Transcript for Lewis Mehl-Madrona M.D. Ph.D

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what’s up folks this is our episode with

dr. Lewis Mel madrone he is a

neuroscientist and they are doing a lot

of really groundbreaking work on how the

idea of creating stories affects how you

deal and cope and heal with trauma so I

think you guys will enjoy this episode

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the human experience is remapping the

neural networks in your brain as we

speak to my desk

Lois Mel madrone Lois welcome to hxp

thank you thank you for having me so

Lois if we could just start this

conversation by kind of getting into

your background your education how you

got into this work I think that would

help lay the foundation sure I attended

medical school at Stanford and got a PhD

in neuropsychology did residences and

family medicine geriatrics and

psychiatry and then got a master’s

degree in narrative studies and on the

one hand on the other hand I grew up in

a indigenous context so I grew up

surrounded by stories and it was amazing

when the two threads converged when I

discovered that there was a neuroscience

of story and that academics and scholars

were talking about story in the same way

that elders and Indians talk about story

so that was pretty exciting and and that

really led to this book remapping your

mind yeah if I could just read a passage

from the book here we are born into a

world of stories that quickly shapes our

behavior and development without our

conscious awareness by retelling our

personal family and cultural narratives

we can form the patterns of our own


as well as the patterns that shape our

communities and the larger social worlds

in which we interact

I mean why why is this so important in

in the way we interact and I mean how

does it affect our learning so much what

have you discovered

so our culture turns everything into

nouns we give people labels we say okay

you’re a bipolar you’re a PTSD you’re an

anxiety disorder you’re schizophrenic

and going back to Story returns

everything to verbs so that you’re

embodying the experience of being

anxious or you’re embodying the

experience being fearful and it’s much

easier to envision change when you’re

dealing with a verb than it is when

you’re dealing with a noun so so by

turning things back into stories which

they were in the first place then we can

imagine change much more readily we

don’t feel stuck we feel like we have

some capacity for action some sense of

agency that we can do something to alter

our lives and the world that we live in

that we can have an impact on the world

what is what is the identity of

narrative that you speak about in your

book that’s the story that we tell

ourselves and other people about who we

are so if I ask you hey who are you

anyway then the story you tell me is

your identity narrative and of course it

varies depending on the context in the


you’ll tell a different story if you’re

applying for a job then if you’re on a

first date so we have a repertoire we

have a stockpile of vignettes that we

pull out to create an identity narrative

and they differ so so we try to match

who we are to the context so that we’re


the audience wants us to D where who the

other person expects us to be you know

and the more skill you have in doing

that the more your social relationships

tend to go well tend to go smoothly so

but from this perspective there is not a

fixed self there’s there are multiple

self that can be created in any given

moment for any given situation based on

all the vignettes of our lives so then

would you say that each person has a

different story that we tell ourselves

based on the context of any given

situation so the way that I see myself

in a personal way is different than the

way that I would construct myself in the

external world right right right

when you’re when you’re sitting at home

with your partner you’re a different you

have a different sense of yourself than

when you’re on the radio or at a bank or

at a professional conference that we we

pull out stories to support the identity

that we’re expected to be the role that

were expected to perform and and and we

tie them together to create an identity

in that context so we have an identity

as parent we have an identity as child

as co-worker and so you know there’s the

federal differences sometimes large

differences and in these identities and

and mostly we navigate through them in

seamless fashion when we don’t then we

have self world’s friction self world

interface friction sparks fly and things

don’t go so well and sometimes people

get labeled they get diagnosed and get

told that they need treatment

we use this narrative to address healing

and to address illness so in its most

simplistic form I’ll give you an example

from my mother my mother has a story

that says ladies don’t sweat now my

mother was born into poverty coal mining

country of southeastern Kentucky and it

was her dream to become a lady and

