Why Dr. Peter Attia Changed his Mind on Fasting (and 4 other Longevity topics)

Summary

In this video, Dr. Peter Attia reflects on changes in his views regarding health and wellness over the past five years. He discusses his altered stance on regular fasting, his growing concerns about GMOs and glyphosate, the underestimated power of exercise, and the complex effects of Metformin as a disease-preventative drug. Additionally, Dr. Attia addresses the significance of emotional health and therapy in overall well-being. He emphasizes the importance of regenerative agriculture, the critical role of exercise, and a nuanced approach to nutrition and medication, illustrating his journey towards a more balanced and informed perspective on health.

Takeaways

• 💦 Dr. Peter Attia changed his view on regular fasting, finding the loss of muscle mass not worth the benefits, leading to discontinuing prolonged fasting since 2020.
• 📚 He shifted his stance on GMOs and organic food, growing more concerned about pesticide effects and the lack of long-term data on glyphosate, and is now more interested in regenerative agriculture.
• 💪 Dr. Attia now views exercise not just as beneficial but as critical for brain, nervous system, cardiovascular health, and overall lifespan, reflecting a deeper appreciation for its impact.
• 🏠 He has evolved his thoughts on agriculture, expressing more nuanced views on GMOs and organic farming, and stressing the importance of soil health for the ecosystem.
• 💰 Endorses the benefits of macadamia nuts and supports sustainable farming practices through House of Macadamia, highlighting the freshness and quality of their products.
• 🚴 Changed his exercise routines due to time constraints, focusing on a balanced approach across stability, strength, and aerobic efficiency.
• 📈 He revisited his stance on Metformin as a prophylactic drug, noting concerns about its effects on lactate levels and mitochondrial function, and awaits the results of the TAME trial for conclusive evidence.
• 😷 Emphasizes the importance of emotional health as part of the longevity equation, advocating for therapy and dialectical behavioral therapy as tools for maintenance and improvement.
• 🌮 Discusses the critical role of nutrition in health but acknowledges past overemphasis at the expense of recognizing the power of exercise.
• 💻 Shares a personal journey of adapting lifestyle practices over time, reflecting changes in professional focus, personal health beliefs, and the integration of new scientific evidence.

Q & A

What change in perspective did Dr. Peter Attia have regarding regular fasting?

Dr. Peter Attia changed his perspective on the importance of regular fasting, noting that the loss of muscle mass outweighed the benefits for him, leading him to discontinue prolonged multi-day fasts since the end of 2020.

How did Dr. Attia's view on genetically modified organisms (GMOs) and organic agriculture evolve?

Initially skeptical about the criticisms of GMOs and organic agriculture, Dr. Attia now has more concerns about GMOs due to the use of pesticides like glyphosate and is more interested in regenerative agriculture and its focus on nutrient density over yield.

Why did Dr. Attia reconsider his use of Metformin as a prophylactic drug?

Dr. Attia reconsidered Metformin due to observations of higher lactate levels and potential mitochondrial toxicity, as well as recent studies challenging the benefits of Metformin in non-diabetics, leading him to stop using it prophylactically.

What has been Dr. Attia's revised approach to exercise?

Dr. Attia now values exercise more for its comprehensive benefits on health, including its effects on the brain, nervous system, and cardiovascular health, and has become more disciplined in how he allocates his limited time for exercise.

How does Dr. Attia now perceive the role of emotional health in longevity?

Dr. Attia has come to see emotional health as a crucial component of longevity, recognizing its importance through personal experience and now incorporates practices like therapy and dialectical behavioral therapy into his routine.

What was Dr. Attia's dietary approach prior to his change in perspective on fasting?

Prior to changing his perspective, Dr. Attia engaged in regular fasting, including seven to ten day water-only fasts quarterly and three-day water-only fasts monthly, which he later deemed not worth the muscle mass loss.

