Full Transcript on Limbic System Retraining Interview
Ashok: Thank you so much for inviting me. Very excited to be here.
Dr. Hedberg: Yeah. So, the limbic system is something that I’ve been interested in since I started practicing 17 years ago, and you know, I have a variety of recommendations that I give to patients for that. You know, things like meditation, mindfulness training, therapy, or just a number of things, but your particular limbic system-intensive program, I heard about it recently and became very interested in it. And why don’t we begin by talking about just the limbic system itself? Can you give people kind of an overview of what the limbic system does and why it’s important?
Ashok: Yes. So, there are many different ways of describing the limbic system. I think primarily if we start with this idea of it being a defensive system to ensure survival, right? So, most people would associate the limbic system with our emotional responses and medicine often separates the kind of psychology and the emotional responses from defense responses as if they’re something different, you know, physiological defense responses versus emotional defense responses. But I see the limbic system as the automatic survival systems that we’ve inherited over generations of different animals and whatever that actually create responses that ensure survival. And so, a fight or flight response, a fear response, an anger response, a memory of a previous experience, all of these things are designed to ensure survival. So, that is for me the primary motive or motivation of that limbic system. And within that limbic system, there are different structures that play specific roles. And a lot of our research focuses on the amygdala, which are two almond-shaped structures that sit behind our eyes that essentially are taking all the incoming information from the outer world and the inner world, process it according to the previous experiences we’ve had in life, our memories, and then creates a coordinated response across the brain to ensure survival, yeah? And one way to look at this Dr. Hedberg, which I find fascinating is to ask the biggest question of all, you know, why are we here? And we can answer that question from a philosophical perspective, but from a scientific perspective, we’re here because over so many generations over millions of years, this nervous system that we’ve inherited, this immune system has adapted to the environment to ensure survival, which is ultimately culminated in this nervous system, this brain, and this limbic system that knows how to identify threats and ensure survival so we pass on our genes to the next generation.
Dr. Hedberg: Right. And let’s talk a little bit about how that gets out of balance. I’ve done a few podcasts talking to guests about adverse childhood experiences and how to overcome trauma and things like that. So, it just seems like, I mean, pretty much any kind of trauma input into the system, whether you’re young or an adult could potentially cause imbalances in the limbic system. So, can you talk about all the potential things that can happen to someone that can cause an imbalance in their limbic system?
Ashok: Yes. It’s fascinating. And it’s great that you’re incorporating that as part of your integrative approach because it’s so important. The way we look at it is the combination of nurture and nature. So, we know that there can be, and it’s a fascinating area, inherited trauma that can actually be passed on through our genes, and then even experiences within the womb can impact on how reactive our amygdalas are, right? So, research has shown that if a mother is having a particularly stressful pregnancy, that can impact on the stress of the child moving forward. The actual experience of childbirth can impact on the limbic system, and then obviously, adverse childhood experiences. So, that might be bullying, abuse, physical or emotional abuse, even sexual abuse, all of these things impact on what we call the factory setting of the amygdala. So, we have the factory setting when we’re born and then it keeps adapting and changing according to those adverse childhood experiences. And then even during teenage years, that can be impacted. Then during our adult lives, we have that genetic and nurture inheritance that then impacts on our reactivity to the world around us. And that is why those adverse childhood experiences can impact on our mental, physical, and emotional health. Now, I think it’s well-documented that our emotional health can be impacted, but the processes on how our physical health is impacted is what we focus here on in terms of our research. And as I said earlier, if we go back to this idea that our brains don’t differentiate between emotional, physical, chemical, or biological threats, the brain simply asks the question, “How do I survive?” So, if we’ve had adverse childhood experiences, which make our brains more defensive, then when we then are exposed to physical dangers, the brain becomes hyper-reactive and hyper-responsive, which then can lead on to so many different chronic illnesses that we experience, you know, in the surgery.
Dr. Hedberg: Right. Right. And one of the things that we’ll see, and I’m sure you see as well is the people who they seem to be doing everything right. You know, they’re sleeping well, exercise, eating well. They’re just doing a lot of the things that one would expect to achieve good health, but they’re just still not feeling well. And so, I think this is one of the areas that is just really the sticking point for a lot of people with chronic illness, the limbic system is out of balance and it’s just not able to recover. So, what are some of the symptoms or conditions that would make someone think they potentially have an imbalanced limbic system?
