February 23, 2021 • 42 mins
In this episode, recorded several months into the pandemic, NYC-based psychiatrist Julie Holland assures Alec it’s not just him, we’re all having a hard-time. Dr. Holland says our brains are wired for connection and isolation is causing many of us to go into “fight or flight” mode where it’s harder to feel safe and loved. But there’s hope. Put down the phone, go outside, call a friend. Connect. And, for some, drugs might help, too. Holland has been deeply curious about the brain since high school and she’s a leading researcher in using psychedelics and cannabis to treat PTSD. In controlled settings, these drugs can restore a sense of being connected with others and the larger world. Holland is the author of several books including Good Chemistry, Moody Bitches, and a memoir, Weekends at Bellevue.
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Episode Transcript
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Speaker 1 (00:02):
This is Alec Baldwin and you're listening to Here's the
Thing from My Heart Radio. My guest today is psychiatrist
Julie Holland. She has a private practice in New York
City and is the author of several books, including the
New York Times bestseller Moody Bitches at a Memoir Weekends
(00:23):
at Bellevue. For decades, she's been researching the use of
psychedelics to treat mental health issues, with a particular focus
on using M D m A and cannabis to treat
post traumatic stress disorder. Many people are struggling with their
mental health in this long period of social distancing, but
(00:43):
Holland says, even before the trauma this pandemic has caused,
we were not doing that well mentally. I've been doing
phone sessions from up here in Duchess County, UM, and
some of my patients are still in the city, but
a lot of my patients have sort of flown the
coup to places where there's a lower density of people,
(01:04):
but importantly places where there's more nature and they're getting outside. Um,
they're getting more sun, more nature, and that I think
for me, it's been a real bomb and one of
the things that's helped me feel balanced or saying, you know,
a good antidote sort of to how toxic the news
is and everything that's happening is if I go out
(01:24):
into the woods or the swamp or the lake, and
I really feel much much calmer. You know, we can
discuss what the snapshot is and what the health of
the country is and beyond during the COVID, but to
whatever extent you're willing to venture an opinion, what was
the mental health of the country like prior to the
Cobb Oh? Yes, well, you know, we actually had a
(01:46):
couple of big epidemics before this pandemic, right. We had
the overdose epidemic. We had more and more people, uh,
not only dying of opiate overdoses or accidental overdoses, but
also more people drinking themselves to death. And we also
had what was called the epidemic of loneliness, where we
had more and more people living alone. Everybody had gotten
(02:06):
into their own little pod even prior to this pandemic,
but we were not happier because of it. I mean,
all the isolation. People felt very lonely, which makes people
feel both depressed and anxious. I would love to talk
more about why social isolation makes us so anxious. You
point out that there are strains in our society beyond
(02:28):
the COVID, the predate the COVID, and I want to
get to later on when people are isolated COVID or no,
and when people are feeling an abundance of distress, are
the cures, healthcare, guaranteed income ways to address I mean,
it seems that people are lonely, they can't afford healthcare,
(02:50):
they can't afford food, and they don't have a job.
The constant fear of the future. Right, So it's impossible
for me to talk about depression anxiety without talking about
politics and health policy and social policy. They're so intertwined.
And you were asking, you know, before the pandemic, how
were we doing, and I was saying, we really weren't
(03:10):
doing very well. You know, whenever there's sort of gross inequality,
a lot of people aren't going to do well. And
it's not just that they have more physical problems, but
they have more mental health problems. And addiction is a
sign of unrest and on wellness. It's not really a
thing in and of itself, it's a symptom of something bigger.
So the fact that we had more and more people
(03:31):
addicted to opiates and and overdosing. I mean, there was
a glut and there, you know, there was a lot
of money being made and making the drug and distributing
the drug. But you know, gobormates is this great thing
which is don't ask why the addiction, asked why the pain.
We were in pain. People were in pain before the pandemic.
You know, nine eleven was very tough on the inhabitants
(03:52):
of New York City, and people got very anxious and
started paying more attention to political issues. And then, honestly,
you know, after Donald got elected, you know, everybody in
the town who knew him and knew who he was
and what he was made of, there was a lot
of despair and and anxiety. And you know, the type
of people who come to see a private psychiatrist I
(04:13):
think tend to lean left, honestly, so I definitely have
a bias sample. But my patients were really not only
afraid for the country and for our democracy, but also
for the planet. You know, there's this sort of background
app that's always running, whether we know it or not,
which is that we are in sort of mourning for
what's happening to the planet, and there's a deep level
(04:34):
of despair. And the more disconnected we are from ourselves,
from our friends, from each other, from the planet, the
worse we feel. The more depressed we are, the more
anxious we are. So it's been going on, and I
would add to that, we're moving further and further and
further away from a connection between the will of the
people and what the government's going to do. The government
(04:56):
operates completely independent of the will of the people, right,
and they do whatever they want to do. They just
ignore what mainstream thought is about. But the end result
for we the people is that we get despairing and
depressed because we're powerless. Right, It doesn't matter what they want, right,
I mean, you know, the popular vote doesn't matter. This
sense of powerlessness is a setup for depression. Right. This
(05:19):
is your fifth book with a book like this comes
along once that process, Like how did this book start
to germinate with you? This book started to germinate while
I was stand up paddling on a lake and there
was mist. There was all this mist coming out of
the lake, and I wanted to be in the midst.
I'm going to be enveloped in the mist, and I
was paddling out to where the mist was, but wherever
(05:41):
I went, it seemed like the mist wasn't there anymore,
and it was somewhere else. And I would paddle somewhere
else where it looked like the mist was thick, and
then it wasn't there. And the thing I finally realized
is you're in the mist. The mist is all around you.
It's just that because of the light, you can't see it,
but it's there. And it was, you know, the sort
of epiphany to me that you know, we're always chase
sing for things, and really the things that we want
(06:01):
were the really right in our backyard. And you know,
while that ended up not being the main message of
good chemistry, it is definitely a message for me now
and for my patients now that you know, a lot
of people were spinning their wheels and running around and
now that they're sort of stuck in place, it turns
out that they do have a lot of things that
they need and that it's been good to sort of
(06:22):
hunker down and go inward or be with family. You know,
it's a cocooning period. One. Yeah, in the beginning, everybody
was like if I just knew when this would end,
I would be okay, you know, if I knew it
was just for the summer or you know, I mean
when it started, it was like when if I know
it was just April, right, But that was a big deal.
(06:43):
For the first few months with my patients, was just
this idea that they needed to be able to encapsulate it.
You know, if it could be compartmentalized, then they could
deal with it. But this idea that you don't know
how long it's going to go on. The thing, obviously,
Michael Turn is about my children. I mean my children.
I want their social skill ills to mature, and I
want them and they're growing so quickly. My daughter who's
(07:04):
seven now, I mean she's like Lillian Hellman, you know,
the stuff that comes out of her mouth now, which
is kind of amazing. She's so sharp and so clever
and so and I want, I don't want their development,
which prior to this we were kind of thrilled by.
And I'm just really just chattered and I'm in a
lot of pain that I'm suffering about how although there's
(07:26):
some beautiful unintended consequences where they found each other and
they only have each other. So the bonding and the
relationships between them have become so profound. But my kids,
like when you have a five year old boy turned
to you the other and he goes, I missed New York.
You know, he said, I missed New York, and I'm
not thought to myself. You know, it sounds like Steve
Rupel in prison. You know what I mean. I missed
(07:48):
New York. I missed Studio fifty four. You know, my
son's five, and he's like, I missed you. I'm going,
Oh my god, tore me apart apart. You know. In
my dealing my patients, sometimes I'm talking to a parent
who's very worried about their kid and whether their kids
going to go in or or go virtually. Um. I
also have some patients who are teachers who are really
(08:09):
worried about the kids. And and you know, everybody has
a different opinion about what should happen. Everybody has the
same fears. Everybody wants what's best for the kids. But
it really is a no win situation. You know. It's
just like everybody gets the misery spread sort of thing.
Nobody really gets exactly what they want, you know, certainly
with hybrid it's for my teachers. It's like the worst
(08:30):
of both worlds. But the thing about our kids is,
you know, we know what they're missing. You know, my
son didn't get to be a c I T at camp,
or uh, you know, didn't get to play drums in
the in the high school musical, or somebody didn't get
to go to the prom. Like, we know what those
things are and we know what they're missing. But the
kids themselves who haven't they don't know what they're missing,
they haven't gone through it. I think it's actually easier
(08:53):
on them. I mean, I'm not saying it's easy on
the kids. I know, and more kids are being diagnosed
with anxiety and being treated with the antiangs I d
meads right now than ever before. So no, it's not
easy on them. But sometimes I think that, you know
what we wish for them, it's this extra layer of
mourning or anxiety that maybe they don't even really have.
I mean, they are more resilient, certainly. I've told this
(09:16):
story before, I think on this podcast, so I'll do
the distilled version of my friend who lived in Italy.
He was British originally and he was there for several years.
And he came back and I said, when you came
back after nine years in Italy, what's the changes you noticed?
He said. One thing I don't like of these applications
that these people have for dating and meeting. He said.
(09:38):
The other thing I hate is ways, because sometimes getting
lost it's the greatest thing that could happen to You
might get lost and go somebody to get directions, and
when you go to the gas station you meet your
wife of the cash register, right, And he said, we've
taken all the serendipity out of out of the world.
Now do you find that people are leading on apps, devices,
(10:03):
all this kind of stuff social media more than ever now? Yeah.