What concerns led Dr. Attia to reevaluate his stance on GMOs?

Dr. Attia's concerns about GMOs shifted due to potential long-term effects of pesticides like glyphosate on health, moving him towards an interest in regenerative agriculture for its emphasis on soil health and nutrient-rich crops.

How has Dr. Attia's exercise routine changed due to time constraints?

With time constraints, Dr. Attia now spreads his limited exercise time across stability, strength, low-end aerobic efficiency, and high-end peak aerobic output, aiming for a balanced approach within 10 to 12 hours a week.

What led Dr. Attia to question the long-term use of Metformin for non-diabetics?

Dr. Attia questioned long-term Metformin use for non-diabetics due to its mild mitochondrial toxicity, higher lactate levels in his observations, and recent studies challenging its benefits, leading him to halt its prophylactic use.

In what ways has Dr. Attia incorporated emotional health into his well-being practices?

Dr. Attia incorporates emotional health through regular therapy sessions, practicing dialectical behavioral therapy, and applying its principles in daily life, recognizing its importance for overall health and longevity.

Outlines

00:00

🔄 Changing Views on Nutrition and Fasting

Dr. Peter Attia discusses significant shifts in his perspectives on nutrition and health practices over the past five years, emphasizing his changed stance on regular fasting. Initially, Attia engaged in extensive fasting, including 7 to 10-day water-only fasts quarterly and 3-day fasts monthly, believing in their health benefits despite the loss of muscle mass. Over time, recognizing the detriment of substantial muscle loss, he reassessed the value of such extreme fasting, concluding the trade-offs were not worth it. Additionally, he touches on his sponsorship with House of Macadamia, highlighting the benefits of macadamia nuts and related products for health-conscious individuals.

05:02

🌱 Shifting Perspectives on Agriculture and Exercise

Attia reflects on his evolving views regarding GMOs, organic agriculture, and the importance of regenerative farming practices for long-term soil health and nutrient-dense food production. He critiques the narrow focus on yield over quality in conventional farming and expresses concern over the long-term effects of synthetic fertilizers on soil biomes. In another shift, Attia reevaluates the role of exercise in overall health, recognizing its profound benefits beyond physical fitness, including its impact on brain health, the nervous system, and longevity. He advocates for a balanced approach to exercise, considering his time constraints and the need to address different physical capacities.

10:02

⏳ Time Management in Exercise and Learning from Past Training

Attia talks about how his current time limitations shape his exercise regimen, limiting him to 10 to 12 hours per week, which he considers low compared to his past routines. He emphasizes the importance of a disciplined approach to exercise, incorporating stability, strength, aerobic efficiency, and peak output within his constrained schedule. Reflecting on his past, particularly during his intensive swimming and cycling phases, he wishes he had incorporated more balance in his training to prevent imbalances and preserve muscle health.

15:03

💊 Reevaluating the Use of Metformin and the Importance of Emotional Health

Attia discusses his skepticism towards the use of Metformin as a prophylactic drug, noting a shift from his previous endorsement based on its potential cancer-fighting benefits. Observing its effects on his lactate levels and considering recent studies, he questions its efficacy and safety. Moreover, Attia underscores a significant realization about the critical role of emotional health in overall well-being, a factor he previously overlooked. Through therapy and dialectical behavioral therapy, he highlights the importance of emotional wellness in longevity and quality of life, advocating for greater awareness and de-stigmatization of mental health care.

20:04

📚 Conclusion and Acknowledgements

In closing, Attia thanks the host, Tom, for the discussion and emphasizes the value of the insights shared during the interview. He mentions linking to additional resources, including his book and relevant podcast episodes, to provide viewers with further information on the topics covered. This segment serves as a wrap-up, reinforcing the importance of continuous learning and openness to changing perspectives on health and wellness.