Ashok: Yes. We collectively call these conditions neuroimmune condition syndromes or NICs. And generally, as you say, someone’s resting, they’re having a good lifestyle, but still, there seems to be, you know, a low level of functioning or continuing background illness or severe illness. And we believe, yes, it’s an imbalance not only in the limbic system, but also, especially in the insular. Now, the insular cortex kind of sits between the kind of limbic system and the cortex. So, it’s more a part of the cortex than the limbic system. And the insular is where we also believe a lot of the imbalances lie. So, it’s not purely in the limbic system in our research. And if I can just describe to you an overview of the hypothesis and that will help then your listeners to kind of understand how it impacts on chronic illness. So, let’s take the example of flu virus or, in fact, even COVID-19, which are obviously in the news right now. If somebody has, let’s say a lot of ACEs or a lot of adverse childhood experiences or is going through a lot of stress, we know that stress reduces the effectiveness of the immune system. And then let’s say they have the flu virus, the brain is prioritizing survival. So, it thinks, okay, we’ve got to now overcome this flu virus. This is potentially life-threatening or COVID-19. And the brain and the nervous system and the immune system coordinate to facilitate that, to overcome this virus and rid it from the body. But if there is a compromised immune system, then that whole system takes a lot longer to fight off that virus. And there comes a point at which the brain becomes traumatized. The amygdala, the insular, the anterior cingulate become traumatized in this response, like a physiological traumatic response where the body says, actually, we don’t seem to be fully and effectively fighting off this virus. We must now go into an overdrive as it were and keep stimulating the nervous system and the immune system to anything that reminds us of the original sensitizing event.
So, the brain keeps overstimulating immune responses and nervous system responses, and it learns that. So, that’s a neurological conditioning in the brain. And even once someone recovers from flu or COVID-19, it’s left a legacy in the brain. The brain has now learned that anything that reminds it of the original infection indicates danger and potentially death. So, even once the virus is gone, the brain makes a logical decision that we must err on the side of caution and keep overstimulating these responses like a conditioned response. And we believe that that is what keeps a lot of people in a chronic state of illness. And this includes things like ME, chronic fatigue syndrome, post-COVID long-haul that we’re getting many people coming to our clinic for, fibromyalgia, fibromyalgia often occurs after a car accident or a localized pain syndrome that generalizes to the entire body. Then chemical sensitivities and mold sensitivities often trains the limbic system and the insular following exposure to a traumatic event or a stressful event. And then lots of other conditions like POTS and Lyme. All of these conditions we believe is due to a traumatic conditioning event in the amygdala and the insular. So, that’s how we see all these conditions fitting together. And once this occurs, then the brain overstimulates, create symptoms in the body, those symptoms double back to the brain, the highly sensitized, highly hypervigilant brain, the brain thinks, “I knew it. I knew we were in danger, let me re-stimulate protective responses so then it re-stimulates aspects of the immune system and the nervous system.” Which create all the symptoms in the body, which double back to the brain, and we get caught in a vicious cycle. So, even if somebody is resting on a beautiful beach in the middle of nowhere and has no stress, it doesn’t matter because the input and the output of the system have become locked together. The brain and the body are simply playing a game of tennis, constantly reacting to each other, and creating a self-sustaining illness model.
Dr. Hedberg: It’s like a bug in the operating system. And we’re getting into the realm of the psychoneuroimmunology research, and I’m seeing a lot of not just the conditions you mentioned, but also related to chronic gut issues like SIBO, irritable bowel syndrome, inflammatory bowel, things like that. And there’s such a strong connection between the gut and the brain, and that axis is going to be influenced by the limbic system. And then you have issues with the vagus nerve as well. You have loss of vagal tone. And the vagus nerve is, of course, very important for digestion, absorption, assimilation. Do you have anything you wanted to add there about the gut, the brain, and the limbic system?
Ashok: Yes. So, we successfully also treat many of these inflammatory conditions related to the gut. And the amygdala is directly sending messages to the gut via the periaqueductal gray, via the parabrachial nucleus. There’s a constant communication between the limbic system and the gut. And so, when the brain is in this hyper traumatized state, it will stimulate the small brain as we call it, obviously, in the gut, creating tightness in the muscles, lack of digestion, imbalance in good and bad bacteria, and overgrowth of bad bacteria, which can then cause a lot of these inflammatory diseases, which then become their own vicious cycle. And people can do a lot of great things, and we support people changing diet, taking supplements, medications, etc., to try and to reduce that. It’s not an either/or. But to really get to the core, it’s going to, why is the brain stuck in this vicious cycle? Why does it keep stimulating the gut unnecessarily? Getting to the root cause of this. And we find that when people engage in brain retraining, naturally the gut comes back to its natural balance as it were.
