Unlocking the Brain: Insights from Neuroscientist - Dr. Sarah McKay - The Daria Hamrah Podcast

Episode Transcript
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Speaker 2 (00:06):
All right.
Hi everyone, welcome back tothe Daria Hamra podcast.
Today we're going to dig deep,beyond the skin and beyond
aesthetics right into the brain.
I'm joined by someone whosework I've admired for years Dr
Sarah Mackay, an Oxford-trainedneuroscientist, best-selling
author, science communicator andfounder of the Neuroscience

(00:27):
Academy.
Sarah has this incredibleability to take the complex
science of the brain and turn itinto real-life, digestible
insight.
So, as someone who works withpeople every day who want to
look the way they feel, thisepisode hits home for me.
We'll talk about everythingfrom neuroplasticity to baby

(00:51):
brain, to why teens think thatparents are the worst and as a
parent of two teenagers, I'mreally interested in that part
and, yes, even body dysmorphiaand in the age of social media.
So let's dive right in.
Sarah, before we, first of all,welcome to the show and thanks
for taking time out of your busyschedule.

(01:13):
I know you're doing a podcasttour, you're going on a bunch of
gigs this year and first of all, tell me, how do you find time
to do all of this?
You know I'm already struggling, as is You're writing multiple
books, you're on almost on everypodcast that I see, you're

(01:33):
actively involved in the fieldand you're a mother to two
children that are teenagers.
How do you do all of that?
Just give us a.
Is there a hack?
Is there a tool?
Is there an app for it?
How do you do it?

Speaker 1 (01:50):
If my husband heard you ask this question, he would
laugh his head off.
It's smoke and mirrors.
I wrote my books last year, sothis year what I'm very, very
busy doing is not a lot.
I'm just trying to ride thewave of having done a lot of
work over the last few years,and this year I am just, as I
say, I'm sort of taking asabbatical, and that I'm not

(02:12):
trying not to write, I'm tryingnot to create, I'm just trying
to Me time.
Not necessarily me time, notcontinually be on the hamster
wheel of of creating and writingand striving, which?
I've done for about 50 years, um, just just having a bit of a

(02:34):
bit of time out.
So this year has been very,very chill and very relaxed.
Actually it just looks like I'mbusy because I'm going on a lot
of podcasts.
My boys are teenagers now, sothey're in their final year.
My oldest son's got just a fewweeks left of high school and my
other son's got two and a halfyears left, so you know they're

(02:56):
pretty self-sufficient.
Now I work for myself.

Speaker 2 (03:02):
So Ari, would you.

Speaker 1 (03:05):
You know, it probably looks like I'm busier than I am
.
Let's let's be honest.
My husband brings me a cup ofcoffee in bed every morning, and
that is one of the greatestlittle pleasures of my life and
that's why I'm thinking he wouldlaugh if he um heard you ask me
how I do it all, because hedoes a lot.
I married well.
He's a legend and I think thatthat's probably part of it.

(03:28):
Plus, I try not to take toomany things too seriously, I
just try.
I turned 50 at the beginning ofthe year.
I've got friends who never madeit this far.

Speaker 2 (03:39):
For your birthday.
Welcome to the club.

Speaker 1 (03:40):
Yeah, I'm just trying to have a good time.

Speaker 2 (03:46):
Yeah, it looks busier than I am, honestly from what I
can hear, it sounds like you'reliving a dream.
Is that true?
Is that safe to say oh?

Speaker 1 (03:56):
sure, I don't know.
Do you have any regrets?
I know we're getting deepregrets about life, regrets
about life or regrets abouttaking a year to just hang out?
I have no regrets really.

Speaker 2 (04:07):
It's too early to judge the year I've taken off.
Yeah, it's too early to judgethat.

Speaker 1 (04:11):
Gosh, no, zero regrets.
I've had the best year ever.
Do I have any regrets?
No, I don't think so.
Sometimes I feel like there'ssliding door moments when you
look back on your life, whereyou know life could have taken
on a completely differenttrajectory, but for a moment.

(04:31):
But I suppose part of what wedo is we create an identity by
telling ourselves stories abouthow we ended up where we are and
I'm quite an optimistic, upbeatperson, and I'm quite an
optimistic, upbeat person.
So I feel like perhaps, ifthere are regrets, I've told

(04:53):
myself or I've woven a narrativearound that story and either
turned it into a joke or turnedit into a story about how I got
to where I am.
So no, no regrets.
Perhaps I had have been alittle kinder to myself when my
boys were little, because thatwas a really hard grind, but I
didn't know then what I know now.

Speaker 2 (05:12):
Well, I think we all did that.
I mean, that's just, no onetook us through motherhood or
fatherhood school.
I mean, I think that's part oflife.
But were you a person that gotout of her comfort zone very
easily, without overthinkingthings?
Or were you someone that wasmore looking towards safety,

(05:35):
security, and just liked to keepthings within the walls of, I
guess, comfort?

Speaker 1 (05:43):
I never felt unsafe walls of, I guess, comfort.
I never felt unsafe.
I've had an incrediblyfortunate upbringing and
childhood with a lot of love andsafety and security, so I never
felt like I had to seek that.
I just had always had theassumption and perhaps always do
that the world is safe andsecure and I never felt like I
was trying to like.

(06:03):
If I look back to like myteenage years and early 20s, I
was very ambitious in that Iwanted to do as well as I
possibly could.
It wasn't necessarily incompetition with other people
and I grew up like my mum anddad left school when they were
both 15 and I'd never met anyonewho went to university in my
life until I went to university,except my family doctor and my

(06:25):
dentist, who happens to bemarried to each other, and me
and my best friend, who's now apsychiatrist we joke.
When we were growing up one ofour friends dad's was an
engineer, so we also knew himwho'd gone to university.
So I never felt like I wastrying.
I was out of my comfort zonebecause I hadn't really quite a

(06:47):
naive view of the world, but Iknew what I liked to do, which
was study and learn, and Ireally enjoyed that.
So that was really what droveme.
It wasn't about feeling safe oruncomfortable, it was just
about doing what I enjoyed doing, which I still do now.
And I guess part of that'scoming from a very happy

(07:08):
childhood, but perhaps withoutvery so.
My parents were not ambitious,but parents whose focus was on
me and my sister, not on theworld around us, and I guess
that's probably shaped a littlebit of who I am now still, and I
guess that's probably shaped alittle bit of who I am now still

(07:30):
.
And then I just quite likeneuroscience still, and I always
say that my career, I suppose,has been about, oh like reading
neuroscience papers and doing abit of research and then finding
what's interesting and thentelling other people about it.
It's not very complicated.

Speaker 2 (07:45):
And you're doing an amazing job to something that's
so scientific and abstract andexplaining it in a way,
communicating it in a way thatthe layman easily understands
and can apply.
So you have this just innateability and not many have it,
especially scientists of aconcept that is very abstract.

(08:06):
Now, how did you even get intoneuroscience?
And also, if you can explain toour listeners what is
neuroscience actually and howdid you get into it?
Because you got into it in atime where I don't think you
know we're exactly the samegeneration, where I don't think
you know we're exactly the samegeneration.
To be honest, when I went touniversity, I didn't even know

(08:28):
about neuroscience.
I knew about neurology, but Ididn't know about neuroscience
per se, and now it's actually avery popular field in medicine
and science.

Speaker 1 (08:43):
Well, thanks first of all for the compliments on how
good I am at explaining this.
But I wouldn't argue it's notinnate, it's.
You know, 30 years of a career,you know you learn a little bit
along the way about and havinga lot of conversations with
people about neuroscience,particularly the last 10 or so
years that I've been teachingneuroscience.
I've learned from my studentshow to talk about the science

(09:08):
with them.
So that's an iterative learningprocess on my part, not
something that's just in me.
In terms of how I got intoneuroscience, well, I always
have the book next to me when Ido a podcast, because people
often ask me about it, and you'dprobably be familiar with this
book from our generation?

Speaker 2 (09:23):
Of course, of course.
Yeah, the man who Mistook His.

Speaker 1 (09:26):
Wife for a Hat by Olly Sacks.

Speaker 2 (09:27):
Yes, I actually read it in German.
You know, I went to school inGermany, I was born and raised
in Germany, and I remember thatthere you go.

Speaker 1 (09:38):
Yes, 1993, psych 101, canterbury University, new
Zealand.
That's in the town ofChristchurch where I grew up and
we were told to read this book.
And I switched universities thefollowing year because Otago
University, dunedin, new Zealand, had just put together a new
degree, discipline inneuroscience.
And I remember talking to afriend of mine who went on to do

(09:58):
dentistry down there and I said, oh wow, I was thinking of I
really love this biology andpsychology idea and I remember
talking about it with him in myfirst year at Canterbury and he
said, oh well, otago's puttingtogether a degree in
neuroscience.
I think they'd formed it thatyear.
So I switched universities andI also really wanted to go to

(10:20):
that university because it had areally great student vibe and
I've always wanted to just goaway to college, live in halls,
have that student life, so itwas a good excuse really.
So I headed down there and thenwas in that first cohort to
degree to graduate with a degreein neuroscience and I'm still
in touch with some of the peoplefrom that year.

(10:41):
One of my closest friends did apostdoc in the US and then went
to work for PubMed for many,many years, sadly just got
replaced by AI, which apparentlyis not doing as good a job as
the actual brains and the humansindexing the journal articles.
But that was really.

(11:01):
It was reading that book, butthat was really.
It was reading that book.
And for those who don't know,oliver Sacks was a neurologist
who writes these amazing casestudies.
He's a fantastic writer andcommunicator as well as a
neurologist who wrote up theunusual case studies of the
things that go wrong with howpeople think and feel and behave
when something goes wrong withtheir brain.
And I was just captivated, andthat's been and I'm still

(11:24):
captivated today.
And then I, yeah, just carriedon.
I was very fortunate and I wentoff overseas, as all Kiwi and
Aussie kids did back then.
They still do now.
After my university degree inNew Zealand, we called it our OE
.
Do you know what the big OE is?

Speaker 2 (11:42):
Yes, of course, yeah, the big overseas experience.
Yes, yes.

Speaker 1 (11:45):
I don't know whether they still use that language now
in New Zealand.
I haven't lived there for along time.

Speaker 2 (11:50):
Well, they use it in England.
Yeah, you go on, your big OE.

Speaker 1 (11:56):
Or they call it a gap year.
Sometimes if you go after highschool.
Yeah, sorry, no, go ahead I wasjust going to say so I went
traveling and when I wasoverseas traveling then I was
going and reading.
I was actually living inEdinburgh working in a pub and I
was picking up the nature Backin the days with nature and
science.
That would actually come in themagazine form which I still do

(12:18):
prefer.
And I was reading theclassifieds in the back, looking
for PhD opportunities, and Isaw that the Welcome Trust was
funding four-year studentshipsto do a master's and a PhD and
they were offering them atCambridge, ucl and London and
Oxford.
So I went and interviewed inall of them.
Actually, I ended up with theOxford spot and didn't go and
interview for the Cambridge onebecause I thought, oh, oxford

(12:39):
seems like quite a good choice.

Speaker 2 (12:41):
You don't want to do that.
You don't want to ruffle anyfeathers.

Speaker 1 (12:45):
Well, it was pretty and coming from this little Kiwi
kid who grew up in the easternsuburbs of Christchurch with
parents who had never been touniversity, it was pretty wild
to end up in Oxford.

Speaker 2 (12:57):
Yeah, you made a huge leap.
Yeah, it was cool, not just toany university.

Speaker 1 (13:01):
But again, because I didn't have imposter syndrome,
it wasn't invented.
Then I just landed there andthought, well, this is pretty
cool.
I'm going to meet some newpeople, drink some beers, party
a bit, do a bit of neuroscienceyeah whatever.
I loved my time there.
It was really fun and I met myIrish husband who was studying

(13:21):
economics, and then we moved toSydney and just carried on what
then?