Keywords

💡Fasting

In the context of the video, fasting refers to the practice of abstaining from food for extended periods, such as 3 or 7-10 days, which the speaker used to do regularly. While he believed there were benefits, he now feels that the muscle mass loss outweighed the potential advantages, leading him to discontinue prolonged fasting since 2020.

💡GMO

GMO stands for Genetically Modified Organism. The speaker initially had no concerns about GMOs, believing the opposition was based on misunderstanding. However, his perspective has shifted, and he now has more nuanced concerns, not about the genetic modification itself but about the potential long-term effects of pesticides and herbicides like glyphosate used in GMO crop production.

💡Regenerative agriculture

Regenerative agriculture is an approach to farming that focuses on optimizing nutrient density rather than yield. It involves practices like using cover crops, avoiding monocultures, and eschewing nitrogen spiking (artificially increasing soil nitrogen levels). The speaker has become interested in this method, believing it produces healthier, more sustainable crops compared to conventional practices.

💡Exercise

Exercise, which the speaker has always enjoyed, has taken on greater significance in his understanding over the past five years. He now recognizes its powerful effects on the brain, nervous system, cardiovascular system, and overall longevity and quality of life. Despite time constraints, he strives to incorporate various forms of exercise, including strength training, aerobic activities, and stability work.

💡Metformin

Metformin is a drug commonly used to treat type 2 diabetes and insulin resistance. Initially, the speaker took metformin prophylactically based on studies suggesting it might have cancer-preventive effects. However, recent research has cast doubt on this, and he has stopped taking it due to concerns about its potential side effects, such as impairing oxidative phosphorylation and increasing lactate levels.

💡Emotional health

The speaker acknowledges that he previously overlooked the importance of emotional health in the longevity equation, focusing primarily on physical factors like cardiovascular disease, cancer, and neurodegenerative diseases. However, he has come to realize the profound impact of emotional well-being on overall quality of life and now incorporates practices like therapy and dialectical behavioral therapy to maintain his emotional health.

💡Dialectical behavioral therapy (DBT)

Dialectical behavioral therapy (DBT) is a form of therapy that the speaker practices regularly. It involves learning and practicing techniques to improve emotional regulation and overall well-being. Rather than just attending therapy sessions, DBT emphasizes incorporating the learned practices into daily life, noting successes and failures, and continuously working on improvement.

💡Nutrient density

Nutrient density refers to the concentration of nutrients in food relative to its caloric content. The speaker has become interested in regenerative agriculture, which focuses on optimizing nutrient density rather than maximizing crop yields through conventional methods like nitrogen spiking and monocultures. This approach aims to produce more nutritious food.

💡Chronic effects

In the context of discussing his concerns about GMOs and herbicides like glyphosate, the speaker mentions his primary worry is about the chronic, or long-term, effects of these substances. While acute toxicity may be low, he believes there is insufficient data on the potential long-term consequences of exposure, prompting a more precautionary approach.

💡Precautionary principle

The precautionary principle is a concept that suggests taking preventive action in the face of potential risks, even if the full extent of those risks is not yet scientifically established. The speaker invokes this principle in his decision to avoid GMOs and herbicides due to the lack of long-term data on their chronic effects on human health and the environment.

Highlights

Dr. Peter Attia discusses changing his stance on the importance of regular fasting, highlighting the trade-offs between benefits and muscle mass loss.

Attia now questions the value of prolonged multi-day fasting, having stopped such practices since the end of 2020.

He shares a shift in perspective on GMOs and organic agriculture, moving towards a concern over long-term effects of pesticides and the importance of regenerative agriculture.

Attia emphasizes the significance of soil health in producing nutritious food and supports regenerative farming practices.

A newfound appreciation for exercise's impact on brain health, nervous system, cardiovascular health, and overall longevity is discussed.

Attia reflects on how his limited time has influenced a more disciplined approach to exercise, focusing on stability, strength, and aerobic efficiency.

He expresses skepticism towards the use of Metformin as a protective agent against diseases, citing concerns over its mechanism and recent studies.

