The HIDDEN TRUTH About Trauma, Chronic Illness & Microdosing

Marie:
Dr. Sara Gottfried renowned Harvard educated physician, four times bestselling author, one of the leading doctors educating us on hormones, functional medicine, and the link between trauma and disease. She spent over 25 years helping millions of women worldwide. Now, with over 80% of us battling autoimmune disorders, she's revealing why our bodies begin to attack themselves, and the unconventional new treatments that can help us heal and get our lives back fast. 

Sara, I have wanted to have this conversation with you on the show for so long, so thank you so much for taking the time to be here. You know, this new book, The Autoimmune Cure, by the way, I have my galley. Everyone needs to get a copy of this. It's incredible. 

Let's start with talking about how many of us are struggling with symptoms like extreme fatigue and hair loss and gastro issues and trouble sleeping, and all of the things like what is happening? I feel like 10 to 15, maybe 20 years ago, I never heard about this stuff, and it just feels like it's everywhere now. 

Sara:
Yeah, we're seeing this exponential rise in the number of people with autoimmune conditions. And I, you know, the way I think of it, Marie, is that there's a spectrum here. There's a spectrum from being completely normal and having none of these symptoms that you're describing to the other end of the spectrum, which is autoimmune disease. And that's when you've got a clear diagnosis of Hashimoto's Thyroiditis or Multiple Sclerosis or, you know, Rheumatoid Arthritis. But there's a vast space in between where you might just start to have some symptoms of, as you described, fatigue, maybe some joint aches or visual changes, something that kind of signals that your body is not quite right. That there might be some issues with your PINE system, your Psycho Immuno Neuroendocrine System. 

So the book is focused on autoimmune disease, but it's really about how there's this backstory that can happen for 7 to 14 years before you actually get a diagnosis of something like an autoimmune disease. 

Marie: 

Well, I think that's really interesting too, because you know, so many folks in our audience, we have a wide range in terms of, you know, all people are welcome, all people watch this, but we do have a high concentration of specifically women in their, say, mid to late thirties all the way through fifties and sixties. And it feels like that may be somewhat of a sweet spot. Again, we know folks experience these kind of conditions throughout their lives, but I'm curious to hear from you. Like, for me, you know, as you start to hit your late thirties and forties, stuff does start changing. And at least in my own psychology, it was like, oh, this is what happens as we age. But is that necessarily true?

Sara: 

It's not true. So I, you know, you asked what percentage of people are experiencing these things? We know that about 80% of women over the age of 40 start to have symptoms of what I would call dysregulation. So that could be hot flashes, night sweats, it could be, you know, not wanting to, um, have sex as much as you used to. It could be vaginal discomfort, it could be, as I described, the joint aches, the fatigue, et cetera. So 80% of women are experiencing these symptoms and dysregulation is not normal. So the idea here is that if you're starting to feel dysregulated, like if you feel more tired than you should, when you wake up in the morning, you don't feel restored, you don't feel like you can, you know, go after your mission the way that you once did, then I would say, don't assume that that's aging. Like, let's investigate. Let's look under the hood. Let's run some laboratory tests, let's do some questionnaires and see what might be behind it. 

Marie: 

Yeah, and I love that you have some of those questionnaires in the book as well. Um, so for anyone that's not familiar with how you would actually define autoimmune disease, what would you say is a, is a definition? So people just understand that phrase as we move forward. 

Sara: 

So, classic autoimmune disease is when your, your body is attacking your own tissues. So it's, uh, the other word that's used in this context is tolerance. So your tolerance, your ability to, you know, kind of, uh, go through a surveillance process of looking at your own tissues and not attack the–

Marie: 

Yeah. 

Sara: 

–that's lost. So you lose tolerance. Now, there's some situations where you wanna lose tolerance, like in pregnancy. So when you're pregnant, you don't wanna be attacking all of the tissues that have your, you know, sperm donors, DNA on it. So you want tolerance in that situation, but it can backfire. So if your immune system becomes dysregulated, if it becomes kind of overactive, which is really common in women compared to men that can lead to this condition of autoimmune disease. But in addition to the classic autoimmune diseases of which there are a hundred. 

Marie: 

Yeah.

Sara: 

There are also a number of conditions that I think of more as kind of neo autoimmune diseases, and that includes endometriosis, adenomyosis, where your body's attacking the muscle of your uterus. 

Marie:

Wow. 

Sara:

It includes some types of irritable bowel syndrome, and it includes fibromyalgia. So classic autoimmune disease is when you've got this loss of tolerance, your immune system starts to attack your own tissues, like your thyroid, like your myelin and multiple sclerosis, which is what helps nerve cells transport signals really fast. And, typically there's an antibody. So your, your B cells in your immune system make an antibody almost like a weapon to attack your own tissues. And that's, that's kind of the path, mnemonic sign of autoimmune disease. But you don't always have to have any antibody. 

Marie: 

So what I loved as a marketer, and as someone who's known you for so long, when I was reading the subtitle of this “healing trauma and other triggers that have turned your body against you”, that specific phrase of turned your body against you – personally, that was a phrase that I didn't even know that I was saying to myself when things started in my own body to Dysregulate. I was like, it's not cooperating anymore. I feel like it's my enemy. And that's not a place that I've ever experienced before in my life. So thank you for breaking that down. 

What are, from your experience, I know there are so many things which you go through so methodically and so compassionately in the book, and knowing that there's, there's not one thing that's causing this, but can you start to uncover for us what are some of the root causes that may lead us in this direction? Because for me, I'll, you know, I had always prided myself, and you've known me for a long time, and we did like a hormone panel, probably 10, if not 15 years ago. And, you know, we could talk more about that later. But, uh, I've always tried my best and definitely far from perfect on eating. So-called clean, and you know what I mean, doing my workouts and doing my meditation, and, you know, doing all the things that we kind of know are important for wellness. And then when things for me just started to slide and not good directions, I was like, why? Nothing's working anymore. So anything that you have to say on how we can start to uncover, what are some of the root causes of, of what sends us in this direction? 

Sara: 

Well, first I do the happy dance when you ask me about root causes, because that's really the nature of functional and precision medicine, the type of medicine that I practice. And it's not the nature of mainstream medicine. So mainstream medicine is mostly about suppressing symptoms and masking them. 

Marie: 

Yes.

Sara: 

And then, you know, sort of be on your way. Like, I don't want to hear about it anymore. So I have to say first, and hopefully I'm not revealing too much. You're one of the most regulated people that I know.

Marie: 

Mm, thank you.

Sara: 

So I met you 15 plus years ago. I've been just so inspired by your work and the testing that we've done. I mean, for the most part, it comes back really in the optimal range. I mean, maybe there's a few little tweaks that we can make. And so hats off to you because you've got the kind of lifestyle that is addressing these root causes that I'm about to dive into. 

So the three root causes that we think of that were first described by Alessio Fasano, who is a gastroenterologist at Massachusetts General Hospital, he describes it as a three-legged stool. So to develop autoimmune disease, you need, number one, a genetic predisposition. Number two, increased intestinal permeability. So-called leaky gut. And then number three, a trigger. So that trigger can really vary. It can be trauma, it could be the pandemic, it could be an infection, it could be perimenopause. So those are some of the most common tr triggers that I see. 

