August 21, 2024 • 52 mins
Ever wondered how NBA stars like LeBron James maintain their mental sharpness under pressure?
Join us as we sit down with Dr. Choulet, a former NBA team’s Sport Psychiatrist and mental health expert.
This episode offers a deep dive into the mental challenges athletes face, from the intense scrutiny of professional sports to the use of innovative treatments like ketamine for managing depression and anxiety.
We explore the NBA's evolving stance on substances like marijuana and the use of FDA-approved therapies such as Spravato (esketamine). Dr. Choulet provides valuable insights into alternative treatments like Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT) for severe depression, all within the context of sports psychiatry.
This conversation sheds light on the critical role of mental resilience, psychological readiness, and the mental conditioning techniques used by elite athletes, including examples from Alex Rodriguez. We also discuss the transformative power of sleep and healthy habits on overall performance, the mental hurdles of injury recovery, and the day-to-day responsibilities of sports mental health professionals.
Whether you're an athlete, coach, or sports enthusiast, this episode is a must-listen for anyone interested in the mental side of high-performance sports.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:18):
We're talking about health and wellness.
We're talking about biohacking,we're talking about mental
health and, dr Shulay, you arethe Phoenix Suns psychiatrist
consultant.
What's your exact title for thePhoenix Suns?
Speaker 2 (00:29):
I am the team licensed mental health
professional and the consultingsport and performance
psychiatrist.
Speaker 1 (00:37):
And do you get a lot of playtime?
Are the players coming in youroffice all day?
Speaker 2 (00:42):
I like to say I make myself readily available.
So then, if there are needs,then I'm there to chat with them
.
But yes, I work a lot withplayers staff, anyone who needs
help within the organization.
Speaker 1 (00:53):
And when you meet with a player is it mostly like
do you do it at the arena or atFootprint Center or at that
practice facility in Arcadia?
Speaker 2 (01:00):
Really all of the above.
So I'll meet with them at thepractice facility, at the arena
before games, at my office, intheir home or virtually so.
Any of those five.
Speaker 1 (01:09):
And is it on the down low or the other players know
that?
Oh my God, you're meeting withBrooke today.
Speaker 2 (01:13):
Uh, it is on the down low, I would say mostly, except
for, like, if it's before thegames and they just finished
warming up on the court andthey're like hey, can I grab a
few minutes?
So we're just sitting out thereon the court chatting.
So that is public and I only dothat when they initiate that
publicly.
Speaker 1 (01:29):
Yeah, and what about when a player gets traded?
I always thought, like, likewatching the emotional
rollercoaster, or that therewould be emotional rollercoaster
being traded.
Do they ever continue talkingto you, even though they're with
another team?
Speaker 2 (01:41):
That is such a tough question because clinically we
can only practice medicine inthe States that we're licensed
in and where the patient'slocated.
So let's say we trade someoneto Memphis.
Now I'm not licensed there so Ican't continue clinical kind of
care with them.
But what I can do is just be aperson and just check in and be
like hey, this was a reallytough time, we miss you here,
(02:01):
How's it going?
And just like be a human withthem.
Speaker 1 (02:04):
They can't call you and do service that way.
Speaker 2 (02:07):
They can call me, but again for that more like casual
conversation.
It can't venture into like aclinical patient relationship
again since I'm not licensed inthat state.
Speaker 1 (02:16):
So how long have you been with the Phoenix Suns?
Speaker 2 (02:18):
I've been with them for three seasons and with the
Mercury for two seasons.
Okay, all right.
Speaker 1 (02:23):
So we had like a bunch of things we wanted to get
into right, carrie.
Speaker 3 (02:25):
We do.
We absolutely want to talkabout some of the issues in
mental health, not really asmuch as you know what you do day
in, day out on the regularmental health side, but some of
the ideas that the players mightgo to or they might search
something on the web that saysthis is a cool new trend, of
something that can help me getbetter.
So we specifically want to askyou about the use of ketamine,
(02:49):
and ketamine is a drug that hasbecome pretty common in the
mainstream market for peoplehelping to deal with clinical
depression anxiety.
We know players deal with a lotof performance anxiety, which
is why you're helping the teamout.
And what has been your thoughtprocess on this new rollout of
an old drug?
Ketamine's been around forever.
We used it in the emergencyrooms to help sedate mostly
(03:10):
young children if we were doingan invasive procedure, but
ketamine has been used now tohelp people overcome the
barriers with depression andwith generalized anxiety
disorder.
What are you seeing happeningwith, specifically in the NBA?
Is there any use or is that aloud drug for the players?
And what has been your take onthat?
Speaker 2 (03:30):
Yeah, I think that it's really easy to get caught
up in what seems to be thenewest fad of things, and in the
NBA, especially when we haveplayers that are performing at
such a high level, it's socritical to make choices and
medical interventions based onlike the most minimal side
effects possible.
So, to me, like that is likethe very end of the conversation
(03:51):
and should not even really comeup, because ketamine, just with
the general population, canhave so many potential side
effects, so much so that at aplace that's doing it well,
you're monitored for two hoursafter a spravato nasal spray.
So I think that it's somethingto keep in mind, especially with
NBA players and especially insports.
Psychiatry training is likewhat intervention can you have
(04:13):
that's evidence-based, that hasthe least amount of side effects
possible?
Speaker 3 (04:17):
Can you help the listeners understand more about
the drug ketamine itself,Because this falls within the
psychiatry realm to some extentright now.
It wasn't originally developedfor that.
Of course, it was more of ananesthesia medication, but
psychiatrists have embodied itand found new applications for
it.
So what has been some of theliterature?
What has been some of themedical studies that have been
(04:38):
done around this drug and usingit on the psychiatry side?
Speaker 2 (04:41):
Yeah.
So I think it's been studiedfor a few different things, some
for PTSD, some for depression,and recently the FDA when they
approved Spravato, they approvedit as the nasal spray for
depression with anantidepressant, which is
interesting because they're notsaying you should just go use
ketamine without evidence-basedpills that are already available
(05:04):
.
They're saying that you can useit in conjunction with
antidepressants.
So in the study that was donethat the FDA had cited in their
statement for Spravatospecifically, it was seen to
have superior efficacy whencompared to a placebo nasal
spray with an antidepressant,compared to the Spravato plus
antidepressant, so that did havebetter efficacy in terms of
(05:27):
treating depression.
Speaker 1 (05:28):
Isn't it an IV drip?
Speaker 2 (05:30):
The Spravato.
So ketamine can be given IV IM,and then Spravato is the nasal
spray as well.
Speaker 1 (05:37):
Spravato is ketamine.
Speaker 2 (05:39):
Is esketamine yes.
Speaker 3 (05:41):
As a nasal spray, but what you're referencing is most
people are actually seeing theclinics pop up as an IV drip.
Speaker 1 (05:47):
I talked to a guy yesterday and I think he's a
pretty clean guy and he goes.
Oh man, I gotta tell you aboutthis ketamine drip I did he goes
.
It was amazing.
He was like I was spinning, Iwas out of control, it was like
I was high and I don't thinkthis guy drinks or does drugs.
Then I have another buddy ofmine who is pretty healthy.
Well, he, I mean, he's afitness guy and he was like dude
(06:08):
.
I got to tell you I didketamine and it was the.
He's done every drug in theworld Right, and he's like and
this made me never want to dodrugs again.
He was so amazing and I waslike well, I don't do drugs, so
I don't need that feeling.
I remember, right after thatconversation, carrie, I went to
you Carrie's my doctor, by theway, my real doctor and she was
like don't stay away from it.
(06:28):
Then I watched this documentaryand actor David Arquette, who's
been on every drug in the worldand addicted.
He goes for these ketaminetreatments and they show the
ketamine treatment and it didnot look pleasant seeing what he
was going through.
Speaker 2 (06:49):
So now I'm like this is coming up all the time, why?
Why are people doing it Likenon-athletes?
Yeah, I think that people wanta quick fix and they want
something that will act fast andgive them a high when they
think it's medically indicated.
Speaker 1 (06:55):
And so it's a high, it's like, it's like a I can't
speak to that.
Speaker 2 (06:58):
I've never tried it, nor have I had my patients try
it, cause I don't recommend itbut I just go back.
I'm so conservative in how Ipractice but I just go back to
like evidence-based medicine.
There's so many other optionswe could try before we even
start talking about some ofthese other things, including
things that are more studied,like TMS or ECT for very severe
(07:19):
treatment, resistant depression.
So sure there's some utilitypossibly and maybe if you do it
in the right setting, but I havenever referred a single one of
my patients to go get ketamine.
Speaker 1 (07:29):
So is it an NBA thing ?
Are people in the NBA doingketamine, or is this just?
Speaker 2 (07:33):
No people in the NBA are not doing ketamine.
Speaker 1 (07:36):
Okay, well, that's good, that's good news, good,
we're making progress.
Speaker 2 (07:40):
Yeah, and psilocybin as well as a prohibited
substance in the NBA.
Speaker 3 (07:43):
So for people who don't know what psilocybin is,
yes, that is like magicmushrooms.
Speaker 2 (07:48):
Oh, Also banned, also banned.
Speaker 1 (07:51):
But marijuana not banned.
Speaker 2 (07:52):
Marijuana not banned.
Synthetic marijuana banned.
Speaker 1 (07:55):
What's that?
What's the difference?
Speaker 2 (07:57):
So I'm not a marijuana expert, because I'm
also anti-marijuana.
Speaker 3 (08:05):
So I'm not the person to ask about the synthetic
versus.
So just syntheticallymanufactured versus deriving it
from the plant.
Speaker 1 (08:08):
Like when you go to these places, everywhere that
sell it, that's normal marijuana, like the plant behind you,
carrie.
No, I'm just kidding.
Synthetic, that's not gummies.
No, no, no, I know you'retalking about synthetically
manufactured, pharmaceuticallymanufactured.
Speaker 2 (08:24):
Yeah, they're chemically making.
Speaker 1 (08:26):
So the normal marijuana is legal in the NBA.
Speaker 2 (08:29):
So I wouldn't say it's legal.
It's not on their prohibitedsubstance list, okay.
Speaker 1 (08:34):
Because there is a very well-known NBA player that
was pushing this and talkedabout doing it all the time.
In fact, I have two sons thatplay basketball and I didn't
want them to watch that clipbecause you know they're very
what's the word I'm looking foraffected or influenced by
players in the NBA and thingsthat they do.
If so-and-so's got a pair ofshoes, they want that shoe.
(08:56):
If they see a very well-knownplayer that might play for the
Suns talking about smoking weedbefore and after games.
In fact, there's one player onthe Suns that I heard.
He's not on the Suns anymore.
There was lots of complaintsabout him from the people I knew
because he wasn't training hard, he wasn't working hard.
They said he smoked weed allthe time.
(09:17):
To me that seems like a bigside effect, because isn't
marijuana a depressant?
Speaker 2 (09:22):
Well, people react differently to marijuana.
Some people it makes themextremely anxious, paranoid,
jittery, and for others it canjust make them totally apathetic
.
Speaker 3 (09:31):
Neither of those good yeah neither good, so why do?
Speaker 1 (09:34):
players want to smoke that stuff, so there's no
benefit to being a betterathlete on it, is there?
Speaker 2 (09:39):
Well, I think that people think that in the short
term it can help with anxietyand depression.
So, yes, that may be true inthe short term, but there was a
study I just read this morningactually that when they looked
at marijuana use and PTSD, inthe short term it was seen to
have some benefit possibly, butin the long term, for long-term
users, there was no benefit andthey just developed a greater
(10:01):
dependence on it.
The other interesting thing tonote too, in terms of young
players or teens that arenon-athletes, is that the
American Psychiatric Societyactually put out a statement
about marijuana in adolescents,because if you use before the
age of 25, when your brain'sfully myelinated, it can have a
lasting effects on your frontallobe, um, which kind of develops
(10:24):
like your executive functioning, how you make decisions, your
impulsivity.
So it can actually havenegative effects on your frontal
lobe development with marijuanause before age 25.
Speaker 1 (10:33):
But then you see these players playing great,
getting $100 million contractsand one of the things they talk
about is smoking marijuana.
Kind of bums me out.
As a dad, you know what I mean.
Speaker 2 (10:41):
Yeah.
Speaker 1 (10:43):
So I'm going to shift gears on a couple things.
If that's cool, we're justgonna jump around right, be all
over the place.
So I've been looking forsomeone in your field for a long
time for a personal use, forfor mike.
I have three boys, two of themare basketball player athletes
and, um, my middle son, whoplays basketball in hawaii.
Uh, we would go when he was inthe aau program.
(11:03):
We would go these long drivesand I was always listening to a
book or something motivational,and I landed on a book written
by a sports psychiatrist orpsychologist, I'm not sure and I
thought it was one of the mostamazing books I've ever read in
this field.
So you're the only other personI've talked to in this field,
outside of this guy, who I'venever talked to.
I tried to track him down and Ibelieve he passed away and I
(11:25):
now I can't remember his name,but the book is called Mind Gym.
Speaker 2 (11:31):
Okay, have you heard of it?
I have not heard of that book,but I've heard the term Mind Gym
actually used in Formula OneMedicine.
So they developed a physicalgym and obviously for physical
strength and conditioning, andthen a Mind Gym that's just as
big as the physical gym.
So Formula One Medicine has aphysical gym and a mind gym and
in the mind gym they havedifferent modalities that are
available, like things that canhelp your mental resilience,
(11:54):
cold plunge, mindfulnesspractice, meditation, things
like that.
So that's where I've heard theterm mind gym.
Speaker 1 (12:00):
Oh well, if you get a chance, the guy was in Arizona,
like he was this guy that had,he had the Cardinals and he had,
um, all the baseball teams.
He was the football playerCardinal guy and he was a guy
for a lot of the all the springtraining teams that came here
and he would tell all thesestories about working with
players mentally Like how, um,you know, you hear like the
(12:22):
secret, like I think the forwardof the book is by Alex
Rodriguez and he says he goesevery night when he was in high
school he'd go to bed.
He lay in bed, look at theceiling and say I hit the ball
hard, I hit the ball hard, I hitthe ball hard and he had his
batting average.
He would say his battingaverage loud, over and over and
over again.
And the guy goes on to be, youknow, world series champion and
gets all this stuff and so he'sin the book.
