dig into it.
I was sexually abused by a babysitter's son from two to four on a weekly basis, I would say.
Very clear memories of all of it.
And that will shape you.
I mean, that will definitely shape you.
And it can have a lot of effects.
It can rob you of agency.
It can certainly make you or contribute to me being hypervigilant.
I'm very slow to trust on and so forth right like that is a formative experience at a formative time.
And then later had, i think, number one a genetic predisposition if you just look at my family to major depressive disorder and that showed up, as let's call it, on average, starting in early adolescence, like three to four multi-week or multi-month depressive episodes year.
That is half of your lived time.
And for people who may have experienced something like this, I will say that there are tools at work.
So now.
Never thought it would be possible, but I would say now.
I have one depressive episode of a few weeks at most every two to three years.
Now, the juxtaposition between those two people is hard to overstate.
Those are two fundamentally different experiences of being human.
A lot of it ties back to some of the levers I was talking about.
Metabolic psychiatry, psychedelic assisted therapy, bioelectric medicine, including accelerated TMS.
These things for certain people really work and can be durable.
They're not one and done.
Very few things are. these are things that you can slowly chip away at and become familiar with.
And instead of feeling like you're held captive by them, feel like you can mold the experience into something that is at least not disabling.
Sometimes you can make it enabling.
I remember a very good psychotherapist said to me, maybe five years ago, six years ago take the pain and make it part of your medicine.
And it was basically like, all that stuff is horrible.
Nothing can excuse it.
Take that pain and make it part of what you offer the world.
And there was, I would say, the combination of that statement and also COVID, during which my girlfriend at the time because she knew about my history very few at that time.
There were maybe two people in the world who knew about it.
Two long-term ex-girlfriends I'd been with for like five to six years each.
Parents didn't know?
Parents didn't know.
Really?
Yeah.
And I was sitting with her during COVID just as it was getting fully ramped.
And I'd always planned on writing a book about it, or like my healing journey after my parents passed away, because I didn't want them to blame themselves.
And My girlfriend at the time over a meal, said something that had a huge impact, which was have you ever thought about how many people are going to pass away from natural causes or from COVID or anything else, before you ever have a chance to write this book?
Because you're probably not going to write that book for 10, 15 years.
Think of all the people you could have helped that you didn't help.
And I was like, okay, maybe I should workshop it on a podcast.
But keep in mind, none of my family knew.
And so I was very fortunate to have a very close friend who's based here in New York City, Debbie Millman Design Matters Podcast, one of the longest running podcasts in the world wonderful human.
And she disclosed to me a number of years back for the first time in full fidelity, extended childhood sexual abuse.
And we talked about it.
And I came clean with her after that conversation with my girlfriend.
And I asked her if she would be open to having a conversation with me that we could record.
But as a conversation, because I knew I couldn't do it as a monologue.
I just knew I couldn't do it.
And I told her in advance, I said, I have no idea if I'm ever going to share this.
But I feel compelled to at least record it.
And so we did.
And ended up publishing that, I want to say, in September 2020.
Something like that.
And holy shit.
I would say the most shocking thing about that to me, I knew the statistics, right?
But statistics are very impersonal.
Like these types of abuse.
This type of sexual abuse is incredibly prevalent, not just involving young girls, but also involving a lot of young boys.
I probably had a quarter to a third of my close, close friends reach out to me first time to talk to anyone and confess that they had had some type of similar experience.
I mean, the percentages were staggering.
That was really hard.
I was willing to absorb it.
I have a lot of capacity for absorbing that type of thing, but it was hard because I would get these tearful voice memos from guys who had never told anyone, giving me graphic details of everything that happened.
It was just gut-wrenching.
I remember walking up and down my driveway and just like tears running down my face.
And like, I don't cry much.
That's not really a thing for me, but just the brutality of it.
And then in retrospect, seeing so many things coalesce where I'm like oh, that explains all of these unanswered questions I had about that friend.
And also for me looking back again, hindsight being 2020.
For a long time I had let's just call it to pick a number out of thin air.
It's like okay, I have a seven mental health, psycho-emotional challenges I need to address.
And I was viewing them as independent problems to address.
But when I was willing to reopen the door and look at the childhood abuse, everything was tied to that.
And sometimes you just have to put on your gas mask and go into the cellar and contend with that.
And there's no one right way to do it.
Psychiatry is still in the dark ages.
It's where surgery was 300 years ago.