Marie:

So what I think is so fascinating there, genetically, I don't know what, if I have predispositions, and thank you for saying the resiliency, but I will say, you know, the past few years for me, there was just a lot of roller coasters. And specifically, before we turned on the camera here, I was sharing with you, probably the past three months or so, I've had some intense gastro issues. And I was like, where the hell did this come from? And, my functional doc, our mutual dear friend, Mark Hyman, and, you know, I didn't realize that the stress I've been experiencing, and I talked about this a lot on my show for the past six months, my parents, there was like an enormous health crisis that happened last year, like out of nowhere and almost lost my mom twice. My dad, who's, you know, and they're relatively young, my dad's just about to turn, um, by the time this will air, he'll be 76, God bless them both. 

But it was like normal, normal, normal. And then went into, uh, for me, I'm gonna describe it this way, crazy town USA in terms of stress, right? Like, I thought I was gonna lose both of them. You had mentioned the traditional medical system, which had me literally, Sara, wanting to put my head through a wall like 17 times a day. 

Sara:

Yes. 

Marie: 

Trying to advocate on their behalf. And from the little that I know from, you know, having the, the, the privilege of knowing you and knowing Mark and, and trying to do my own research on these things, I kept stressing to anyone that was trying to give care to my mom. Like, can we look deeper under the hood? Can we test and understand what's happening with certain biomarkers, because this is not okay. 

And they just kept wanting to, you know, shove more medications into her, which I understood. But when you made that comment like, here, let's take care of the symptoms and shoo shoe away. Like I don't know if I've ever experienced that much, stress in my entire life, sustained for six months. And when my gastro thing started popping up, you know, Mark was like, what's happening? What's going on? I was like, well, it's probably the worst six months of my life. And I never realized how much, for me stress is like kryptonite. 

Sara:

Yes. 

Marie:

And took my entire system and including, you know, you had mentioned leaky gut, and I was like, wow, I, everything got thrown off. So I just wanna share that because I know there may be people watching and listening right now who maybe their entire lives, it was like, I'm pretty strong, everything's going great. And then you, for me, it was like, you start to get these stress stacks, these triggers that build up, and then everything gets dysregulated. So, um, I don't even–

Sara:  

I think a lot of folks can relate to the point that you're making about, uh, the connection between this, what sounds like toxic stress.

Marie: 

Yes. 

Sara:

For about six months. 

Marie:

Yes. 

Sara:

And how it affects your gut. 

Marie:

Yes. 

Sara:

So, you know, when I talk about the PINE system, the Psycho Neuroendocrine System, that's the part of our body that's the most vulnerable to this type of stress that you're describing. 

Marie:

Yeah.

Sara: 

And so it might be helpful just to get a little bit specific about what could have been happening behind the scenes for you. 

Marie:

Yeah. 

Sara:

So what we know is that when you've got toxic stress, especially with such high stakes, you know, almost loosen your mother twice, we know that there's this stress response system in the body, which normally works amazingly well in your, in your network. But the, it starts in the brain, it starts with the amygdala and kind of the way that you're serving the environment, maybe the hospital and this healthcare system that you're struggling with. And you get the release of something called CRH corticotropin-releasing hormone. You don't have to remember these names, but CRH then goes to the pituitary in the brain, which is like right in here, and it gets it to release something called ACTH, Adrenal Corticotropin-Releasing Hormone. And that then goes to the adrenal glands, those cute little adrenals in the back to release cortisol. 

So why is this important? What's important is that the CRH, which kicks this off stress, CRH, the CRH pokes holes in the gut. 

Marie:

Hmm. 

Sara:

And that's what kicks off this whole cascade, because when you have leaky gut, you know, normally the gut is like this really tight barrier. We like get nice and tight, and when the, the tight junctions get looser, the foods that you're eating, the, you know, maybe some exposures that you have with, foodborne pathogens, those are starting to trigger the immune system, 70% of which is below the gut lining. So that's how we're starting to connect the dots here. So the PINE system, the immune system can then become dysregulated because you've got this increased permeability. 

Marie:

Yes.

Sara:
You've got this trigger of chronic stress, toxic stress, and now your immune system is involved in the game. 

Marie:

Yeah. And I do wanna give a little more color to this just for the audience. So it was like, these are things that I don't necessarily always talk about just because, you know, they're life. 

But it was, it was an interesting, it was almost like a venn diagram, I call it. I was like a tiramisu of stress where there was a, like a long-term renovation happening in our home. So I wasn't in nature as much as normal, probably for a few years. And anyone who's ever tried to build something or renovate something, especially an old house, like it's a lot. You never, 

Sara: 

It's, it's so much more than you ever think it is! 

Marie:

Than you ever think it is! And it's like a beautiful thing, and it's an awesome thing. And I'm so, so grateful that we were able to do it. And it's like, I joke that it was another part-time, full-time job for years. That was like really expensive and really a pain in the ass. And it's awesome now. But like, that was happening. I'm like, holy s**t. Then the parents, then we had big changes in our business, you know, making changes in staffing, a lot of which were, were challenging, you know, and different things that we wanted to rebuild.

And I remember Josh, he's like, Marie dealing with any one of these things would make a normal person be on the floor, you know, doing the all be cry. He's like, you're dealing with five at once for a sustained amount of time. You gotta give yourself a break. And it was really hard for me, cognitively and emotionally to realize that I was, I was like, no, no, no, I can do this, I can do this. 

But I just, I wanna say that because I know that for many of us, it's like we're used to being, or thinking of ourselves, at least I'll speak for myself. It's like, I got this, I got this, I got this. And when those stress triggers or whatever happens keeps coming in and it's sustained over time, it is gonna have an impact. And so I love that we're talking about this, because it's not that my body turned quote unquote against me in a way, you know what I mean? That it was doing something, it was like, Hey, need help here.
Sara:
Well, your body was doing what it's programmed to do.
Marie:
Yes.
Sara:
Which is, oh my gosh, there's a crisis–
Marie: 

Yes.
Sara: 

–In this body called Marie Forleo.
Marie: 

Yes.
Sara:
And so let's protect her.

Marie:
Yes.

Sara:
Right. Like, let's send in the cavalry.

Marie: 

Yes. 

Sara: 

And let's get the immune system involved. And you know, I think it's, it's critical to understand that a lot of us have a certain volume of stress, a dose of stress that we're accustomed to.
Marie:
Yes.
Sara:
And it's not that stress is bad. Right?

Marie: 

Yes.

Sara:
Like I, we know that there's sort of a, a perfect amount of stress, so called eustress that allows you to be so productive that allows you to, you know, launch Marie TV and launch B-School and like do all these amazing things that you've done. And then there's sort of a tipping point where you get to the place where, actually it's too much for my system. 

Marie: 

Yes. 

