Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Integrative Psychiatry: Marni Chanoff
40 Plays4 years ago
Season 2, Episode 4: Dr. Marni Chanoff is an integrative psychiatrist in Boston, Massachusetts. Listen to Marni discuss the core principles of Ayurveda, the migration of mental health resources to virtual platforms, and ongoing research in nutritional psychiatry. See below for more information regarding Dr. Chanoff's new integrative health platform, Joy in Health:
Marni Chanoff, MD
Founder of Joy In Health, Integrative Psychiatrist
IG: @docmarnichanoff
Recommended
Transcript
Introduction and Guest Introduction
00:00:09
Speaker
You're listening to The Wound Dresser, a podcast that uncovers the human side of healthcare. I'm your host, John Neary. Today, my guest is Dr. Marnie Chanoff. Dr. Chanoff is an integrative psychiatrist on staff at McLean Hospital and Harvard Medical School. Dr. Chanoff did her medical training at the University of Miami School of Medicine and completed her residency at Harvard Medical School.
00:00:38
Speaker
She has also trained extensively in ayurvedic studies, nutrition, and lifestyle medicine, which she incorporates into her treatment plans. Dr. Chenoff also maintains a private practice and will be launching an online integrative health program in 2022 called Joy in Health. Marnie, welcome to the show.
What is Integrative Health?
00:00:56
Speaker
Thank you, John. Great to be here.
00:00:59
Speaker
So integrative health is a term we are beginning to hear more online at our gyms, at our yoga studios, and throughout our healthcare system. So as a clinician, what does the term integrative health mean to you as an approach to medicine and healthcare? Well, to me, it means taking the best
00:01:22
Speaker
knowledge and approaches from various medical systems and healthcare systems and figuring out how they can work together and compliment each other to bring a holistic, nuanced, individualized treatment approach to the person who I'm working with.
00:01:49
Speaker
Can you discuss how you got interested in integrative psychiatry and perhaps how it deviates from traditional approaches to psychiatric care?
Inspiration Behind Integrative Psychiatry
00:01:58
Speaker
Sure. So when I was going through my psychiatry training, which was very rigorous and intense as training programs are, I found that the things that I
00:02:17
Speaker
the things that I were doing to take care of myself was sort of a combination of my own yoga practice and yoga learning and sort of understanding the kind of the yogic way of life together with my own psychotherapy
00:02:39
Speaker
my own reaching out to friends and family for support, my own nutrition practices, you know, eating well, trying to get some sleep where I can, although, you know, when you're a resident, it's really difficult to have much control over your schedule. And so what I walked away from those, you know, four years of training was that, that it takes
00:03:03
Speaker
you know, multiple practices and multiple sort of ways of looking at health to really, for me to really support my own resilience.
00:03:15
Speaker
And that was further validated later on in life when I was, I went through the hardest time of my life so far taking care of my mother who was diagnosed with pancreatic cancer and got very ill very quickly. It's a very, very stressful, sad, you know, devastating period of time. I also had two little kids at home working full time and
How Does Ayurveda Support Resilience?
00:03:42
Speaker
You know, what I realized then was that I actually didn't need to go and talk and process it so much with a professional, a therapist, you know, like the therapist who was wonderful, who I was seeing during residency. But what I really needed to do was get back to my yoga practice and use my body as a source of grounding and support and wisdom along with the breathing practices that go along with yoga.
00:04:12
Speaker
And when she passed away and I was grieving, I went to Kripalu, which is a yoga healing center, and I gave myself the gift of three days of healing, of just quiet time to myself. And there I was introduced to Ayurveda.
00:04:34
Speaker
as a whole healthcare system that brought together all of the modalities that I was intuitively using for myself to heal and to support my resilience. And when I saw that there was this healthcare system that had been in practice for thousands of years,
00:04:51
Speaker
It's a healthcare system originating from India. What I realized was that I didn't have to figure out a new system and didn't have to figure out a new way of putting all these things together, that there was this really beautiful system that already sort of understands the importance of
00:05:09
Speaker
of this comprehensive way of caring for oneself. And all I had to do was learn this new system and understand the way these modalities were related to
Integrating Eastern and Western Practices
00:05:19
Speaker
each other. And so I did that. I marched up to the dean's office, and I sat with her and said, I absolutely need to understand this. I need to learn this. It was one of those aha moments in my life. And there I was. And it was a student, again, learning from the very beginning.
