176 | Defeating Autism and ADD (Part 2) : Innovating Treatment for Neurobehavioral Disorders with Dr. Rob Melillo and Dr. Peter Scire - Inflammation Nation: Science Informed Wellness

Episode Transcript
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Speaker 1 (00:03):
Hey everyone, Welcome to the Funkbed Nation podcast.
I'm your host, Dr Steve Noswery.
The views and opinionsexpressed by my guests in this
podcast are not necessarilyconsistent with my own views and
opinions.
However, I do my best to berespectful of their views and
opinions as they express them,even if they differ from my own.

(00:23):
Now let's get to the podcast.
Let me just start by sayingthat one of the things that I
would like to accomplish in thispart of the conversation, if I
can, is to make sure we kind ofhave maybe two parallel
discussions.
It's always nice to give hope tohealthcare consumers, people

(00:47):
who are suffering fromneurological symptoms or
dysfunction but also to try toinspire practitioners to commit
some time and effort to learningabout the brain, because it's
so critically important.
And I think where we want toend up in the conversation which
is where we ended off last timewas talking about

(01:10):
immunodeception, the insularcortex and some of the really
cool work that you guys aredoing based off the research
that's out there, and I've spentsome time brushing up on that
just recently.
So hopefully I sound like Iknow at least a little bit of
what I like, like I know whatI'm talking about, but, Rob, can
you take just a second foranybody who might be tuning into

(01:30):
this episode that maybe missedthe first one.
Can you just do a quick recapof the disconnected kids book,
the third edition, and you canjust, you know, keep it super
quick, but just to ground peoplein, maybe in the nuts and bolts
of the first conversation thatwe had, Sure, all right.

Speaker 2 (01:49):
So you know, just recently, the third edition of
Disconnected Kids, which was,you know, my primary book for
the general consumption.
It was meant to be one anexplanation to people as to what
is actually happening in theirchild's brain, or maybe even a
window into what happened totheir brain as a child, because,

(02:10):
again, it's all about braindevelopment and we know that 90%
, if not more, of all adultmental health issues and many
physical health issues reallystart in childhood and it has to
do with development.
And you know that book wasfirst written as an explanation
but also a real hands-on manualto give people real tools to

(02:31):
assess their child, to really beable to take that and put
together an individualized homeprogram and then to lead them
through the implementation ofthat program, at least at a
pretty basic level.
And Peter and I, for the yearsit has been something that many
practitioners when they say,what do I do?
I don't know what to do.
In my office you know we oftensay use that book and use it and

(02:55):
go through the assessments anduse that.
So you know it first came out in2009, first edition.
Then the second edition wasabout maybe five, six years ago
or so, and the third editionjust came out.
The book is translated into 18languages.
It's more popular now than it'sever been.
As a matter of fact, the lastfew years it's really increased.

(03:17):
That's why they asked me to doa third edition, and we've been
doing a ton of research in mylab and with my group.
We published six or seven oreight papers last year alone in
some of the top journals in theworld, and a lot of the new
edition really includes a lot ofthat new research.
New information is two newchapters on primitive reflexes

(03:39):
and what they mean and how theywork, and so you know that book
is out there now and that'sreally a good place for people
to start.

Speaker 1 (03:45):
Yeah, um, peter, with , uh, with all the work that
you've done with Rob over theyears and the teaching that you
do, uh, under the moniker of theMalila method, can you like
travel back five, 10 years agoand could you at that point see
where you would be today, withwhere the research is and the

(04:06):
clinical applications thatyou're doing?
Could you have anticipatedwhere you are?

Speaker 3 (04:11):
Yeah, I do believe.
So I mean doing Rob's work forover 20 years and obviously,
coming from the background thatwe've all come from as a
chiropractic neurologybackground and our diplomate
program that we all completed,you know you had that basis.
And then when I met, you know,robert in 2004, and at the time
he only had a 50-hour coursejust on two topics ADHD 1 and

(04:35):
ADHD 2.
And it just kept evolving.
Every two years he evolved theprogram and then once we started
actually doing the brainbalance centers in 2007, um, I
mean, dr Miller doesn't doanything without a plan.
Okay, and you know there's a lotof people out there that talk
about, you know, setting goalsand and writing it down.

(04:59):
I mean I know this man does it.
I know he does it.
At the end of the year he sitsdown and he evaluates his
achievements of his goals forthat prior year and then what's
going next.
And so I knew, you know, when Ifirst met him and when we spoke
about even the possibilities ofdoing this program at the time,

(05:20):
you know he said, hey, get backto me in a year or two, we're
going to have something.
And I went back to him andthere it was.
And then when, we actuallystarted the centers.
We had a five-year goal and thenwe had a 10-year goal.
So I think that everythingwe've ever done, there's always

(05:41):
been specific goals that havebeen set.
So, without a doubt, there wasalways okay, let's get you know,
could we duplicate his model?
Could we duplicate what he wasdoing in his brain balance
center in New York?
Could I take it and duplicateit?
And then could others take itand duplicate it.
And we did that.
And then the next thing was okay, can we get all these reference

(06:01):
ranges for all these children'sand normative data and then be
able to compare our resultsagainst normative data?
And then we started publishingthose type of papers and then
from there we went into basicscience papers and actually
started doing more originalresearch other than just doing
retrospective or prospectiveresearch studies.
So, yeah, so everything he'sever done and has always been

(06:22):
with an intent behind it and aspecific goal that was to do
this.
And then let's do this after wedo this and I know that what
we're doing right now in theneuro immunology of of the
developmental world that we'relooking at right now, um, we
were just together and you know,working on outlines and

(06:43):
groundwork of research papersand where we want to be even the
next 12 months.

Speaker 2 (06:48):
Yeah, yeah, Steve, I can jump in on that a second
because Peter's right, ObviouslyI have everything.
I write things down, I havegoals and I have goals in the
way I run my practice and wehave yearly, monthly, weekly,
daily goals for every departmentthat all my staff knows, daily
goals for every department thatall my staff knows.
But the one thing I didn'tanticipate five years ago was

(07:08):
the level of expertise thatPeter would bring in the
immunology world.
Right, Because obviously I'msetting goals based on what I
know my goals to be, and my goal, you know, with Peter has
always been to have him playeven a bigger role in the
teaching end of it.
But with Peter has always beento have him play even a bigger
role in the teaching end of it.

(07:31):
But you know, being an expert, aworld-class expert in
everything, is very hard, right,you still have to focus, and so
you know where Peter has takenthis and his level of work over
the past five years has beenreally remarkable and it's
really really been incredible towatch it.
It reminds me of myself when Iwas, you know, about the same
age where I really became likethis, passionate, obsessive,

(07:54):
compulsive, you know, wrote mytextbook and, you know, really
decided that I was going tobecome a world-class at
something and I've seen that inhim and what he's been able to
add in this area of immunologyand really being able to educate
me but also be able to bringand help us bring the knowledge

(08:15):
of the immune system with thebrain and the nervous system at
a level that you know I wouldn'thave anticipated, you know,
five, six years ago.
So that for me, has been a hugechange in the positive.
I mean, it's really lighted usto and, I think, allowed us and
me to bring this to a wholedifferent level.

Speaker 1 (08:36):
Yeah, yeah, teamwork always is better and I, you know
I'm I'm kind of fond of seeingin the functional medicine
seminars that I teach, becauseyou know, we teach them under
names like mastering this andmastering that.
And you know, I think once youdecide you're going to become an
expert in this one thing, youautomatically suck at everything

(08:57):
else, because you have toignore everything else to be
really good at that one thing.
And that might be a little bitof a stretch, but, know, I think
you, you understand what I'mtalking about.
So here's um, here's a questionfor both you guys.
Um, I would imagine that to thelay public, the brain is kind of
a mysterious black box, likeyou know.

(09:19):
We all, everyone knows theyhave a brain.
Nobody really knows how itworks and you almost take it for
granted.
But if we switch theconversation and focus on
practitioners, it seems to methat universally, across
disciplines, the brain is notvery well understood.
So why do you guys think thatso few healthcare practitioners

(09:42):
on either side of theconventional or alternative
fence?
Why do so many not understandthe brain, particularly from a
function standpoint, notnecessarily from a pathology
standpoint?

Speaker 2 (09:59):
I guess I'll jump in and start.
Yeah, you're absolutely right.
I mean, you know, I always saythat the most important organ
that we all have is our brainand it's the one that most
people know the least about.
You know, you know more aboutyour heart and your gut and you
know nothing about your brain.
But you know also, withpractitioners, really very few
practitioners really knowanything functionally about the

(10:22):
brain, even neurologists, even,you know, neuropsychologists or
psychologists Most people don'trealize that most psychologists
have never had almost anyneuroanatomy courses at all,
like most zero.
And I think one is because it'sreally hard and it's the most
complicated thing I think tounderstand.

(10:43):
And I also think becausethere's a bias in the
traditional medical worldtowards the biochemistry and
towards the chemicalunderstanding and that's not
really the foundational way thebrain works.
It works really as a product offunction, of actions, of
sensory feedback, of cognitiveskills, of you know there's a

(11:04):
physics that underlies the brainand the connectivity, and so
most people are not exposed tothat or don't understand that,
and I think those two reasonsare partly where I think there
are very few people that reallyhave any real working knowledge
of the brain at all, and that'swhy I think there's so many
misconceptions out there as well.

(11:26):
Right, you know, like you know,that most brain problems start
in the gut and things like thatyou know, because of really a
lack of knowledge of the brain.

Speaker 1 (11:36):
Yeah, peter, when you graduated with your basic
science and DC degrees, did youcome out of school thinking that
you really understood the brain?

Speaker 3 (11:46):
Well, I mean I was actually a little bit lucky
because while I was a student inchiropractic school, I got
exposed to some people that wereactually talking about the
brain.
I got exposed to the likes ofDan Murphy.
He turned me on to the likes of,obviously, our carrot training
that we all went through and soon.
So you know, my last two yearsof my DC schooling I was really

(12:10):
wrapped into chiropracticneurology, functional neurology,
and it also coincided with theCARIC Institute being born at
that time in that early 2000s,and so for me it was a little
bit different.
But I would say for the vastmajority of my colleagues that
were in my quarter with me,that's not where their head was

(12:33):
and if I had not gone in anddone all those hours, those 300
plus hours of diplomate andother seminars I did, that were
targeted towards the brain.
You know, no, I would have justhad that basic science, that
would have passed my boards andthat would have been it, like
most of the chiropracticcommunity.
But what I will just say isthat I think what Dr Malone

(12:53):
touched on was is one of thechallenging factors for even the
functional medicine, becausethe functional medicine world
still looks at the brain oh okay, let's just do a supplement for
the brain, let's just do greenmedicine.
For the most part Is that we'renot going to.
If we're not using pharmacology, we'll use some herb or
something like that to influencesome biochemistry.

(13:16):
Where again, we're coming at itfrom a whole different
perspective.
We're talking aboutdevelopmental neuroscience.
We're talking about how doesthe brain develop longitudinally
through these very specificsteps?
And if they don't go throughthese very specific steps, how
does that alter the connectivityof the brain?
And you know how do we seethese functional disconnection

(13:37):
syndromes not only in thechildhood world, but we see it
in the adult world.

Speaker 1 (13:43):
Yeah, and that kind of teases.
Another question, and Rob, yousaid this that a lot of adult
neurological disorders havetheir root in poor development
and I think if you marry thatwith just a general lack of
understanding on theintervention side conventional

(14:03):
medicine you end up with a heavyemphasis on either
psychotherapy or pharmacy right.
Neurotransmitter reuptakeinhibitors, that kind of stuff.
If we focus in on function,because you mentioned it, and
then we kind of went on to someother things.
You talked about how the braindevelops as a result of action.

(14:24):
Talk about that piece a littlebit more, because you know, I've
quite often said when I'vetaught, say, brain chemistry
courses, I've often said that,like movement is nutrition for
the brain, the brain is thatorgan with which we experience
life.
That's how we go out andexplore the environment,

(14:46):
understand the environment, whatallows us to appreciate art,
understand humor, pretty mucheverything that makes life
worthwhile happens in the brain.
So when you said that the braindevelops as a result of action,
tease that out for me, diveinto a little bit more detail.
What does that really mean tothe layperson and then to the

(15:06):
practitioner?