You know when when I wrote Good Chemistry, it was
before COVID, but I was already saying, you know, put
down your phone. You have to go out and see
people in real space. First of all, you know, anybody's
profile picture, like maybe it's them, maybe it's them on
their best day, or maybe it's some photoshopic not even
(10:26):
be them. I mean you just you just don't know.
And also it's not you know how tall somebody is
or how they look three dimentially, it's really is also
how people smell. And this is something I explained in
Moody Bitches that we actually mate to some degree. You know,
Pheromone detection is a real thing, and it helps us
figure out not only whether we like the way someone smells,
(10:46):
but whether they would be a good physiological match for
us on a genetic level. You know, if you're immune
to five things and somebody else is immune to five things,
if you have a kid, it's possible that kid will
be immune to all ten things. So you want somebody
who's a little bit genetically dissimilar to you. And one
of the ways that the body figures that out for
mating is through smell, So you know, until there's like
(11:08):
a scratch and sniff app I think that people are
going to have to really you know, it's good to
get together before you know, I just tell people to
I mean before COVID, I was like just you know,
meet for a coffee or whatever. But you can get
so delusional about who you're texting or you know, if
they happen to spell the way that you think, you know,
if you care about spelling or uh, you know it's political,
(11:30):
but like you know, they you really it's not just
about how they spell and it is. You know, there
are such things as like auras and energies and you know,
souls and spiritual things like that. And you know, I
know psychiatrists aren't supposed to say any of those words,
but I think they're real, and I think that you know,
intuition is a real thing. You know, your gut reaction
(11:50):
to somebody, you're not gonna get. You just gonna project
all of your own things onto something because you don't
have enough information. Back to the book, which is that
so the mist is everywhere and you're pandling yourself towards
the mist that it's there. But what did you want
to cover in this book? What did you want? What experience?
What people have when they read the book. Well, the
book is really about how important it is for us
(12:13):
to connect and sort of the physical aspects of connection,
the physiology why our bodies are designed so that if
we feel connected, we are soothed, and if we feel disconnected,
we get kind of agitated and anxious or depressed. So
it's about these very basic ideas of connecting with the self,
being in your body, being present in the moment. Right.
(12:35):
So the way good chemistry is set up. The first
chapter is about connection with the self. The second chapter
is about connecting with another person and all about pheromones
and sex and orgasm and all that fun stuff. The
third chapters about family and how those connections work from
a physiological point of view. Right, So I start talking
a lot about oxytocin, which is a hormone that's involved
in pregnancy, nursing, delivery, and again, and it's very high
(12:59):
oxytose and state for orgasm. Then after self coupled Family,
there's a chapter in society where I talk about how
communities connect and what the physiology is of that, and
how oxytocin plays a role in us versus them. Right,
if you think, oh, you're on my you know you're
in my tribe, you're my people. But that guy over there,
you know he's them, that's an oxytocin effect. Also, then
(13:23):
there's a chapter on connecting with nature and about sort
of ecological activism versus this. You know, feeling despair, you
know that action will help you feel better, Plus it's
better for the planet. Then the last chapter is about
connecting with the cosmos, or perhaps if you're fortunate enough
to have had a psychedelic experience and you've had a
(13:43):
peak experience. You have this sense of everything is connected.
You know, it all makes sense, it's all connected, and
I'm part of that, and that is a peak mystical experience.
It is also a high oxytocin experience. So the book
is about oxytocin as sort of the the hormone or
the neuro transmitter that underlies all these feelings of connection.
(14:04):
They make us feel safe, like we belong. And oxytocin
is an antidepressant. It can be used to treat drug addiction,
and it coincidentally, there's some drugs that make you feel
safe and like you belong, and that's one of the
reasons why we use them. Psychiatrist Julie Holland. If it's
connection you're seeking, subscribe to Here's the Thing on the
(14:26):
I Heart radio app, Apple podcasts, or wherever you get
your podcasts. If Dr Holland's research into psychedelics to treat
mental illness has piqued your interest, be sure to check
out the Here's the Thing archives. At my conversation with
author Michael Pollen, I started looking at that really interesting
question is why is the species? Do we want to
(14:48):
change our consciousness? I mean, it's not adaptive, right, It
puts you at all sorts of risk. But we have
this desire and in fact, many animals have it too,
which is kind of a mystery, which which animals have
a desire to. Elephants love to get drunk, and you
can imagine how much it takes. You can hear the
rest of my conversation with Michael Pollen at Here's the
Thing dot Org after the Break. Psychiatrist Julie Holland explains
(15:12):
why she's dedicated her life to understanding how our brains
are wired. I'm Alec Baldwin and you're listening to Here's
the Thing. Dr Julie Holland says she's hearing from a
(15:33):
lot of people who are self medicating their way through
the pandemic. I'm thirty five years sober in a twelve
step program, and I'm always mindful of, you know, the
substitutive nature. You know what else did I put in
their food? Sex, money, power, workaholism, love, addiction, whatever. I'm
wondering if you have seen that with your patients as well.
(15:54):
We're during lockdown. I don't want to use the word abuse,
but you know, medicating themselves with food pornography. Yeah, definitely,
all of it. Yeah, at the same time, well, you
can multitask with you know, two computers, I guess in theory, um,
I mean, there's there's a lot there to unpack, you know.
(16:14):
We there are all sorts of ways that people soothed themselves.
I think one thing to keep in mind is that
the way most of us were taught. The earliest ways
we were soothed were orally right, somebody stuck a past
fire in your mouth, or a bottle, or if you're lucky,
you got a nipple and abreast and a person holding you.
But still there were times when that wasn't available. You
learn to suck your thumb or bite your nails. You
(16:36):
start eating, maybe if you're a woman growing up in
the United States America, whenever you eat, you feel guilty,
and then you end up soothing that agitated guilty state
with more food. So the COVID nineteen like people gaining
nineteen pounds during the quarantine, is a real phenomenon for
my patients. The quarantine e has taken on a life
(16:58):
of its own. I definitely patients who are smoking more
pot um, you know, I thought it was fascinating that
cannabis went from being you know, Schedule one illegal drug
to like essential during the pandemic. That was like, okay,
that's pretty interesting. Moon. And you know, the other thing
I want to say about the sort of embarrassment of
riches or a lot of abundance besides there being a
(17:21):
lot of options of cannabis based medicines, is there's something
really exciting happening in psychiatry now. You know, we've had
a lot of the same tools for a long time,
and some things are hard to treat, especially post traumatic
stress disorder. And what we're seeing now with m d
M A assisted therapy, which is better known as ecstasy
(17:41):
or molly or psilocybin assisted psychotherapy, as that psychiatry all
of a sudden has some new tools at our disposal.
Ketamine is another very sort of separate and controversial issue,
but at least people are getting used to this idea
that they can have some sort of inexperience where they
can examine themselves more, maybe look at their childhood trauma process.
(18:05):
Some things come out of this altered state a little
bit better, a little bit less depressed, a little bit
less anxious. That's a new paradigm that's a completely different
way of thinking about these drugs. Uh. This idea of
psychedelic psychiatry brand new, pretty exciting, but something you've been
in love for a while, not new to me, right.
I want to talk about that. Be your beginnings in
(18:27):
terms of that and your beginnings in terms of psychiatry,
because as a psychiatrist, you're obviously a medical doctor, correct,
I am, Where did you go to medical school? I
went to University of Pennsylvania. Undergrad, I went to Temple
for med school, so I stayed in Philadelphia, and then
I went to New York City and I did my
psychiatric residency at Mount Sinai Hospital, and then I spent
(18:47):
nine years running the psychiatric emergency room every Saturday night
and Sunday night, which was kind of a rock and
roll psychiatry job. It was the e R at Bellevue Hospital,
the psyche r. So after those nine years, I a
book call weekends at Bellevue about my time there. But
because I had grown up in the seventies and a
suburb full of interesting drugs to try. And then when
(19:10):
I was an undergrad, I started learning about this m
d M a assisted psychotherapy, which I was very interested
in because when I was at Penn, all of a sudden,
I was reading about and hearing about a new drug,
and like you know, when you're studying psychopharmacology at at
undergrad and there's a new drug that's a that's a
big summer for you. So I got very interested in
(19:31):
m d m A and I wrote a big paper
about it because I was at a summer school class
I was taking um. That turned into the Ecstasy Book,
and that was my first book. I assigned chapters to
every expert um on every different facet of M d
m A. And then a few years later I ended
up doing that with the Pop Book also, So those
are actually two books that I edited. I wrote some
of it, but not all of it. I knew I
(19:53):
was going to be a psychiatrist from a pretty young
I mean I knew I wanted to do something with
the brain, well, knowing that psychiatry involves a far greater
commitment academically because of the medical degree than of being
a psychologist or a social something related. What's the impulse
to psychiatry in the young woman from your background? Like,
when did you know you wanted to do this? And
(20:14):
put in all that time I wanted to be a
doctor from a pretty young age. I mean, you know,
I was definitely the kind of person who played doctor,
you know, wrapped people up in bandages. I mean I
I am. I was a smart kid, was very interested
in drugs, very interested in the brain. Um pretty sure
I was going to be either like a neurologist or
(20:34):
nursergon or psychiatrist before I even went to undergrad Like,
I chose pen because they had a major called the
Biological Basis of Behavior. It was all about the brain
and psycho farm. I had a subscription of psychology today.