Speaker 2 (13:25):
we moved to Sydney and just carried on.
What made you move to Sydney?

Speaker 1 (13:29):
We were.
I got to the end of my PhD.
My husband was working inLondon in financial services as
an economist and we thought,well, where else in the world
should we live?
He's, you know, Irish and Kiwistravel.
And then we wrote down a listof really cool cities in the
world we'd like to live in, andSydney was on that list.

(13:49):
And then he made some inquirieswith someone that he knew who
worked in the company he waswith, and they said, oh, we've
actually got a position here now.
How soon can you move?
And we were like, oh, let's goto Sydney.
And he told his Irish motherwe'll go to Sydney for a year
and that was in 2002.
And then we came here and wewere like Sydney, Australia the

(14:12):
northern beaches, where we liveis perhaps one of the better
places in the world to live.
We're very fortunate, they letus in and it's our home.

Speaker 2 (14:21):
I have a cousin actually that lives in Sydney,
so I haven't ever been there tothe island, but it's on my
bucket list, it's just.
Yeah, it's been.
Um, I just have to find a time,but I'm not.
How did he get adapted andclimated to the sun down there,
your husband coming from ireland?

Speaker 1 (14:38):
lots of sunscreen, yeah, um annual skin cancer
checks, I mean, and I grew up, Imean I'll probably be worse off
than him because I grew up inNew Zealand and we didn't really
start wearing sunscreen untilmaybe I was about 10, 11, 12.
I grew up, you know, with myskin peeling.

Speaker 2 (14:52):
I think at our age sunscreen wasn't invented.
Yet I think it wasn't invented.

Speaker 1 (14:58):
They started a skin cancer campaign called Slip,
Slop, Slap, which everyone frommy age would.
I'm not going to sing because Ican't sing.

Speaker 2 (15:04):
What year was that?
Do you remember?

Speaker 1 (15:05):
I can't remember it was late childhood, early
teenage years perhaps Slip, Slop, Slap, which was slip on a
shirt, slop on sunscreen, slapon a hat, and then they added
slide on some sunglasses to tryand bring the skin cancer rates
down.
But I have an annual skincancer check now just to keep on
, and I've had a few littlethings burned off, but nothing

(15:28):
major.
Most people I know have.

Speaker 2 (15:31):
To that point I think people associate.
Still, I think sunscreen issomewhat of a it's not a
misnomer, but it implies onlyhalf the truth because people
are associated.
At least I'm trying tore-educate my patients that
sunscreen is not just to preventsunburn, it is also to prevent

(15:52):
aging of the skin At the sametime.
The sun is so important for usfor ourselves because it has
very valuable infrared component.
The invisible part of the lightthat is so important for our
mitochondria, for our cellularfunction, our brains and our

(16:15):
mood, has so many benefits thatfinding a middle is just so hard
to educate the patients.

Speaker 1 (16:23):
People don't seem to like to find a middle these days
, do they?
And I think, growing up inAustralia, we have a very
different attitude towards that,because every single person has
the experience of if you don'twear sunscreen and you're
outside you get severely.
Well, no, it's not skin cancer.
You get severely burned very,very easily.
So there's not really an eitheror about whether you should be

(16:43):
wearing sunscreen because youabsolutely have to.
Everyone knows what happens ifyou don't.
The balance then is that doesnot mean that then you stay
inside and never go in the sun.
It's how to spend time outdoorssafely.
Um, you know, wear sunscreen,wear the protection, don't have
but don't avoid the sun, andmost Aussies don't.

(17:04):
I mean, we're pretty outdoorsy,sporty people.
Kiwis too, I kind of considermyself a bit of both now, but
you know the conversations now.
Of course, as we know, you'refrothing at either side.
It's either black or white andthe truth lies somewhere in the
middle.
And the sunscreen argumentseems quite ridiculous to people
living in this part of theworld.

Speaker 2 (17:25):
Yeah, very true.
So let's change gears here alittle bit and you know I want
since I wanted to get an ideafor the audience to understand
what the word neuroplasticitymeans, because a lot of what
we're going to be discussingkind of will refer back to that
so getting some definitions setfor the audience so that we're

(17:49):
talking about the same thingsand they kind of understand it.
So let's start with the basicswhat does neuroplasticity
actually mean and how canunderstanding this help people
who are trying to reinventthemselves or change change for
the better break out of theirshell and do something different

(18:12):
, whether it is through healththerapy or whatever that may be
lifestyle change?
Can you explain neuroplasticityin that context for our
audience?

Speaker 1 (18:23):
Well, I mean, I kind of see them as somewhat
different conversations, sort ofbehavioral change.
But I'll talk aboutneuroplasticity first, because I
think it's very easy toconflate the two and think,
because one happens the otherautomatically will.
Staticity is simply an umbrellaterm to describe the many

(18:44):
various mechanisms and ways bywhich the brain changes, and it
does that while it's learningand also during development.
So there's a lot of differentways a brain can change and a
brain can learn, and a brain cangrow, and a brain can be
altered by experience.

(19:05):
And under that sort of umbrellais I mean, if you kind of think
about a brain changing, what dowe mean by that?
We can zoom all of the way in,which is what I kind of like to
do.
We've got to zoom all of theway in and take a look at
individual neurons andconnections between neurons that

(19:26):
we call synapses, and how theymight change in terms of
structure and function inresponse to some experience that
the organism or the human ishaving and we know quite a lot
and a great deal of detail abouthow connections between neurons

(19:46):
change in response toexperiences and a lot of this
underlies what we might calllearning.
So remembering what you didearlier in the day, or if you
pick up a book at night, you canremember what was happening as
you were reading that book.
So your brain has retained thatinformation and to retain that
information it has in some wayhad to have changed, whether

(20:07):
it's changed structurally, howthe structures of whole neurons
or perhaps neural pathwayschange.
So we might see during veryearly in utero and childhood

(20:36):
development we see the explosionin numbers of new neurons.
You're getting neurogenesishappening, so new neurons are
being born and we could put thatunder the guise of plasticity.
How much neurogenesis ishappening in an adult human
brain after adolescence isdebatable, but it's probably

(20:56):
pretty minimal.
And if it does happen it's onlyhappening in very specific
parts of the brain, most likelythe hippocampus, which is
involved with learning andmemory.
But whether or not those newneurons are part of the learning
process in an adult human isdebatable, because we know that
most learning happens at thelevel of the synapse.

(21:17):
We could look to see, we couldlook at a more kind of gross or
not microscopic level but sayyou were to put someone's brain
in a brain scanner and image it.
We could look to see.
Does the structure of a wholebrain change to areas of cortex
get thinner or thicker as youacquire a new skill?
Do we see subcortical nuclei sodeep below the cortex?

(21:40):
Do we see changes in thestructure of whole nuclei In
human brains?
It's pretty minimal.
We couldn't pop a brain in abrain scanner and say, hey,
you've learned a new habit,therefore your striatum is
bigger.
We don't often see and we cantalk about pregnancy and
adolescence, because that's alittle bit different.

(22:01):
We do see large structuralchange and that's why it's hard
to talk about plasticity,because there's so many things
that can change.
And then we could also-.

Speaker 2 (22:10):
It's a broad term.

Speaker 1 (22:12):
Yeah, we could put a brain in a brain scanner and a
functional MRI or some type ofbrain imaging that looks at
patterns of activity and hownetworks interact and
communicate, and we could seethese networks shift in response
to experiences we have, whetherthey be hormonal shifts in our
body or perhaps learningsomething new, as you're

(22:33):
learning to master a new skilllike how to shoot a hoop or
something in basketball so wecould see how networks shift and
alter in response toexperiences.
So under this big wordneuroplasticity, which is almost
kind of taken on quite likekind of a mythical kind of
meaning, there's many, many,many levels of organization in

(22:54):
the brain, from changes incurrents across a membrane to
changes in brain structure.
Does that mean, then?
The next kind of thing is,which was the second part of
your question so does that mean,then the next kind of thing is,

(23:18):
which was the second part ofyour question.
What does that mean in terms ofbehavior change and in terms of,
you said, therapy as well,which is perhaps something
different, because you might betrying to address a problem and
I would say that is.
I mean, we might take adifferent approach, just
teaching a kid how to learn toread, or a child learning to
walk, or perhaps learning toregulate emotions, or perhaps
learning a new habit.
It's probably easier just tothink about learning a new skill
.
What do we see happening in abrain when you're learning a new

(23:39):
behaviour or learning a newskill?
And we see changes all the wayfrom the level of you know the
kind of the currents within anindividual neuron, the firing
rates of individual neurons,synapses, all the way out to
maybe broad-scale changes in hownetworks interact, and we can
see that play out.

(23:59):
But simply because we can seeit happen, when it does happen,
doesn't mean it's easy to change.
There was a meta-analysis thatcame out, I believe.
What year are we in now?
I don't know, because I'mgetting my years confused.
No, whether it was 2023 or 2024,was this broad-scale

(24:21):
meta-analysis that looked atbehaviour change across both
individual health behaviourswhere people were trying?
to improve health or more on akind of a sort of a public, sort
of societal level.
And they looked at things like,say, vaccination campaigns or

(24:41):
trying to get people to changehabits for environmental reasons
.
And if we just look at theindividual behavior change for
health because I think that'skind of most meaningful for us
it was looking at can we tapinto mindset, can we look at
motivation, can we look atteaching people new skills?
And it kind of ranked almostthe different ways we can look

(25:04):
at behavior change and it foundthe most powerful way to help
someone change was to look athabits, and this is both habits
that someone may have formedthat are preventing them from
behaving in a new way, orteaching someone a new skill or
behavior that then eventuallybecomes habitual.

(25:24):
And habits are really a reallykind of fun way to think about
brain plasticity, because habitscome about via you performing a
particular behavior over andover and over and over again.
It's very similar to motorlearning, like learning to ride
a bike or learning to shoot ahoop or any kind of motor skill,

(25:45):
performing a particularbehavior enough times that your
brain kind of goes, and this iswhat brains consciously think.
But this is sort of a loosemetaphor the brain goes.
Well, that skill is soimportant I am going to move it
down into a region of the braincalled the striatum where I

(26:05):
store my automated motor skillsand behaviors so that that
behavior just rolls out inresponse to a cure or a
situation, because I want tofree up cortex.
I want to free that up forlearning something new or
reacting or responding to changein my environment.
I don't want to be consciouslythinking about performing that

(26:27):
behavior.
And so if we think aboutlearning to ride a bike, you
know you learned whatever ageyou learned to ride six, seven,
eight.
You had to figure it out andlearn how to ride and you were
showing hair and you balancedand you wobbled and it probably
took all of your learning andthinking and motivation and
emotion regulation and theneventually you learned how to do

(26:48):
it.
But you don't need to bemotivated to remember how to
balance on a bike.
You don't need to work throughthat kind of the steps or the
strategies to remember how toride a bike, you just know how
to ride a bike.
It's become stored as anautomated behavior, um, or and

(27:08):
habits.
Habit formation is, is, is verysimilar, um.
So whether you brush your teethevery morning you don't usually
nowadays, most of us you wouldhope don't have to I'm gonna
brush my teeth today.
It's gonna work up themotivation to do that right, and
then when I do it, I have toremember the steps of how to do
it.
In fact, I say to people notonly is the act of brushing your

(27:30):
teeth, what we would habitual,so probably too is the motor
movement, the way you brush,move your brush around your
mouth.
So next time you brush yourteeth, think about the way
you're moving your brush aroundyour teeth, like what's?
What way are you doing that?
If are you doing that, youprobably do it the same every
time.
Yeah, yeah, and that's greatbecause it frees your mind up to
think about something else.
It's a system.

(27:50):
You have a system in place.

Speaker 2 (27:52):
But to me the hard part is not creating a habit,
it's to initiate a habit.

