Dr. Michael Broukhim shatters psychiatric norms with remarkable results, proudly owning his identity as the "anti-psychiatrist psychiatrist." Our conversation reveals why this integrative practitioner achieves what many consider impossible: helping patients recover completely from conditions typically labeled as chronic.
The heart of Dr. Broukhim's revolutionary approach lies in his expansive understanding of faith not as religious doctrine, but as "a belief that there is value in connecting with other beings." This inclusive definition becomes a powerful prognostic factor for recovery. Patients recognizing the importance of connection with humans, animals, or plants demonstrate dramatically improved outcomes compared to those remaining isolated.
We explore the fascinating science behind storytelling as medicine. Did you know 80–90% of your brain cells are actually immune cells? Dr. Broukkim explains how negative thoughts trigger inflammatory responses that can lead to autoimmune conditions, while positive narratives promote healing—the biology behind placebo and "nocebo" effects. This understanding transforms mental healthcare from symptom management to genuine healing.
Originally destined for internal medicine, Dr. Broukhim found his calling in psychiatry through the profound human connection it offered. "I've never had a boring day of psychiatry," he shares. "If a patient's being open and authentic, every person is very interesting." This passion for authentic human connection has expanded beyond his clinical practice to iexperiencelife.com, his consulting company, and soon into rabbinical studies, all pathways to help people navigate crises of meaning before clinical conditions develop.
The most powerful medicine might be reconnecting with others and transforming the stories we tell ourselves. Whether you're struggling with mental health challenges, supporting someone who is, or simply curious about innovative approaches to wellbeing, this conversation offers genuine hope and practical wisdom for true healing.
Learn more at iexperience.life!
Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.
Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:00):
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
Me Next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
(01:04):
Today's guest challengeseverything you think you know
about psychiatry.
Dr Michael Brakeem is anintegrative psychiatrist and
medical director of HopeIntegrative Psychiatry, a
practice that blendsconventional treatment with
holistic healing andstorytelling.
His journey into medicine wassparked by his father's cancer
diagnosis, kept hidden from himfor nearly a decade, and shaped
(01:29):
by a mission to heal beyond thelimits of traditional care.
After falling in love withpsychiatry, just two days into
his rotation, dr Brakeemredefined what healing could
look like.
He's built a thriving clinic,developed innovative training
programs and launched IExperience Life, a consulting
company that bringspsychological and spiritual
(01:52):
insights into industries,organizations and creative
projects.
Now he's even preparing toenter rabbinical school.
In today's episode, we talkabout why most mental health
conditions are not chronic.
We discuss a more encompassingdefinition of faith and how
faith and connection are centralto recovery, and the ways
(02:13):
storytelling and the stories wetell ourselves can truly
transform our lives.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
(02:36):
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next with DrMichael Bracheem.
Hey, michael, thank you so muchfor joining me on Shadow Me
Next.
I am so interested to hear whatyou have to say about your
whole journey and how you treatpatients I'm excited to talk
about a variety of topics.
(02:58):
Excellent Good.
So, first and foremost, I wouldlove for you to explain one of
the ways you describe yourselfas the anti-psychiatrist
psychiatrist.
So tell us a little bit aboutthat term and how it came to be.
Dr. Broukhim (03:11):
Yeah, there's a lot of paradoxes behind it,
because I say this often.
I can't imagine a psychiatristenjoying the job more than I do,
because my experience inpsychiatry is that I see people
come to me at sometimes theirlowest moment in their life and
then I get to see them at theirhighest sense of
self-satisfaction andfulfillment and to be able to
(03:35):
see that feels like one of thebest jobs ever.
So I really enjoy it.
At the same time, when I lookat the field like the history of
the field I look at the generaloutcomes.
They history of the field.
I look at the general outcomes.
They just seem like they'regetting worse.
And so I say I'm theanti-psychiatrist psychiatrist
because I feel like I have greatresults in clinical practice
but a lot of the generalguidelines are just not helpful
(03:59):
and so I don't do what a lot ofother psychiatrists do.
Ashley (04:04):
And you get good results from that.
It sounds like.
Dr. Broukhim (04:07):
Yeah, the good result is people don't see me
anymore because they're feelinga lot better or they see me a
lot less and there are caseswhere they've worked towards not
being on medications anymore.
They might see their therapist,potentially, or coach, every
week or every other week, butyeah, it's not years of seeing
me.
It's either therapistpotentially, or coach every week
or every other week, but yeah,it's not years of seeing me
(04:27):
every month or three months.
Ashley (04:30):
Which I'm sure is such an interesting position to be in
in medicine, right?
Is that ideally, as clinicians,most of the time, well checks
are fabulous and we enjoy doingwell checks, but especially in
psychiatry, I would imagine youdon't see many patients coming
in saying, hey, I feel supergood, I just wanted to check in,
make sure you think I sound andlook super good and we move on.
(04:54):
You know, I would imagine thatmost of your patients come in,
like you said, in distress andoftentimes on their worst day,
and then your goal is to not seethose people anymore, which is
an interesting thing, a uniqueposition, I think, in medicine.