00:05:38
Speaker
And so from there, what I tried to do was recognize the ways in which I was bringing all of these kind of intuitive practices to my own life and how to slowly and cautiously and responsibly start bringing them into my work with patients. And what I found was many patients were desperate.
00:05:59
Speaker
for other resources and other modalities to complement what we were doing with their medication management and their psychotherapy.
00:06:10
Speaker
not everybody, but many people were really, really excited and motivated to bring these into their lives. And so from then, I've been working hard to figure out the art of the blending, the art of bringing in Western and Eastern practices in a way that makes sense to everyday people.
Patient-Centered Approach and Lifestyle Changes
00:06:33
Speaker
Yeah, I think just the beautiful thing that you said that was reiterated to me by another integrative physician I talked to is that the cool thing is that you can go out and sort of try all these things for yourself and connect with patients at such a deeper level because you've sort of explored all these things as opposed to other aspects of medicine where a surgeon necessarily can't go through a surgery and talk about his experience with the patient who's set to have it.
00:07:01
Speaker
You mentioned obviously a lot of things, Ayu Verda, reaching out to friends for social support. I know you're really big in nutrition. How do you kind of, like you said, kind of master this art of incorporating so many different modalities into an individualized treatment plan?
00:07:21
Speaker
Well, I'm not sure I've mastered the art yet. It is, you know, it is, you know, as these things are in our personal lives, it is, it is a practice. I think because I've been at it for a while now, these things have become part of my life. And so as, as you were saying, they've come.
00:07:42
Speaker
It comes from a place of firsthand knowledge or firsthand experience. And so what's most important to me is that I don't become like, you know, rigid about
00:07:56
Speaker
any of this and I don't pretend that I have the answers for the person that I'm working with that's right in front of me, right? So the place that I start, which I think is really important is that the person in front of me is on their own path. They're on their own journey and their journey is different than mine. And they are open and receptive and ready to integrate
00:08:23
Speaker
some things in their lives that I probably would never be ready or open to doing and vice versa. And so I try to approach this as this individualized kind of art where I asked a lot of questions. I really get to know the person as much as I can in front of me. And I'm very aware that the things that I would love for them to do are not yet in their
00:08:54
Speaker
They're not ready for it yet, maybe one day, maybe never. So what I try to do is get a sense of how ready the person is to make change. And making these changes in lifestyle, diet, taking in practices,
00:09:13
Speaker
you know, that have been established 5,000 years ago, many of them are being sort of validated by scientific research right now, and some of them are a little bit more intuitive, which, you know, may really resonate with some and may not with others. I try to just gauge, you know, for this particular person, what do I think, number one, could be most impactful, and two, what are they ready to try?
00:09:39
Speaker
And so sometimes I get it right and sometimes I get it wrong. And oftentimes I just take the approach of opening it up to conversation. Here's all the things that we could try, which one of these to start feel like they resonate with you the most. And then we start from there. And it can be just one small, small thing because, you know, change is hard. And, you know, especially if you're struggling with, you know, depressive symptoms or anxiety or
00:10:09
Speaker
mood instability or trauma, you know, making these changes can be very challenging.
Ayurveda's Natural Balance Principle
00:10:14
Speaker
And so we try to start with like one thing and just from there you build and you make, you know, you make progress by building a sense of confidence and competence and you support someone as much as you can and recognize that change is not linear and that there's going to be many bumps in the road. And that's all part of the process.
00:10:34
Speaker
Yeah, I think it's super interesting what you're saying about how you need to meet the patient where they're at and kind of explore what they're ready for. I imagine, you know, any sort of lifestyle changes, right, requires a lot of work. And I think especially when it comes to nutrition, we can kind of feel like, you know, if making this change is sort of depriving myself or it's just going to be, you know, not worth the work and the effort. So how do you kind of, you know, set the right tone and attitude for patients to kind of, you know,
00:11:04
Speaker
acknowledge that there will be work in making lifestyle changes, but that'll be worth it in the end for better health.