Speaker 1 (27:58):
To start, because you have to start it, To start
something new Once you start itit becomes much easier.

Speaker 2 (28:04):
So I try to re-educate a lot my patients on
also health and wellness, whereI have to re-educate them about
changing their lifestyle,whether it be exercising more,
eating more, mindfully pickingtheir diet as opposed to just
eating what's in front of them.
So those are habits that theyhave to create, but to initiate

(28:27):
that change and back to what youstarted saying is does it get
more difficult to learn a newhabit or start a new habit the
older we get?
We say always you can't teachan old dog new tricks.
Is that true or is that somesort of myth within that context
?

Speaker 1 (28:45):
That's a very interesting question.
I think it's always easier tolearn when you've got a younger
brain which is more plastic, butit is probably domain specific,
so it probably depends.

Speaker 2 (28:54):
What does that mean exactly?

Speaker 1 (28:56):
That means.
So if we think about learningto ride a bike when you're five
years old, about, uh, learningto ride a bike when you're five
years old, sure, motor, you knowyou're, you're still in the
process of um, learning motorskills and refining those parts
of the brain which would beinvolved with and by motor I

(29:17):
mean movement the control ofyour muscles compared to
learning to ride a bike for thevery first time when you're 65,
it's probably going to be awhole lot harder.
So that's what I mean by domainspecific.
I think the key to changinghabits is to understand are you

(29:37):
performing a behavior that youno longer want to perform or are
you trying to learn a newbehavior?
That all comes down to, ifthere's a behavior that you're
performing that you no longerwant to, that could be part of
your health.
Say, um, what's an unhealthyhabit someone might have?
Um, like, maybe they have likeeating junk food like a massive

(29:59):
bowl of ice cream after dinnerevery night.
So what's?
the cue for late night meals orlate night meals, there's always
a cue or a trigger or asituation which means that that
behavior rolls out.
And so you've got to identify,when it comes to behavior change
, are you performing a behavioryou no longer want to, and
therefore, what is the cue orthe situation that causes that

(30:20):
behavior to just roll outwithout thought or motivation or
much emotion whatever, and thencan you change that cue or
situation.
If it's a particular personthat you see that always causes
a particular thought pattern toroll out, can you avoid that
person?
Perhaps you can't avoid thatperson.

Speaker 2 (30:41):
It triggers you for some reason.

Speaker 1 (30:42):
It can't eliminate that person from your life, can
you remove the cue?
Because if you remove the cueor the situation, then there's
nothing prompting the habit.
If you cannot remove the cue orthe situation, you can't move
house, move job.
Moving house is a really greattime to implement new habits and
behaviors and this has beenquite well studied because

(31:05):
you're changing all of thecontext in the situation you're
in.
When you move to a new house.
The first evening you're inyour new house and it starts to
get dark.
You don't know where the lightswitches even are to go and turn
on the lights, right as you'velived in that house for a few
years and it starts to get dark,you're not having to think
about where the light switchesare to turn the lights on right.
So context is incrediblyimportant and it's a great time

(31:30):
to implement new behaviours iswhen you move house, because
you've changed context.
So you've got to figure out isthe behaviour I'm doing one I
don't want to do, or is there anew behaviour I want to
implement but say I can sort ofstack it on something else I
already do?
So my husband recently he'salways got to, you know, putting
his back out every now and thenand that's where he kind of

(31:50):
stores his stress he went andsaw the physio and the physio is
like well, I need you every day, I need you to be doing leg
swings and I need you to bedoing squats.
And so then the physio is likeand this is classic behavior
change sort of strategy.
Do you make coffee everymorning?
My husband is like and this isclassic behavior change sort of
strategy.
Do you make coffee everymorning?
My husband's like yeah, he'sgot his fancy coffee machine.

(32:11):
And the physio says okay, well,will you turn your machine on?

Speaker 2 (32:14):
and then, when you stand there, do your squats, do
something, do your leg swings.
That's actually what I do.

Speaker 1 (32:18):
Yeah, you're stacking a habit onto something Because
you're always going to have yourcoffee right.

Speaker 2 (32:22):
Yes.

Speaker 1 (32:22):
Because coffee is a habit, but there's also caffeine
in there which is addictive,Although coffee is probably one
of the few substances we canbecome addicted to, and doesn't
you know, you don't drink toomuch.

Speaker 2 (32:33):
It's actually good for you.
It's actually quite good foryou.
It's a lot of studies on there.
We just think I love my coffee.

Speaker 1 (32:39):
You know up to three cups, you're good I get so
excited when I go to bed atnight.
I'm one of those people.
I can't wait to go to bedbecause I get my coffee, and
then I sit up and bed.
My husband brings me the coffeeafter he's done his squats, and
so this is so to change yourbehavior.

Speaker 2 (32:55):
Can we stack onto a behavior?

Speaker 1 (32:56):
we are already doing.
And then what?
And so you've got a prompt.
And then great advice and, butthen you've got to then roll
that behavior out and thenthat's what's hard, is doing the
behavior enough times so itfeels good and it feels
rewarding that your brain'sgoing to go.
Okay, I'm just going to do thisautomatically.

Speaker 2 (33:17):
So that way it turns into a habit.

Speaker 1 (33:19):
But that's not always necessarily.
That's easier than said thandone.
It depends on how rewarding andengaging that behavior is.
So a great example here we cantalk about teenagers, right.

Speaker 2 (33:30):
Yes.

Speaker 1 (33:31):
So how many times would you have to tell a
teenager to clean and tidy theirroom and put their clothes in
the washing basket to be washedfor them to automatically do
that without being asked?

Speaker 2 (33:42):
You just set off a trigger in there.
I don't know yeah.

Speaker 1 (33:44):
Like weekly for five years.
They probably still won't do itright.
Because there's.
It's perhaps not very fun orrewarding or exciting for that
behavior for them to become ahabit.
But how, how long did it takethem?
You gave them one of thesethings and, um, how long did it
take that for their behavior tobecome habitual?

(34:05):
Because this is like way moreengaging and you get so much
reward from that behavior, itbecomes a habit to use it very,
very, very quickly compared tocleaning and tidying their room.
So there's no set number ofparticular repeats for that
behavior to become habitual.

(34:26):
It's all mixed up with howengaging and rewarding and fun
that behavior is for you torepeat well, I think it goes
back to dopamine, right?

Speaker 2 (34:34):
um, maybe you can tell us a little bit what
dopamine does to our brain,because you know you, you
pointed out this thing here andfor the listeners we're holding
up our cell phones and talkingabout teenagers and talk to us a
little bit about how the rewardsystem in the brain works and
why.
Basically, the principle ofwhat you just said.

Speaker 1 (34:57):
So dopamine is?
I like to think of it as alearning molecule, Essentially
what it does and all our brainsare doing.
Let's just take a step backfrom dopamine.
All our brains are doing andinteresting I think our immune
system is quite similar to ournervous system is it is learning
by experience.
It's experiencing all of thestuff that's happening in our
body and the world around us andmaking meaning of it and going,

(35:19):
huh, that was useful, I'm goingto do it again next time.
Or huh, that sucked, I'm notgoing to do that.
And part of that process oflearning and understanding what
was great, so I will do it again, and what sucked, I'm not going
to do that ever again is thatprocess of learning.
And one of the neuromodulators,which is the molecule, dopamine,

(35:44):
which has released its synapses.
There's not actually that manydopaminergic neurons in the
brain.
There's quite a limited number.
But we've got neurotransmittersin our brain and the two main
ones are glutamate and GABA andthey actually do all the heavy
lifting and all the work andmost of the synapse
communication.
And then we haveneuromodulators, which are far
more famous and I always feelsorry for glutamate and gaba

(36:04):
because they do the work, butneuromodulators the neurons that
make them.
They're far fewer in number butthey have a kind of a broader
kind of effect and that thatit's almost.
I think of them as like anold-fashioned radio, like what
we grow up with.
You know, you had your trebleand your bass and you could dial
up and dial down.
I don't know what you do now.
You just press play on Spotifyor whatever, and neuromodulators

(36:29):
almost kind of allow you todial in or dial out, or they
amplify or minimize thesignaling of glutamate and GABA.
And one of the roles of dopamineas a neuromodulator when you
have an experience is you go ohwell, that was really cool, I
enjoyed picking up that phone,and so you've got dopamine.

(36:52):
Kind of it's almost it's.
Neurons with dopamine aretonically active, which means
they're not on or off, they'realways kind of firing away.
And when something happens thatyou really enjoy, it goes.
Loads of dopamine is kind ofreleased.
And that something happens thatyou really enjoy, it goes.
Loads of dopamine is kind ofreleased, and that's a learning
cue.
And so your brain goes huh,that experience was quite good.

(37:12):
And that means next time, inanticipation of that experience,
before it even happens,dopamine is released to remind
you that that was quite good andthat kind of drives you
forwards to want to do thatagain.
It doesn't.
You don't get the reward.
Once you've done that behaviora few times, the dopamine is

(37:32):
released almost in anticipationof that.
So it's like the coffee we'regoing oh, I'm looking forward to
having the coffee.
It's not necessarily thedrinking of the coffee, it's the
anticipation it's the dopamine.
But dopamine, because it'stonically active and this is
really important.
It's like a guy beating a drumor a drummer it could be a girl

(37:53):
as well, A drummer there'salways a da-da-da-da-da-da-da-da
, and that's really greatbecause it means it can go
faster, but it can also goslower.
And dopamine, when youexperience something that you
really do not like or it's a bitof a letdown, dopamine kind of
signals a bit of likedisappointment or that sort of
sucked, and that means next timeyou think about that experience

(38:15):
or an anticipation of thatexperience, you're like oh,
you're almost kind of, insteadof moving towards, you're kind
of moving back and not wantingto engage in that again, because
dopamine has also signaleddisappointment.
It's not just reward, it'sactually learning.
It's like what worked, I'mdoing it again, what sucked, I'm
not going to try that again.

(38:36):
And that is a very interestingthing to think about,
particularly if, say, you've gotkids who have really negative
experiences, say in education.
My 15-year-old son is studyingMacbeth at the moment and he's
got an essay on Shakespeare too,and there's perhaps not many
15-year-olds who are lovingwriting their comparative essay

(39:01):
on Macbeth and the pursuit ofhappiness.

Speaker 2 (39:04):
Those were my nightmare in high school.
Oh my God.

Speaker 1 (39:06):
Everyone has been, and my oldest son, who is very
academic but a bit of a, helikes to think he's quite sigma,
he's quite a cool guy actuallyhas decided he likes Shakespeare
, I think, just to wind hisyounger brother up, but has been
an amazing coach on trying tocoach his younger brother up,
but as being an amazing coach ontrying to coach his younger

(39:27):
brother through this essaywriting.
And then the four of us were inthe car this morning driving to
.
I dropped my boys off at schooland my husband off at the ferry
, which the four of us arehardly ever in the car anymore.
You've got teenagers thatdoesn't happen.

Speaker 2 (39:40):
And then I was like isn't?

Speaker 1 (39:40):
it great, the four of us are in the car.
And my husband says I know.
And then I was like, isn't itgreat?
The four of us are in the car.
And my husband says what can wetalk about?
Let's come up with a topic.
And my oldest son says let'stalk about Macbeth.
And of course he just did thatto piss his younger brother off
Jokingly, yeah, yeah.
No, he's like me and my husband.
Let's talk about Shakespeareand my youngest son's going.

(40:01):
I hate Shakespeare and that'sbecause he's had these
experiences of Shakespeare,which is hard, it's hard to get
your mind, you can't kind of getthrough it, and very few kids,
I think, get to the other sidewhere they go.
Actually, they like the grind,they like the learning curve.

Speaker 2 (40:20):
See, I feel it's too early because in English we had
to do Reed Macbeth and that wasin Germany.
Actually, here in the Statesthey canceled it because they
said it's sexist or racist, Idon't know what.
It's crazy.