Dr. Broukhim (05:09):
Yeah and I said this in another meeting that we
have the best medical care everfor acute conditions across the
board.
I feel like that for psychiatry.
I feel like that for psychiatrywhen people are having severe
episodes of psychosis, mania ordepression, anxiety, whatever it
(05:34):
is.
We have amazing tools to makethese conditions not chronic.
Unfortunately, the US is in aposition where, per capita, we
have the highest rate of mentaland physical health conditions
in the world.
But I think with AI technology,we have such quick access to
train professionals andinformation and like online
tools, whatever it is to reach astate of long-term health.
Ashley (05:59):
And we're kind of talking a little bit about
psychiatry specifically, but I'dimagine that this relates to
other elements of medicine in away which you kind of understand
, because I think correct me ifI'm wrong but you plan to
specialize in internal medicineoriginally and then, after the
first two days on yourpsychiatry rotation it kind of
shifted.
Tell me about that.
(06:19):
What interested you in thatshift?
Dr. Broukhim (06:23):
The reason why I liked internal medicine
originally.
It was eventually going tobecome an oncologist or
gastroenterologist potentially,but I liked how as an internal
medicine doctor you can workwith like so many different
systems.
I can do a little bit ofneurology, you know.
I can look at the kidney system, cardiac system, I can really
(06:44):
look at the whole body and itcan be like detective work in
that way.
But what happened was that onmy rotations it felt very
algorithmic and not much roomfor really connecting with
patients and hearing their story.
And then when it came topsychiatry, it's very bizarre.
My first psychiatry rotation wasin an emergency psych unit and
(07:08):
about a third of the cases I sawwere meth-induced psychosis
when a lot of these cases theway that some of these patients
came in it looked like a WorldWar Z zombie who was going to
rip your head off.
Wow, it would be like two tothree police officers would
bring them in Super intense andI would eventually sit in with a
(07:31):
lot of these patients.
So I saw them go from that to avery calm person and I hear
their story and I just just thestories were definitely sad.
They were fascinating in thesense of how can someone who
grew up as an innocent child, goto this and then also now be
(07:56):
like calm and present with me.
I've never had a boring day ofpsychiatry.
The only days where I get boredis when a patient is not being
open with me.
If a patient's being open andauthentic, every person is very
interesting.
I think that's why podcasts arebecoming more and more popular.
(08:17):
Even if we have reels onInstagram where you're watching
30 30 seconds one minute, thefact that the most popular forms
of media is multi-hour longconversations between two people
or more, it shows you like wereally do want to connect on a
deeper level with other humans,like that's even the age of
(08:38):
technology, where there's allthese shows.
The number one podcast, whichis, you know, joe's podcast,
these are two hour, three hourconversations.
So it's kind of like that forme as a psychiatrist, and that
desire to connect with humanbeings and be of service in that
way has led me to also want tostart rabbinical school in two
(09:00):
months to have the opportunityto help people before they have
that depressive or anxietyepisode, before they become
psychotic, and meet them whenthey're having a crisis of
meaning and not knowing why am Ihere, what am I doing?
Ashley (09:16):
I think that's fabulous.
In rabbinical school, thatwould be to become a rabbi.
Is that correct?
Yes, so, and oh my gosh,there's so many different ways
we could go with this right now,and I am so glad you brought up
storytelling.
That's something that I reallywanted to talk about in a little
bit, and just the authenticityand really almost the dying art
of the conversation.
Yeah, you know, in the textmessage world, I think it's
(09:40):
where storytelling is sointeresting and it's what makes
people so curious in it.
So we'll come back to thatbecause that's so good.
But I do want to talk on theimportance of faith in your
practice.
Is that something that wouldhelp this inner mix of faith and
science, faith in medicine?
Are they one in the same?
Do you keep them separate?
Does it depend on the patient?
Patient?
Dr. Broukhim (10:02):
it is a universal thing that's needed love that so
if I have a patient who doesn'tbelieve in god or doesn't
subscribe to any religion, Istill need to cultivate a sense
of what is something that theycan go beyond themselves Any
human being that doesn't see thevalue of connection with other
(10:28):
human beings, or at least life.
You might not like human beings, but you like animals, you like
plants, you can recover.
If you don't want to beconnected to any living being or
see the importance of it, youvery likely need something like
(10:48):
psychedelic-assistedpsychotherapy to remind yourself
of how important it is to beconnected to living things.
Ashley (10:56):
It's almost like a prognostic factor for recovery,
right?
Thank you for sharing that.
What an interesting idea.
So you start rabbinical schoolin two months.
You said, yep, fabulous.
I don't know how you're makingtime to do all of these things,
because I also want to talkabout this new consulting,
coaching, advising company thatyou started too.
Let's actually dive into thatright now.
(11:17):
Why don't we wwwiexperiencelife, which I love that title?
That is fantastic, very cool.
Tell us a little bit about thisas well, because I'm very
interested.