Attia notes the importance of emotional health as a critical component of overall well-being and longevity.

The discussion covers Attia's journey through therapy and the adoption of dialectical behavioral therapy as part of his routine.

Attia addresses the stigma surrounding therapy, advocating for its importance in maintaining mental and emotional health.

He acknowledges the need for a balance in nutrition, avoiding extremes in dietary practices.

The conversation includes insights into the potential downsides of excessive fasting, such as muscle mass reduction and nutrient deficiencies.

Attia's evolving views on agriculture emphasize a nuanced understanding of GMOs and the ecosystem's health.

He reevaluates his exercise routine, incorporating varied forms of physical activity to address time constraints and health goals.

The interview concludes with a discussion on the role of scientific analysis and clinical trials in validating the use of drugs like Metformin for non-diabetic purposes.

Transcripts

Dr Peter attiev we all change our mind

on things uh I want to go into some

detail with some things you've changed

your mind over the last five years Let's

Just Jump Right In

um

let's start with a couple in

um nutrition so I think the the the

first one that I would say I've changed

my mind on is the importance of regular

fasting so I used to really do a lot of

regular fasting

um probably considered excessive by by

some

um so probably did a seven day seven to

ten day water only fast once a quarter

in a three day water only fast once a

month and

um I think while there were clearly some

benefits of doing that

um

I think you know it's very difficult to

measure what's happening cellularly but

my belief at least was that the benefits

of that outweighed the downside the

downside of doing that by the way is

you're going to lose a lot of muscle

mass

um

you know as much as you might exercise

during those periods of fasting which I

tried to uh you know you're just not

going to be able to maintain lean mass

so you you basically I was always sort

of accumulating a little bit of a debt

of lost muscle mass and over a period of

about three years I probably lost about

10 pounds of lean mass

um and so today I just don't feel that

that trade-off is worthwhile at least at

that extreme level uh that I was doing

and so I don't I haven't done a

prolonged multi-day fast since the end

of 2020 actually I popped the link down

below for House of macadamia if you want

to try them out too they are where I get

my macadamia nuts these days they're all

grown in South Africa when you buy from

them you're directly supporting the

farmers as well so the farmers really do

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goes back to working through the farmers

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everything is harvested and packaged

less than an hour from each other they

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everything's Super Fresh not going

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they have macadamia nut oil macadamia

nut bars straight up macadamia nuts with

all kinds of different flavors so really

easy to add to your diet I just I

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you're going to spend a fortune at the

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can save a few bucks I'm getting some

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that link a free 20 ounce bottle of cold

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only cold pressed macadamia nut oil that