Speaker 2 (15:07):
Yeah, no, it's great, great question, great that you
pointed out because this isactually so important.
You know, we talk aboutbiochemistry and chemical
interactions and it definitelyhas an impact on biasing the
brain and can have an impact onbehavior, but it doesn't change
the brain.
It temporarily may modify it ina way, but it doesn't change it

(15:30):
.
That's why most medication orsupplements don't have any
neuroplasticity that they create.
So it's like, you know I kindof use the example that the
muscle is like.
You know, the brain is likelike your muscles, right, you're
taking vitamins, takingsupplements, even taking
steroids might change yourmuscle tone a little bit or
whatever.
But unless you're exercisingand unless you're doing

(15:52):
something specific and you needto do specific training, if I
want to work on my right bicep,I need to do right bicep
exercises and I need to doresistance training.
Doing aerobic exercise orlifting with my left arm is not
going to work on my right armand the brain is all about doing
things and we know that thereason why we have brains to

(16:15):
begin with on this planet, thefirst brain evolved because a
living thing moved.
You know, it's basicunderstanding that living things
that don't move don't havebrains, and so movement is what
initiated the necessity for abrain, and the more we move and
the more complex we move.
You know, in neurosciencethere's a saying simple movement

(16:36):
, simple brain, complex movement, complex brain.
Humans have the most complexmovement, one with bipedalism
and then speech.
Those two things are unique tohumans and we have by far the
most complex brain.
We also have by far the mostasymmetric brain.
Those things are related to oneanother.
So you know, we have toactually do things we.

(16:56):
You know there's areas of thebrain that process light and
sound and we need light andsound to change those areas.
And if we use light and soundat specific frequencies we can
literally change physically,change the brain Cognitively.
We need to use attention orreading, or doing math or, you

(17:18):
know, doing social skills.
We have to do those things tobuild them.
We have to do specific motoracts to change our brain in
specific motor areas.
You know just, you know, takinga pill isn't going to enhance
our motor cortex or change it,or change the connectivity in
our brain.
And that's basically the beautyof the brain it's such a living

(17:41):
, dynamic organ, it's soadaptable and if you learn
something new within one hour,we can literally measure
physical changes in the brain.
But if you take a pill, itdoesn't work that way.
If you take a supplement, itdoesn't work that way.
If you modify your diet, itdoesn't change the brain.
So when we talk about literallychanging the brain, it's the

(18:02):
difference between doingphysical rehab for an injury
right, where you can actuallychange it and you can work on it
and you can be really specificto that modality and that action
and that type of movement,versus just taking a pain
medication which may reduce thepain and may, you know, you know
, make you a little bit moreflexible or whatever, but you're

(18:24):
not really changing the motorsystem.
You're not changing the way yourmuscles react, you're not
changing the endurance.
And so the brain requiresspecific actions, experience,
movement, and you need to do itvery specifically, and the right
and left brain requiredifferent types of stimulus to

(18:45):
actually change them.
But that literally does changethe brain.
It changes the genetics, itchanges genetic expression, it
creates rewiring, it can evencreate new brain cells, and so
most people have no idea aboutthat because that's not how the
traditional MD is trained.
They're not trained on thosethings and you know, even though
you have people doing thingslike OT and PT and whatever that

(19:08):
may actually change your brain.
They don't really understand it.
They don't know how they'rechanging the brain.
They're just doing things totry to improve or enhance a
skill, but without any specificdirection.

Speaker 1 (19:19):
Yeah, they, they know if we do this, then we usually
get a positive outcome, and sowe just keep doing that Right,
even though, like you said, theydon't necessarily understand it
.
Peter Rob mentioned asymmetry inthe brain, that the more
complex brains are, they havethis element of asymmetry.
I thought balance was what wewere after and I'm kind of being

(19:44):
a little facetious with myquestion.
But my understanding, if youcan clarify for me, is that
there are some functions thatare by design lateralized and
there's a purpose for that.
Can you comment on that?
That we don't always wantexactly the same thing happening
on both sides of the brain.

Speaker 3 (20:02):
Yeah, well, the way the brain has been designed, you
know, and through what Dr Nollis talking about, this
epigenetic expression, thesesensory stimulations that are
going into the brain, firingthese different receptors that
then begin to build thesedifferent connections, you know,
different sound or differentlight frequencies are activating

(20:26):
receptors in, like, say, theoccipital cortex or the temporal
lobe or the, let's say, thefrontal lobe.
So we have this stimulation thatcomes in, begins to drive these
different expressions ofdifferent parts of the brain and
within those different parts ofthe brain they begin to develop

(20:46):
a level of functionality thatis different and then the right
brain may have a more biased in,let's say, visual skills of
visual spatial areas where theleft brain, visually, might have
more of, like, a detailrelationship.
So you know, you're gettingthese different sensory
stimulations that are coming inearly on in the womb and then

(21:08):
early developmentally, throughthe first, let's say you know,
12 to 36 months of life, thatreally start explaining these
shifts in brain.
And one of the things that DrMelo did a tremendous job on
with his son about a year agothey wrotea paper on, you know,
how does the brain actuallylateralize and there's actually
even some thought that there issome genes that are there that

(21:29):
are specifically coding for thislateralization, because we
don't only see it in humans, butwe also know that other animals
, like birds and other mammals,have very clear lateralization
aspects.
So there is a certain level ofprobably this genetic expression
that happens based on thesensory stimulation that allows

(21:51):
for this level of connectivityto happen in one region of the
brain that then dictates thatparticular functional skill of
that particular side of thebrain.
Okay, so, and again, not tohave you know, you don't want
redundancy.
We're not looking forredundancy in the brain.
Okay.

Speaker 2 (22:09):
Gotcha.

Speaker 3 (22:10):
So that's really, ultimately, what we're looking
at is that you know.
We know that for the most partthat you know there might be
certain things that can happenin one side of the brain.
That's very specific, and theremight be a little bit of that
in the right side, but thedominancy of it is to one side
and again, the reality of it isthat we're not looking for
redundancy.
It allows us to have thisgreater timing mechanism that

(22:34):
exists between two sides of thebrain and gives us just a
greater degree of computationpower.

Speaker 2 (22:39):
Yeah, that's a great way of doing it.
That was a really good question, steve.
Actually no-transcript.

(23:09):
But, as Peter just said, wedon't want both sides to do
exactly the same thing, becausethat would be a waste of space.
We don't want redundancy.
We want them to clearly dodifferent things, so that we
have literally two brains in one, but we need to be able to have
them communicate and talk toone another, and to do that, the
speed of processing and thematurity of the brain needs to

(23:32):
be balanced, and so that's.
You know, that's thedistinction there, but really
good question.

Speaker 3 (23:37):
That's a great point because the excuse me, steve the
idea that you know, for example, one of the common tools that
we use in our assessment processand also rehabilitation process
is the interactive metronome,and it's probably the one piece
of technology that Robert and Ihave always felt like is just

(23:58):
this amazing piece of technologythat we can use to determine
processing speed of the brain.

Speaker 2 (24:06):
Okay, and change it.

Speaker 3 (24:08):
And change it too.
Because we can look at thistiming aspect and we're able to
really look at this timingmechanism that is existing
between the cerebellum, morespecifically the inferior olive
part of the brainstem, thencommunicating to the motor
cortex and the frontal lobe, andwhen a patient is on this

(24:32):
technology and they're trying,they're hearing a steady
repetition of a beat justclapping like or in their ear,
and then they have to do a motoraction to it.
We can measure that in thisvery finite millisecond
relationship and, again, knowingthat the brain is operating on,
you know, on, maybe on a slowlevel, a millisecond, but even
much faster.
But the technology does allowus to say, okay, if the child or

(24:53):
the adult is way off, theirprocessing speed is dramatically
slow.
And then as we actually startrehabbing their brain and
changing the way their brain isdeveloping from an imbalanced
way, we actually can see theirprocessing speed get faster and
the closer and closer theyactually get to the normative

(25:15):
data that's been developed bythe utilization of this
technology is that their brainbegins to actually have a more
whole timing mechanism.
And what's fascinating is thatwhen we do the initial
evaluation, sometimes we can seea timing difference in the left
hemisphere compared to theright hemisphere.

(25:35):
That's 10 times, 20 times, 30times difference in the timing
mechanism.
And really where we studiedthis the most was actually when
we did our Harvard study withMcLean Hospital, because that
was probably the single largestmodality that they used in that
study was the interactivemetronome and having the patient

(25:56):
population in that ADHD groupdo a tremendous amount of work
on it, and what we were able toshow was how we began to
integrate areas of the brain,begin to take out the, the
disturbance that was happeningfrom the lower part of the brain
to the upper part of the brainand then also see that we
created the top down regulationthat we needed to happen.

(26:19):
But it all it happened reallybecause of the timing activity
that occurred in the lower partof the brain and, obviously, the
hemispheric influence that wehad when we were using that
therapy.

Speaker 1 (26:31):
Yeah, you know, back to this idea of laterality or
imbalance, it seems to me thatwe expect to have a little bit
of asymmetry, not necessarily infunction, where something might
be completely lateralized, likelanguage for example, housed in

(26:52):
generally the left brain, butit seems to me that a little bit
of asymmetry between rightbrain and left brain, within
tolerable limits, is just partof who we are, it's just part of
personality, right.
So we might know somebody who wego okay, that person's really
left brain, they're veryscientific, they're the engineer
type, and then the right brainis more of the artistic, make

(27:16):
love, not war, type person, andso we kind of expect that,
within tolerable limits, to justbe part of the diversity of
humanity.
But obviously there's a point,there's a threshold where the
asymmetry exceeds that tolerablelimit and then we start running
into problems.
And so in the book and I know inthe work that you're part of,

(27:40):
peter you guys talk about leftbrain dominance, right brain
dominance, and I guess I shouldpoint out that, for example, the
left brain dominance might comeas a result of increased left
brain activity or probably morecommonly, a decreased right
brain, because there's the wordbalancing and there has to be
some balance.
So the tendency is, if one sideof the brain doesn't work as

(28:03):
well or as efficiently, theother one becomes dominant
because there's a deficiency.
So how is it like the averageperson who's listening here,
even practitioners and they'regoing like, okay, well, I am
bent a certain way, I'm moreartsy, I'm more scientific how

(28:25):
would they look at themselves orlook at someone they love and
care about and think tothemselves whatever asymmetry is
going on might be beyond thetolerable limits, and maybe we
can talk about kids and thenadults.
What are the early warningsigns that there is an asymmetry
that is beyond the tolerablelimit that we might be concerned
about and take some action on?

Speaker 2 (28:45):
Yeah, great question.
So, yeah, I think you know theway to look at asymmetry in the
brain from a natural standpoint.
You know, I believe that we'reall a little right brain or left
brain dominant, and that's whatwe call cognitive style.
It's just like beingright-handed or left-handed, you
know, and there's nothing wrongwith either.
One One isn't better than theother, it just is.

(29:06):
And they're built on a trait,right?
If your parents areright-handed, you're going to be
, you're supposed to be,right-handed, but you may end up
being left-handed and that isnot the way it's supposed to be.
So that could be morereflective of an issue right
During development.
And all of this, really all ofit, is a byproduct of the
developmental growth of thebrain.