Dr. Broukhim (11:27):
So I see all types of patients, different
backgrounds, they work indifferent industries and
sometimes they'll bring in theirindustry like what's happening
in their job, what's happeningin the industry as a whole.
And I've noticed that I've andthis is why I like psychiatry
also is that I get to becreative as a psychiatrist.
(11:47):
The questions I ask how I wantto respond, what experiences do
I want to like bring forpatients, whether it's a men's
group, improv class or retreatand I've noticed that I'm kind
of co-creating at times with apatient in terms of like
reorganizing their whole life inlike multiple domains.
My experience of working indifferent settings, that when I
(12:10):
work with a team of clinicians,we can create like a really
amazing organizational structureof healing.
But also when I've worked withpatients about their industries,
I will give suggestions to kindof bring to their work and then
, like it works, I want to workwith executives or teams of
(12:30):
people and companies, nonprofits, artists to really cultivate
their work further if they feelstuck, because I do think from a
psychological and spiritualperspective, if we can address
those things, it can reallyoptimize whatever they're doing
in a variety of settings.
Ashley (12:49):
I love the organizational structure of
healing.
It helps us remember that we donot become healed.
Afflictions are not cured justby going to the doctor and
getting our meds.
It has to be ingrained intoevery aspect of our lives if we
want to be lasting right.
Dr. Broukhim (13:10):
Yeah, and there's a lot of talk about psychedelic
medicine being an up-and-coming,major treatment in mental
health.
The part that's still, I feellike the part of the
conversation that's missing, iswe need to change the structure,
the container in which healingis being done.
(13:31):
Even psychedelics, where youwould want to make sure that,
relationally, at home, at work,the other doctors that you're
working with are all alignedwith the intention that you have
in working with.
You know, ketamine ispsychotherapy, psilocybin is
psychotherapy, whatevermedallion it is even just
(13:53):
psychotherapy.
A lot of people do greatone-on-one work and then we try
to integrate in their lives.
Well, if their family system,friend system, romantic partner
system, kids work, whatever itis is not, if they're not
aligned, you're not really goingto improve.
Ashley (14:13):
Very thought provoking too, and I would imagine that
would be.
There's a lot of really goodinterview questions that I could
think of for pre-healthstudents.
Based on that, which actually Ido want to pause, there is a
segment on the show calledquality questions, and it
actually is where we talk aboutan interview question.
So do you have an interviewquestion that you'd like to ask
(14:35):
Before we hear what Dr Brokeem'squality question is?
And he doesn't just give us one, he gives us two.
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Broukhim (14:55):
There's multiple segues into this.
Pre-health student is.
I think it's what is the typeof life that you want to lead,
not just the type of doctor youwant to be or the type of
practitioner you want to be,because what you want to do as
someone that works in thehealthcare field, it's not a
(15:16):
siloed experience.
It leads into the idea ofpartnership having kids, where
you want to live, how many hoursyou want to work, traveling.
I would like to ask thatquestion.
There's two more things I wantto share.
When I was asking doctors aboutshould I become a doctor, most
(15:38):
of them said no, and even onedoctor who was treating my
father when he was slowlypassing away from cancer.
It was a nephrologist.
He saw me volunteering in ahospital and he went up to me
with a cane saying what are youdoing here?
You should leave the hospitalright now.
Look at me.
I can't barely walk.
I don't see my family.
I'm working long hours.
He was kind of yelling at meand when he left I didn't listen
(16:00):
to family.
I'm working long hours.
He was kind of yelling at meand when he left I didn't listen
to him.
I told myself I was 19 years old.
I told myself.
I'm going to make sure I'mgoing to be a doctor that finds
a way to enjoy his life while hepractices, and I've been able
to do that.
So this is the last thing Iwant to say.
Related to this question is themost memorable answer that I've
ever gotten from anyone beforewas I was in South Korea at a
(16:25):
Buddhist monk temple and therewas a monk who's in his 70s and
he became a monk in his mid 20sand I asked him at this stage of
your life, what are you workingon?
And he said what I'm working onis the exact same thing I've
been working on for the past 50years To choose to primarily
(16:48):
focus on mindfulness while I'mpraying, cooking and cleaning
every single day.
The struggle is the samestruggle I've been doing for 50
years, and it just reminded meof the idea of commitment, that
the struggle of committing towhat you're passionate to
despite all the stressors maycome.
I think about that answer a lotwith what I do in my life.
Ashley (17:10):
Commitment and discipline.
Those are two really goodexamples, because one is a
motivator because you don't wantto be like him, like the cranky
old doctor house guy with thecane that was yelling at you,
and then the other is amotivator among the positive
Somebody you do, I mean I wouldlove to say that that's what I
was working on every day.
(17:30):
How simple but at the same timehow incredibly difficult.
Yeah, oh, very cool.
Let's talk about a day in yourlife.
What does the day look like foryou?
Dr. Broukhim (17:42):
I wake up and I really try to focus on this
thing of like what type ofadventure am I going to have
today?
And really trying to have noexpectations for what's going to
happen.
Have some decaf coffee, becausewhen I have caffeine I
overestimate how much I can do.