I know of that's on the market and

you're getting one completely free if

you just use that link down below

there's no catches it's just to get the

word out there where do you stand

nowadays on the occasional 24 hour or

the occasional 20 hour yeah I think

that's totally fine yeah yeah okay what

else

another one in nutrition is

um I've really had a change of heart

around

agriculture right so I used to sort of

subscribe

to the view that there was nothing wrong

with GMO like just from a scientific

basis I always felt it was misunderstood

right like GMO is really just a crop

trait strategy right so GMO is modifying

organisms to make them resistant to

pesticides and you know I thought that

people's opposition to that was a little

conspiracy theory-ish and you know

there's nothing wrong with a plant that

was genetically modified

um I also felt that sort of the entire

organic industry was kind of a scam sort

of masquerading as you know kind of a

you know a tribe of you know like

a food tribe basically just another sort

of dietary phony altruism yeah yeah yeah

I have a much more nuanced of that today

and I would say that

I do have actually more concern of GMO

today again not because of the actual

Gene modification of the plant but

because of the herbicide because of the

pesticide I don't think we have

sufficient long-term data on the effects

of glyphosate and I think that we have

been probably overly concerned with

acute toxicity which is I would be

fairly comfortable to say the acute

toxicity of glyphosate and herbicides

and fertilizers is very low if not

non-existent but I don't think we have

sufficient data on The Chronic side and

therefore I think that the

um the precautionary principle would

actually suggest we're doing this

incorrectly and so on a personal level

today I am far more interested in what

I'm learning about regenerative

agriculture and the principles of

optimizing around nutrient density as

opposed to yield

um furthermore the more I learn about

this and I would still consider myself

quite early in that Journey having only

read you know three books on the subject

matter so far but it's been very

influential and it's really shifted my

thinking about this to the point where

I'm now basically asking the question

yes I think organic is still a bit of a

bad term because it doesn't mean

anything

um and organic food can still be

horribly grown but there's something in

this about the importance of how we grow

food and to the best of my understanding

right now I think if I could wave a

magic wand I would never eat anything

that was not produced regeneratively

meaning crops that are grown not as mono

crops not without cover crops without

using any nitrogen spiking but rather

done through this longer life cycle of

regenerative production what does

nitrogen spiking actually do I'm curious

well what it's basically doing is

altering the soil

environment so just as we are pretty

familiar with how we have our gut biome

the soil is the biome of the plant and

when we nitrogen Infuse that which was

really a process that was started uh

kind of roughly around World War II uh

which is really when we saw crop yields

explode right we you know we had

historically been producing about 20

bushels per acre per year of corn uh

globally let's just say in the United

States even

for you know most of the modern history

and and then post World War II that

number has just gone up and almost

increased in some places tenfold so you

know in the United States today you're

probably seeing 140 to 200 bushels per

acre per year of corn production

um and that came through a lot of things

that

um you know involved just pumping more

and more nitrogen in because of course

plants have to fix nitrogen externally

and carbon from the air

but what that's done is completely

changed the health of the soil and so

at the risk of being a bit sort of cute

about it

you if you don't have healthy soil you

won't have healthy plants if you don't

have healthy plants you won't have

healthy animals if you don't have

healthy animals you don't have healthy

humans I think we're kind of in a little

bit of that life cycle

um and while I don't think that

this is something that you know can't be

managed

um I definitely have worry about

long-term soil health and as a result of

that I I I've become much more

interested in something that I had been

quite dismissive of in the past yeah

well it's it's a good way to look at it

as far as GMO inherently isn't the

problem it's the fact that that's sort

of a canary in the coal mine for okay

well what are we protecting this plant

from does that indicate that there's

more crap on this plant yeah you know

and that's a really interesting way to

look at it all right what's next

say overall on just exercise in general

I think despite the fact that I've been

a lifelong exerciser I love exercise

it's always been kind of enjoyable to me

it's never been something that's

required like discipline I've got to

make sure I got an exercise I don't

think I fully appreciated how powerful

exercise was as

um as a drug frankly for lack of a

better word uh until really the last

five years I think I had you know sort

of

thought it was beneficial in a sort of

holistic way but I don't think I

understood what its effects were

specifically on the brain what its

effects were specifically on the nervous

system what its effects were on the

cardiovascular system at a really deep

level and and and overall what its