(12:44):
A couple football players fromthe Cardinals are in the book
about having a positive mindsetand manifestation and like,
where are you on that?
Speaker 2 (12:52):
I think that's so critical.
So in a lot of the mentalskills training for athletes of
all sports is that positive.
They call it positive self-talk.
So it's like affirmations,habit building.
I think like to that habitbuilding is so important for
these players that you knowthere's so many NBA players or
just basketball players that aregreat athletes but what makes
(13:13):
like the LeBron James, stephCurry's, what makes them
different is also that mentalresilience and that kind of
immediate decision-makingability in a game.
So how can you hone in both themental skills part of things
and the physical skills ispartly by doing things like that
.
That positive self-talk, verbalaffirmations, guided and visual
(13:33):
imagery, those all play a bigrole in really differentiating
those that excel.
Speaker 1 (13:39):
So when you say visual imagery, what exactly do
you mean?
Can you have an example?
Speaker 2 (13:42):
Yeah.
So an example would be like afive-minute guided thing maybe,
talking about.
Imagine yourself in the lockerroom.
You're just about to go out onthe court.
You can feel the positiveenergy of your teammates.
You see yourself taking yourfirst shot and it's literally
guiding them through a positiveand a successful encounter in
the game is that something yousay to the guys on the suns, If
(14:04):
you're talking to them?
That's one modality I use forthose that are interested in
pregame, kind of guided imagery.
Yeah.
Speaker 1 (14:10):
Yeah, Cause I would tell my sons I'd be like,
visualize, visualize, Like whenyou go to bed at night, you see
you walking on the court, yousee the ball going in, you see,
you see everything ahead ofWatch this documentary called In
Search of Greatness, If you geta chance to see that.
It's amazing too, becausethat's where you have Tom Brady,
the greatest quarterback of alltime Excuse me, the greatest
(14:30):
quarterback of all time.
And he, at that combine wherethey measure you, he's the worst
performing ever.
Right Now he's the greatestquarterback of all time, but at
this combine place he was theslowest, he was the most out of
shape, but he's the greatestquarterback of all time.
So the documentary goes on tosay we measure things because we
can measure them.
I was talking to you about thisthe other day.
Speaker 3 (14:51):
We were talking about it the other night, yeah.
Speaker 1 (14:52):
I was like, because it's like, you know, just
because you went to Stanforddoesn't mean you're the best
doctor in the world, right?
So here's Tom Brady, who is thebest quarterback of all time.
Um, why is he so great?
What, what is it?
And he talks about motivation.
Same with muhammad ali, samewith jerry rice.
He's like.
Jerry rice said he would go tobed and throw a football in bed
every night, every night, andvisualize every single game.
(15:14):
Before the game happened thenext day.
He had it all in his head, heknew, he saw everything.
So did michael jordan.
So I feel there's got to besomething to that.
Speaker 2 (15:23):
Yeah, and what's really interesting, too, is like
at what point does it becomeunproductive?
Like I talk a lot about withpeople unproductive versus
productive anxiety, and aproductive anxiety is something
you could do something about, solike oh, I'm worried about my
SAT score, okay, well, you couldstudy more, whereas an
unproductive anxiety is, oh, I'mworried, I'm going to get cut
from the team Well, there'snothing you can really do about
(15:50):
that worry, and it's it'sderailing your performance.
So I think it's important forpeople to change their worries
into productive worries and thenact, instead of just sitting
with the worry.
Speaker 1 (15:55):
That's good, that's really good.
How about athletes that sufferan injury coming back from an
injury?
Speaker 3 (16:01):
That's a mental game.
Speaker 2 (16:02):
It is, yeah, a lot.
Because you know, especially atthe start of a season, for
example, let's say, you get abig injury.
You've mentally prepared allsummer to be able to get back
out on the court and potentiallywin a championship, and now you
get a season ending injury.
That's devastating to a lot ofathletes.
Speaker 3 (16:18):
It's devastating and that what if?
Is still in the back.
They know they have a weak linkin their armor.
Right, they're going to go out.
But in the back of their headthey're constantly trying to
battle this issue of what if Igo down again?
And it's.
Even though physically we tellthem you're 100% back, you're
110% back, you're even betterthan you were, they go out there
and they play as if that injuryis still there.
(16:38):
And that's a well-documentedissue with players coming back,
and that's something that Ithink definitely psychiatry gets
more actively involved in totry and help them work through
the anxiety, the performanceanxiety, because that's where it
shows coming back off an injuryand teaching them how to act as
if you know you're talkingabout throwing the football a
hundred times, you knowenvisioning the game.
(17:00):
We're trying to tell them to goback out and act in their mind
as if that injury never occurred, because they keep replaying
the injury over and over again.
Speaker 1 (17:09):
Yeah, like my kids, my son was hurt.
He won't watch.
No, there's a couple of famousinjuries on video of ballplayers
, right, paul George broke hisleg and he's like, oh, check it
out, paul George, I don't wantto see that.
I don't want that in my head,right?
I don't want to see that.
I don't want that in my head,right.
But so you're saying so.
You train like you never had it, pretend you never had it.
You never had the injury.
Speaker 3 (17:31):
You have to get them to train as if they never had it
.
And that's the hard obstaclebecause it's really deeply
imprinted.
It's a form of PTSD almost, forthat player.
So you've got to find a way toovercome that and really get
them to believe they truly areintact, they are uninjured.
At this point they may actuallyeven be stronger than how they
got injured the first time.
Speaker 1 (17:49):
That's what I heard.
Have you been to her facility?
Speaker 2 (17:51):
I have.
It's beautiful, thank you.
Speaker 1 (17:53):
Like the athletes that go there, I think you go to
a hyperbaric chamber, like shehas at Menis Air, and you come
out.
Better to keep doing it.
I watched this documentary onthis hockey player, Connor
McDavid.
Did you watch it?
I did, yep.
So this dude tore everything,everything and they were gonna
have him have surgery.
He didn't wanna do the surgery,so he went in a hyperbaric
(18:16):
every day two hours for 45 daysstraight and then he did his
MRIs and you just see theligaments all starting to get
back together again right,that's crazy.
Yeah, he signed a $100 milliondeal at 23 years old after his
injury.
Speaker 2 (18:32):
That's amazing.
One thing that I'm trying tobring in more to light is that
there's so many physicalindicators of when you can get
back to your sport right, likeyou go through physical therapy
and they look for certainmarkers and mobility and
measures and force and strength.
But one thing that is juststarting to be introduced is
psychological readiness toreturn to play is just starting
(18:54):
to be introduced aspsychological readiness to
return to play.
So that's a big thing in sportspsychiatry world that I've been
diving more into recently iswhat measures are there to
validate or measure yourpsychological readiness to
return?
And what I've found is thatkind of dividing injuries based
on length of injury.
So like, okay, if your injurytimeline is one to two weeks,
it's not as detrimental as, like, a four to eight week or a 12
(19:15):
to 16 week.
And so what are questions thatwe can ask that are validated
and studied, that measure yourconfidence and resilience and
confidence in yourself to getback out on the court?
And not using that asprohibitive, like, oh, your
score was a 40 out of a hundred,you can't go back, but using
that as an indicator of whereare the weak areas, like what
would get you from a 40 out of100, you can't go back.
But using that as an indicatorof where are the weak areas,
like what would get you from a40 to a 50 in confidence.
(19:37):
Because if we can identifythose steps, then we'll have a
better likelihood of you beingmore successful when you get
back out on the court.
Speaker 1 (19:44):
So you have that already or you're working on
that.
Speaker 2 (19:47):
We have implemented that already this season.
Speaker 1 (19:49):
So what are some questions you ask?
To find out if they're okaymentally to come back on the
court after an injury.
Speaker 2 (19:53):
Yeah, Like um, how confident are you to take your
shot that you normally take on ascale of one to a hundred?
Speaker 1 (20:00):
But will they be honest with you, cause I think
they'd be like a hundred, ahundred percent, but really, how
do you know you're getting?
Speaker 2 (20:14):
Well, I think I I always like um say ahead of time
like your score is not going todetermine if you're going to
get back out on the court or not, the physical rehab side of
things is going to determinethat.
So, like, let's just have realconversation and this stays
internal.
So any conversations I havewith players or really anyone um
, is confidential.
So if they talk to me and canbe honest, it could help their
performance If I can help themidentify some areas where
they're still feelinguncomfortable and work towards
(20:35):
those.
Speaker 1 (20:36):
So let's say, I had a hurt oblique, tore my oblique.
Now I'm ready to come.
I feel like I'm ready to comeback, like, how do you?
What would you ask me?
Speaker 2 (20:45):
Yeah.
So the goal is that every weekduring your rehab that we would
be checking in and going throughthat same seven question scale
and so so then I could measureyour progress.
It's not just like, okay,you're ready to go back out on
the court.
What's your measure today?
You?
Speaker 3 (20:58):
would give him homework, essentially goal
targeted direction, that wouldhelp him go back and kind of
revisit why he's hesitating,feeling anxiety towards going
back.
It would help you guide exactlywhat modality, if you will,
that you're going to give him towork on For goal setting.
Speaker 2 (21:15):
I like to try and get them to set their own goals
first before I.
I never want to try and tellsomeone what I think their goal
should be, so I just try andwork with them on goal setting.
I just facilitate their mentalexercise of setting goals for
themselves.
Speaker 3 (21:30):
Have you ever had a player that you worked with
where the physical medicine teamsaid, okay, they're ready to go
back, let's push them back outthere, and you've had to pull
back and say he's not ready togo, he's going to get re-injured
?
Has that ever been a problem?
Speaker 2 (21:42):
Not yet, because the psychological readiness to
return we've just implementedthis season Okay, and it's quite
early in the season still.
Speaker 1 (21:50):
So how can you walk us through how you became the
team psychiatrist for thePhoenix Suns?
Like was it?
Was there a job opening postedon?
Oh, no, I was on LinkedIn.
Speaker 3 (21:59):
I'm just wondering how that works.
Speaker 2 (22:00):
What's interesting is that the league mandated this,
I think back in 2019, either2018 or 19, that teams had to
have both a consultingpsychiatrist and a licensed
mental health professional, andthat could be it's not the same
thing, no.
So that could be a social worker, it could be a psychologist,
but then regardless they have toalso have a consulting
psychiatrist.
So us and two other teams arethe only teams that actually
(22:24):
have the psychiatrist in bothroles, that does, the therapy
and the med management.
Most other teams have atherapist and psychologist,
because I think in a lot ofareas the consulting
psychiatrist is affiliated withwhatever the team sponsor is.
So, like in town, here it'sBanner Health, so out in Utah,
like the University of Utah, isthe consulting psychiatrist, but
(22:47):
they have their own in-houseperson.
So here we're unique in that Iprovide both and I'm in private
practice and have the time toreally dedicate to both.
Speaker 1 (22:56):
So when you go to work, you go to your private
practice, or do you get up andyou go to Footprint Center, or
you go to the practice facility.
Speaker 2 (23:01):
I get up and I go to the practice facility.
I'm there until about oneo'clock and then I'll go to my
office.
Speaker 1 (23:06):
But you get there.
What time?
Speaker 2 (23:07):
I get there around 8 am.
Speaker 1 (23:09):
And literally you get there at 8 am and like there's
someone at your door, I need totalk to you.
Speaker 2 (23:12):
It's so strange.
Like I try to explain this topeople all the time.
I'm like, okay, so I get thereand like I'll go up in the
breakfast area and I'll just sitand work and make myself
available, because the numberone thing with professional
athletes and on any team, anysport, is familiarity.
Like I think what people forgetis that these guys' lives and
women are really isolating.
(23:33):
I think what people forget isthat these guys' lives and women
are really isolating.
Like they are constantlyworried about motives of people,
friendships, like who can theytrust?
Who just wants money from them?
I'd hate to have my salaryposted online, so I'm sure they
hate that.
Like they're they are constantlygetting badgered by people
wanting something from them.
So I think like it took me aseason and a half just to make
(23:55):
myself like known that I wastrustworthy and not there to
tattle on them or tell theorganization what issues they
had.
So I think it took a lot oftime just to even get buy-in of
of like this is a confidentialresource.
Speaker 1 (24:09):
Did you watch Ted Lasso?
I did.
Okay, remember how Ted wouldhave these anxiety, panic
attacks.
Is that a real thing?
Like, have you had players havethat?
Like, how would you describewhat he was?
Gary, he's on the soccer fieldand he's the coach and all of a
sudden he just had to freeze upand leave.
Speaker 2 (24:25):
right, yeah, Does that happen in real life?
I think typically it doeshappen in real life.
I would say it's justsituational, Like it may happen
in the locker room before a game.
I'm not saying that happenshere.
I've just heard that thishappens, that you know before a
game is incredibly stressful, orafter a loss.
I think typically during a gamepeople are pretty locked in and
(24:45):
focused.
Speaker 1 (24:48):
So after a game you sometimes have to meet with a
player.
A player wants to meet with youat 11 o'clock at night because
the game's over at 10 30.
Speaker 2 (24:51):
I've had phone calls late in the evening just to talk
about things or decompress, youknow, not just players but
people throughout anorganization so they have access
to you all day.
Speaker 1 (25:01):
Yes, they call you at 11 o'clock at night.
Speaker 2 (25:02):
You pick up luckily that doesn't happen too often.
I think the latest call I'veever gotten and it wasn't even
related to sports was 10, 30, oh, and I did pick up like I was
at the game the other night.
Speaker 1 (25:13):
It was like over at 10 and and or some of those
games start at 8 and they'reover late and I would think
after, like, my son had a game,a scrimmage, last week.
Um, of course he's in hawaii,so he's three hours behind.
But I went to bed, woke up inthe morning, he was like I
played terrible um, and he justhe just got very emotional and I
wish I was there for him, butit it was late, it was midnight
(25:33):
at one o'clock, and then a halfhour later he's like it's okay,
I'm just gonna have to workharder, is what he said, right,
and 45 minutes later.
So I felt like if he had accessto someone like you, or I feel
bad.
I wasn't there to take it, buthe was fine the next day.
But sometimes I think, do theycall you like that, like I?
Just they're driving home, man,I don't know what did I do
(25:53):
wrong?
Speaker 2 (25:54):
So to me I would see that almost like as a failure of
my role if they needed to dothat, because my goal is to give
them the skills and the toolsthat they can kind of like
process it themselves.
And I feel like if they can't,I haven't done my job.