(18:02):
And, you know, exercise for atleast seven minutes intensely
and I might be doing a lot ofthings that morning.
I could either be meetingsomeone for networking, working
on a collaborative project orgoing straight to see patients.
My days are very varied betweenclinical care, teaching,
collaborating with otherprojects.
(18:23):
Today I'm going to be workingwith a artist and other
volunteers for five hours on anart project.
That's what I'm doing today, soit's very varied.
I might have a men's group onTuesdays.
I'm in leadership training.
Right now.
I do a lot of groupexperiential things like men's
(18:49):
group to stay connected in adeep way to other human beings
and just making sure that anyblind spots that I have in life
are being addressed.
I think that's one reason whysomeone may want to continue in
therapy or coaching is becausewe're day to day.
There's so much messaging abouthow horrible our world is.
(19:10):
When you go on Instagram, thealgorithms are kind of showing
you we're in crisis mode and anyday there's, you know, the
world's gonna be blown up bynuclear explosions or climate
change or whatever it is.
Many of us may be surrounded bypeople that have self-limiting
stories about humanity.
It can get really dark thesedays, so it's a major battle to
(19:36):
maintain the story, thenarrative of we're actually
becoming more humane.
I think homicides are going tobe at their lowest point in the
United States this year.
There's so many stories ofthings are actually getting a
lot better, but it seems like90% of the content is how much
worse everything's getting soday to day.
I try to not allow that toenter my consciousness.
Ashley (19:58):
We have to protect ourselves against that sort of
thing.
You know we wake up every dayand you just kind of have to put
on that armor.
Dr. Broukhim (20:04):
I want to address put on the armor because that's
a lot of work.
It's very heavy to wear a lotof armor.
So you might put on armorbecause your consciousness feels
like I'm going to go into warVersus.
I might not want to wear anyarmor because I have a belief
(20:26):
that we're actually buildingtowards a greater sense of
humanity.
So I really believe that thestory that you're telling
yourself about how the world isit will be reflected in terms of
what's brought to you.
It feels like it's a science.
It works like science, but Ithink there's evidence that
quantum mechanics is reallypointing towards that idea that
(20:48):
the way we perceive reality willdictate what's in front of us.
Ashley (20:53):
I think that is incredible.
Dr. Broukhim (20:55):
I have to give you an experiment that kind of
backs that up.
There was a study.
In one room they had a man byhimself, and in one room they
had a man by himself and inanother room they had a plant by
itself.
They told the man in theexperiment to imagine burning a
plant in his mind.
When he was told to imagineburning the plant in his mind,
the plant next door was theywere able to measure that was
(21:18):
sending off distress signals.
Wow, when the man wasconsciously visualizing burning
a plant.
So you can imagine what youvisualize, what you're creating
in your mind.
It has actual physiologicaleffects on your environment,
just like it did with the plants.
Ashley (21:37):
And I think we've always understood that.
We just haven't reallyunderstood it perhaps to the
depth that we do now.
Yeah, this is a great segue.
You mentioned usingtransformative power of
storytelling.
What does that look like foryou?
And specifically, let's talkabout specifically in the
clinical setting what does thatlook like for you?
Dr. Broukhim (21:57):
I have different stories for different types of
situations.
Oh, here's a great one.
Ashley (22:18):
I'll tell the story of how important your thoughts are,
and a great clinical example ofthis is I'll ask people to
initiate the story.
So I'm gonna ask you right nowDo you know what percentage of
the cells in your brain areimmune cells.
Dr. Broukhim (22:25):
Oh, I would have to guess.
My guess would be 15%.
It's 80 to 90%.
Okay, what that means is thatyour thoughts can dictate how
your immune cells are going tobehave.
So, the immune cells in yourbrain so microglia is the way
they're categorized is that theycan be pro-inflammatory.
If you're having a lot ofthoughts related to anxiety or
(22:48):
negative self-worth, it's gonnamake those immune cells
pro-inflammatory.
They can start cleaving away atyour own brain or they might
communicate with the rest ofyour body to attack itself.
Wow, which will lead toautoimmune conditions Versus
anti-inflammatory.
When you're thinking morepositive thoughts, thoughts that
relate to self-empowerment,compassion and empowerment,
(23:13):
compassion and acceptance, andyou can say that's what the
placebo versus nocebo effect is.
Placebo effect is that if youtell yourself you're going to
feel better, that you're goingto get better, that you're going
to get better, you end up beingbetter.
Actually, like physiologically,you show improvement versus
nocebo is that you're telling.
If you're gonna tell yourselfyou're gonna get worse, I mean
(23:33):
you will.
Actually there's measurementsthat'll show like you're
actually getting worse.
So when you hear that story, itmakes you want to be even more
mindful about what story you'retelling yourself or what you're
telling about the world.
Ashley (23:48):
That's perfect.
It's evidence, right.
Thank you for sharing that.
Thank you for sharing all ofthese things.
Gosh, I could never.
I don't even think I could pickmy favorite moment.
I think I don't know.
I think faith in medicine.
