This hidden wisdom will change how you treat your body forever | Giulia Enders: Full Interview

0:00 My name is Giulia Enders. I am an author and physician from Germany and I just wrote my second book which is called Organ Speak, what really means to listen to our bodies. Today on Big Think we're going to talk about five body parts, the lung, the immune system, the skin, the muscles and the brain and what each of them can teach us about life. >> Thank you for watching Big Think. If you'd like to support our work, we encourage you to join our members community. As a member, you'll receive our quarterly print magazine, a beautifully designed collection of the ideas and interviews that matter most.

0:35 Big Think is for curious people who want to take deep dives into big ideas. To support the media you want to see in the world, go to bigthink.com/membership. And now back to the interview. Chapter 1, the lung, softness as a superpower. >> After I wrote my first book on the gut, I started working in a hospital and soon realized that I can't only focus on this one organ exclusively. I really need to understand how everything goes together, how different organs influence each other and while doing that, I also noticed that we have a pretty old-fashioned view on our body often times and this wouldn't be so bad if it's just like a common thing and you just go with the flow, but it sometimes really is in the way of us healing, of us, you know, achieving things, of us feeling good in our body and I thought how could you update this? Is there some different way to look at these things?

1:30 So the lung is an organ that is kind of odd when you look at it through societal values because in our Western societies we usually think, oh you have to be really eager, you know, put your elbow out, achieve something, put in more hours, be really tough or something. And then there's this organ, so soft, so passive, just like going along with what the muscles around it do, accommodating everyone, having some dents because of organs just taking up room there. And it's at the central part of our body.

2:01 It's where one of the most important needs is being met, breathing. Without oxygen, we're dead after a few minutes. So, you would think in the beginning, why on earth did our body put body put this like passive plummely lummely organ there that when you just poke a little needle in your thorax, it goes and like shrinks together like old soap foam or something. And the answer is because being soft, being passive, being accommodating isn't necessarily always a weakness. It isn't just something of lower quality compared to like the tough ones. In a body, it is perfect at the place where it's at because without the lung being soft and accommodating, we couldn't take 20,000 breaths a day. We wouldn't have the energy. It would be so hard. For some diseases, this happens.

2:49 Takes us to too much calories to breathe then because it's not so soft and accommodating anymore. And when you look around in your life and society, we oftentimes devalue these softer parts where people arrange around others, really try to make everything happen, are smooth and harmonious sometimes, but often these are also very fundamental important parts of us, all functioning of everything really going well in families, in workplaces, and also in your own life and achieving things. And I've learned this from the lung and now I use it at times.

3:23 The part the lung plays in breathing is an undervalued part in achieving things in general or getting things that you want because, you know, there's three parts really. There's the brain that initiates the movement of breathing in the first place. So, it it'll give like a nervous impulse. And then there's the muscles around the lung that will then act on this impulse and really pull and pull in air. And then this third part is the lungs really being soft, accommodating, and really taking it in and being able to at the same time doing that. And when you look at what we think about achievements, you have this value of impulse, really having a great start idea for a business or something.

4:01 Everyone understands that. And then, of course, we know the concept of hard work, the muscles pulling in what they want, sure. But then, this whole aspect of the lungs and how they're built and how they have a whole architecture of receiving and really dealing with what comes their way. This is a part, I think, of achievement we sometimes do not notice or do not have in our mind. Really being able to receive what you worked so hard for and what you wished for in the first place. And then, when you look at the architecture of the lung, it's all about that. It had built so many structures, so many different like forms and variations just to do that. So, I think there's way more to dive into when it comes to that part of achievements.

4:42 What I think of now sometimes, what I didn't understand back then, was an advice my grandma often gave me. She said when I was being very eager, going like to get something, you know, but tense maybe, she would say "A deutsche a deutsche a mausie." Which was like soft soft. And back then, I always thought it's like this relax, you know? And when you're kind of like tensed up, that's not a great advice to get cuz you usually don't relax then. But when I read about the lungs, I realized I think she meant something entirely different.

5:13 It was that, you know, life can be hard, challenges can be tough. And if we just tense up in reaction towards that, energy doesn't suffice. We really need sometimes to use softness to go all the way. And now, when I have a very stressful day, earlier I would have clenched up and put my muscles into like attack mode and my jaw would maybe get a bit tense, too. But nowadays, in between like meetings or something, I will go really soft and just really relax. And then I realize, oh, this is a way that really makes my energy work for me. And this is how I can go through a long, hectic day way better than just tensing up. So, softness is actually a really important counterpart in, you know, going the extra mile, getting the things you want, softening up in between.

6:00 There's something very unique about our breath, which is that can be regulated by the consciousness and the subconscious parts of our brain. So, when you look at the rest of our inner organs, there's nothing like it, really. You can't tell your kidneys, for example, that they should just not produce urine because you're in a traffic jam. That's not possible, and you can't tell your bowels to just stop digesting cuz something is very exciting at the moment. This is not how it works.

6:26 And also, your heart, when you're nervous, you can't say, "Oh, just slow down." Some monks have trained this ability, but usually it's really not possible to tell your inner organs what to do. But with the breath, suddenly we can say, "Oh, I want to dive, so I'll hold my breath, you know?" Or I'll do these breathing exercises. I'll breathe really slow. Or we can use it for singing different tones in various lengths. And then, when we don't pay attention, it goes back to this mode of the subconscious, where it's just regulated by the things our brains notices, how much oxygen we need, how much we need to exhale. And suddenly, you know, it shifts over to another part of the brain. And this is not only an interesting feature, but it's also a feature that, when you understand it better, you can really use it to your advantage.