00:11:13
Speaker
Well, you know, I think that I can tell someone that, but unless they start to experience that, it's just gonna feel like another lecture from another doctor, you know, as much as I try to, you know, try to feel like I'm presenting it in a different way. It's, you know, so many people have gone to the doctor and have like sat there and the doctor says, you know, you really should exercise more or, you know, you really need to lose weight. And, um,
00:11:42
Speaker
those experiences can be really demoralizing for people. And when people are demoralized, in some cases traumatized, they can leave with a real sense of shame and shame makes people feel like they need to just shut down and protect themselves. So I try to just find a place to start that feels like it wouldn't be
00:12:11
Speaker
depriving. And so that can be in the form of figuring out how to get someone to start moving in a different way, even if it's starting with when you commute to work, although a lot of people are not commuting to work as much anymore. But is there a way that you can just get off from the train at two stops before and add a five-minute walk into your day?
00:12:40
Speaker
Or can you just start parking on the parking spot farthest away from the grocery store? Or can you call a friend and go for a 10, 15 minute walk once a week? Those kinds of things. Or with diet, can you start, even starting with a lot of people are really trying to work on their addiction to sugar.
00:13:05
Speaker
Are there sugar substitutes? Are there ways that you cannot feel like you're giving up sugar completely, but that there are certain things that you're learning that, you know, doesn't, they don't have to be as sweet or, you know, even with coffee, you know, putting less sugar in just a little bit at a time, work your way down.
00:13:22
Speaker
And that doesn't work for everyone because a lot of people are dealing with intense addiction to sugar or people are dealing with severe depressive symptoms that make it hard to want to do any of this. But you get the sense of just starting small and figuring out
00:13:39
Speaker
what's most important to this person? What are they most ready or not, even if they're just contemplating kind of making change, what would be a place for them to start? What's most important to them?
00:13:55
Speaker
And so you get it's not easy right so you get the picture of like you just have to find the seedlings of where the energy and the drive and the motivation and the interest really are and then you just sort of work from there.
00:14:12
Speaker
I do try to provide a roadmap. These are all of the aspects of health. These are all of the areas that we can work on. And if someone is really motivated, it's really helpful to come up with goals, three-month goals, six-month goals. If you could choose where you'd like to be in three months from now, what would that look like for you?
00:14:38
Speaker
So that that could be a really nice approach for some people. And then for some people, they're not ready to do that work. And so we have to start with more of the foundation building so that they can even imagine having a healthier life.
Body Awareness and Societal Pressures
00:14:52
Speaker
Sometimes that can even be difficult in and of itself. Can you talk about the main principles and concepts in Ayu Verda and how we can kind of in Western medicine learn more from the healing tradition?
00:15:07
Speaker
Sure. So as I mentioned, Ayurveda is a whole healthcare system recognizing that we have to tend to the mind, the body, and the spirit. And this healthcare system is like other traditional medicines where it's based on the laws of nature. As humans, you know, in this modern society,
00:15:33
Speaker
There are so many ways that we feel like we don't have to really live our lives according to the natural laws, right? We have air conditioning, we have heat, we have lights, we have fast food, we have processed food. There's all these ways that we don't really have to sort of live our lives like the way that human beings have been living their lives for thousands of years. We've found ways to kind of skirt around those.
00:16:01
Speaker
which all turn out to be not particularly healthy, you know, convenient, but not healthy. And so this goes back to the fact that we are all, you know, we are natural beings. And if we can start living according to the laws of nature, then we will be healthier.
00:16:18
Speaker
And so this is an elemental science, much like other traditional medicines, where there are natural elements that comprise all of us, that live within us. Ayurveda talks about these kind of life forces that govern our anatomy and physiology.
00:16:42
Speaker
And it mostly talks about the fact that we actually know what we need. We have this innate healing, this inner wisdom. The body and the mind and the spirit already know what they need to be balanced.
00:17:04
Speaker
And because of our lifestyles and because of life circumstances and because of trauma and loss and grief and stress, we have a real tendency to become imbalanced and everybody knows what that feels like. But to conceptualize it in this way, to me, is very smart because what it says is
00:17:27
Speaker
Of course, we're all out of balance at times. The trick with Ayurveda that can be extremely helpful is to start paying very, very, very close attention to all of the signals and the cues that the mind and the body and the spirit give you.
00:17:43
Speaker
Scream to you, I'm not well, I'm not well, I'm not feeling good today. I'm exhausted, I'm stressed, I'm anxious. And to start paying attention to all of those signs and signals that the body and the mind give you, and really start being in relationship with those. Because those are the earliest, earliest signs of imbalance. And Ariveda believes that if you can catch these imbalances early, you can reverse them.