Dr. Hedberg: Right. Right. I mean, we’ll see you know, about two-thirds of people with SIBO end up relapsing and a lot of times it’s because of some of the reasons you’ve mentioned. So, now, one of the reasons I wanted to have you on was to talk about the science and the research behind what you’re doing. And so, this recent paper that you were involved in, so the title for the listeners is “Mindfulness-Based Program Plus Amygdala and Insula Retraining for the Treatment of Women with Fibromyalgia: A Pilot Randomized Controlled Trial.” This was published in the “Journal of Clinical Medicine.” And it’s really important that we have evidence-based medicine, and that’s why this paper is so important. So, can you just give us some basic overview of this paper that you published?
Ashok: Yes. So, we’re very excited to have published this, and hopefully, it will lead on to more research that we’d love to do because it’s so important for us to have evidence behind what we’re doing. So, in this study, we took 45 women with fibromyalgia and split them and randomized to two groups. One received relaxation techniques for eight weeks and the other group received The Gupta Program for eight weeks. And we measured them obviously at baseline. These were all patients who had a confirmed diagnosis of fibromyalgia. And we found that just after an eight-week intervention, now bearing in mind The Gupta Program is a minimum six-month intervention that we encourage patients to engage in, but simply after an eight-week intervention in the control group, there was no change in the fibromyalgia scores. But in The Gupta Program group, there was close to a 40% reduction in fibro scores with many patients, you know, going back to full-time work and feeling, you know, fully well. And there was a halving of pain catastrophizing, a 50% increase in perceived health with only 16% in the control group, and also a halving of anxiety and depression. And we believe that had this been a six-month trial, the results would have been, you know, even more magnified and even better. But as a pilot study, this really is a groundbreaking result because there’s nothing out there that we’ve seen that could have a 40% drop in fibro scores within 8 weeks. You know, this really is you know, a groundbreaking result and it’s been published obviously in a highly respected journal as well.
So, we’re very excited to have this and not only did we measure subjective outcomes, but we measured some objective outcomes. So, there was a statistically significant reduction in inflammatory markers. But it wasn’t, sorry, it wasn’t statistically significant enough to be put in the paper. But what we did have was a reduction in BDNF. Now brain-derived neurotrophic factor is often raised in fibromyalgia, but in our group, The Gupta Program group that reduced towards normalized levels. So, there were some objective markers supporting the research. And you know, this has given great hope to patients with fibromyalgia, but also ME/CFS that there is a way through. And now, we have at least some evidence behind it. Obviously, what we’d love to do is a Phase 3 trial with hundreds of patients randomized and really show the power and effectiveness of these types of approaches for illnesses which are very difficult to treat normally.
Dr. Hedberg: I was impressed with the drop in brain-derived neurotrophic factor because that’s a real driver of plasticity and that’s one of the most difficult things to reverse. So, it makes sense when you look at the limbic retraining and classic fibromyalgia with it, it’s because it’s characterized by an issue with the central nervous system and central allodynia and things like that, that we would get the change there. So, this is excellent to have this published. Is there anything else that you wanted to mention about the study? I don’t wanna get into too much, you know, technical detail there.
Ashok: I think that just as a background, we did publish a clinical audit on our patients in 2010. So, that was a separate study which was published many years ago. And that showed that after a year intervention, 92% of patients improved and two-thirds of patients reached an 80% to 100% recovery after 1 year. And the mean number of years of illness was 10.5 years. So, that is published on our website as well. So, there are other pieces of research that we’ve done, but this is in our view or our experience, the first randomized controlled trial ever published on a neuroplasticity, limbic-brain retraining type program. And really, you know, medicine can often move quite slowly, but we hope that this publication is really going to raise eyebrows in the mainstream professions because it’s so important. You know, medicine is very good at treating a human being as if they are like a car or let’s take the example of a computer, right? So, if there’s something wrong with a hard drive, they can open up the hard drive and fix the hard drive, right? But there are a whole new generation of illnesses, which are what we call software illnesses. The hardware is absolutely fine. It’s the software that is running the hardware, where there is a bug, like you said. And those bugs in the system are very difficult to shift and change once the system has got to its new layer of homeostasis or its new way of functioning that it thinks ensure survival. And this new generation of modern illnesses can only really be approached through these software approaches.