(29:26):
So that what we see is that ifthere is, you know, your natural
strengths and weaknesses if oneside of the brain or the other
takes too much of a dominanceduring growth and development,
it may come online too early andit may hold back the other
brain.
So really, it's a matter of amaturational imbalance, maturity

(29:50):
imbalance, and that also endsup with an activation imbalance.
But the bottom line is, whensomebody is not able to function
in a normal realm, like if achild isn't able to learn
properly, they're not able tofunction in a normal realm,
right, like if you, a childisn't able to learn properly,
they're not able to read the waythey're supposed to, or they're
not socializing like theyshould, or they're not behaving

(30:11):
like they should, or there's allof these different immune
dysregulations.
You know that's when it mayfall to the point of, okay, we
need to intervene.
But what, like we say all thetime, the people that are most
gifted in an area of the brain.
Because basically, when someoneis gifted or talented or
intelligent, what does that mean?
It means that certain areas oftheir brain are stronger than

(30:34):
most people, meaning they'refaster, they process information
, they have stronger connections.
And as you get stronger in onearea, you're a little bit weaker
in the other area, and that'snormal, right, that's an
advantage and that advantage maybe really good for a while, but
when you cross a certainthreshold, the disadvantage

(30:55):
outweighs the advantage.
You know, the analogy that I use, and that was used in a really
great article that I read, isthat if you have like, let's say
, you're breeding for a fastracehorse, you will breed for
longer, thinner legs.
So they get longer, thinnerlegs, they get faster and faster
and faster and faster for eachgeneration, and that's a good

(31:17):
thing, that's an advantage.
It's an advantage to them inmany ways.
But at a certain point the legbecomes so long and thin that as
soon as they start to run theybreak their leg.
And now it's not an advantageanymore.
And that's why even you knowtraits and even issues like
autism and schizophrenia andbipolar, even though they

(31:38):
actually reduce evolutionaryfitness, they reduce the chance
of having children, they areactually increasing dramatically
through society because at alower level of concentration,
they give great advantage,especially for our modern
society, which is driving moreand more towards a left brain
world, right?

(32:00):
So it's a matter of looking atthese traits and looking at, you
know, the way that the brain isgoing to grow and develop,
superimposed on what we do wellor and what's in our family.
And that's why you talk aboutsome families.
They might be better in musicaltype things, or they might be
all engineers, or they might,you know, be all you know,
artists of one level, and theseare things that run in families.

(32:22):
But you know, that's kind ofthe way to look at it, rather
than you know, as some you know,we're not saying that everybody
should be perfectly balanced.
Having you know, we know, thatthere's good that makes that

(32:43):
increases your survival.
If everybody's good at onething and everybody's bad at one
thing, that group is going tosurvive very long, right.
So diversity is good, but toomuch diversity or too much
asymmetry in the brain, then theweaknesses outweigh the
strengths and then it becomes adisability.

Speaker 1 (33:02):
So, peter, with like thinking about developing kids,
like give me something specificif you can.
What would be the first sign?
This is top of mind for mebecause I just had a grandchild,
born a month ago, a month agotomorrow, and I just, thankfully
, I just had a chance to spendthree or four days with them in

(33:23):
South Carolina and hold them andget to know them.
So, thinking about parents withnewborns or parents with
infants who might be, you know,three, four, six months old,
what would be the first signthat would alert them to their
baby has got a developmentaldelay?

Speaker 3 (33:43):
Well, I mean, I think we first want to look at, you
know, was the child a vaginaldelivery or cesarean?
Okay, because if they werecesarean, then there's a greater
probability that the primitivereflexes are probably not going
to go to their longitude.

Speaker 1 (34:00):
Okay, all right, let me just pause you there for a
second, as we mentionedprimitive reflexes in our last
conversation.
We never really got into it.
It's a big topic of the book,obviously, and I don't know all
the ins and outs of the Melillomethod, but I know that
primitive reflex remediationlike identifying retained

(34:22):
primitive reflexes is importantand even in the adult population
, right.
You can have these things comeback as a result of injury, for
example, or just aging.
So let's just pause, if youdon't mind.
Let's define what a primitivereflex is and why these are
important, Not from just adevelopmental standpoint in the

(34:44):
infant and child, but to anadult who may be suffering from
anxiety, depression, motordisorders, anything that you
could list as an adultneurological manifestation.

Speaker 3 (34:57):
Let's just break down the word Primitive, being
meaning that it's thereinitially, it's almost like an
innate response.
It's a stereotypical responseof the central nervous system at
that, at the moment of, ofduring gestation okay, because
you do have them appear atcertain gestational weeks, okay,

(35:18):
and they come online and againthere are.
They are just these verystereotypical functions of the
central nervous system because,again, when the baby is born,
there's really not this reallybig brain that they have.
They're really relying onmostly their brainstem at that
moment, okay, and and where theprimitive reflexes are housed?

(35:39):
Or in their, in the brainstem.
So they're doing these veryspecific reflexive functions
based on movement, okay,movement of the body and the
head in space and the limbs andespecially the head as it moves,
as the spine, if the headrotates.
For example, the asymmetricaltonic neck reflex is a reflex

(36:00):
that starts early on ingestation and the paw and head
movement will cause armextension on that one side and
the opposite side, a flexionmovement of the arm.
So you have these verystereotypical functions,
reflexes that are happening inthe womb.
There are several of them thatare designed to assist with the

(36:21):
birthing process.
Okay, the asymmetrical tonicneck reflex, the symmetrical
tonic neck reflex, the spinalgallant reflex.
So these are reflexes thatactually allow the baby to
actually move and twistthemselves through the birth
canal and then they actually setup the staging of then the next
primitive reflexes that arehappening immediately after

(36:44):
birth, and so on.
And so what has to happennormally is that the child goes
through these different stagesof the reflex being active for a
certain period of time, maybe athree-month window, and then
they release and they give wayto another set of primitive
reflexes, and then we move topostural reflexes, and the
postural reflexes are the reflexthat actually allow the infant

(37:06):
to go upright, okay, and thenobviously eventually go through
the stages of crawling and intowalking.
Okay Now.
And so right off the bat, ifthe child doesn't go through the
stages of crawling and intowalking, okay Now.
And so right off the bat, ifthe child doesn't go through the
birth canal.
There may be an alteration ofhow that sequence happened.
Okay, so that would be first,and one of the also the most

(37:26):
important reflexes that we haveis the reflex that has to do
with latching onto the breast.
Okay, so the rooting reflex, so, right off the bat, if a mother
wants to breastfeed, the childmay not latch completely.
So if there is a relationshipthere where they're not latching
, then you need to maybe see ifthe rooting reflex is not even

(37:49):
actually happening.
Okay, and then at that point,is there some level of muscle
tone that that might be alsothere, a lack of muscle tone
that's contributing that?
So we might in that case haveto activate the rooting reflex
to allow the child to suck.
So that would be immediately, Imean immediately, right a
within the first hours of birth,to kind of see whether or not

(38:11):
there's also a palmer graspreflex.
That should happen right away.
So if the mom or anyone goes totouch the palm of the hand and
they don't grasp something, thenthat might be again another
sign that these reflexes are noton.
Okay, so that would beimmediately.
And then, as we talk about inthe book, there is these

(38:34):
basically like 11 primaryreflexes.
There are others, but the 11primary ones that we really
assess, that we would like tosee being assessed immediately
through a standard pediatricneurological exam.
Now this was done 30 years ago.
I mean, rob shows in his coursethat there was textbooks that
outlined this and pediatricianswould do this, but they got away

(38:56):
from it and it's not like theOTs or PTs that are maybe
trained in this.
They're not seeing a child inthat early three months or six
months level.
So we got to get back toteaching that as a primary part
of a normal pediatric exam so wecan actually see that the
children are actually goingthrough these stages of

(39:17):
maturation.
Because if they're retained,and they're retained beyond the
12-month mark, 15-month mark and18-month, then we know we have
a delay in maturation.
We may not yet know exactlywhich hemisphere is beginning to
be the immature hemisphere, butwe definitely can say that, hey
, the child is having delay.

(39:39):
Now, as Dr Malou said, thetraits of the parents or the
grandparents may give us biasalso into which hemisphere may
be beginning to become morefaster growing and the other one
being delayed.
For example, we know that ifthe left hemisphere turns on
very early, we may see veryearly language skills arise.

(40:01):
You know, we may see childrenat 16, 18 months actually begin
to develop a very sophisticatedlanguage.
Okay, and so, right off the bat, if that happens, then there's
probably a good indication thatthe left hemisphere is
developing more rapidly andwe're going to see further
suppression of that right brain.
Obviously, muscle tone is a bigissue there.

(40:22):
So I mean, those would be theearly signs right off the bat.

Speaker 1 (40:27):
Yeah, so you described some of these reflexes
as aiding in the birth process.
And then the rooting andsuckling reflex.
I mean that's kind of asurvival thing, right?

Speaker 2 (40:37):
Like you know.

Speaker 1 (40:38):
You brush the cheek and the baby will turn and open
its mouth.
Anybody who has had a child, oreven has been around a newborn,
knows that it's just a flurryof spastic, spontaneous movement
.
Right, there's nosophistication, the eyes are
roaming, they don't really havemuch control of their, their
core, their head, and thatdevelops just simply.

(41:01):
Within a matter of weeks, theybegin to orient their eyes and
and maybe turn their head with alittle bit of control but
that's because those reflexesthere.
Okay, yeah, and so, and this iswhy what I was thinking about is
is that, with all the spasticmovements of arms and legs,
which is very discoordinated,right, because that system
hasn't developed yet, it seemsto me that that almost serves

(41:22):
like a wind-up mechanism to putinput into the brain to allow it
to develop.
And as the brain develops, as aresult of all the spontaneous
reflexive movements, it learnsto control those things.
And now we see the abolishmentof the things that allowed the
brain to develop.
And so when you talk aboutretained primitive reflexes,

(41:45):
it's primitive reflexes thatsomebody had that didn't go away
because that connection betweenthe reflexive movement and
brain development didn't happenthe way that it should have.
Am I on track with that, Rob?

Speaker 2 (41:58):
Yeah, yeah, essentially, you know, as we
said.
You know these reflexes arethere because human babies are
the most immature babies of anyanimal in the animal kingdom,
right?
I mean every other baby can getup and run away or do things.
As you said, they can movetheir body.
And again we said movement wasthe key to brain development.
It's why we have brains, it'sthe key to brain development.

(42:20):
Anything that alters that fromnormal development is going to
have a major impact on the brain.
And so you know, even from thevery beginning, if a you know, a
mom has a problem where thebaby isn't, is in breech
position, the baby is designedwith these reflexes to get
themselves into that position.

(42:40):
If they don't get into thatposition, you have to ask why.
And it's usually becausealready there's a motor issue
with the baby that they can'tmove and they can't activate the
reflexes or they have a lowertone, as Peter was saying.
You know 80, 85, 90 percent ofthe kids that we work with they
never latched on appropriatelyin the first few days or a few

(43:03):
weeks, some not at all.
So there's already analteration of muscle tone and so
the way it works is that.
You know we're born with thesereflexes because we don't have
any control.
You know, we have no volitionalcontrol over our movements.
It's all random and chaotic atthat point, as you're saying,
and the reflexes at least givesome control, so that you said,

(43:27):
we can survive, we can feedourselves, we can do basic
things, and then they shouldlead us through and get us to
move, do basic things and thenthey should lead us through and
get us to move and as we move weengage those senses and then
those senses, as you alluded togive feedback to the brain,
activate the genes calledexperience-dependent genes that
then cause our brain to matureand grow and get more

(43:49):
connections and bring morecoordination and more control.
And the brain literally buildsfrom the bottom up.
It starts in the brainstem,which is the foundation of our
brain.
That's where the reflexes comefrom.
And then that as we move and wego through the world and we
increase that feedback and weengage our senses and it builds

(44:09):
a more complex brain which thenallows for more control and
complex movement.
That then increases morefeedback.
That creates another stage ofcomplexity and allows for more
complex movement.
And then all of this iscalibrating our brain to the
world around us, because a lotof our software is already there
, but we need to calibrate it tothe world around us so that it

(44:31):
makes sense and we can use it atthe appropriate time and in the
appropriate way.
And that process is veryspecific and the right brain
takes the lead for the firstthree years and builds more in
the right brain, and then theleft brain kicks in for the next
three years and then theyshould catch up to one another
at six years or so and then theyshould be lateralized and

(44:53):
integrated and that's the way itshould develop.
Anything that alters that isgoing to have an impact on that
development and make things comeon too early or too strong or
things delayed in theirdevelopment, and then that sets
up this asymmetry.
And that's where all thesymptoms come from is from that
asymmetry and its impact on thebody, on the digestive system,

(45:16):
on the immune system and all ofthat.