00:18:14
Speaker
It's when you ignore, ignore, ignore, push through, push through, push through for months, maybe years that these things start to form these kind of more solidified permanent problems in the body. And that is the precursor to disease. And then once you have a disease, it can be much, much harder to reverse them. And then you get into kind of
00:18:41
Speaker
disease management or illness management rather than prevention. I think for our purposes, that's probably, I mean, I could get into a lot more detail, but I think that that kind of summarizes the beauty and the power of this medicine.
00:19:00
Speaker
Yeah, can you talk about the challenges of sort of tuning into those signals, like you said, from the body, the mind and spirit, when a lot of our, as you've alluded to previously, like the American culture is about sort of just pushing through and kind of being successful in, you know, whether it be work or school or whatnot, and kind of, you know, those circumstances aren't always, you know, don't really allow us to tune into what's going on.
00:19:30
Speaker
Right. I mean, that is the great challenge. We're living in a culture that, you know, that overpowers these signals and, you know, the influences and the pressures and the conditioning in our society
00:19:54
Speaker
are much more loud and powerful and persistent sometimes than those early warning signs. So that is the power of yoga.
00:20:08
Speaker
And that's the power of breathing. And that's the power of therapy. And I say therapy, a lot of people work with themselves if there's other practices that support you. But you have to be able to take breaks. You have to be able to find quiet time. You have to be able to tune out all the noise.
00:20:36
Speaker
and all of those external pressures and voices. Because what happens is those external pressures and voices from a very, very early age become internalized. And we become conditioned at a very early age, like this is normal. This is okay. This is what I'm supposed to be doing. And you have all of this modeling that if you do all of this, you're going to be successful.
00:21:02
Speaker
and you have all these outside pressures that say, this is what success looks like, or this is what is expected of you. And if you're not doing all of these things, you're gonna fall behind. You're not gonna get into that school. You're not gonna get that job. You're not going to get that promotion, right? And so it's deeply conditioned from a very early age that like that hard work, that pushing through is essential for success.
00:21:30
Speaker
And to be fair, there are times in life where that may be true, right? So there have been times in my life where I was not taking care of myself. And training to be a physician is, you give up a lot, you sacrifice a lot. And when you're young, the body and the mind are, for some people, not for everybody, can be more sort of tough.
00:21:56
Speaker
I can roll with the punches a little bit more and, you know, can bounce back. But as you, as you kind of are, you know, are at it for many years and you get older and, you know, it becomes harder to bounce back and your body becomes more sensitive to sleep deprivation and the chronic stress.
Dr. Chanoff's Online Program Introduction
00:22:15
Speaker
And that's when all of these chronic issues set in for some people. Now, that's not true for mental health, because there are some people from a very early age who develop depression and anxiety and all of that. So I don't want this to get confused with primary conditions or primary issues that
00:22:36
Speaker
you could be the most well-rounded and get the most sleep and eat the most healthy food and you can still develop symptoms. I don't wanna get into that. I don't want to minimize that part of it, because that is true. But generally, especially with this chronic stress, it's something that gets conditioned early. And so if you wanna go through this path of healing
00:23:05
Speaker
It's not just about, you can't start over, but so you have to start reversing some of these patterns and develop different ways and strategies to connect with your deeper inner wisdom. And that can be in the form of meditation or even in a light version of that, just learning how to sit with oneself in a quiet room.
00:23:32
Speaker
for five minutes, maybe 10 minutes, and just to be with oneself and pay attention to what's happening. I mean, it's meditation. Yoga is a practice that allows you also to just pay attention to what's happening in the body. Where are you holding stress? What does that feel like? Where is the pain? Where is the tension?
00:23:59
Speaker
And then when you're working with that in your daily life,
00:24:05
Speaker
you start to notice that pain and tension showing up for you while you're sitting at your desk and on a Zoom call. And you're like, wow, that's there all the time. What can I do to work with that? And then there are these both mental and physical practices that you can start to work with it. And I think it's just as simple as that really getting down to that very, very sort of simple, simple connection with oneself.
00:24:31
Speaker
You tell our listeners more about your program that you're launching, Joy in Health, and kind of why you decided to spearhead this initiative. Sure, sure. This is an exciting time. So when COVID hit in March of 2020, I was in the process of thinking about expanding my practice to include more of these integrative modalities.