7:10 So, the funny thing about our consciousness influencing our breath is that it oftentimes can also be a bit stupid and ineffective, too. Because you would think our consciousness is this great thing that makes humans such a important brilliant species, you know, solving all these problems, being so intelligent and rational. But when it comes to a body and really regulating it well, it's actually not so much better than the subconscious. The subconscious is actually doing a better job. So, oftentimes you will see people when they focus too much on their breathing eagerly or they're being stressed in the workplace, suddenly breathing dysfunctional. So, they will, for example, breathe way too slow way too fast or way too deep or, you know, tensing up their muscles in order to breathe just from their chest cuz they're stressed and this all isn't so effective, healthy, takes up a lot of energy and might lead to people feeling a bit more nervous than they would have to or being a bit dizzy or having like neck pain or headache in the afternoon or becoming really tired in the early afternoon already because of using all that energy. So, that's the negative part of breathing with your consciousness, but then, luckily, there's also a positive part of using your consciousness. And this usually is when our subconscious is not doing so well. When it's getting scared by something or stressed and other factors are taking a toll on it. So, it's becoming like emotional and worried, for example, or gets up in the night because something's bothering it. And then our conscious can actually, for once, take care of the subconscious and really consciously slow the breathing down so that the heart can relax a bit more cuz the heart usually gets a bit hectic when it has to pump around all this freshly oxygenated blood all the time. So, when you breathe slower, this gets a bit of like a more chilled mode. The nerves around the heart will notice. So, then the nerves in the brain will notice and this drives down like stress hormones in the blood and heart rate and all these factors. Sometimes can help with anxiety if you really know how to get in the groove, how to cooperate well. And then sometimes it's times when you're really tired and you want to wake your brain up a little bit and your nervous system and you use the other technique, which is breathing really fast. Some call it espresso technique. So, those are the two ways that it can go. Advantage, disadvantage, more awake, more relaxed.

9:34 And if you know how to play with it, this can come in quite handy at times. The breathing center in our brain gets information from all different areas. And some of them are the conscious ones that can stress it out. And then we breathe unnecessarily fast and deep sometimes, which is called dysfunctional breathing. And about 10% people, probably a little bit more even, breathe like this when they're for example at a stressful job. And it can take a toll on it and can make a stress stressful job that's already stressful even more stressful. So, you might want to check out your inner part of stress and like workload as well because that you can easily fix.

10:14 And when we look at the solutions for this type of dysfunctional breathing, it is learning again to letting the subconscious take over because it's doing a better job and not like annoying your breathing center all the time with these stresses. And you have maybe come across one or two techniques like this because it's also one aspect of meditation, where people will say, "Just sit down and observe your breath." And it's quite hard to just observe it and not try to consciously regulate while you do so, but that's exactly what you should do in those moments and what you can actually also learn to do. And another technique is to really stop your breath after you've exhaled and really wait for an urge to breathe in again.

10:57 So, it doesn't become a reflex that every time you breathe out, you instantly have to breathe back in cuz that really drives up the tempo of breathing sometimes unnecessarily. So, really waiting a little bit until you feel the urge to breathe back in is also a technique advised to people who suffer from asthma, for example, can adapt these dysfunctional patterns. Sometimes this worsens their disease without really the disease doing that. So, these are just two aspects where you can chime in, regulate a little bit, and then see where that takes you.

11:29 There's this one aspect that I came across when reading more and researching about the lung, which I found quite intriguing. And it might be an accidental one, but you know, it's also an interesting parallel, which is the parallel of human society in the last 100 and 200 years really taking a sprint, having all these achievements, industrialization, and all these buildings, and all the things we've done in such a short time compared to the rest of human human history. And then a body running and taking a sprint. And something that happens in both of these situations is that we accumulate all these waste products while we're doing that, while we're having such a sprint.

12:09 In our body, we're accumulating CO2, because that's what the muscles have as a side product when we're really moving and doing a lot of, you know, work with our body. And in the world, we just saw exactly the same thing. We also created all this CO2 and waste products from, you know, doing so much in a really really short time. And when you ask, "Well, what's the solution? What does the body do then?" You see, it actually uses more energy and really has to put in an effort to get rid of this additional CO2.

12:41 Suddenly, breathing out, exhaling, will cost the body energy, which it usually doesn't. When we just sit around relaxed, it doesn't take any energy to exhale. It's just like a the elastic fibers just go back, basically, and we don't need energy. But when we have a sprint and that we're doing, then it really needs some extra energy to exhale. We need to push out the energy. And the fascinating parallel here is that it takes about 5% of our energy resources to do this suddenly. And when you look at climate change and the you know, pollution that we produce while progressing in society, all the like well-renowned research teams say it's about 5% of the GDP that it would cost us to get rid of these wastes in a responsible and like smart way. So, there's a parallel where we can look to the body and say, why shouldn't we do it like the body does?

13:38 Doesn't seem to be such a bad idea. >> Chapter two, the immune system beyond the war metaphor. >> When we talk about the immune system, we often times use words related to war and fighting and killing. And while that is one aspect of immunity and also an important one, it's really not the whole story and it's also sometimes quite a bit inaccurate. And so, I like to introduce a different picture here and you can use it or not, but that was one that really had an impact on me when I was growing up. It was the best friend of my grandma and he was a pianist from the United States. He came to Germany and then had a house somewhere in the forest really and every weekend all kinds of people would come there and when I think back, it becomes pretty like special to me now because as a child you just take it as it is, but how safe everyone felt and very different people felt so safe there. It was, you know, a kind of like a strict lawyer somewhere from the city and then a woman from Iran with a difficult family background then some, you know, theater director, a colorful person and all these people very different just came together and felt good, felt safe, felt like being themselves and later on I came to realize there was a different element to safety that Bill shares with the immune system might say and that was in a way really getting to know people really non in a non-judgmental way, really being very curious about them. Our immune system does something absolutely similar which is it roams our cells every second while I'm sitting here does so and then asks, "How are you doing? What's going on here? How's it going over here?" So that it can really make sure safety is happening in in a smart way. For example, it would not attack an optical nerve if there's a virus sitting in it because we might go blind. But it very well so does that when it's an our throat cell and it can just replace this cell. So it is smart in a way, but that's just because it really knows, you know, our cells in our body and build it the same thing. And then also for some people build it tolerated them brilliantly. Maybe it wasn't too fond of them, but you know, it didn't matter. Why waste energy to have some unnecessary inflammation. Our immune system really has to do the same to keep us safe. Unnecessary inflammations as in allergies or autoimmune diseases are you know, not only wasteful to energy resources, but dangerous.

16:09 And then the last part is also to really cooperate well and friendly with good microbes, which of course build it brilliantly having all these wonderful friends and people. And our immune system does the same thing with our gut microbes and microbes all over our skin and like surfaces where it cooperates with them in order to keep us really really safe cuz those are the ones producing like tiny antimicrobial peptides or other things and giving us vitamins from our food and it if it didn't do that, there would be no safety. So attacking and war metaphors really aren't the only way to safety. And Bill and the immune system, you know, kind of gave me that insight.