Speaker 1 (45:18):
Yeah, you know, you just described a well-designed
and guided process, like it juststruck me as you were speaking
that you know, like we justtalked about, with the primitive
reflexes designed to supportthe birthing process and then
survival immediately and thenbegin the early developmental
stages of the brain.
And because the right brain is,I mean, obviously it does many

(45:43):
things but part of it isawareness of self.
Right, it just struck me thatbecause the right brain is more
awareness of self left brain isawareness of your external
environment and seeking behavior.
It would seem to be completelyinappropriate if the left brain
developed first right and so youhave an infant or a child who

(46:06):
has very little understanding ofself, who just gets out in the
world and explores, I mean, thechild could get themselves under
trouble pretty easily.

Speaker 2 (46:15):
Absolutely, and they may get early verbal skills.
Like Peter said, we get kidsthat can read.
You know I had one kid from theUK that could read at eight
months old.
So you know no one should readat that point.
And so, yeah, the right brain.
You know Ian McGilchrist.
You know we love him becausehe's so eloquent in his writing
and you know he's a psychiatristat the UK and he's done such

(46:36):
beautiful descriptions and hetalks about how the right brain
should be the master.
I talk about how the right brainshould be the dominant one and
as the left brain comes online,the left brain is hyperactive
and impulsive and aggressive anddoesn't really care about
people so much and isn't reallyconnected to our body and
doesn't care about theenvironment.
It cares about facts, it caresabout details, it cares about,

(46:59):
you know, goals and seeking andaccumulating things and all of
these things that are good andnecessary but, you know, aren't
altruistic and aren't really,you know, aren't social and
aren't about emotionalregulation.
And so the right brain shouldact almost like the parent,
always through most of our life.
The right brain is the wisebrain.

(47:20):
The left brain has theinformation, but the right brain
is the wise Like.
Why do we use that and how dowe do it?
And the right brain is even moreintelligent than the left brain
and it's gotten a bad rap inthe years.
But the right brain synthesizesa ton of information
instantaneously, subconsciously,and is aware and knows things

(47:41):
and, you know, sees beauty andyou know, understand things
without things that you can'treally describe in words.
And the left brain slows itdown and is slower and really
kind of less intelligent, eventhough we think of it as the
intellectual brain and thedominant brain and the language
brain.
But just because it has a voicedoesn't mean it's smarter,

(48:02):
right, just because it has amemory doesn't mean it's smarter
.
And so, yeah, you're exactlyright.
And that is autism, where theright brain is delayed in its
development because thesereflexes aren't going away and
other factors.
That left brain comes onlinetoo early because they're
naturally gifted and now itdominates over the right and now

(48:22):
that is a bad situation andthat gets worse as time goes on
and we literally have kids thatare non-speaking, that can type
on letter boards and tell usthat there's this raging battle
between the left and the rightbrain, where the left brain
doesn't want to give up itsdominance because it's
essentially a control freak.

Speaker 1 (48:42):
Yeah, we'll eventually have to bring the
conversation to like some of thethings that you guys are doing
in clinic to change that Stevecan I jump in one moment?

Speaker 3 (48:51):
Yeah, absolutely.

Speaker 1 (48:52):
And then I have a question for you.

Speaker 3 (48:54):
So back to something we said earlier but also Dr
Miller just brought it up, andagain you guys were both
alluding to like kind of when isthat breaking point, right, and
how do we see that breakingpoint in this asymmetrical
distribution?
I think this is one of thethings that we see in the
diagnostic continuum that weoften see with the children that

(49:16):
present to our office.
Okay, where you know, let's say, a 10-year-old child or a
12-year-old child presents toeither one of our practices and
you do the history workup onthat.
Yeah, my child was very verbalearly on in development, okay,
around thattwo-and-a-half-year-old,
three-year-old mark, anddeveloped almost like a

(49:37):
professor syndrome type of thing.
The kids had this very highvocabulary.
And then when they go toelementary, they go to preschool
or pre-K or kindergarten.
They do okay, but they'reinitially maybe being described
as inattentive or maybe more sohyperactive or impulsive, okay,

(49:57):
or they may even show some signsof stim behavior where, you
know, obviously they have thesevery repetitive behaviors that
they're doing, maybe with theirhands or their body, or maybe
even verbal stims or somethinglike that, and usually what
happens is that, as Dr Mulleralluded to the idea that the two

(50:19):
sides of the brain are goingthrough these developmental
shifts and that when that leftbrain that shouldn't really have
turned on to maybe about twoand a half, going into that
three to six year window okay,because the first three years is
the right, but usually aroundthat four, five and six year old

(50:41):
level, if the left hemispherealready was developing too
rapidly in those first threeyears, we get a major bump then
okay, as they're beginning toenter, like, maybe, first grade
or you know, transitioning,maybe now getting up a little
bit higher in the second grade.
So this is usually what we seediagnostically, where all of a

(51:01):
sudden it went from like, let'ssay, maybe like an adhc
diagnosis to now they go totheir pediatrician.
The pediatrician is saying,well, not only does your child
have ADHD, but your child haslike a motor tics, okay.
Or maybe even showing, you know, some Tourette-like symptoms or
worse, maybe even showing someobsessive compulsive types.

(51:23):
And so I think that that's wherewe see it and so, unfortunately
, what happens in the medicalmodel is this the child maybe
went on their adhd medicationokay early on but, now, okay, we
need to add such and suchmedication in to control the
motor tic.

(51:44):
Or we need to need such and suchmedication now to control the
obsessive, compulsive aspect.
Or how about anxiety?
I can't tell you how many timesover the years where we've seen
children that have anxiety withflushing the toilet bowl or
they develop a stim behavioraround flushing the toilet bowl.

(52:04):
So I think that that's when youbegin to see these changes,
where you see changes infunctionality, where that left
brain is going further andfurther in terms of its
functionality, but the sametimes as it's going up it's
really inhibiting that leftbrain.
So we don't see theself-regulation that we would
normally see.

(52:24):
We don't see the maturation oftheir social engagement system.
We don't see the maturation oftheir right brain emotions, that
the further development of thatintrospective, that theory of
mind.

Speaker 1 (52:37):
Yeah, yeah, rob, in one of the past answers or
little monologues that youblessed us with, you use the
phrase experience gene and Iremember back when I did my
neurology diplomate, we used totalk about how 60% of the brain

(52:58):
was hardwired.
These are neurological tracksthat are the same between you
and me and Peter and everybodyelse, and roughly 40% was
developmental and was unique tothe individual.
Have those numbers or thoseconcepts changed at?

Speaker 2 (53:15):
all, I would say that there's probably more than 60%.
That's actually developmental,because even the hardwired part
is still dependent on geneexpression, you know formation
of networks and where things aresupposed to form, and all of
that is really more, again,experience dependent.

(53:37):
Give an example we know thatthe thalamus is the area that
all our sensory input goes inand goes into the brain.
It's the main relay, and thereare two main nuclei.
One is the main relay for anyauditory information coming in
and that goes up into thetemporal lobe.
And then we know that there'sanother one that is all the
visual input comes in and thatgoes up into the temporal lobe.
And then we know that there'sanother one that is all the
visual input comes in and thatgoes to the back of the brain.

(53:58):
Well, a few years ago, you know,there were some studies where
they changed the input and theytook all the auditory input and
they put it into the nuclei thatnormally would get hearing and
they switched them and whathappens is the back of the brain
became the hearing brain andthe side of the brain became the

(54:19):
visual brain, meaning that thatback of the brain is not
hardwired to be a visual cortex.
It's made that way by the inputthat goes in there and that can
be changed if you change thatinput.
So that shows that the hardwiring that we supposedly have
in our brain is really not thathardwired and is also experience

(54:43):
dependent.
So it's a lot more malleableand things can go wrong in a big
way.
But the good news is we canalso change it in a big way
pretty rapidly and prettyquickly by just knowing how the
system works and being able touse that to our advantage.
So there's almost none of theseissues that can't be changed.

(55:07):
You know, and the idea that,okay, once you have this, these
are lifelong problems, that cannever be to me that's complete
BS.
You know, because, first of all, if you know anything about the
brain, that's not the way thebrain works.
We can change it.
You know it's not like baking acake.
You know we made a cake, oh, weforgot the eggs.
We can't go back and put eggsin now.
But the brain, we can do thatbecause it remakes itself and it

(55:30):
can change and it's a livingorganism and you put new input
in and it completely can reshapeitself.

Speaker 1 (55:37):
Yeah, and that you know, even even within within
our group of functionalneurologists.
Um, I remember the notion andin fact I've heard other people
use that baking a cake analogythat once you bake, bake the
cake, you've got a cake.
It can't become anything else.
Um, and so I get in and thisleads into one of the questions

(55:58):
I was going to ask.
You is like once someonedevelops an asymmetry as a child
, at what age does it become?
I was going to use the wordimpossible, but I'll refrain
from that.
At what point or under whatcircumstance does it become more
difficult to introduce changesthat will for lack of a better

(56:20):
way of saying it rebalance thoseasymmetries?

Speaker 2 (56:24):
Yeah, that really is from a standpoint of
neuroplasticity or the abilityto actually change the brain.
We never lose that, Even whenyou're 80 years old, we can
change it.
But the only limiting factorthat I found is that when a kid
becomes a certain age, we needto get them to do physical

(56:44):
exercises.
We need to make an effort to dothings Because, as we said,
changing the brain requiresaction.
It requires doing something.
We can do a lot of it passivelyinitially, but at a certain
point you know they have to be apart of it and at a certain
point what you may get arepeople that are, you know, kids

(57:05):
that may be very violent oraggressive and may be very
resistant to allowing any ofthat to be done.
Or even as an adult, wherethere's such an imbalance, such
a lack of self-awareness or alack of motivation that it you
know, they just can't getthemselves to do it or they're

(57:26):
completely resistant or theyrefuse any sort of treatment,
and that's really the onlylimiting factor as far as I'm
concerned.

Speaker 1 (57:33):
Yeah, it's just the willing to participate and, you
know, take ownership of thatprocess, which is difficult,
like even, especially if youhave kids that have that
decreased right brain function.
They lack that wisdom, rightthey?
They lack the context.
They can't uh necessarilyproject into the future and
understand the consequences ofnot doing what it is they really

(57:56):
should do right and thatunfortunately, um, you know I
speak into parents out therelike my heart breaks for for
parents of children who havethese issues, and the parents
know it.
They desperately want them toengage, but they just simply
refuse.
And you can, as the old sayinggoes, lead a horse to water.

Speaker 2 (58:16):
You know, and a lot of it is really how you explain
it to people too.
You know, I have a, you know, a30 something year old man today
that came in who's severelydepressed, suicidal and, you
know, has a lot of other issueslike immune issues and had
chronic Lyme disease.
And then COVID hit anddepression hit him really badly

(58:36):
and you know, he is just feelslike he's.
You know, I'll never get rid ofthe Lyme, I'll never be able to
get over this and it's hopelessand that's what his brain is
telling them.
And so I spent a lot of timetalking to him about how all of
this is neurological.
Everything you're feeling,everything is because of these
imbalances in your system.

(58:57):
And you know, and afterwards hesaid, you know, thank you for
explaining that to me I wouldhave never thought of any of
that and I just thought like I'ma hopeless case, I went to
every doctor and went to allthese people and nobody can help
me.
And so I I'm, you know, I'mthinking that maybe it's best
for me to just check out of thisworld.
And you know, you justexplained it to me, where it's

(59:19):
not my fault and I'm not a badperson and I'm not weak and I'm
not broken.
I just you know.
I just have to be able to findsomebody that can show me how to
do this.

Speaker 1 (59:28):
Yeah, it's, it's something that's happened to me
rather than who.
I am Right.
Yeah, peter, how many times inconsulting with adults have you
heard someone who blames all oftheir symptoms say, oh, it's my
hormones.
Or, you know, it's my this,it's my that.