00:25:02
Speaker
I was in solo private practice and doing a lot of this, but you realize that if you want to really integrate more and more of these practices, you need a team of experts who maybe have expertise in one certain area and you can't do all of this work alone. It's always nice to have a group of people then you're combining your expertise and thoughts and
00:25:30
Speaker
approaches. So I was planning on moving in that direction. And then with COVID, I like everybody else went home and never went back to my office. And so what happened with that was very interesting because all of a sudden, the media was really interested in mental health.
00:25:54
Speaker
I think the media became very interested in how people were going to get through that time of early COVID. And there was so much suffering that the media started to recognize that this part of this COVID story needed to be told. So I was working with the media relations team
00:26:18
Speaker
at McLean Hospital and started doing media where I would go on the local news or the radio and talk about the stress response and talk about practices that people could use to get through this enormously difficult time.
00:26:34
Speaker
And what I started recognizing was that, number one, everyone was at home. And number two, Zoom was effective. And we're all learning that Zoom actually can be effective in many ways. I don't think it's the end all be all, but we all have figured out how to use Zoom, particularly in mental health, telemedicine.
00:26:56
Speaker
think actually quite well. And so I decided last spring to create a program for people to really work with re-entry anxiety. That was when the vaccinations were coming out and people were starting to think about getting back to life. And what I was seeing in my practice was a lot of anxiety and a lot of uncertainty and people weren't sure that they were going to be able to make that transition safely or
00:27:21
Speaker
They didn't have the tools to go back. So I did a Zoom-based COVID anxiety workshop. And I got a lot of really great feedback. People seemed to really enjoy it. And it really got me thinking about things that I could do online to help support people's at-home practices.
00:27:50
Speaker
And it could be video based. And with that, I could reach so many more people than I can in my private practice and in my office setting. So I decided to move forward and I've reached out to some of my most trusted and inspiring leaders in the field of integrative medicine in Ayurveda.
00:28:14
Speaker
And I called them and said, this is what I'd like to do. I think that if we can put together an online program, we can reach a lot of people. We can do our best to keep it accessible and affordable rather than private practice care, which can be very expensive for all kinds of reasons. And the other thing is that so many mental health clinicians right now are full. It's really, really hard to find someone that, excuse me, that have openings in their practices.
00:28:44
Speaker
Everyone is inundated, hospitals are inundated, clinics are inundated. It can be like, I have people who tell me it can take months to find a therapist. And so I thought, well, that's okay, get on those wait lists. But there's so much we can be doing at home for ourselves. We just need to provide the knowledge, the resources and the sort of that coaching piece to help people.
00:29:12
Speaker
And so what we've decided is to launch this program, give it a try. It'll be, you know, be really interesting and fun. And it's going to, we're going to launch it hopefully the, you know, January, February and get the first, we're going to hopefully have some really nice kind of intro launch events in January. And then the first module we're planning to start in February.
00:29:37
Speaker
So do you, I kind of spring boarding off what you're saying, do you feel like this is kind of an inflection point for mental health care delivery and that, you know, people don't really can't really access it, whether because of the price point or because there's no availability and that, uh, you know, you're going to start seeing more of these online options for, for people to, to get the, the care they need.
00:29:58
Speaker
I think it's yes, I do. I mean, we know that actually like the group model can really bring down costs for people. And we know that it's makes it more accessible. You can reach people. The tricky part is differentiating care.
00:30:16
Speaker
from knowledge and support. So this program will not be treatment. This will be providing information, inspiring, empowering people to do all of the things that can complement treatment. So that's gonna be tricky because if someone has a significant depression or anxiety,
00:30:43
Speaker
it doesn't solve the problem of them not having access to care with a proper psychiatric evaluation and medication management and psychotherapy. We're not in the position to be able to provide care online right now. And even that is tricky because of licensing requirements and practicing within one state and all of that. So there's all kinds of reasons why providing treatment online
00:31:11
Speaker
You know, it can be challenging, although there's so many programs popping up that, you know, people are doing psychotherapy online and other modalities of treatment online. So, but, but this is going to be just like sort of.
