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Marc Lewis, neuroscientist, former opiate addict and author of Memoirs of an Addicted Brain, believes that addiction rates increased recently because lockdowns deprived people of the physical proximity to loved ones that the brain finds so nourishing. Here, he explores his thesis with Medcan's clinical director of mental health, Dr. Jack Muskat, in a wide-ranging conversation about the nature of addiction, the neurological benefits of hugs and physical affection—and the unintended consequences of pandemic restrictions.

Episode 90 webpage

LINKS

Check out Marc Lewis on LinkedIn and Twitter, and read his bio.

Lewis' 2015 book is: The Biology of Desire: Why Addiction Is Not A Disease.

Lewis' 2012 book is: Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs

Here's the link to Marc Lewis' blog post about addiction and COVID lockdowns, and here's the main link to his blog, Understanding Addiction.

Watch Marc Lewis' 2013 TEDx Talk on addiction and trust here.

Read this The Guardian article by David Shariatmadari to learn more about Marc Lewis' life and experiences with addiction, or this CNN article by Maggie Fox that explores how drug overdose deaths in 2020 hit the highest number ever recorded.

More on the Internal Family systems therapeutic model.

Check out some scientific research on addiction, such as a 2021 study published in Nature Medicine about the conceptualization of addiction as a brain disease and the criticism around it, or a 2020 study about COVID-19 and addiction, published in Diabetology & Metabolic Syndrome.

INSIGHTS

In the rush to institute COVID lockdowns, Marc Lewis says "the need for social connection was overlooked for an almost obsessive attunement to the disease." We tried to replace physical proximity to loved ones with social media and Zoom, but it didn't work. "The actual presence of other people—proximal, real flesh and blood people that you can feel and touch and hug and smell— is really important," says Lewis. [02:21]

Lewis' research indicates that it's not who you are, but what happens to you that determines how likely you are to become addicted to something. "There is no addiction gene cluster. It's how well you fit with your surround," says Lewis. In his experience as a psychotherapist, Lewis estimates that more than 90 per cent of his patients with addiction problems have histories of trauma. [14:53]

Addiction wasn't considered a problem until the 20th century, when addicts were labeled as "sinners," "weak" and "self-indulgent." The 1980s and 90s introduced the disease model of addiction, which removed the blame from the addict but still connected them inherently to their "disease." "It's a way of thinking that makes the problem intrinsic to the person," says Lewis. [19:09]

In contrast, Lewis uses the Internal Family Systems (IFS) model of therapy when he treats addiction patients. IFS identifies the part of the addict that wants to get high as one component of a greater whole. "There's a particular part of me that when I get upset enough, scared enough, depressed enough, this part knows how to fix that with drugs, booze, or whatever else," says Lewis. [21:35]

When people become addicted, it is often because they are trying to cope with problems or stress in their lives. According to Lewis, we have become too preoccupied with treating our issues as disorders or diseases. "We don't all need to be running to the drugstore to deal with things that humans have suffered with forever," says Lewis. Treating, and warding off, addictive behaviours is complex, but one thing that helps is developing a network of loving friends and family, with which one maintains frequent, physical contact. [27:35]

The growing field of art therapy argues that paintings and sculpture can improve your wellness. In collaboration with Art Toronto, host Shaun Francis examines the evidence with such experts as the contemporary artist Marcel Dzama, RxArt founder Diane Brown, Sinai Health psychiatrist-in-chief Dr. Lesley Wiesenfeld and Montreal Museum of Fine Arts art therapist Stephen Legari. Plus: Medcan's art strategist, Stacy Francis, discusses her innovative approach to art.

Episode 89 webpage

LINKS

See this year's Art Toronto event featuring more than 300 Canadian artists, running from October 29-31 at the Metro Toronto Convention Centre, and online until November 7.

Here's a FAQ about the art therapy process

Check out Diane Brown's nonprofit organization, RxART

See Sinai Health's Creative Arts Therapy program.

Learn more about Marcel Dzama here.

Read about museotherapy at the Montreal Museum of Fine Arts, where art therapist Stephen Legari practices.

See Medcan's art collection, curated by Marshall Webb and Stacy Francis, including Liz Magor's Gut Jacket.