(59:49):
And the one thing that they'releaving out of the equation is
all of these things have theirimpact, not solely on the brain,
but it's a key part of that.
So it kind of begs the questionand maybe the question or the
answer is in the question butwhy is brain health and function

(01:00:10):
so important and function soimportant?
And should we prioritize that,not to the exclusion of, but
should we prioritize the brainover things like the endocrine
system or hormones, or even overthe immune system or over gut
health?
Should we prioritize that inour thought process Doesn't mean
we ignore everything else, butshould we put the brain at the

(01:00:32):
pinnacle?

Speaker 3 (01:00:34):
I do believe that.
I believe that's where whatwe've been seeing for many years
, I mean I you know I've been inand out of working with kids
and adults.
you know, over the last,especially over the last decade
when I left, you know full-timeworking with children and now
I've seen patients go, you know,to come into my office and been
around the America round offunctional medicine and

(01:00:57):
conventional medicine and whenyou actually probably really
drill down to a lot of theircore issues.
You know, in my opinion itprobably stems from a brain
asymmetry that they have a brainimbalance.
That's happened and I thinkyou're getting a greater
magnitude.
One of the other things that Ithink is important when you're
working with adults and this issomething that Dr Nolte spent a

(01:01:18):
great deal in his coursestalking about is adverse
childhood experiences.

Speaker 2 (01:01:22):
ACEs.

Speaker 3 (01:01:24):
So when you get into that population of working with
20-, 30-year-old, 40-year-old,50-year-old people and even in
the 60th decade of life, one ofthe things that we do have them
do is score an ACEs checklist.
Okay, because you need to be ona long for that, because you
know, and especially when you'realso doing your metabolic work

(01:01:44):
upon them and the way ourquestionnaires are set up is to
really try to go back as far asthe patient can remember about
their health history.
You can begin to see wherecertain things going on, maybe
in their teenage years, maybethey don't remember the adult
doesn't remember back to theirelementary years, but you begin
to get a sense that there was abrain asymmetry.

(01:02:06):
I have a gentleman that reachedout to me recently who again
had gone to a lot of differentfunctional medicine practice and
after I did his intake itclearly showed up that he had a
very left-brain dominance.
He really was this very strongengineer type of person and that
he was developing this reallygreat social anxiety, and then

(01:02:34):
he was impacting hisrelationship with his wife for
you know many of decades at thispoint, um, and so again he was
looking for something different.
He didn't want me to just say,hey, take this supplement or let
me run this lab he had all thisstuff and you know he said,
okay, what you're telling memakes sense, and the further
that we went into his history,it was very clear from a very

(01:02:56):
early age that this man, even inthe 70s, had a very clear left
brain dominance, and so he feltvery relieved after I explained
that to him and that he got ahold of the book and read the
book and he's like oh man, thisexplains me when I was 10 years
old, explains me when I was 20years old, and so on.

(01:03:17):
So it's always nice when you cangive that patient a different
approach that says, hey, this isprobably more brain-centric and
everything from.
There is just a downstreamissue to this brain hemispheric
imbalance.
And I think that's what Rob andI are really trying to do to
shake up the whole functionalmedicine world, that the

(01:03:37):
functional medicine world hasbecome so compartmentalized.
You have your, as Datis says,your green medicine guys.
You have your methylators, youhave these genomic people and
everybody.
And part of a lot of it, Ithink, is influenced by all the
lab companies that are out therethat are driving people to do
it this way or that way.
But they've got away fromlooking at a central mechanism

(01:03:59):
and obviously we believe thatthe central mechanism is its
imbalance.

Speaker 1 (01:04:04):
Yeah, yeah.
So I think that's probably agood segue into interoception in
the insular cortex and we'vebeen talking in general terms
about left brain and right brain, and Rob, you mentioned the
thalamus and Peter you talkedabout, I think you mentioned the
cerebellum and there's allthese different structures and
substructures in the brain.

(01:04:25):
But if we say left brain, thatincludes the left frontal lobe,
the left parietal lobe, the lefttemporal lobe and structures
that are deeper to that.
And I do this all the time.
In fact, I'm traveling toCalifornia in November to teach
our mastering brain chemistryclass and one of the first
things I do is I have peopletake out a piece of paper and

(01:04:45):
ask them to draw a side view ofthe brain and label the lobes of
the brain and just one or twothings that those parts of the
brain do.
And the only people who canactually do that with any
proficiency are people who havetaken the course before, or
maybe it's a functionalneurologist or a chiropractic
neurologist that's taken afunctional medicine course, and
that just underlies that wedon't teach medical chiropractic

(01:05:09):
acupuncture students.
We don't teach them about thebrain, certainly not from a
function standpoint.
Having said that, most docswould probably fail to name the
insular cortex as a part of thecortex, and I know that that's a
somewhat recent classificationor maybe reclassification, that
it's considered its own, I guesslobe of the brain in addition.

(01:05:34):
But it's a fascinatingstructure.
So much is going on there and Iknow, rob, that you have placed
a lot of emphasis of your ownlearning and study and a lot of
the work, peter, that you'redoing with the immune system,
and bringing that in gets to asubcomponent of interoception,

(01:05:55):
which is the thing calledimmunoception.
So let's start with the bigpicture stuff first.
What is the insular cortex?
What does it do?
Why is that important?
And either one of you can takethat yeah.

Speaker 2 (01:06:09):
So when a child is born, obviously from a survival
perspective and remember, theright brain comes online first
and the first job it has is tokeep us alive, right.
So that means that they need,we need to able to non-verbally
communicate to our parents orcaregivers that we're in pain,
that we're hot, that we're cold,that we're hungry, that we

(01:06:30):
thirsty, that we have to bechanged, and smell and taste are
very involved with that right.
So that's online right from thebeginning as a key survival and
to be able to somehow allow ourparents or caregivers to
understand that that all happensin the right brain, in that
right insula, primarily, and sothis is what we call

(01:06:51):
interoception.
So it is really critical tosurvival that we have these
basic senses that we canperceive and that we can
communicate in some way.
But then, built on top of thatare feelings, emotions,
cognitive abilities, especiallythe ability to socialize,
because the number one key tosurvival for humans is we must

(01:07:13):
get along with other people, wemust actually be part of a group
.
You know you couldn't be in theStone Age and be by yourself
for any length of time withoutbeing killed, or if you were
kicked out of a group becauseyou didn't get along, it was a
death sentence.
So again, that hardwired forsurvival should be our drive to
attach to other humans.

(01:07:35):
And so, right from thebeginning, we should attach to
our parents and then, time froma little baby in the crawling,
they should want to be withother children and approach
other children and play withthem like little puppies, and
play with each other and learnhow to read social cues and
mostly non-verbally interactingwith one another.
And that forms the foundationof social emotional connections

(01:07:59):
and emotional regulation, whichis really the foundation of that
wisdom of the brain andself-awareness and becoming
embodied where, at about twoyears of age, a child recognizes
themselves in the mirror andfor the first time says, oh,
that's me, I'm a separateindividual, I own this body,
this is me.

(01:08:19):
And then after that, shortlyafter that, they can then start
to have agency, meaning I cancontrol my actions and I can
have, you know, cause, an effecton the world around me, and
that's really important.
And so what we see is that inkids with autism in particular,
as a model in where I study wesee that that is greatly

(01:08:41):
impacted, where they often havevery, very low or almost absent
interoception early on, whichtells us that that right brain
is delayed.
They don't have a drive toconnect to other children, they
don't become embodied, theydon't ever really get ownership.
And then that left brain comesonline and they don't get agency

(01:09:03):
.
So that left brain is doingthings kind of randomly,
haphazardly they're stimming andthey're moving, and they're
doing all these things andthey're having outbursts, and
their immune system is out ofcontrol and they're not in
control.
They don't feel their body,they can't control their body,
and they know, on the other hand, though, that all their words
are there, they're smarter thanother people around them, they

(01:09:24):
know all of that, but they can'tshow it and they can't say it,
and that's been one of my mainareas of research.
That's taken me 30 years to gethere.
Why don't they speak?
No one's ever explained that,and I think that understanding
the insula and interoception,that's why they don't speak.
They don't feel their tongue,they don't feel their body, they

(01:09:45):
can't control it, and speech isthe most complex motor act, and
without having complete beingembodied, you can't control that
.
So you know this.
Is that why that insula, inparticular, the right insula, is
so important to this.

Speaker 1 (01:10:02):
Is it fair to say that the insular cortex develops
prior to the frontal lobe,temporal and parietal lobes?

Speaker 2 (01:10:11):
Yeah, sure, If we look at the brain as growing
from the bottom up and from theinside out, the insula, if you
cut away the surface of theneocortex and pull it away,
underneath that still part ofthe cortex, but underneath the
male layer is the insula.
So it forms the inside part ofthe brain and really borders on

(01:10:36):
the frontal lobe.
So that, again, self-awarenessand also empathy, theory of mind
, what Peter said, being able tounderstand what other people
are feeling non-verbally thetemporal lobe it borders, so
smell and taste and emotions arethere, and also the parietal
lobe where we have ourvestibular sense and where the

(01:10:57):
world is.
And all of this creates a mapof our body in our brain, so we
know where our body is.
And again, this is part ofbecoming embodied and self-aware
.
And so the right brain is thefoundation.
The insula is the foundation ofthose areas of the cortex and
if that doesn't develop then therest of it will not develop

(01:11:18):
appropriately.

Speaker 1 (01:11:19):
So if that's true, Peter, do we know what the
primary input is into theinsular cortex?

Speaker 3 (01:11:28):
Well, the primary input is going to be more of
this visceral input coming infrom our viscera.
It's going to be more of thisvisceral input coming in from
our viscera, it's going in intothat.
So you know, our organ systemaffirmatively going in and then
also then the connectionsobviously back out to to that
area, to the areas that arestimulating.
So definitely the viscera isgoing to be the main driver to

(01:11:53):
the insulin.

Speaker 2 (01:11:54):
Yeah, so we were just mapping that out this weekend.
Even more greater detail.
There's something called thecentral autonomic network, which
is a newer network that youknow when we talk about.
Where in the brain is theautonomic system represented?
Where is our, our organs andwhere is the immune system

(01:12:14):
perceived, right?
So how do we know to activateour sympathetic or
parasympathetic?
We need to get some sensorytype of signals.
So it really starts with nerveendings in our organs and mostly
travels up to the vagus nerve,afferently into the nodal
ganglion and then up into thenucleus tractus solitarius and

(01:12:36):
then the parabrachial nucleusand then the hypothalamic
pituitary, into the locuscoeruleus, the periacto ductal
gray, the amygdala, the anteriorcingulate, the orbital frontal
and the insula, and that's theconnection up there.
And then there's also a pathwaythat comes up through the

(01:12:58):
spinal cord into the dorsal rootganglion, in through the
spinothalamic tract or theanterolateral system, through
lamina one, up into the thalamus, into the ventral basilar
nucleus and then also into theinsula and into the parietal
lobe.
So that's where theseconnections kind of come from
and you know we're outliningthem even in more detail and

(01:13:19):
that's something we want to do,even more research on.

Speaker 1 (01:13:23):
Would it be fair to say you know you mentioned the
thalamus before as one of thegreat sensory integrators.
Is there an analogous, notrelationship?
But is the thalamus, does itserve the same role in terms of
sensory input, say throughkinesthesia or proprioception,

(01:13:46):
as the insula would in terms of,say, visceroception?
Right, peter was talking aboutthe brain's awareness of the
sensory input coming from ourinternal organs.
Is there that analogous or isthat an analogous situation
between the thalamus and theinsular cortex, or are we
talking at different levels inmore complicated circuits?

Speaker 2 (01:14:08):
No, it's pretty similar, actually meaning that
you know the thalamus, there aredifferent nuclei that go into
the insula and that, you know,go into the parietal lobe and,
as I said, that insula bordersall of that.
So some of the viscerotopicmaps are more like in the
temporal lobe.
But you know, again, we canlocalize right.
When you have stomach pain, youknow, oh, I have stomach pain.