I think how firmly you believethat those two things require
each other, I think is great.
Dr. Broukhim (24:04):
Yeah, I think the best way to describe faith is a
belief that there is value inconnecting with other beings.
That's the belief Great, yourprognosis for improving is going
to be significantly improved.
Ashley (24:18):
And what an inclusive definition of that too, Because
I would imagine the vastmajority of healthy people
perhaps all would say yes, thereis an innate good in that, so I
love that.
Michael, thank you so much forjoining us today.
On Shadow Me Next, I appreciateyour insight and what you're
doing with iExperiencelife, thefact that you're going to
(24:40):
rabbinical school.
Best of luck with that.
Thanks again for joining us.
Dr. Broukhim (24:44):
Thank you so much, Robyn.
Ashley (24:46):
Thank you so very much for listening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
You're always invited to shadowme next.
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
Me Next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
(01:04):
Today's guest challengeseverything you think you know
about psychiatry.
Dr Michael Brakeem is anintegrative psychiatrist and
medical director of HopeIntegrative Psychiatry, a
practice that blendsconventional treatment with
holistic healing andstorytelling.
His journey into medicine wassparked by his father's cancer
diagnosis, kept hidden from himfor nearly a decade, and shaped
(01:29):
by a mission to heal beyond thelimits of traditional care.
After falling in love withpsychiatry, just two days into
his rotation, dr Brakeemredefined what healing could
look like.
He's built a thriving clinic,developed innovative training
programs and launched IExperience Life, a consulting
company that bringspsychological and spiritual
(01:52):
insights into industries,organizations and creative
projects.
Now he's even preparing toenter rabbinical school.
In today's episode, we talkabout why most mental health
conditions are not chronic.
We discuss a more encompassingdefinition of faith and how
faith and connection are centralto recovery, and the ways
(02:13):
storytelling and the stories wetell ourselves can truly
transform our lives.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
(02:36):
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next with DrMichael Bracheem.
Hey, michael, thank you so muchfor joining me on Shadow Me
Next.
I am so interested to hear whatyou have to say about your
whole journey and how you treatpatients I'm excited to talk
about a variety of topics.
(02:58):
Excellent Good.
So, first and foremost, I wouldlove for you to explain one of
the ways you describe yourselfas the anti-psychiatrist
psychiatrist.
So tell us a little bit aboutthat term and how it came to be.
Dr. Broukhim (03:11):
Yeah, there's a lot of paradoxes behind it,
because I say this often.
I can't imagine a psychiatristenjoying the job more than I do,
because my experience inpsychiatry is that I see people
come to me at sometimes theirlowest moment in their life and
then I get to see them at theirhighest sense of
self-satisfaction andfulfillment and to be able to
(03:35):
see that feels like one of thebest jobs ever.
So I really enjoy it.
At the same time, when I lookat the field like the history of
the field I look at the generaloutcomes.
They history of the field.
I look at the general outcomes.
They just seem like they'regetting worse.
And so I say I'm theanti-psychiatrist psychiatrist
because I feel like I have greatresults in clinical practice
but a lot of the generalguidelines are just not helpful
(03:59):
and so I don't do what a lot ofother psychiatrists do.
Ashley (04:04):
And you get good results from that.
It sounds like.
Dr. Broukhim (04:07):
Yeah, the good result is people don't see me
anymore because they're feelinga lot better or they see me a
lot less and there are caseswhere they've worked towards not
being on medications anymore.
They might see their therapist,potentially, or coach, every
week or every other week, butyeah, it's not years of seeing
me.
It's either therapistpotentially, or coach every week
or every other week, but yeah,it's not years of seeing me
(04:27):
every month or three months.
Ashley (04:30):
Which I'm sure is such an interesting position to be in
in medicine, right?
Is that ideally, as clinicians,most of the time, well checks
are fabulous and we enjoy doingwell checks, but especially in
psychiatry, I would imagine youdon't see many patients coming
in saying, hey, I feel supergood, I just wanted to check in,
make sure you think I sound andlook super good and we move on.
(04:54):
You know, I would imagine thatmost of your patients come in,
like you said, in distress andoftentimes on their worst day,
and then your goal is to not seethose people anymore, which is
an interesting thing, a uniqueposition, I think, in medicine.
Dr. Broukhim (05:09):
Yeah and I said this in another meeting that we
have the best medical care everfor acute conditions across the
board.
I feel like that for psychiatry.
I feel like that for psychiatrywhen people are having severe
episodes of psychosis, mania ordepression, anxiety, whatever it
(05:34):
is.
We have amazing tools to makethese conditions not chronic.
Unfortunately, the US is in aposition where, per capita, we
have the highest rate of mentaland physical health conditions
in the world.
But I think with AI technology,we have such quick access to
train professionals andinformation and like online
tools, whatever it is to reach astate of long-term health.
Ashley (05:59):
And we're kind of talking a little bit about
psychiatry specifically, but I'dimagine that this relates to
other elements of medicine in away which you kind of understand
, because I think correct me ifI'm wrong but you plan to
specialize in internal medicineoriginally and then, after the
first two days on yourpsychiatry rotation it kind of
shifted.