Speaker 1 (40:35):
You can look at it within, but I think you look at
it within the context right thewoke society in the U S that
that shifted the pendulumtowards the other side.

Speaker 2 (40:45):
But in Germany I had to read Macbeth in English,
which was our yeah, yeah, thedouble challenge.
It was a double challenge.
I hated it because I justdidn't understand it.
I was 15.
I was chasing girls.
I just didn't understand why Imy brain wasn't even wired.

Speaker 1 (41:03):
You sound like you, sound exactly like my son.

Speaker 2 (41:06):
I hated it.
It was torture.
It is torture.

Speaker 1 (41:10):
And because there's no reward around that.

Speaker 2 (41:12):
But why is it part of the curriculum?

Speaker 1 (41:14):
Because I think it's a really good.
It's very good to understandEnglish.

Speaker 2 (41:17):
Yeah, in college.
No, I disagree, because inAustralia you don't go in and do
everything in your first yearof university.

Speaker 1 (41:24):
That's true, I think it is really good to be
intellectually challenged and tobe-.

Speaker 2 (41:30):
I guess yeah, you're right.

Speaker 1 (41:32):
They were not going to go down that path in Germany,
because the German academiccurriculum is so intellectual
and intellectually rigorous.

Speaker 2 (41:38):
And.

Speaker 1 (41:39):
I think we need to challenge kids.
We perhaps just need to teachit in new and different ways.
And if you've got a greatteacher and you get all the way
through that process and youunderstand the themes, you
understand, you learn about thelanguage, you learn about the
figures of speech and you cansee how those themes are still
current today.
But that process of gettingthere doesn't feel like a lot of

(42:02):
fun, and so the brain is goingthat sucked, I don't want to do
it again.
That really sucked, I reallydon't want to do it again.
So there's no motivation towant to repeat the behavior.
So you're moving away from thatand essentially so.
We've just used Macbeth hereand Shakespeare as, and you're
still a little bit troubled byyour experience.
Whereas I loved Macbeth, Ithought it was awesome.

(42:26):
I love that play, it's myfavorite but that's what the
brain is doing.
All it's doing is learning.

Speaker 2 (42:31):
It's interesting.
I want you to kind of tell us alittle bit about the difference
between a male and female brain, because I remember all the
girls in my class around thatage first or second year of high
school, when we're doingMacbeth and also in German
literature, where we're doingthe German literature all the
girls were hyper-engaged, likethey were the ones that were

(42:52):
raising their arms.
They had usually the bettergrades and for us at least for
me and other than several one ortwo boys it was just much
harder.
We weren't that interested.
Is it because the maybe teenagefemale brain develops a little
faster, matures faster, and sobecause they had a better

(43:14):
understanding, they wouldcomprehend things better, they
got more engaged and we werejust not mature enough yet, even
though we're the same age.
How does that differ betweenthe two genders at that age?
So there's kind of two questionsthere, just like the male
versus female brain and then theteenage brain.

Speaker 1 (43:35):
So I'll come back to talking about broad scale sex
differences in the brain but Iwill just say, yes, brains go
through puberty too in the brain.
But I will just say, yes,brains go through puberty too.
But what we see and there's abit of it's like girls are more
mature than boys and part ofwhat we would see in classroom

(43:58):
behavior is partly that.
but it's also that's the kind ofthe social expectation, whereas
girls have been socialized andyou know happier to kind of sit
in class and engage and puttheir hands up whereas the boys
are a little bit slower to dothat, and I see every and I've
told this story a number oftimes as well when I go to my
son's high school prize givingevery year the first, and
they're in high school for sortof six years.

(44:19):
we don't have middle school hereso from sort of 12 through to
17, and the girls are gettinggetting the first prize,
first-in-class prizes probably70% are girls sort of years 7, 8
, grade 7, 8, 9, 10, 11.
And then we start to see theswitch, and in that final year
it's the boys are topping that.

Speaker 2 (44:40):
Is that a maturation shame?
Is that maturity.

Speaker 1 (44:43):
Is that testosterone?

Speaker 2 (44:46):
Is that social?

Speaker 1 (44:47):
Because that was exactly my story, yeah, and, and
you see that, and I think thatthere's so many pieces to that
like.
Firstly, I will say we seebrain maturation and during um
puberty and adolescence tracksalongside pubertal stage versus
chronological age.

Speaker 2 (45:04):
Makes sense.

Speaker 1 (45:05):
So we see you could have an early maturing boy with
a more mature stage of braindevelopment than a late maturing
girl.
So again we've got standarddistribution curves of
everything, including pubertaldevelopment.
So on average a group of 1,000girls would go through puberty
about a year or so before agroup of 1,000 boys.

(45:26):
But you'll have kids at eitherkind of end of that.
So perhaps that's part of it.
Girls have also been socializedfrom a very, very young age to
kind of behave in ways that area little bit more appropriate to
the classroom, and that startsquite young.
But we do see these differenttrajectories in terms of, say,
maths achievement and andchildhood with girls is slightly

(45:48):
less than boys.
And is that to do?
You know how much of that issocialized versus biological the
trajectory and I have aquestion on that.

Speaker 2 (45:56):
If we can come back to that too, yeah, so we've got,
we've got a couple of thingsyou've put.

Speaker 1 (46:00):
Can you put the pins in these?

Speaker 2 (46:01):
things.
Yes, I will, I will.

Speaker 1 (46:02):
I've put the pins, I'm looking around for a pen to
write notes, to remind myself tocover these off.
I'll remind you yeah, and it'sinteresting because I suppose
we've got that maturation aspect.
We've also got the social kindof environment the kids are in
and how girls are socializing inadolescence and how boys are
socializing in adolescence.
Boys are socializing inadolescence and we know once

(46:22):
testosterone enters the picturethere's that kind of social
hierarchy and jostling forposition that boys and males
across all species do.
We see that across all culturesthere's that and it's much more
good-natured, whereas girlsaren't socialized and perhaps
have less of a biological driveto be as hierarchical as boys

(46:45):
are.

Speaker 2 (46:46):
Is that an evolutionary biology thing?

Speaker 1 (46:48):
Perhaps I don't know enough about it, and this is
just my observation.
But my oldest son said to me Isaid oh well, what's happening
with the girls?
He said oh well, the girls whoused to be first in class in
year seven and eight aren't nowand all the boys are kind of
working their way up.
And he said all the girls aretoo busy fighting with each

(47:10):
other.
This, they're becoming moresocially complex and they're not
wanting to compete with eachother, whereas the boys are
happy to compete and happy tohave to compete for rankings in
ways that the girls aren'tnecessarily, and so that's like
a combination.
There it's hard to say is thatall biological?
How much is testosterone?
How much is socialized in waysthat the girls aren't

(47:30):
necessarily?
And so that's like acombination.
There it's hard to say is thatall biological?
How much is testosterone?
How much is socialized?
It's always going to be acomplex mix of the two, and
often what we see is boys justmuck about for a lot of high
school and then right at the endof high school in Australia at
least, when it really countsthen they kind of lock in and
then they study to get the gradeto get into the university
course.
So how much of that is nature.
How much is nurture?

(47:50):
Is it mother nature?
Is it the patriarchy?

Speaker 2 (47:52):
It's going to be a combination, as everything to do
with the brain and behavior isWell I mean, if you go back
millions of years and you seehow, even in the animal kingdom,
how males and females behave.
I mean, of course, a lot of ourbehaviors have to do with
hormones, the social ranking andstatus even in the animal

(48:14):
kingdom, and I think, from anevolutionary biology standpoint,
is how things evolved.
You know, when the female in theanimal kingdom or the women in
humans, when they bear a child,you know their brain is their
entire focus is on protectingthe child and raising the child,

(48:38):
and so all the biochemistry intheir brain is basically, from
an evolutionary standpoint, justgeared to focus on the child,
to protect the child and raisethe child.
And back in the days when wewere cavemen, you know, I'm sure
there were a bunch of womenwith a bunch of children,

(49:00):
protecting them, feeding them,raising them, just like in the
animal kingdom.
And then, even though with thelions is the, the females that
go hunting, but then the maleswould go and, you know, hunt or
protect the tribe and then comeback with food.
How much of that do you thinkhas to do with how the
neurochemistry or, um, ourbrains have evolved, because

(49:21):
we're talking about millions ofyears, we're not just talking
about the patriarchy, or becausewe're talking about millions of
years, we're not just talkingabout the patriarchy, or we're
not talking about the past, Ialways say is it Mother Nature
or the patriarchy?

Speaker 1 (49:31):
I think there are, across cultures and across
species, sex-based differencesin terms of behavior,
particularly when it comes tochild-rearing, because of course
mothers get pregnant and bearthe young and mammals we feed
are young.
But some mammals are notalloparents like humans are,

(49:52):
whereby we raise our children atgroups.
You know, you've got a cat whohas kittens in the wild.
She needs to go and hunt andgather food to bring that back
for her own kittens.
She's not got someone elsedoing that for her, so we've got
.
When you go through yourpregnancy and then have your
babies, there are veryspecies-specific behaviors which

(50:14):
emerge as part of the maternalbrain which determine which
behaviors you need to do to keepyour babies alive.
A dolphin's behavior is going tobe very different from a
herding animal's behavior from ahunting and gathering animals
from a predator's behaviorTypically whatever that mother
needs to do to keep her babiessafe and alive, she's going to

(50:35):
get better at, and then thatmeans her attention will be less
focused on other types ofbehaviors.
I just want to get back to,before we talk about the
maternal brain, the sexdifferences question, because
that's really quite.
I used to not like talking aboutit, but now I'm really happy to
talk about it because I feellike the data has emerged to
kind of give us insight intoanswering some of these

(50:58):
questions, because we've gotmore data now so we can say with
more certainty various things.
But also, I've been thinking alot about the brain for many
years now, and when we look at abrain there's so many different
things that we can measureabout that brain.
If we were to look at adifference between a male brain
and a female brain, what wereally should be doing is

(51:19):
looking at like a thousand malebrains and a thousand female
brains and we are able to dothat now with biobanks and data
sharing et cetera.
But to get a metric of a brainto compare to another brain,
there's a thousand differentthings you could measure.
You could look at the overallsize and shape of a brain.
You could look at varioussubcortical nuclei and look at
their size and shape.
You could look at countingneurons.

(51:41):
You could look at receptors.
You could look atneurotransmitters.
You could look at what does thebrain look like in a scanner in
response to a particularstimulus.
What do the networks look like?
How do they change acrosspuberty, across other
reproductive life?
You know experiences in females.
You could look atsusceptibility to disease, to

(52:01):
mental health risk.
You could look at particulartypes of behaviours.
You could do a battery ofcognitive tests.
You could do 15 different typesof cognitive tests, and so
you've got thousands ofdifferent metrics and some of
those measures.
If we looked across male andfemale populations, you would
see sex-based differences andsome of those metrics you see no

(52:22):
differences whatsoever.
Sometimes people talk about amosaic and that you'll see some
differences in some metrics andnot in others.
And when we do see a sex-baseddifference, typically if we look
across populations asoverlapping standard deviation
curves, you've not got blue andpink.
You know blue brains over hereand pink brains over here.