But still there are certain things that work, often without knowing the mechanism, seem to help a lot of people.
So there are tools.
I think internal family systems created by Dick Schwartz is very interesting.
The MDMA-assisted psychotherapy, certainly for PTSD, very interesting and generally well-tolerated.
Not right for everybody.
And then a number of the other things that I mentioned.
Family constellation therapy, also quite helpful for a lot of people.
But it's not insurmountable.
What I would not say is that some people and I think that I would love to be able to do this, but I just can't get there who would say like I don't regret it.
I'm glad it happened because here's the silver lining.
No.
Like, if I could control Z and remove that stuff, 100% I would.
I mean, it did a lot of damage.
But it gives me a credible voice when I am talking to people who have had these experiences, and that is valuable.
Can you explain to me what you've learned about how?
How you were two years old at the time, between the age of two and four, you said what is?
I'm kind of asking about the mechanism here.
What is happening in a two to four year old child's brain that causes the damage?
Because, presumably at two years old, you don't understand what's happening.
You don't understand what this individual, this person who's older than you is doing and the context of it.
Yeah, so i'm, i'm trying to understand how, what the mechanism of harm is to a, to an innocent child who doesn't understand, understand the context of what's going on here.
Yeah i, i don't think anyone can really answer that particularly well with high conviction, but what?
What i'll say is that uh, I am blessed and cursed with a near photographic memory for some things.
So you have the original injury, the original insult.
But if you have, as I do, which is weird, but like I can draw the floor plan of almost any building, any restaurant I've ever been in.
That's great.
Even once.
I don't know why that is, but I can do that.
Now, there are upsides to that.
There are a lot of downsides too in the case of abuse.
And...
As you have greater and greater ability to navigate the world and realize what has happened, what is happening, what might happen, and you can recontextualize high-fidelity memories, well then you realize that that thing that was very weird at the time was a lot more than just weird, right.
It was just straight exploitation.
And abuse.
So that's the best answer i think i can give to that question.
It's similar to what lisa dr lisa feldman told me.
She's a neuroscientist who said she told me this story.
It's obviously an anecdote, so it's an n of one um, so obviously taken with caution.
But she she told me the story of a young woman who was abused by her uncle and um lived a normal life.
Everything was fine, slept well then watched oprah.
Oprah had on there an array of women that were abused when they were younger.
And she recontextualized what happened to her.
And from that day onwards, she had all the symptoms of someone who was abused.
She had sleep disruption, health disruption, all these things.
Because she had suddenly, as you used that term, reconceptualized actually what happened there.
Yeah.
Yeah, I mean look, I think people who have been abused are those who survive and do well afterwards, in some way become very good, by force, by necessity, at compartmentalizing.
If you look at some of the very, very top tier military special forces units and so on, the percentages of those guys who've been abused very high.
Now, why would that be an asset?
If you're in battle, if you're in a chaotic environment where people are dying or at risk of dying, and you need to act effectively and calmly in the most disruptive, unpredictable environment imaginable, compartmentalizing is a superpower.
Where you can basically detach and take this observer status, almost as if you're watching yourself doing kill and capture raids or whatever it might be.
But when some of those folks come back to civilian life, the compartmentalization is a severe handicap and disruptor in family life.
Right,
So that superpower becomes a super weakness.
And I think that that is true outside of the military for people who survive abuse.
They may bury it completely, put under lock and key subconsciously, so they don't even have explicit recall of the event until perhaps there's some triggering catalyst that brings it back up.
They might just say hey look, that happened, it's terrible.
Like no need to dwell on the past.
I want to move forward, which i think frankly, is a viable strategy.
I don't think everyone needs to go, you know, put on their hazmat suit and unearth everything bad that has ever happened to them.
I don't think that is automatically productive or helpful.
Can make people really despondent because you can't fix the past right.
So I would say that in my case, that compartmentalization was on some levels very enabling, right?
Like I could outlast, out-endure a lot of people in sports, in work.
My pain tolerance was incredibly high, But there is a price to be paid when you cauterize certain aspects of yourself and disallow certain types of emotions.
Like there are prices to be paid.
And I will say that I think the potential and promises of psychedelics by and large are overstated.
But in terms of bringing emotions back online, that was almost entirely due to psychedelic experiences.
For me,
Bringing emotions back online.
Yeah.
So I hadn't cried in like 20 years.
Couldn't remember the last time I cried.