00:31:26
Speaker
all of those other practices, nutrition, lifestyle, yoga, meditation, all of those practices that can complement treatment as someone is either in treatment or waiting to get into treatment, or for people with very mild symptoms that are more about these imbalances, empowering people to try these and see how much of those imbalances they can start to reverse on their own.
00:31:50
Speaker
And maybe it's prevention. And they don't need to, the urgency around starting a medication or starting psychotherapy is not as urgent. Or at least in their mind, they think, well, maybe I can do other things to support my health. So it's just basically like opening up the options and trying to help people realize that with or without active treatment, there's so much that they can be doing. Yeah, I certainly feel like
00:32:21
Speaker
There's a number of people I encountered in my life who are kind of on the borderline, right? COVID has created a lot of stress, a lot of anxiety, but for a lot of people, it's at the point where do I try and create a formal clinical relationship, or do I just seek support and resources? So what advice would you give to people who perhaps don't know whether, is it an either-or thing in your mind, or can they do both?
00:32:47
Speaker
What's the best way to kind of look for resources or look for actual clinical treatment? Well, ideally, you would have a mental health clinician help you decide.
00:33:02
Speaker
So you're getting the best advice and you're getting the best clinical recommendations to help figure out, is this something that could really benefit from more formal treatment or not? Now that, again, is really hard to access right now. And actually for many people have always been hard to access.
Challenges in Mental Health Care Access
00:33:28
Speaker
And so I think
00:33:31
Speaker
getting a lot of your own education, doing the research, trying programs like Joy in Health and others to see how much benefit you personally can get from these practices. And does it target your symptoms? Does it help you feel more empowered and resilient to keep building on these practices?
00:33:56
Speaker
Or, you know, there are some people that they do all of this, and it's not enough, and that becomes clear, like I'm doing all the things I hear this a lot I'm doing all the things. I'm working on my sleep, I'm exercising, I try to meditate, I'm reaching out to friends.
00:34:14
Speaker
I'm trying to eat healthier. I'm doing all the things and I still feel awful. Okay. Well, that's a lot of information and that would be a real signal that there may be something that, um, that's out there in the form of treatment that will be much more effective for you. You know, and then there's other people who are like, you know,
00:34:35
Speaker
I'm starting to feel calmer. You know, I do this practice most days, you know, I'm starting yoga online. I'm starting to really go to sleep earlier. I'm changing the content of, you know, the media content that I'm consuming. I'm, you know, shutting down my phone and reading a book instead of getting all worked up on Instagram or Twitter.
00:34:59
Speaker
And I realized that I'm starting to feel a little better. Well, great, that's a really great place to begin. And for some people that may be enough. But what we're hoping to do with joy and health is not just sort of say, these are the things that you should be doing or that you could be doing, but to actually provide the education to explain why one should really invest in these practices.
00:35:27
Speaker
to really provide the education. Like this is what your body, this is how your body is wired. This is what the nervous system does. Because unless you've gone through training, unless you've taken anatomy and physiology, a lot of people don't really know how the body works. And knowledge is power. If you know how the nervous system works and you know that there are these
00:35:55
Speaker
you know, thousand-year practices that are now evidence-based that shows you if you do this, you can actually change the way your nervous system functions. That's huge, right? And it gives people a sense of like, oh,
00:36:14
Speaker
I didn't know that, maybe I should try that. If that makes sense to me, you know, like people are really smart and people, like I was saying before, people have this inner wisdom and this intuition. So if you tell people the why, if you explain the why and the importance of trying, and then they can try, they can feel it. So you're combining that kind of education with this first person experience and together those kinds of,
00:36:40
Speaker
experiences can really inspire people to try and to keep learning. I want to ask you a few more questions about just your clinical experiences as a psychiatrist. I imagine, you know, over the years you've encountered a lot of people in severe mental and emotional distress. So what is it like to work with a patient in crisis?
00:37:09
Speaker
Um, well, you're right. I have, um, and I will tell you that particularly right now, a lot of people are in crisis. Um, I'm sure you've been seeing the numbers and reading about the mental health crisis. So a lot of people are in crisis right now. Um, you know, those moments of getting someone through a crisis, um, can be really scary. Um,
00:37:39
Speaker
They can be very powerful in this line of work. It's often the power of the relationship that can get someone through.
00:37:53
Speaker
Um, you know, you, you have to use that connection that you've hopefully established, whether it be with one visit or five to 10 years of treatment, um, to really help people feel number one, not alone and two hopeful.