Check out some existing scientific research on art therapy, like a 2019 trial that suggested art therapy was effective in reducing anxiety and improving quality of life. Plus a 2017 study showed how just one art therapy session improved participants' mood, and reduced pain and anxiety. A 2014 article suggested art therapy can affect those with Alzheimer's and other dementias.

The World Health Organization's 2019 scoping review on the role of the arts in improving health and wellbeing

INSIGHTS

"When we're patients, we're still people, and we're people who are going through stress and strain." According to Dr. Lesley Wiesenfeld, our healthcare experience can be improved by the presence of art that is beautiful, engaging or thought-provoking. [04:31]

The art on the walls at Medcan has been carefully picked out by Stacy Francis and art consultant Marshall Webb. The pieces were chosen for their potential to provoke attention and create a reaction in the people who see it. "I wanted [clients] to just have a contemplative moment that was not about the next test that they were about to receive," says Francis. [07:03]

Art therapy is the combination of therapy with the presence or creation of art. Stephen Legari is an art therapist at the Montreal Museum of Fine Arts. "Art therapy allows people to externalize their experience, enjoy a therapeutic relationship with art and feel supported as they're doing that," says Legari. [10:36]

When we do things that don't come naturally to us (like art!), we use and connect more neurons in our brains. And that becomes more important as we age, according to Dr. Lesley Wiesenfeld. "This is why people get advice about, if you're left handed, use your right hand, [and] if you love crosswords, you should actually try a number puzzle instead," she says. [13:54]

When we realize we aren't good at a hobby or activity, we tend to move on to something else. But Dr. Lesley Wiesenfeld says that "there's good support for the value of developing habits that are about both mastery, and tolerating our absolute mediocrity at something." [26:24]

Interest in art therapy is growing fast. RxART is a nonprofit organization that commissions artists to transform hospitals and healthcare settings, and its founder Diane Brown has seen the interest first-hand, both from hospitals and from artists. Every RxART project is fully funded by the charity and free to the hospitals. Artists receive small honorariums. "We don't have problems getting artists to collaborate. Rarely does an artist turn us down," says Brown. [29:06]

There are a lot of self-help books out there, but none of them are written by a hockey legend with four Olympic gold medals and a medical degree. Hayley Wickenheiser's extraordinary success as a woman in a male-dominated sport happened because of her remarkable grit and resilience. In this episode, she chats with Medcan's Chief People and Growth Officer Bronwen Evans about her new book, Over the Boards: Lessons from the Ice, and tells stories of the moments and mentors that made her who she is.

Episode 88 webpage

LINKS

Check out Hayley's social media: Twitter, Instagram, LinkedIn and Facebook

Read Hayley's bio and see her Olympic details here

Watch CBC's The National and its feature on Hayley and her COVID-19 vaccine campaign, "This is Our Shot" here

Learn more about Conquer COVID, the organization that worked with Hayley to deliver PPE in 2020.

Hayley Wickenheiser TEDx YYC talk: Make a new status quo

Read about Wickfest, The Canadian Tire Wickenheiser World Female Hockey Festival founded by Hayley.

INSIGHTS

According to Hayley Wickenheiser, the best athletes often are not the most talented—rather, they're the most resilient. "They're willing to get knocked down and get back up again," she says. For many years, Hayley was the only girl playing hockey on boys' teams in rural Saskatchewan. She cut her hair short and had to change out of her gear in the car. Those years taught her how to be comfortable with being uncomfortable. Now, her resiliency is her greatest strength, and something she encourages everyone to develop. Pushing through difficult situations will toughen your skin, and prepare you to face other challenges that come your way. "You don't have to be great at anything to be able to develop your resiliency," she says. [09:16]

People are power: Many people think that raising a child will hinder the success of your career, but Hayley says her son Noah has done the opposite. He taught her how to leave the stress of her job on the ice, and keep her family life separate. "Your kids just want you to be present," Hayley says. "Noah didn't care how many goals I scored, and he made me a better player because of that. I was more patient and I was able to have more empathy for my teammates." The people in your life want to see you succeed. "If you don't have good people around you, you don't really have a chance to be successful," she says. [12:11]