(52:45):
You're looking at quite subtlestatistical differences.
And if you do see thesestatistical differences, the
question then is whatcontributes to that?
Is that 100% biology?
Is that all down to XY, xxchromosomes, testosterone in
males, sex you know hormones infemales or is it down to perhaps

(53:08):
something a little bit morelike you know reproductive life
experiences in the female, or isit completely socialized?
Does it all come down to sortof experiences you have by
virtue of growing up, male andfemale?
And there's a couple offascinating studies that have
come out in the last couple ofyears, some of them within the
US, looking at between states,and some of them globally,

(53:31):
looking between countries.
So one of the studies was inthe journal PNAS 2023-ish I
believe it came out, and theywere looking at brain structural
differences between males andfemales in different countries
in the world.
So it's mri looking at thestructure of the brain and
people in early midlife, so likelate 20s, early 30s, so past,

(53:56):
you know, adolescence, earlyadulthood so basically mature
brain yeah, an early maturebrain and looking to see based
on the gender equality withinthat country.
So equality of education,equality of employment, equality
of environmentally enrichedexperiences.
And they ranked all of thosecountries and so countries like,

(54:18):
say, the Nordic Scandinaviancountries, very high gender
equality and this study, Ibelieve Turkey, brazil and I'm
not sure what other countriesTurkey and Brazil ranked quite
low and India ranked quite lowin gender equality and the
differences between the male andfemale brains were greater when
there was greater genderinequality and were more similar

(54:40):
when there was gender equality.
The male brains were prettysimilar everywhere in the world.
It was the female brains incountries with more gender
inequality that were kind ofdeviated.

Speaker 2 (54:50):
And then what does that mean?
Is that like are weinterpreting it in a good way or
bad way, or neutral?

Speaker 1 (54:57):
Well, I don't think it's good or bad.
What it's saying is that it'snot just biological sex which is
contributing to the differencesthat we always see.
When we see a difference betweena group of males and a group of
females, it's always going tobe a combination of both.
So here we're seeing genderinequality made the differences

(55:18):
greater because there was lessenriched we would call it an
enriched environmentalopportunity for girls in
education and then in employment, and then perhaps the stress of
gender inequality in thoseparts of the world.
And similar studies have beendone looking at not just and
that's looking at brainstructure.
So in the last year or twostudies have been done within

(55:40):
the US looking at equality ofopportunity within different
states in the US, looking atpeople in their 80s and 90s and
so casting back to what theirearly lives were like and which
state in the US they lived inand the states that had the
greatest equality of opportunityfor people when they were in

(56:01):
early life and going throughadolescent and early life
development and off the top ofmy head I can't remember it was
a state like Connecticut, Ibelieve, that had greater
equality.
The people in those states inthe 80s and 90s had better
cognitive health and a lowerrisk of dementia than people
who'd grown up where there wasless equality of opportunity,

(56:24):
which I believe and I can'tquite remember.
I think it was Mississippi andI'm not from the US, so I'm just
kind of imaging a map in mymind where there was greater
inequality for people now intheir 80s and 90s.
So we've got biological sex, butwe've also got the experiences
that you have by virtue of thebiological sex you are.

(56:46):
Gender is something different,because gender is.
We could use gender to describethe experiences that we have
based on the biological sex weare.
So we would talk about genderequality or gendered experiences
.
But then gender now is alsoused to describe the feeling
that you have about yourbiological sex and whether the
feelings that you have matchwith your biological sex.

(57:07):
And we can't image that becausethat's a belief or a thought
process about your biologicalsex.

Speaker 2 (57:13):
We're staying within the context of the biological
definition of sex.

Speaker 1 (57:19):
But your biology determines the life experiences
you have, but it depends wherein the world you are.
So are you going to compare thebrain of a woman who's 80 years
old, living in India, with thebrain of an 18-year-old living
like my son, living in Australia, with every kind of advantage
given to him, just by virtue ofthe fact of where he was born,

(57:39):
they're going to have vastlydifferent life experiences.
So the only thing that's it'snot only biological sex, that is
driving that.
It's an experience of a lifetimethat's also driving those
differences.
So it's so.
It's fascinating to think andtalk about.

Speaker 2 (57:55):
And when some people say, yes, there are sex
differences and other people say, no, there are not, some people
say it's all mother nature,some people say it's all
patriarchy it depends whichmeasure you're looking at, which
one you want to pick out andthen study and then say what's
driving that of course and itthat's very interesting because
really, I mean it totally makessense our brains are, um, the

(58:20):
sum of our biology, of of ourexperiences, of what we went
through.
All of those things take aneffect, and that's something you
talk about a lot.

Speaker 1 (58:30):
Yeah, biology and biography.

Speaker 2 (58:32):
Exactly.

Speaker 1 (58:33):
And then also expectation.
And then also, you know,because we're humans, we've got
whether we call it mind, orwhether we call it thoughts or
whether we call it expectations,we've got what's happening in
our biology, we've got our lifeexperience, but we're filtering
that through and creating anarrative and an identity and
making meaning of that andthat's also influencing, then,

(58:53):
the outcomes and the experiencesthat we have, what we believe
may happen.
Well, you know, what we tuneour attention into can also
alter, you know, alter thatexperience that we have.

Speaker 2 (59:06):
So let me ask you a question, and this is probably
difficult to answer because it'slike asking was it the chicken
or the egg?
What is an introvert and what'san extrovert?
Can you turn an introvert intoan extrovert and vice versa?
I can imagine vice versa isprobably easier.
But how much of it is againgoing back to the question, how

(59:29):
much of it is biology?
How much of it is how you wereraised?
How much of it stems fromchildhood experiences, how you
were raised, perhaps what youexperienced as a child?
Do we know anything about that?
Because, as you said, the brainis as far as neuroplasticity,
has the biggest plasticity inwhat I heard you say in a
podcast during the first fiveyears of your life.

(59:53):
And so how much of that has todo with being introvert versus
extrovert?
Is it from the day you wereborn?
Is it written in your genes?

Speaker 1 (01:00:02):
I don't know anything about the science of
introversion and extroversion,so I can't answer that at all.
Sorry about that yeah.
I don't know much about that.
I mean, that's kind of more interms of personality science and
I'm not that familiar with thatso I wouldn't want to say but
any kind of behavior is going toemerge like, as I said, as a

(01:00:24):
combination of your biology andyour biography.
It all stacks up In terms ofwhen our brain's most plastic.
So if we think about brainsdeveloping loosely from the back
to the front, and if we thinkabout what's at the back of our
brain in terms of our cortex asour visual system, and so we
know that that's developed andpatterned up and starts to see

(01:00:46):
in the experiences that we have,as we see wire up the visual
part of the brain and that'salmost the first part of our
cortex to develop.
And that's what I actually didmy PhD research on was
development of visual cortex andwhat drives the development and
the wiring up of patterns, ofconnections in that part of the
brain.
And then, if you move a littlefurther forward in your brain,

(01:01:09):
you've got like hearing andyou've got language and you've
got sensory input, you've gotmotor and movement and then
finally the frontal parts ofyour brain are more involved
with things like socialcognition cognition, executive
function, emotional regulation,planning, judgment, reasoning,
and we see this trajectory ofbrain development and the

(01:01:29):
emergence of behaviors andskills across development from
birth all the way through tolate adolescence.
And so we see these kind ofwindows of plasticity sort of
open and close off more or lessclose off, depending Vision will

(01:01:49):
close off much earlier and muchfirmer than, say, your ability
to regulate your emotions, whichis a bit fuzzier around the
edges in terms of that windowopening and closing.
And by plasticity that meansthat the experiences you have
are often fundamentally requiredto guide the wiring up.

(01:02:10):
So the experiences you have aregoing to determine what that
brain kind of functions likelater in life.
Language is a great example ofthat and we now know how and I
don't know whether it happenseverywhere in the world but
certainly in Australia babiesare screened for hearing loss
before they even leave thematernity ward and the hospital.

(01:02:30):
Because if they are born deafand no one picks it up until
they're three, four or five, thelanguage centres of their brain

(01:02:51):
have kind of reached the limitsof experience-dependent
plasticity and it's that muchharder for those brain centres
to be able to learn and changeand grow.
So we've got that kind oftrajectory of plasticity.
The changes that we see duringadolescence are these kind of
more frontal lobe functions, andthat doesn't mean that those
parts of the brain are notworking, or the terms I hate
when people talk about theteenage brain and adolescence
are like it's undergoingrenovation, or it's half

(01:03:12):
developed or it's not fullydeveloped.
And we are so dismissive andderisive towards teenagers
learning those skills.
We should be enabling them tolearn these skills.
We're nurturing.

Speaker 2 (01:03:23):
We should be enabling them to learn these skills.
We're nurturing.
We should be nurturing them.

Speaker 1 (01:03:26):
And we say so when teenagers perhaps make decisions
which might show lack ofjudgment or planning.
We go oh well, it's becausetheir brains are half developed.
They will eventually develop bythe age of 25.
We would never speak totoddlers going oh well, they
can't pronounce that wordcorrectly.
I suppose by the time they'refive their brain will be
developed and they can speakclearly or look at them falling

(01:03:48):
over while they learn to walk.
I suppose their brain's halfdeveloped.

Speaker 2 (01:03:52):
We wouldn't dream of that.

Speaker 1 (01:03:53):
We are so mean to teenagers.
Well, what we should be doingis ensuring Maybe it's because
they're mean to us.
Well, they are.
But there's a reason for that,right, Because part of what we
need brains to do and the ownersof those brainsorientation,
which is necessary for them tokind of develop their own

(01:04:14):
identity and make their way outinto the world and they need to

(01:04:37):
be focused more on their friendsthan on their family that type
of input from outside of thefamily nest, the family home, to
guide and wire up those partsof the brain and leaving the
family nest requires bravery, itrequires courage, especially
when you first start steppingout.

(01:04:58):
It's quite scary and the flipside of that sometimes is almost
too much courage, too muchsensation-seeking, and we might
call that bravado.
But teenage brains need to besensation-seeking because they
need to be driven to trysomething new and different than
what they've always done athome as kids.
They need to besensation-seeking and part of

(01:05:18):
that involves a lot of thesensation-seeking and perhaps
risky behaviors and silly thingsthat teenagers do.
And no judgment to anyone outthere who's a parent, because
I've got teenage boys and I'veseen some wild and crazy things
go on as they are sensationseeking and that's not because
their brains are half developedand they are stupid until

(01:05:39):
they're 25 or they don't knowwhat they're doing.
It's just the drive to seeksensation and yeah I hear
sensation and tribal approval,while you were doing that.

Speaker 2 (01:05:49):
I actually heard an evolutionary biologist talk to
that topic, saying that when youlook at the animal kingdom, for
example, lions, the young,adolescent lions, that's why
they even attack the pack leaderor their own father in you know

(01:06:10):
, in term, in so that they canmove up the hierarchy.
But the reason why they becomeor start turning on their own
pack and hating it is just sothat they can leave the pack and
join a different tribe and sothey don't co-populate in their

(01:06:31):
own tribe from a biologicalstandpoint and behavior is also
embedded, so that the teenager,just like you said, will obtain
the courage to go out and makenew connections and learn new
stuff in order to develop thebrain.

Speaker 1 (01:06:52):
Yeah, and they're probably moving towards new and
interesting sensations andpeople and experiences, but
there's perhaps also a bit ofmoving away from.

Speaker 2 (01:07:04):
Yeah, so you don't co-populate.
Yeah, 100%, so you get morevariety of genes.

Speaker 1 (01:07:10):
Absolutely, and the brain requires those types of
experiences, and that's all partof identity formation as well.
And even if we look at thestories that we tell ourselves
about who we become as we arebecoming young adults or as
we're becoming parents or laterin life, we've constantly got
these narratives and thesestories that we're telling as we

(01:07:32):
create ourselves, and we cansee the emergence of the meaning
that we make about the storieswe tell about ourselves through
adolescence too.

Speaker 2 (01:07:38):
Certainly certainly.

Speaker 1 (01:07:40):
And that's the becoming of an adult.
So we talk about adolescence,becoming of an adult.
So we talk about adolescence,and I think we so often default
to talking about dysfunction andtalking about the things that
they do wrong, instead ofunderstanding that their brains
are Well, humans love to bejudgmental.

Speaker 2 (01:07:54):
Yeah, we just love to be judgmental.
That's just a societal issuethat we have.
We love judging things.