00:38:14
Speaker
So those moments are very scary and challenging, but they're also extremely powerful in that you recognize that through the use of your own self and all of the work and training and education that you have, that you can really be there with someone to guide them so that they can make the right decisions for themselves moving forward
00:38:44
Speaker
And sometimes you can work with someone closely enough to get them through the crisis based on your own relationship.
00:38:52
Speaker
oftentimes it's just helping them see that they need more and that they need to access resources in an emergency room or hospital or a more intensive program than at least right now in private practice that I'm able to provide. But so those moments are very scary and also very intimate and very, very powerful. Can you talk about sort of the emergence of
00:39:22
Speaker
nutritional psychiatry and the research that's connecting gut health to mental wellness. Sure. So this is an exciting time for nutrition. We now have at least a few
00:39:40
Speaker
randomized control studies looking at the role of nutrition in depression. There are people, there are providers out there who are doing a lot of this work, both research-wise and clinically. And we're finding that even in the research outside of mental health, the very intricate connection between what's happening in the gut and what's happening all over the body and mind in terms of inflammation.
00:40:10
Speaker
So what's really interesting about this is that in Ayurvedic terms, they've been practicing this for thousands of years. So it's really, really interesting to see how it's becoming more and more sort of accepted and studied and validated in Western medicine. But it makes perfect sense. We all hear the term, you are what you eat. We now have science showing that what you put into your gut affects
00:40:39
Speaker
physiology in the gut, which has multiple connections to other areas of the body, other organs of the body, which make perfect sense, right? So if you're eating food that has a certain nutritional profile, that of course is going to support the entire body, every cell in the body. And what we're finding is that
00:41:02
Speaker
you know, through the kind of the Western diet, the American diet full of processed foods, trans fats, salt, sugar, that these are pro-inflammatory foods causing inflammation throughout the body and the brain. And so
00:41:23
Speaker
it's another way of seeing that if you can change the actual content of the food, you can impact the way you feel physically and mentally. So we now are moving into an evidence base, which is kind of the gold standard in Western care to support this. And we can get down into the nitty gritty of certain
00:41:50
Speaker
you know, the nutrients that are better for the brain, certain foods that seem to be better for the brain. You know, there's a lot of research now looking at those kind of those essential nutrients and what they do in the body. I tend to start with more of just the big picture
00:42:11
Speaker
you know, moving towards more whole foods. I don't tend to prescribe very specific diets unless there's a medical condition, but just thinking more holistically about this, you know, this meal you're having.
00:42:31
Speaker
how much of it seems like real food to you? How much of it is processed? How much of it is packaged? How much of it has these really high salt and sugar and fat and content? Of course, there's really healthy fats that you can get from Whole Foods. So I tend to just practice from there. And then really through culinary coaching, which is kind of a new, really exciting field, help people figure out how do you take that information
00:43:01
Speaker
and start working in your own kitchen with very simple tools and pots and pans and utensils to start learning how to make very simple, healthy whole food meals. And the more you can help people realize that the more home cooking you do, the more control you have over what you're eating.
00:43:23
Speaker
the less processed food you're consuming, the more control you have over what you're putting in your body in the form of whole foods and less chemicals and less processed processed foods. And people start to feel better.
00:43:37
Speaker
Last question I have for you is kind of related to some of your psychotherapy training. I know you were trained as a psychodynamic therapist. Can you explain what psychodynamic therapy entails and why exploring the subconscious with the patient can be a useful exercise?
00:43:59
Speaker
Sure, sure. You know, I think it's actually similar to this idea of tuning in and starting to really get under all the muck and all the conditioning to connect with your deeper, deeper self, right? Through these other intuitive meditation, yoga practices. This kind of comes at it through the mind. And what we know, again, from a very, very early age, we are deeply conditioned
00:44:28
Speaker
to think, act, feel certain ways. And that's just what happens when we grow up as a kid and as an adolescent. And then from there, we develop basically these strategies for survival. And a lot of those strategies keep us safe and protected and resilient and successful.
00:44:59
Speaker
And a lot of those strategies, whether they're conscious or unconscious, they get in our way of living our most authentic lives. And so as we get older, some of those old patterns and behaviors and ways of keeping ourselves safe and protected get in the way of growth.