When I was in high school, Like, I was one
of those kids who just kind of I like this,
and what did your parents do? My mom was a
(20:55):
science teacher, and my dad is a structural engineer, very analytical.
I was interested in science, and I was very analytical.
And and I grew up in the seventies where just
drugs were all around me, and I was fascinated that
a little piece of paper could make you, you know,
see the world in a completely different way. And how
would you distinguish for people who don't have that much
(21:17):
of an intimacy with certain kinds of pharmaceuticals? And a
certain kind of drugs. Like for me when I was
growing up and I was in my you know, riding
the range out there in my drug and alcohol phase. Uh,
you know, cocaine was the king. But for people who
don't know about ecstasy and psilocybin, you feel there are
benefits to either or both, Why what did they achieve
(21:40):
in terms of therapy? So here's what I would say
about m DMA and psilocybin in terms of psychiatry. I mean,
first of all, the thing to keep in mind is,
right now, these are still research chemicals. They're not legal.
People can't prescribe them, but they are both going through
an FDA approval process so that they will be prescribable
in the context of their rapy. Right. So this is
(22:01):
not you know, buying a tablet of ecstasy or some
white powder that somebody tells you as molly and being
on a dance floor and getting overheated or overhydrated, and
those things are seriously dangerous. Also you just don't know
what you're getting. This is in the context of that
you're lying on a couch with a hundred and twenty
milligrams or maybe even only eighty milligrams, which is pretty
(22:23):
low dose of pure m d m A. You're not
dancing for hours, you're not overhydrating, so the medical risks
in that situation are pretty minimal, which is why the
FDA is allowed these studies to go ahead. Right now,
there are multi center trials going on with m d
m A assisted psychotherapy sessions all over America and a
few other countries, and psilocybin assisted psychotherapy research is happening
(22:46):
in America and all over Europe and given to who
for what, so for Some of the psilocybin studies are
for treatment resistant depression and some of them are just
for regular major depression. The m d m A studies
are looking at pos traumatic stress disorder. There's also one
m d m A study where they looked at social
anxiety in adults on the autistic spectrum. For people who
(23:10):
don't know anything about ecstasy or molly or what, you know,
this is methylene dioxy meth emphetamine m d m A.
So the methymphetamine part may sound familiar to you. It's
sort of a cousin of speed, but it has a
more of a psychedelic component to it, So what you
end up with is something that increases your serotonin massively,
so you're very relaxed and you feel sort of satiated,
(23:33):
like you don't need anything. It also increases your dopamine
because of the methymphetamine base, so you are awake, alert,
you have very good recall for the event. You want
to talk, you want to dig, you want to conn.
But there's one more very important part of m d
m A as it increases oxytocin, so you have that
sense of safety and connection, like you belong, and so
(23:56):
you end up with this sort of you're calm, but
you're open, right, So the openness like open to bonding,
open to trusting, open to looking at your ship. You know,
it's almost like anesthesia with or without surgery. Like when
you go to therapy. You get to a certain point
where you're like, oh no, that hurts that bad stuff
happened there. That's too tender. I don't want to talk
(24:17):
about it. And the therapist says, okay, maybe next week
we will. But then maybe you cancel and you don't
see her. You know, it fits and starts. It takes
a long time for therapy. This is one or two
sessions where you feel comfortable enough and trusting enough, but
awake and alert enough that you can really do some digging.
So it is like a catalyst for therapy. So that's
(24:38):
M D M A and psilocybin is different. It's something
really different. Well, right, so it's you you have a
mystical psychedelic experience. Maybe you're in a void which is scary.
Maybe you are in that place where I said, like
where you feel like everything is connected in your bathe
with love. But what happens reliably and people when you
give them psilocybin is you can do some mystical experience.
(25:01):
And when you have that sense of everything is connected
and love is the answer that when you have that
sort of big experience, it can lead to a lot
of behavioral changes. And also there's something called neuroplasticity, which
is the brain rewiring itself. I'm up for that. I
need that, right. So there's some psychedelics that cause neurons
(25:24):
to grow or synapsis to grow. You get neurogenesis or
synapter genesis. This means you're getting new brain cells, new connections.
So not the frying pan and the egg that we
are exposed to in the eighties, Like this is you know,
this is drugs. This is your brain on drugs. It
really for these particular drugs, it is quite the opposite
where you've got new brain cells, it's not killing brain cells,
(25:45):
and you've got new connections, a little bit of rewiring.
But do you do some predictive kind of work, like
for example, you say to me hallucinogenics like psilocybin, and
I think to myself, I'm sitting on my couch and
I take this pill and all of a sudden, I
feel like I'm paddle boarding into the mist on a
lake and upstatement, you are going to have left my couch,
right do you do? You do you do predictive things
(26:06):
with them before you give them the drug before because
because some people might have a negative reaction to it.
Not okay, so quite so. The most important thing I
can tell you is it because this is just research. Now,
people are screened like you and believe, very heavily screamed. Right,
So if you have a history of psychosis, if you
have a family history of psychosis, you're not going to
be on that couch. But you know, I actually don't
(26:28):
say hallucinogen because it's it's not like you see pink
elephants that aren't there. I mean, you know with with SILSA,
I mean you may have visions, but you kind of
know their visions. You know, you don't start interacting with
things that aren't there. But their mind manifesting medicines, their
consciousness medicines. And I would say, Alec that these are
disruptive medicines and psychiatry. This is a disruptive paradigm making
(26:51):
therapy go deeper and faster and getting people to turn
away from instead of taking a daily dose of antidepressants
or anti anxiety meds, they're having single sessions or maybe
two or three sessions over half a year or a year,
but they don't need the daily dose afterwards. And in
the m d M A PTSD studies, they're not meeting
criteria for PTSD at the end of the study. When
(27:13):
did you ascertain that you had developed the ability to
know when you were taking drugs and you were self
medicating in a recreational way, and when you were taking
drugs and it was part of your scientific research, Meaning
when did you sidestep the Dr Checkl and Mr Hyde
steven sony and a chapter of your life there? Well,
I would say for many people who use drugs. It
(27:35):
is a daily calibration and a daily question and an
important question to be conscious of. What is your relationship
with this drug? When are you using it, How are
you using it, Why are you using it? Is it
interfering with other things that need to happen? But you know,
I think these are hard questions. Did you come to
(27:57):
that point yourself when you were younger where you said
there are things you were doing that that you thought
you thought as if this isn't helping me, right? Sure?
I mean I I smoked cigarettes for years and years
and years before stopping, and that was something I'm a singer,
so I knew that that was just stupid to do. Um,
but it was really hard. And I quit cigarettes twice
for two years and started up again twice, and I
was amazed. Um, I knew I could quit, so I
(28:19):
knew I could start up again. And the kind of
rationalizations you make when you started up again. I know
you grew up with brothers. I grew up with sisters,
but I'm I'm the youngest of three, and you know
I was I wanted to do what their friends were doing.
So when I was eight, I had my first beer.
When I was ten, I had my first cigarette. When
I was twelve, I have my first cannabis, and when
I was fourteen, I have my first psychedelic. So very young, yes, precocious,
(28:43):
but always taking notes, learn learning, going to the library.
You know, we didn't have the internet back then. You
want to learn something, you had an encyclopedia, or you
asked your mom to drive you the library. But I
would do like any time I had to do a report,
you know, I would be doing it on the brain
or on the Smoking thing was the thing you did
when you were very young. It wasn't like five years
(29:03):
ago your husband catches you in the bat in the
in the garage smoking out there in the country. So
I mean, thank goodness. I quit smoking right before I
met Jeremy. And it's a good thing I did, because
I don't think you would have spoken to me if
I had a cigarette in my hand. So I quit
when I was twenty nine. But I smoked, you know,
steady from like fifteen to twenty nine, and not so
much steady from ten to fifteen. But still I would
(29:24):
like bumb cigarettes from people. And it was like, look
at this cute little kid bone a cigarette. That's so cute. Yeah,
and I've got a handful of friends who are formally
getting divorced now. Of course, the groundwork was laid prior
to the COVID, but the COVID has certainly pushed everybody
over the edge. They filed for divorce, They're getting divorced.
(29:44):
Not a discussion anymore, They've moved on. I was gonna
mention before when I said that people are falling back
on and relying on different things to medicate themselves, like
food and media and social media and TV watching and pornography.
I thought, you win a house, and you're just as likely,
maybe not more likely, but just as likely to go
in the bathroom with a computer and have online sex,
(30:07):
you know, and watch porn than you actually have sex
with your partner in your house because the two of
you are so sick of each other, like like normally
there is there is there like a spike in the
birthrate after a lockdown, And are we not going to
see the spike in the birthrate from this because everyone's
in the bathroom doing their own thing. Now, Yeah, well,
then connecting with that person a couple of things there,
(30:28):
I mean, you know, I actually I wrote about masturbating
to porn quite a bit in moody bitches, because you know,
when you have an orgasm, you have an increase in
oxytocin that makes you bond or trust or be open
to the person who enabled that orgasm. But if you're
doing that with your laptop, are you bonding with your
laptop every time? So maybe? But the other thing I
(30:49):
will say is that I definitely have patients who have
left their husbands or left their partners during these past
six months. There's no question this has been like a
crucible where you're like, oh my gosh, we're in the
best place we've ever been in or yeah, no, that's over.