I believe that, you know, drugs and change in diet can be supportive, but they never really get to the root cause, which is why people, you know, stay chronically ill for so many years. So, we’re really hoping that this study stimulates further research. We’re actively now going out there and looking for partners who’d like to collaborate on a Phase 3 trial, and this is of the good for everybody, really to have this. And we’re not looking to hold onto the IP, the intellectual property of this. We’re not like this is The Gupta Program, and we only want to be the people who do this. We just want to get this out there. We just want to get patients better. So, if we get a larger scale trial and people, you know, really appreciate that this is the best intervention out there, we just want to train up other people, other practitioners, other CBT practitioners, or occupational therapists, or you know, physiologists to deliver this type of treatment and, you know, support the recovery of as many patients as possible. We want this to be embedded within existing healthcare systems once we get that Phase 3 trial. That’s really our aim.
Dr. Hedberg: So, a lot of people may be wondering, you know, what is involved in this program, in The Gupta Program, the mindfulness-based program, limbic retraining? Can you give people just kind of a basic overview of what this might look like for someone? You said, you know, it’s like a six-month commitment, there’s work to do on a daily basis. Can you give us some more insights into the method?
Ashok: Yes. So, in terms of time commitment, we say it’s a minimum of 30 minutes a day in terms of commitment in one sitting, and then there’s brain retraining techniques that occur throughout the day. And people can use it even if they’re in full-time employment right through to being bed-bound. You know, we have patients across that whole scale. And so, we make it as easy to implement as possible. And the program has three core areas and we describe it like a dove learning to fly. So, for a dove learning to fly, it needs two wings and it needs the tail feathers. So, the two wings that really ensure recovery, number one is retraining. So, the core is having one wing, which is retraining the brain out of these reactive responses. The second wing is relaxing the nervous system. So, we need to bring down the overall stimulation of the nervous system, and as you’ve mentioned, vagal tone is a very important part of this. And then thirdly, the tail feathers represent a direction. And we call that re-engaging with joy, which is often missed in, you know, modern medicine. You know, it reminds me of the film “Patch Adams,” you know, the idea that actually, state of mind and joy is an incredible part of healing. And when we’re unwell, we often focus on being unwell rather than re-engaging with the small joys in life that can support healing. So, those are the kind of tail feathers. So, the first part, retraining the brain, we help a patient understand and become aware of what those little signals are from the limbic system that indicate danger. And normally, we’re not aware of those, they’re on the periphery of our consciousness, but when we tune into what those messages are, we’re then able to bring it to awareness and retrain it.
And that…it’s not a psychological process, it is a brain retraining process. And it reminds me of when they talk about patients’ phantom limb syndrome, where people may have had a limb amputated, but the brain still thinks that limb’s still there and they still get pain signals from a part of their body that doesn’t exist. So, gradually, through brain retraining, people are able to reset those processes. And so, in the same way, we are resetting the brain back to its original state before the conditioning occurred. So, that’s the brain retraining aspect, and that involves lots of different specialized techniques. The supporting techniques are relaxing the nervous system. So, those are the things you’ve already mentioned, like meditation, breathing techniques, a good sleep regime, and we give lots of tips on sleep, having a good diet, anti-inflammatory diet and anti-inflammatory supplements, getting into nature, the importance of sunlight. All of those things are encapsulated within relaxing the nervous system. And then thirdly, re-engaging with joy. As I’ve mentioned, we help the patient understand that don’t wait to be happy once you’re well, learn and understand how you can actually boost your immune system through shifts in state of mind and mindset right now, here in this moment, despite all these symptoms you’re experiencing, and that will support your healing. So, it’s that idea of there’s no path to joy, joy is the path. But the core of it, as I said, is the brain retraining that often for most patients is, you know, enough to start the healing process and getting their body well.
Dr. Hedberg: It’s so interesting that you brought up re-accessing joy because that’s something that, you know, with all the great things that conventional medicine does and I would say even functional medicine, that’s something that is just not a part of it. And I think also at the same time, I think it’s too much to ask of say, you know, a functional medicine or a conventional physician to be able to incorporate all of that into their practice as well. It’s almost you start to get into the realm of, say, life coaching and things like that. So, it really does take a truly integrative approach to helping someone get well when they have these issues. And so, I’m really glad you brought that up and I hope the listeners think about that a little bit more, because like you said, when you’re sick, when you’re not feeling well, it is very hard to focus on joy, but you just have to find those things in life that bring you joy.