We're more than what we do: Your identity should be something deeper and more integral to your personality than achievements or failures. After her team's loss against the U.S. at the 1998 Nagano Olympics, Hayley was devastated and went into what she calls an "Olympic depression." Her coach, Wally Kozak, noticed how the loss affected her and handed her a piece of paper that read, "A gold medal is a wonderful thing. But if you're not enough without it, you'll never be enough with it." Hayley still carries the piece of paper in her wallet today, more than twenty years later. The idea, then, is to develop a sense of self that is deeper than one's successes or failures. [16:21]

As a child, Hayley had emotional outbursts so dramatic that her mother would spray her with water from the kitchen faucet to calm her down. Over time, Hayley learned how to manage her emotions and use them productively. "If I need to worry or be sad or angry, I'll give myself an hour where I'm just going to lay it all out. When that hour's up, I've got to let it go and move on," she says. Everyone experiences emotion, and it's important to feel those emotions, to process them. But it can also be difficult to put them aside when it comes time to work or focus. Hayley considers her so-called "freakout sessions" as effective ways to compartmentalize and cope with difficult feelings that you can't always control. [18:36]

Back when Hayley was training for the Olympics, she received some advice from Ryan Smith, at the time the captain of the Edmonton Oilers: "Rest is a weapon, Hayley. Use it." At the time, she was pushing herself extremely hard. As she aged, Hayley realized how wise that advice was. "I do really cherish my rest days, and I try not to book anything when I have a day off," she says. Sleep is very important for recovery and for chronic diseases, but rest doesn't have to mean sleeping or doing nothing. "It can be doing things you enjoy, spending time with family or friends, anything that fills your cup up again," says Hayley. [24:22]

Whether you're talking kombucha or kimchi, fermented foods are all the rage. They're taking over grocery store aisles—and being featured in some important clinical trials. Recently, Stanford scientists Dr. Christopher Gardner and Dr. Justin Sonnenburg established that eating a diet high in fermented foods promotes a healthier, more diverse gut microbiome, and lowers inflammation. What does that mean? Why does it matter? In this episode, they chat with Medcan Director of Food and Nutrition Leslie Beck about their groundbreaking new study, the fermentation process, the microbial friends living in our digestive tracts, and how to make sure you're buying the right fermented foods.

Episode 87 webpage

LINKS

Study published in Cell: Gut-microbiota-targeted diets modulate human immune status

Article from Stanford Medicine about the study results

Justin Sonnenburg's bio and his Sonnenburg lab

Christopher Gardner's bio

NYT article by Anahad O'Connor: "How Fermented Foods May Alter Your Microbiome and Improve Your Health"

NYT article by Tara Parker-Pope: "The Dos and Don'ts of Fermented Foods"

NYT article by Anahad O'Connor: "A Changing Gut Microbiome May Predict How Well You Age"

Read Justin & Erica Sonnenburg's book: The Good Gut: Taking Control of Your Weight, Your Mood and Your Long-Term Health

Want to make your own fermented foods? It's easy! Check out this recipe packet by Justin and Erica Sonnenburg from the 2021 Healthy Kitchens, Healthy Lives conference