Sara: 

And what tends to happen when you're in that place, as you described, is that some of these other things that help to create a healing state of consciousness, like being outside, like forest bathing, like, you know, great sex and fantastic orgasms, meditation, you know, I need really 30 minutes a day, twice a day, if I'm honest about it. 

So often the dose of those healing states of consciousness isn't commensurate with the load of stress that you have. And so that also is then kind of tipping you in the direction of dysregulation. 

Marie: 

Yeah. I wanna read something you wrote in your introduction, because I think, we have so many high achievers that watch this. And I think so many people that share, a little bit of our DNA so to speak, in terms of our ambition and our desire to, do meaningful work and to, you know, crush at life for, for lack of a better way to put it. At least that's, that used to be me. 

So I wanna read this. You said: 

‍“I was stuck, I was addicted to my body's own stress hormones, trapped in a self perpetuating loop in a near constant flight mode, overwork over functioning and relationships. I craved high pressure situations, and I felt bored if there wasn't a lot of tension at the workplace or home. I had a chronic pattern of high conflict in my relationships. I had trouble relaxing and sitting still. I was always on the go. I was constantly overscheduled. All this combined with pores boundaries led to a near perpetual cycle of saying yes, then feeling depleted. And it was only in the last few years that I realized this was no way to live.” 

I wanted to share that because people might think like, Sara, oh my gosh, she's this incredible doctor, you know, and this incredible healer. It's like, Hey, we all experience this. So how has this journey for you helped you transform your own relationship to stress and to the mission that you have in this world, which is so big and you've helped so many people?

Sara:
Well, the mission still stands because I really feel like service is what pulls me forward. And it's, it fills me with purpose and meaning. The methods have changed because, you know, I feel like there's a way, and now we're gonna maybe start talking about trauma.

Marie:
Yeah.

Sara:
So I, you know, part of that overachiever, type-A personality being so self-reliant, being hyper-independent– 

Marie:

Which I'd never heard that phrase before until I read it in your book. Hyper-Independent. I was like, guilty.

Sara:
Yeah, yeah. And I, you know, our culture rewards people who do this. And yet, when we're really honest, when we get quieter and kind of look at the inner cost of behaving in this way, it's not quite as pretty as we might hope. There's a way that it accelerates kind of the rusting process in the body. There's a way that it eats at the immune system, it can, you know, for people who are quite resilient, often the P of the PINE system, the Psycho part that may be functioning well, like I don't have anxiety, depression or, uh, post-traumatic stress disorder, but I've got a fair amount of trauma in my system. 

So the adverse childhood experiences score, I've got a score of six, which is not the kind of test that you wanna really high score on. Zero is really considered normal. And so I had to take a look at the way that I was behaving in the world, especially this piece of over functioning. And honestly, this isn't about me. This is about our listeners and viewers who might relate to– 

Marie: 

Yes. 

Sara: 

–this whole issue of over functioning. And I was in a state of, you know, sort of jumping from one lily pad of overwhelm, and then I'd go on vacation, or I'd like get a new meditation routine, and then I would get to another lily pad of overwhelm. So I-I didn't love living that way, but the thing that got me to really look at this with fresh eyes was that I had a conflict with a family member. 

So I had this person that I just really adored who, I became estranged from. So we didn't talk for about a year, and it was devastating to me. This is someone that I talk to on a regular basis. And, and that was the turning point for me because I realized, you know, in some ways my own physiology wasn't enough to get my attention. But I realized with this person that I love so much that if trauma and toxic stress was driving me to be estranged from her, then I wanted to do absolutely everything possible to heal from it. Because I didn't wanna live my life for another second. In a way that trauma was dr-driving my behavior. And in some ways it didn't matter, sort of her experience and her side of the street, I had to clean up my side of the street. 

So that's what really got me kind of on this path. And then to start to look at, oh, there's so many signs of dysregulation. My heart rate variability is so low. My immune system is dysfunctional. I've got positive anti-nuclear antibodies. I have problems with my endocrine system. I've got cortisol issues that are a little too high, a little too low. And yes, I can right size them for a minute or an hour or a day. But then my baseline is, I kind of go back to a state of dysregulation. But it was really that relationship that got me to say, I surrender. 

Marie:

Yes. 

Sara: 

Let's look at this in a new way.
Marie:
I think it's so important too, because, you know, at least in my experience, I would say maybe the past decade, a little bit less as a culture in certain circles, certainly the ones that we run in, there's been so much attention paid to kind of, I hate this word, but like biohacking, right? So you're paying attention to the metrics and then you're taking the supplements, or you're doing the cold plunge, or you're doing the sauna. And all, all those things are amazing. Those are wonderful. They're a piece of the puzzle. 

But what I am so excited about with, this new book and what you are looping together is the more holistic view and saying, okay, these things are wonderful. They have their place. Absolutely. We'll talk more about diet and we'll talk more about the other things that we can do in terms of therapeutics on all the range. But it's like, hey, let's look at what's underpinning it. And if there are real roots of trauma that we can start to address as well, that might be just as crucial as that ice bath, if not more. 

You know, I had experimented– it was the first time, um, that I ever had kind of dove into anything in this realm from a therapeutic sense was EDMR. Am I saying that right? 

Sara:

Yes. Yes. Yes.

Marie:
And it was a few years back. And in the kind of prefrontal cortex, I was like, I'm good. You know what I mean? Like, oh, I'm so good. I'm so good. And then when I remember doing the first couple of sessions, I was like, Whoa, This is so powerful. So in terms of ACES, for anyone that doesn't know adverse childhood experiences, can you just give us a little bit of a breakdown of a primer, like what that is, and if anyone suspects that they may have it? 'cause I know you said zero is kind of, that, that would be our ideal. I feel like every single human I know is like, ain't no way. I think I am, about a five.  

Sara:

Okay. 

Marie:

On that scale. 

Sara: 

Okay. Okay. The picture is starting to make sense. So the ACE questionnaire was developed 20 plus years ago, initially by the Centers for Disease Control. They did a study at Kaiser Permanente. And the study was really interesting. They asked these 10 questions about trauma that they thought was the most significant. It's not a comprehensive list. It doesn't include bullying or some other things that, children experienced. But what they did was they asked middle-aged folks, so 40 to 65, who, were members of Kaiser Permanente in San Diego. So they were, you know, people mostly middle class, upper middle class, and, had employment. So these folks did this questionnaire, and they found that the people who had a score of one or higher were as, that was associated with an increased risk of more than 45 different chronic diseases. 

So not what you would think, not just mental health issues, anxiety, depression, PTSD, disordered eating, things like that. But autoimmune disease, cardiovascular disease, greater risk of diabetes, higher risk of alcohol use disorder, and other addictions. So 45 different conditions have been associated with this test. 

So what is the test? The test is a simple questionnaire. You can Google it. I've got a link on my website for one that you can do with some interpretation. And it's looking at physical abuse, sexual abuse before age 18. It's looking at neglect. Did you have a parent who went to jail? Did you have a parent who, had alcohol use disorder? Did you– did your parents get divorced? 