(01:14:29):
That means you have to have amap in your brain, in your
parietal lobe, that allows youto know somatotopically oh, this
pain is coming from my stomachor my heart is beating out of my
chest right now.
Right, it's not necessarily thesame as saying, oh, I'm being
touched here or there.
It's not maybe as explicit thatwe were aware of it.
It's more subconscious and it'smore almost you know, a gut

(01:15:19):
feeling.

Speaker 1 (01:15:19):
It's intuitive, it's harder to put to words, which is
all what you would expect withthe right brain language.
Right, but it's, it's reallysimilar pathways that we would
have for the be fair to say thatinteroception at a very top
level is the brain's awarenessof everything that's happening
inside the body.

Speaker 2 (01:15:30):
Yeah, I think that, yes, on the internal part of our
body, you know, being able tofeel again, like, like I said,
feeling if your stomach hurts,if your heart is beating, if you
feel nervous, if you feelanxious, if you feel sick to
your stomach, you know.
Or if you just have thissubconscious intuition that I
shouldn't go there, that'sdangerous.
All of that is is part of whatI would look at as as

(01:15:53):
interoception.

Speaker 1 (01:15:54):
Right, and so that's the umbrella category.
There's different subcategoriesVisceroception is one of those,
and immunoception, peter, Iwant to throw that over to you
here in a second.
But it occurred to me that, asyou were describing the
circuitry going, say, frominside the body up through all
these different structures tothe insular cortex, it seems to

(01:16:18):
me, especially as it relates tovisceroception, that a lot of
the focus and attention that'sbeen placed on the vagus system
or the vagal nerve, and tryingto harness that as a therapy to
improve autonomic control oranxiety states and calm people
down, all this kind of stuff.

(01:16:39):
Are we really trying to accessthe insular cortex through the
vagal system?
Is that really what we'retrying to do?

Speaker 2 (01:16:46):
So, when you look at where in the brain is the
representation of thesympathetic and parasympathetic
nervous system?
Where in the cortex right?
I mean again, hardly anybodyhas ever really talked about
that, we don't think about it.
We know there's brainstemmechanisms but ultimately it
comes into the brain andsomewhere in the cortex has to
perceive it and then modify it.

(01:17:07):
And that area, that primaryarea, is the insula cortex.
On either side, we believe theleft side is more sympathetic,
the right side is moreparasympathetic and ultimately
where the vagal afferents gointo is into that.
They ultimately end up in theinsula, especially in the right
insula.
So therefore, you know again,just affecting the vagus nerve

(01:17:31):
isn't affecting the brains.
You know again, it's likeanything else.
It's like saying you know, Iwant to affect something, a
higher level skill, and I'mgoing to do it through basic
nerve stimulation.
There's some input, butultimately it's the
parasympathetic system.
That's why it bugs us when wehear people saying, well, just
stimulate the vagus nerve.
It doesn't work that way.

(01:17:52):
And then which one are yougoing to do?
Are you going to do the rightversus the left, because that
matters, right?
So it's more complicated andultimately does come down to
that insula.

Speaker 1 (01:18:01):
So, peter, would you say that if someone's interest
is to drive the vagal system,they'd be better off activating
the insular cortex?

Speaker 3 (01:18:13):
Yeah, I mean, I think that's where we're at at this
point, where I mean we've playedaround with different types of
vagal stimulators at differentfrequencies and at different
anatomical relationships and wehaven't seen it have the
proclaimed effect that othershave where we go in and we start
obviously stimming.
And I think part of it also,too, may be the fact that those

(01:18:36):
people are not obviously drivingthis from a developmental model
.
We're driving a developmentalmodel.
We're looking at where some ofthe roadblocks are in the
brainstem and the vestibularsystem and the cerebellum and
its relationship to thelateralization.
Because I think Dr Millerbrought up a good point earlier
where again, this idea that thebrain is not only developing

(01:18:57):
vertically but it's alsodeveloping from a posterior to a
frontal relationship and it'salso actually maturing from a
medial to lateral relation.
So, and we look at, you know,obviously, that kind of like
medial, maybe intermediate areaof where the insular is talking
about and then around it that hewas talking about, that you can

(01:19:17):
cut out is, you know, obviously, probably the posterior
structures of the frontal lobewhere it meets the parietal lobe
.
But also, you know, getting'refinding out now is where, when
we're doing a bottom-upstimulation model of stimulating

(01:19:38):
these networks, then we startable to come in and start doing
top-down modulation okay, withour other more sophisticated
therapies.
And so I think that that's whatwe're finding out that we could
probably have a better effecton that network of the insular
and the salience network that'spart of that insular

(01:19:59):
relationship through some of ourtop down treatments, but it's
superimposed on the bottom uptreatment that we did.

Speaker 2 (01:20:08):
Yeah, right, yeah, because in the brainstem, there
where the primitive reflexescome from, is where the two
primary or three primary nucleiof the autonomic system sit
right.
So the dorsal motor nucleus,the rostral, ventral, lateral
medullary nucleus, which is themain nucleus for the sympathetic
, and then the nucleus ambiguous, so that's that whole polyvagal

(01:20:31):
system that Porges has talkedabout.
And so, again, if thosereflexes don't go away, that
nucleus ambiguous and thatparasympathetic nervous system
which has a lot to do with thefeedback into that insula,
ultimately, as it grows up, doesit mature, and so it prevents
that maturation and it preventsthat development of that that

(01:20:55):
you know, input into the insulaand growing it, along with motor
input and sentry input thatgrow all aspects of the brain,
so that you know that brainstem.
And looking at those reflexes,if those reflexes are there,
then the person has not had theoptimal or appropriate
development also of theirautonomic system and that insula

(01:21:17):
.
And again, so that's where alot of this starts.

Speaker 1 (01:21:21):
Yeah, and so I mean to create an analogy.
If you have a home with a wallthat's not on the right angle
because the foundationunderneath has cracked it, you
can fix the wall over, and, overand over again.
It's still going to go out ofalignment, so to speak, until
you fix the foundation exactlyso peter, when you were saying,

(01:21:41):
starting from the bottom up,you're talking identifying and
then remediating these retainedprimitive reflexes, and then
that is your foundational piece,and then moving up from back to
front and then from medial tolateral is kind of a sequential
process.
Is that what I'm hearing?

Speaker 3 (01:22:01):
Yeah, I mean because we start eliminating those
primitive reflexes, at the sametime we're also activating the
vestibular nuclei and firingthose vestibular pathways,
because part of those primitivereflexes are reflex and
symmetrical tonic neck reflexeslike labyrinth reflex, marrow
reflex.
These are reflexes that arealso involved in vestibular

(01:22:24):
functionality and so a lot oftimes we see immature vestibular
function.
Then we also know we haveimmature muscle tone.
So we're not getting thatfeedback, that sensory feedback,
from our muscles into ourspinal cord then traveling up to
our cerebellum.
So we know that the areas thatare dependent on that input are

(01:22:46):
not receiving that input, thestimulation that's coming in
activating these experiencingdependent genes to fire these
particular or create thesedifferent connections in these
variolobular areas and they'redependent on that.
So you have to fire the brainthrough its two primary systems

(01:23:08):
and firing it from aproprioceptive-based scenario
and a vestibular-based scenario.
Proprioceptive-based scenarioand a vestibular-based scenario.
And many times when you'reactually doing the remediation
of these primitive reflexes,you're doing activities that are
actually firing those systems.
Okay, so you are firing theproprioceptive system and you're
firing in the vestibular system.

(01:23:30):
Now we're doing it probablymore in an asymmetrical way that
we're looking at theasymmetrical presentation,
because a lot asymmetrical waythat we're looking at the
asymmetrical presentation,because a lot of people again
are looking at primitivereflexes more than ever,
probably because of theawareness that Dr Malou has
brought to the topic over thelast 20 years.
And he does have the number onemost published, the number one
ranked paper in primitivereflexes in PubMed.

(01:23:50):
So you know and we know hispapers are being referenced.
But the bigger thing is theasymmetrical relationship of how
we rehabilitate.
And then the same way comesinto how do we look at the
asymmetrical difference inbetween one vestibular system
versus the other vestibular, onecerebellum relationship to the
other cerebellum.
So that's how we're trying todrive up those systems.

(01:24:13):
And then we're coming andstacking on top of that.
Or multimodal aspects ofauditory input Do we want to
activate one auditory systemversus the other?
Do we want one visual systemversus the other?
How about somatosensory input?
So we're going to do that.
Or olfactory stimulation, sowe're going to look at that in
terms of a laterality aspect.

(01:24:36):
And as we do that, then weshould start seeing this
top-down maturation.
That's happening and we'reseeing the formation of these
more sophisticated frontalstriatal systems, the frontal
pathways of the development ofthe frontal lobe, the oval
frontal area, the intermediatefrontal lobe, the lateral
frontal aspects that are thengoing to dry down and fire and

(01:24:57):
really put modulation on thosedifferent primitive aspects of
inhibiting those primitivereflexes but also dampening the
output of some of those deeperparts of the brain like our
limbic circuitry, of ouramygdala and our other
structures that are in theanterior cingulate and so on,

(01:25:18):
and also our basal ganglia, andbeing able to modulate the
output of that basal ganglia.
So we're not getting overfiring, especially of that
direct pathway that's producingthese hyperkinetic type of
movements or these obsessive,compulsive types of functions
that we see from yeah, um, youknow you, you mentioned

(01:25:40):
multimodal um, and and that isthat's the nature and the
essence of the insular cortex.

Speaker 1 (01:25:48):
Right, it's, it's, it receives and transmits
olfaction and gustatory senseand auditory and visual and
somatosensory and vestibular.
It's got connections to thefrontal lobe and it almost seems
like it is the central nexus,which makes sense.
I mean what you're saying aboutdevelopmentally the primitive

(01:26:09):
reflexes and brainstemmaturation drive the insular
cortex.
The primitive reflexes andbrain stem maturation drive the
insular cortex and that seems todrive development of all of the
other cortical lobes, whichmakes total sense.
We have been speaking as ifright brain deficiency or
decreased right braindevelopment seems to be like the

(01:26:32):
root of all evil, and thatcertainly is true in the
autistic spectrum disorders,aside from developmental issues
that we would put on thespectrum, if we talk about the
adult population and things likeanxiety, depression, ocd, you
know very common things that wesee in clinical practice.

(01:26:52):
You know very common thingsthat we see in clinical practice
.
Does it still hold true thatthe right brain tends to need
care, or do we see an equalsplit between right brain and
left brain, or do we see mixedpatterns where it's not the
whole right brain or the wholeleft brain.
It's a little bit on the leftand a little bit on the right,
like what's the, what's thespread and the diversity on the

(01:27:14):
clinical presentation side.

Speaker 2 (01:27:16):
Yeah, I think that you know.
For when you look at it as aspectrum, like going from more
least severe to most severeright the least severe there are
just a little bit ofaccentuated asymmetries, right,
but there's a little bit of adeficiency on one side, a little
bit on a deficiency on theother, or we may have one side

(01:27:37):
that's really dominating.
And as we go down the road Ithink we see more and more of
these clear asymmetries where wehave this deficit and
overactivity.
And so the right brain again,when we talk about the root of a
lot of autism and a lot ofmental health issues, alan Shore
really describes it's reallygood in his book.

(01:27:59):
You know they're almost allright brain but then also an
accentuation of the right brain.
So deficiencies butaccentuations are what's driving
things like anxiety at a biglevel, social anxiety, things
like anxiety at a big level,social anxiety, fear, sense of
danger, embarrassment, shame,guilt.

(01:28:22):
The right brain generatessadness.
The right brain generatesembarrassment.
The right brain generates fear.
The left brain is happiness, isjoy, is pride and anger right
and aggressiveness andmotivation right.
So when we have these rightbrain like this guy I was just
talking about, I mean his rightbrain is out of control.
He's been dyslexic his wholelife.
Again, he goes back to earlychildhood.
All of his primitive reflexeswere there and very creative.

(01:28:47):
He's an incredible athlete.
He was a great artist.
He wants to.
His dream when he was a kid wasto be a stand up comedian Right
.
So all of these things arethere.
Those are the traits that he'sbuilt on.
But what happens is that rightbrain becomes overactive.
It's hypersensitive.
It the insula and the anteriorcingulate on the right in
particular generate.