So um. There's not much middle ground here. And when
this ends, if it ends how it ends, there is
(31:10):
going to be post traumatic stress disorder. I think that's
pretty clear. You know, we are currently being chronically stressed,
and so in theory, once the chronic stress is over,
then you have the post traumatic stress disorder. You know,
people who have PTSD. From nine eleven, It was a
terrible day in New York City, but it was one
day and then it was over. Psychiatrist Julie Holland. When
(31:34):
we return Julie Holland talks about why the pandemic is
particularly challenging for already anxious kids. I'm Alec Baldwin, and
this is here's the thing. I wanted to understand why
(31:55):
someone starts seeing a psychiatrist. So usually if somebody comes
to me, it's because they're already in therapy and their
therapist is saying, I think you need to talk about medicines.
I think medicines would help you. So they've already sort
of gone past the threshold. It's not just like people
are coming to me and saying, you know, I feel
lousy and I don't know why, although I mean back
(32:16):
in the nineties that was the case. The people were
just I don't know what's the matter with me, and
I would have to sort of hold their hand and
convince them that, you know, maybe they ainty medicine. I
don't have to do any kind of destigmatizing with medicine.
Now everybody knows somebody who's taking antidepressants, anti anxiety meds,
sleeping pills, they're everywhere, right, they're advertised. We you know,
we're all sort of soaking in it. So I do
(32:36):
think ever since nine eleven, I think a lot of
people got permission to medicate themselves, so when they come
to you, it's beyond talk. So yeah, they're coming because
they're wondering if they need medicines. They hit a wall,
they need the medicine to get through that wall. They've
definitely hit a wall. Or I have people coming to
me who've been on medicines for years who want to
get off, and that's something that I help people do.
And it's really complicated to get off antidepressants when you
(33:00):
been on them for decades, which unfortunately happens a lot.
You know, these meds were really only studied to be
used for six months or maybe twelve months, and in
some people you have to take them long term. But
almost everybody, they get on them and they stay on
them because they do make it easier. You know, what
I talk about in good chemistry is they don't necessarily
give you more connections in your life. They just make
(33:22):
you not mine that you're disconnected. That's my friend. My
friend said that once. He said, I took drugs because
I wanted to care less about my problems, he said,
And I stopped dating taking drugs because I wanted to
care again. I wanted to care again. And he said,
and that that was the mechanism in which I can
then move forward and start to care about what's happening
(33:42):
to me, my loved once, my children, right and then
and if you care, you can make changes. And you know,
I definitely want to say for the twelve step programs
that there is a lot of love in those rooms,
and there's a lot of connection in those rooms. And
you walk in fit's your home meeting, and you're going
again and again. There is that sense of belonging and
safety and all of those things feeling connected, feeling safe,
(34:03):
feeling like you belong to something bigger than you. Those
are high oxytocin states that get you out of fight
or flight and into this whole other paradigm for your body,
which is called the parasympathetic nervous system. Right, So it's
the opposite of the sympathetic nervous system. And good chemistry
talks a lot about how to get yourself out of
fight or flight and over into what you could call
(34:25):
rest and digest or connect and protect, or tend and befriend.
But it's it's the things that aren't fighting and running away.
It's things like staying and negotiating and cooperating and collaborating.
You know, all those things can't happen when we're in
fight or flight. And if we're being traumatized, and if
we're afraid of contagion, and if we have a sense
(34:46):
of powerlessness, we're all going to be in fight or
flight way too much of the time. Are you concerned?
I mean, our research such as it is, you know
my show, are producers that anti anxiety prescriptions for kids
have on up significantly during the COVID. Does that concern you? Oh? Absolutely? Yeah.
First of all, you know, over pathologizing women and children
(35:08):
is really a reflection of the sort of patriarchal structure
in medicine. But we you know, some people get sort
of narcissistic about their kids, and their kids are like
extensions of themselves, you know. And there is a little
bit of a sort of a niche population in New
York City where it's almost like you take pride if
your kid is going to a psychiatrist, or your kids
(35:28):
in therapy, or your kid has like special classes or something.
So here's the thing. Are culture is pretty toxic right
now and very anxiety producing right now, and it is
normal to be anxious fear of contagion is a real thing,
and it is normal to be afraid that you're gonna
get sick, or that your parents are gonna get sick,
or that your grandparents are gonna die. That's all normal anxiety.
(35:51):
And then it's normal to be anxious if you don't
know what's going to happen next month or next year,
or whether you're going to be in class or at home,
you know, or whether you're gonna be allowed to touch
your friends or hug your friends or play sports. I mean,
there's so many reasons we have right now for kids
being anxious. All the rules have changed, right that everything
they used to be able to do, they can't do anymore.
And also wearing masks. And I'm not saying that we
(36:14):
shouldn't wear masks. We should all wear masks, but you know,
it would be great as if we had clear masks
because interpreting social cues, if we could interpret social shoes.
You know, now with a mask, you can't tell if
someone's smirking at you or smiling or yawning, right, and
so and our brains because back when we were cave people,
if you got kicked out of the group, you were
(36:35):
gonna get picked off the herd. You were gonna die,
or no one was going to share their food with you,
or no one's going to help you build a structure.
You know, if you weren't in the club and in
the tribe and you got separated or ostracized, you were
gonna die. And so we still, on a very deep level,
have that kind of reaction. Am I safe? Am I
in the group? Am I okay? So when you're on
a zoom meeting and there's like eight people, your brain
(36:57):
is scanning, scanning all the time to make sure everybody's
okay with you. And if it's a herky jerky connection
or you can't see their face or their cameras off,
that's missing data that your brain is trying to, you know,
fill in. So that will make us anxious. So these
kids that are on zoom calls or the kids that
can play with their friends but they can't really play
the way they used to play. And don't don't go
(37:17):
run to Johnny. You know, Johnny's dad works in the
emergency room. Don't stand back like the rules keep changing,
the social rules are changing, and they and they can't
be held and comforted by so many people Now it's
just maybe your parents and that's it. I have always
viewed myself that I've typically been for most of my life.
(37:38):
A person that functions under my trust is yours to lose.
When I met people, I was very open, regardless of
what I did for a living. And now with this
what's going on in the world, as much as anything
in combination with the COVID, it's made me think, you know,
my trust is yours to gain. I'm going to go
out in the world now filled with suspicions. I'm wondering,
(38:00):
do you find that this suspicion, this neurosis about going
back out into the world. Are we going to go
back into the world and everyone's going to be different. Well,
so there's a few things that are making us suspicious.
We're worried about somebody getting us sick, and we're worried
about our democracy crumbling and that people around us don't
get it or they're so misinformed that they're never going
(38:22):
to get it. Yeah, it's all completely terrifying. So look,
you know, the the idea with oxytocin is if somebody
makes you trust them, then you are more open. You
have more oxytocin you become more trusting. They feel that
you're becoming more trusting, they start to have more oxytocin
and its cycles upward from that, you know, more eye
(38:43):
contact if you could hold them or like a really
great but but is everybody get to turn the oxytocin
spick it off when they go out? It has been
turned off? First of all, you only have oxytocin if
you're in that parasympathetic state. We're calm, right, so it
has been turned if you know, here's the analogy I
give of. You know, when you're in fight or flight,
which we all are now, right, if your kitchens on fire,
(39:06):
you don't pick up the phone if it's ringing, or
make a call, or you know you're that a fire
and like where's the fire extinguisher? Or have to run
out of the house. You don't have any social skills.
You're not. There's no niceness there. So the more we're
in fight or flight and the more we're in the
sympathetic mode, the lousier are social skills are, the less
we trust, the less oxytocin we have. You know, you
(39:27):
don't really have oxytocin when you're in fight or flight.
You have adrenaline and cortisol. And this is why we
can't sleep. You know, we're biting our nails, we're trying
to soothe ourselves orally, you've got this fat around your stomach.
It's because we're in fight or flight. It deranges your metabolism.
It makes it very hard to sleep, you don't digest
your food. Well, all the things that happen in parasympathetic
(39:48):
where you can rest and digest and you can have
sex and you can be social, none of those things
happen when we're in fight or flight. Like for me,
my fear this is so antathetical to my nature. But
my fear is I'm gonna go out into the world
with with this idea of like the less people in
my life now the better people are the problem. And
(40:09):
I need people in my life on an as needed basis.
Everyone who's in my life, why are you in my life?
And if I don't have a really good reason, it's
it's literally like we're all gonna on an emotional level,
we're gonna go in and we're all going to clean
out the closet now right, Well, it's like does this
person spark joy or not? No, they have to go.
So yeah, but that's good. I want to say one
(40:32):
thing about your on WE at five o'clock in the evening,
and that is, if you ever have a morning that
you can get out and go see a sunrise. It
is the antidote to that on WE that if you
happen to be around for dawn and sunrise, you will
have a little more hope. Um, and you know, don't
bring your phone, don't don't like no news, have like
an hour of nature, you know. No, I turned my
(40:54):
phone off a lot. I've been doing much better with
my phone. Well, listen, I think, I think if you
read me correctly, I'm not quite sure, but you are
a professional listener. What I want is I want to
take some pharmaceuticals with you, and we're going to paddle
out into the mist together. We're gonna just open ourselves
up to whatever the universe is telling us. I mean,
I'm being silly, but it's like, well, it's soothing though.
(41:14):
It's like hydrotherapy, you know, just listening. You know, first
of all, even just the salt air, even just smelling
the salt there is good for your brain. Thank you
so much for doing this with us. Thank you so much,
absolutely my pleasure. Anytime you know you need to talk
to a shrink, you come call me. I'm gonna get
in touch with you, okay it' Psychiatrist Julie Holland has
(41:37):
a private practice in New York City. I'm out like Baldwin.