INSIGHTS

• Food becomes fermented over time when controlled amounts of yeast and bacteria are added to it. "The live bacteria has to sit around long enough to enzymatically convert some of the carbohydrates in the food to alcohol or organic acids," explains Dr. Christopher Gardner. Those alcohols or acids are what give fermented food its sour, tangy taste. They also promote a healthy gut microbiome, which is the community of microbial cells in our digestive tract. "We often think of humans as a single species. We actually are walking ecosystems. We have hundreds to 1000s of species that make up the human body. We harbour so many microbial cells that by cell number, we're actually more microbial than we are human," says Dr. Justin Sonnenburg. [8:45][1:59]
• Eating fermented foods leads to a healthier gut microbiome because the more diverse your microbiome is, the more anti-inflammatory compounds your gut produces. This makes your body less likely to develop inflammatory diseases. "The converse of that is, if you're not eating fermented foods, you may be depressing your microbiota diversity," says Dr. Justin Sonnenburg. High fat diets, artificial sweeteners and the emulsifiers in processed foods contribute to a less diverse gut microbiome, making you more susceptible to inflammation. [10:43]
• During Dr. Christopher Gardner and Dr. Justin Sonnenburg's 10-week study, they fed one group of participants a high-fibre diet, and fed the other group of participants a high-fermented food diet. "What we saw with fermented foods was mind blowing," says Dr. Sonnenburg. "We saw this increase in gut microbiota diversity across the entire cohort... as this was happening, many of their inflammatory markers were decreasing." Participants ate six servings of fermented food a day, up from the zero to half a serving a day they were eating before the study. That might sound like a lot of fermented food, but "different combinations of six servings tended to be about 300 calories. It's not like you were eating fermented food all day long!" says Dr. Gardner. [25:33]
• So how does our gut microbiota protect against inflammation? Dr. Justin Sonnenburg says there are many different pathways in the relationship between gut microbial diversity and inflammation. But a major one involves the byproducts that result from microbes interacting with the food in our gut. "We think the metabolites that the microbes are producing can help to degrade foods that we're eating," says Dr. Justin Sonnenburg. "This is why diet is such an important component of determining how our microbiome connects to our health and our immune status." He and Dr. Gardner hope that their research will lead to a deeper understanding of how we can feed our own communities of microbes in a way that enables them to produce molecules that are leading to a healthier immune system. [40:30]
• Not all fermented foods will increase the diversity of your gut microbiome. So how to make sure you're buying the right fermented foods? "You have to be careful," warns Dr. Justin Sonnenburg. "Many things that claim to be fermented foods are just pickled with something like vinegar." Look for fermented food products in the refrigerated section, with labels that read "contains live microbes," "contains probiotics" or "contains live cultures." Look out for high sugar content as well. Since fermented food is naturally sour, many products have lots of added sugar to mask their taste. Finally, although wine and beer have been fermented, they won't promote a more diverse microbiome! They've gone through a heating process that kills all their bacteria. [44:53]

Want a cheat sheet on how to extend your life, while staying healthy and happy along the way? Medcan Chief Medical Officer Dr. Peter Nord has been a sailor for more than 50 years. He noticed that his fellow sailors are staying incredibly fit, sharp and healthy well into their old age. This week, Dr. Nord joins host Shaun Francis to describe five secrets of longevity that we can all incorporate into our lives — each one drawn from the way sailors live, as well as medical research. Don't worry, no sea legs required.

Episode 86 webpage.

LINKS AND INSIGHTS

Secret #1: If you like your work, keep at it for as long as you possibly can. Studies have shown that people who retire later are more likely to live longer, and Dr. Peter Nord has seen this first-hand among his fellow sailors who continue to sail well into their 90s. "Like my dad told me, if you love what you do, you'll never work a day in your life," he says. Working later at jobs that are mentally taxing is a way to keep the mind engaged, which can help to promote longevity. "Those days of retiring and sitting on the front porch are leaving us, and it's a good thing," says Dr. Nord. [06:48]

Additional links:

• Brookings study on retirement age and longevity, among other things
• Delaying retirement by just one year, from 65 to 66, resulted in an 11% drop in mortality rate

Secret #2: Figure out how to get exercise without it feeling like exercise. "It's great to go to the gym, great to do aerobic exercise, great to do strength training, those are all important things. But we don't need to necessarily do that," says Dr. Peter Nord. As a sailor, a lot of his day is preoccupied by strenuous physical activity around his boat. Things like raising sails, handling ropes and even just keeping balance. "If we can be constantly moving… structuring our lives so that we can be doing things day to day that keep us active… All of those things are just incredibly valuable and have been demonstrated through research to add years to our lives." Hobbies like walking, gardening, sailing or skiing are great ways to keep movement in our daily routine. [10:24]

Additional links:

• Regular physical activity performed by elderly people might play a certain protective role against Alzheimer's disease
• Associations of light, moderate, and vigorous intensity physical activity with longevity
• 10 percent of all deaths among Americans 40 to 70 years old are a result of too little exercise