Speaker 1 (01:08:00):
And they're at their peak of learning and that I
don't love shakespeare, yeah,but that's okay, we're.
So you know this.
The studies that have been done, looking at risk taking, for
example, and you can get youknow, there's this really
well-known study where theywhere they got kids, teenagers,
into the research lab and theygot them to play like kind of a

(01:08:22):
driving game, like kind of achicken game, and the more risks
they took, the more points theygot them to play like kind of a
driving game, like kind of achicken game, and the more risks
they took, the more points theygot.
And when they were driving bythemselves, the teenagers took
no more risks than when an adultdid.
It was only when they had theirmates looking over their
shoulder, kind of egging them onto take more risks.
So, they're well able to makejudgments and take risks, but

(01:08:44):
the sensation seeking and thetribe approval and the and the
sense of belonging that comesfrom doing something a little
bit edgy um is outweighs thesense of decision making.

Speaker 2 (01:08:56):
If my boys are listening, just drive alone.
Don't have your friends in theback seat.

Speaker 1 (01:09:00):
I think, yeah, and I mean, I don't know what it's
like in the us, but here we'vegot quite strict rules, and in
New Zealand as well, when you gooff your learner's license,
here it's called being on yourprovisional, your P's, and you
have a P on your car.
There's quite strict rulesabout how many other people
you're allowed in the car aftera certain time.
You're only allowed one otherperson after 11 pm in the car

(01:09:21):
with you et cetera.
And that's exactly because ofthat, because when they're by
themselves they don't typicallymake as silly decisions as when
they're in a group.
And that's all normal andnatural and healthy, I think.
But we tend to be so brutal andwe've fixated on this idea
about 25.
A lot of the brain developmenthappens kind of during puberty.

(01:09:45):
I just think we need to flipthe script.

Speaker 2 (01:09:50):
Yeah, what is up with that?
Because you know what does itcome from.

Speaker 1 (01:09:54):
Because it doesn't like get to 25.
And then it's mature and youbecome this complete mature.

Speaker 2 (01:09:59):
I know people my age.
They behave like 12-year-olds.
I behave like an 8-year-oldsometimes, so I don't buy into
all of that.

Speaker 1 (01:10:07):
I totally agree with you, but why?

Speaker 2 (01:10:09):
is it that they say the male brain, especially the
frontal lobe, the part of thecognition, doesn't fully mature
up until age I don't know 27 orwhatever that age is, and why is
it?

Speaker 1 (01:10:20):
different than the female brain.
Well, I haven't heard that it'sany different from the male or
female brain.
It's just typically and maleshave also got, you know, the
added bonus of and testosteroneis pretty wild in terms of
development.
I've got teenage boys in thehouse.
I have this newfound respectfor how it creates these bodies
and these brains and thesebehaviors.

(01:10:41):
So there is more risk-takingthat we would perceive as risky
in young males, and there hasbeen and there is in every
culture.
But then females also engage in, you know, like falling
pregnant is perhaps one of theriskiest things that you can do
as a female in terms ofmortality and in terms of health
.
But we don't tend to think ofthe risks that girls and women

(01:11:04):
take in the same way as we dowith boys and men.
So there's a bit of the socialperception of what risk is the
age 25,?
There's lots of differenttheories out there.
I think it's just one of theseideas which has kind of taken
hold and become popularised andwe see a trajectory of
development from, you know, inutero life the whole way through

(01:11:26):
, and we see different skillsand behaviors and cognitions
peaking and waxing and waning atdifferent ages.
There's some really cool newresearch which has just come out
from a friend of mine here insydney university more an irish
who's a cognitive neuroscientist, sydney University, more an

(01:11:46):
Irish who's a cognitiveneuroscientist who is looking at
measures of behavioral andcognitive flexibility.
So how flexible are you in yourthinking and your behaving, how
more or less set in your waysare you?
And the most flexibility isaround kind of your mid-40s to
your mid-50s.
So actually we peak in somethings at this age, which is
great news, right, becausetypically we valorize and only

(01:12:07):
talk about the kinds ofcognitive skills that we're
probably quickest and sharpestand fastest at and like, say,
you know, late teens, early 20s.
We seem to think that those arethe skills that matter the most,
perhaps in the workplace.
You know that quick fire memory, problem-solving thinking, but
other types of skills that weget better at through life,

(01:12:31):
wisdom.
You know you've got a lifetimeof experience.
That's guided you.
Wouldn't you rather you know ifsomeone was doing surgery on
you and your face, you'dprobably want one of your
contemporaries versus some younggun who's 22?
Right, just because I've got aquick memory, wouldn't you want
someone experienced and wisewith judgment?

Speaker 2 (01:12:52):
yeah, in our profession we say when um the in
our profession as a surgeon, wereally reach our peak around
age 50.
So yeah because you have a tonof experience and you're not old
yet.
You haven't fallen off theother side yet, where you know
maybe your eyesight or your Idon't know stamina, or your

(01:13:12):
hands are maybe shaking.
Yeah, yeah, yeah, your finemotor skills mid-40s to mid-50s.
That's our prime decade, andit's because of that you have
experience, perspective andstill you're on top of your game
.
But talk to me about let's getback into the 60s, 70s and

(01:13:37):
further.
Let's talk about brain fog.
This is a topic that it's becomea buzzword on social media,
especially as it pertains toaging, whether hormones,
especially in women withmenopause, or even with men, or
as a component of aging ingeneral.

(01:13:57):
It's affected most middle-agedto older population.
Can you kind of talk to us alittle bit about what causes
brain fog, because I heard youtalk a lot about that, the

(01:14:20):
common denominator when it comesto brain fog.
Really, to me, all things leadback to how much sleep we get
and how much of a quality sleepwe get, whether we're in
menopause, whether we're getting, quote unquote, older, so forth
.
How much of it has to do withthe, whether it's hormonal

(01:14:44):
issues or other habits, or is itlike a biochemical thing, or is
it just the aging of the brain?
That's how the cookie crumbles.

Speaker 1 (01:14:52):
Well, I think brain fog is probably one of those
words, but, like, stress needssome-.

Speaker 2 (01:14:58):
Yeah, it doesn't get vaguer than that.

Speaker 1 (01:15:00):
We need a bit of words German's quite good for
that or context, yeah, yeah, weneed.
I suppose we've got brain fog inpregnancy and motherhood.
We call baby brain.
Depending where you are in theworld, people with ADHD have
brain fog.
You've gone throughchemotherapy, you just missed a
few nights sleep, you've drunktoo much, whatever it's one of
these words which is, I mean,you would know, in medicine.

(01:15:29):
It doesn't have a formaldefinition.
It's a colloquial description ofsymptoms that someone would
bring to a doctor and say helpme out, and it's most often like
but I am 50, I am a 50 year oldfemale, so my entire algorithm
is geared towards sending meinformation about menopause
right now as if it is thislooming catastrophe, and I'm not
finding it particularlycatastrophic, um, but you know,
I'm perhaps doing a lot ofthings to avoid the catastrophe,
at least not the expectationand the mindset around the

(01:15:53):
information, because socialmedia is an active ingredient.
The information we absorb is anactive ingredient, in our
experience too.
So, yeah, I think we needbetter words for brain fog In
terms of brain fog around infemale menopause which is I
suppose where I'm most familiarwith it.

(01:16:13):
You use the term chicken and egg, and I think that's quite true.
We don't know whether brain fogfeeling like you can't remember
or not being able to find words, and for me particularly it's
names of people.
But then sometimes my husbandcan't remember names and I've
been with male people my age.

Speaker 2 (01:16:33):
One of my mates the other day.

Speaker 1 (01:16:35):
Yeah, I used to be really quick.
I'm just a bit slow.
I was with a mate the other dayand we were walking along a
river and there was a sunkenmattress in the river and he
said, oh, look at that mushroom.
I mean mattress.
And I knew he meant mattresswhen he said mushroom, but it
kind of looked like the color ofa mushroom.
So I know why he said that andI'm like he's not menopausal, so

(01:16:55):
it's not just Campy.

Speaker 2 (01:16:57):
That was a good guess .

Speaker 1 (01:16:58):
This is the thing, chicken and egg.
Is it directly due torollercoastering hormones of
menopause or the loss ofhormones after menopause?
Or is it some knock-on impactthat the changes in hormones are
having, perhaps on our sleep orperhaps on network
reorganization?
So we see, as brains mature, gothrough midlife, instead of

(01:17:22):
there being very specific,defined brain networks activated
while we complete tasks or tryand remember a name or a word?
We see more integration betweennetworks.
It's almost like the brain goeshey guys, we need more neurons
to get this job done, so let'steamwork so as we're going from
segregated networks to moreintegrated networks, is it that?
Is it?
And one thing that I thinkpeople forget when they're

(01:17:45):
talking about brain fog acrossmenopause is if we're now
including perimenopause andpeople are now saying, well, I'm
getting perimenopause symptomsin my early 40s, we could be
looking at 10 or 15 years ofbrain aging as well, until we
get to the other side ofmenopause.
So we've got natural brain aginghappening during that time.
So we don't know whether it'sdirectly due to hormones per se

(01:18:09):
that is directly impacting thefunction of neurons, or if it's
disrupted sleep, or if it's acombination or a kind of a
complex web of lots of factors,which it's probably going to be
a complex web of factors,because everything to do with
the brain always is.
I will say some studies thathave been done looking at
trajectories of women goingthrough, and we really need more

(01:18:31):
longitudinal studies.
We follow large groups of womenthrough so we see the various
trajectories and the individualvariation, because not all women
are the same.
And right now, because there'sbeen neglect within this space
in terms of education andresearch, we're only hearing the

(01:18:51):
worst stories because we'retrying to like dial up the
interest in this space.
We can't just go on.
Many women are fine.
That's not a very interestingstory.
We'd see women with differenttrajectories going through.
So some women will go throughthe perimenopause and menopause
and don't notice a thing.
Some women might go through andI'll probably put myself in
this space, being 50 and let'ssay I'm still perimenopausal,

(01:19:15):
with slight changes in verbalrecall and it's typically around
words because women aretypically if we looked at a
large population of women andmen men might be slightly better
at some aspects of mathematicalreasoning or spatial rotation.
Women on average might beslightly better at verbal recall
or kind of word games, say, andsome women might just see a

(01:19:42):
slight dip during perimenopausein terms of remembering words or
names or just blanking on words, and then they improve once
they hit menopause.
Other women, you know, kind oflike almost a perfect storm of

(01:20:08):
perhaps terrible sleep, othertypes of health issues, perhaps
out of control, vasomotorsymptoms which can't be managed
very well.
So we typically see kind of aconstellation of symptoms there.
And do we see those womenalways improving?
Not necessarily, but they mightnot necessarily keep declining
either.
So there's differenttrajectories of women and

(01:20:29):
different experiences women arehaving going through
perimenopause.
I think because we've talked somuch about brain fog right now,
my concern is that, as I say,this is also an active
ingredient in an experience.
You'll go looking for it andthen you will notice it and then

(01:20:49):
you might make the experiencefeel worse than it otherwise
might be.
Added on top of that right nowabout the only tool that we have
for perimenopause and menopauseis to add in some more hormones
.
We've got menopause, hormonetherapy, or still called HRT, in
many parts of the world and allwe can do is just keep adding

(01:21:11):
in some more estrogen andprogesterone, and maybe
testosterone, if you want to.
That's never going to mimic thatbrain ovarian conversation that
we've had throughout our lives,which is like a feedback loop
where there's this constantconversation.
That's very well regulated.
All we can do is just kind ofthrow some estrogen in to the

(01:21:32):
system and hope that that willhelp.
And when it comes to cognition,we don't always necessarily see
that helping.
If it's helping someone treatvasomotor symptoms, hot flashes,
night sweats and they'resleeping better, we might see an
improvement, but not if perhapsthey've got depression
alongside that.
So it's very complicated.
I think that give us another 10years, we might have some more

(01:21:53):
sophisticated ways of thinkingabout and understanding about
what's going on here Right now.
it's all very blunt tools.