Here's the thing is brought to you by my Heart Radio.
We're produced by Kathleen Russo, Carrie donohue, and Zach McNeice.
Our engineer is Frank Imperial. Thanks for listening all
This is Alec Baldwin and you're listening to Here's the
Thing from My Heart Radio. My guest today is psychiatrist
Julie Holland. She has a private practice in New York
City and is the author of several books, including the
New York Times bestseller Moody Bitches at a Memoir Weekends
(00:23):
at Bellevue. For decades, she's been researching the use of
psychedelics to treat mental health issues, with a particular focus
on using M D m A and cannabis to treat
post traumatic stress disorder. Many people are struggling with their
mental health in this long period of social distancing, but
(00:43):
Holland says, even before the trauma this pandemic has caused,
we were not doing that well mentally. I've been doing
phone sessions from up here in Duchess County, UM, and
some of my patients are still in the city, but
a lot of my patients have sort of flown the
coup to places where there's a lower density of people,
(01:04):
but importantly places where there's more nature and they're getting outside. Um,
they're getting more sun, more nature, and that I think
for me, it's been a real bomb and one of
the things that's helped me feel balanced or saying, you know,
a good antidote sort of to how toxic the news
is and everything that's happening is if I go out
(01:24):
into the woods or the swamp or the lake, and
I really feel much much calmer. You know, we can
discuss what the snapshot is and what the health of
the country is and beyond during the COVID, but to
whatever extent you're willing to venture an opinion, what was
the mental health of the country like prior to the
Cobb Oh? Yes, well, you know, we actually had a
(01:46):
couple of big epidemics before this pandemic, right. We had
the overdose epidemic. We had more and more people, uh,
not only dying of opiate overdoses or accidental overdoses, but
also more people drinking themselves to death. And we also
had what was called the epidemic of loneliness, where we
had more and more people living alone. Everybody had gotten
(02:06):
into their own little pod even prior to this pandemic,
but we were not happier because of it. I mean,
all the isolation. People felt very lonely, which makes people
feel both depressed and anxious. I would love to talk
more about why social isolation makes us so anxious. You
point out that there are strains in our society beyond
(02:28):
the COVID, the predate the COVID, and I want to
get to later on when people are isolated COVID or no,
and when people are feeling an abundance of distress, are
the cures, healthcare, guaranteed income ways to address I mean,
it seems that people are lonely, they can't afford healthcare,
(02:50):
they can't afford food, and they don't have a job.
The constant fear of the future. Right, So it's impossible
for me to talk about depression anxiety without talking about
politics and health policy and social policy. They're so intertwined.
And you were asking, you know, before the pandemic, how
were we doing, and I was saying, we really weren't
(03:10):
doing very well. You know, whenever there's sort of gross inequality,
a lot of people aren't going to do well. And
it's not just that they have more physical problems, but
they have more mental health problems. And addiction is a
sign of unrest and on wellness. It's not really a
thing in and of itself, it's a symptom of something bigger.
So the fact that we had more and more people
(03:31):
addicted to opiates and and overdosing. I mean, there was
a glut and there, you know, there was a lot
of money being made and making the drug and distributing
the drug. But you know, gobormates is this great thing
which is don't ask why the addiction, asked why the pain.
We were in pain. People were in pain before the pandemic.
You know, nine eleven was very tough on the inhabitants
(03:52):
of New York City, and people got very anxious and
started paying more attention to political issues. And then, honestly,
you know, after Donald got elected, you know, everybody in
the town who knew him and knew who he was
and what he was made of, there was a lot
of despair and and anxiety. And you know, the type
of people who come to see a private psychiatrist I
(04:13):
think tend to lean left, honestly, so I definitely have
a bias sample. But my patients were really not only
afraid for the country and for our democracy, but also
for the planet. You know, there's this sort of background
app that's always running, whether we know it or not,
which is that we are in sort of mourning for
what's happening to the planet, and there's a deep level
(04:34):
of despair. And the more disconnected we are from ourselves,
from our friends, from each other, from the planet, the
worse we feel. The more depressed we are, the more
anxious we are. So it's been going on, and I
would add to that, we're moving further and further and
further away from a connection between the will of the
people and what the government's going to do. The government
(04:56):
operates completely independent of the will of the people, right,
and they do whatever they want to do. They just
ignore what mainstream thought is about. But the end result
for we the people is that we get despairing and
depressed because we're powerless. Right, It doesn't matter what they want, right,
I mean, you know, the popular vote doesn't matter. This
sense of powerlessness is a setup for depression. Right. This
(05:19):
is your fifth book with a book like this comes
along once that process, Like how did this book start
to germinate with you? This book started to germinate while
I was stand up paddling on a lake and there
was mist. There was all this mist coming out of
the lake, and I wanted to be in the midst.
I'm going to be enveloped in the mist, and I
was paddling out to where the mist was, but wherever
(05:41):
I went, it seemed like the mist wasn't there anymore,
and it was somewhere else. And I would paddle somewhere
else where it looked like the mist was thick, and
then it wasn't there. And the thing I finally realized
is you're in the mist. The mist is all around you.
It's just that because of the light, you can't see it,
but it's there. And it was, you know, the sort
of epiphany to me that you know, we're always chase
sing for things, and really the things that we want
(06:01):
were the really right in our backyard. And you know,
while that ended up not being the main message of
good chemistry, it is definitely a message for me now
and for my patients now that you know, a lot
of people were spinning their wheels and running around and
now that they're sort of stuck in place, it turns
out that they do have a lot of things that
they need and that it's been good to sort of
(06:22):
hunker down and go inward or be with family. You know,
it's a cocooning period. One. Yeah, in the beginning, everybody
was like if I just knew when this would end,
I would be okay, you know, if I knew it
was just for the summer or you know, I mean
when it started, it was like when if I know
it was just April, right, But that was a big deal.
(06:43):
For the first few months with my patients, was just
this idea that they needed to be able to encapsulate it.
You know, if it could be compartmentalized, then they could
deal with it. But this idea that you don't know
how long it's going to go on. The thing, obviously,
Michael Turn is about my children. I mean my children.
I want their social skill ills to mature, and I
want them and they're growing so quickly. My daughter who's
(07:04):
seven now, I mean she's like Lillian Hellman, you know,
the stuff that comes out of her mouth now, which
is kind of amazing. She's so sharp and so clever
and so and I want, I don't want their development,
which prior to this we were kind of thrilled by.
And I'm just really just chattered and I'm in a
lot of pain that I'm suffering about how although there's
(07:26):
some beautiful unintended consequences where they found each other and
they only have each other. So the bonding and the
relationships between them have become so profound. But my kids,
like when you have a five year old boy turned
to you the other and he goes, I missed New York.
You know, he said, I missed New York, and I'm
not thought to myself. You know, it sounds like Steve
Rupel in prison. You know what I mean. I missed
(07:48):
New York. I missed Studio fifty four. You know, my
son's five, and he's like, I missed you. I'm going,
Oh my god, tore me apart apart. You know. In
my dealing my patients, sometimes I'm talking to a parent
who's very worried about their kid and whether their kids
going to go in or or go virtually. Um. I
also have some patients who are teachers who are really
(08:09):
worried about the kids. And and you know, everybody has
a different opinion about what should happen. Everybody has the
same fears. Everybody wants what's best for the kids. But
it really is a no win situation. You know. It's
just like everybody gets the misery spread sort of thing.
Nobody really gets exactly what they want, you know, certainly
with hybrid it's for my teachers. It's like the worst
(08:30):
of both worlds. But the thing about our kids is,
you know, we know what they're missing. You know, my
son didn't get to be a c I T at camp,
or uh, you know, didn't get to play drums in
the in the high school musical, or somebody didn't get
to go to the prom. Like, we know what those
things are and we know what they're missing. But the
kids themselves who haven't they don't know what they're missing,
they haven't gone through it. I think it's actually easier
(08:53):
on them. I mean, I'm not saying it's easy on
the kids. I know, and more kids are being diagnosed
with anxiety and being treated with the antiangs I d
meads right now than ever before. So no, it's not
easy on them. But sometimes I think that, you know
what we wish for them, it's this extra layer of
mourning or anxiety that maybe they don't even really have.
I mean, they are more resilient, certainly. I've told this
(09:16):
story before, I think on this podcast, so I'll do
the distilled version of my friend who lived in Italy.
He was British originally and he was there for several years.
And he came back and I said, when you came
back after nine years in Italy, what's the changes you noticed?
He said. One thing I don't like of these applications
that these people have for dating and meeting. He said.
(09:38):
The other thing I hate is ways, because sometimes getting
lost it's the greatest thing that could happen to You
might get lost and go somebody to get directions, and
when you go to the gas station you meet your
wife of the cash register, right, And he said, we've
taken all the serendipity out of out of the world.
Now do you find that people are leading on apps, devices,
(10:03):
all this kind of stuff social media more than ever now? Yeah.
You know when when I wrote Good Chemistry, it was
before COVID, but I was already saying, you know, put
down your phone. You have to go out and see
people in real space. First of all, you know, anybody's
profile picture, like maybe it's them, maybe it's them on
their best day, or maybe it's some photoshopic not even
(10:26):
be them. I mean you just you just don't know.