So there's a number of different questions. That's not the most complete list, but the idea is that a score of zero is what we're looking for. And you're right, I mean, at that time, somewhere around 60, 70% were testing positive, having a score of one or higher, higher in women than in men. And, I feel like we're at a point now in our lives where especially post pandemic, almost no one is unscathed. 

Marie:

Yes. And I think understanding that and knowing that is so important because one of the cool things about where we are right now in culture, there are so many incredible therapies depending on what you feel called to, what seems to align with your values or something that you're genuinely interested in. And so many of them are backed by really good science. You know, I remember, I think it was Dr. James Gordon, I might be getting that wrong. But, an incredible person specifically around trauma who had worked with, so many different populations, specifically across Europe, in the middle of war zones, and all of these incredible therapies that cost close to nothing, if not nothing that we can access for free, using the body mind connection to start to heal some of these, traumas that all of us have in our bodies. 

You know, you wrote something, and I think that this is true. You know, we touched a little bit upon stress. It's like, dude, stress ain't going away. Right? If you're alive, you're gonna have stress. And as you noted, there's a specific amount of it that's actually positive, that's productive, that can help us grow. 

How can we start to stress better? Because again, we know that's gonna be a part of our lives. Are there any things that you found, you mentioned for you the optimal amount is like two sessions of meditation twice a day. Like if you're really honest with yourself, you're like, that's what really does it for me. Are there any other things that you would wanna say in terms of how we can stress better so it doesn't make us sick before we start moving on to, to gut and diet and all those good things?

Sara: 

Measure. So I think measuring is a really important way of creating objectivity and also accountability. 

Marie:

In terms of our stress. 

Sara:

In terms of stress. So, you know, what I find is that so many people I work with both men and women, but so many people have a fake sense of the effect of stress on their body. I mean, you're pretty sensitive. And so you were able to discern in this period last year that it was too much for your system. 

Marie:

Yes. 

Sara:

But so many of us become disembodied and, maybe being a famous hip hop dancer sort of makes that a little more accessible. But, you know, I find, so here's another thing I noticed about myself, and then when I noticed it myself, I start to look and see if it's true in my clients. And it was. So I noticed that I dissociate and I would call it functional dissociation. And I'm not talking about, you know, multiple personality disorder, but I would, when I was feeling stressed in my marriage, when I was feeling like, you know, I had two kids that I raised and I was running this busy, functional medicine practice, and I often felt like I had to be in two places at once. And so there was a toll associated with that, and I-I wasn't really sensing it. 

So there's this thing called interceptions that if your ability to sense into the cues of your body, and I think a lot of women as a result of the way our culture is kind of working against us, that just railroad over that and don't have a sense of how stress is landing in our body. 

So for that reason, to develop your introception, to develop kind of that intuitive sense of what's true with your subtle energetic anatomy and, you know, kind of your general anatomy, I like to measure. So I use a ring to measure heart rate variability. Tells me readiness each morning. I like it for tracking sleep. 

Marie: 

Oura. Is it an Oura Ring?  

Sara:

Yep. And so you use it too. And it's, you know, there's a couple of features I really love. I know that I need two hours of deep sleep for my gut to be in its best state possible. And, there's some work that has to be done for that to happen. 

Marie: 

Is that you specifically, or is that something that you've noticed over your clients? 

Sara:

I've noticed it in, I would say the majority of my clients, especially those that are 40 and older. The other thing that I love with the Oura, they do a daytime stress feature. 

Marie: 

Yes. 

Sara: 

Right? 

Marie:

I can't wait to tell you about my experience with that. I wanted to throw it against the fricking wall, but yes. Oh my God. I was like, I thought I'm doing good today. Meanwhile, I looked at my results, this is like all last fall, and I literally, I held the phone up to Josh. He's like, are you okay? I'm like, apparently not. 

Sara:

Well, That's the accountability. 

Marie:

Yes. 

Sara:

It creates the loop of integrity where you might be telling yourself, oh, I'm fine. I'm managing– 

Marie:

Yes. Yes. Yes.

Sara:

I'm doing okay with all this. And then when you have this objective measure reflected back to you that says, actually, you spent most of the days stressed. 

Marie: 

Yep.
Sara:
You engaged a little bit, but you didn't relax and you didn't restore. I think that's incredibly helpful. 

Marie:

It is. And I, but I do, this, is this one thing an Oura, if you're listening, I don't know. But the one thing that I was paying attention to, because I was really trying to peel into it also because I'm slightly competitive, you know, with myself and being like, I can do better. I noticed that it actually showed real stress, and I guess this makes sense. I'm curious to hear your perspective on it. Like things when I would talk to my best friend, so it was like, you're stressed. I'm like, I'm actually having a damn good time for once in this hell hole that I'm in right now. And then the other thing was when I would go to some of my fitness classes, which again for me was just such an amazing opportunity to let energy get through my body and work through things. And it was like, you know, the stress was off the charts and I was like, I can't win here. Do You know what I mean?

 So I don't know if it's, it's sometimes counting quote unquote good stress in the same way. But, you know, that's an open question. I-I don't know the science behind it. 

Sara:

Well, There's certainly good stress. 

Marie:

Yeah. 

Sara:

So your workouts, you know, the way I approach workouts, I also am stressed when I do my workouts. I do heavy weight lifting. So, of course my system is pretty stressed, but what I see afterwards is that I'm more likely to get into a relaxed or restored state. 

‍

Marie:

Mm-Hmm. 

‍

Sara:

So it's not so much while it's happening, it's the aftermath that I'm looking at. 

‍

Marie:

Okay. Good. 

Sara:

And then with your best friend, you know, what's interesting about that is there's a part of the brain that's involved in kind of understanding what's happening with you. And then there's a different part of the brain that's involved in healing. And sometimes when you're rehashing what's going on with you– 

Marie:

Mm-Hmm. 

Sara:

–That part, that understanding part that's kind of, uh, reinforcing the trauma that you're already in. 

Marie:

Yes. 

Sara:

That can be stressful for the body. So– 

Marie:

That's interesting. 

Sara:

So Yeah, I mean it, I would never say don't talk to your best friend. 

Marie:

Yeah. 

Sara:

Like, that's so critical. 

Marie:

Yeah. 

Sara:

But there's, we just wanna be aware of what's the truth of the body. And also, I wouldn't put all of my eggs in one basket. It's not just what the Oura Ring is telling me about my daytime stress.

Marie:

Totally.  

Sara: 

It's also how I feel. 

Marie:

Yes. 

Sara:

We wanna find kind of the middle ground. 

Marie:

Yeah. I love that you said that because it was funny, Josh had said to me, he's like, I think that ring is stressing you out even more. He's like, maybe you gotta take it off for a minute. I was like, maybe you're actually right. 

So we've talked about this a little, but I wanna dive deeper. What role do you think of any genetics play in this? Like if you were to, to kind of divvy that up, would you be like, ah, you know, it, it does play a huge role and, and what are things that we can proactively do, especially if it's like, Hey, I'm more genetically predispositioned to have to pay attention to this. 