And then I'd be like on a plane watching a really compelling kind of heart-wrenching documentary and just start crying on the plane.
I'd be like, what the fuck is going on here?
What the fuck?
And certain emotions just came back online.
And I think that once those were online, that is in part what then pulled along with it this revisiting of these high fidelity memories.
And then um, I had a very rough period because of that and ultimately decided you know what like?
This is the lead domino that has already been tipped over, that has affected so many things.
I can continue to do patchwork, like remediation with bandaid solutions for various things, but I'm just I'm plugging holes in the side of the boat, not asking why it's filling with water in the first place.
And I just decided, you know what, I'm just going to take six months.
And I know psychiatry is pretty messy.
But priority number one is to try to find some resolution with this.
And that's what I did.
I canceled everything because I was having basically like a nervous breakdown and wasn't sure I would be able to sort of function in a business capacity anyway.
Um, So yeah, quite the adventure, quite the misadventure, but you know, you play your hand the best you can.
So having a podcast, having the books, having a blog has actually been incredibly therapeutic for me in finding some way to extract value from those experiences.
And let me just mention this because I don't make anything from it.
If people are going through any experience like this or if they've had a history of trauma, you can just go to Timblog slash trauma and it's got the conversation with Debbie.
It's a hard conversation, but it also has a list of resources, because what I used as a toolkit and what Debbie used are completely different.
So you get two very different perspectives on things.
And I would say, if I had to pick one other tool blog post in this case that I am was the hardest to put out.
And also that I think I'm proudest of it would be some practical thoughts on suicide.
There's a post called some practical thoughts on suicide.
And um, I know that has, I know directly that has saved a few hundred lives and it it details my personal experience of almost killing myself in college.
Coming very close,
Like I had a date on the calendar and the only reason it didn't happen was is because I lucked out.
This is luck.
So at the time I was taking a year off of college to work in a few different jobs and ended up being very isolated because my whole class was graduating.
My roommates at the time had full-time jobs, so I was just kind of stuck at home working on my senior thesis.
Not a good recipe for mental health.
And I reserved a book from the Princeton University Library about assisted suicide.
And the book was out.
Popular book, it would seem.
And back in the day the way the system worked is they would mail you a physical postcard to your address that was at the registrar's office.
I had not updated my address to my off-campus apartment.
So the card that said good news, your book on suicide has arrived at Firestone Library.
It got mailed to my parents.
And that's what snapped me out of it, was realizing, oh, this isn't just about me.
Now I don't have the plausible deniability.
I was going to make it look like an accident.
It's like, now I don't have it.
That's been taken away.
Retrospect, thank God.
And so it didn't happen.
But the reason I wrote that post is because I was at an event.
I was actually being interviewed by Jason Calacanis on stage at this live event this week in startups event.
A few hundred people in the audience and stuck around afterwards.
And a bunch of people came up and wanted books signed and things like that.
And there was one really nice guy well-dressed, had himself put together, who asked me to sign two books, one for himself.
And then he asked me to sign a book for his brother.
And I said, what would you like me to say to your brother?
And he just kind of froze.
And I was like, okay, well, I don't want this guy to feel stressed out.
I was like, I'll tell you what, we can figure it out or you can just leave it to me.
There's no rush.
Like we can do this after the event.
All right.
So took care of everybody else.
And then the guy walked me to the elevator and he explained, he said, yeah, sorry about that.
I froze because my brother committed suicide and we kept his room exactly how it was.
And he was a huge fan of your writing.
And so I wanted to get a book signed by you and put it in his room.
And he said, have you ever thought about talking about mental health?
Because you could really help a lot of people.
A lot of people listen to you.
And unbeknownst to him, I had all the history with coming this close to killing myself.
And I sat with that.
And I was like, yeah, he's right.
He's really right.
I have a responsibility to write about it.
And that blog post took me at least a month to write and rewrite, and rewrite and have proofread.
Consider deleting.
And, uh, because that was also something that my family didn't know about.
I mean, they, they knew about the book, but they didn't, they didn't realize how close it was.
So um, that was also another wonderful call with family to be like.
So there's this thing about to come out.
Should probably give you a heads up so you don't hear about it from everybody in the extended family.
But uh, When your parents received that thing in the post, that slip, the library slip, did they call you?
My mom called me with this very shaky voice, being like, what is this?
Why did you reserve this book?
And I lied.