And also it's not you know how tall somebody is
or how they look three dimentially, it's really is also
how people smell. And this is something I explained in
Moody Bitches that we actually mate to some degree. You know,
Pheromone detection is a real thing, and it helps us
figure out not only whether we like the way someone smells,
(10:46):
but whether they would be a good physiological match for
us on a genetic level. You know, if you're immune
to five things and somebody else is immune to five things,
if you have a kid, it's possible that kid will
be immune to all ten things. So you want somebody
who's a little bit genetically dissimilar to you. And one
of the ways that the body figures that out for
mating is through smell, So you know, until there's like
(11:08):
a scratch and sniff app I think that people are
going to have to really you know, it's good to
get together before you know, I just tell people to
I mean before COVID, I was like just you know,
meet for a coffee or whatever. But you can get
so delusional about who you're texting or you know, if
they happen to spell the way that you think, you know,
if you care about spelling or uh, you know it's political,
(11:30):
but like you know, they you really it's not just
about how they spell and it is. You know, there
are such things as like auras and energies and you know,
souls and spiritual things like that. And you know, I
know psychiatrists aren't supposed to say any of those words,
but I think they're real, and I think that you know,
intuition is a real thing. You know, your gut reaction
(11:50):
to somebody, you're not gonna get. You just gonna project
all of your own things onto something because you don't
have enough information. Back to the book, which is that
so the mist is everywhere and you're pandling yourself towards
the mist that it's there. But what did you want
to cover in this book? What did you want? What experience?
What people have when they read the book. Well, the
book is really about how important it is for us
(12:13):
to connect and sort of the physical aspects of connection,
the physiology why our bodies are designed so that if
we feel connected, we are soothed, and if we feel disconnected,
we get kind of agitated and anxious or depressed. So
it's about these very basic ideas of connecting with the self,
being in your body, being present in the moment. Right.
(12:35):
So the way good chemistry is set up. The first
chapter is about connection with the self. The second chapter
is about connecting with another person and all about pheromones
and sex and orgasm and all that fun stuff. The
third chapters about family and how those connections work from
a physiological point of view. Right, So I start talking
a lot about oxytocin, which is a hormone that's involved
in pregnancy, nursing, delivery, and again, and it's very high
(12:59):
oxytose and state for orgasm. Then after self coupled Family,
there's a chapter in society where I talk about how
communities connect and what the physiology is of that, and
how oxytocin plays a role in us versus them. Right,
if you think, oh, you're on my you know you're
in my tribe, you're my people. But that guy over there,
you know he's them, that's an oxytocin effect. Also, then
(13:23):
there's a chapter on connecting with nature and about sort
of ecological activism versus this. You know, feeling despair, you
know that action will help you feel better, Plus it's
better for the planet. Then the last chapter is about
connecting with the cosmos, or perhaps if you're fortunate enough
to have had a psychedelic experience and you've had a
(13:43):
peak experience. You have this sense of everything is connected.
You know, it all makes sense, it's all connected, and
I'm part of that, and that is a peak mystical experience.
It is also a high oxytocin experience. So the book
is about oxytocin as sort of the the hormone or
the neuro transmitter that underlies all these feelings of connection.
(14:04):
They make us feel safe, like we belong. And oxytocin
is an antidepressant. It can be used to treat drug addiction,
and it coincidentally, there's some drugs that make you feel
safe and like you belong, and that's one of the
reasons why we use them. Psychiatrist Julie Holland. If it's
connection you're seeking, subscribe to Here's the Thing on the
(14:26):
I Heart radio app, Apple podcasts, or wherever you get
your podcasts. If Dr Holland's research into psychedelics to treat
mental illness has piqued your interest, be sure to check
out the Here's the Thing archives. At my conversation with
author Michael Pollen, I started looking at that really interesting
question is why is the species? Do we want to
(14:48):
change our consciousness? I mean, it's not adaptive, right, It
puts you at all sorts of risk. But we have
this desire and in fact, many animals have it too,
which is kind of a mystery, which which animals have
a desire to. Elephants love to get drunk, and you
can imagine how much it takes. You can hear the
rest of my conversation with Michael Pollen at Here's the
Thing dot Org after the Break. Psychiatrist Julie Holland explains
(15:12):
why she's dedicated her life to understanding how our brains
are wired. I'm Alec Baldwin and you're listening to Here's
the Thing. Dr Julie Holland says she's hearing from a
(15:33):
lot of people who are self medicating their way through
the pandemic. I'm thirty five years sober in a twelve
step program, and I'm always mindful of, you know, the
substitutive nature. You know what else did I put in
their food? Sex, money, power, workaholism, love, addiction, whatever. I'm
wondering if you have seen that with your patients as well.
(15:54):
We're during lockdown. I don't want to use the word abuse,
but you know, medicating themselves with food pornography. Yeah, definitely,
all of it. Yeah, at the same time, well, you
can multitask with you know, two computers, I guess in theory, um,
I mean, there's there's a lot there to unpack, you know.
(16:14):
We there are all sorts of ways that people soothed themselves.
I think one thing to keep in mind is that
the way most of us were taught. The earliest ways
we were soothed were orally right, somebody stuck a past
fire in your mouth, or a bottle, or if you're lucky,
you got a nipple and abreast and a person holding you.
But still there were times when that wasn't available. You
learn to suck your thumb or bite your nails. You
(16:36):
start eating, maybe if you're a woman growing up in
the United States America, whenever you eat, you feel guilty,
and then you end up soothing that agitated guilty state
with more food. So the COVID nineteen like people gaining
nineteen pounds during the quarantine, is a real phenomenon for
my patients. The quarantine e has taken on a life
(16:58):
of its own. I definitely patients who are smoking more
pot um, you know, I thought it was fascinating that
cannabis went from being you know, Schedule one illegal drug
to like essential during the pandemic. That was like, okay,
that's pretty interesting. Moon. And you know, the other thing
I want to say about the sort of embarrassment of
riches or a lot of abundance besides there being a
(17:21):
lot of options of cannabis based medicines, is there's something
really exciting happening in psychiatry now. You know, we've had
a lot of the same tools for a long time,
and some things are hard to treat, especially post traumatic
stress disorder. And what we're seeing now with m d
M A assisted therapy, which is better known as ecstasy
(17:41):
or molly or psilocybin assisted psychotherapy, as that psychiatry all
of a sudden has some new tools at our disposal.
Ketamine is another very sort of separate and controversial issue,
but at least people are getting used to this idea
that they can have some sort of inexperience where they
can examine themselves more, maybe look at their childhood trauma process.
(18:05):
Some things come out of this altered state a little
bit better, a little bit less depressed, a little bit
less anxious. That's a new paradigm that's a completely different
way of thinking about these drugs. Uh. This idea of
psychedelic psychiatry brand new, pretty exciting, but something you've been
in love for a while, not new to me, right.
I want to talk about that. Be your beginnings in
(18:27):
terms of that and your beginnings in terms of psychiatry,
because as a psychiatrist, you're obviously a medical doctor, correct,
I am, Where did you go to medical school? I
went to University of Pennsylvania. Undergrad, I went to Temple
for med school, so I stayed in Philadelphia, and then
I went to New York City and I did my
psychiatric residency at Mount Sinai Hospital, and then I spent
(18:47):
nine years running the psychiatric emergency room every Saturday night
and Sunday night, which was kind of a rock and
roll psychiatry job. It was the e R at Bellevue Hospital,
the psyche r. So after those nine years, I a
book call weekends at Bellevue about my time there. But
because I had grown up in the seventies and a
suburb full of interesting drugs to try. And then when
(19:10):
I was an undergrad, I started learning about this m
d M a assisted psychotherapy, which I was very interested
in because when I was at Penn, all of a sudden,
I was reading about and hearing about a new drug,
and like you know, when you're studying psychopharmacology at at
undergrad and there's a new drug that's a that's a
big summer for you. So I got very interested in
(19:31):
m d m A and I wrote a big paper
about it because I was at a summer school class
I was taking um. That turned into the Ecstasy Book,
and that was my first book. I assigned chapters to
every expert um on every different facet of M d
m A. And then a few years later I ended
up doing that with the Pop Book also, So those
are actually two books that I edited. I wrote some
of it, but not all of it. I knew I
(19:53):
was going to be a psychiatrist from a pretty young
I mean I knew I wanted to do something with
the brain, well, knowing that psychiatry involves a far greater
commitment academically because of the medical degree than of being
a psychologist or a social something related. What's the impulse
to psychiatry in the young woman from your background? Like,
when did you know you wanted to do this? And
(20:14):
put in all that time I wanted to be a
doctor from a pretty young age. I mean, you know,
I was definitely the kind of person who played doctor,
you know, wrapped people up in bandages. I mean I
I am. I was a smart kid, was very interested
in drugs, very interested in the brain. Um pretty sure
I was going to be either like a neurologist or
(20:34):
nursergon or psychiatrist before I even went to undergrad Like,
I chose pen because they had a major called the
Biological Basis of Behavior. It was all about the brain
and psycho farm. I had a subscription of psychology today.
When I was in high school, Like, I was one
of those kids who just kind of I like this,
and what did your parents do? My mom was a
(20:55):
science teacher, and my dad is a structural engineer, very analytical.
I was interested in science, and I was very analytical.