effects are in terms of lifespan and

health Span in other words how much it

reduces all-cause mortality and how

important it is at preserving quality of

life which again it seems pretty obvious

but I think I had been overly fixated on

nutrition and that that just came at the

expense of me thinking really long and

hard about exercise and how we need to

be more thoughtful in our application of

that tool has that changed

how you personally exercise and

I'll couple that with I know you have a

different

life circumstances now you're focusing

on different things and that's changed

how you look at exercise but has your

view of exercise

itself changed how you exercise it

certainly has because if

because this is the first time in my

life where I'm truly time Limited

so up until I was you know in my early

40s

I don't know even though I was always

busy I I've somehow always had seemingly

as much time as I wanted to exercise

and therefore I could always kind of

just pursue my Bliss in that whatever

way I was doing

now I'm truly limited by time I really I

mean if I had more time I if I had more

time to exercise I would today but I

can't I'm really stuck at

you know what still sounds like a lot

for people but for me is historically

low you know 10 to 12 hours a week is

the most I can really make time for with

the other commitments I have that are

more that I deem you know for any

marginal time I would deem those other

commitments more important so yes in

that sense my view is much more

disciplined about how that time is spent

you know if it were

10 years ago I might use that time today

to just focus on one thing whereas now I

have to spread that time out across

stability strength uh low end aerobic

efficiency high-end Peak aerobic output

I have to spread it across those four

pillars so if you could go back to say

prime time maybe early 30s uh or you

know whenever you were putting a lot of

time into your endurance work if there

was something that you could do

differently than what would it be

well I would still allow myself to kind

of pursue my Bliss right so in my early

30s or yeah in my early 30s I guess

mid-30s it was swimming ultra distance

swimming I think I would have just been

a little more thoughtful about what I

was doing in dry land so instead of

spending you know 25 to 30 hours a week

swimming I should have been in the

weight room at least you know three

hours a week on top of that uh same

thing when I was at you know when I was

just cycling non-stop I think I could

have been more thoughtful about other

types of activities uh to balance out

some of the obvious imbalances that come

with being crunched over on a bike all

day yeah I think I can speak for myself

with uh yeah I mean resistance training

I probably went too full bore into that

for a while where you know I had to

unravel walking like a robot for quite a

while you know and so okay what's uh

what's next on the list here uh probably

my

skepticism for the use of Metformin as a

zero protective molecule so metformin is

a drug that has been widely used for the

early intervention of patients with type

2 diabetes and even patients with you

know severe insulin resistance who are

not yet type 2 diabetics uh and in that

regard it's been a productive drug uh so

it it seems to work by reducing

hepatic glucose output and so in other

words it works by putting less glucose

into the system

uh but of course it became a drug of

interest about a decade ago because of

some epidemiology that suggested that

people who took metformin uh with type 2

diabetes had better odds at surviving

cancer than people who didn't have

diabetes and didn't take metformin and

that was an enormous suggestion because

we understand very clearly that people

with type 2 diabetes are at a much

greater increase for cancer so how is it

that people with this disease who have a

much higher incidence of cancer if they

take this drug seem to not get cancer at

the same rate as non-diabetics who don't

take the drug

and there's clearly some interesting

mechanisms of action for why that might

be the case it could be that

um you know activation of ampk

itself is protective it could be that

just lower in glucose and lowering a

growth factor like insulin and igf is

protective there are lots of

explanations for this

and as a result of that

gosh I mean I was taking metformin

prophylactically I.E is zero protective

agent starting in about 2011 is when I

began taking it and

by about 2018 2019 so about five years

ago

you know I noticed a couple of things

that I didn't like one was as I track my

lactate levels I noticed my lactate

levels were always higher than I thought

they should have been this was most

notable even at rest and also doing kind

of zone two activity

um

that might not be surprising when you

understand how metformin Works which is

it's at least in part a weak

mitochondrial toxin so if you're

poisoning the mitochondria just slightly

which is what you're doing to get that

ampk activation you're also impairing

somewhat oxidative phosphorylation and

that's why you're going to see a higher

lactate

that struck me as not a great idea uh at

least in a person who's capable of

exercising greatly as I am and many of

my patients are

furthermore there was a a study that

came out quite recently that only had me

kind of double down on that thinking

which was it was a repeat of the

epidemiologic analysis that suggested

that metformin was beneficial relative