16:50 The thing about microbes and often times I think we get a really wrong picture of this is that most of the time they're absolutely not dangerous or harmful or threatening. The thing about bacteria is that there's like quadrillions of them on this earth, but really just 1,400 species are known pathogens. So this is a tiny fraction. If you compare it to humans, it would be as if only six people on this planet are kind of like nasty and mean, and the rest is quite all right and okay. So, I think this gives you a bit of a better proportion of what bacteria actually are, and that they're not bad all the time. And you know what? Actually, their main task is to just borrow around genes to animals, to us humans, and help us with things like digestion, or just protect us from other bacteria that shouldn't be on our surfaces by sitting there and taking up space. So, you know, I think this is rather the full picture on bacteria.

17:46 When you look at those who are capable of making us sick, there are some factors, sometimes funnily similar to factors in human life or psychology, that aren't so beneficial. And one of them, for example, is stealing, but stealing things that are important to the other person. So, microbes really here are decided upon like sort of a Robin Hood scheme. Cuz if you take something from a host, from a human body that the body doesn't necessarily need, that's okay, you know, that's not a microbe, a bad microbe. And there are some bacteria will take some of our food, and they produce something out of it, and then we don't even mind, and it's maybe even good for us. But others, they take nutrients, for example, like iron. And iron is really scarce and hard to get from food, so those usually are pathogens doing that. And it leads to one interesting phenomenon, which is when we have an infection, our immune system will cleverly get all the iron out of our blood, like put it somewhere in a hidden spot, and then wait until we're good again, and release the iron back into the blood. So, shortly after an infection, you might have a lowered iron value when you go to a blood test, for example, but that's not necessarily a bad thing, because it will probably return within the next day.

18:59 And then other aspects for pathogenity, for bacteria being harmful to us, is for example, overstepping borders. Not being okay with, you know, a line someone draws a line "No, this is my throat, so you can't invade here." Bad microbes will just ignore that there's a limit. Good microbes will just say, "Oh, apparently there's a wall, there's a throat wall that we're not going to, you know, invade. We're just going to stay here on the mucous membrane and we'll be fine just living here." And then everyone can get along well, you know.

19:30 But bad microbes will ignore that sometimes and even cross the borders with going into ourselves. That's usually then a bad sign, not tolerating when someone really says, "Up to here and no further." And then something else, for example, is well, a sort of gaslighting, you could almost say, which is called immuno-invasion. So, when our bacteria notice that our immune system is not okay with them doing something to ourselves, they have a choice. They can either become a little nicer, shutting off some genes that are irritating us, or they can try to go around the reaction of the immune system. And, you know, bad bacteria opt for the latter. And in a very mild way, sometimes this doesn't have to be horrible, can just mean that they make our immune system more tolerant. So far then, that's still okay. Some of them might even protect us from unnecessary allergies. But if they go further and really like fake it or really mask themselves or really pretend that they're not there and the immune system is looking for a problem but they're hiding from it and pretending like maybe it's our own cells, they use proteins from our blood to cover themselves and seem like, you know, maybe we're ourselves doing that harm to our to our own body cells, then this is the case of immune invasion and it's a sign that, you know, they're tricking us.

20:53 They're not reacting to our upset, they're just hiding from it. And then it's usually bacteria doing some pretty stupid or dangerous infections. Then there's also toxins, which is little things bacteria produce that fool our own regulation mechanisms. So, for example, with toxin-producing bacteria that cause diarrhea, they will go in between our gut cells and there is a place where they can initiate diarrhea.

21:23 And by doing that, the cells will then, you know, spread a little bit and let all the liquids through, so diarrhea can happen. And but this is just used by these bacteria to get in this area of in between gut cells. And so, they're using something our body actually does to protect us, but to their own advantage and completely unregulated. This is usually horrible diarrhea with like ounces and ounces of liquids coming out compared to normal diarrhea where after a day or so and a few times on the toilet, you're okay. So, manipulating in a way that you make others think they're doing the right thing or they're actually moving in a good way, but it's really to their disadvantage. That's something very bad and toxin-producing bacteria oftentimes, you know, are the ones we have to vaccinate against or we have to have some preliminary medicine or caution because they can cause some quite heavy infections.

22:18 Some bacteria turn into bad bacteria, well, because of us, because we're doing something. And this is a rather like new finding, too, because we now have all these great ways to analyze bacteria sitting on all kinds of surfaces of the human host and we see that actually quite a few people have throat soreness causing bacteria or diarrhea bacteria or some other bacteria that aren't supposed to be good, but they're not doing anything. They're just hanging around. And so, now we understand a bit better that sometimes if bacteria are, you know, part of a good community, they're not being attacked by the immune cells or by stress reactions in our body, they won't unpack all of their properties and all of their maybe disease causing factors. And they will just, you know, go with the flow and be a bit milder version of themselves. And also when you look at things like, you know, pandemics, related to us, you know, maybe chopping down all kind of trees in a forest and then animals going to city areas and they carrying bacteria or viruses that aren't necessarily bad for them, but for us or just having, you know, some egg salad standing around too long at a party and it has been a few more salmonella after a while. So, what we do to others, to microbes, also can cause them to become more evil or disadvantageous to us. So, we are a factor as well.

23:42 I think the way the immune system judges things, if they're like bad or good, sometimes gives you a fresher perspective on what bad is. Because we tend to now put things in boxes saying like, oh, this is bad, stupid, like we look down on it, it's horrible. It's just like of a negative quality of the of overall. And then we have the good things we aspire to be and so on. But for an immune system, it really has to be a bit more differentiated. And it's also not as simple as saying something is just bad.

24:15 And when you look at the history of humans, trying to figure out which bacteria are bad, they made some very dumb mistakes and simple mistakes in the beginning. And they just get better at evaluating these kind of things by learning from the immune So, initially, for example, humans would say all bacteria are bad because they found them in, you know, diseases. And then they said, oh, they cause tuberculosis. So, bacteria in general must be horrible. And then there was a time where even surgeons would cut out a whole large intestine because they found bacteria in it. And people had some troubles with them. And that was, of course, horrible.