00:45:22
Speaker
and get in the way of having deep, meaningful, loving relationships and getting in the way of like a true expression.
Benefits of Psychodynamic Therapy
00:45:30
Speaker
And so this form of therapy, oftentimes we think of it as kind of insight oriented therapy, trying to use the connection that you can create with someone to really kind of go deeper and deeper and deeper and recognize where people are using kind of
00:45:49
Speaker
protective mechanisms, we call them defenses, to keep themselves safe, which actually can then sort of create these walls and or toxic behaviors that no longer serve. And if you can help people start to become aware of
00:46:14
Speaker
ways in which they are doing that because a lot of this you know a lot of the things we do as humans to survive and to get through you know we're doing it like you said subconsciously unconsciously like we're not even aware of it sometimes it takes someone to be like you do you realize you're doing that like do you realize what you're saying right now can you slow it down
00:46:34
Speaker
And can we look at that together? And can we see how this strategy that you're using right now, can you see how that shows up in your life over and over and over again? That might happen over the course of a few months or a few years, but you realize that the things that keep us strong or that we used to think helped us or did help us or helped us survive,
00:47:00
Speaker
they become more rigid and unhelpful. And so the idea is to build awareness of that and to help people come up with new ways of coping and develop more sort of mature or nuanced ways of coping. So they don't have to rely all the time on those old patterns and behavior, but first you have to help people see it. It's that awareness, it's that insight.
00:47:29
Speaker
And then the next step will be okay, how ready are you to start building in these new ways, which you know if someone needed these defenses to keep themselves safe you know if they grew up
00:47:43
Speaker
in a home that wasn't safe, it's not easy to let go or to kind of relax these defenses. And that can take a lot of time and a lot of work to let go or to relax so that you can bring in new practices and new strategies.
00:48:04
Speaker
Yeah, I think, yeah, just what you're talking about is pretty fascinating. I think it could take you a lot of interesting places in terms of exploring consciousness. And we all kind of have, you know, we can talk about our individual subconscious, but we also kind of have a collective unconscious, subconsciousness in a way, right? That sort of permeates society and builds values that we may not necessarily be cognizant of. So something I hope to explore kind of in the future as well.
00:48:33
Speaker
Mm hmm. Mm hmm. I think I think therapy or this kind of building awareness and insight is good for all of us, you know, they, you know, in psychiatry training, they say, you know, everyone should go through their own therapy.
Dr. Chanoff's Personal Self-Care Tips
00:48:47
Speaker
And many of us or most of us, I hope do, and it is extremely informative and, you know, can really help shape the course of one's life. So I'm all for it.
00:49:00
Speaker
Yeah, and I just think, yeah, the amazing thing about integrative health and some of the stuff you're doing, it's like you said, not only about sort of treating pathologies, treating conditions, but also sort of the betterment of the well and promoting health instead of just skipping to disease states and when we're thinking about healthcare. Last thing I have for you is a lightning round. So that's a series of fast-paced questions that tell us more about you. So what is your go-to self-care technique?
00:49:31
Speaker
I, uh, well, I have, I have a few, but the thing that just came to my mind is a really nice hot bath at the end of the cold, cold winter day. What is the most used app on your phone? I think in that vein, I would say, I don't know. The thing that just came to my mind is the weather app, but I'm a Florida girl living in Boston. So you get the idea. Okay. What is your pet peeve?
00:50:00
Speaker
Uh, my pet peeve. I think when people, um, people think that they, they know what they know what's right for others without really having a full understanding of things that kind of drives me crazy. What is your favorite thing to cook? I love making soup, different, all kinds of soup.
00:50:25
Speaker
Also good for those cold Boston days, right? Yeah. Lastly, what is a topic you look forward to exploring more in psychiatry? I am actively exploring and learning about psychedelics and psychiatry. Nice.
00:50:45
Speaker
Yeah. I think isn't, isn't like Michael Poland. Is he pretty, did he write a book about that psychedelic? Oh yeah. Yeah. We credit him with bringing the psychedelics to, you know, the, the, the world in a really, um, wonderfully related way. Nice. All right. Dr. Martin Shahnoff. Thanks for so much for joining the show.
Episode Conclusion
00:51:08
Speaker
All right. Thank you so much for having me.
00:51:21
Speaker
Thanks for listening to The Wound Dresser. Until next time, I'm your host, John Neery. Be well.