Secret #3: Build your muscles well into your later years. We generally associate strength training with younger adults, but it becomes increasingly important as we age. "Strength training prevents falls," Dr. Nord says, adding, those who strength train tend not to break bones when they do fall. In turn, not breaking bones as much means you're "not in hospital, which means you're not going to get pneumonia, [or] that downward spiral that can happen with people as they age." Muscle power gradually decreases after 40 years of age. Incorporating light resistance training exercises with dumbbells or stretchy bands doesn't take long, and has been proven to help you live longer. [15:00]

Additional links:

• The ability to lift weights quickly can mean a longer life (press release by European Society of Cardiology)
• Strength training is significantly associated with decreased overall mortality
• Article from Blue Zones: "Anti-Aging Benefits of Strength Training"
• Two decades of inactivity doubled Norwegian people's risk of dying young

Secret #4: Limit your intake of sugar and processed foods. When Dr. Peter Nord is sailing, he doesn't have a lot of time to snack. "When you're on a boat and you're working hard, you're probably not ordering takeout… and you're not going to sit down to a four-course meal on your boat," he says. Whether you're at sea or on land, contribute to your longevity by avoiding sugar and focusing on the Mediterranean diet with lots of fruits, vegetables, fish and fibre, and very little red meat. Studies show that sugar and processed foods have both been linked to higher rates of mortality. If you've got a sweet tooth, artificial sweeteners are a great alternative that won't affect your longevity. [17:50]

Additional links:

• There is a significant relationship between added sugar consumption and increased risk for cardiovascular disease mortality.
• Some quick guidance from Eat Move Think guest host Leslie Beck on how to follow the Mediterranean diet.
• An increase in ultraprocessed food consumption may be associated with an overall higher mortality risk

Secret #5: Spend time in nature. Multiple studies have shown that when we get outside and connect to nature, our blood pressure, heart rates and risk of diabetes and cardiovascular diseases go down (ScienceDirect). As a sailor, Dr. Nord spends more time connecting with nature than most people. "Sailors are outdoors, they're in the wind, sun, you're connected to what's happening around you," he says. Being in nature also contributes to our mental health. "We need to be exposed to sunlight, not just for vitamin D, but for preventing seasonal affective disorder. If we don't get outside, many of us get depressed." Spending 30 minutes to an hour a day in nature will improve your health, no matter your age. [20:23]

Additional links:

• The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes
• Higher levels of green vegetation were associated with decreased mortality in American women

"Psychedelics saved my life," says Payton Nyquvest. "Now [I'm] on a mission to pay that forward." Nyquvest is the CEO of Numinus Wellness, a publicly traded Vancouver start-up that manufactures such illegal psychedelics as MDMA and psilocybin for clinical drug trials. The intent is to determine how effective they are as a therapy for mental illness. And if their potential pans out, Numinus Wellness wants to administer the drugs to patients in guided sessions across the continent. In this episode, the second of a two-part series, host Shaun Francis walks Nyquvest through his fascinating life story, his predictions for the future of psychedelic therapies—and how ayahuasca kickstarted his journey.

Episode 85 webpage.

Part one of the series.

LINKS

Check out Numinus Wellness and read Payton Nyquvest's bio here. Check out Payton on Linkedin, Twitter and Instagram.

Learn more about MAPS (Multidisciplinary Association for Psychedelic Studies) and John Hopkins Centre for Psychedelic & Consciousness Research, two of the leading entities in psychedelic research.

Read up on some exciting studies on psychedelics and mental health:

• MDMA and PTSD trial in Nature Medicine
• Trial on psilocybin and depression in New England Journal of Medicine
• Psilocybin clinical trial for treatment-resistant depression
• Ketamine clinical trial to treat bipolar depression
• Psilocybin-based compound clinical trial for MSP-1014 to treat mood disorders
• MDMA clinical trial to treat PTSD (phase 3)

Learn about Project MK-Ultra, which experimented on human subjects with LSD, in this episode of The Fifth Estate by CBC.

Check out this study in Nature Medicine to learn more about ayahuasca and its effects. Read this story in The New Yorker to learn more about its cultural history and current popularity.

Learn about how marijuana was legalized in Canada in October 2018. Read the Cannabis Act here.