Speaker 1 (26:09):
So get specific.
What's something like like whattell us like how, what's it
something?
You give them a tool, what's atool that we can give somebody
watching this right now?
Speaker 2 (26:17):
Yeah, I think some tools are like a mindfulness
kind of breathing exercises.
So if someone is having a panicattack, they're now having
physical manifestations of theiranxiety, right, they're getting
short of breath palpitations.
Sometimes they show up in theER to their their outpatient
physician saying that I'm dyingno-transcript about this the
(27:01):
other day of like settingboundaries.
So both her and I practiceconcierge medicine and one of
the questions I get a lot andI'm sure you do too is oh, do
you get called at 2am?
Speaker 3 (27:10):
Always.
Yeah, everybody swears,everybody must call me all night
long because they have my cellphone.
And it's so not true.
Speaker 2 (27:15):
Right, it is so not true, and I feel like our job to
be good physicians is to giveour patients tools to work
through things themselves,whether it be for physical
medicine or mental health care,and then, if things are bad, of
course, call us, but I think itwould be a disservice to people
if I was just like theirlifeline that they needed to
just call and I was the only fix, if that makes sense.
Speaker 3 (27:38):
I think the family members end up being the
lifeline.
So I wanted to ask you do youalso help with mental health for
the family members?
Is that part of the extensionof your services?
Speaker 2 (27:47):
I do, but in my private practice.
So if someone of course that'sa family member is welcome to
come see me, it's just doneoutside of the building in my
own private practice.
Speaker 1 (27:57):
Would you say that you've met with every player on
the Suns?
Speaker 2 (28:05):
I can't say for certain whether I have met with
every player or not, but I willsay that it is a requirement,
just like physical health to getclearance at the start of the
season and how long is thatsession?
I can't say, you can't say no,those are all way too specific,
would you?
Speaker 1 (28:15):
say that the players on the Phoenix Suns if they saw
you at a grocery store, theywould know who you are.
Speaker 2 (28:21):
Yeah, I mean, I would hope so.
I'm at the practice facilitylike three days a week, so I
would hope that they would knowwho.
Speaker 1 (28:26):
I am.
But would they say hi, yeah, sothat means every player knows
who you are, but not because Imean that's like she sits in the
cafeteria.
Yeah, we're late in thecafeteria over there.
Speaker 2 (28:39):
Yeah, but for the first season and a half I think,
it was like who is she?
Why is she here?
And so it just takes time andbuy in what about for you?
Speaker 1 (28:46):
like when the new owners came in, did you think
you were secure or did you gothrough anxiety going?
Oh man, they're getting rid ofeverybody that's a question.
Speaker 2 (28:54):
I think I was more so focused on helping everyone
else during the transition thatI didn't really think about me,
and I think the reason that Ididn't think about that, too is
because I have a privatepractice and that wasn't my sole
job.
Speaker 1 (29:05):
Right.
Okay, but it's like sometimes Ifeel like in my career that
there's a lot of parallels withbasketball, the NBA it's kind of
like with, I would assume,players.
Do they get freaky or nervousabout being traded?
And if they do, do they come toyou and they say the rumors are
they're going to trade me?
Like I've heard rumors about myjob and it makes me sick to my
stomach and my wife's, likethat's not going to happen.
(29:27):
Get it out of your head.
You can't control that right.
Speaker 2 (29:29):
I would say that there are certain peak times of
anxiety throughout the seasonplayoffs, trade deadlines, all
of that, I think, are highanxiety times just because of
the uncertainty.
But unfortunately it's a partof the business and I think
people just know that.
They just hope to be playingsomewhere.
Speaker 1 (29:48):
And have you ever been like?
Thank God, they traded that guyI really enjoy meeting every
single person.
Speaker 2 (29:55):
I think they each bring a different flavor to the
team, so I have not had thatthought.
Speaker 1 (29:59):
So you don't go to any of the coaches that guy with
number 25.
Speaker 3 (30:03):
So we keep talking about the male players.
Let's talk about the femaleplayers, because you also work
with the Phoenix Mercury.
So do you see a big differencebetween WNBA, nba?
Speaker 2 (30:14):
Yeah, I'd say just on a broad scale.
I feel like the WNBA is stillgetting accustomed to having
mental health services becauseit was brought on a little bit
later, I believe, than the NBA,I think one or two seasons later
if I can remember correctly.
But I think that the genderdynamic is interesting.
So I think some teams reallyvibe with a female mental health
(30:39):
person.
I think other teams prefer amale.
It really depends on the teamculture.
So I think that's aninteresting dynamic.
I've seen is like I thinksometimes the male players more
like to seek a female providerversus the female players might
prefer a male Do you think thestressors are the same between
the two for gender dynamics, ordo the women bring?
Speaker 3 (31:01):
do they have a added level of stress that men don't
have to carry?
Speaker 2 (31:06):
I think there are different levels of stress.
I think that there's a lot ofviewers and people in attendance
and sponsorship, money at stakeand things like that for the
men, um, on a smaller scale forthe women.
But I think that there's justdifferent types of stressors,
because it almost throws me backto thinking of like 20 girls in
a sorority in college and Ithink that the it can present
(31:28):
difficulty and high tensions attimes.
Speaker 1 (31:32):
You know I brought up Ted Lasso.
He had a psychiatrist too,remember, mm-hmm.
Is that what it's like?
A session like the session hehad?
Speaker 2 (31:38):
I don't think so.
It's not like that I don'tthink so.
Speaker 3 (31:41):
It's made for TV.
Yeah, it's made for TV.
Speaker 1 (31:48):
I know, but it makes it seem like he comes in, sits
down in her office.
They a while.
Speaker 2 (31:52):
That would be if I had an office.
I've had to get creative thenthere and I use a patio.
So a private patio with fourchairs?
Speaker 1 (31:59):
Yeah, do you go on the trips with them when they
play in another city?
Speaker 2 (32:02):
A few times Last season I was traveling up until
I hit about 34 weeks pregnantand then I decided to stay home.
So I traveled through Januaryor December of last season and
then for this season I justtraveled for the preseason trip
and the first regular seasontrip.
Speaker 1 (32:19):
How important is sleep for mental health.
Speaker 2 (32:21):
So important I mean for everyone, I think anywhere
from pregnant women experiencingmental health crises that are
trying to not precipitate amanic episode if they have a
history of bipolar disorder.
Sleep is so protective and samefor athletes like.
Your body needs to recover bothphysically and then your mind
needs to recover mentally, soyou need good sleep.
Speaker 1 (32:42):
So what's a good amount of sleep?
Speaker 2 (32:44):
I think it depends on the person.
I think it's really difficult,like I can probably thrive at
about seven hours of sleep andmy husband, up until he got his
CPAP, needed like nine to 10hours of sleep.
Speaker 1 (32:56):
I have a CPAP.
Yeah, so wait was he snoringand keeping you up.
Speaker 2 (33:00):
He was snoring and then he would stop breathing and
then I thought he hadnarcolepsy, because he was
sleepy in the afternoons and hehad all of it.
Speaker 1 (33:06):
So and how long has he had the CPAP?
Speaker 2 (33:09):
He's had it now for a year and a half and it changed
his life.
Speaker 1 (33:12):
Right.
Yes, I love my CPAP, but doeshe get marks on his face?
I got marks, he has a nasalpillow.
Speaker 2 (33:17):
Oh, I can't stand those.
Speaker 3 (33:20):
So you have your own concoction, yeah.
Speaker 1 (33:21):
I do, I have, I've rigged up something, but I I
think I wish I would havefocused more on sleep earlier in
my career, because I wasworking on four hours sleep.
I just thought that was the wayto do it.
And up until actually, up untilI started training or working,
having Carrie as be my doctor,where she told me to get the
aura ring and I became obsessedwith monitoring my sleep and now
everybody in my family has theaura ring and we compete to see
(33:44):
who has better sleep, and it'sgreat.
And then it's like you know,because you can, you can see
everybody's sleep.
It's like so what happened?
What happened last night?
And all of my roommate'sbirthday, we went out, or I had
to study for a final, so it'sreally it's or my youngest son
sneaks out to go see a girl.
We're like why is your sleepscore at 70?
Speaker 2 (34:04):
or ring outed him yeah, that's pretty cool so how
much sleep do you get now afterliving at four hours?
Speaker 1 (34:10):
now I've pushed this six and a half, sometimes seven,
okay, right, for which I wish Iwould have discovered this 15,
20 years ago.
It's crazy and I feel better,but I'm still shooting for eight
and I and I really it's, it'salmost like but eight's not a
real number it's not talkedabout that.
Speaker 3 (34:26):
No, eight is just.
It's kind of that rumor thateverybody needs to have eight
hours and, just like Brooke wassaying, it's so dependent on the
different individual, theirchronotype and their sleep
algorithm.
So for some people, four hoursis actually adequate.
What we discovered with you isfour hours was far from adequate
.
Speaker 1 (34:42):
Right.
Speaker 3 (34:43):
For the rest and recovery for the REM and the
deep stage that you needed.
It just didn't work.
Speaker 1 (34:47):
Well, it's like so on no sleep.
I was miserable, right.
So now I'm trying to get alittle bit more sleep.
And I started.
We got stem cells.
We went to Mexico and got stemcells and I feel like I'm
operating at a whole differentlevel with stem cells, which I
just can't imagine.
What I'd be like without stemcells and a little sleep.
Do you know what I'm saying?
I mean, it's crazy.
Speaker 2 (35:07):
What did you notice?
The biggest difference withstem cells.
Speaker 1 (35:11):
I just feel like I don't take naps anymore, like
I'm just moving all the time.
I feel more creative.
I feel Mental alertness yeah,physical exhaustion.
Speaker 3 (35:24):
We experience mental exhaustion a lot of times in our
careers and the mentalexhaustion actually is one of
the things that you notice goesaway, which is weird, I find
myself being because I'm gettingbetter sleep.
Speaker 1 (35:36):
I find myself being more kind to people, more
willing to.
I think I have resting bitchface.
You know what I mean.
So when I walk up and down thehallways at work people would be
like, oh, he's a jerk.
And I'd be like, why would theysay that?
But I think it's because I wasalways so tired.
So now I find myself workingwell with other departments at
the radio station and otherpeople.
Speaker 3 (35:55):
Increased tolerance.
Speaker 1 (35:57):
That's a great way of putting it, cause I used to be
like not have tolerance.
Speaker 3 (36:02):
No, get out of here.
Speaker 1 (36:03):
Now I'm a little bit boy, that's such a great way.
Speaker 3 (36:07):
Increase the.
But one of the things we donotice after stem cells because
so many people who get stemcells also have aura ring
tracking and you can track withthe WHOOP it's not just an
aura-exclusive deal but wenotice that their deep sleep and
their REM sleep actuallyincreases percentage-wise.
So if they traditionally sleepsix and a half hours, the
percent of time spent in deepand REM sleep within that six
(36:29):
and a half hours increases, andthat's one thing we see
consistently across everyone.
Speaker 1 (36:33):
Do you have an Oura Ring?
Speaker 2 (36:35):
I don't.
Speaker 1 (36:35):
Do you monitor your sleep?
I do not.
Do you tell the players to dothat?
Speaker 2 (36:40):
Well, I think that with the players, it's very
important.
So I have an eight-month-old soI think it is not helpful to
monitor my sleep right now, butI will say she's a rock star.
She started sleeping throughthe night at four months, so I
now know like basically myalarm's going to go off at six,
so I just backtrack and try andgo to bed at 10.
Speaker 1 (36:58):
Does she have an aura ring?
Speaker 3 (36:59):
Will you leave the show today and get an aura ring.
Speaker 2 (37:04):
I think I've been very interested in monitoring,
so I think I could see myselfusing something like the Whoop
more instead of a ring.
But yeah, I think the trackingis very helpful and it gives
someone some good data.
Who might not put the piecestogether about how much sleep
they're actually getting?
Another big thing to consider,too, if someone says they're
having a hard time sleeping, isto ask about naps, because one
(37:26):
time I remember just in myoffice I asked someone about
like you know, they're like oh,I'm having so much trouble
sleeping.
I get like three hours of sleepat night.
Speaker 1 (37:33):
I'm like well, do you take naps?
And they're like yeah, I napabout four hours a day.
I'm like, well, that's theproblem, right, I can I go.
I'm going for 10 minutes andshe's like no, you got to and
she'll sleep for four hours.
Oh, my gosh, right, but thenshe'll go back to sleep again,
like I think it's the stem cellstoo.
(37:53):
She got some stem cells too.
What about recovery?
And you brought up cold plungesand all that stuff.
Where does that fall in themental Well?
Speaker 2 (38:01):
I think that there's some good evidence that it could
help with mental recovery aswell as physical recovery, just
helping people with theiroverall mood and the dopamine
and norepinephrine surge canhelp with mood overall.
Speaker 1 (38:17):
So the cold plunge have you seen all this stuff
about the cold plunge?
They say it's the same dopamineas doing cocaine.
Have you seen that?
Speaker 3 (38:24):
No, I haven't seen that I've heard that.
Speaker 1 (38:25):
Is that real or is that not real?
Speaker 2 (38:27):
Well, I think that it it boosts that reward system
like the dopamine.
That is like with THC activatesand other drugs.
That activates the rewardsystem.
I you know, I can't say I knowscientifically that that's true.
But I I do know that peoplethat do use cold plunge and get
up to their neckline with thevagus nerve kind of being
(38:47):
activated do have mentalbenefits from it.
Speaker 1 (38:50):
What's your take on, since you're a psychiatrist but
also a child psychiatrist,family psychiatrist?
This whole thing with vapingright now, right, it's
everywhere.
Teens are doing it like crazy.
Speaker 2 (39:02):
Yeah, yeah, and it looks so subtle too, like I had
someone telling that they foundsomething that looked like a
bookmark or a USB plug and theyopened it and it was a vape pen.
It's like terrifying how easyit is to hide and how discreet
it can be.
Speaker 1 (39:16):
And I've seen do athletes vape.
Speaker 2 (39:20):
I don't think they would want to tell me much about
it, because I think they vapethe weed too.
Speaker 1 (39:25):
Yeah, you can vape right, yeah, marijuana but
that's the thing that themarijuana and the vaping and the
drinking, it's like.