Sara:

Well, genetics are one of the three parts of the stool, the three-legged stool. So, you know, there's nothing you can do about your genetics, of course, but there are a lot of workarounds. So the genetics, the genetic predispositions, which I talk about in the book, people can test and see if they have them. 

And then there's, you know, really the book is about the workarounds. Yes. So the, the levers like food, the, um, embodiment, the sleep, the immunomodulators things like DHA and curcumin and vitamin D, and also potentially psychedelic medicine. But let me contextualize that for a moment. 

Marie:

Yeah. 

Sara:

Because there's the genetic predisposition. We don't know exactly what percent it contributes to autoimmune disease. I would guess it's somewhere around 20 to maybe 40%, dunno the exact number. And so that means that environment affects probably 60 to 80% of the story. 

Marie:

Yes. 

Sara:

And so you've got a lot of control potentially over environment. And another piece that's important to mention is epigenetic change. So we know that, for instance, when you, when we look at people like, those who survived 9/11. People who, survived the Holocaust in their offspring. Even a more recent set of data looking at something called the ice storm in Canada that happened in 1998. We know that there are ways that your DNA gets like a little tag put on it, a little sticky note that says we had a problem. And so we're gonna change the way that this DNA is expressed going forward. 

And so what we know from the Holocaust, from 9/11 from Project Ice Storm, is that the genes that are modified, that change the way they talk to the body, are in two different categories. Your immune system and your metabolic system. So for you, it might be the immune system could be dysregulated. For me it's both the immune system and the metabolic system. Like, I've struggled with my weight most of my life. 

And so it's important to realize that that's the, those are the, the sets of genes that we, that are most vulnerable. But then there are all these things we can do about it. The way I think of it is that they're like soul wounds. So even if your ACE score is zero, even if you feel like you're relatively free of trauma, you might have inherited from your mother or your grandmother, or your great-grandmother or further back in your lineage, some sort of vulnerability from an experience with toxic stress or trauma. 

Marie:

And so, we're gonna keep going because what we're gonna get into next is all of the different ways about how we can start addressing these things. I wanna talk more about the gut. We know this, right? We know there's not one right way to eat. 'cause every body is so different. But let's go into just some areas where I think we all can have confusion from time to time and can go back and forth. At least I have. How about sugar? What do we think about sugar? 

I think, for me, most recently, right now I'm doing, I was telling you this, I think before the cameras turned on that I'm doing AIP for a little stretch of time. And Sara, I was blown away when Mark's like, Hey, you gotta do this. I want you on this for two weeks. Within 24 hours I saw symptoms. I was literally like, What? I could not believe how quickly my body started to respond. So go, let's, let's start with sugar. What's your take? 

Sara: 

I'm not a fan of sugar. 

Marie:

Yeah. 

Sara:

So, you know, I think about what our bodies were designed to eat back on the savanna. What our bodies were designed to eat, when our DNA developed, and it's not sugar, it's not gluten, it's not processed foods, it's not packaged foods. So all of those things I think are, they really have no place in the body. And, you know, yes, occasionally have a birthday cake, enjoy a cheesecake. But I would say for the most part, sugar is not your friend. 

Marie:

Yeah.

Sara:

For many, many reasons. 

Marie:

It's funny, I was reading, I don't know if it was your book or another book, but it was, it kind of stuck with me. It was years ago. I remember. So one of the things I do every year is, you know, I write down kind of all of my biggest lessons of the year. Like the things that became really apparent to me. And then of course, because sometimes I'm a little hardheaded, I write down the same lessons the next year. You know what I mean? That I learned again and I learned again. And I kind of look for the patterns over time. 

And I remember there was a spiritual book that I was reading and, there was this notion about how alcohol is just toxic. And like, you know, I grew up in New Jersey. I-I didn't drink as like a teenager, but when I got to college, O-M-G, was I a party girl, do you know what I mean? I was out and about all the places all the time. And then as I started to get into my thirties and forties, it was like, it's not my friend do. Like, I don't feel good. It doesn't feel the same. And the moment that I had this thing put together through the spiritual book that I was reading, it was like, you just gotta be honest. Like your body's not meant to consume it. And there was something in that for me, again, there's no judgment to anyone else, but it was this connection point where I was like, oh, I don't wanna put a toxin in my body. That's just how I linked it up. And then this book that I read like a day or two ago, or within a few days, it was like had that same connection for me around sugar. And it was the first time that I had that connection. I was looking at it newly going like, I really wanna take care of this thing. I love this thing. And I wanna give her every ability that she has to feel her best to help me feel at my best. And so, just thank you for saying that. It's like, yeah, cake's gonna happen, birthdays are gonna happen here and there. But for me it was a really useful viewpoint to, to see it as something more toxic. Again, outside of fruit, outside of naturally occurring sugar that's in whole foods that we eat. 

Sara:

Well alcohol is such a, a good point to raise because it is toxic for the body. You know, we had decades and decades of seeing the Mediterranean diet. It's the most proven diet that's out there. And yes, of course you can have a glass or two of red wine. 

Marie:

Yeah. 

Sara:

It's full of polyphenols. And then we went back and looked at some of that data and realized that that's not right. 

Marie:

Well, You would also need to like drink cases and cases of wine. 

Sara:

Yes. 

Marie:

Right. To to be, 

Sara:

To get the resveratrol 

Marie:

Correct. 

Sara:

Right. But the other connection I wanna make here is that when you think about your gut lining, it's really delicate. 

Marie:

Yes. 

Sara:

Like, it's amazing how delicate it is. You would think it would be more hearty at this point. But the way that we induce leaky gut in animal studies is to give them alcohol because it's so reliable– 

Marie:

Really! 

Sara:

–with poking holes in the gut. 

Marie:

Oof. 

Sara:

So that's one of the key things that alcohol does. It pokes holes in the gut. It, you know, it, it causes, it shrinks the brain. Women have double the risk of Alzheimer's. It's, it's a toxin. Some people think of it as liquid sugar, especially cocktails and certain wine. And what I would say about alcohol, because a lot of people don't like to hear me say that, I don't think alcohol is good. There's so many other good sacred medicines out there. 

Marie:

Yes. 

Sara:

And other ways of creating healing states of consciousness. Like if you're looking for a cocktail or, a glass of wine to help to state change, you know, at the end of the day you just wanna relax at 6:00 PM like, let's go. There's so many other things you could do. 

Marie:

Yes. Yeah. No, there is. And we're, we're gonna talk about that too. So, um, food first philosophy. I feel like if anyone is, experiencing anything on the continuum of autoimmune right now, or any of the things that we described at the top of the conversation, tell us about a food first philosophy when it comes to just getting on this healing path. 'cause I feel like it's one of the things you don't need to go find a particular provider, right? That's something that you can do yourself. What would you say to people if they're like, I think I should start experimenting. Talk to us about food first. 

Sara:

Well, I think food is the most fundamental, lever that we wanna push when it comes to this, dysregulation that we're talking about. What happens with a lot of folks, what I see in my practice is that when you've got increased intestinal permeability and you start reacting to foods, the most common food reactions when it comes to autoimmune disease are, gluten, dairy, sugar, and sometimes nightshades. So I recommend doing an elimination diet. So you mentioned the autoimmune protocol. AIP is a form of an, elimination diet. And the cool thing about it is it's free. Like there's no cost associated with this, right? 