thanks to Berea College which gives free

education to Appalachian youth she got

to do that so once he was graduated from

college it was her steadfast desire to

never sweat again she could go but she

would not sweat so fast-forward sixty

years later my mother has to have her

aortic valve her place and she sent home

with a piece of paper that says come to

cardio pulmonary rehab we will make you

sweat so what does my mother do the

first thing when she gets home is to

hide that piece of paper and the bottom

of her cabinet no one’s going to see

that no one is going to make her sweat

so I happen to find it and I showed it

to her and and it led to an intense case

of the vapors I don’t know if you’ve

ever seen the vapors but it’s a southern

illness in which the person puts their

arm to their forehead and says oh my I

feel things I must go to bed so so

consequently my mother didn’t have as

good an outcome from her aortic valve

surgery as she could have because she

would never go to rehab and and

simplistically again people have stories

about food and some of those stories

don’t work really well if you’re a

diabetic I’ve met people they there will

not change how they eat because it’s

more important to them to eat with their

family and to eat what their family’s

eating then to die of diabetes so our

stories are powerful in our health and I

think we you know Barbara and I and my

co-author in the book we we take it

further and we play with this story that

the illness would tell about the person

is living within because we think that

it generates metaphors that help us to

understand the illness so so let’s say

that you have hip pain so here’s

somebody I worked with recently and so

we got hip pain to talk and hip pain

turned out to be a grumpy woodchuck

grumpy old woodchuck and the squirrel vo

which accent you’re just always driving

me you’re just always making me work

they’re just always pushing me to the

limit you never take care of me you

never get any pampering for me I want

some pampering give me some pampering

you know stop trying to force me to get

better so so the question you know to

the client was well so that make any

sense and he said well yeah you know I I

really haven’t been going for any kind

of treatment I’ve just been trying to

ignore my pain and just push through it

and visualize getting better and and and

so I said well what about you know

making an appointment with an osteopath

he said well I guess I could try that so

so once he started getting work done he

started getting better but he but so his

his pain had a story about him that was

quite accurate and annoying to his pay

and he had a story about his pain that

was quite accurate for him and annoying

to his pain which was you know by God if

you’ve got a pain you just pushed

through it and tell it to get better and

pretend that that it’s not there so it

took negotiating that story with both

the pain and him for him to go get help

and for the pain to start improving so

if I’m understanding this correctly so

that the narrative that I tell myself

through a story can determine whether I

am healing or not healing yes because it

reflects the stories that you live by

so we tell ourselves stories about how

to live what are the virtues that we

should follow what is a good life looked

like anyway and what am I willing to

sacrifice for a good life

so I have a I have a nephew who’s

visiting right now and he’s in college

and he’s not exercising and it’s not

very good for him

and he knows if he exercises he’ll stop

feeling depressed and he’ll get his work

will improve and everything will go

better but his notion of exercising is

that he should run ten kilometers in the

freezing cold outside in Montreal where

he goes to college so well that doesn’t

sound like fun so but that’s his story

about what exercises so my wife has been

saying to him well why don’t you go to

the gym and like in the warmth in the

nice warm gym why don’t you walk on a

treadmill and watch TV while you’re

doing it

or read one of your books for school

that could be exercise you see and and

so he because he has an extreme story

that only running outside in the middle

of winter in in cold Montreal qualifies

as exercise he’s not doing any so so he

needs he needs a kinder gentler story

about exercise than the one he has and

you know it in in in psychiatric

conditions which I work with to a to

some degree we have stories about how to

get what we want from the world and you

could you could think of them as

strategies for how to move around in the

world if your strategy is to throw a

tantrum that might always work in might

backfire if your strategy is to never

say directly what you want but to make

hints you might never get what you want

it might be really frustrating so though

so this this seems like something that

is pretty cutting edge I mean has

cognitive neuroscience kind of picked up

on what you guys are doing or our people

still oh yeah understanding this know

there’s a whole there’s a journal even