Speaker 2 (01:22:00):
Yeah, but I think you broke it down beautifully
because it is a multifactorialthing and I don't think anyone
it even would make sense to beable to narrow it down to one
thing, because nothing is justone thing, you know.

Speaker 1 (01:22:15):
No, nothing is yeah.

Speaker 2 (01:22:16):
It was never one thing that developed your brain,
so it can never be just onething that affects your brain,
you know, and so it wouldn'teven make sense.

Speaker 1 (01:22:25):
Yeah, but I think that they're not the stories
that you know.
The charismatic solutions ofone thing sells a story right,
and that's not like you say.
It's never one thing.
People want it to be one thing.
The one tool that we have whenwe're having this conversation
about women in midlife Besides,of course, the boring advice

(01:22:51):
about exercise well and eat welland sleep well and try not to
get too stressed is to use HRT,and it's a very blunt tool and
right now it doesn't seem to bedespite what you may hear
otherwise the only answer forcognitive health.

Speaker 2 (01:23:04):
And it's certainly not, it's just a tool.
Yeah, it's certainly not.

Speaker 1 (01:23:07):
It's not a tool.
The data again, despite whatmany people may hear, is
incredibly mixed in terms of howit's going to impact
longer-term brain health,dementia risk.

Speaker 2 (01:23:17):
Certainly.

Speaker 1 (01:23:18):
It's very, very mixed data.
It's not preventing dementia,it's not causing dementia.
We've got studies saying bothand I often think about dementia
risk or risk for any health onone of those old-fashioned
scales where you've got weightsthat you put on either side and
you've got risks on one side andprotective factors on another
and sometimes you can't doanything about some of these

(01:23:41):
factors, Even simple habits likealcohol consumption, that can
affect it.

Speaker 2 (01:23:47):
You could have your hormones perfectly regulated.
You could have perfectlifestyle habits as far as sleep
, diet.
You put alcohol in the mix.

Speaker 1 (01:23:57):
it just shifts the whole balance of weight,
especially when it comes tobrain and maybe it depends how
big the alcohol.
I mean, are you drinking abottle of wine every night or
are you going?
Out and having a glass of winewith your friends once a week
and having a laugh.
So you know, you've got thesocial impact there and I think
with HRT in particular,menopause hormone therapy right

(01:24:18):
now we don't know the size ofthe weight and which side to put
it on and there's a few littleweights going on either side.
That's tipping the scales oneway or another and then we've
got like our sort of our geneticrisk underlying that.
We've got our genetic makeupand it may be that there's
different trajectories of peopledepending on their genes and

(01:24:39):
maybe that's going to be alteredby their early life experiences
, including how much educationthey had in early life.
All of that's going to senddifferent people off on
different trajectories of aging.

Speaker 2 (01:24:52):
They actually did an epidemiology study on looking at
the demographic status,education status, wealth status
of different various populationand their biologic age and their
all-cause mortality and youcould clearly see a huge

(01:25:13):
difference just populations fromdifferent socioeconomic status
that have a complete, higherall-cause mortality, different
biologic age, and so all ofthese affect and that proves the
point that there's so manyfactors involved in how we even
age, and to me, brain aging orhealth, is part of aging, it's

(01:25:35):
just like any other cell.
If your skin ages, your heartages, your lungs age, your brain
will age too, and vice versa,so it's so multibacterial, and
so that's why I always chucklewhen there is these influencers
coming say you have to do this,and if you do this this will
happen, and I'm like, really, ifit was just that easy.

Speaker 1 (01:25:59):
If it was that easy, it would be that easy and I
always joke.
I say there's the gut brainpeople and the hormone brain
people and the sleep brainpeople and the cold bath boys
and the socioeconomic factorsand there's all of these
different factors and thebrain's just like.
Well, I'm just in the middlehere, guys, taking on board all

(01:26:21):
of this data from all of thesedifferent sources throughout a
life, and you know what I'mwithin an ecosystem and you know
what the risk with that is.

Speaker 2 (01:26:29):
Sarah and I've.
I see that trend.
People get so confused and whenpeople get confused, guess what
they do?
They won't change and theywon't do anything.

Speaker 1 (01:26:39):
So we're really scaring them of making that,
changing those habits that yousay that they need to do yeah uh
to to move the needle yeah, andand wellness has become very
pious.
It's not very.
It's not much fun either.
I think people feel like it'sboring, isn't it?
perfect, these perfect bros whodo absolutely every single thing

(01:27:00):
to, to, to change the needleand and, and we know what's
actually going to change thehealth of a population more than
are you going to take your icebath or not.
Actually, you saidsocioeconomic status and poverty
is the greatest predictor oflongevity.
Look at Queen Elizabeth.
She perhaps is such a greatexample of someone whose health

(01:27:20):
span and lifespan were both longand great.
But she was born into massivesocioeconomic privilege.
She had access to kind of everyprivilege that that anyone that
as possibly ever had in termsof health and well-being.
But she was socially connected,she was intellectually
stimulated, um, she had fourkids when she passed.

(01:27:43):
She was in her 90s, but you knowshe was working up until a
couple of days before she died.
Yeah, I remember Her life wasvery and she probably didn't
drink as much as her sister did.
Your sister drank and smokedall that time.
But I mean, you know, there'salso people who drink and smoke,
and you know the oldest everliving woman, jeanne Calment.

Speaker 2 (01:28:07):
French lady smoked until she was age 117 or
something.
Those are genetic exceptions.
Those are genetic exceptions.
That's the thing.
That's a genetic exception.

Speaker 1 (01:28:12):
We can try our very best.
I just think what is missing isa little bit of fun and joy
along the way.

Speaker 2 (01:28:20):
Human connection is so important.

Speaker 1 (01:28:23):
People are being very pious and very boring.
I think I don't want to spendmy whole life trying to optimize
myself.
I want to have a bit of a goodtime along the way.

Speaker 2 (01:28:33):
I totally hear you.
I went through all the phases.
Now I've gotten to that pointwhere I'm trying to find the
balance, because you have tohave fun living.
That doesn't mean drink a glassof scotch every night or a
whole bottle of wine every night.
That's not what I mean byhaving fun.

Speaker 1 (01:28:50):
There's other fun ways to have apart from alcohol.
The key is moderation.
Yeah, I drink alcohol.
The key is moderation.
Absolutely the key ismoderation.
Yeah, I drink it and I thinkfor me it's social.
It's great fun to go and have adrink with my mates.
It's one of my favorite thingsto do go out with the girls,
have a laugh, um, and that'sokay.

(01:29:11):
So what do you do for yourhealth and what do you do for
your health and wellness?

Speaker 2 (01:29:15):
where are you right now in your life?
How do you find your balance?
Uh, kind of walk us throughyour weekly routine.
Do you have, if you have one?

Speaker 1 (01:29:24):
Well, coffee in the morning and beer thanks to my
lovely husband.

Speaker 2 (01:29:28):
He's getting a lot of credit, man.

Speaker 1 (01:29:30):
Well, he deserves it he deserves it.

Speaker 2 (01:29:32):
Yeah, wow, it goes a long way.
A cup of coffee goes a long way.

Speaker 1 (01:29:35):
I live in perhaps one of the I would say it's
probably a blue zone thenorthern beaches of Sydney,
australia.
It's a very healthy, wealthy,has a very high well-being index
.

Speaker 2 (01:29:49):
And what makes it that I think everyone is very
healthy, wealthy, outdoorsy,very accessible.

Speaker 1 (01:29:58):
They can literally go and rank.
You can rank each suburb basedon well-being index.
We're by the sea.
We have a very fortunate worldin which we live here, so it's
very easy, when everyone elsearound you is living a life like
that, to live in a way that'shealthy.
So, yeah, it's great, I love it.

(01:30:23):
I try, I mean, and I havestresses in my life.
I have teenage sons and I haveaging parents and all of those
things, and I try my best toregulate my stress, occasionally
perhaps when I shouldn't, withalcohol, but whatever.
I quite like a jigsaw puzzletoo as a way to calm myself down
.
I try and go to the gym or doexercise almost every day.

(01:30:43):
So I lift weights two or threetimes a week, I do pump classes,
I do Pilates, I do oceanswimming, my boys sail and surf,
and I enable them to do that asmuch as possible.
I've got a really cool set ofhilarious friends the same age
as me.
I'm in a musical theatre groupwith some of them.

(01:31:04):
I can't sing or dance, but wejust have fun.
I have lots of very loyalfriends from early childhood who
I'm in touch with, you know, ifnot every day, easily every
week, and I, you know, I eatpretty well, but every now and
then I'll eat too much chocolate.
I try to just follow all of thethings but try not to achieve

(01:31:29):
perfection, because that'sboring and I protect my sleep
almost above and beyond anythingelse.
So I'll have a couple of cupsof coffee in the morning.
I won't have any more the restof the day, and I try to never
do anything except when I'mteaching some of my courses.
Sometimes I teach from 7 until8.30 and I do not like that
because then I can't get tosleep easily afterwards.

(01:31:51):
So, most of the time, I'm in bedby 9, read my trashy books, and
then I usually sleep prettywell.

Speaker 2 (01:31:59):
Interesting, Any anti-aging tips for the brain
that you can give us.
Are you actively based on yourknowledge of neuroplasticity and
brain anything you actively doand make part of your habit to
slow down the car that's drivingtowards the cliff?

(01:32:19):
When it comes toneurodegenerative disease and
prevention thereof, Any tips youcan give us, or would you just
say you know what?

Speaker 1 (01:32:31):
Besides being very thankful, for living where I do
here in Australia and myecosystem is pretty great.
I would say sleep, but I'vealways been a good sleeper and
so I try and protect and nurturemy sleep, and I have been.
I only just started wearing aFitbit.
I didn't want to get an AppleWatch because I didn't want to
constantly have interactions.

(01:32:52):
I know I got rid of mine, but Ihave a Fitbit now and I have
been paying more attention to,you know, my resting heart rate
and trying to peak heart rate afew times a week.
I've been trying to pay alittle bit more attention to
those metrics, without obsessingover it.

Speaker 2 (01:33:15):
It's very easy to get into that obsession.

Speaker 1 (01:33:17):
Let me tell you, but also because I think it's a bit
boring to be obsessed overthings like that.
It's not that interesting, butI'd keep an eye on it.
So that has perhaps encouragedme to be a bit more.
But I've always been prettygood at going to the gym.
Actually, I just got told bythe gym the other day I've done
225 pump classes in the lastcouple of years.

(01:33:37):
That's lifting weights to musicGood job.
So there's that, and thenthere's this sort of the.
As I said, I've got this greatecosystem I live in.
But the social side of things Ipurposefully and actively try
to engage and interact sociallywith other people.
And what I wanted to do forturning 50 this year was we're

(01:33:59):
having a big party in a coupleof weeks, me and my husband.
He's also turning 50.
We're invited, like far toomany people, it's going to be a
rager.
It's going to be awesome.
But, we also went around theworld to have dinner with
friends, so we wanted to justengage with people that we know
and love, that we've had in ourlives for many years, and so

(01:34:20):
that's perhaps more important tome than almost anything.

Speaker 2 (01:34:24):
There's a lot of research on that, on connections
, on social connections andanti-aging and neurodegenerative
disease.

Speaker 1 (01:34:31):
And there's being actively socially engaged, which
I think there's being alone,and there's loneliness.
And we know loneliness is theperception you can be surrounded
by people but feel lonely.
So there's that perceptionwhich is not great for your
mental health and your overallphysical health and brain ageing
.
And then I think when you getinto late life, the social

(01:34:54):
isolation there's the lonelinessof that and the stress and the
knock-on effects on metabolichealth et cetera that that would
have.
But then having someone to helpyou get to the doctor or, you
know, encourage you to eat goodmeals or encourage you to
exercise we see that with olderpeople become very set in their
ways and don't have the supportsystems around them to enable

(01:35:16):
the kind of healthy behaviorsand and things that they need.
So those are those aspects.
Right, I'm not at that point,but I've got people in my life
who are that I need to lend ahand to.