Read some books that spurred the hype around psychedelics and wellness:

• How To Change Your Mind by Michael Pollan
• A Really Good Day by Ayalet Waldman

Learn more about True Patriot Love and its support of military members, Veterans and their families, founded by Eat Move Think host Shaun C. Francis. Plus here's a link that provides information on how TPL is supporting innovative therapies to treat PTSD.

INSIGHTS

Nyquvest turned to psychedelics as a last-ditch therapy for chronic pain. He had been trying treatments for years with no results. "When you're in the emergency room," he says, "and physicians are looking at you sort of compassionately, saying, 'Sorry… we don't have answers here for you,' it's a very lonely and isolating place." Eventually, Nyquvest became desperate for relief. "I was getting hospitalised two to three times a week, and had really run out of options, and turned to psychedelics, really as a last ditch effort to try and save my life." Nyquvest insists that psychedelics aren't a panacea or a magical solution, but they were the first thing that worked for him to treat his chronic pain. [02:55]

Rather than making psychedelics available on the open market, Nyquvest believes psychedelic therapies should be administered by experienced professionals in guided sessions. "It's a service-based model, not a product-based model," says Nyquvest. By way of contrast, cannabis is a product-based model, which sees the substance available for sale for recreational use by civilians. Nyquvest doesn't want to see the same thing happen to psychedelics. "The integration, the working with therapists, the support system is as much, if not more, important than just the psychedelic experience itself," he says. [12:58]

"When you have depression, you become labelled as a depressed person. You get put on some kind of an SSRI, and it's this symptom management thing that pharmaceutical companies have been profiting from significantly over the last number of years," says Nyquvest. Psychedelics, in contrast, are already showing that they have potential not just to treat, but to cure mental illnesses, Nyquvest says. He mentions a MAPS study where "over 66 percent of the people who did MDMA for post traumatic stress disorder no longer met the PTSD criteria after three treatments." In other words, two-thirds of participants were cured. Today, psychedelics may be administered as a last-ditch effort to cure a certain mental illness. In future, Nyquvest wants psychedelics to be administered on a "preventive mental health model, where people are able to get ahead of some of these things before they become a significant problem… so that they can get back to continuing to do their jobs, and living more happy and full lives." [23:20]

With the help of psychedelic-assisted therapy, Nyquvest has been able to separate his physical and mental health from the conditions that once plagued him. "I was labelled as someone who was very, very sick… and the recognition that there's actually inherently nothing wrong with me, [but that] there were events that happened in my life that I was struggling with… that was a big thing for me," he says. Nyquvest uses the metaphor of dentistry to describe the way he sees psychedelics being used preventively. "Most people have great teeth… and still go to the dentist twice a year. I think it's a similar sort of thing in the way we should be treating the brain. I don't know a person who gets out of life unscathed in terms of some kind of event that happens in their life that they could probably use some looking at, and some support. And I think that's a huge opportunity for psychedelics." [26:03]

Nyquvest says that the old stereotype, of psychedelics users simply looking for an escape from reality, is just plain false. "A lot of the people that I know that have worked with psychedelics are very high-performing, entrepreneurial or otherwise type of people," he says. "They've been able to clear a lot of the noise and really look at what is motivating [them]. The more deeply you understand some of those motivations, the better you can work with them, and the better you are at some kind of control or understanding of what's driving you." [27:35]

When Payton Nyquvest co-founded Numinus Wellness, his focus was on healing, curing, and developing new treatments. "The plan was always to just build a company that could make a significant impact, there was no plans of taking the company public, it wasn't even really something we thought was going to be on our radar screen for quite some time," he says. But the world's excitement around psychedelics has led to more interest, more research and more funding. "It made sense for us to go public," he says, because that's provided the funding to acquire mental health clinics, where Numinus may one day provide guided psychedelic therapies to patients at large. Going public came with challenges, though. "People talk about the overnight success and huge amount of enthusiasm in the psychedelic space, but when we went public, it was actually met with a significant amount of challenge and scrutiny." Numinus has come a long way since then, holding onto a cash balance of more than $63 million in their latest quarter. [29:38]