I, like you know, I always usedevin booker as an example to my
kids, because there's thisinterview I saw with him where
he talks about he didn't go toprom, he didn't go to homecoming
, he didn't have a lot offriends, he played basketball
(39:46):
and he trained, he.
He trained with his team calledthe Alabama Challenge, and I
always tell my son, if he'sgoing to go to a party or
something, I go.
Hey, man, alabama Challenge,alabama Challenge, get back in
here, get some sleep and trainand train and train.
And that's what that book, mindGym talks about.
This is the different mindsetyou have to have to be there's,
there's what everybody else does, and then you have to be better
(40:07):
.
Right?
Speaker 2 (40:08):
yeah, there's a push to be the best.
You have to work hard andeliminate all the distractions
and eliminate all the noise, andyou could argue maybe that and
I you know that players that areout there partying, staying up
late, you know, drinking,drugging, whatever they are
going to have severe impacts ontheir performance because
they're not going to get thatrestful sleep and recovery.
Speaker 1 (40:31):
So Carrie had a patient that I met and he was a
wonderful guy.
He was very open about hishealth because I know you can't
talk about stuff, but he waslike ask me anything and then we
did it.
We did it, yeah Right, anything.
He had heart problems, he hadall kinds of stuff.
He was like talk about anything.
And I kind of feel the same way, like I'm willing to talk about
anything if I can help somebody.
Now, has there ever been apatient of yours or an athlete
(40:53):
of yours that has had the samething that you can talk about?
Speaker 2 (40:56):
Unfortunately not.
Speaker 1 (40:57):
Like you can't say oh , I sat down with Charles
Barkley, you, there's nothinglike that.
Speaker 2 (41:02):
No, unfortunately I can't.
Speaker 1 (41:04):
Dang I know, but is there anybody?
Have you had a player thoughthat you were like they had some
serious concerns, or is itstuff that's textbook that you
can handle?
Yeah, I think I don't think youcan handle any, but I mean, you
know.
Speaker 2 (41:14):
Yeah, I think that there's definitely clinical
things that come up in sports,and I think that's the thing
people need to understand isthat, you know, athletes aren't
perfect, they're not superheroes.
They have clinical concerns,they can have general anxiety,
they can have major depression.
Just because someone's a starplayer doesn't mean that they
don't have things going on offthe court.
And so I think that's the thinga lot of fans miss is that they
(41:37):
treat these players like assets, right, and they don't treat
them as actual human beings.
And you know, like I think justjust witnessing the like,
almost like heckling and namecalling and like you must sign
my t shirt and like yelling atthem as if they're things, is
really, really hard for them.
Speaker 1 (41:55):
I'm sure don't.
It's like they signed 75 tshirts the 76 one they got to go
right and that one person saysthey're a jerk, that whatever,
because they didn't sign it, butat some point it stop.
Right now is there.
Have you had a meeting with aplayer where you're helping them
?
There?
It is what it is, but you kindof in your mind you're like I
(42:15):
can't believe if the world knewthat this superstar player had
this question or that they havethis insecurity.
You know, it's like what I'masking, I guess, is that some
sort of peace of mind thatsometimes these mega players are
human like us and they have thesame insecurities that we have.
Speaker 2 (42:31):
Well, I think that that's true with all high
performers and achievers, likecorporate executives that are
high up in their positions,athletes, like everyone some
sort of insecurity aboutthemselves, or what like I
clinically call a cognitivedistortion, where it's like
something in your mind.
Like a cognitive distortion,for example, is like fortune
(42:51):
telling.
So it's like before, let's saybefore I walk in to record this
podcast and like I know I'mgonna suck, he's gonna hate me,
I'm, I'm gonna totally ruin thisshow.
That's a cognitive distortion.
Everyone has some type ofcognitive distortion.
It just plays out differentlyfor different people.
So I think that everyone hassomething that is a deep
insecurity to them.
Speaker 1 (43:13):
But you're saying so.
If you go into the mindset ofthis podcast that we're going to
hate you, it's going to beterrible, then, using that
manifestation, it could turn outthat way.
But if you go into the morepositive outlook right man, this
is going to be great.
I'm at the best podcast in theworld.
It's gonna be like that.
Doesn't that change the vibe?
Speaker 2 (43:30):
A little bit.
So this is all.
The premise of cognitivebehavioral therapy, or CBT, is
like, how does an automaticthought impact your emotion,
which then impacts your behavior?
Right?
So like if I had that automaticthought, then I could use some
CBT skills on myself and be like, well, out of the last 15
podcasts you did, how many ofthem were absolutely horrible
and they said you sucked?
(43:51):
Well, zero.
And then you start torationalize and use that logic.
So then the emotion then is notfeeling bad and then sucking in
the podcast.
It's going to be like feelinghopeful or optimistic and it's
going to lead to feelinghopefully good overall about it.
Speaker 1 (44:06):
What about with these elite players that you deal
with?
Do they?
Do you see anything a commondenominator with them?
I have a couple of friends.
One is a world series champion,another one is a world
Superbowl champion, and theyhave there's just something
different about them when theycompete Even it's a board game
game Like they want to kill you,Right.
Speaker 2 (44:31):
Now, is that a common trait with champions?
You mean the kind of just supercompetitive?
Speaker 1 (44:34):
mentality.
Yeah, there's just somethingdifferent about them.
I can't place it exactly, butthere is a different operating
system with these guys.
Speaker 2 (44:40):
I don't think so.
I think everyone brings theirown flavor, which makes each
team each year very interesting.
You know, some people are justreally kind nice people that you
know get ready quietly and goout on the court and smile at
people, whereas other ones arelike locked in and serious
looking and, you know, look likevery scary when they're out
there.
So you know, I think that itjust is really dependent on the
(45:02):
person.
But that doesn't mean theyachieve differently.
I think is the point.
Speaker 1 (45:05):
What about rituals or OCD behaviors?
Do a lot of players have that?
Speaker 2 (45:13):
Yeah, so in the sports psychiatry training they
actually have a whole kind ofmodule on ritualistic behaviors
and that's not OCD, right?
Because the difference betweenlike rituals and OCD is that it
causes dysfunction to your dailylife.
OCD does, ocd does so that wouldbe like if I had to wash my
hands 200 times a day.
That probably gets in the wayof me functioning in my
day-to-day life Versus, if youknow before.
Let's say, if I'm an athleteand I go out on the court which
(45:36):
thankfully I'm not veryathletically talented but, um,
but that would be like maybe tiemy shoe in a certain order.
Uh, watching a video, listeningto the same song, like those
are all rituals, but notnecessarily OCD, because it
doesn't cause dysfunction.
Speaker 1 (45:52):
Well, that's good to know.
Speaker 3 (45:53):
Rituals are positive.
Speaker 1 (45:54):
Yeah, because I have been a shit ton of rituals so I
always thought it was OCD stuff.
Man, it's freaked me out.
What about medication Likewhat's your take on the Vyvanse
and what's the other one,adderall?
Speaker 3 (46:07):
We've got a whole bunch of different stimulants.
Speaker 2 (46:09):
Yeah.
So I think that in people withtrue ADHD that they can be life
changing.
But the thing to always screenfor and be aware of is are you
also using marijuana?
Because if someone's usingcannabis it can actually
precipitate like psychoticparanoia, hallucinations, and it
can be really dangerous.
So I've seen that throughout mychild psychiatry training is
(46:31):
kids coming in after using somesort of like a wax pen or some
really like strong cannabis andthen it kind of pushes them over
the edge into psychosis.
So I think you know the ADHDmedications have real utility if
they're not using marijuana andthey actually have a diagnosis
of ADHD.
Speaker 1 (46:50):
Are there players that take ADHD medicine?
Speaker 2 (46:53):
So in the league there's definitely players with
ADHD, but there's certainprotocols that throughout the
league, if a player has ADHD,you have to submit the
appropriate documentation,because they will fail a urine
drug test, and so you want tokind of get ahead of that stuff,
that's that med, comes in aurine test.
Yeah, because it's anamphetamine.
Speaker 1 (47:14):
Oh yeah, you know I was talking to you earlier about
the new trainer at the Suns whoI know, keegan right, does that
position like that.
Is it a trainer?
What do you call it?
What he does.
He's the guy that, the PT guy,athletic trainer.
Do they come to you and go, hey, so-and-so, tore his ACL, he's
six months out.
Can you talk to him Like, dothey do that?
Or does a coach or somebodyever come up to you and go, can
(47:35):
you talk to so-and-so aboutwhatever?
Speaker 2 (47:40):
I think they're feeling a little down and you
know there are like departmentmeetings and in those meetings
it's discussed like what theinjury updates are.
Speaker 1 (47:48):
What about management and ownership?
Do you talk to those guys, oris it just players?
Speaker 2 (47:54):
So I mean in terms of just talking to them.
Speaker 1 (47:56):
Yes, I interact with them.
I mean therapy sessions client.
Speaker 2 (47:59):
I can have sessions with anyone in the organization.
So I can say that.
Speaker 1 (48:04):
Really so, even the person that's ripping the ticket
if they want to talk to you.
Speaker 2 (48:09):
So anyone that's at the practice facility.
So that's really likebasketball ops.
Speaker 1 (48:12):
Do you ever use any of the things at the practice
facility?
Speaker 2 (48:15):
In terms of for myself.
Speaker 1 (48:16):
Yeah, like the cryo machine You're asking if she
shoots hoops, no, like I heardthat there's a cryo machine in
the back that no one even knewabout forever and then they
started using that and I thinkthey got the ice baths and all
that stuff.
Speaker 2 (48:28):
Okay, yeah, if that's all in the male locker room,
then I don't have access to that.
Speaker 1 (48:33):
Oh, so you don't go in there and lift weights.
So you don't go in there.
Speaker 2 (48:35):
No, I probably wouldn't want to be walking
around in my bathing suit overthere.
Speaker 1 (48:39):
Is that how you lift weights In my?
Speaker 2 (48:41):
workplace and the cold plunge.
Speaker 1 (48:43):
Well, good, this has been very cool, right yeah?
It's been cool.
Anything else we need to bringup Carrie.
I'm fascinated with all.
You should, in my opinion,check out that book, mind Gym
Okay, I will, because I think itis.
I've listened to it, I've readit twice.
I listen to it as much as I canto interview him because I was
(49:05):
just blown away, because it'salso old enough to where I feel
it's a secret weapon.
You know what I mean.
Like not everyone's doing thatnow.
And also I mean he name dropseverybody that he works with,
from the Cardinals to famousbaseball, and it's at that point
where you might know some ofthe players you might not.
Like I'm not a sports guy.
I mean I'm turning into one nowbecause of my three boys, but
(49:26):
back then, oh yeah, I rememberthat guy's name, I remember
so-and-so, you know.
So it's kind of neat.
And they get specific.
How you help them manifest andproject stuff.
See, what you put out in theuniverse comes back.
Do you believe that?
Speaker 2 (49:39):
Yeah, I think so, really believe in that.
One other book.
Speaker 1 (49:47):
I recommend to everyone is Atomic Habits.
That book is fantastic.
My son, who I had read Mind Gymwith, he told us to read Atomic
Habits.
It's great.
What other books that you?
Speaker 2 (49:54):
like Flow State.
So any books on maintaining aflow state are really I'm super
into.
Right now I'm reading a lotabout flow state and just how
can you get in the zone.
Another one called Deep Work Ilove that term, so flow state.
And just how can you get in thezone.
Another one called like deepwork.
Um, I love that term is like soif I don't want to be bothered
and my husband comes in and I'mlike actively working, I'm like
deep work, honey, deep work.
(50:15):
So I love yeah, I love um booksthat are talking about, like,
how to really enhance yourperformance and get in the zone.
Speaker 1 (50:23):
Okay, so for my son who plays basketball in Hawaii,
I should tell him to get DeepWork.
Speaker 2 (50:28):
And Atomic Habits.
Speaker 1 (50:28):
He already read that one.
Okay, and what was the otherone?
You?
Speaker 2 (50:31):
used Flow.
Speaker 1 (50:31):
State.
That's the name of the bookFlow State.
Speaker 2 (50:33):
Yes, I believe so it has a light blue cover.
Speaker 1 (50:36):
What's your favorite TV show?
Speaker 2 (50:38):
Oh, that's so hard.
Right now it's the GoldenBachelor.
She's dissecting that apartfrom a psychiatrist standpoint.
And Morning Report withJennifer Aniston, morning Show.
Speaker 1 (50:50):
Morning Show yeah, you know what?
I started watching season threeand I just the first episode
bothered me Really.
I couldn't get it just seems soI forget what it was.
It was so silly almost.
Oh, she's going into space.
Speaker 2 (51:01):
Oh, yes, yes, and I was like come on, it does get
better from there.
Speaker 1 (51:05):
Oh it does.
I was like I can't.
This is silly.
Speaker 2 (51:07):
What's your favorite TV show?
Speaker 1 (51:11):
I'm watching.
It's called Generation V Gen V.
Oh yes, I'm watching that.
I'm watching that.
I just finished a movie calledPainkillers or Pain Hustlers.
Speaker 3 (51:22):
Pain Hustlers, which is different?
Speaker 1 (51:24):
yes, there's Painkinkiller and then there's
um, what's the one same thing.
It was the doc I told you, uh,it won all these awards on hulu.
It was all about the opioidcrisis, it was uh oh, I know, I
see the cover in my mind.
I know what you're talkingabout that was with the guy that
played batman, michael keaton,and then they did another one
called pain killers, and that'swhat the guy that played ferris
bueller.
Correct and then this came outand this is the guy that plays
(51:46):
Captain America, and it's a truestory about the pharmaceutical
companies, but it's fentanyl.
In six months, they were makinghundreds of millions of dollars
and now all the people are inprison.
That's number one on Netflixright now.
Speaker 2 (52:01):
Okay, I'll check it out.
Speaker 1 (52:03):
What about you, Carrie?
What are you watching?
What are you reading?
Speaker 3 (52:07):
Well, I'll check it out, but good, what about you,
carrie?
What are you watching?
What are you reading?
I'm not well.
I read medical journals everyday, so that doesn't really
count.
It's like an endless.
Speaker 1 (52:12):
She knows more about anything than anybody you've
ever met might tell her.
Speaker 3 (52:16):
I'm kind of a history buff, so I'm actually
re-watching Band of Brothers.
Speaker 1 (52:20):
Oh yeah, that just came out on Netflix, didn't it?