Speaker 2 (01:35:33):
Yeah, beautiful, beautiful set.
Actually, I just noticed Iwould love to close it because
this was such a beautiful thingto close it with, but I forgot
to ask a very important question.
I don't know whether or notit's something you can actually
answer, because it's somethingthat's very near and dear to me
and I deal with on a daily basis, and I just wanted to pick your
brain on it, no pun intended,on social behavior, especially

(01:35:59):
when it comes to body image andbody dysmorphia in teenagehood,
and then I see another peak inmiddle ages with the transition
of that.
Is there anything in your fieldas far as brain development that
has been researched or can beexplained, or does it go more

(01:36:23):
towards into the behavioralsciences?

Speaker 1 (01:36:26):
I think it's more social.
And I'm 50, and I'm constantlyfighting this because I have not
had Botox, which you can telland I'm not going to.
But gosh, it's a hard dailybattle internally, especially if
you're a Gen.
Xer you grew up because you, Isuppose, like what you said

(01:36:48):
earlier, you've got patients whodon't look the way that they
feel and you look in the mirrorand you see your face.

Speaker 2 (01:36:53):
It's the first thing they tell me.

Speaker 1 (01:36:55):
And you start to see your mother and you're like I
don't want to look that way whenI still feel young and that's a
really hard.

Speaker 2 (01:37:06):
It's almost like a cognitive dissonance.

Speaker 1 (01:37:08):
It is.
I did another podcast recentlyand I was like, oh my God, I
look fat and jaundiced.
It's just like the lighting andthe angle.
It's really weird.
I didn't even want to share itbut I was like I had to.
I was like I look terrible andthen I'm trying to get into my
people aren't?
I'm not a model.
I have a very good friend who'sa model.
I'm not a model, I'm aneuroscientist.
People might just be interestedin what you're having to say,

(01:37:30):
not what you look like, but it'sa really.
For me it's.
It's a daily, not a battle.
But there's this wonderful umwoman here in Australia who won.
Her name is Gina Chick.
We have the same kind ofliterary agents and she won
Alone Australia here a couple ofyears ago.
And she's just this goddess,this Amazonian woman who is so

(01:37:51):
wise.
And she said this phrase, whichI repeat to myself all of the
time we are of nature and thereare no mirrors in nature.
The closest thing that we couldsee in nature as a mirror might
be like a.
You look into a pool of waterand even that's ripply and
blurry and we spend so much timeon screens and looking at

(01:38:13):
ourselves and reflecting backand that's so unrealistic and
I'm determined.

Speaker 2 (01:38:19):
Yeah, and we compare, especially with social media
and younger and teenagers, theyconstantly compare each other.

Speaker 1 (01:38:26):
Yeah, they're comparing, and it doesn't get
any better when you get older,despite the positive aging
influences which are out therewho are all beautiful anyway.
So I would like a reallynon-classically beautiful
midlife influencer to be outthere talking.
So I don't know about theneuroscience of that.

(01:38:48):
All I can just say is mypersonal feelings about that.
But I often then think aboutall of the women in my musical
theatre group.
And we're doing all that, whenwe have our performances and we
spend a lot of time in ourunderwear and we're changing,
we've got our Spanx on and we'reall just laughing at each other

(01:39:08):
and thinking we're all in our40s and 50s and when does the
body image stuff fade away?
And we're all going oh, maybeit never will.
The only way around it is tolaugh about it.

Speaker 2 (01:39:27):
That is such a great attitude.

Speaker 1 (01:39:28):
I love that and I also feel liberating, such when
I see my other friend.
Most of my friends who I grewup with I'm still very close to
around the world.
None of them have done anythingto their faces.
They're not we're not Botoxusers, we haven't had any work
done, and I just feel suchtenderness and warmth when I see

(01:39:50):
their faces aging like minebecause I'm like we're all.
It just makes me feel very Home.

Speaker 2 (01:39:59):
Like you know them.

Speaker 1 (01:40:00):
We know them.
Oh God, it makes me feel reallyweepy.
It's really weird.
It's like we've all agedtogether and there's something
really beautiful in that.

Speaker 2 (01:40:07):
Yeah it's a connection.

Speaker 1 (01:40:10):
Yeah, but there's a cognitive dissonance there when
you do stuff on social media andyou're constantly looking at
your face.

Speaker 2 (01:40:15):
I hate that.
It's because it has two partsto it.
I could speak to it, but whatyou're saying is beautiful,
because when you see someone'sface that is unaltered, you can
see how they lived.
And so when you said, that isbecause you lived with them, you
know everything about theirlives.
And these are memories that youguys cherish, which creates

(01:40:39):
this bond and you don't wantthat to be altered.
It's almost like you don't wipe, you don't want the part of the
your common history to be wipedout by wiping out the wrinkle.
And yeah, I've never thought ofit until you just said it and it
just became so clear to me andyeah, and I'm not surprised why
you got a little watery, becausethis speaks to the emotional

(01:41:00):
impact.

Speaker 1 (01:41:00):
Yeah, and you and we're all turning 50, so many of
my friends, because these willbe school friends and it's like
we're all in the same place nowand we've all got teenagers who
are leaving high school andgoing off to university and
we're all having to, like,retell us, you know, recreate a
new identity.
You go through matricence whenyou become a mother and there's

(01:41:23):
such an identity shift and everytime the world moves under your
feet, you have to, and it mightnot for many years.
It's just like motherhood.
You're a mother and you've gotall of those years, those
primary school and high schoolyears, where your day-to-day
life is reinforcing the storythat you're telling yourself
about who you are, and then itshifts again, forcing the story

(01:41:44):
that you're telling yourselfabout who you are, and then it
shifts again.
And I think so.
Perhaps that's what midlife isabout is just being wise enough
to tell a new story aboutyourself.
And if you've got other peoplealongside you who are looking
the same as you and my oldfriends look the same as me lots
of women in sydney, don't?
Perhaps?
Lots of women in Sydney don't?
Perhaps lots of women in lotsof parts of the world don't, and

(01:42:04):
but they're not who I grew upwith and are growing old with,
so perhaps I should not thinkabout it, and I just always
think there's no mirrors innature, there's just each other.

Speaker 2 (01:42:14):
So I love that.

Speaker 1 (01:42:16):
That's the reflection I should be looking at.

Speaker 2 (01:42:18):
I love that.
That's something that I reallytake very seriously, I take to

(01:42:39):
heart.
I try to give my patients Trustme.
I decline so many patients thatcome.
They want to make so healthyattitude that I see it so rarely
now.
Maybe because it's of myindustry, the people that come
to me, I don't know.
But even when I look around inour society, especially here in
the United States, and I knowit's different in Europe and I
think Australia is probably moresimilar to Europe than it is to

(01:43:03):
the US, I don't know just fromhearing you talk and maybe I'm
biased because I don't know manyNew Zealanders or Australians,
but it's definitely a much, much, much, much healthier way of
going by it than constantlytrying to keep up with the
Joneses and with your other.

Speaker 1 (01:43:24):
Yeah, I wouldn't mind one of those facelifts that
you're seeing on social mediaall the time.
I always look at myself in themirror.
Yeah, I mean, oh well.

Speaker 2 (01:43:31):
So there's nothing wrong with turning back the
clock.
I tell my patients right youwant to turn back the clock a
little bit.
That's fine, but you don't wantto alter the way you look, you
know turning back the clockmeaning how it was, maybe 15, 20
years ago and that's a veryhealthy attitude.

Speaker 1 (01:43:46):
Yeah, I don't know.
It feels very silly and shallow.
If it's all about looks,because really it should be
about what's underneath that?
Haven't we been telling thegirls, the teenagers that yeah,
but you know what?

Speaker 2 (01:43:57):
to me it is much deeper than that.
To me, it's more aboutself-esteem and self-confidence.
It's not any different thanputting on lipstick.
It's styling your hair, wearinga certain dress or putting some
jewelry on.
It's not any different.
We do that just so we feelbetter, and maybe lifting your

(01:44:20):
brows or getting rid of somewrinkles.
I don't personally see it anydifferent, and even in my
patients I treat cleft lip andpalate children that were born
with facial deformities.
The psychology in them is thesame.
They just want to lookconfident in their skin.
For them it's.
They want to look confident,they want to blend into society.

(01:44:43):
They don't want people to stareat them as soon as they see
them.
It all is about self-confidenceand self-esteem and I believe,
having in this business for 20years, I think the key for
everyone is to find their happyplace and not to worry about how
others judge them and also notjudge others for what they do,

(01:45:05):
because you know who cares.
I mean, at the end of the day ifyou're happy and content, more
power to you, and there's noright or wrong way you know.
So, um, this was such amind-opening conversation, sarah
, I can't believe this wasprobably my longest podcast
actually.
Well, I'm very long-winded, soI'm not surprised, yeah, but

(01:45:28):
this was very mind-opening,actually, pun intended.
Your work to me brings so muchclarity to the chaos people feel
, especially about these termsthat we discussed, like brain
fog or brain development versusplasticity, especially when

(01:45:50):
they're going through changes.
They don't really understand.
So thank you for reminding usthat our brains are built for
growth and not just you knowdecline, not just dysfunction
and decline.
Right, and so I reallyappreciate that, and please tell

(01:46:11):
people how they can find you.
Look you up online and tell usabout your recent books that you
just wrote and where people canget it road and where people
can get it, because I thinkthey're such valuable insights.

Speaker 1 (01:46:29):
if someone wants to dive more deeper into our
conversation.
Yeah well, my website isdrsarahmckay M-C-K-A-Y, or McKay
, as you might say, in the USdot com, and so I teach a lot of
professional developmentcourses in applied neuroscience
and brain health, so I've stillgot a few of them this year, if
people want to join in them.
And I've written well, I say,three and a half books.

(01:46:49):
So I've written two books onwomen's brain health the Women's
Brain Book and Baby Brain,which is about pregnancy and
motherhood the Women's BrainBook.
I've just written a secondedition update, so there was the
2018 version and then the 2025version, which just came out
about a month ago.
So, much has happened to women'sbrain health is no longer a
niche.
And then I've also writtenbrain health for dummies.

(01:47:12):
So the four dummies, thatyellow and black iconic brand
that you might have Excelspreadsheets for dummies or dog
training for dummies.
There's brain health fordummies, and that was fun to
write because the whole point isit's not pious and super
serious.
It's kind of fun andentertaining and I got to use

(01:47:33):
lots of dad jokes and sillylittle turns of phrase in it and
so you can buy-.

Speaker 2 (01:47:41):
Should we give your husband some credit for that?

Speaker 1 (01:47:43):
A hundred percent.
He always gets all of thethanks him, the boys and the
dogs.
The two women's health booksyou can listen on Audible
Globally, spotify, anywherewhere you buy audio books.
There's different versions ofthose books available in
different parts of the worlddepending on publishing
jurisdictions.
Someone in the US wants to pickthem up, be my guest?
Brain Health for Dummies isavailable everywhere.

Speaker 2 (01:48:05):
Wonderful.
Thank you so much, sarah, andfor everyone listening.
If something in today's episodesparked an insight shared with
a friend or someone navigatingthe same stages of their lives,
and if you want more of Sarah'swisdom, check out her books,
like she mentioned, and heronline academy.

(01:48:27):
Remember beauty starts in thebrain.
Until next time, take care ofyour mind, your body and your
story.
Thank you and good nighteveryone.
Thank you, sarah.

Speaker 1 (01:48:40):
You're welcome.

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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;}Unlocking the Brain: Insights from Neuroscientist - Dr. Sarah McKay