Asked to predict the future of Numinus Wellness, and the psychedelic space in general, Nyquvest says that he believes we're only just starting to learn about what psychedelics can do for mental healthcare. He hopes Numinus will remain at the forefront of the field. "Our goal has always been to be the number one most trusted brand in the psychedelic space… Our licencing out of the lab is an international licence, so we can work with any organisation all over the world… when you think about doing psychedelic therapy, [we hope] you go to a Numinus location in order to do that." In the short term, Numinus Wellness will continue to collaborate with mental health clinics and MAPS, the Multidisciplinary Association for Psychedelic Studies. [31:20]

They're portrayed as a mechanism to achieve self-knowledge in the Amazon Prime show, Nine Perfect Strangers. They were the subject of promising clinical trials in the New England Journal of Medicine and Nature Medicine. They fascinate Joe Rogan and Tim Ferriss, and their promise was even the subject of a book by Michael Pollan (How to Change Your Mind). So is the buzz about psychedelics justified? What's the deal with microdosing? And exactly which mental illnesses might benefit from psychedelic therapies? Psychopharmacologist Dr. Roger McIntyre of the University Health Network and Dr. Ishrat Husain, a psychiatrist at the Centre for Addiction and Mental Health, discuss the latest scientific developments for psilocybin, MDMA, ketamine and more.

Episode 84 webpage.

LINKS

Learn more about Dr. Roger McIntyre's company, Braxia Scientific, his Canadian Rapid Treatment Center of Excellence and the rest of his publications here. Here's Dr. McIntyre's webpage at U of T.

Check out Mindset Pharma Inc, where Dr. Ishrat Husain is scientific advisor. See Dr. Husain's scientific publications here. Here's Dr. Husain's webpage at CAMH.

The New England Journal of Medicine study on psilocybin.

The Nature Medicine study on MDMA and PTSD.

Read up on these psychedelics and wellness trials happening now:

• Psilocybin clinical trial for treatment-resistant depression Braxia
• Ketamine clinical trial to treat bipolar depression - Braxia
• Psilocybin-based compound clinical trial for MSP-1014 to treat mood disorders - Mindset
• MDMA clinical trial to treat PTSD (phase 3) - Numinus.

Learn about earlier psychedelics studies at the trailblazing John Hopkins Centre for Psychedelic & Consciousness Research, where research on psilocybin began more than 20 years ago.

Read some books that spurred today's hype around psychedelics:

• How to Change Your Mind by Michael Pollan
• A Really Good Day by Ayelet Waldman

INSIGHTS

We use the term "psychedelics" a lot in this episode. But what does that word mean, and which drugs fall into that category? Dr. Husain explains that the term is Greek in origin and means "mind manifesting." He calls them "very potent substances" that can "cause very profound hallucinatory experiences, which can be very powerful, but at the same time, for some people, can be quite distressing." Dr. Roger McIntyre considers in the psychedelic category such drugs as lysergic acid diethylamide (LSD) and psilocybin (the active ingredient in so-called "magic mushrooms"), as well as dimethyltryptamine, ayahuasca, mescaline, MDMA (known as "ecstasy" or "molly"), and ketamine. [07:20]

Canada legalized marijuana for both recreational and medical use in October 2018, and now anyone of legal age can access many different types of marijuana, as long as it's less than or equal to 30 grams of dried cannabis. Dr. Ishrat Husain says, "With cannabis, a lot of the research wasn't completed before it was extended to medicinal use. And I hope the same thing doesn't happen with psychedelics, I think that it would be really important for us to do the robust research before it's translated into medicinal use." The powerful nature of these drugs means that their administration needs to come with medical supervision from experts trained in psychedelic treatments. [08:21]

Both Dr. Husain and Dr. McIntyre discourage recreational use of psychedelics. They also discourage microdosing of LSD and other psychedelics for self-administered therapeutic purposes. "I do cringe… when I hear about people taking micro- and macrodosing for whatever medical problem," says Dr. McIntyre, "We just don't have the evidence that that works and it's safe." Similarly, Dr. Husain says, "we don't know what the risks are… I mean, these aren't risk free drugs...they do come with adverse effects that can cause, for instance, anxiety, it can cause dissociation, which means sort of like a break from reality, as well." Specifically about microdosing, Dr. Husain says, "there is no study that confirms the mental health benefits of microdosing psychedelics at this point. In fact, studies that have looked at recreational users have shown that microdosing psychedelics are no better than taking a placebo." [10:21]