I know, or on Netflix, or Max.
Speaker 2 (52:23):
Yeah.
Speaker 1 (52:24):
Yeah, but that's why she's good at what she does.
Speaker 2 (52:26):
She's constantly reading.
Speaker 1 (52:28):
Oh, I know, Like you don't like normally I'll Google
something.
She's a human Google in themedical world.
Yeah Well, thank you for yourtime.
Speaker 2 (52:37):
Thank you Appreciate it.
Speaker 1 (52:39):
Yeah, very nice, thanks, bye.
We're talking about health and wellness.
We're talking about biohacking,we're talking about mental
health and, dr Shulay, you arethe Phoenix Suns psychiatrist
consultant.
What's your exact title for thePhoenix Suns?
Speaker 2 (00:29):
I am the team licensed mental health
professional and the consultingsport and performance
psychiatrist.
Speaker 1 (00:37):
And do you get a lot of playtime?
Are the players coming in youroffice all day?
Speaker 2 (00:42):
I like to say I make myself readily available.
So then, if there are needs,then I'm there to chat with them
.
But yes, I work a lot withplayers staff, anyone who needs
help within the organization.
Speaker 1 (00:53):
And when you meet with a player is it mostly like
do you do it at the arena or atFootprint Center or at that
practice facility in Arcadia?
Speaker 2 (01:00):
Really all of the above.
So I'll meet with them at thepractice facility, at the arena
before games, at my office, intheir home or virtually so.
Any of those five.
Speaker 1 (01:09):
And is it on the down low or the other players know
that?
Oh my God, you're meeting withBrooke today.
Speaker 2 (01:13):
Uh, it is on the down low, I would say mostly, except
for, like, if it's before thegames and they just finished
warming up on the court andthey're like hey, can I grab a
few minutes?
So we're just sitting out thereon the court chatting.
So that is public and I only dothat when they initiate that
publicly.
Speaker 1 (01:29):
Yeah, and what about when a player gets traded?
I always thought, like, likewatching the emotional
rollercoaster, or that therewould be emotional rollercoaster
being traded.
Do they ever continue talkingto you, even though they're with
another team?
Speaker 2 (01:41):
That is such a tough question because clinically we
can only practice medicine inthe States that we're licensed
in and where the patient'slocated.
So let's say we trade someoneto Memphis.
Now I'm not licensed there so Ican't continue clinical kind of
care with them.
But what I can do is just be aperson and just check in and be
like hey, this was a reallytough time, we miss you here,
(02:01):
How's it going?
And just like be a human withthem.
Speaker 1 (02:04):
They can't call you and do service that way.
Speaker 2 (02:07):
They can call me, but again for that more like casual
conversation.
It can't venture into like aclinical patient relationship
again since I'm not licensed inthat state.
Speaker 1 (02:16):
So how long have you been with the Phoenix Suns?
Speaker 2 (02:18):
I've been with them for three seasons and with the
Mercury for two seasons.
Okay, all right.
Speaker 1 (02:23):
So we had like a bunch of things we wanted to get
into right, carrie.
Speaker 3 (02:25):
We do.
We absolutely want to talkabout some of the issues in
mental health, not really asmuch as you know what you do day
in, day out on the regularmental health side, but some of
the ideas that the players mightgo to or they might search
something on the web that saysthis is a cool new trend, of
something that can help me getbetter.
So we specifically want to askyou about the use of ketamine,
(02:49):
and ketamine is a drug that hasbecome pretty common in the
mainstream market for peoplehelping to deal with clinical
depression anxiety.
We know players deal with a lotof performance anxiety, which
is why you're helping the teamout.
And what has been your thoughtprocess on this new rollout of
an old drug?
Ketamine's been around forever.
We used it in the emergencyrooms to help sedate mostly
(03:10):
young children if we were doingan invasive procedure, but
ketamine has been used now tohelp people overcome the
barriers with depression andwith generalized anxiety
disorder.
What are you seeing happeningwith, specifically in the NBA?
Is there any use or is that aloud drug for the players?
And what has been your take onthat?
Speaker 2 (03:30):
Yeah, I think that it's really easy to get caught
up in what seems to be thenewest fad of things, and in the
NBA, especially when we haveplayers that are performing at
such a high level, it's socritical to make choices and
medical interventions based onlike the most minimal side
effects possible.
So, to me, like that is likethe very end of the conversation
(03:51):
and should not even really comeup, because ketamine, just with
the general population, canhave so many potential side
effects, so much so that at aplace that's doing it well,
you're monitored for two hoursafter a spravato nasal spray.
So I think that it's somethingto keep in mind, especially with
NBA players and especially insports.
Psychiatry training is likewhat intervention can you have
(04:13):
that's evidence-based, that hasthe least amount of side effects
possible?
Speaker 3 (04:17):
Can you help the listeners understand more about
the drug ketamine itself,Because this falls within the
psychiatry realm to some extentright now.
It wasn't originally developedfor that.
Of course, it was more of ananesthesia medication, but
psychiatrists have embodied itand found new applications for
it.
So what has been some of theliterature?
What has been some of themedical studies that have been
(04:38):
done around this drug and usingit on the psychiatry side?
Speaker 2 (04:41):
Yeah.
So I think it's been studiedfor a few different things, some
for PTSD, some for depression,and recently the FDA when they
approved Spravato, they approvedit as the nasal spray for
depression with anantidepressant, which is
interesting because they're notsaying you should just go use
ketamine without evidence-basedpills that are already available
(05:04):
.
They're saying that you can useit in conjunction with
antidepressants.
So in the study that was donethat the FDA had cited in their
statement for Spravatospecifically, it was seen to
have superior efficacy whencompared to a placebo nasal
spray with an antidepressant,compared to the Spravato plus
antidepressant, so that did havebetter efficacy in terms of
(05:27):
treating depression.
Speaker 1 (05:28):
Isn't it an IV drip?
Speaker 2 (05:30):
The Spravato.
So ketamine can be given IV IM,and then Spravato is the nasal
spray as well.
Speaker 1 (05:37):
Spravato is ketamine.
Speaker 2 (05:39):
Is esketamine yes.
Speaker 3 (05:41):
As a nasal spray, but what you're referencing is most
people are actually seeing theclinics pop up as an IV drip.
Speaker 1 (05:47):
I talked to a guy yesterday and I think he's a
pretty clean guy and he goes.
Oh man, I gotta tell you aboutthis ketamine drip I did he goes
.
It was amazing.
He was like I was spinning, Iwas out of control, it was like
I was high and I don't thinkthis guy drinks or does drugs.
Then I have another buddy ofmine who is pretty healthy.
Well, he, I mean, he's afitness guy and he was like dude
(06:08):
.
I got to tell you I didketamine and it was the.
He's done every drug in theworld Right, and he's like and
this made me never want to dodrugs again.
He was so amazing and I waslike well, I don't do drugs, so
I don't need that feeling.
I remember, right after thatconversation, carrie, I went to
you Carrie's my doctor, by theway, my real doctor and she was
like don't stay away from it.
(06:28):
Then I watched this documentaryand actor David Arquette, who's
been on every drug in the worldand addicted.
He goes for these ketaminetreatments and they show the
ketamine treatment and it didnot look pleasant seeing what he
was going through.
Speaker 2 (06:49):
So now I'm like this is coming up all the time, why?
Why are people doing it Likenon-athletes?
Yeah, I think that people wanta quick fix and they want
something that will act fast andgive them a high when they
think it's medically indicated.
Speaker 1 (06:55):
And so it's a high, it's like, it's like a I can't
speak to that.
Speaker 2 (06:58):
I've never tried it, nor have I had my patients try
it, cause I don't recommend itbut I just go back.
I'm so conservative in how Ipractice but I just go back to
like evidence-based medicine.
There's so many other optionswe could try before we even
start talking about some ofthese other things, including
things that are more studied,like TMS or ECT for very severe
(07:19):
treatment, resistant depression.
So sure there's some utilitypossibly and maybe if you do it
in the right setting, but I havenever referred a single one of
my patients to go get ketamine.
Speaker 1 (07:29):
So is it an NBA thing ?
Are people in the NBA doingketamine, or is this just?
Speaker 2 (07:33):
No people in the NBA are not doing ketamine.
Speaker 1 (07:36):
Okay, well, that's good, that's good news, good,
we're making progress.
Speaker 2 (07:40):
Yeah, and psilocybin as well as a prohibited
substance in the NBA.
Speaker 3 (07:43):
So for people who don't know what psilocybin is,
yes, that is like magicmushrooms.
Speaker 2 (07:48):
Oh, Also banned, also banned.
Speaker 1 (07:51):
But marijuana not banned.
Speaker 2 (07:52):
Marijuana not banned.
Synthetic marijuana banned.
Speaker 1 (07:55):
What's that?
What's the difference?
Speaker 2 (07:57):
So I'm not a marijuana expert, because I'm
also anti-marijuana.
Speaker 3 (08:05):
So I'm not the person to ask about the synthetic
versus.
So just syntheticallymanufactured versus deriving it
from the plant.
Speaker 1 (08:08):
Like when you go to these places, everywhere that
sell it, that's normal marijuana, like the plant behind you,
carrie.
No, I'm just kidding.
Synthetic, that's not gummies.
No, no, no, I know you'retalking about synthetically
manufactured, pharmaceuticallymanufactured.
Speaker 2 (08:24):
Yeah, they're chemically making.
Speaker 1 (08:26):
So the normal marijuana is legal in the NBA.
Speaker 2 (08:29):
So I wouldn't say it's legal.
It's not on their prohibitedsubstance list, okay.
Speaker 1 (08:34):
Because there is a very well-known NBA player that
was pushing this and talkedabout doing it all the time.
In fact, I have two sons thatplay basketball and I didn't
want them to watch that clipbecause you know they're very
what's the word I'm looking foraffected or influenced by
players in the NBA and thingsthat they do.
If so-and-so's got a pair ofshoes, they want that shoe.
(08:56):
If they see a very well-knownplayer that might play for the
Suns talking about smoking weedbefore and after games.
In fact, there's one player onthe Suns that I heard.
He's not on the Suns anymore.
There was lots of complaintsabout him from the people I knew
because he wasn't training hard, he wasn't working hard.
They said he smoked weed allthe time.
(09:17):
To me that seems like a bigside effect, because isn't
marijuana a depressant?
Speaker 2 (09:22):
Well, people react differently to marijuana.
Some people it makes themextremely anxious, paranoid,
jittery, and for others it canjust make them totally apathetic
.
Speaker 3 (09:31):
Neither of those good yeah neither good, so why do?
Speaker 1 (09:34):
players want to smoke that stuff, so there's no
benefit to being a betterathlete on it, is there?
Speaker 2 (09:39):
Well, I think that people think that in the short
term it can help with anxietyand depression.
So, yes, that may be true inthe short term, but there was a
study I just read this morningactually that when they looked
at marijuana use and PTSD, inthe short term it was seen to
have some benefit possibly, butin the long term, for long-term
users, there was no benefit andthey just developed a greater
(10:01):
dependence on it.
The other interesting thing tonote too, in terms of young
players or teens that arenon-athletes, is that the
American Psychiatric Societyactually put out a statement
about marijuana in adolescents,because if you use before the
age of 25, when your brain'sfully myelinated, it can have a
lasting effects on your frontallobe, um, which kind of develops
(10:24):
like your executive functioning, how you make decisions, your
impulsivity.
So it can actually havenegative effects on your frontal
lobe development with marijuanause before age 25.
Speaker 1 (10:33):
But then you see these players playing great,
getting $100 million contractsand one of the things they talk
about is smoking marijuana.
Kind of bums me out.
As a dad, you know what I mean.
Speaker 2 (10:41):
Yeah.
Speaker 1 (10:43):
So I'm going to shift gears on a couple things.
If that's cool, we're justgonna jump around right, be all
over the place.
So I've been looking forsomeone in your field for a long
time for a personal use, forfor mike.
I have three boys, two of themare basketball player athletes
and, um, my middle son, whoplays basketball in hawaii.
Uh, we would go when he was inthe aau program.
(11:03):
We would go these long drivesand I was always listening to a
book or something motivational,and I landed on a book written
by a sports psychiatrist orpsychologist, I'm not sure and I
thought it was one of the mostamazing books I've ever read in
this field.
So you're the only other personI've talked to in this field,
outside of this guy, who I'venever talked to.
I tried to track him down and Ibelieve he passed away and I
(11:25):
now I can't remember his name,but the book is called Mind Gym.
Speaker 2 (11:31):
Okay, have you heard of it?
I have not heard of that book,but I've heard the term Mind Gym
actually used in Formula OneMedicine.
So they developed a physicalgym and obviously for physical
strength and conditioning, andthen a Mind Gym that's just as
big as the physical gym.
So Formula One Medicine has aphysical gym and a mind gym and
in the mind gym they havedifferent modalities that are
available, like things that canhelp your mental resilience,
(11:54):
cold plunge, mindfulnesspractice, meditation, things
like that.
So that's where I've heard theterm mind gym.
Speaker 1 (12:00):
Oh well, if you get a chance, the guy was in Arizona,
like he was this guy that had,he had the Cardinals and he had,
um, all the baseball teams.
He was the football playerCardinal guy and he was a guy
for a lot of the all the springtraining teams that came here
and he would tell all thesestories about working with
players mentally Like how, um,you know, you hear like the
(12:22):
secret, like I think the forwardof the book is by Alex
Rodriguez and he says he goesevery night when he was in high
school he'd go to bed.
He lay in bed, look at theceiling and say I hit the ball
hard, I hit the ball hard, I hitthe ball hard and he had his
batting average.
He would say his battingaverage loud, over and over and
over again.
And the guy goes on to be, youknow, world series champion and
gets all this stuff and so he'sin the book.
(12:44):
A couple football players fromthe Cardinals are in the book
about having a positive mindsetand manifestation and like,
where are you on that?
Speaker 2 (12:52):
I think that's so critical.
So in a lot of the mentalskills training for athletes of
all sports is that positive.
They call it positive self-talk.
So it's like affirmations,habit building.
I think like to that habitbuilding is so important for
these players that you knowthere's so many NBA players or
just basketball players that aregreat athletes but what makes
(13:13):
like the LeBron James, stephCurry's, what makes them
different is also that mentalresilience and that kind of
immediate decision-makingability in a game.