causing the neuroscience of fiction and

it’s published out of the University of

Toronto and neuroscientists are really

excited by this whole idea of narrative

it turns out that there’s a circuitry in

the brain that does nothing but produce

stories it’s the story brain and you

know it it runs along the midline from

front to back and it’s what we do on

idle it’s also called default mode

Network so when our brain is on idle we

sit around making up stories about other

people and what they want what we want

from them and how to get what we want

from them

and how to talk to them to get what we

want from them and I know that anyone

listening was ever commuted can relate

to this so if you’re if you’re going

home on a train or if you’re driving

home in a car or walking home riding the

subway you’re thinking about who’s at

home and what the condition was of the

relationship when you left home and

you’re fantasizing what you should say

when you go home maybe you’re trying to

decide whether to pick up flowers

Chinese takeout chocolate or to stop off

at the pub for a pint before you brace

the slings and arrows at home right so

but we’re all doing that that’s what our

brain does on idle it turns out that the

turn off story brain and to turn on say

meditation brain burns more glucose

involves spending more energy than just

sitting around making up stories

I mean um the the event indexing model

and that you mentioned this in your book

I mean it from what I understand that it

it kind of indexes all incoming actions

into five indexes can you get into that

a little bit yeah and and people are

thinking that there’s probably more or

less than five you know it is probably

unique to each person but you know when

when things come in we need to quickly

sort them we need and we need to compare

them with experiences we’ve had before

and how those experiences have turned

out and so I mean the the obvious

example is if if you’re standing on a

hilltop and you see someone on the next

hilltop you need to quickly figure out

if if their friend or foe are they Fermi

or again me because if they’re against

you you might want to run and if their

friend you might want to walk over and

shake their hand and so so you know

that’s a really basic category friend or


and we can sort events into and we we

can sort events into probably Pleasant

probably unpleasant probably neutral we

can we can sort of isn’t of interest to

me of no interest to me

you know so we we do this kind of

glossing really quickly because we have

to make quick decisions and we have this

this sort of storehouse of well I would

call them stories I mean some people

call them you know memories but their

memories that are stored memories that

exist as stories and and we know how

things turned out so if it looks like a

particular event that’s already happened

if it’s starting to look like that event

then we jump to conclusions and say well

that’s how it’s going to turn out so I

better run away know sometimes we’re

wrong and we miss out on great

opportunities and there’s you know

there’s stories about that it’s a

classic movie plot right is is romance


boy likes girl girl jumps to conclusions

that boys no good boy fights to convince

girls that he’s really good girl changes

might and marries boy

I you know I just saw that the other

night in Bollywood it was a great

Bollywood movie called Bride & Prejudice

which was a Hindu remake of Pride and

Prejudice you know it was it was just


you know the whole village is dancing

and singing you know it’s like musical

comedy at its best but that was the plot

and you know it’s um it’s leads into my

next question how does I mean how does

as a casual observer how I mean how do

we when we look at narrative based

entertainment in our culture I mean it’s

obviously based on store

so I mean how how would you say that are

you know media and culture are either

helping or detracting from this sense of

identification within ourselves well I

think that we’re surrounded with stories

good and bad we’re surrounded by stories

that are uplifting and positive and

we’re surrounded by stories of war and

and and you know there’s the whole

rhetoric of hate that we’re hearing now

on the campaign trail and so I think

that the media has every option for us

and we have to decide what stories will

pay attention to that that you know that

it’s up to us to tell good stories and I

I do a group for people with chronic

disease and this morning a couple people

in the group one woman was telling about

how she got from living in a van with

her ten month old baby to being employed

having a home having three children and

having it and going to school which is

an amazing shift she accomplished that

over the course of five years and I was

a really uplifting story it was a really

inspiring story about the discovery of

self agency and about meeting people who

believed in her and listening to them

and taking their help and running with

it and and we know you know so many

stories that that if one is in medicine