I said oh well, I have a friend at Rutgers and he was trying to get this book for a research project and they didn't have it at their library, so he asked me to get one through Firestone.
But I was just lying.
But I knew the jig was up, right?
And...
That was the turnaround point.
And that was also, because this was in 1999 where I just decided to go 100% into physical training.
And there's a lot of backstory behind it.
People can read about it if they want on that post, some practical thoughts about suicide.
But this is not, it is so fucking common.
It's very disturbing.
Like when you realize, it's disturbing and reassuring.
It's disturbing because you realize how prevalent it is. and how close so many people have come.
It's reassuring because you realize also very quickly that you are not alone.
You're not uniquely flawed.
This doesn't need to be personal and permanent.
People have solved for this.
Looking at my audience over the last 10 years, every mental health complication or diagnosis that I can think of is up and to the right just hockey stick.
So chronic anxiety, treatment resistant depression, you name it, right?
Obesity, loneliness, which can take many different forms, usually self-imposed.
And when I see a constellation of issues like that, I try to identify if I can not just the symptoms, because then you end up putting band-aids on things that are interrelated, but treating them as silos, but looking underneath it to see if there are root causes that we can address.
So let me speak to that first.
So on the mental health side, I'll just throw out a few things that have been very, very helpful.
There are the behavioral questions, and I would agree that, at its simplest level, you can just look at what we're evolved for.
Just take a close look at evolutionary biology.
Independence, lone wolf, is not in our programming.
It just is not.
So I would say, when in doubt, revert on some level to what people were doing a few hundred years ago, at the most recent.
And that would be sort of assumption number one.
Then I would say to people who are suffering right now The social interaction analog human interaction, I would just say is the one target when hit.
That solves a multitude of other problems that otherwise you'll be playing whack-a-mole with.
But if there are then remaining problems with say, chronic anxiety OCD, when we get into some slightly trickier terrain schizophrenia, borderline personality disorder, et cetera.
There are a few things that I have found in the course of doing a lot of work with different scientists and also a lot of experimentation on myself, having grown up with multiple long-duration depressive episodes every year.
And those are a short list of different types of brain stimulation, specifically something called accelerated TMS.
The before and afters that I've seen with that are beyond incredible and equal or surpass in some cases the amplitude of effect and the durability of effect of psychedelic-assisted therapies.
Accelerated TMS, so transcranial magnetic stimulation.
And Nolan Williams, Dr. Nolan Williams at Stanford is a good person to look up for more on that.
What exactly is that?
Is that putting something on your head, and There are different ways to do it depending on the hardware that you're using.
But in effect...
Accelerated TMS refers to a new protocol with better hardware and software of a technology TMS that has existed probably for 40 years, if not more on some level.
And you will, instead of doing two or three sessions a week for many months, you do 10 sessions a day for five days straight.
So you are getting stimulated on the hour, every hour for about eight minutes.
And you do that for 10 hours straight.
And then you compound that over five days.
And you see, for instance, to give one example, a friend's child, very terrifying story, but he was a cutter, this 14-year-old.
Self-harming.
Yeah.
The parents were just waiting for the call that their child had committed suicide.
And this went on for two or three years, I want to say.
And then within three days of accelerated TMS treatment, it was like reversion back to old self.
And then with boosters every, say, three to six months, that has been durable.
The before and after is impossible to overstate.
It's pretty wild.
What are they doing to the brain?
Is it electric? electrodes, or is it music?
It's magnets.
Magnets.
Yeah.
And what it feels like is someone kind of like flicking the side of your head.
It's sort of the sensation.
It is, from a safety profile perspective, really compelling.
Like the downside risk is very, very minimal.
And me.
With the most recent sessions that I've done myself, I had probably four to five months of no anxiety.
Like all of that stuff vanished as if by magic wand.
And I felt like I'd been meditating twice a day for a year.
I mean, it was incomprehensible.
It was really, really, really remarkable.
And there's good clinical evidence for this.
It's not just end of one anecdote.
So that's one is the kind of neuro stim piece.
And there's a lot more that's going to happen in that space.
But bioelectric medicine.
That would be one example big lever that I think is worth investigating if people are suffering with any number of different conditions.
Then you have metabolic psychiatry.
Primarily, that would be dietary intervention.
Chris Palmer at Harvard is someone who's popularized this in the last handful of years.
Metabolic psychiatry, specifically putting people on a ketogenic diet.