to non-use in non-diabetics but just

done on a different cohort of patients

and frankly done a little with a little

bit more statistical rigor and it came

to the opposite conclusion it came to

the conclusion you would expect which is

that patients with diabetes who take

Metformin still actually fare worse than

the other than non-diabetics not taking

metformin when adjusted for all of their

variables and uh you know for reasons

that I cover in a newsletter that I

wrote which you know we can maybe link

to I find the latter study more

compelling not simply because it agrees

with my newfound thinking but because I

simply think it's a more reasonable uh

scientific analysis ultimately we will

find this out one way or the other

because there is a clinical trial that

is going on that's asking this question

and so my hope is that in five years

we'll just have the answer and we won't

have to rely on this

indirect Insight or indirect information

that's always going to be prone to

biases and therefore is ultimately not

dispositive in helping us understand

this and if we're sitting here in five

years in the tame trial which is the

name of the trial found that metformin

is indeed zero protective I'll be the

first one to be taking it again so a

question that I've always had that might

sound like a total Noob question but if

if metformin is a mild mitochondrial

stressor and activates ampk

is it potentially going to inhibit

hypertrophy like I mean are you are you

potentially limiting the rate of muscle

preservation or potentially growth

it's possible I don't know yeah yeah

it's an interesting interesting thought

that it's always crossed my mind but

well all right so we've got one more put

you on the spot

uh potentially the the most important

just in terms of quality of life has

been you know something I write about a

lot in the book or not a lot but it's

something I write about at the end of

the book which is the importance of

emotional health

um and I think that

I just had never really considered that

an important part of the equation of

this you know longevity equation right

um it didn't fit neatly into a box of

you know delaying death from

cardiovascular disease cancer

neurodegenerative disease it was a

little amorphous and I I think you know

I just had my own blind spot to it which

was ironic given that it was a part of

my life that wasn't especially healthy

so I think now having been through all

I've been through and you know sort of

reflecting on what I've learned I

realize not that not only for me was

this a very important thing but I

suspect it is for many people as well

um if they will you know take the

opportunity to to kind of probe that

yeah it's I mean it's a it's a huge

umbrella that people definitely miss and

it's just It ultimately is the

umbrella literally of just how I guess

not literally figuratively but how we

look at life and how it changes how we

look at exercise and how we perform and

how we eat and how we and not to mention

the actual physical effect that we have

of being in a good mood and what are

some things that you're doing today to

improve that

well luckily I'm kind of more in a

maintenance mode now I mean I think I

had to go through sort of the heavy the

heavy lifting

um you know

six seven you know or you know

three four five six years ago

um so so what I do today I think is is

much easier than what I did in the past

but I still work with a therapist once a

week

um and I still practice uh something

called dialectical behavioral therapy so

that's one form of therapy that I do and

um and that is just what it is right

it's like a practice so it's sort of

like saying like we'll you know

you know is it enough to know that a

workout is important no you actually

have to do the workout so similarly it's

not just enough I think to kind of show

up for an hour a week to do the therapy

you have to be able to kind of take what

you learn in that therapy and then put

it into daily practice and if you

succeed you note it if you fail you note

it but you're just constantly trying to

to sort of get better and DBT or

dialectical behavioral therapy is a

system that I really like and it really

works for me and it works for many

people

um I've done a podcast on it actually

which maybe we could link to I think

it's a it's something I think a lot more

people should know about yeah I mean my

life changed for the better when therapy

became a regular part of my life and I

think there's a stigma that's attached

to it and that needs to get broken down

significantly because people don't go to

therapy until there's a cause for it or

a reason for it and especially this day

and age not to you know go off on a

tangent but it's very it's difficult to

have that connection and sometimes

therapy is the only place you actually

get that connection especially if you're

not married you don't have a spouse you

don't not going home to someone you know

and you're just on your device all day

so I think that's really really good

advice and it's something that I would

Echo I think over the last five six

years I would have I don't think I would

have casted judgment upon someone that

was going to therapy but I certainly

wouldn't have looked at it with the same

lens that I look at it now so I think

that's a great one yeah well we'll link

out to those episodes down below we'll

also link out to your book so as always

keep it locked in here and Dr Tia thank

you very much yeah thanks Tom