one gets to hear so many stories that

aren’t that inspiring in the emergency

department for example and and then the

person immediately who came after her

was a young man who told

an amazing story about sitting around

with nothing to do drunk on there was a

reservation and somebody sent him a

plane ticket to come here to Maine and

and he did and he got here in a

snowstorm it came from a warm climate he

got here in a snowstorm with shorts

sandals and a t-shirt and since then he

started he taught himself how to design

websites he’s making YouTube videos he’s

being really successful as a dancer he’s

he’s gotten married he has two children

he’s turned his life around and that’s

really inspiring yeah it is it is really

intriguing Turner sorry to interrupt you

there yeah I just I mean if we could

just get into the science of it I mean

what is happening in the brain what

parts of the brain are being activated

as we access these stories in our minds

well you know we’re when we visualize

the story we’re using of course visual

cortex and visual association or cortex

and we’re we’re using the posterior

cingulate and the pre cuneus put

together you know kinesthetic memories

with the story and and feelings in

essence we’re using our motor cortex to

imagine moving as we would move in in

this story we’re using our temporal

opposed to to give other people beliefs

and intentions desires and you know

we’re monitoring the the are our gut you

know our brain is sending the whole

package to our God which is monitoring

the whole story and giving us feedback

through his reactions to this story so

when we say that something is got

wrenching we really mean it

or that something makes us sick to our

stomachs we really mean it so and and so

positive stories are sending back happy

hormones you know to simplify you know

in tasty endorphins and and

endocannabinoids and and traumatic

stories are sending back you know

catecholamines activating the

sympathetic nervous system

fight-or-flight nervous system they’re

you know producing corticosteroids the

the stress response hormones they’re

giving us extra insulin so we can run so

it’s quite a different experience you

know so I mean it seems like a lot of

this is incredibly dynamic in the sense

that we can go back into our minds and

change the way that our memory exists

about an event or an experience to

reframe it into a sort of positive

context and thereby institute a sort of

healing mechanism absolutely and and we

do that quite naturally and I have an

example of a friend who did that she’s a

comedian and a storyteller and to her

chagrin and embarrassment she got taken

in by one of those Nigerian scams and

since money to the wire that they give

you you know my send yes

mortified when she found out what she’d

done just felt like she was the

stupidest person on the planet and so

she kept telling the story and and

making it funnier and funnier and

funnier until she finally performed it

as a storyteller at a storytelling event

and the audience was in stitches the

audience couldn’t stop laughing every

other line

was a punch line and and everyone was

laughing with her and it was such a

beautiful example I mean a simple

example a lot you know but but similar

to what people do for for more severe

trauma maybe they don’t make

quite as funny but but you know she had

metabolized her shame and her

embarrassment into humor and it was just

incredible to see her a week later

performing this story that was so

incredibly funny about you know the

money that she gave away to the


and so you know people who have been

terribly traumatized saying war you know

there’s something called narrative

exposure therapy where we’re up here

listens to them tell the story until it

triggers it doesn’t trigger anything

anymore it’s just a story so they just

keep telling it and telling it and

telling it until the the emotional

component is gone it’s just it’s just a

boring story and then they can move on

so I mean I really want to ask this

question and I think this is important

you know there’s there’s a lot of

research right now that is kind of

coming out with the use of psychedelics

psilocybin and I you asked to kind of

treat PTSD mdma-assisted therapy what is

what is your opinion on that and what is

your stance on that in regards to the

research that you’re doing well I’ve

read some of this work and I think that

it’s potentially positive in the sense

that what it seems to do is that it jars

people loose from the story that they’ve

grown accustomed to that they’ve grown

attached to and I have a colleague at

the University of Arizona who studies

psilocybin for obsessive-compulsive

disorder and when I read the

descriptions of some of his subjects it

sounds like what the psilocybin does is

it completely shifts their point of view

and they they exit this rigid mindset

and can see things from another


and I think if you’re working with a

skillful therapist who’s I think that

can be positive I I think it could be