You have folks who have been treated with 15 different medications for schizophrenia for a decade, who get off all of their medications within three to six months.
Stay off simply by stabilizing a handful of things in the brain, including adding a very beautiful, clean energy source, which is ketones.
There are also a lot of possible applications of the ketogenic diet or modified ketogenic diets.
Exogenous ketones, meaning supplemental ketones for neurodegenerative disease.
So I have three relatives right now who have Alzheimer's.
And genetically, I'm very predisposed.
So I'm thinking a lot about this also from a preventative perspective.
So can I potentially bolster mitochondrial health, cellular cleanup, reduction of plaque buildup, et cetera, by doing strict ketosis for a month a year, fasting for a week, perhaps once a year, water only?
I think there's actually pretty compelling evidence that those are all worthwhile interventions to consider if you're very highly predisposed, as I am.
And then I would say the last one I'll mention now, the psychedelic assisted therapies for various conditions.
I do think that psychedelics and this is to quote a very famous psychotherapist named Stanislav Grof.
Stan Grof, what the telescope did for astronomy, what the microscope did for biology, psychedelics will do for the mind.
I don't think that's an overstatement, because a lot of the clinical outcomes that we're seeing are with treatment resistant PTSD.
People who've had an average diagnosis duration of like 14 to 17 years, nothing succeeded.
They do two to three sessions and then you see like a 50 plus percent complete remission of PTSD.
What is going on there?
I think, in a very productive way, leading us to question some of the very fundamental assumptions that are made in the world of psychiatry, particularly with pharmaceutical interactions or pharmaceutical prescriptions.
And that's really exciting to me because I think there is an argument to be made that you can address certain root causes.
And there are different explanations for this.
Gould Dolan, who's now at UC Berkeley.
She was at Johns Hopkins talks about the reopening of critical periods for development.
So you could potentially use psychedelics for stroke patients who are trying to relearn motor control.
So I would say that those are broadly kind of the three pillars.
There's one other that I'm digging into that I think could end up being very, very interesting overall.
This is one that is sort of TBD personally.
I am experimenting with it.
But vagus nerve stimulation.
There is a sea of bullshit floating around related to vagus nerve stimulation.
The vast majority of what you'll bump into is pseudoscientific nonsense.
So if I'd never heard about vagus nerve stimulation before, how would you?
Yeah, I can explain it.
All right.
So the vagus nerve is a bit of a misnomer, because there are actually two bundles of nerves that that travel down from around your brain, stem down either side of the neck kind of where you would feel your pulse.
It's right alongside the carotid artery.
And you can think of them as almost transatlantic cables.
So you don't have.
You have two primary vagus nerves, but there are about 100000 fibers in each of them.
And we only know what a tiny fraction of those do.
They then travel down and they innervate and touch pretty much everything you can imagine, including your gut.
And there's some very interesting communication between the gut microbiome and the brain vis-a-vis the vagus nerve.
It's wild.
And the most credible voice that I've found in the world of vagus nerve stimulation or VNS for short science is a guy named Dr Brian Tracy T-R-A-C-E-Y.
He wrote a book called The Great Nerve, which is a very good introductory read on all this.
One of the most heavily cited scientists of the last 30 years.
He's incredibly incredible.
And he co-founded a company, I want to say at least 10 years ago or 11 years ago.
It was involved at least as a primary scientific advisor for an implant.
The implant is about the size of a omega-3 fish oil capsule.
It gets implanted right in the neck.
So surgical procedure, but pretty minor.
And That has just been approved.
It was the cover of the New York Times a few weeks ago for rheumatoid arthritis.
And the before and after that you see in some of these conditions again is something straight out of science fiction.
You see, someone who's been mostly bedridden chronic fatigue, can't hold a job, struggling to interact with their kids, has this procedure.
And then, like two weeks later, they're running up a flight of stairs to catch a train on a trip to Europe and have the problem of too much energy.
It seems to have broad potential application to autoimmune conditions.
So you might think of, say, a Crohn's disease or IBS.
It seems to have applications to significantly enhancing HRV, heart rate variability.
So I have a friend who, for the longest time, he's former tier one operator, military.
He's got a lot of sympathetic overdrive, so he had trouble sleeping.
And he tried... all sorts of sophisticated breathing programs, which can help.
He tried cold exposure which can help, but those were all incremental gains on his HRV maybe improved 10 to 15.
Lots of meditation twice a day 10 to 15.