(01:29:10):
It's like the early warningsign.
Like you know, why are we goingto be vigilant to something?
Why are we looking at something?
How do we pay attention?
So the salience network saysthis is important.
You know, pay attention, payattention.
And then it activates theattention network and the right
brain is overactive.
In kids with dyslexia, they paytoo much attention to facial

(01:29:33):
expressions.
In kids with dyslexia, they paytoo much attention to facial
expressions and it has thisincredible effect on causing
this dramatic stress response intheir body and it can be
overwhelming, like they're tooaware and they don't know any
different.
This has been as they've beensince the beginning of their
life and so they feel likethey're being judged by others
and they feel they have lowself-esteem even though they may

(01:29:54):
be incredibly talented andcreative and have great
abilities.
So you know the overactiveright.
These are people that will killthemselves because they feel
such hopelessness, such depth ofsadness, shame and guilt.
So you know, lack of joy andhappiness with overwhelming
sadness combined with guilt andshame, that's the definition of

(01:30:17):
major depressive disorder andthat's what it is Recipe for
disaster.
And that is bipolar disorder,where you get overactive on that
right where schizophrenia is,you know overactive on the left.
So the right brain, though youknow, from a standpoint of being
deficient and how it affectsthat insula or overactive, where
you're too connected to yourbody, you're too connected to

(01:30:40):
your emotions, you're in suchemotional pain or you're so
hypersensitive to other people'semotions.
That also is devastating and wesee this epidemic of anxiety
right now and a lot of it isdriven by that overactive right
brain.

Speaker 1 (01:30:57):
Interesting.
So I know that you're adetail-oriented person.
Have you tracked stats in yourclinics or do you have a sense
of what the relative dominanceis of a right brain deficiency
versus an overactive right brain?

Speaker 2 (01:31:13):
Well, you know, if we look at just the statistics out
there right now, obviouslyautism, adhd, ocd, tourette's
and tics is increasingdramatically.
Right, we know that, you knowthe epidemic rise.
But we also see the anxiety isthe number one mental disorder
amongst people and a lot of thatis driven by overactive right

(01:31:34):
brain.
And we know that the number one, you know, disability of all is
really learning disabilitiesand in particular, dyslexia,
which affects almost 20% of thewhole population.
So both of them are pretty big.
It kind of like anything else,Steve, it's like you know where,
what do you attract into yourpractice?
Right, but it's, it's pretty,it's pretty equal.

(01:31:57):
Although you know, working withchildren and looking at who's
going to seek out that type ofcare, you know the parents of
kids with right brain deficitsare usually become aware of it
much earlier.
And especially, you know we'reworking with very severe kids
that aren't speaking, and youknow.
So that is, you know, thepeople that are going to be most

(01:32:18):
desperate right off the bat,seek help right away and travel
from all over the world.
So our practice, the majorityof it, is in that area, but you
know, but there is, you know, anequal amount of people walking
around with that big right brainissue and is really struggling
so that that's the personallyfor me.

Speaker 3 (01:32:36):
I mean, that's been my life.
My, my early developmentaldelay was a learning disability
and Wasn't able to read andforget.
I was a good athlete but alwaysbeen very, you know, over,
probably sensitive andhypersensitive to people's
emotions and tone of voice andwhat people perceive them.
You know, am I good enough?

(01:32:58):
you know, again, going back toyour earlier vision myself, you
know, doing achieving what I'veachieved at this point
professionally, you know,probably early on in my life,
probably not, probably wasn'tsomething that you know, in my,
in my third grade, fourth grade,when I was in special ed
classes and being made fun ofand all the time, and then my
escape was, you know, obviouslyyou know playing sports, but the

(01:33:22):
struggle was real anddevastating for many years, with
the difficulty with reading andlearning and more than anything
, as that, somehow, you know,through just the luck of what my
mom did for me, somehow kickedmy left brain in and got my left

(01:33:45):
brain to develop by the time Iwas like seventh and eighth
grade.
But it's always been somethingthat you know I've had to be
very hyper aware in my 20s andeven now that I still have to
stimulate my brain at timesbecause my salience can really
take over and sometimes drivesome almost like manic behaviors
in the sense of like what DrMiller refers to as bipolar
aspects.
You know you can get really sadand you can get really

(01:34:08):
especially when I lost my dad 20some odd years ago Tough time
in my life to deal with that,you know, and really not try to
like completely withdraw fromeverything.
So this is a real thing and Ithink you know, like Dr Miller
says, that you know you have,you know, 20% of the population
of children that have learningdisabilities but no one's

(01:34:32):
associating everything else thatthey're dealing with the
anxiety or maybe being veryintroverted and not really
wanting to be, even though theysocially can.
But you want to be withdrawalbecause of that left brain

(01:34:52):
overactive, right brain sorryand you don't have that approach
, behavior that you want to gotowards people.
So that's a big thing is that Idon't think anybody's put that
relationship together, otherthan for Dr Malolo to say that,
hey, these learning disabilitiesare one thing, but the bigger
thing might be what comes downin terms of depressive and

(01:35:13):
higher forms of social anxiety.
I don't think anybody's madethat leap yet other than him.

Speaker 1 (01:35:19):
Is it always the case that a dominance pattern is
caused by a deficiency of theopposite hemisphere?

Speaker 2 (01:35:29):
Yeah, I believe that's the general reason.
So you know, when I was firstlooking at this, Steve and again
, you know there's a lot ofdifferent things out there and
people like you know talkingabout whether it's overactivity
causing symptoms orunderdevelopment, or what is
what's the chicken, what's theegg, right?
So when you look at theattention research out there

(01:35:50):
that's been out there for yearsand it's probably more studied
than anything else they lookedat that and they were saying
that you know, it's kind of likethis flashlight thing, meaning
both sides of the hemispheres,you know, shine light on the
opposite world, right, and payattention to it.
And so they were saying that,you know, it looks like you know
where our attention is drawntoo much to one side of the

(01:36:12):
world and away from the other,and that's what we call neglect
syndromes, right.
So you know they were saying,well, is it overactivity of the
attention network or is it anunderdevelopment or injury to
the other attention networkwhich causes that one to
overcompensate?
And what the literature clearlyshowed is that it was initiated

(01:36:33):
by the underactivity of oneside or the underdevelopment or
the injury, and so theunderdevelopment is what
initiates it, and then thatpromotes the overactivity and
then the overactivity becomes aproblem.
And you know, and we addressboth, so both sides are a
problem.

(01:36:53):
You know people havemisconstrued my work and say,
say well, he's only working onone side of the brain or the
other.
No, we're always working onboth sides of the brain, but
we're focusing it primarily onthe deficit.
But now we have new tools thatdeveloped over the past 10 or 12
, 15 years that we can do thingsto actually dampen the brain in
a safe and effective way.

(01:37:14):
Things like transcranial,direct current or alternating
current or magnetic or usinglasers in a particular way,
where we can actually then bothdampen and activate.
When you're dealing with higherfunctioning things and things
that are, you know, kind ofmilder imbalances, just activate

(01:37:35):
the underactive side is enoughto cause that, to inhibit the
other side and drive it down.
But when you're dealing withsomething like autism, where
they're stimming constantly andeverything they're doing is
feeding that left brain, orsomeone with so much anxiety,
where their, their thoughts areso perseverative on all of the
negative fear or whatever umthat it's, unless you can dampen

(01:38:01):
that it may not release theimbalance.
It's almost impossible toovercome that.
And so we've we've been able toreally inhibit things and, and
you know, and that was one ofthe reasons why you know, I
really developed that with KevinJames when he spoke on Joe
Rogan about how I helped hisdaughter.
That was one of the things thatreally we were developing that

(01:38:23):
and allowed us to get rid ofthose horrible tics that she
developed because of that, notonly stimulating that right
brain but really driving downthat left to be able to allow
that right brain to arise up.
But the initiator is always thedeficit that leads to the
overactivity.
But both of them becomeproblematic, Both of them become

(01:38:45):
symptomatic and we need toaddress both when we're when
we're looking to resolve theseissues.

Speaker 1 (01:38:51):
Yeah, you know, I was just thinking more on the
metabolic side that if you havea very significant asymmetry,
let's say it's a left brain,dominant right brain, deficient
situation, increased rates ofneuronal activity demand higher
energy utilization and it seemsto me that these situations

(01:39:15):
would almost beself-perpetuating, that a
dominant left brain wouldutilize, say, more than 50% of
the energy supply, which wouldleave the right brain, which
needed stimulation and needsenergy for that stimulation to
work, it would leave it at adeficit and you're almost locked
into this pattern which becomesself-perpetuating.

(01:39:37):
Would that be an accuratestatement from how you guys see
it?

Speaker 2 (01:39:40):
Yeah, and then if you try to treat it and you do
everything equally to both sides, that hyperactive side is going
to pick up on it quicker thanthe other side, and so it
actually creates more of animbalance.
This is what no one seems tounderstand.
That you know, and that's whyeverybody's like well, don't you

(01:40:00):
have to work on both sides?
No, if you work on that side,that's already.
Everything they do isconstantly stimulating that, and
now you feed into that more.
Yeah, is there maybe adeficiency on that side?
Yes, but it's.
You know, and that's why youknow, if you don't do modalities
in a directed way directed toincrease one side and decrease

(01:40:23):
the other and you just work tostimulate both sides, you end up
stimulating the overactive sidemore and that further inhibits
the other side and it actuallycreates more of an imbalance.
And so you know, that's howmost therapists are trained.
You know, even as chiropractorsadjust one side, adjust the
other, you spin them in one side, you spin them in the other.

(01:40:44):
You stimulate one side.
You stimulate just by changingthat and only directing it.
You know the, the increasedstimulus to one and the decrease
on the other.
That changes everything.
And it's for exactly what youjust said.

Speaker 1 (01:40:59):
Yeah.
So just to pick up on, you saidlike DC, current transcranial
stimulation, would it be?
And I'm just thinking off thetop of my head as we're going
through the conversation You'reusing some kind of a DC, direct
current stimulation.
If you wanted to inhibit onepart of the brain, let's say on

(01:41:21):
the left, you would put thereference lobe over a specific
Broadman area, right, thecathode the negative.
And then you would put the otherelectrode on the right side
over a Broadman area that youwant to activate.
Would that be a rough approach?
Other electrode on the rightside over a Brodmann area that
you want to activate.

Speaker 2 (01:41:37):
Would that be a rough approach?
Yeah, the anode, the red lead,goes over the side you want to
activate, over a particularBrodmann area that we want to
activate, and then, usually onthe exact same other side, we're
using the cathode to and thisis literally how it works and
there's a lot of research thathas proven that that it actually
drives and more hyper polarizesone side and depolarizes the

(01:42:00):
other, and it literally can beused to help induce a balance,
but that's a top down effect.
So if you're not working on thebottom up at the same time,
right then you may have aneffect, but that effect will
only be temporary.

Speaker 1 (01:42:15):
Yeah, yeah.
And let me throw a caveat outthere, anybody who's listening,
don't just go buy a DC unit andstick it on your brain and turn
the dials Like there arespecific protocols that these
docs have developed that make itsafe and effective.
So that's just my publicservice announcement, right
there, peter.

Speaker 3 (01:42:33):
Well, what I was going to say is that that bottom
of interference is what DrMalone was really alluding to,
that idea that when we have theretained primitive reflexes, or
we have the immaturity in thevestibular system or the
immaturity in the cerebellum, wejust have this tremendous
interference.
That's happening and we're notgetting that higher level of

(01:42:56):
lateral lateralizationspecificity of those those lobes
that we've been talking, okay,yeah, and we're not getting that
maturation of posterior tofrontal mechanism.
You know when we're, when we'redoing everything.
We just have this very specificdevelopmental blueprint that Dr
Mool has created over the yearsthat takes us through these

(01:43:18):
longitudinal processes andrelating it to where we have a
vertical development, we have ahorizontal development and then
we have an integrative model.
So I think that, again,sometimes that's lost in how
people view his model.