dangerous if you’re doing it on your own

because we need a scaffolding if we’re

changing stories typically we need a

scaffolding to hold us up during the

transition and without that scaffolding

things could fall apart and come undone

I think but and I remember reading some

of the early LSD research and it was

certainly promising as a possibility

though it quickly got shut down and

never to see the light of day again but

you know there there are these

possibilities and I I think ketamine may

do some of that

it’s a intravenous treatment for a

severe depression that’s being done in

some hospitals and my sense is that when

it works it dissociates people from

their habitual stories long enough that

they can see the world differently Wow

and then when it’s over they can they’ve

had the experience of having seen

themselves from a different lens from a

different standpoint right we’ve

established that a narrative our

unconscious and conscious narrative is

completely essential to our healing and

how we progress through you know our

psychological disorders our

physiological disorders I mean in your

opinion what what can a person do that

is perhaps listening to this show right

now – with a problem that they may be

struggling with to kind of help

themselves or a short technique that you

could give someone one of my favorites

is to take a problematic situation

and write about it with but in the third

person so we get stuck Lumi journal in

the first person and we say I think this

and I think that they did this to me and

etc etc but it all in the third person

once upon a time there was a man who

worked in a hospital and had an argument

with the cafeteria you know about not

having gluten-free bread or you know and

and so when we when we write it down in

the third person lots of times we can we

can see things that we couldn’t see when

we were just thinking about it in the

first person and and there’s another

technique that that is rampant in

children’s literature which all which

gives us even more distance and

perspective which is to turn all the

characters into animals and so make the

grumpy cafeteria worker into a hard

harness I have the Potamus absolutely

you know and and what do you want your

character to be you know are you a

coyote or a woodchuck are you a raccoon

what what jumps out for you today and

and sometimes that’s just amazingly

illuminating in terms of on seeing it

differently you know stepping out of the

rat and taking a different look at this

situation you mentioned heroes the hero

of a story why is that so important to

the story well the the hero’s journey

just usable but Joseph Campbell it’s

it’s thought by some neuroscientists

to be a metaphor for adaptation and so

in the hero’s journey think things are

going along fine everybody’s happy you

know nothing much is going on to

anyone’s feathers and and suddenly

things change you know

Gandalf shows up to talk about horrible

things to come or Luke Skywalker’s

parents are murdered by stormtroopers or

white people show up on the coast of

Maine or something changes Captain Cook

appears and and so then the hero’s

journey is about how the hero responds

to that event and restores harmony to

the world to the world around him or her

and and so the the key the key element

in the hero’s journey is that the hero

has to do something the hero has it has

to have agency an agency is incredibly

correlated with mental health and with

physical health so when we have agency

we take action because we believe that

our actions will improve things and when

we don’t have agency we tend not to do

anything because nothing matters anyway

and whatever we do it will help so why

bother and and and he wrote the hero’s

story also the first action doesn’t

always succeed so sometimes we have to

try try and try again sometimes we have

to go get help like Luke Skywalker goes

to Dagobah to study with Yoda we have to

do something to strengthen our position

and all of these things are about

adapting to adverse circumstances that

have suddenly appeared whether it be

adapting to an illness or overcoming a

problem at work or you know suddenly

you’re given a disability and you have

to make the most of it

so you know these heroes stories explain

to us how to do it and and we we need

that in order to go make change for

ourselves and for our world yeah it’s I

mean I find this work

utterly fascinating and I’m truly

perplexed and I mean in a good way by

how powerful this seems and how much

what we tell ourselves can affect you

know what we’re thinking how we’re

thinking and the way in which we think

it I just want to thank you for your

time where can people find your work

your website my website is institute us and i

can be googled I’m a Nora no main and

happy to dialogue with people great dr.

Lewis thank you so much for being here

thank you for having me this is the

human experience we are gonna get out of

here we will see you guys next week

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