Used vagus nerve stimulation for somewhere between two and four weeks, tripled his HRV.
What?
Yeah, tripled.
How did he stimulate his vagus nerve?
This is where we get into some controversial territory.
All right, so the device he used is a device.
It's called GammaCore.
It's by prescription.
It is applied to the neck.
It provides electrical stimulation for two minutes at a time, I believe.
It's very, very minimal.
It's two minutes twice a day, I want to say.
Maybe it's five minutes twice a day.
And that seems to have just a downstream collection of benefits or potential benefits.
Most of the research for gamma core is for, i believe, migraines and or cluster headaches in terms of published literature.
Or option b, which has a lot more in terms of published studies, would be auricular, so ear stimulation And that's stimulating something called the simba concha right here.
It's a very particular location.
And so you apply stimulation to the ear.
I'm experimenting with both the ear and also the neck.
I would say vagus nerve stimulation has top of mind access right now for me in terms of interest.
I bought this Bonn Charge face mask, this light panel for my girlfriend for Christmas.
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Before the Diary of a CEO was what it is today, it was just an idea.
And it started with me, a cheap plug-in microphone, and my Mac right here.
And I have to say, when I first had the idea for the Diary of a CEO, my thinking was that the world might want to see into the diaries of some of the most interesting successful people, really in high places, that were doing interesting things.
So, after recording that first episode under my duvet, I sat on my Mac, which is from our sponsor Apple, and spent hours editing.
And eventually uploaded it, and honestly...
I thought that would probably be it.
But a couple of my friends said they enjoyed it, so I kept on recording.
And over time, the microphone has changed and we now have this incredible setup here.
But the thing that has stayed the same is I'm still using the Mac.
Even today, my entire team across our studio still uses the Mac.
Our first few episodes maybe had tens of people listening, but now tens of millions of people tune in all over the world, which is still absolutely crazy to me.
So if there is an idea that keeps tapping you on the shoulder...
This is your sign to start.
Your great ideas start on Mac.
And you can find out more at apple.com slash Mac.
Because of what you do and because of the way that you are, in terms of your broad curiosity and the way that you think and the way that you learn, I have to ask you the question what is it that you see coming down the pipe, like coming down the line in terms of macro trends?
It probably makes sense for us to just stick with health for a second.
You've talked about Vegas.
Is there anything else that you think, 10 years from now, everybody's going to be doing, but they're not currently doing or thinking about?
One of them i'll throw out?
There is something i've been thinking about is air quality.
I think i see a rise in people's concern about co2 levels and also outside air quality, so i imagine i'll be wearing some kind of device and my iphone will be telling me about the air quality in the room or outside.
Yeah, that wouldn't surprise me.
I think bioelectric medicine is a big category, so whether it's accelerated tms or focused ultrasound uh, where you might take something that looks like a hockey puck and put it over your liver, for instance, or spleen to affect various things.
Using microchips over pills, I think is going to be a huge growth area and that we'll realize more and more how much is dependent on the immune reflex and different types of communication mediated by electricity that can be affected by external or internal devices like an implant.
So, for instance, I'll give you a wild factoid, which is people may have heard the story, which is based on real science, where you transplant the microbiome from say, obese mice into lean mice and those lean mice then become obese just by transplanting the gut microbiome.
If you sever the vagus nerve before you do the transplant, that doesn't happen.
They don't become obese.
So what's happening there?
It would seem that the microbiome is communicating with the brain vis-a-vis the vagus nerve.
And when you sever something experimentally in that way or ablate it or whatever, oftentimes this might seem paradoxical, but you can achieve similar effects with stimulation that you can with severing, and I think many of the assumptions that we have currently, which form the bedrock of our quote, unquote understanding of mental illness and so on, are just going to be completely false.
They're going to be completely untenable within 10 years.
A lot of that, I think, is going to be driven by a better understanding of the body electric.
It will be driven by better understanding of how Fuel utilization in the brain drives many different psychiatric conditions that can be mitigated or completely addressed by say, providing an alternate fuel source instead of glucose ketones right.
That would be just kind of a simple example.
But there's a huge compliance issue with the ketogenic diet.
People don't want to do it for a lot of good reasons.
So how do you get people to stick with it?
Well, maybe there are other options for achieving ketogenic like effects, such as systemic anti-inflammation, with the use of electricity instead of diet.