24:52 Many people died back then because of that. We got a bit more differentiated and said, "Mhm, maybe it's certain species of bacteria being bad." And you could almost say this relates to like racial theory saying this species is bad or that. And those are very stupid mistakes because it's not that simple. And in every species, there's bacteria doing great things and bacteria doing a bit of trouble. And then when we get better and better in science and more nuanced, we with we saw that even of the same kind, like let's take E. coli bacteria, they can be genetically almost identical, but one is just an E. coli hanging around in the gut going do do do, and the other one is an E. coli causing a disease like EHEC, a so a very severe bloody intestinal infection, very dangerous to your life. So then really asking and turning to the immune system taught science that it's not about all these boxes you want to put things in, but it's really about looking very detailed what's the interaction.

25:50 Are bacteria going that way around your immune system to avoid it? Are bacteria stealing something from the you that you need? And then you can even go further and ask what is our take in it? What did we do to these microbes to sometimes react that way? How, you know, how did it come to play? Sometimes these are just survival strategies. Like a sore throat causing bacteria doesn't want to harm anyone. It's just trying to find a new place to live, >> >> you know? And then maybe now with very new approaches to antimicrobial therapies, we're not even planning on killing them all with antibiotics. We're trying to be even smarter. We're trying to just maybe block one protein that's doing us harm, for example. Or really by that maybe even teaching the bacteria to select the ones that are not doing this disadvantageous thing, but maybe are becoming a bit nicer on the way. So it's really about making this interaction smoother, smarter, more diplomatic. For for quite a lot of bacteria, you might actually be able to go around, you know, them harming us, but actually becoming just like some colleagues sitting around doing nothing.

26:53 By getting to know them and understanding them way better. And I think that can be a lesson for the bad things in life as well. Don't just, you know, shoot them, try to push them away, but really understanding, looking into the final reasons why can sometimes give you a good way out. And sometimes it can also show you there's no good way, so we really have to avoid those, but, you know, not always. And these cases are then the interesting ones.

27:20 So, oftentimes when people are diagnosed with an autoimmune disease, what they will hear in a doctor's office is the sentence that your immune cells are attacking your own body. And I really don't like that sentence, and I also think it's scientifically not accurate anymore. >> >> Because what we know now, when looking at research from like the '90s, the danger hypothesis and so on, is that the immune system is not just stupidly aggressive or something. All the cells that exist in our immune system just have this one goal, which is to keep us safe.

27:53 And sometimes they might go a bit too far with it. You could even say almost like overprotective parents. They really want to be very sure that nothing horrible is happening, so they just do a bit too much. And that can be, you know, an ungood thing, I would say. And of course, those diseases are to be taken seriously, and they're not fun, and it's not good that the immune system is making a mistake like that. But it's really not because it's just aggressively turning against us. And I think understanding that can also really sometimes shift your perspective on how to deal with it and how to, you know, have this phenomenon and treat it.

28:32 Because, for example, we have now all these additional therapies or options that, besides medicals and medications, you can also turn to and see which ones work for you. Doing like stress relief techniques, looking or watching your diet closely. Some have like meditation and aromatherapy and all these kinds of things that can be used. It's not because it's just like saying do some good things, but it's because making your body feel better sends also a little notice to your immune cells, I'm doing better. You can, you know, maybe tone it down a little bit. And taking medications for sometimes decades of your life also, I think, feels very different when you say, I'm swallowing to like fight back this stupid autoimmunity. Mhm, compared to saying, I'm taking this to like calm you down, you know, you don't have to go so hard. I'm okay. I think that these things do matter. And I've seen in hospital in the way that my patients reacted to when I could explain it differently that these things matter.

29:32 And to say one example of that, for example, is one of the like original moments for me to understand that this was an important way of explaining it differently. I had a patient in very early years of my medical career that was diagnosed with a chronic inflammatory bowel disease. And she had been in our hospital a few years earlier for a very severe intestinal infection. And she was so downbeat about receiving this diagnosis, understandably. And I went to her room a little bit later in the day and I said, you know, your gut really witnessed this horrible infection. And I know it seems like, you know, double trouble to now also be diagnosed with this disease, but it's also because your immune system had this very dangerous thing happening and they had then to learn that they should have reacted a little bit earlier or could have done more or could have been a bit more careful. And now they're just following through with this lesson. In diseases like chronic inflammatory bowel disease, they may be going against things like like just very harmless gut bacteria, you know, initiating inflammation right away. And it is a mistake, but it's not because it's aggressive and stupid. It's really because it witnessed something horrible and now really tries to protect you at all costs going a bit too far. And I think just understanding it this way helped my patient and it gave her a more mild attitude towards this disease and I think, you know, I hope this does something.

31:04 One lesson that the immune system really taught me and that sticks with me to this day is that, you know, safety doesn't mean having no risks at all and really, you know, getting all the bad away from you far, far away. Safety really also means coming up with solutions, being flexible, finding ways and our immune system does exactly that, you know, by having some sort of memory cells, by reacting towards germs flexibly, whether they are in a wound somewhere or somewhere in the optical nerve or in the gut. And so, it has all these ways of finding solutions instead of just and only attacking stuff or keeping away things that are risky. And thinking of safety like this has given me a bit less like anxiousness about safety in my own life.

31:53 I know that when I know myself and I just look out for maybe different ways of solving something, I'm I'm I'm well off, you know, compared to just trying to have everything risky far away. >> Chapter three, the skin. How wounds teach us to heal. >> I've come across this thing with my patients, but also personally, that sometimes in situations during our everyday life, we feel like I shouldn't feel this way. I should feel different.

32:29 For example, you know, someone you love passing, which was the case for me when my grandma died. I wasn't this grieving widow in the black dress crying into her little soup. No, I was just sort of numb. And then there's other situations like being promoted, but you don't feel so excited about or the birth of your first child and you're not immediately heavily in love or something. And people think, "What's wrong with me?" And they often say, "Am I broken? Am I weird?"

32:54 And I've heard this so many times now and witnessed it myself and I think, "No, you're absolutely not. It's just that humans are a bit more complex compared to like Hollywood movies or things on some social media thread telling you how you should then feel or how excited you should be." It's just complexity. And the human body is complex and it can just sometimes in those situations really be a very nice rail to hold on to and to figure out what's happening and going on. And for me, it was when I was feeling so numb and didn't have all these typical emotions like just being, you know, wailing in tears when I read about wounds.