Marie:

Totally. 

Sara:

I mean, you have to be strict and you have to be really stringent about what you're eating. But the benefit is that you feel better so fast. 

Marie:

So fast!

Sara:

Like you said, 24 Hours! 

Marie:

24 hours, and, and just for everyone, like you gotta know, I'm like a food lover. I think, you know, in my life I've probably used food in different areas, you know, especially when I was talking about that just hellish landscape for six months, dude, food was a way that I was soothing myself. 

Sara:

Sure. 

Marie:

So I was absolutely putting things in that I was like, maybe not so good. But it's like, mama needs something at this moment. And I will say this, it's, I had a moment after Mark was like, girl, you need to do – he didn't say, this is my vernacular but it was like – you need to be on AIP for the next few weeks. And then we hung up our call and like I went to look it up and I will tell you immediately, Sara, I felt stressed. Like, I was like, oh gosh. Oh boy. Like I had the whole list of all of the social engagements and you know, all the things that I had to do. I'm like, oh s**t, now I gotta figure this out now. Right now. But after I got through that little momentary oh, shitness and was like, everything is figureoutable. You wrote the book on it. Get your, get your ass in the game. I was like, this is actually, it can be easy. Yes. If I keep it simple, it can be easy. 

Sara:

It is figureoutable and I love your book! I feel like the misery of reacting to foods is so much worse than the oh s**t-ness of like stepping into following a protocol like this.  

Marie:

Just for a few weeks. And it's not something– 

Sara:

Just for a few weeks! 

Marie:

Just for a few weeks. It's nothing that necessarily, right? One would be on forever. But for me, it almost felt like a clearing of the cache. 

Sara:

Yes. 

Marie:

Like, it felt like an ability to, you know, if your computer is just, you know, you got this spiral of death, nothing is working, everything is not connecting. And you're like, you know what, maybe if I just turn it off for a moment and let it sit and let everything just calm down, then we can step away and we can come back in and go, okay, what's gonna be best moving forward? And that's what it's been feeling like for me. 

Sara:

Yeah. So I would add a couple things if I may. 

Marie:

Yeah, of course! 

Sara:

So, this issue of leaky gut and food reactions, what happens is you tend to react especially to proteins. So for instance, when I-I went on a smoothie bender where I was having a smoothie every day and I was drinking pea protein and I started to have a reaction to it. So when your immune system is primed and you've got increased intestinal permeability, it's often specific proteins that you're reacting to. 

So what we know with elimination diets, and they're well studied in a multiple, trials, looking at, uh, rheumatoid arthritis and some other conditions, we know that you need a certain length of time that you're on it. And here I'm gonna disagree with Mark, I think absolutely. Because you benefited so much. I would say he may have told you at the beginning, let's do it for two weeks. But once he got you hooked and feeling better, I imagine he's gonna say, let's go a little bit longer. 

Marie:

He might! He definitely might. Yep.  

Sara:

Yeah. So, the other piece is it's not just an elimination diet, it's an elimination provocation diet. And so a really critical part is that when you agree to end it and start to add food back, you wanna do that in such a slow and methodical way. Because as you said, you cleared the cache. You don't wanna just like throw in all the garbage again. You want to add back, I mean, the way I do it is pretty careful, and I take your hand in this book to guide you through it, but I like to add back cooked tomatoes first. 

Marie:

Mm-Hmm. 

Sara:

And then, see what happens over the next four days. See what happens in terms of gastrointestinal symptoms, mood, bloating, anything along those lines, pain. And then after four days, I add back raw tomatoes. And so I'm doing things really slowly and methodically. Eggs are another really common culprit. And so, you know, I-I add back egg yolks first and then watch for four days and then egg whites. So I think it's important to realize it's not just an elimination diet. You also wanna do the provocation so then you can see what are the foods that you're reacting to. 

Marie:

I love this. And I feel like there's also a meta message in what you're sharing about this, the slowing down. 

Sara:

Yeah. 

Marie:

And the intentionality and the patience, which is something in our culture in general that I think we've been trained away from. 

Sara:

Yes. 

Marie:

You know, with technology, the pace of modern life, you know, all of our expectations, we order something on Amazon, why isn't it here yesterday? You know, so we've just kind of gotten into, many of us, a cycle of quick, quick, quick, quick, quick. And what I love about your emphasis on the reintroduction, the re-challenging and to do it so intentionally and so slowly so that you're gaining the wisdom that you need– 

Sara:

Gaining the wisdom, gaining the data. 

Marie:

Yeah. 

Sara:

Because the medicine I was taught is medicine for the average. 

Marie:

Mm-Hmm. 

Sara:

It's based on mostly randomized trials. Observational studies. Like, is hormone therapy good? Yes or no? It's based on, not the individual, but on the entire population. And when you do something like an elimination diet, you are discovering the truth of your individuality. It is what I call an n-of-one experiment. And I was also taught when I went to Harvard Medical School that the highest form of evidence is the n-of-one experiment. 

So noticing, for instance, what happens to your heart rate variability when you don't drink alcohol for two weeks, or noticing what happens to your system, to your gut health, maybe to your readiness score with the Oura to your daytime stress when you're on an elimination diet. And I agree that people need to slow down. And it's a good reminder for myself too. The other thing that I see a lot as a clinician is that people get the f**k-its and they're just like, oh my God, I've been on this elimination diet for three weeks, or, you know, a month and I just can't take it another second. My kids want pizza. I want pizza. And they eat the pizza and the pizza, you know, all of a sudden is exposing them to gluten and dairy and tomatoes, maybe some other things. And so I just wanna caution people to not get the f**k-its like to notice when you have those thoughts. 

Marie:

Yes. 

Sara:

And to, to slow it down, to keep it to one reintroduction at a time. 

Marie:

Yeah. It's really, really important. And I feel like, it's also just a great reminder, a lesson in terms of our own ability. I'll speak for myself to be really caring and, and disciplined. And I say that in the highest form of the word disciplined, not about being perfect and not about being hard on myself, but really adhering to something that I know intuitively is gonna help me heal. 

Sara:

Yes. 

Marie:

And is gonna get me on the path that I most want, which is to be my strongest, most powerful, most whole self. 

Sara:

Can I add one quick thing onto that? 

Marie:

Yes, of course. 

Sara:

So I love, love, love this concept of discipline. The other thing it evokes for me is integrity. 

Marie:

Yes. 

Sara:

Like, it creates this sloop of integrity where you say, okay, I'm gonna follow this elimination diet. I'm gonna do it for three weeks. I'm gonna be strict about it, even though I've got all these social engagements. I'm gonna make it happen. I'm gonna add food back one at a time. Notice for four days what happens that creates this integrity where you do what you say you're gonna do, you commit to your own healing, your own healing states of consciousness, and then you follow through on it. 

Marie:

Yes. 