And and I grew up in the seventies where just
drugs were all around me, and I was fascinated that
a little piece of paper could make you, you know,
see the world in a completely different way. And how
would you distinguish for people who don't have that much
(21:17):
of an intimacy with certain kinds of pharmaceuticals? And a
certain kind of drugs. Like for me when I was
growing up and I was in my you know, riding
the range out there in my drug and alcohol phase. Uh,
you know, cocaine was the king. But for people who
don't know about ecstasy and psilocybin, you feel there are
benefits to either or both, Why what did they achieve
(21:40):
in terms of therapy? So here's what I would say
about m DMA and psilocybin in terms of psychiatry. I mean,
first of all, the thing to keep in mind is,
right now, these are still research chemicals. They're not legal.
People can't prescribe them, but they are both going through
an FDA approval process so that they will be prescribable
in the context of their rapy. Right. So this is
(22:01):
not you know, buying a tablet of ecstasy or some
white powder that somebody tells you as molly and being
on a dance floor and getting overheated or overhydrated, and
those things are seriously dangerous. Also you just don't know
what you're getting. This is in the context of that
you're lying on a couch with a hundred and twenty
milligrams or maybe even only eighty milligrams, which is pretty
(22:23):
low dose of pure m d m A. You're not
dancing for hours, you're not overhydrating, so the medical risks
in that situation are pretty minimal, which is why the
FDA is allowed these studies to go ahead. Right now,
there are multi center trials going on with m d
m A assisted psychotherapy sessions all over America and a
few other countries, and psilocybin assisted psychotherapy research is happening
(22:46):
in America and all over Europe and given to who
for what, so for Some of the psilocybin studies are
for treatment resistant depression and some of them are just
for regular major depression. The m d m A studies
are looking at pos traumatic stress disorder. There's also one
m d m A study where they looked at social
anxiety in adults on the autistic spectrum. For people who
(23:10):
don't know anything about ecstasy or molly or what, you know,
this is methylene dioxy meth emphetamine m d m A.
So the methymphetamine part may sound familiar to you. It's
sort of a cousin of speed, but it has a
more of a psychedelic component to it, So what you
end up with is something that increases your serotonin massively,
so you're very relaxed and you feel sort of satiated,
(23:33):
like you don't need anything. It also increases your dopamine
because of the methymphetamine base, so you are awake, alert,
you have very good recall for the event. You want
to talk, you want to dig, you want to conn.
But there's one more very important part of m d
m A as it increases oxytocin, so you have that
sense of safety and connection, like you belong, and so
(23:56):
you end up with this sort of you're calm, but
you're open, right, So the openness like open to bonding,
open to trusting, open to looking at your ship. You know,
it's almost like anesthesia with or without surgery. Like when
you go to therapy. You get to a certain point
where you're like, oh no, that hurts that bad stuff
happened there. That's too tender. I don't want to talk
(24:17):
about it. And the therapist says, okay, maybe next week
we will. But then maybe you cancel and you don't
see her. You know, it fits and starts. It takes
a long time for therapy. This is one or two
sessions where you feel comfortable enough and trusting enough, but
awake and alert enough that you can really do some digging.
So it is like a catalyst for therapy. So that's
(24:38):
M D M A and psilocybin is different. It's something
really different. Well, right, so it's you you have a
mystical psychedelic experience. Maybe you're in a void which is scary.
Maybe you are in that place where I said, like
where you feel like everything is connected in your bathe
with love. But what happens reliably and people when you
give them psilocybin is you can do some mystical experience.
(25:01):
And when you have that sense of everything is connected
and love is the answer that when you have that
sort of big experience, it can lead to a lot
of behavioral changes. And also there's something called neuroplasticity, which
is the brain rewiring itself. I'm up for that. I
need that, right. So there's some psychedelics that cause neurons
(25:24):
to grow or synapsis to grow. You get neurogenesis or
synapter genesis. This means you're getting new brain cells, new connections.
So not the frying pan and the egg that we
are exposed to in the eighties, Like this is you know,
this is drugs. This is your brain on drugs. It
really for these particular drugs, it is quite the opposite
where you've got new brain cells, it's not killing brain cells,
(25:45):
and you've got new connections, a little bit of rewiring.
But do you do some predictive kind of work, like
for example, you say to me hallucinogenics like psilocybin, and
I think to myself, I'm sitting on my couch and
I take this pill and all of a sudden, I
feel like I'm paddle boarding into the mist on a
lake and upstatement, you are going to have left my couch,
right do you do? You do you do predictive things
(26:06):
with them before you give them the drug before because
because some people might have a negative reaction to it.
Not okay, so quite so. The most important thing I
can tell you is it because this is just research. Now,
people are screened like you and believe, very heavily screamed. Right,
So if you have a history of psychosis, if you
have a family history of psychosis, you're not going to
be on that couch. But you know, I actually don't
(26:28):
say hallucinogen because it's it's not like you see pink
elephants that aren't there. I mean, you know with with SILSA,
I mean you may have visions, but you kind of
know their visions. You know, you don't start interacting with
things that aren't there. But their mind manifesting medicines, their
consciousness medicines. And I would say, Alec that these are
disruptive medicines and psychiatry. This is a disruptive paradigm making
(26:51):
therapy go deeper and faster and getting people to turn
away from instead of taking a daily dose of antidepressants
or anti anxiety meds, they're having single sessions or maybe
two or three sessions over half a year or a year,
but they don't need the daily dose afterwards. And in
the m d M A PTSD studies, they're not meeting
criteria for PTSD at the end of the study. When
(27:13):
did you ascertain that you had developed the ability to
know when you were taking drugs and you were self
medicating in a recreational way, and when you were taking
drugs and it was part of your scientific research, Meaning
when did you sidestep the Dr Checkl and Mr Hyde
steven sony and a chapter of your life there? Well,
I would say for many people who use drugs. It
(27:35):
is a daily calibration and a daily question and an
important question to be conscious of. What is your relationship
with this drug? When are you using it, How are
you using it, Why are you using it? Is it
interfering with other things that need to happen? But you know,
I think these are hard questions. Did you come to
(27:57):
that point yourself when you were younger where you said
there are things you were doing that that you thought
you thought as if this isn't helping me, right? Sure?
I mean I I smoked cigarettes for years and years
and years before stopping, and that was something I'm a singer,
so I knew that that was just stupid to do. Um,
but it was really hard. And I quit cigarettes twice
for two years and started up again twice, and I
was amazed. Um, I knew I could quit, so I
(28:19):
knew I could start up again. And the kind of
rationalizations you make when you started up again. I know
you grew up with brothers. I grew up with sisters,
but I'm I'm the youngest of three, and you know
I was I wanted to do what their friends were doing.
So when I was eight, I had my first beer.
When I was ten, I had my first cigarette. When
I was twelve, I have my first cannabis, and when
I was fourteen, I have my first psychedelic. So very young, yes, precocious,
(28:43):
but always taking notes, learn learning, going to the library.
You know, we didn't have the internet back then. You
want to learn something, you had an encyclopedia, or you
asked your mom to drive you the library. But I
would do like any time I had to do a report,
you know, I would be doing it on the brain
or on the Smoking thing was the thing you did
when you were very young. It wasn't like five years
(29:03):
ago your husband catches you in the bat in the
in the garage smoking out there in the country. So
I mean, thank goodness. I quit smoking right before I
met Jeremy. And it's a good thing I did, because
I don't think you would have spoken to me if
I had a cigarette in my hand. So I quit
when I was twenty nine. But I smoked, you know,
steady from like fifteen to twenty nine, and not so
much steady from ten to fifteen. But still I would
(29:24):
like bumb cigarettes from people. And it was like, look
at this cute little kid bone a cigarette. That's so cute. Yeah,
and I've got a handful of friends who are formally
getting divorced now. Of course, the groundwork was laid prior
to the COVID, but the COVID has certainly pushed everybody
over the edge. They filed for divorce, They're getting divorced.
(29:44):
Not a discussion anymore, They've moved on. I was gonna
mention before when I said that people are falling back
on and relying on different things to medicate themselves, like
food and media and social media and TV watching and pornography.
I thought, you win a house, and you're just as likely,
maybe not more likely, but just as likely to go
in the bathroom with a computer and have online sex,
(30:07):
you know, and watch porn than you actually have sex
with your partner in your house because the two of
you are so sick of each other, like like normally
there is there is there like a spike in the
birthrate after a lockdown, And are we not going to
see the spike in the birthrate from this because everyone's
in the bathroom doing their own thing. Now, Yeah, well,
then connecting with that person a couple of things there,
(30:28):
I mean, you know, I actually I wrote about masturbating
to porn quite a bit in moody bitches, because you know,
when you have an orgasm, you have an increase in
oxytocin that makes you bond or trust or be open
to the person who enabled that orgasm. But if you're
doing that with your laptop, are you bonding with your
laptop every time? So maybe? But the other thing I
(30:49):
will say is that I definitely have patients who have
left their husbands or left their partners during these past
six months. There's no question this has been like a
crucible where you're like, oh my gosh, we're in the
best place we've ever been in or yeah, no, that's over.
So um. There's not much middle ground here. And when
this ends, if it ends how it ends, there is
(31:10):
going to be post traumatic stress disorder. I think that's
pretty clear. You know, we are currently being chronically stressed,
and so in theory, once the chronic stress is over,
then you have the post traumatic stress disorder. You know,
people who have PTSD. From nine eleven, It was a
terrible day in New York City, but it was one
day and then it was over. Psychiatrist Julie Holland. When
(31:34):
we return Julie Holland talks about why the pandemic is
particularly challenging for already anxious kids. I'm Alec Baldwin, and
this is here's the thing. I wanted to understand why
(31:55):
someone starts seeing a psychiatrist. So usually if somebody comes
to me, it's because they're already in therapy and their
therapist is saying, I think you need to talk about medicines.