33:31 And suddenly, it clicked and I thought, "This is the process that I'm going through." It's like tissue being ripped from your skin, then there comes this crust just covering it like in the first few seconds to just like cover it up and it's a numb crust just like how I was feeling. And sometimes, I know, you look down on it after a few days and you're like, "Is even anything happening there? It still looks the same like 2 days ago." And I saw this illustration in a medical book where you see all the things that are actually happening underneath the numb crust. And it is reorganization. It is attracting cells that could help fix this or really finding new structures of patching things up. And in that moment, suddenly I felt at ease again with myself and I was able to cry because I realized it's just that. I have to do all this reorganization with this person that I loved so much. And maybe it is not conscious all the time and it maybe it doesn't hurt right away and maybe it is covered up with something, but it's happening and it's okay, you know, to let it and I even realized some similar things like oh, now I feel like I want to take a walk again or I want to drink this or eat that. And similar to a wound attracting the cells and factors it needs to heal.

34:47 And this made it easier for me and I think quite a lot of other processes in a body can do that to people feeling like this. The fascinating aspect about human touch is that it can have quite similar effects to medication. And oftentimes we think for certain you know, benefits we need to go to a pharmacy and pay money and swallow the pill, but you know, we're also human beings. Not everything has to come in a in a pill package. We thrive on touch. We have all these positive effects we see it for example in people that are intensive care units. We see it in people that don't even like touch so much like people with autism or ADHD sometimes find it a bit over stimulating. Even them when they're being touched by someone that they feel it's okay, it has all these benefits to their physical being, to their nervous system. This whole area of research was opened up with research about preterm born babies. Where it could be shown that they had skin contact after birth and this would really benefit them. They would lower their stress hormones. Their metabolism would show better results and even after 1 year later you could see differences in in children having good skin contact, being less stressed, being a bit more flexible in reactions.

36:01 compared to kids and babies that didn't. And so not being touched and being touched is a fundamental thing for a human and especially also in phenomenons like loneliness. widows for example are well advised to maybe go and get a massage sometime. Just you know, to have a little bit of touch if this is something that you're deprived of now. And just think that it's not only medication that can calm you down. One very good example for the effect of human touch just in everyday life is something called interpersonal synchronization. And an experiment which was also replicated afterwards that shows this effect is one person laying in a tube and a partner person that they really like or feel close to sitting outside holding their hand. And while they do that, they don't see each other, but you can tell that their heart rate is synchronizing, you know, their skin conductivity is a sign for like stress activation is like coming down and your blood pressure and stress hormones and all is coming to the level of the person which is more relaxed. So, you can actually just by being in skin contact with each other transmit a calmer nervous system to the other person and not the other way around which is, you know, good thing.

37:16 So, we know about this now and when we know about it, we might use it. When you look at loneliness, you have of course the typical loneliness which is not having other people around you, feeling close to them, feeling connected. But, there's also, I think, another kind of loneliness which I would depict as like self loneliness. And I would say so because of studies that look into how do you touch yourself, how do you talk to yourself, how do you handle yourself, how do you take care of yourself sometimes. And there's very various ways and we rarely ever talk about these because we don't so much think about having an like an inner world and a relationship with an inner world also and not just an outer world.

37:59 We're so focused on the outer world with all this noise coming at us and news and messages all the time. Just like that, an inner world is shaping how we go about life and how we feel. And people will, for example, touch their face when they get nervous as if they would be like, "Hello, I'm still here." And you can see this popping up in brain signals signaling like, "Oh, face. Face is there." Sort of. And then you have it in people, you know, showering just at this conversation. How do you go about that? Do you scrub yourself like a farm animal, being really fast and effective, or are you a bit gentle and like careful with yourself? Those are questions that can be equally translated to the way you talk to yourself. Are you talking down on your body or actually a bit friendly with it? And so, medically speaking, we have indicators that there is this way of being so removed and hostile to yourself that you become a bit self-lonely instead of self-friendly, you could say. In all different levels, touch, thought, and action.

39:00 Genetically, humans are capable of healing wounds in two different ways. The one way we generally know with the, you know, a little scar in the end. And this scar comes about from immune cells really trying to keep everything safe while something vulnerable, damaged, even, is being healed up. So, they're producing all these kind of substances, sometimes a bit aggressive ones, to like fend off incoming intruders like bacteria, let's say. And this makes sense and it's just a step of caution. But when we are in the womb as embryos, we don't heal that way.

39:34 We just say, "Okay, what's there, left and right?" And we pull it together with sort of like a tissue string. And this way it doesn't cause any scars. And we can get a bit closer to that by taking good care of wounds if they're really, really clean and we are make sure of that that they're clean. You can put like a water-resistant bandage over it. It's called like wet wound healing in medicine. And by that, the immune system gets a bit more safety. It can use different techniques and often the scarring is less when you do so.

40:03 When we look at wound healing up, one step is forming a scar, right? And the interesting part about this process is that there can be quite some similarities to human and psychological healing after being wounded or hurt, which is wounds don't all heal the same way. Some of them might overreact after they've had like a hurtful incident, like compared to someone, you know, being burgled then you have like five locks on your door or someone being cheated on you always then are mistrusting and checking the phone of your partner constantly. Just like that a bit too much can happen with wounds also. It's called like hypertrophic scarring when there's a bit more like tissue working its way up than necessary. And this can even go completely out of hand, which is then the case of keloid scars, which won't even stop growing new tissue unless you have a professional coming in, like a doctor, and really helping with certain techniques. There's also the opposite possible. We have scars that sink under the level of our skin around it, hypotrophic scars. And what's happening here is in a way similar to people after they've had a tragic loss or something, always going back in the head and like being really hard on themselves, saying, "What could I have done differently? Was it all my fault?

41:20 Why did I do this and that?" Our immune cells can do just that, and when there's been an incident and a wound, they go to that place and keep attacking all these structures that are just trying to like build back to like everyday life. And because they do so, it'll sink under the level of our skin, causing these scars that sometimes, you know, after a vaccination in the arm, like older vaccinations could do that, or acne scars can create something like this.