Speaker 1 (01:43:33):
Yeah, I want to ask you guys about cold plunges, but
let me do a time check here.
We're at an hour and threequarters.
We haven't even talked aboutimmunosception yet, so I'm good
to stay on.
We can either finish theconversation if you guys don't
have a hard time limit, or maybewe could do a part three.

(01:43:53):
It's up to you.

Speaker 3 (01:43:54):
How do you guys want to handle it?
You want to do a part three.

Speaker 2 (01:43:57):
Yeah, I think a part three would be good.
I think we've gotten a lot ofstuff, but this is also a lot
for people and we, you know itmight overwhelm people there,
but and I think leaving them foryou know more I think would be
good, and then we can do a partthree and really get into that.

Speaker 1 (01:44:11):
Yeah, cause this is great.

Speaker 2 (01:44:13):
You're doing a great job, steve.
You're really bringing up a lotof things you know.
You really appreciate that.

Speaker 1 (01:44:18):
I appreciate it.
So let me throw this one out asas the last question.
Um, you know, there's withthings like cold plunges which
of course is like the new shinytoy that everyone talks about
and does, and, um, I've never Ihaven't heard anyone talk about
it from a neurologicalperspective, certainly not an

(01:44:39):
interoceptive perspective.
It's usually, you know, heat,shock proteins and you know
maybe some immunological impacts.
But because the insular cortexdeals with um, you know thermal
sense and my understanding isthat cooling will act, activate
the insular cortex, more thanheating will.
It seems to me that perhaps oneof the primary mechanisms that

(01:45:02):
cold plunges can be beneficialfor people with autonomic issues
, with autoimmune issues, withpsychiatric issues, is this
relationship of I get in reallycold water, it's painful, it's
uncomfortable, but it's going todrive my insular cortex and
from there I start to get.
I get this, even though it'sgoing to be bilateral, I still

(01:45:24):
get this increased ability togovern and control things Right.
Have you guys looked at coldplunging from that perspective?
I mean, I know it sounds goodon paper, but are you guys using
and leveraging that in practice?
Or are you doing things like Iactually did something myself,
because I was doing someliterature review today and I

(01:45:49):
was listening to Mozart's SonataK488 in my left ear and I had
my left hand in a bucket of icewater while I was doing some
work yeah.
And the intent was to bias thethermal.
You know, basically it was aleft-sided cold plunge, but just
with my hand.
My rationale was, if you lookat the somatosensory cortex and

(01:46:12):
the sensory homunculus, you havemore representation in your
hand than you do, say, in yourcore.
So I thought, well, I don'thave a cold plunge, so I'll just
stick my hand in a bucket ofice water and I will listen to
Mozart.
And that's been studied.
That particular sonata has beenused in studies on treatment

(01:46:33):
for schizophrenia with success,and the link is increased,
insular, but the paper and theresearch didn't seem to be
designed for laterality.
So I you know, had my headphones, I took my right earbud out so
I listened to it through my leftear, had my right hand Not that
I think that I have any rightinsular cortex I just wanted to
see what happened and I was justkind of casually watching my

(01:46:55):
iWatch and checking my heartrate and, sure enough, my heart
rate starts to come down alittle bit.
I feel this sense of relaxation.
Anyways, you know, just kind ofspitballing and trying to
synthesize all this information.
But the question is about coldplunges and insular cortex
activation, and could it belateralized, kind of like the

(01:47:17):
way that I was doing?
Does that make sense?

Speaker 2 (01:47:20):
Yep, and I'll give you an example of it.
So this isn't just theoretical,it's, it's um, you know, when
looking at the idea, all of this, you know, and the idea of
self-awareness, and using as amodel the neglect syndrome,
hemi-neglect syndrome, which isa loss of body ownership right,
and that is related to rightparietal strokes, so strokes

(01:47:43):
that involve the inferiorparietal lobule, which is broad
area 39 and 40, which is whereour primary area for a lot of
proprioceptive input come from.
We know, when there's strokesthere, people may lose the
perception of the left side ofspace and again, this is when we

(01:48:06):
see these attentional mechanismshifts where they only see the
right side of the world.
They literally don't see theleft.
So there's a lot of differentstudies looking at things like,
you know, a T 10 unit on theleft side of the neck, vibration
from the left side of the body,optokinetic stimulation.
But there was always studieslooking at cold caloric
irrigation of the left ear andit always threw me off because I

(01:48:27):
was like cold caloricirrigation from the left ear
should inhibit the rightparietal lobe, from the left ear
should inhibit the rightparietal lobe, not activate it,
right?
But yet it was one of the bestthings for bringing back body
ownership.
And so I thought about it andsaid, and then, once I started
really understanding and lookingat the insula, I said, okay,

(01:48:49):
the effect isn't the caloricirrigation of the inner ear,
it's the cold in the inner earthat is activating the right
insula, which is actually givingbody ownership and actually
reducing the neglect syndrome.
It's the cold that's doing it,because otherwise, based on what
we know, you know, putting coldwater in, and one of the things

(01:49:10):
that was a key phrase in theresearch was that it was done
below the level of nystagmus, soit wasn't doing it to the point
where it actually creatednystagmus, so it wasn't an
actual inner ear vestibulareffect.
So what was it?
It was a cold effect, it wasthermal.
And so that's where, when wetalk about again, you know,

(01:49:32):
again, um, you know, people saycold is stimulating the vagal
system.
What do you mean?
So I do believe that is morelight, that if you use a cold
plunge it's more lateralized tothe right, it's more activating
the parasympathetic versus thesympathetic, and that's why your
heart rate went down, um, andthat if you do it to the left
side, it's going to have even amore lateralized and more

(01:49:55):
specific effect and, yeah, thatis something that we do
sometimes use as a modality likethat, although, you know, again
, it's kind of hard to get a kidand force them to put their
hand in cold water or hot water,but many of them don't even
feel that, they don't even feelit.
I mean, I had a kid recentlythat the parents were saying
that we know they don't evenfeel, that they don't even feel
it.
I mean, I had a kid recentlythat the parents were saying

(01:50:16):
that we know they don't feel hotand cold and that's a deficit
of the right insula.
And they said you know, theydid something in class where
this is like a five-year-old kidand where they were having
these kids, you know, hold icecubes in their hand and put it
in warm water.
And this one little girl washolding onto the ice cube and
she wouldn't let go of it.

(01:50:37):
She kept on holding onto it andholding on where the other kids
couldn't hold it anymore.
She didn't want to let go of itand she never did until it
melted and she's not evenperceiving it, and that's
something we see all the timeand that's a basic question we
ask.

Speaker 1 (01:50:50):
Yeah, I know, I know in our world, like we all, have
miracle stories, but I have avery short, a cool story of
using a cold caloric and resolvethe case of cortical blindness.

Speaker 2 (01:51:05):
Wow, wow, yeah, well, well, you know.
Again, it'd be interesting toknow if that cortical blindness
was partly a neglect syndrome,um, you know, and maybe a visual
neglect, and that, you know, byusing the cold, you, you know,
activated and, you know, createdmore integration in there.

Speaker 1 (01:51:21):
Yeah, yeah, and it was, you know, 20 odd years ago,
so I don't remember all thespecifics of the case.

Speaker 2 (01:51:26):
But yeah, that's pretty wild.

Speaker 1 (01:51:28):
Yeah, nevertheless, all right, so we're resolved to
do a part three, absolutelyMaybe.

Speaker 2 (01:51:33):
All right, so we're we're resolved to do a part
three, absolutely.

Speaker 1 (01:51:34):
Maybe there's going to be a part five somewhere
along the way.

Speaker 2 (01:51:37):
Maybe, if there's a demand, why not?
That's right.

Speaker 3 (01:51:40):
Absolutely, because we are working on multiple
immunological pathways right nowand trying to get some papers
written, so I'm sure we'll haveplenty.

Speaker 1 (01:51:51):
Yeah, so I mean let's .
And even even if the you knowpart four, part five or six
months apart, that's pretty cool, I'd love to have you guys back
.
This quality and this level ofconversation I think is unusual
for the podcast world Right.

Speaker 2 (01:52:06):
Absolutely.

Speaker 1 (01:52:08):
I truly respect and admire and appreciate your
expertise and certainly yourtime, and admire and appreciate
your expertise and certainlyyour time.
Any parting words of wisdombefore we hop off and then
furiously text each other tofigure out when the next
conversation is going to happen.

Speaker 2 (01:52:24):
You know I think you know from the very beginning you
mentioned that very few peoplereally understand functional
neurology and really don'tunderstand the brain, and that's
what prevents them from reallydoing that, and I think this was
a demonstration of that.
All of these terms, all ofthese pathways, all of these
neuroanatomical locations andthings, we use them fluently as

(01:52:45):
part of our language.
This is what we do and this, tome, is really the essence of
what functional neurology shouldbe the understanding of that.
And if you don't have thatlevel of knowledge of the brain,
then you know you really haveto be careful.
What you're saying, thedifferent comments, the
limitations you put on treatment, telling people that you can't

(01:53:06):
get that better when you reallydon't know what the problem is.
But you know, this is a gooddemonstration of we're not
saying these phrases to impresspeople.
This is how we talk, this iswhat we do.
It's the language.
Yeah, yeah, this is it.

Speaker 1 (01:53:20):
I don't know any other way to actually think of
it.

Speaker 3 (01:53:22):
Yeah, yeah, I think that's great because I think
what we've always said, andespecially when we did our New
York courses this past year, youknow, we talked about how you
know, Rob was probably teachingthem French and I was teaching
them German we were layeringneurology and this very
sophisticated anatomicallanguage of neurology and the
way we did it and the way wetaught it, and I think that

(01:53:43):
that's where for clinicians outthere that really want to
probably up their game, I dohighly recommend that they maybe
participate in taking the 10courses that we taught that are
available online now, because wereally did, I think, you know,
probably the best we've everdone and the best I've ever seen
Dr Millel do it.
But we put it together in suchan orderly way that you can go

(01:54:07):
from one course to the next andsee how we taught developmental
neuroscience and thendevelopmental immunology in a
very, you know, a sequential way.

Speaker 2 (01:54:18):
Yeah, yeah, and I also have a neuroanatomy course
for that reason as well, tooadvanced neuroanatomy, clinical
neuroanatomy.
But you know, I was just inGermany, I was lecturing to a
large group of chiropractors inDusseldorf, and it was a great
organization, a great group andand whatever.
And one of the things that oneof the doctors was saying is
that they were really excitedbecause their goal was to bring

(01:54:38):
you know, make sure that youknow they had world-class
chiropractic and healthcare inGermany, Right.
And so you know, when I did mylecture, the first thing I
talked about well, if you wantto bring world-class, if you
want to bring world-classchiropractic, you have to be the
world, you have to beworld-class, right, and you have
to know this stuff at aworld-class level.

(01:55:00):
That's where it starts, youknow.
You can't just sit back and go.
We want to bring it to that.
No, you have to do it, you haveto learn it If you want to
learn the information and befluent with it that way, and
that's, that's all there is toit, you know.

Speaker 1 (01:55:16):
And, uh, we'll leave it at that.
What's the website where docscan go if they want to learn
more about the training courses?

Speaker 2 (01:55:23):
Dr Robert Melillocom.
Um, you know, we can sign upfor the courses there.
There's information on them Ifthey go to the website.
Um, you know, under coursesthere's there's a lot of
information and yeah, so, andit's all there, it's all online
at this point as well.

Speaker 1 (01:55:41):
All right, Rob, Peter , guys, thank you so much and
I'll be in touch soon.
We'll schedule part three.

Speaker 2 (01:55:47):
All right, steve, great Thank you.

Speaker 1 (01:55:48):
All right, you guys have a great night.
Bye.

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176 | Defeating Autism and ADD (Part 2) : Innovating Treatment for Neurobehavioral Disorders with Dr. Rob Melillo and Dr. Peter Scire

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}176 | Defeating Autism and ADD (Part 2) : Innovating Treatment for Neurobehavioral Disorders with Dr. Rob Melillo and Dr. Peter Scire