Right, i think that's possible, and i've invested in a few companies that are aiming to do that, which is very exciting because it means that you might have options for affecting brain function that do not require you to take molecules that get into your brain directly.
That's really exciting.
So bioelectric medicine, I think, is going to be a very exciting space to watch.
And there are a lot of researchers doing some wild stuff with bioelectric medicine.
So we'll see where it goes.
Where are you today in terms of what's guiding you at the moment in this season of your life?
What are your big goals?
Are you aspiring towards anything in particular?
It's relationships.
It's Looking forward to the next big chapter for me, which would almost certainly not almost certainly be partner family, all of that.
I mean, another startup's not going to make any difference to my life.
You know, another podcast.
I love all of those things.
I love startups.
I love the podcast.
I love the books.
But we're at the squeezing out of marginal gains at this point.
Are you married?
You're married or i'm not married.
Don't have any kids that i'm aware of but uh, dating a lovely woman right now, very excited about it, do you think it's quite strange that a lot of podcasters don't seem to be like i'm not married yeah, i don't have any kids yet.
Yeah um, i've just turned 33.
But so many of the big podcasters don't seem to have kids or be married, other than really rogan yeah, Yeah.
Someone tweeted about it the other day.
I was like, oh, fuck.
Yeah.
Yeah.
I mean, look, I think that I'm not pointing fingers at you, but I know quite a few of these guys.
If we're talking about guys.
Yeah.
I mean, I know a bunch of female podcasters as well, quite a few of which are married.
But on the male side I will say you know, if you're a good-looking guy and you're putting videos on YouTube, your DM inbound –.
And your plethora of temptation that you need to resist is going to make remaining single very attractive.
And that's true for a lot of these guys.
So I don't think there's a mystery to be solved.
In other words, it's like if they go on the dating apps, it's just like shooting fish in a barrel.
And I don't think ultimately, that the dating apps, despite what they might say, are designed to be deleted.
I do not believe that.
They're casinos intended to keep you in the casino.
Yeah, it's just follow the money, follow the subscription plans.
Well, you talk about the paradox of choice.
Yeah, and so there are times and I think this is probably misplaced envy where I'm like, you know, maybe there was something to arrange marriages, you know, and this whole idea of like soul mate, romantic love, driving everything is a relatively new invention on the scale of human history.
Uh, Now would I want someone deciding who I marry and have kids with.
Not particularly.
But there is a certain simplicity to it that I find enviable, when you end up in the modern digital casinos of dating apps where yes, that person was an 8 out of 10 but man, that 9 or 10 is just right around the corner.
I know it's just a few thousand swipes away.
And you get the variable reward, at least if you're like a healthy, sexually vigorous male, I'm sure for women as well.
I just think that men tend to think with their smaller head a lot more often.
You're going to get these incredible dopamine hits of variable reward.
It's just like dog training, but you're training yourself with the dating app to continue using the dating app by getting these Scooby snacks.
In terms of you know, fill in the blank with your imagination.
I don't meet, I have not met a single person who is like, I love dating apps.
No one.
I have not met a single person.
And yet, right?
What does the crack addict want?
More crack.
And they might say, I just need one more hit.
That's not how it works.
So there is, I think, a lot to be said for applying positive constraints.
I'm scared to be single again.
I just the way I look out at current mechanism of finding someone, these dating apps, and i just think and also i do understand it would be a significant distraction from whatever i'm doing here.
Oh, can you imagine me being in new york city tonight single and like uh, and having the evening off and what would go through my head and and then you'd have to go on a date with someone.
You've got to do all the small talk stuff.
I got out the game before the game like began.
Like seven years ago, I was at the game.
I saw this tweet from this.
I think it was a Vietnamese woman who said you know, I wonder if It wasn't Gen X, I wonder if X, Y and Z people of this generation are looking at dating apps and thinking wow, we got the last chopper out of NAMM.
Literally.
Literally.
And... Oh, my God.
That's not far from the truth.
Paradox of choice is a real problem.
People think it's quality problem of abundance.
I'm not convinced that that's true way.
It's not possible.
I have so many my friends that struggle with dating the most date the most.
Yeah sure, i've got two or three friends that i can think of, i won't name them, but two of them are women and one of them's a guy.
They do 50, between 50 and 100 dates a year yeah, and they're just convinced that it's through lack, of lack of option, and i just it's impossible.
But you know yeah, i'm uh very happy to be off of the dating apps.
I was on the dating apps for two or three years.