41:45 And so, sometimes that parallel that you now know of could be helpful when you yourself going through a troubling time, experience something hurtful or loss. You might think, "Mm, am I going in a hypertrophic scar direction?" Or, you know, "Am I being too tough on myself? Am I going in the hypotrophic scar direction?" And what is actually necessary for a scar to heal, you know, nicely and without disruption is having like some patch over it to calm it down, to not have too many influences to outside, to really be on its own, like having the cells do their thing without too much disturbance, without too much stress on the skin, and just some good nutrients and you know, calm to get through this.

42:31 So, when you look at a human, you basically see all the skin and what it is is dead. Because that's the very outermost layer of our skin, it's just dead cells. And it seems to me sometimes a bit ironic or maybe just genius that death is the coach of life when you want to look at it that way. For the skin, it makes a lot of sense because these dead cells are not sensitive like the ones that are underneath it. So, you can have some robust scratching or moving and touching and it's not so bad. Also, they can't be infected by viruses because viruses need alive cells to live gate and thrive in.

43:12 But these dead cells look just like a chair or the floor to a virus. So, it's actually a great invisibility cloak to the viral world that we have on here. The only viruses that you know that can infect skin are wart viruses and they can never do so with intact skin. They always need a little tear or a little thing to get underneath this first dead layer of cells to the alive skin cells to do their thing.

43:36 And then also, the very uppermost layer can't really bleed. If you cut it just like these few micrometers deep, it doesn't bleed. Like if you cut deeper, then it starts to bleed and you will even see at a certain level tiny little dots of blood vessels that you then reach. But all in all, this creates this whole atmosphere of protection around the alive cells. And in a way, couldn't you just also say that's what happens during life? We need death, we need this limit, we need the contrast to really value, appreciate, and protect aliveness, being alive.

44:11 Well, certainly in a body it works that way. >> Chapter 4, the muscles. Why strength isn't just force. >> The image we have about strength and like achieving things and getting stuff done, I think is still very old-fashioned. And in a way, the perspective we have on our muscles and what we think they used to have strength and go about things to achieve things is just in the same way old-fashioned. We always have this Popeye image of someone, you know, prepping their biceps, having a big weight, and then doing thing. And of course, men have more muscles, so it's like men are a bit more stronger and they get stuff done.

44:50 And when you look at muscles and how they work, there's this different angle at strength, at achievement, and it's not only this one way of moving things and getting things done. And I picked my mother as an entry image for the muscle chapter because she resembles that to me. She has a way of achieving great things that maybe are not seen like that in society, but are very strong and very, well, powerful to me, at least. And she raised her children as a single mother, and she did so with all this energy, like always going 150% and I would sometimes see her on on the couch at night and she fell asleep a bit early cuz the day was so stressful. And I really always liked that as a child. I was like, "Oh, she looks so peaceful."

45:37 But now I understand it was because it was really hard to do all this work. And just like my mother had her own ways of bringing things forward, and sometimes they were not lifting something heavily, having a great career everyone can see on your business card, like the weight kilogram or, you know, weight amount that you lifted, but it was doing other things. It was like, for example, just having a certain attitude that takes a lot of strength. And in a muscle, we have that as well. We don't have only as concentric force, which moves things, but we also have like force that just lets your spine be in a straight-up way, for example. Or we have forces that are just forces of resistance when things are really heavy, really going against the way you want to move into. Your muscles can use force and strength to just not have it go that way or not have it go that way so far. Like if you would have a heavy thing in your hand and you let it down really slowly instead of, you know, letting it hammer to the floor. So, in muscles, there are several different ways of using strength. And then also in the whole body, you have very different muscles going about strength in very various ways. You'll have one of the strongest muscles is actually the muscle for chewing because it uses a perfect angle. And then you have the muscles of your eyes, which are the best at very fast switches of directions, which is also a type of strength. So, there's all these varieties. We have muscles in our bladder, which we hardly ever think of.

47:04 You wouldn't brag of your great strong bladder, for example, usually. And but those are muscles as well and they triumph just by using tiny amounts of energy to getting their work done. Being maybe a bit slow in the process, but being super like resourceful. And strength is like put in the body in all these different ways. And I think in work life and society, sometimes we just see this one Popeye way, but we don't see all these different ways strength can come in. And our muscles remind of us that. And well, my mom did remind me of that, too.

47:36 There are all these great effects of physical exercise, you know, brain health nowadays even metabolic health, like reducing the risk of all kinds of diseases. But when you really look at what's happening is that these wonderful effects happen during the downtime. They don't happen while you exercise. They happen afterwards when you lay down and just do nothing and regenerate. And maybe that can teach us a lesson or two about great things happening not only from actions and thing we things we do, but during the time we give ourselves afterwards to really reflect, to really see what could be necessary doing it the next time, maybe even a bit better. And in the body, this is then when our heart muscle becomes more like resources, strengthen up a bit, like has more you know, capacities or our lungs become a bit more strong and powerful, our muscles replenish all their storages and maybe put a little bit more in for, you know, challenging things that might happen the next day. And our brain health even.

48:39 When you look at a brain, it reacts so sensitive to sports and exercise that sometimes you might think, "Well, my muscles aren't growing, but I've been in the gym all week." If you could only see your brain then, you know, it has all these neuroreceptors really reacting towards what was demanded from it to get this movement done. Working and getting things done is often compared to like achieving something in exercise and sport. It's like going the extra mile, carrying the load, like all these words we use for it. But while we do so, we lose sight a little bit of actually the beneficial things that come from exercise and sport. They happen in the regenerative phases afterwards, the downtime when you lay down.

49:20 And in work, I don't think we see that so often, but I think it's quite similar. And all kinds of like medical work research show this, too. That you have different kinds of little breaks during your day. You can have just a few seconds to just go and sigh or, you know, a minute or so to just have a coffee or talk to a colleague. Then you would need 1 hour to have lunch and then a weekend to really replenish and your you know, evening time after you've worked. And we don't take these things so seriously.

49:50 We just see them as charging the battery to you know, get stuff done afterwards. But, when you want to go through with this muscular comparison, you have to see that these are sometimes the more important phases. This is when your body reflects and says, "Oh, how much resources do I need here? Should I strengthen the heart muscle and the lungs? Should I maybe change my brain chemistry a little bit to get things done better?" Like, all these beneficial effects praised about exercise really come from that time. And professional athletes will plan their training schedule not by the things they get done actively, but by how long it takes them to really recover. Only then will they go again and do more stuff. And in work, this could be quite helpful for things like burnout syndrome. When people don't even look at the breaks anymore because they think they're so unimportant, they should just get more stuff done. It makes them actually get less stuff done, as it does in training. When you overtrain all the time, over the course of weeks, you will even be able to lift less weight because your muscles didn't have the time to like really build up on and like use random regeneration to get stronger.