Sara:

That's so critical! 

Marie:

Yeah, it is. And you know, it was funny 'cause yesterday, an invitation came in for dear friends, um, of ours, and they're like, oh, we heard you guys are coming out this weekend. Come over, we're having a dinner party. And I had a pause there for a moment because I never wanna be that pain in the a** friend to who's like showing up to someone else's dinner party where I know how much it takes. You know what I mean? To prepare a whole event for a bunch of people. And I text back, I said, Hey, I really wanna say yes, and here's what's happening for me. I'm happy to bring my own food. You know what I mean, to not be– to make your life even more hectic. And they were so sweet. They're like, Hey, this is actually what we have on the menu. What works for you? And then we'll make some other, I was just like, thank you so much. But I think it's those kind of things that if you don't speak up and just express yourself, it could lead you to the fu**-its faster.

Sara:

That's right. 

Marie:

Where there's so many creative ways to be able to, again, stay in integrity with yourself and still have a full life and still be on this ha this path to healing. So I love, one of my favorite parts of the book is stretching out into some, what we'll call their becoming more conventional, but historically unconventional treatments in terms of ketamine and psilocybin and, um, MDMA and all of the kind of plant medicines and, and some not plant-based that can assist us in these healing states of consciousness. What led you on this path and, and what have you seen? I know for myself, you know, microdosing, psilocybin, and, I've definitely, like I said in my earlier days, this was not in a therapeutic sense. This is like Marie running around with glow sticks and clubs. Do you know what, like that, that's what was going on in those days. And they were– 

Sara:

Are there videos? 

Marie:

I wish, you know, it was like pre, it was pre iPhone. Do you know what I mean? Actually, I wish, and I'm like super grateful. But let's talk about that because in this notion of healing our trauma and, and again, of, of looking towards, healing states of consciousness, we have so many more opportunities now than, than we did years ago. 

Sara:

Yeah. Healing states of consciousness. There's so many ways in which I think is the first imitation. You know, there are some people who, are more like the way I was before I turned 50. I was kind of square, Marie. I wasn't running around in college like I was in the library. And I never took, I didn't smoke pot, I didn't take any psychedelics at all. But when I turned 50 and I had this conflict with a family member, and I had that moment of, oh my gosh, if I could heal this, if I could heal this relationship, if I could heal the trauma and the way it drives my behavior and my reactivity, I'm gonna do this by any means possible. And that was juxtaposed with some of the early data on MDMA assisted therapy. So I would say out of all of these medicines that we're talking about, MDMA is the most proven in the context of being used as therapy. So there was a randomized trial that was published in 2021 showing that, with people with severe post-traumatic stress disorder, about two thirds of them no longer met criteria for PTSD once they did two to three, sessions of MDMA assisted therapy. That is like revolutionary because it's– 

Marie: 

Yeah. 

Sara:

Nothing works like that does. 

Marie:

Right. 

Sara:

I mean, if you look at the literature like I did on talk therapy, even trauma informed therapy and, the gold standard right now, which is usually talk therapy plus minus a selective serotonin reuptake inhibitor, the effectiveness is like 30%. 

Marie:

Which is not good. 

Sara:

It's not good. I mean, if I were told in my twenties that the next few decades of talk therapy, which, you know, people do at great expense and it takes a ton of time, if I was told that the efficacy was 30%, I don't think I would've done it. 

Marie: 

Yeah, no, it's not promising. 

Sara:

It's not promising. And that, you know, the, I think it's important to realize that I don't think people get full informed consent. Once again, the part of the brain that's related to understanding and talking about your trauma is different than the part of the brain that's involved in resolving it. And so we have to figure out how to get to the resolution. And it seems that psychedelic medicine, MDMA assisted therapy with an efficacy of 67% and the latest randomized trial is 71% resolution of symptoms. It's more than double as effective. 

Marie:

Yeah. 

Sara:

So there was another randomized trial published in 2023 this time in a more diverse patient population. So 50% non-white, and they found that 71% resolved their symptoms of PTSD. So this is one of the most effective trauma therapies. It's probably gonna get FDA approved sometime in the next year. That's what we hope. And then it's gonna be available to more people. 

Marie:

I hope so, because that was like the big thing, you know, it's like where do you find the safe stuff? You know? And I remember again, back in the day, we didn't– I'm talking back to my club days, you know what I mean? Like, this is back in the world where it, it wasn't, we didn't have these, um, fears about things kind of off the street with fentanyl and all this stuff. And so now, in terms of anyone watching this and we have a global audience, would you recommend, is it first important for people to just start talking to their doctors or talking to their friends and just kind of taking that figure outable approach to finding a good provider? 

Sara:

That's where you start. 

Marie:

Yeah. 

Sara:

You know, I think word of mouth is really critical. 

Marie:

Yeah. 

Sara:

You can also join a research program and so many universities now around the world.  

Marie:

Oh, what a great idea. Yes. 

Sara:

Offer, psychedelic assisted therapy in a research context. So Johns Hopkins was one of the first, and NYU has a great program. I'm in San Francisco at UCSF, where we recruited Robin Carhart Harris, who's, you know, kind of the founder of the default mode network and some of the ways that psychedelics can act. So I would say first go to a research based program. Once it becomes FDA approved in the US you'll have a wider swath of clinicians that you can go to. 

There's this whole underground too, which of course is probably worth mentioning. 

Marie: 

Yeah. 

Sara:

You know, there's some countries where it's legal. There's places like, you can go to Amsterdam, you can go to Costa Rica and take psilocybin. You can go to places like Portugal and have an experience. But, there's this above ground scene, which I'm part of. So I'm, I've got like three certifications in psychedelic medicine, and there's a lot of licensed therapists who've gone through, for instance, the maps training and are ready and poised to do MDMA assisted therapy. And then there's the vast underground and there's this whole indigenous culture and history of using plant medicines for healing states of consciousness. So I can't speak as much to the underground, because I'm a licensed physician, but it certainly exists. 

Marie:

Let's talk macro dosing versus microdosing. One of the things that I was, discovering lately, and it was just one thing that I read, so I'm curious to hear your perspective on it, but that in terms of microdosing and taking these very tiny doses of, particular medicine, that the goal is actually not to feel anything. 

Sara:

That's right. 

Marie:

Yeah. Can you unpack that a little bit more? Because that was actually news to me. And I, again, I think because my history was in the recreation zone and I hadn't understood like, oh, great. What are all of these other ways in that aren't, again, me running around with glow sticks. Um, let's talk about microdosing and, and, and what that can potentially look like in any experience that you've had with your patients. 

Sara:

So microdosing is super interesting. There's not a ton of research on it, but what I could found, find, I put in the book, the idea with microdosing is that you're taking what's called a sub perceptible level of the plant or a medicine. So the most data that we have is with psilocybin, with magic mushrooms, microdosing, and also with LSD. So, which, you know, uh, depending on your state, you may or may not be able to get access to psilocybin. So Colorado and,  Oregon are the ones who are kind of leading the charge here. And also the, uh, city of Oakland in California has decriminalized psilocybin. 