Tell me about that.
(06:19):
What interested you in thatshift?
Dr. Broukhim (06:23):
The reason why I liked internal medicine
originally.
It was eventually going tobecome an oncologist or
gastroenterologist potentially,but I liked how as an internal
medicine doctor you can workwith like so many different
systems.
I can do a little bit ofneurology, you know.
I can look at the kidney system, cardiac system, I can really
(06:44):
look at the whole body and itcan be like detective work in
that way.
But what happened was that onmy rotations it felt very
algorithmic and not much roomfor really connecting with
patients and hearing their story.
And then when it came topsychiatry, it's very bizarre.
My first psychiatry rotation wasin an emergency psych unit and
(07:08):
about a third of the cases I sawwere meth-induced psychosis
when a lot of these cases theway that some of these patients
came in it looked like a WorldWar Z zombie who was going to
rip your head off.
Wow, it would be like two tothree police officers would
bring them in Super intense andI would eventually sit in with a
(07:31):
lot of these patients.
So I saw them go from that to avery calm person and I hear
their story and I just just thestories were definitely sad.
They were fascinating in thesense of how can someone who
grew up as an innocent child, goto this and then also now be
(07:56):
like calm and present with me.
I've never had a boring day ofpsychiatry.
The only days where I get boredis when a patient is not being
open with me.
If a patient's being open andauthentic, every person is very
interesting.
I think that's why podcasts arebecoming more and more popular.
(08:17):
Even if we have reels onInstagram where you're watching
30 30 seconds one minute, thefact that the most popular forms
of media is multi-hour longconversations between two people
or more, it shows you like wereally do want to connect on a
deeper level with other humans,like that's even the age of
(08:38):
technology, where there's allthese shows.
The number one podcast, whichis, you know, joe's podcast,
these are two hour, three hourconversations.
So it's kind of like that forme as a psychiatrist, and that
desire to connect with humanbeings and be of service in that
way has led me to also want tostart rabbinical school in two
(09:00):
months to have the opportunityto help people before they have
that depressive or anxietyepisode, before they become
psychotic, and meet them whenthey're having a crisis of
meaning and not knowing why am Ihere, what am I doing?
Ashley (09:16):
I think that's fabulous.
In rabbinical school, thatwould be to become a rabbi.
Is that correct?
Yes, so, and oh my gosh,there's so many different ways
we could go with this right now,and I am so glad you brought up
storytelling.
That's something that I reallywanted to talk about in a little
bit, and just the authenticityand really almost the dying art
of the conversation.
Yeah, you know, in the textmessage world, I think it's
(09:40):
where storytelling is sointeresting and it's what makes
people so curious in it.
So we'll come back to thatbecause that's so good.
But I do want to talk on theimportance of faith in your
practice.
Is that something that wouldhelp this inner mix of faith and
science, faith in medicine?
Are they one in the same?
Do you keep them separate?
Does it depend on the patient?
Patient?
Dr. Broukhim (10:02):
it is a universal thing that's needed love that so
if I have a patient who doesn'tbelieve in god or doesn't
subscribe to any religion, Istill need to cultivate a sense
of what is something that theycan go beyond themselves Any
human being that doesn't see thevalue of connection with other
(10:28):
human beings, or at least life.
You might not like human beings, but you like animals, you like
plants, you can recover.
If you don't want to beconnected to any living being or
see the importance of it, youvery likely need something like
(10:48):
psychedelic-assistedpsychotherapy to remind yourself
of how important it is to beconnected to living things.
Ashley (10:56):
It's almost like a prognostic factor for recovery,
right?
Thank you for sharing that.
What an interesting idea.
So you start rabbinical schoolin two months.
You said, yep, fabulous.
I don't know how you're makingtime to do all of these things,
because I also want to talkabout this new consulting,
coaching, advising company thatyou started too.
Let's actually dive into thatright now.
(11:17):
Why don't we wwwiexperiencelife, which I love that title?
That is fantastic, very cool.
Tell us a little bit about thisas well, because I'm very
interested.
Dr. Broukhim (11:27):
So I see all types of patients, different
backgrounds, they work indifferent industries and
sometimes they'll bring in theirindustry like what's happening
in their job, what's happeningin the industry as a whole.
And I've noticed that I've andthis is why I like psychiatry
also is that I get to becreative as a psychiatrist.
(11:47):
The questions I ask how I wantto respond, what experiences do
I want to like bring forpatients, whether it's a men's
group, improv class or retreatand I've noticed that I'm kind
of co-creating at times with apatient in terms of like
reorganizing their whole life inlike multiple domains.
My experience of working indifferent settings, that when I
(12:10):
work with a team of clinicians,we can create like a really
amazing organizational structureof healing.
But also when I've worked withpatients about their industries,
I will give suggestions to kindof bring to their work and then
, like it works, I want to workwith executives or teams of
(12:30):
people and companies, nonprofits, artists to really cultivate
their work further if they feelstuck, because I do think from a
psychological and spiritualperspective, if we can address
those things, it can reallyoptimize whatever they're doing
in a variety of settings.