50:53 So, I think this can teach us a thing or two. And it especially teaches us that we're not machines that you plug in and then all the great things happen. We're beings that adapt, that geniusly evolve and shape ourselves. And we do so during downtimes. There's also the aspect of over-relaxation. That is to also equally be taken seriously, you know? And people know this phenomenon when, you know, you don't do any exercise, you lose muscle, of course. If you have to sit and lay in bed for a while, people sometimes lose dangerously large amounts of muscle.

51:24 But, we also know this from everyday life. When people retired, they are scared of this time. Why? Because they're scared that they'll just get less and less stuff done. And sometimes that is the case with not challenging yourself. So, equally as there is like burnout and overtraining, we have like over-relaxation as well. Dangerous to people who, you know, lose maybe employment or are in a state of not having a task right away. So, both of that we find in a muscle muscle and both of that we can tackle similar to a to muscle work, you know.

51:55 So, not long ago, actually a few years ago, science discovered this protein called Titan. And it is a protein that solved a riddle that they have had for a long time, which is isn't success unlike muscle workout just based on how much work we put in. Don't we get exactly that out what we put in eagerly? And Titan suddenly explains why the answer is no, we don't. Because there's dynamics, life is dynamic, there are influences and sometimes forces coming your way really inhibiting you, standing in your way and you have to sort of work around this.

52:29 And our body knows that this is the case. And for that, it has this protein that is a little bit like a spiral, you know, like a telephone cable, these old ones when we still used to have those telephones. And it can take up energy that is coming your way actually, you know, being in the way of the movement you want to do and it takes up this energy, works together and then when you have a chance of moving your way, going this way again, then it unloads this energy and gives you an extra spring in the step, so to say. And we have not understood why this is the case until we discovered Titan, but we now understand phenomena like why do Olympic sprinters jump before they run? They do so because that's the way you can charge your Titan and put some energy on it. Or exercises like yoga and Pilates, why do they make like athletes who are already really strong even stronger? It is because it's exactly those types of movements that strengthen and modify and really fine-tune your Titan springs in your muscles. And also about just work life and success, it's not only about how much like work and time and eagerness you put in, it is about understanding dynamics and really cooperating with them well.

53:42 I have to say that when I started getting into the research on exercise and sports, I was a bit slow because I've always had this weird attitude towards exercise where I just feel like isn't it so weird that we're going to a gym, doing unnecessary movements that have no purpose at all? Like if I went to my job like this and just pretended to be on the phone 20 times, it would be so weird. But we're doing that with muscles. And it seemed to me like maybe we're just like doing this because we all live in this era of only head work and the body just completely loses its job, so we give it some like be occupational therapy by going to the I was always a bit like weirded out by that to be honest. So when I got into sport research more, I discovered like all these great theories and researches and things they found out. And so then it started to grow on me. And one of them was Herman Pontzer and his work on like a very traditional people living close to nature, roaming in nature, collecting all these plants and hunting and really moving so much. But he showed that they only need 2,000 calories a day, just like you know, we need when we sit on the computer all day. So it really exercise is just a bit of like distributing your energy differently.

54:59 And if your body notices after a while, like let's say 6 months usually, first 6 months you might really lose weight because you're using all this energy to move around. But then your body smartly adapts and it will just distribute it differently. So you might produce a little less like sex hormones. You might produce a little less immune cells. You might have a little less energy molecules stuffed in your your depots and storages. And by saving that energy, it then makes possible all this movement you're now doing all the time. And this just goes to show that sports and exercise is not about taking calories off. It's about making your metabolism more efficient and resourceful, actually. And that is quite a nice effect because having less sex hormones, having less immune cells, having less storage molecules reduces your risk of some of these typical modern diseases, cancers associated with sex hormones like breast cancer and testicular cancer, metabolic diseases, obesity when you have less storage stuff everywhere. That is one way sport does these beneficial effects. But there's also quite a few other effects that sports has that I wasn't so aware of that I now really appreciate.

56:12 To people who find exercise miserable, I would say you're absolutely right. Exercise is miserable. It is so similar to a disease. Your temperature rises, your heartbeat goes up, you know, your blood pressure really has to deliver. It is stressful. You have stress hormones in your blood even. But that also is the intriguing thing about it cuz if maybe we don't take it so serious all the time. Or maybe we can tune out those voices telling us, "If you don't exercise, it's your fault when you're unhealthy and now also your mind health, your mental health, and how you look and everything is your fault when you don't do it." I really don't appreciate that pressure because what exercise can be is a playfulness, a playful game of stress.

56:57 Stress that isn't really dangerous to you, where you can stop anytime you want to, where you can even get a giggle out of something, or where you just enjoy moving your body. Your brain and your muscles coming together doing their thing sort of like friendly also, not having to make sense for work, not having to carry responsibilities, just moving and feeling. And you know, a playful game with stress is actually quite a good idea cuz it can teach your body that a rise in temperature and is not so horrible, that it can come down to a relaxed state quite quickly, that taking all these energy molecules or breathing really quickly isn't so dreadful or vibrations all over your body can strengthen the bones, for example. Playing a little bit with stress, not being so serious about it. I think this sort of like perspective on it can bring back an aspect of sports that in history it has often had in other cultures and that is a bit more enjoyable than the perspective we now have on it often times.

57:57 One key thing to understand about strength when you look at a body is that it is much more than just moving one thing forward or just lifting something heavy up. We see that well, where does strength come from even? It's an interesting question. We see that it is not our own strength that we possess and then we use. It is really a way of converting energy. And if you want to see the big picture, this is energy that was produced in the Big Bang and it's now being, you know, guided to all these different systems and humans and living beings managed to guide this energy into movement. And movement can be very different. It can be lifting something heavy, but it can also just standing very stiff and still and holding a certain posture and attitude. It can be working against forces that are not going your wished way, resistance so to say. And it can be all these different kinds of movements, eyes moving really slow or really fast, a heart pumping 24 hours without any break. a bladder being absolutely resourceful or a large intestine being that or just muscles wasting a huge amount of energy very quickly like the legs or arms do just to get ahead. But it's really all these different kinds of strength that I think we can learn to appreciate and that they are just using energy in different ways.