So how can you hone in both themental skills part of things
and the physical skills ispartly by doing things like that
.
That positive self-talk, verbalaffirmations, guided and visual
(13:33):
imagery, those all play a bigrole in really differentiating
those that excel.
Speaker 1 (13:39):
So when you say visual imagery, what exactly do
you mean?
Can you have an example?
Speaker 2 (13:42):
Yeah.
So an example would be like afive-minute guided thing maybe,
talking about.
Imagine yourself in the lockerroom.
You're just about to go out onthe court.
You can feel the positiveenergy of your teammates.
You see yourself taking yourfirst shot and it's literally
guiding them through a positiveand a successful encounter in
the game is that something yousay to the guys on the suns, If
(14:04):
you're talking to them?
That's one modality I use forthose that are interested in
pregame, kind of guided imagery.
Yeah.
Speaker 1 (14:10):
Yeah, Cause I would tell my sons I'd be like,
visualize, visualize, Like whenyou go to bed at night, you see
you walking on the court, yousee the ball going in, you see,
you see everything ahead ofWatch this documentary called In
Search of Greatness, If you geta chance to see that.
It's amazing too, becausethat's where you have Tom Brady,
the greatest quarterback of alltime Excuse me, the greatest
(14:30):
quarterback of all time.
And he, at that combine wherethey measure you, he's the worst
performing ever.
Right Now he's the greatestquarterback of all time, but at
this combine place he was theslowest, he was the most out of
shape, but he's the greatestquarterback of all time.
So the documentary goes on tosay we measure things because we
can measure them.
I was talking to you about thisthe other day.
Speaker 3 (14:51):
We were talking about it the other night, yeah.
Speaker 1 (14:52):
I was like, because it's like, you know, just
because you went to Stanforddoesn't mean you're the best
doctor in the world, right?
So here's Tom Brady, who is thebest quarterback of all time.
Um, why is he so great?
What, what is it?
And he talks about motivation.
Same with muhammad ali, samewith jerry rice.
He's like.
Jerry rice said he would go tobed and throw a football in bed
every night, every night, andvisualize every single game.
(15:14):
Before the game happened thenext day.
He had it all in his head, heknew, he saw everything.
So did michael jordan.
So I feel there's got to besomething to that.
Speaker 2 (15:23):
Yeah, and what's really interesting, too, is like
at what point does it becomeunproductive?
Like I talk a lot about withpeople unproductive versus
productive anxiety, and aproductive anxiety is something
you could do something about, solike oh, I'm worried about my
SAT score, okay, well, you couldstudy more, whereas an
unproductive anxiety is, oh, I'mworried, I'm going to get cut
from the team Well, there'snothing you can really do about
(15:50):
that worry, and it's it'sderailing your performance.
So I think it's important forpeople to change their worries
into productive worries and thenact, instead of just sitting
with the worry.
Speaker 1 (15:55):
That's good, that's really good.
How about athletes that sufferan injury coming back from an
injury?
Speaker 3 (16:01):
That's a mental game.
Speaker 2 (16:02):
It is, yeah, a lot.
Because you know, especially atthe start of a season, for
example, let's say, you get abig injury.
You've mentally prepared allsummer to be able to get back
out on the court and potentiallywin a championship, and now you
get a season ending injury.
That's devastating to a lot ofathletes.
Speaker 3 (16:18):
It's devastating and that what if?
Is still in the back.
They know they have a weak linkin their armor.
Right, they're going to go out.
But in the back of their headthey're constantly trying to
battle this issue of what if Igo down again?
And it's.
Even though physically we tellthem you're 100% back, you're
110% back, you're even betterthan you were, they go out there
and they play as if that injuryis still there.
(16:38):
And that's a well-documentedissue with players coming back,
and that's something that Ithink definitely psychiatry gets
more actively involved in totry and help them work through
the anxiety, the performanceanxiety, because that's where it
shows coming back off an injuryand teaching them how to act as
if you know you're talkingabout throwing the football a
hundred times, you knowenvisioning the game.
(17:00):
We're trying to tell them to goback out and act in their mind
as if that injury never occurred, because they keep replaying
the injury over and over again.
Speaker 1 (17:09):
Yeah, like my kids, my son was hurt.
He won't watch.
No, there's a couple of famousinjuries on video of ballplayers
, right, paul George broke hisleg and he's like, oh, check it
out, paul George, I don't wantto see that.
I don't want that in my head,right?
I don't want to see that.
I don't want that in my head,right.
But so you're saying so.
You train like you never had it, pretend you never had it.
You never had the injury.
Speaker 3 (17:31):
You have to get them to train as if they never had it
.
And that's the hard obstaclebecause it's really deeply
imprinted.
It's a form of PTSD almost, forthat player.
So you've got to find a way toovercome that and really get
them to believe they truly areintact, they are uninjured.
At this point they may actuallyeven be stronger than how they
got injured the first time.
Speaker 1 (17:49):
That's what I heard.
Have you been to her facility?
Speaker 2 (17:51):
I have.
It's beautiful, thank you.
Speaker 1 (17:53):
Like the athletes that go there, I think you go to
a hyperbaric chamber, like shehas at Menis Air, and you come
out.
Better to keep doing it.
I watched this documentary onthis hockey player, Connor
McDavid.
Did you watch it?
I did, yep.
So this dude tore everything,everything and they were gonna
have him have surgery.
He didn't wanna do the surgery,so he went in a hyperbaric
(18:16):
every day two hours for 45 daysstraight and then he did his
MRIs and you just see theligaments all starting to get
back together again right,that's crazy.
Yeah, he signed a $100 milliondeal at 23 years old after his
injury.
Speaker 2 (18:32):
That's amazing.
One thing that I'm trying tobring in more to light is that
there's so many physicalindicators of when you can get
back to your sport right, likeyou go through physical therapy
and they look for certainmarkers and mobility and
measures and force and strength.
But one thing that is juststarting to be introduced is
psychological readiness toreturn to play is just starting
(18:54):
to be introduced aspsychological readiness to
return to play.
So that's a big thing in sportspsychiatry world that I've been
diving more into recently iswhat measures are there to
validate or measure yourpsychological readiness to
return?
And what I've found is thatkind of dividing injuries based
on length of injury.
So like, okay, if your injurytimeline is one to two weeks,
it's not as detrimental as, like, a four to eight week or a 12
(19:15):
to 16 week.
And so what are questions thatwe can ask that are validated
and studied, that measure yourconfidence and resilience and
confidence in yourself to getback out on the court?
And not using that asprohibitive, like, oh, your
score was a 40 out of a hundred,you can't go back, but using
that as an indicator of whereare the weak areas, like what
would get you from a 40 out of100, you can't go back.
But using that as an indicatorof where are the weak areas,
like what would get you from a40 to a 50 in confidence.
(19:37):
Because if we can identifythose steps, then we'll have a
better likelihood of you beingmore successful when you get
back out on the court.
Speaker 1 (19:44):
So you have that already or you're working on
that.
Speaker 2 (19:47):
We have implemented that already this season.
Speaker 1 (19:49):
So what are some questions you ask?
To find out if they're okaymentally to come back on the
court after an injury.
Speaker 2 (19:53):
Yeah, Like um, how confident are you to take your
shot that you normally take on ascale of one to a hundred?
Speaker 1 (20:00):
But will they be honest with you, cause I think
they'd be like a hundred, ahundred percent, but really, how
do you know you're getting?
Speaker 2 (20:14):
Well, I think I I always like um say ahead of time
like your score is not going todetermine if you're going to
get back out on the court or not, the physical rehab side of
things is going to determinethat.
So, like, let's just have realconversation and this stays
internal.
So any conversations I havewith players or really anyone um
, is confidential.
So if they talk to me and canbe honest, it could help their
performance If I can help themidentify some areas where
they're still feelinguncomfortable and work towards
(20:35):
those.
Speaker 1 (20:36):
So let's say, I had a hurt oblique, tore my oblique.
Now I'm ready to come.
I feel like I'm ready to comeback, like, how do you?
What would you ask me?
Speaker 2 (20:45):
Yeah.
So the goal is that every weekduring your rehab that we would
be checking in and going throughthat same seven question scale
and so so then I could measureyour progress.
It's not just like, okay,you're ready to go back out on
the court.
What's your measure today?
You?
Speaker 3 (20:58):
would give him homework, essentially goal
targeted direction, that wouldhelp him go back and kind of
revisit why he's hesitating,feeling anxiety towards going
back.
It would help you guide exactlywhat modality, if you will,
that you're going to give him towork on For goal setting.
Speaker 2 (21:15):
I like to try and get them to set their own goals
first before I.
I never want to try and tellsomeone what I think their goal
should be, so I just try andwork with them on goal setting.
I just facilitate their mentalexercise of setting goals for
themselves.
Speaker 3 (21:30):
Have you ever had a player that you worked with
where the physical medicine teamsaid, okay, they're ready to go
back, let's push them back outthere, and you've had to pull
back and say he's not ready togo, he's going to get re-injured
?
Has that ever been a problem?
Speaker 2 (21:42):
Not yet, because the psychological readiness to
return we've just implementedthis season Okay, and it's quite
early in the season still.
Speaker 1 (21:50):
So how can you walk us through how you became the
team psychiatrist for thePhoenix Suns?
Like was it?
Was there a job opening postedon?
Oh, no, I was on LinkedIn.
Speaker 3 (21:59):
I'm just wondering how that works.
Speaker 2 (22:00):
What's interesting is that the league mandated this,
I think back in 2019, either2018 or 19, that teams had to
have both a consultingpsychiatrist and a licensed
mental health professional, andthat could be it's not the same
thing, no.
So that could be a social worker, it could be a psychologist,
but then regardless they have toalso have a consulting
psychiatrist.
So us and two other teams arethe only teams that actually
(22:24):
have the psychiatrist in bothroles, that does, the therapy
and the med management.
Most other teams have atherapist and psychologist,
because I think in a lot ofareas the consulting
psychiatrist is affiliated withwhatever the team sponsor is.
So, like in town, here it'sBanner Health, so out in Utah,
like the University of Utah, isthe consulting psychiatrist, but
(22:47):
they have their own in-houseperson.
So here we're unique in that Iprovide both and I'm in private
practice and have the time toreally dedicate to both.
Speaker 1 (22:56):
So when you go to work, you go to your private
practice, or do you get up andyou go to Footprint Center, or
you go to the practice facility.
Speaker 2 (23:01):
I get up and I go to the practice facility.
I'm there until about oneo'clock and then I'll go to my
office.
Speaker 1 (23:06):
But you get there.
What time?
Speaker 2 (23:07):
I get there around 8 am.
Speaker 1 (23:09):
And literally you get there at 8 am and like there's
someone at your door, I need totalk to you.
Speaker 2 (23:12):
It's so strange.
Like I try to explain this topeople all the time.
I'm like, okay, so I get thereand like I'll go up in the
breakfast area and I'll just sitand work and make myself
available, because the numberone thing with professional
athletes and on any team, anysport, is familiarity.
Like I think what people forgetis that these guys' lives and
women are really isolating.
(23:33):
I think what people forget isthat these guys' lives and women
are really isolating.
Like they are constantlyworried about motives of people,
friendships, like who can theytrust?
Who just wants money from them?
I'd hate to have my salaryposted online, so I'm sure they
hate that.
Like they're they are constantlygetting badgered by people
wanting something from them.
So I think like it took me aseason and a half just to make
(23:55):
myself like known that I wastrustworthy and not there to
tattle on them or tell theorganization what issues they
had.
So I think it took a lot oftime just to even get buy-in of
of like this is a confidentialresource.
Speaker 1 (24:09):
Did you watch Ted Lasso?
I did.
Okay, remember how Ted wouldhave these anxiety, panic
attacks.
Is that a real thing?
Like, have you had players havethat?
Like, how would you describewhat he was?
Gary, he's on the soccer fieldand he's the coach and all of a
sudden he just had to freeze upand leave.
Speaker 2 (24:25):
right, yeah, Does that happen in real life?
I think typically it doeshappen in real life.
I would say it's justsituational, Like it may happen
in the locker room before a game.
I'm not saying that happenshere.
I've just heard that thishappens, that you know before a
game is incredibly stressful, orafter a loss.
I think typically during a gamepeople are pretty locked in and
(24:45):
focused.
Speaker 1 (24:48):
So after a game you sometimes have to meet with a
player.
A player wants to meet with youat 11 o'clock at night because
the game's over at 10 30.
Speaker 2 (24:51):
I've had phone calls late in the evening just to talk
about things or decompress, youknow, not just players but
people throughout anorganization so they have access
to you all day.
Speaker 1 (25:01):
Yes, they call you at 11 o'clock at night.
Speaker 2 (25:02):
You pick up luckily that doesn't happen too often.
I think the latest call I'veever gotten and it wasn't even
related to sports was 10, 30, oh, and I did pick up like I was
at the game the other night.
Speaker 1 (25:13):
It was like over at 10 and and or some of those
games start at 8 and they'reover late and I would think
after, like, my son had a game,a scrimmage, last week.
Um, of course he's in hawaii,so he's three hours behind.
But I went to bed, woke up inthe morning, he was like I
played terrible um, and he justhe just got very emotional and I
wish I was there for him, butit it was late, it was midnight
(25:33):
at one o'clock, and then a halfhour later he's like it's okay,
I'm just gonna have to workharder, is what he said, right,
and 45 minutes later.
So I felt like if he had accessto someone like you, or I feel
bad.
I wasn't there to take it, buthe was fine the next day.
But sometimes I think, do theycall you like that, like I?
Just they're driving home, man,I don't know what did I do
(25:53):
wrong?
Speaker 2 (25:54):
So to me I would see that almost like as a failure of
my role if they needed to dothat, because my goal is to give
them the skills and the toolsthat they can kind of like
process it themselves.
And I feel like if they can't,I haven't done my job.
Speaker 1 (26:09):
So get specific.
What's something like like whattell us like how, what's it
something?
You give them a tool, what's atool that we can give somebody
watching this right now?
Speaker 2 (26:17):
Yeah, I think some tools are like a mindfulness
kind of breathing exercises.
So if someone is having a panicattack, they're now having
physical manifestations of theiranxiety, right, they're getting
short of breath palpitations.
Sometimes they show up in theER to their their outpatient
physician saying that I'm dyingno-transcript about this the
(27:01):
other day of like settingboundaries.