It was just it is a part-time slash full-time job.
We have a closing tradition on this podcast where the last guest leaves a question for the next guest, not knowing who they're leaving it for and you're, you know, the person who wrote your question sat there i kid you not for 30 minutes in total silence, thinking about these eight words.
Oh wow, they sat there for i've never seen anything like it.
All right, And the eight words that they wrote, Oh man.
I know, right?
That's nine words.
What is your favorite color today?
Can you imagine?
Yeah.
What's your favorite sandwich?
No, I'm joking.
How would you spend your final day on Earth?
With my closest friends and family.
No doubt.
It wouldn't be pizza.
It wouldn't be... I mean, maybe it involves pizza.
But it would be... telling the people I love that I love them and spending time with them.
It doesn't need to be anything fancy.
You could be sitting on a porch on a rocking chair, and that might seem like a trite answer, but I am putting that into practice every year, with periods of time that are blocked out for this.
So I'm not waiting until my last day, but last day certainly wouldn't be dating apps.
Wouldn't be an opium bender.
It would be, it would be time with my absolute closest friends and family.
And I'll add a elaboration on the past year review when I'm looking at relationships.
Before investing in new relationships, I look at my top, say five to 10 relationships and ask myself did I spend the amount of time I would want to spend with these people last year?
And if the answer is no, I always reinvest in those people and only the overflow gets allocated to new relationships.
I really focus on the tried and true, proven relationships with deep levels of trust over long periods of time.
In terms of systems, have you put a system in place to make sure that life doesn't get in the way of those people coming together?
Yeah.
I mean for 25 plus years.
I've had a annual reunion around my birthday, every year in the summer, where all of my or those who can make it but incredibly old friends show up.
They know it's on the calendar.
It's roughly the same date every year.
And they fly in from all over the country, all over the world.
And it has nothing to do with my birthday.
It's just a reunion of friends.
Tim, thank you.
Thank you for several reasons.
I think the first reason is you're one of the I said to you before one of the founding fathers of what we do here.
And if it wasn't for people like yourself and Joe, there is a 0 chance.
I think that people like me would be doing what we do now.
And that's given us so much.
There's really really like a very, extremely low chance that if People like you hadn't taken the risk and created a blueprint and shown that it was like an effective medium and the long form was interesting and everything that you guys proved,
There's no chance that people like me would exist.
And so whenever I meet people like you that I consider to be standing on the shoulders of or have stolen a blueprint on, I feel like I am obliged to say thank you.
Thanks for saying that.
But it's true.
It's true.
And I was inspired also by people who preceded me right when i did the launch for the four-hour chef in 2012, with going on joe rogan and mark maron and nerdist and so on, like those guys also showed me that something interesting was afoot.
So uh, you're 33.
You said 33.
Yeah, you got a lot of runway man.
You're in a good position.
I'll add one last thing that i neglected to mention earlier, but in terms of productivity and we're talking about weekly architecture I think everyone should put as a challenge for themselves, particularly if they're an entrepreneur, a four-week mini retirement once a year where you are unavailable.
You are off the grid.
No laptop, no phone outside of maybe Uber and Google Maps and OpenTable, where you are literally completely unavailable.
And the reason I recommend that, there are a few.
Number one.
It's going to allow you to play the long game at high intensity, having that deloading phase.
The second is it will force you to improve all of your policies rules, guidelines for autonomous decision-making by employees, et cetera, et cetera.
It'll force you to clarify all of that on a regular basis.
So when you come back, all of those systems improvements will endure beyond the mini-retirement.
But it's a forcing function.
It also forces you to take a very close look at the non-business interests that you have either maintained or cultivated, or let atrophy in complete disuse.
And if you end up having a slight panic attack because you don't know what to do with your time, that's a great wake-up call.
You need some other things to offset the type A maniacal focus on chasing that rabbit around the greyhound track.
Amen, thank you.
Tim thanks, thank you.
Thank you so much.
If there's anything we need, it is connection, especially in the worlds we're living in today.
And that is exactly why we created these conversation cards, because on this show, when i sit here with my guests and have those deep, intimate conversations, this remarkable thing happens time and time again we feel that deeply connected to each other.
At the end of every episode, the guest I'm interviewing leaves a question for the next guest, and we've turned them into these conversation cards.
And we've added these twist cards to make your conversations even more interesting.
And there are so many more twists along the way with the conversation cards.
This is the brand new edition.
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