Ashley (12:49):
I love the organizational structure of
healing.
It helps us remember that we donot become healed.
Afflictions are not cured justby going to the doctor and
getting our meds.
It has to be ingrained intoevery aspect of our lives if we
want to be lasting right.
Dr. Broukhim (13:10):
Yeah, and there's a lot of talk about psychedelic
medicine being an up-and-coming,major treatment in mental
health.
The part that's still, I feellike the part of the
conversation that's missing, iswe need to change the structure,
the container in which healingis being done.
(13:31):
Even psychedelics, where youwould want to make sure that,
relationally, at home, at work,the other doctors that you're
working with are all alignedwith the intention that you have
in working with.
You know, ketamine ispsychotherapy, psilocybin is
psychotherapy, whatevermedallion it is even just
(13:53):
psychotherapy.
A lot of people do greatone-on-one work and then we try
to integrate in their lives.
Well, if their family system,friend system, romantic partner
system, kids work, whatever itis is not, if they're not
aligned, you're not really goingto improve.
Ashley (14:13):
Very thought provoking too, and I would imagine that
would be.
There's a lot of really goodinterview questions that I could
think of for pre-healthstudents.
Based on that, which actually Ido want to pause, there is a
segment on the show calledquality questions, and it
actually is where we talk aboutan interview question.
So do you have an interviewquestion that you'd like to ask
(14:35):
Before we hear what Dr Brokeem'squality question is?
And he doesn't just give us one, he gives us two.
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Broukhim (14:55):
There's multiple segues into this.
Pre-health student is.
I think it's what is the typeof life that you want to lead,
not just the type of doctor youwant to be or the type of
practitioner you want to be,because what you want to do as
someone that works in thehealthcare field, it's not a
(15:16):
siloed experience.
It leads into the idea ofpartnership having kids, where
you want to live, how many hoursyou want to work, traveling.
I would like to ask thatquestion.
There's two more things I wantto share.
When I was asking doctors aboutshould I become a doctor, most
(15:38):
of them said no, and even onedoctor who was treating my
father when he was slowlypassing away from cancer.
It was a nephrologist.
He saw me volunteering in ahospital and he went up to me
with a cane saying what are youdoing here?
You should leave the hospitalright now.
Look at me.
I can't barely walk.
I don't see my family.
I'm working long hours.
He was kind of yelling at meand when he left I didn't listen
(16:00):
to family.
I'm working long hours.
He was kind of yelling at meand when he left I didn't listen
to him.
I told myself I was 19 years old.
I told myself.
I'm going to make sure I'mgoing to be a doctor that finds
a way to enjoy his life while hepractices, and I've been able
to do that.
So this is the last thing Iwant to say.
Related to this question is themost memorable answer that I've
ever gotten from anyone beforewas I was in South Korea at a
(16:25):
Buddhist monk temple and therewas a monk who's in his 70s and
he became a monk in his mid 20sand I asked him at this stage of
your life, what are you workingon?
And he said what I'm working onis the exact same thing I've
been working on for the past 50years To choose to primarily
(16:48):
focus on mindfulness while I'mpraying, cooking and cleaning
every single day.
The struggle is the samestruggle I've been doing for 50
years, and it just reminded meof the idea of commitment, that
the struggle of committing towhat you're passionate to
despite all the stressors maycome.
I think about that answer a lotwith what I do in my life.
Ashley (17:10):
Commitment and discipline.
Those are two really goodexamples, because one is a
motivator because you don't wantto be like him, like the cranky
old doctor house guy with thecane that was yelling at you,
and then the other is amotivator among the positive
Somebody you do, I mean I wouldlove to say that that's what I
was working on every day.
(17:30):
How simple but at the same timehow incredibly difficult.
Yeah, oh, very cool.
Let's talk about a day in yourlife.
What does the day look like foryou?
Dr. Broukhim (17:42):
I wake up and I really try to focus on this
thing of like what type ofadventure am I going to have
today?
And really trying to have noexpectations for what's going to
happen.
Have some decaf coffee, becausewhen I have caffeine I
overestimate how much I can do.
(18:02):
And, you know, exercise for atleast seven minutes intensely
and I might be doing a lot ofthings that morning.
I could either be meetingsomeone for networking, working
on a collaborative project orgoing straight to see patients.
My days are very varied betweenclinical care, teaching,
collaborating with otherprojects.
(18:23):
Today I'm going to be workingwith a artist and other
volunteers for five hours on anart project.
That's what I'm doing today, soit's very varied.
I might have a men's group onTuesdays.
I'm in leadership training.
Right now.
I do a lot of groupexperiential things like men's
(18:49):
group to stay connected in adeep way to other human beings
and just making sure that anyblind spots that I have in life
are being addressed.
I think that's one reason whysomeone may want to continue in
therapy or coaching is becausewe're day to day.
There's so much messaging abouthow horrible our world is.