59:25 And as in people in the workplace or as in people in the family, it's very different strength and very different ways of using energy and strength. And the body uses them at just the perfect places sometimes. And so it's not about who's the who's the strongest lifting a weight, but who's in the perfect place. A bladder is in the perfect place. A bicep should never be there, you know? So, I think that's one or two things you can learn about strength from the body.

59:54 >> Chapter five, the brain. Why we're more than machines. >> When I wrote about the brain, I had to think of my sister often because the both of us are sort of this team where one has strengths and capabilities that the other doesn't and the other way around. And often times there are these areas of the brain where it's quite similar. You would think, you know, being awake is always valued far more than being asleep. You would think being like soft and emotional is always a bit talked down on compared to this great rationality and genius of clear conscious thinking. You would have things like addiction and motivation where you think one is very great and the other is very horrible and you sort of separate all these things. And you also sort of separate the brain and its relationship to the rest of the body where you feel like this is the chef, you know, up here it's telling the stupid flesh mountain underneath what to do. But really the brain is about relationship and really the brain is about connecting very different abilities and strengths to get the best out of them. And it's never the case that one is worse or less important than the other. You need sleep to be awake. You need to be awake to really have a good sleep. And it goes for all these other areas just like that.

61:13 When we have this concept of artificial intelligence, which now seems to be everywhere really, I think we go overboard with it a little bit because we make it to be this genius thing smarter than humans can ever be sort of soon, you know, getting everyone unemployed. And while there's definitely truth and danger and importance in that, we really also have to check numbers and quality a little bit. Compared to the immune system, for example, one researcher that I admire, Irun R.

61:43 Cohen, says that when you look at the immune system and AI, you want to compare them a little bit because both of them create networks. An immune system has all these cells that communicate with each other and that deliver information and connect them into patterns like an immune reaction or an allergy or something. And AI will do so as well and we have about 150 million data connection points that create an AI answer and pattern. But when you look at something organic like the immune system, you have two to three trillion cells connecting information. And that is actually far more than any AI we have at the moment.

62:21 So, it's way more complex. And so, Irun R. Cohen, for example, says that the immune system is more comparable to human consciousness. With its nerves and information connection can come, you know, way up above that number and be genius in that way and create consciousness of all these thoughts and feelings and patterns. And when you think of a human brain, AI and the processes that it can emulate are about 10 to 15% of the stuff that the brain is doing. But all the rest is doing this phenomenon of being alive, of feeling, of having taste, of having smell, of connecting it all to experiences. And I think we sometimes, by being so fascinated by machines, by computers, by phones, by AI, we ignore that we have so much more than this.

63:07 Being alive and the sensation of living is so much more than this. And we can emulate a little part of this and call it AI and work it with great amounts of data, and that is wonderful, but we'll never have this thing that's alive, that is conscious, that is experiencing. So, you know, I want to take a little bit of the glamour away if you let me because it also means we are not stupid, broken, incapable, or less than machines. It means we are genius beings, and we should sort of have a feeling for that.

63:42 Since we live in a time where it's become really noisy and loud from the outside, this sometimes dictates to how we see ourselves or how we think we should feel about ourselves, our bodies, our lives a bit too much, I think. So, let me put a counterweight here, which is maybe necessarily to do with money. Let's weigh it up. Let's look at the numbers. If you would try to rebuild a body, and you would really, really try like using human cells, getting them in all the right shapes, and tiny blood vessels, and very delicate nerve fibers, you could easily end up at a sum about, you know, 11 trillion dollars.

64:22 And just a brain is one of that. So, there's all these structures, and look at this value. That is like the 10 most valuable companies that we have at the stock market in the moment. That is all the buildings in New York City or all the buildings in London. And if you want to be a bit more like fine about it, it's all the artwork that we know that's there on the market to sell. So, what does that tell us? There is this value of the outer world and all these things they scream at us to be or not to be, but there's also the value of this live, earthy world that has been there for millions, that has perfected its ways for millions of years, and that we luckily are part of. And sometimes I see my patients in the hospital when they're really sick or maybe even at the end of their lives realizing that they've had this valuable body, this wonderful body, sometimes making mistakes, but really having them able to be alive through this delicate and ingenious thing.

65:22 And now it will soon be gone. And they realize it's value all of a sudden. And they realize how they've ignored it or not really tried to understand it or cooperate more lovingly. And when I see this, it's very touching. And I'm grateful that I witnessed this a little bit earlier in my life. And I want other people to feel this and notice and incorporate a little bit earlier in their lives as well. We are so caught up in this cognitive world. Sometimes we're on our phone, we're at screen and the brain the whole time.

65:54 And we lose a little bit track of reality. We use, you know, the touch of reality. And this can be quite funky and also a bit dangerous. In a body, we see that people who spend more time detached from their physical sensations, just being in their thoughts, having a higher risk of, you know, anxiety, depression, feeling irritated, having some mental diseases even. That's a sign of that. And I wonder sometimes, is that happening to us as a society as well?

66:25 Do we detach too much from the realness of life, to what we actually really need to be alive and well, to what is necessary to have good relationships, you know, to feel safe? And I feel like the body can re-anchor us, can bring us back to the to the reality of life at times. And the brain suddenly learning more about its organs and really understanding their geniusness and their strength and how to then really deliver to them and cater to them and working with them better than before, it's very valuable. And I think in more aspects of everyday life than you would think.

67:03 I think learning about organs, about our like inner life, teaches us sometimes to not look down on our body as much, or not to just see it as something that has to function and be optimized, maybe. But really as something where there is a lot of wisdom. there's a lot of lost wisdom sometimes, like seeing the intelligence of softness, of accommodation, of not seeing safety as just a military operation, but really smart ways of cooperation, tolerance, diplomacy, anteriority.

67:37 Or you know, defining strength a bit more modern. when you look at modern research of muscles, that's simply possible. So, taking the intelligence of the body and the systems and all these fascinating structures that were there long before all these man-made systems and value systems coming up, I think that is a very grounding force and a friendly one. And quite frankly, a very polite and lovely sort of power.

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