Ashok: Yes. And it’s about this new approach that we’re all taking now, which is healing the person, not the disease. And it does unfortunately require a bit more time with the patients, a bit more awareness, really tuning in and listening in to what’s going on in their lives. And so, we provide a lot of stress management techniques and how to deal with difficult relationships or how to deal with our inner trauma that we may be experiencing, how to deal with aspects of our personality that may be impacting our ability to go back to work. So, 50% of our program is, you know, learning how to retrain the brain and get back to normal health. And 50% is how are you going to get back to work and back to normal life and stay well, how are you going to stop yourself from going back into those stress reactions, which may re-trigger some of these physiological responses, these traumatized responses? And so, that is an integration of treating the person, their lifestyle, their personality, the way that they interact with people and situations in their lives, all of that needs to be looked at. Otherwise, any one of those things can re-trigger a relapse. And having that ongoing support, so we have 30 to 40 trained coaches around the world that support The Gupta Program and have one-on-one work with people if required, but the core of our program, we’ve made it into an interactive video program where people get that support, they get that learning, they get webinars with myself. They have a support group of 2,000 to 3,000 people where they can ask questions and see how other people are healing. So, there’s so much support that people require. And I hope that this is the new model for medicine, which is peer support and lots of handholding as someone moves forward along their journey of healing.
Dr. Hedberg: Well, this is really exciting. I’m going to start recommending this program now that we have some published research on it. And so, we have a code and that code is Hedberg, H-E-D-B-E-R-G for the program. And Ashok, what would be the discount with that code?
Ashok: Okay. So, yes your listeners, if they use the code Hedberg, there’ll be a 15% discount on the program. And just to explain how the process works, people can come to our website and sign up for the free trial. So, you don’t even have to have a credit card. You can just go on, watch lots and lots of videos, which would explain what causes these conditions, see if you feel this is right for you. So, there’s no upfront expectation. But once you’ve watched those free videos, how to surf around, you can then decide to buy the full program, and there you’ll get 15 interactive video courses, about 30 audio exercises, and as I mentioned, access to our very busy and supportive forum and webinars with myself as well for 3 months. So, there’s a lot you get there. And until we get the large-scale Phase 3 trial results, we are offering a one-year money-back guarantee on our program, because we know that people often have limited finances and if this doesn’t work for them, we’d like them to spend that money elsewhere. So, people can use it for a minimum of six months, if they get no benefit, then after six months and up to a year, they can return it. No questions asked. Have their money back and spend that on another treatment. So, people have got nothing to lose by giving this a go and see if it can heal whatever they’re experiencing.
Dr. Hedberg: That’s fantastic. So, really nothing to lose to give it a try. And so, the website is guptaprogram.com and use the code Hedberg for 15% off. And Ashok, any final parting thoughts for the listeners?
Ashok: Yes. Something that’s so important for all of us to share is this concept of long-haul COVID. We are seeing a secondary pandemic of so many people that after many weeks, after many months, they’re still not recovering from COVID-19 or, in fact, they’ve recovered from COVID-19, but they’re having post-viral effects because of the heightened anxiety or, you know, the strong impact this virus has on certain patients. And what we’re really looking to do to avoid the secondary pandemic, we have some videos on our websites where we actually, you know, have interviewed people who have long-haul COVID, we’re already treating it at our clinic, is to explain to people once you have COVID-19, please rest during and after the infection. Because if people don’t fully physically, mentally, and emotionally rest, in our view, they have a higher chance of going on to developing long-haul COVID as a result of our hypothesis that I’ve explained. So, if you do know people who have COVID-19 or have had it in the past and are still getting over it, that’s a really important, I suppose, public health message to encourage them to fully rest before they get back to normal life. And then second, if people do have long-haul COVID, we’ve already started healing and treating patients for that at our clinic. So, I think that’s something that we probably all know people who are experiencing COVID-19, but there’s no information out there on how you can make sure it doesn’t turn into something chronic. So, that’s a really, really important message I’d love for people to share.
Dr. Hedberg: Excellent. Well, thanks for tuning in, everyone. This is Dr. Hedberg. If you go to drhedberg.com and search for limbic retraining, you’ll find a full transcript of this interview and links to The Gupta Program. So, take care, everyone. This is Dr. Hedberg, and I will talk to you next time.