So what are we talking about here? We're talking about small doses of what I think of as immunomodulating doses. So they're not enough to trigger the serotonin receptor, the 5-HD2A and create hallucinations and visualizations, but it's a lower dose that kind of makes you feel what you can describe how you feel on it. I feel sort of, sparkly and creative when I do microdosing and like you can see with my Oura Ring, I'm much more likely to be relaxed and restored. 

Marie:

Mm-Hmm. 

Sara:

And it's, it's a little harder to get me to be reactive and stressed. 

Marie:

That was actually the big thing for me was, the experience of, of, of it was so subtle and that's like, oh, this is great. It was the potential to get frustrated, angry or impatient felt it was like so far away and everything else was completely as I know it, but it was just, there was a heart opening and a sense of spaciousness and patience again, and less reactivity that I was like, that is fascinating. 

Sara:

Yeah. So you're pioneering and you know, we're still in the early stages of understanding what is a microdose? Is it one tenth of the normal dose? Like how much is the right amount? 

Marie:

Mm-Hmm. 

Sara:

I'm someone who needs heroic levels of some of these medicines. So I-I typically to have my first experience with psilocybin, I needed seven grams. That is a huge amount of, mushrooms, that's dried mushrooms. And so when I'm microdosing I'm taking more like a hundred milligrams. It's a really small amount. 

Marie:

So let's talk now about some of the somatic healing. So MINDBODY therapies, Hakomi, did I pronounce that right? 

Sara:

Yes. 

Marie:

Yes. Talk to us about Hakomi. 'cause that is something I had never, been exposed to before or neuro emotional technique. 

Sara:

So with, I've gone through the level one certification, it is a somatic based mindfulness approach to self inquiry. And it's a really extraordinary way of, you know, not staying cognitive. I'm hyper cognitive. And so it allows me to really come downstairs and kind of develop this introception that we're talking about, the sense of what's going on in your body. It's designed to look for missing nourishment that you might have from childhood or maybe from recent experiences. It's not specifically a trauma informed way of taking care of patients, but it's, it's a form of therapy that I find to be just brilliant. It's systems based. 

Marie:

What does that mean? 

Sara:

Meaning that it's, you know, when you think of like cognitive behavioral therapy, it's designed to look at some of these hooks that you have with the way that you think and to kind of unhook and maybe broaden the perspective. Whereas Hakomi is much more about how you feel. It's not really about how you think. 

Marie:

Interesting. 

Sara:

And if anything, it tries to get you to come downstairs and think less and just dwell in your body and talk about it from that place. 

Marie:

And so, Neuro Emotional Technique.

Sara:

Neuro Emotional Technique is really interesting. It's something that we study at Thomas Jefferson University in Philadelphia, and it's a, it's a combination of traditional Chinese medicine and, kind of these cues that the therapist uses. I haven't learned how to do it. I've seen it, demonstrated a lot of times. I, the chairman of the department has, done it with me. I went through a very difficult divorce last year, and he did a lot of neuro emotional technique with me, which I found so helpful. 

And it was developed originally by a chiropractor. So it's a, it's what I think of as an integrative treatment. And it's been well proven in a number of studies that we've done at Thomas Jefferson to affect the parts of the brain that are involved in trauma, especially the cerebellum, the brainstem. And, with brain imaging, we've seen how people recover. A lot of the studies that we've done with the Neuro Emotional Technique, I wasn't part of them, but, the ones that Dr. Dan Monti, the chair has done,  look at people who've are cancer survivors who have, you know, significant trauma associated with that process and Neuro Emotional Technique really allowed them to find freedom and release from the trauma they experienced. 

Marie:

That's incredible. You know, for folks watching who might be in a position right now who are suspecting that there are things that are changing within them, right? And we've talked about so many, and again, your book is so beautifully comprehensive. We couldn't even peel into, you know, a fraction of the kind of prescriptive how-tos and resources that are in the book. But for someone watching right now who's like, where do I get started? And I just wanna preface this with in my own little journey, I was talking about my experience with my family, you know, wanting to put my head through the wall with traditional medicine. And I even had a experience recently with a, you know, primary care doc, right? So most of us have, or some of us, I should say, have multiple providers for different things. And when I started to express what was happening for me gastro wise, the first thing that came through was a prescription to address the stomach cramps. And I was like, mm-hmm. I need to get, and again, it was like me going, like. So for someone listening, watching, what would be the first step? Where should they start to peel into this work? What's like the easiest, the least expensive, the, the place to go? Especially if, if for me, I've often felt mistrustful of traditional medicine and, felt like I didn't know who I could trust. And there's so many different things out there to pay attention to and people to ask. 

Sara:

The place to start is to measure your trauma, first of all. So I think knowing your ACE score is really critical. There are some people who have more adult events, like you had this experience last year, but you have a sense of how that was dysregulating for you. So I think start with an inventory, see where you are in terms of toxic stress and trauma. Number two, I love wearables. I think wearables, you can't lie. And yes, there's the risk of becoming somewhat obsessive about them, but I would say overall, and I imagine this is probably true for you, there's more benefit than harm in terms of having this objective mirror that tells you what's going on with your physiology. 

So what we're looking for there is dysregulation. Do you have trauma, toxic stress? Do you then as a result, have this signature of trauma living on in your body that's related to dysregulation? And then it depends on what sort of symptoms you have. You know, for some people it might be just that their cortisol is screwed up, so let's do a cortisol test, or maybe your gut is messed up, so let's do a gut test. I like to look at the microbiome. There's lots of different ways that we can do that. So I think it depends on your particular vulnerabilities, whether that's gut or endocrine or immune or your nervous system, and be guided by what your wearables tell you. 

Marie:

Anything else that you want people to take away? Obviously we hope that they get The Autoimmune Cure. It's a brilliant, brilliant book. But anything else that you wanna leave people with today? 

Sara:

Well, I think, you know, we were talking about this in the context of the elimination diet, that the misery of food reactions and your gut, you know, not functioning the way that that it's meant to is so much worse than fixing it with something like a food first approach. But I would say it's even broader than that. So let's, you know, let's make this larger. The misery of having toxic stress live on in your body, whether you recognize it or not, is so much worse than the steps that you can take to address it, to become regulated again. And to, you know, once you feel that regulation, like I feel so regulated hanging out with you, I feel co-regulate. I felt that the first time I met you like 15 plus years ago. And once you feel that regulation, there's no going back, there's no going back. You just, you can't have the difficult relationship anymore. You can't have the fight with your spouse. There's no going back. And that's what we want. That's what I want for our listeners and followers.

Marie:
Sarah, thank you so much for your decades and decades of dedication to helping us feel our best and be our best. Your new book is brilliant, and I adore you and I-I can't wait to have more and more decades together. 

Sara:

Thanks, Marie. 

Marie:

Oh my goodness. Sara is amazing. I hope you felt so too. If you liked this video or any of our videos, hit that subscribe button right now. Thank you so much for tuning in. And until next time, stay on your game and keep going for your big dreams, because the world really does need that very special gift that only you have.