So both her and I practiceconcierge medicine and one of
the questions I get a lot andI'm sure you do too is oh, do
you get called at 2am?
Speaker 3 (27:10):
Always.
Yeah, everybody swears,everybody must call me all night
long because they have my cellphone.
And it's so not true.
Speaker 2 (27:15):
Right, it is so not true, and I feel like our job to
be good physicians is to giveour patients tools to work
through things themselves,whether it be for physical
medicine or mental health care,and then, if things are bad, of
course, call us, but I think itwould be a disservice to people
if I was just like theirlifeline that they needed to
just call and I was the only fix, if that makes sense.
Speaker 3 (27:38):
I think the family members end up being the
lifeline.
So I wanted to ask you do youalso help with mental health for
the family members?
Is that part of the extensionof your services?
Speaker 2 (27:47):
I do, but in my private practice.
So if someone of course that'sa family member is welcome to
come see me, it's just doneoutside of the building in my
own private practice.
Speaker 1 (27:57):
Would you say that you've met with every player on
the Suns?
Speaker 2 (28:05):
I can't say for certain whether I have met with
every player or not, but I willsay that it is a requirement,
just like physical health to getclearance at the start of the
season and how long is thatsession?
I can't say, you can't say no,those are all way too specific,
would you?
Speaker 1 (28:15):
say that the players on the Phoenix Suns if they saw
you at a grocery store, theywould know who you are.
Speaker 2 (28:21):
Yeah, I mean, I would hope so.
I'm at the practice facilitylike three days a week, so I
would hope that they would knowwho.
Speaker 1 (28:26):
I am.
But would they say hi, yeah, sothat means every player knows
who you are, but not because Imean that's like she sits in the
cafeteria.
Yeah, we're late in thecafeteria over there.
Speaker 2 (28:39):
Yeah, but for the first season and a half I think,
it was like who is she?
Why is she here?
And so it just takes time andbuy in what about for you?
Speaker 1 (28:46):
like when the new owners came in, did you think
you were secure or did you gothrough anxiety going?
Oh man, they're getting rid ofeverybody that's a question.
Speaker 2 (28:54):
I think I was more so focused on helping everyone
else during the transition thatI didn't really think about me,
and I think the reason that Ididn't think about that, too is
because I have a privatepractice and that wasn't my sole
job.
Speaker 1 (29:05):
Right.
Okay, but it's like sometimes Ifeel like in my career that
there's a lot of parallels withbasketball, the NBA it's kind of
like with, I would assume,players.
Do they get freaky or nervousabout being traded?
And if they do, do they come toyou and they say the rumors are
they're going to trade me?
Like I've heard rumors about myjob and it makes me sick to my
stomach and my wife's, likethat's not going to happen.
(29:27):
Get it out of your head.
You can't control that right.
Speaker 2 (29:29):
I would say that there are certain peak times of
anxiety throughout the seasonplayoffs, trade deadlines, all
of that, I think, are highanxiety times just because of
the uncertainty.
But unfortunately it's a partof the business and I think
people just know that.
They just hope to be playingsomewhere.
Speaker 1 (29:48):
And have you ever been like?
Thank God, they traded that guyI really enjoy meeting every
single person.
Speaker 2 (29:55):
I think they each bring a different flavor to the
team, so I have not had thatthought.
Speaker 1 (29:59):
So you don't go to any of the coaches that guy with
number 25.
Speaker 3 (30:03):
So we keep talking about the male players.
Let's talk about the femaleplayers, because you also work
with the Phoenix Mercury.
So do you see a big differencebetween WNBA, nba?
Speaker 2 (30:14):
Yeah, I'd say just on a broad scale.
I feel like the WNBA is stillgetting accustomed to having
mental health services becauseit was brought on a little bit
later, I believe, than the NBA,I think one or two seasons later
if I can remember correctly.
But I think that the genderdynamic is interesting.
So I think some teams reallyvibe with a female mental health
(30:39):
person.
I think other teams prefer amale.
It really depends on the teamculture.
So I think that's aninteresting dynamic.
I've seen is like I thinksometimes the male players more
like to seek a female providerversus the female players might
prefer a male Do you think thestressors are the same between
the two for gender dynamics, ordo the women bring?
Speaker 3 (31:01):
do they have a added level of stress that men don't
have to carry?
Speaker 2 (31:06):
I think there are different levels of stress.
I think that there's a lot ofviewers and people in attendance
and sponsorship, money at stakeand things like that for the
men, um, on a smaller scale forthe women.
But I think that there's justdifferent types of stressors,
because it almost throws me backto thinking of like 20 girls in
a sorority in college and Ithink that the it can present
(31:28):
difficulty and high tensions attimes.
Speaker 1 (31:32):
You know I brought up Ted Lasso.
He had a psychiatrist too,remember, mm-hmm.
Is that what it's like?
A session like the session hehad?
Speaker 2 (31:38):
I don't think so.
It's not like that I don'tthink so.
Speaker 3 (31:41):
It's made for TV.
Yeah, it's made for TV.
Speaker 1 (31:48):
I know, but it makes it seem like he comes in, sits
down in her office.
They a while.
Speaker 2 (31:52):
That would be if I had an office.
I've had to get creative thenthere and I use a patio.
So a private patio with fourchairs?
Speaker 1 (31:59):
Yeah, do you go on the trips with them when they
play in another city?
Speaker 2 (32:02):
A few times Last season I was traveling up until
I hit about 34 weeks pregnantand then I decided to stay home.
So I traveled through Januaryor December of last season and
then for this season I justtraveled for the preseason trip
and the first regular seasontrip.
Speaker 1 (32:19):
How important is sleep for mental health.
Speaker 2 (32:21):
So important I mean for everyone, I think anywhere
from pregnant women experiencingmental health crises that are
trying to not precipitate amanic episode if they have a
history of bipolar disorder.
Sleep is so protective and samefor athletes like.
Your body needs to recover bothphysically and then your mind
needs to recover mentally, soyou need good sleep.
Speaker 1 (32:42):
So what's a good amount of sleep?
Speaker 2 (32:44):
I think it depends on the person.
I think it's really difficult,like I can probably thrive at
about seven hours of sleep andmy husband, up until he got his
CPAP, needed like nine to 10hours of sleep.
Speaker 1 (32:56):
I have a CPAP.
Yeah, so wait was he snoringand keeping you up.
Speaker 2 (33:00):
He was snoring and then he would stop breathing and
then I thought he hadnarcolepsy, because he was
sleepy in the afternoons and hehad all of it.
Speaker 1 (33:06):
So and how long has he had the CPAP?
Speaker 2 (33:09):
He's had it now for a year and a half and it changed
his life.
Speaker 1 (33:12):
Right.
Yes, I love my CPAP, but doeshe get marks on his face?
I got marks, he has a nasalpillow.
Speaker 2 (33:17):
Oh, I can't stand those.
Speaker 3 (33:20):
So you have your own concoction, yeah.
Speaker 1 (33:21):
I do, I have, I've rigged up something, but I I
think I wish I would havefocused more on sleep earlier in
my career, because I wasworking on four hours sleep.
I just thought that was the wayto do it.
And up until actually, up untilI started training or working,
having Carrie as be my doctor,where she told me to get the
aura ring and I became obsessedwith monitoring my sleep and now
everybody in my family has theaura ring and we compete to see
(33:44):
who has better sleep, and it'sgreat.
And then it's like you know,because you can, you can see
everybody's sleep.
It's like so what happened?
What happened last night?
And all of my roommate'sbirthday, we went out, or I had
to study for a final, so it'sreally it's or my youngest son
sneaks out to go see a girl.
We're like why is your sleepscore at 70?
Speaker 2 (34:04):
or ring outed him yeah, that's pretty cool so how
much sleep do you get now afterliving at four hours?
Speaker 1 (34:10):
now I've pushed this six and a half, sometimes seven,
okay, right, for which I wish Iwould have discovered this 15,
20 years ago.
It's crazy and I feel better,but I'm still shooting for eight
and I and I really it's, it'salmost like but eight's not a
real number it's not talkedabout that.
Speaker 3 (34:26):
No, eight is just.
It's kind of that rumor thateverybody needs to have eight
hours and, just like Brooke wassaying, it's so dependent on the
different individual, theirchronotype and their sleep
algorithm.
So for some people, four hoursis actually adequate.
What we discovered with you isfour hours was far from adequate
.
Speaker 1 (34:42):
Right.
Speaker 3 (34:43):
For the rest and recovery for the REM and the
deep stage that you needed.
It just didn't work.
Speaker 1 (34:47):
Well, it's like so on no sleep.
I was miserable, right.
So now I'm trying to get alittle bit more sleep.
And I started.
We got stem cells.
We went to Mexico and got stemcells and I feel like I'm
operating at a whole differentlevel with stem cells, which I
just can't imagine.
What I'd be like without stemcells and a little sleep.
Do you know what I'm saying?
I mean, it's crazy.
Speaker 2 (35:07):
What did you notice?
The biggest difference withstem cells.
Speaker 1 (35:11):
I just feel like I don't take naps anymore, like
I'm just moving all the time.
I feel more creative.
I feel Mental alertness yeah,physical exhaustion.
Speaker 3 (35:24):
We experience mental exhaustion a lot of times in our
careers and the mentalexhaustion actually is one of
the things that you notice goesaway, which is weird, I find
myself being because I'm gettingbetter sleep.
Speaker 1 (35:36):
I find myself being more kind to people, more
willing to.
I think I have resting bitchface.
You know what I mean.
So when I walk up and down thehallways at work people would be
like, oh, he's a jerk.
And I'd be like, why would theysay that?
But I think it's because I wasalways so tired.
So now I find myself workingwell with other departments at
the radio station and otherpeople.
Speaker 3 (35:55):
Increased tolerance.
Speaker 1 (35:57):
That's a great way of putting it, cause I used to be
like not have tolerance.
Speaker 3 (36:02):
No, get out of here.
Speaker 1 (36:03):
Now I'm a little bit boy, that's such a great way.
Speaker 3 (36:07):
Increase the.
But one of the things we donotice after stem cells because
so many people who get stemcells also have aura ring
tracking and you can track withthe WHOOP it's not just an
aura-exclusive deal but wenotice that their deep sleep and
their REM sleep actuallyincreases percentage-wise.
So if they traditionally sleepsix and a half hours, the
percent of time spent in deepand REM sleep within that six
(36:29):
and a half hours increases, andthat's one thing we see
consistently across everyone.
Speaker 1 (36:33):
Do you have an Oura Ring?
Speaker 2 (36:35):
I don't.
Speaker 1 (36:35):
Do you monitor your sleep?
I do not.
Do you tell the players to dothat?
Speaker 2 (36:40):
Well, I think that with the players, it's very
important.
So I have an eight-month-old soI think it is not helpful to
monitor my sleep right now, butI will say she's a rock star.
She started sleeping throughthe night at four months, so I
now know like basically myalarm's going to go off at six,
so I just backtrack and try andgo to bed at 10.
Speaker 1 (36:58):
Does she have an aura ring?
Speaker 3 (36:59):
Will you leave the show today and get an aura ring.
Speaker 2 (37:04):
I think I've been very interested in monitoring,
so I think I could see myselfusing something like the Whoop
more instead of a ring.
But yeah, I think the trackingis very helpful and it gives
someone some good data.
Who might not put the piecestogether about how much sleep
they're actually getting?
Another big thing to consider,too, if someone says they're
having a hard time sleeping, isto ask about naps, because one
(37:26):
time I remember just in myoffice I asked someone about
like you know, they're like oh,I'm having so much trouble
sleeping.
I get like three hours of sleepat night.
Speaker 1 (37:33):
I'm like well, do you take naps?
And they're like yeah, I napabout four hours a day.
I'm like, well, that's theproblem, right, I can I go.
I'm going for 10 minutes andshe's like no, you got to and
she'll sleep for four hours.
Oh, my gosh, right, but thenshe'll go back to sleep again,
like I think it's the stem cellstoo.
(37:53):
She got some stem cells too.
What about recovery?
And you brought up cold plungesand all that stuff.
Where does that fall in themental Well?
Speaker 2 (38:01):
I think that there's some good evidence that it could
help with mental recovery aswell as physical recovery, just
helping people with theiroverall mood and the dopamine
and norepinephrine surge canhelp with mood overall.
Speaker 1 (38:17):
So the cold plunge have you seen all this stuff
about the cold plunge?
They say it's the same dopamineas doing cocaine.
Have you seen that?
Speaker 3 (38:24):
No, I haven't seen that I've heard that.
Speaker 1 (38:25):
Is that real or is that not real?
Speaker 2 (38:27):
Well, I think that it it boosts that reward system
like the dopamine.
That is like with THC activatesand other drugs.
That activates the rewardsystem.
I you know, I can't say I knowscientifically that that's true.
But I I do know that peoplethat do use cold plunge and get
up to their neckline with thevagus nerve kind of being
(38:47):
activated do have mentalbenefits from it.
Speaker 1 (38:50):
What's your take on, since you're a psychiatrist but
also a child psychiatrist,family psychiatrist?
This whole thing with vapingright now, right, it's
everywhere.
Teens are doing it like crazy.
Speaker 2 (39:02):
Yeah, yeah, and it looks so subtle too, like I had
someone telling that they foundsomething that looked like a
bookmark or a USB plug and theyopened it and it was a vape pen.
It's like terrifying how easyit is to hide and how discreet
it can be.
Speaker 1 (39:16):
And I've seen do athletes vape.
Speaker 2 (39:20):
I don't think they would want to tell me much about
it, because I think they vapethe weed too.
Speaker 1 (39:25):
Yeah, you can vape right, yeah, marijuana but
that's the thing that themarijuana and the vaping and the
drinking, it's like.
I, like you know, I always usedevin booker as an example to my
kids, because there's thisinterview I saw with him where
he talks about he didn't go toprom, he didn't go to homecoming
, he didn't have a lot offriends, he played basketball
(39:46):
and he trained, he.
He trained with his team calledthe Alabama Challenge, and I
always tell my son, if he'sgoing to go to a party or
something, I go.
Hey, man, alabama Challenge,alabama Challenge, get back in
here, get some sleep and trainand train and train.
And that's what that book, mindGym talks about.
This is the different mindsetyou have to have to be there's,
there's what everybody else does, and then you have to be better
(40:07):
.