(19:10):
When you go on Instagram, thealgorithms are kind of showing
you we're in crisis mode and anyday there's, you know, the
world's gonna be blown up bynuclear explosions or climate
change or whatever it is.
Many of us may be surrounded bypeople that have self-limiting
stories about humanity.
It can get really dark thesedays, so it's a major battle to
(19:36):
maintain the story, thenarrative of we're actually
becoming more humane.
I think homicides are going tobe at their lowest point in the
United States this year.
There's so many stories ofthings are actually getting a
lot better, but it seems like90% of the content is how much
worse everything's getting soday to day.
I try to not allow that toenter my consciousness.
Ashley (19:58):
We have to protect ourselves against that sort of
thing.
You know we wake up every dayand you just kind of have to put
on that armor.
Dr. Broukhim (20:04):
I want to address put on the armor because that's
a lot of work.
It's very heavy to wear a lotof armor.
So you might put on armorbecause your consciousness feels
like I'm going to go into warVersus.
I might not want to wear anyarmor because I have a belief
(20:26):
that we're actually buildingtowards a greater sense of
humanity.
So I really believe that thestory that you're telling
yourself about how the world isit will be reflected in terms of
what's brought to you.
It feels like it's a science.
It works like science, but Ithink there's evidence that
quantum mechanics is reallypointing towards that idea that
(20:48):
the way we perceive reality willdictate what's in front of us.
Ashley (20:53):
I think that is incredible.
Dr. Broukhim (20:55):
I have to give you an experiment that kind of
backs that up.
There was a study.
In one room they had a man byhimself, and in one room they
had a man by himself and inanother room they had a plant by
itself.
They told the man in theexperiment to imagine burning a
plant in his mind.
When he was told to imagineburning the plant in his mind,
the plant next door was theywere able to measure that was
(21:18):
sending off distress signals.
Wow, when the man wasconsciously visualizing burning
a plant.
So you can imagine what youvisualize, what you're creating
in your mind.
It has actual physiologicaleffects on your environment,
just like it did with the plants.
Ashley (21:37):
And I think we've always understood that.
We just haven't reallyunderstood it perhaps to the
depth that we do now.
Yeah, this is a great segue.
You mentioned usingtransformative power of
storytelling.
What does that look like foryou?
And specifically, let's talkabout specifically in the
clinical setting what does thatlook like for you?
Dr. Broukhim (21:57):
I have different stories for different types of
situations.
Oh, here's a great one.
Ashley (22:18):
I'll tell the story of how important your thoughts are,
and a great clinical example ofthis is I'll ask people to
initiate the story.
So I'm gonna ask you right nowDo you know what percentage of
the cells in your brain areimmune cells.
Dr. Broukhim (22:25):
Oh, I would have to guess.
My guess would be 15%.
It's 80 to 90%.
Okay, what that means is thatyour thoughts can dictate how
your immune cells are going tobehave.
So, the immune cells in yourbrain so microglia is the way
they're categorized is that theycan be pro-inflammatory.
If you're having a lot ofthoughts related to anxiety or
(22:48):
negative self-worth, it's gonnamake those immune cells
pro-inflammatory.
They can start cleaving away atyour own brain or they might
communicate with the rest ofyour body to attack itself.
Wow, which will lead toautoimmune conditions Versus
anti-inflammatory.
When you're thinking morepositive thoughts, thoughts that
relate to self-empowerment,compassion and empowerment,
(23:13):
compassion and acceptance, andyou can say that's what the
placebo versus nocebo effect is.
Placebo effect is that if youtell yourself you're going to
feel better, that you're goingto get better, that you're going
to get better, you end up beingbetter.
Actually, like physiologically,you show improvement versus
nocebo is that you're telling.
If you're gonna tell yourselfyou're gonna get worse, I mean
(23:33):
you will.
Actually there's measurementsthat'll show like you're
actually getting worse.
So when you hear that story, itmakes you want to be even more
mindful about what story you'retelling yourself or what you're
telling about the world.
Ashley (23:48):
That's perfect.
It's evidence, right.
Thank you for sharing that.
Thank you for sharing all ofthese things.
Gosh, I could never.
I don't even think I could pickmy favorite moment.
I think I don't know.
I think faith in medicine.
I think how firmly you believethat those two things require
each other, I think is great.
Dr. Broukhim (24:04):
Yeah, I think the best way to describe faith is a
belief that there is value inconnecting with other beings.
That's the belief Great, yourprognosis for improving is going
to be significantly improved.
Ashley (24:18):
And what an inclusive definition of that too, Because
I would imagine the vastmajority of healthy people
perhaps all would say yes, thereis an innate good in that, so I
love that.
Michael, thank you so much forjoining us today.
On Shadow Me Next, I appreciateyour insight and what you're
doing with iExperiencelife, thefact that you're going to
(24:40):
rabbinical school.
Best of luck with that.
Thanks again for joining us.
Dr. Broukhim (24:44):
Thank you so much, Robyn.
Ashley (24:46):
Thank you so very much for listening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
You're always invited to shadowme next.
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