I think medicines would help you. So they've already sort
of gone past the threshold. It's not just like people
are coming to me and saying, you know, I feel
lousy and I don't know why, although I mean back
(32:16):
in the nineties that was the case. The people were
just I don't know what's the matter with me, and
I would have to sort of hold their hand and
convince them that, you know, maybe they ainty medicine. I
don't have to do any kind of destigmatizing with medicine.
Now everybody knows somebody who's taking antidepressants, anti anxiety meds,
sleeping pills, they're everywhere, right, they're advertised. We you know,
we're all sort of soaking in it. So I do
(32:36):
think ever since nine eleven, I think a lot of
people got permission to medicate themselves, so when they come
to you, it's beyond talk. So yeah, they're coming because
they're wondering if they need medicines. They hit a wall,
they need the medicine to get through that wall. They've
definitely hit a wall. Or I have people coming to
me who've been on medicines for years who want to
get off, and that's something that I help people do.
And it's really complicated to get off antidepressants when you
(33:00):
been on them for decades, which unfortunately happens a lot.
You know, these meds were really only studied to be
used for six months or maybe twelve months, and in
some people you have to take them long term. But
almost everybody, they get on them and they stay on
them because they do make it easier. You know, what
I talk about in good chemistry is they don't necessarily
give you more connections in your life. They just make
(33:22):
you not mine that you're disconnected. That's my friend. My
friend said that once. He said, I took drugs because
I wanted to care less about my problems, he said,
And I stopped dating taking drugs because I wanted to
care again. I wanted to care again. And he said,
and that that was the mechanism in which I can
then move forward and start to care about what's happening
(33:42):
to me, my loved once, my children, right and then
and if you care, you can make changes. And you know,
I definitely want to say for the twelve step programs
that there is a lot of love in those rooms,
and there's a lot of connection in those rooms. And
you walk in fit's your home meeting, and you're going
again and again. There is that sense of belonging and
safety and all of those things feeling connected, feeling safe,
(34:03):
feeling like you belong to something bigger than you. Those
are high oxytocin states that get you out of fight
or flight and into this whole other paradigm for your body,
which is called the parasympathetic nervous system. Right, So it's
the opposite of the sympathetic nervous system. And good chemistry
talks a lot about how to get yourself out of
fight or flight and over into what you could call
(34:25):
rest and digest or connect and protect, or tend and befriend.
But it's it's the things that aren't fighting and running away.
It's things like staying and negotiating and cooperating and collaborating.
You know, all those things can't happen when we're in
fight or flight. And if we're being traumatized, and if
we're afraid of contagion, and if we have a sense
(34:46):
of powerlessness, we're all going to be in fight or
flight way too much of the time. Are you concerned?
I mean, our research such as it is, you know
my show, are producers that anti anxiety prescriptions for kids
have on up significantly during the COVID. Does that concern you? Oh? Absolutely? Yeah.
First of all, you know, over pathologizing women and children
(35:08):
is really a reflection of the sort of patriarchal structure
in medicine. But we you know, some people get sort
of narcissistic about their kids, and their kids are like
extensions of themselves, you know. And there is a little
bit of a sort of a niche population in New
York City where it's almost like you take pride if
your kid is going to a psychiatrist, or your kids
(35:28):
in therapy, or your kid has like special classes or something.
So here's the thing. Are culture is pretty toxic right
now and very anxiety producing right now, and it is
normal to be anxious fear of contagion is a real thing,
and it is normal to be afraid that you're gonna
get sick, or that your parents are gonna get sick,
or that your grandparents are gonna die. That's all normal anxiety.
(35:51):
And then it's normal to be anxious if you don't
know what's going to happen next month or next year,
or whether you're going to be in class or at home,
you know, or whether you're gonna be allowed to touch
your friends or hug your friends or play sports. I mean,
there's so many reasons we have right now for kids
being anxious. All the rules have changed, right that everything
they used to be able to do, they can't do anymore.
And also wearing masks. And I'm not saying that we
(36:14):
shouldn't wear masks. We should all wear masks, but you know,
it would be great as if we had clear masks
because interpreting social cues, if we could interpret social shoes.
You know, now with a mask, you can't tell if
someone's smirking at you or smiling or yawning, right, and
so and our brains because back when we were cave people,
if you got kicked out of the group, you were
(36:35):
gonna get picked off the herd. You were gonna die,
or no one was going to share their food with you,
or no one's going to help you build a structure.
You know, if you weren't in the club and in
the tribe and you got separated or ostracized, you were
gonna die. And so we still, on a very deep level,
have that kind of reaction. Am I safe? Am I
in the group? Am I okay? So when you're on
a zoom meeting and there's like eight people, your brain
(36:57):
is scanning, scanning all the time to make sure everybody's
okay with you. And if it's a herky jerky connection
or you can't see their face or their cameras off,
that's missing data that your brain is trying to, you know,
fill in. So that will make us anxious. So these
kids that are on zoom calls or the kids that
can play with their friends but they can't really play
the way they used to play. And don't don't go
(37:17):
run to Johnny. You know, Johnny's dad works in the
emergency room. Don't stand back like the rules keep changing,
the social rules are changing, and they and they can't
be held and comforted by so many people Now it's
just maybe your parents and that's it. I have always
viewed myself that I've typically been for most of my life.
(37:38):
A person that functions under my trust is yours to lose.
When I met people, I was very open, regardless of
what I did for a living. And now with this
what's going on in the world, as much as anything
in combination with the COVID, it's made me think, you know,
my trust is yours to gain. I'm going to go
out in the world now filled with suspicions. I'm wondering,
(38:00):
do you find that this suspicion, this neurosis about going
back out into the world. Are we going to go
back into the world and everyone's going to be different. Well,
so there's a few things that are making us suspicious.
We're worried about somebody getting us sick, and we're worried
about our democracy crumbling and that people around us don't
get it or they're so misinformed that they're never going
(38:22):
to get it. Yeah, it's all completely terrifying. So look,
you know, the the idea with oxytocin is if somebody
makes you trust them, then you are more open. You
have more oxytocin you become more trusting. They feel that
you're becoming more trusting, they start to have more oxytocin
and its cycles upward from that, you know, more eye
(38:43):
contact if you could hold them or like a really
great but but is everybody get to turn the oxytocin
spick it off when they go out? It has been
turned off? First of all, you only have oxytocin if
you're in that parasympathetic state. We're calm, right, so it
has been turned if you know, here's the analogy I
give of. You know, when you're in fight or flight,
which we all are now, right, if your kitchens on fire,
(39:06):
you don't pick up the phone if it's ringing, or
make a call, or you know you're that a fire
and like where's the fire extinguisher? Or have to run
out of the house. You don't have any social skills.
You're not. There's no niceness there. So the more we're
in fight or flight and the more we're in the
sympathetic mode, the lousier are social skills are, the less
we trust, the less oxytocin we have. You know, you
(39:27):
don't really have oxytocin when you're in fight or flight.
You have adrenaline and cortisol. And this is why we
can't sleep. You know, we're biting our nails, we're trying
to soothe ourselves orally, you've got this fat around your stomach.
It's because we're in fight or flight. It deranges your metabolism.
It makes it very hard to sleep, you don't digest
your food. Well, all the things that happen in parasympathetic
(39:48):
where you can rest and digest and you can have
sex and you can be social, none of those things
happen when we're in fight or flight. Like for me,
my fear this is so antathetical to my nature. But
my fear is I'm gonna go out into the world
with with this idea of like the less people in
my life now the better people are the problem. And
(40:09):
I need people in my life on an as needed basis.
Everyone who's in my life, why are you in my life?
And if I don't have a really good reason, it's
it's literally like we're all gonna on an emotional level,
we're gonna go in and we're all going to clean
out the closet now right, Well, it's like does this
person spark joy or not? No, they have to go.
So yeah, but that's good. I want to say one
(40:32):
thing about your on WE at five o'clock in the evening,
and that is, if you ever have a morning that
you can get out and go see a sunrise. It
is the antidote to that on WE that if you
happen to be around for dawn and sunrise, you will
have a little more hope. Um, and you know, don't
bring your phone, don't don't like no news, have like
an hour of nature, you know. No, I turned my
(40:54):
phone off a lot. I've been doing much better with
my phone. Well, listen, I think, I think if you
read me correctly, I'm not quite sure, but you are
a professional listener. What I want is I want to
take some pharmaceuticals with you, and we're going to paddle
out into the mist together. We're gonna just open ourselves
up to whatever the universe is telling us. I mean,
I'm being silly, but it's like, well, it's soothing though.
(41:14):
It's like hydrotherapy, you know, just listening. You know, first
of all, even just the salt air, even just smelling
the salt there is good for your brain. Thank you
so much for doing this with us. Thank you so much,
absolutely my pleasure. Anytime you know you need to talk
to a shrink, you come call me. I'm gonna get
in touch with you, okay it' Psychiatrist Julie Holland has
(41:37):
a private practice in New York City. I'm out like Baldwin.
Here's the thing is brought to you by my Heart Radio.
We're produced by Kathleen Russo, Carrie donohue, and Zach McNeice.
Our engineer is Frank Imperial. Thanks for listening all
Host
Alec Baldwin
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