Right?
Speaker 2 (40:08):
yeah, there's a push to be the best.
You have to work hard andeliminate all the distractions
and eliminate all the noise, andyou could argue maybe that and
I you know that players that areout there partying, staying up
late, you know, drinking,drugging, whatever they are
going to have severe impacts ontheir performance because
they're not going to get thatrestful sleep and recovery.
Speaker 1 (40:31):
So Carrie had a patient that I met and he was a
wonderful guy.
He was very open about hishealth because I know you can't
talk about stuff, but he waslike ask me anything and then we
did it.
We did it, yeah Right, anything.
He had heart problems, he hadall kinds of stuff.
He was like talk about anything.
And I kind of feel the same way, like I'm willing to talk about
anything if I can help somebody.
Now, has there ever been apatient of yours or an athlete
(40:53):
of yours that has had the samething that you can talk about?
Speaker 2 (40:56):
Unfortunately not.
Speaker 1 (40:57):
Like you can't say oh , I sat down with Charles
Barkley, you, there's nothinglike that.
Speaker 2 (41:02):
No, unfortunately I can't.
Speaker 1 (41:04):
Dang I know, but is there anybody?
Have you had a player thoughthat you were like they had some
serious concerns, or is itstuff that's textbook that you
can handle?
Yeah, I think I don't think youcan handle any, but I mean, you
know.
Speaker 2 (41:14):
Yeah, I think that there's definitely clinical
things that come up in sports,and I think that's the thing
people need to understand isthat, you know, athletes aren't
perfect, they're not superheroes.
They have clinical concerns,they can have general anxiety,
they can have major depression.
Just because someone's a starplayer doesn't mean that they
don't have things going on offthe court.
And so I think that's the thinga lot of fans miss is that they
(41:37):
treat these players like assets, right, and they don't treat
them as actual human beings.
And you know, like I think justjust witnessing the like,
almost like heckling and namecalling and like you must sign
my t shirt and like yelling atthem as if they're things, is
really, really hard for them.
Speaker 1 (41:55):
I'm sure don't.
It's like they signed 75 tshirts the 76 one they got to go
right and that one person saysthey're a jerk, that whatever,
because they didn't sign it, butat some point it stop.
Right now is there.
Have you had a meeting with aplayer where you're helping them
?
There?
It is what it is, but you kindof in your mind you're like I
(42:15):
can't believe if the world knewthat this superstar player had
this question or that they havethis insecurity.
You know, it's like what I'masking, I guess, is that some
sort of peace of mind thatsometimes these mega players are
human like us and they have thesame insecurities that we have.
Speaker 2 (42:31):
Well, I think that that's true with all high
performers and achievers, likecorporate executives that are
high up in their positions,athletes, like everyone some
sort of insecurity aboutthemselves, or what like I
clinically call a cognitivedistortion, where it's like
something in your mind.
Like a cognitive distortion,for example, is like fortune
(42:51):
telling.
So it's like before, let's saybefore I walk in to record this
podcast and like I know I'mgonna suck, he's gonna hate me,
I'm, I'm gonna totally ruin thisshow.
That's a cognitive distortion.
Everyone has some type ofcognitive distortion.
It just plays out differentlyfor different people.
So I think that everyone hassomething that is a deep
insecurity to them.
Speaker 1 (43:13):
But you're saying so.
If you go into the mindset ofthis podcast that we're going to
hate you, it's going to beterrible, then, using that
manifestation, it could turn outthat way.
But if you go into the morepositive outlook right man, this
is going to be great.
I'm at the best podcast in theworld.
It's gonna be like that.
Doesn't that change the vibe?
Speaker 2 (43:30):
A little bit.
So this is all.
The premise of cognitivebehavioral therapy, or CBT, is
like, how does an automaticthought impact your emotion,
which then impacts your behavior?
Right?
So like if I had that automaticthought, then I could use some
CBT skills on myself and be like, well, out of the last 15
podcasts you did, how many ofthem were absolutely horrible
and they said you sucked?
(43:51):
Well, zero.
And then you start torationalize and use that logic.
So then the emotion then is notfeeling bad and then sucking in
the podcast.
It's going to be like feelinghopeful or optimistic and it's
going to lead to feelinghopefully good overall about it.
Speaker 1 (44:06):
What about with these elite players that you deal
with?
Do they?
Do you see anything a commondenominator with them?
I have a couple of friends.
One is a world series champion,another one is a world
Superbowl champion, and theyhave there's just something
different about them when theycompete Even it's a board game
game Like they want to kill you,Right.
Speaker 2 (44:31):
Now, is that a common trait with champions?
You mean the kind of just supercompetitive?
Speaker 1 (44:34):
mentality.
Yeah, there's just somethingdifferent about them.
I can't place it exactly, butthere is a different operating
system with these guys.
Speaker 2 (44:40):
I don't think so.
I think everyone brings theirown flavor, which makes each
team each year very interesting.
You know, some people are justreally kind nice people that you
know get ready quietly and goout on the court and smile at
people, whereas other ones arelike locked in and serious
looking and, you know, look likevery scary when they're out
there.
So you know, I think that itjust is really dependent on the
(45:02):
person.
But that doesn't mean theyachieve differently.
I think is the point.
Speaker 1 (45:05):
What about rituals or OCD behaviors?
Do a lot of players have that?
Speaker 2 (45:13):
Yeah, so in the sports psychiatry training they
actually have a whole kind ofmodule on ritualistic behaviors
and that's not OCD, right?
Because the difference betweenlike rituals and OCD is that it
causes dysfunction to your dailylife.
OCD does, ocd does so that wouldbe like if I had to wash my
hands 200 times a day.
That probably gets in the wayof me functioning in my
day-to-day life Versus, if youknow before.
Let's say, if I'm an athleteand I go out on the court which
(45:36):
thankfully I'm not veryathletically talented but, um,
but that would be like maybe tiemy shoe in a certain order.
Uh, watching a video, listeningto the same song, like those
are all rituals, but notnecessarily OCD, because it
doesn't cause dysfunction.
Speaker 1 (45:52):
Well, that's good to know.
Speaker 3 (45:53):
Rituals are positive.
Speaker 1 (45:54):
Yeah, because I have been a shit ton of rituals so I
always thought it was OCD stuff.
Man, it's freaked me out.
What about medication Likewhat's your take on the Vyvanse
and what's the other one,adderall?
Speaker 3 (46:07):
We've got a whole bunch of different stimulants.
Speaker 2 (46:09):
Yeah.
So I think that in people withtrue ADHD that they can be life
changing.
But the thing to always screenfor and be aware of is are you
also using marijuana?
Because if someone's usingcannabis it can actually
precipitate like psychoticparanoia, hallucinations, and it
can be really dangerous.
So I've seen that throughout mychild psychiatry training is
(46:31):
kids coming in after using somesort of like a wax pen or some
really like strong cannabis andthen it kind of pushes them over
the edge into psychosis.
So I think you know the ADHDmedications have real utility if
they're not using marijuana andthey actually have a diagnosis
of ADHD.
Speaker 1 (46:50):
Are there players that take ADHD medicine?
Speaker 2 (46:53):
So in the league there's definitely players with
ADHD, but there's certainprotocols that throughout the
league, if a player has ADHD,you have to submit the
appropriate documentation,because they will fail a urine
drug test, and so you want tokind of get ahead of that stuff,
that's that med, comes in aurine test.
Yeah, because it's anamphetamine.
Speaker 1 (47:14):
Oh yeah, you know I was talking to you earlier about
the new trainer at the Suns whoI know, keegan right, does that
position like that.
Is it a trainer?
What do you call it?
What he does.
He's the guy that, the PT guy,athletic trainer.
Do they come to you and go, hey, so-and-so, tore his ACL, he's
six months out.
Can you talk to him Like, dothey do that?
Or does a coach or somebodyever come up to you and go, can
(47:35):
you talk to so-and-so aboutwhatever?
Speaker 2 (47:40):
I think they're feeling a little down and you
know there are like departmentmeetings and in those meetings
it's discussed like what theinjury updates are.
Speaker 1 (47:48):
What about management and ownership?
Do you talk to those guys, oris it just players?
Speaker 2 (47:54):
So I mean in terms of just talking to them.
Speaker 1 (47:56):
Yes, I interact with them.
I mean therapy sessions client.
Speaker 2 (47:59):
I can have sessions with anyone in the organization.
So I can say that.
Speaker 1 (48:04):
Really so, even the person that's ripping the ticket
if they want to talk to you.
Speaker 2 (48:09):
So anyone that's at the practice facility.
So that's really likebasketball ops.
Speaker 1 (48:12):
Do you ever use any of the things at the practice
facility?
Speaker 2 (48:15):
In terms of for myself.
Speaker 1 (48:16):
Yeah, like the cryo machine You're asking if she
shoots hoops, no, like I heardthat there's a cryo machine in
the back that no one even knewabout forever and then they
started using that and I thinkthey got the ice baths and all
that stuff.
Speaker 2 (48:28):
Okay, yeah, if that's all in the male locker room,
then I don't have access to that.
Speaker 1 (48:33):
Oh, so you don't go in there and lift weights.
So you don't go in there.
Speaker 2 (48:35):
No, I probably wouldn't want to be walking
around in my bathing suit overthere.
Speaker 1 (48:39):
Is that how you lift weights In my?
Speaker 2 (48:41):
workplace and the cold plunge.
Speaker 1 (48:43):
Well, good, this has been very cool, right yeah?
It's been cool.
Anything else we need to bringup Carrie.
I'm fascinated with all.
You should, in my opinion,check out that book, mind Gym
Okay, I will, because I think itis.
I've listened to it, I've readit twice.
I listen to it as much as I canto interview him because I was
(49:05):
just blown away, because it'salso old enough to where I feel
it's a secret weapon.
You know what I mean.
Like not everyone's doing thatnow.
And also I mean he name dropseverybody that he works with,
from the Cardinals to famousbaseball, and it's at that point
where you might know some ofthe players you might not.
Like I'm not a sports guy.
I mean I'm turning into one nowbecause of my three boys, but
(49:26):
back then, oh yeah, I rememberthat guy's name, I remember
so-and-so, you know.
So it's kind of neat.
And they get specific.
How you help them manifest andproject stuff.
See, what you put out in theuniverse comes back.
Do you believe that?
Speaker 2 (49:39):
Yeah, I think so, really believe in that.
One other book.
Speaker 1 (49:47):
I recommend to everyone is Atomic Habits.
That book is fantastic.
My son, who I had read Mind Gymwith, he told us to read Atomic
Habits.
It's great.
What other books that you?
Speaker 2 (49:54):
like Flow State.
So any books on maintaining aflow state are really I'm super
into.
Right now I'm reading a lotabout flow state and just how
can you get in the zone.
Another one called Deep Work Ilove that term, so flow state.
And just how can you get in thezone.
Another one called like deepwork.
Um, I love that term is like soif I don't want to be bothered
and my husband comes in and I'mlike actively working, I'm like
deep work, honey, deep work.
(50:15):
So I love yeah, I love um booksthat are talking about, like,
how to really enhance yourperformance and get in the zone.
Speaker 1 (50:23):
Okay, so for my son who plays basketball in Hawaii,
I should tell him to get DeepWork.
Speaker 2 (50:28):
And Atomic Habits.
Speaker 1 (50:28):
He already read that one.
Okay, and what was the otherone?
You?
Speaker 2 (50:31):
used Flow.
Speaker 1 (50:31):
State.
That's the name of the bookFlow State.
Speaker 2 (50:33):
Yes, I believe so it has a light blue cover.
Speaker 1 (50:36):
What's your favorite TV show?
Speaker 2 (50:38):
Oh, that's so hard.
Right now it's the GoldenBachelor.
She's dissecting that apartfrom a psychiatrist standpoint.
And Morning Report withJennifer Aniston, morning Show.
Speaker 1 (50:50):
Morning Show yeah, you know what?
I started watching season threeand I just the first episode
bothered me Really.
I couldn't get it just seems soI forget what it was.
It was so silly almost.
Oh, she's going into space.
Speaker 2 (51:01):
Oh, yes, yes, and I was like come on, it does get
better from there.
Speaker 1 (51:05):
Oh it does.
I was like I can't.
This is silly.
Speaker 2 (51:07):
What's your favorite TV show?
Speaker 1 (51:11):
I'm watching.
It's called Generation V Gen V.
Oh yes, I'm watching that.
I'm watching that.
I just finished a movie calledPainkillers or Pain Hustlers.
Speaker 3 (51:22):
Pain Hustlers, which is different?
Speaker 1 (51:24):
yes, there's Painkinkiller and then there's
um, what's the one same thing.
It was the doc I told you, uh,it won all these awards on hulu.
It was all about the opioidcrisis, it was uh oh, I know, I
see the cover in my mind.
I know what you're talkingabout that was with the guy that
played batman, michael keaton,and then they did another one
called pain killers, and that'swhat the guy that played ferris
bueller.
Correct and then this came outand this is the guy that plays
(51:46):
Captain America, and it's a truestory about the pharmaceutical
companies, but it's fentanyl.
In six months, they were makinghundreds of millions of dollars
and now all the people are inprison.
That's number one on Netflixright now.
Speaker 2 (52:01):
Okay, I'll check it out.
Speaker 1 (52:03):
What about you, Carrie?
What are you watching?
What are you reading?
Speaker 3 (52:07):
Well, I'll check it out, but good, what about you,
carrie?
What are you watching?
What are you reading?
I'm not well.
I read medical journals everyday, so that doesn't really
count.
It's like an endless.
Speaker 1 (52:12):
She knows more about anything than anybody you've
ever met might tell her.
Speaker 3 (52:16):
I'm kind of a history buff, so I'm actually
re-watching Band of Brothers.
Speaker 1 (52:20):
Oh yeah, that just came out on Netflix, didn't it?
I know, or on Netflix, or Max.
Speaker 2 (52:23):
Yeah.
Speaker 1 (52:24):
Yeah, but that's why she's good at what she does.
Speaker 2 (52:26):
She's constantly reading.
Speaker 1 (52:28):
Oh, I know, Like you don't like normally I'll Google
something.
She's a human Google in themedical world.
Yeah Well, thank you for yourtime.
Speaker 2 (52:37):
Thank you Appreciate it.
Speaker 1 (52:39):
Yeah, very nice, thanks, bye.
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