To minimize the risk that psychedelics are legalized before the medical and scientific implications are known, as well as minimize the risk of a backlash similar to what psychedelics experienced in the '70s, Dr. McIntyre believes it'll be necessary for experts from many different fields to work together. "If you engage the medical establishment, you engage the political establishment, the legal establishment, the regulatory environment, and have all players at the table saying, can we find a line of sight here? How can we do this safely and appropriately? We've got to do this with [a] multilateral partnership." [12:43]

The interest that society and the media have taken in psychedelics recently is exciting for those studying them, says Dr. Roger McIntyre. "We don't get enough hype in psychiatry," he says. "So I welcome the hype, I welcome the hope. We need hope for people who are affected by PTSD and depression and so on…" The attention, Dr. McIntyre says, has also helped attract funding for research studies. Still, Dr. Husain warns that we shouldn't let the hype lead the way. "There's so much that we don't know yet," Dr. Husain says. "We need to do the work before we can say that they're even useful as a treatment option," he says. [13:35]

Scientists are still learning what, exactly, psychedelics do to our brains. According to Dr. Husain, we know that psilocybin, the active compound in magic mushrooms, does at least two different things. It stimulates the receptors that create serotonin, a brain chemical responsible for improved mood, Dr. Husain explains. "Another thing that it's shown to do is, reset the brain. There's a network in the brain called the default mode network, and when we're in our own internal world, thinking about things or wondering how other people view us, that network in the brain is very, very active. And it's thought that psilocybin comes in and disrupts that network, so that we start fresh." [16:40]

Where is the future of psychedelics going? Both our experts think there's much more study, and many more therapeutic uses, ahead. "We are entering the first inning of a baseball game," says Dr. Roger McIntyre. "my dream in the ninth inning of this baseball game, is that we have a cure for these horrible illnesses and we can reduce suicide… we can get people better, get people better fast, and not just sweep symptoms under the rug, but can actually cure the illness." Dr. Ishrat Husain is also hopeful that the research will clarify exactly how psychedelics work, so that we can use them as efficiently and safely as possible. "It would be fantastic if we're able to show that, yes, these medications are effective, and we understand why they're effective." [18:39]

Humans are social creatures. Our wellness as individuals depends on the extent we feel like we belong in community settings at work, when socializing, and at home. But how can today's leaders encourage strong ties among coworkers when so many are working virtually? Host Shaun Francis, the CEO of Medcan, explores the challenge of creating strong social bonds with climbing expedition leader Scott Kress of Summit Team Building, who has climbed the Seven Summits (the tallest mountains on each of the seven continents) and who provides team-building advice to corporations of all kinds. After this episode, you'll be better equipped to encourage social cohesion whether you're scaling Mt. Everest or hopping on your morning Zoom conference.

Episode 83 webpage.

LINKS

Scott's series on the future of team-building is here:

https://summitteambuilding.com/team-building-definition/

https://summitteambuilding.com/virtual-team-building-the-future-of-team-building-part-2/

https://summitteambuilding.com/in-person-team-building-the-future-of-team-building-part-3/

https://summitteambuilding.com/in-person-team-virtual-team-building-the-future-of-team-building-part-4/

You can find Scott on LinkedIn and his company, Summit Team Building, on Twitter. His blog features posts about his expeditions and team-building philosophy. You can also find clips of his talks here.

Learn more about Scott's adventures and team-building in his book, Learning in Thin Air.

Watch this quick video to learn more about Outward Bound & its mission

Check out this Forbes article on a recent research study on the proven benefits of team-building and strong leadership.

Want to read more about Scott's 2008 Everest expedition? Here's an article from the Burlington Times about his journey.

Read this CNBC article by David Novak to learn more about Tom Brady's leadership style.

INSIGHTS

1: The task of team-building has changed in the last 18 months. Coworkers are working virtually, which means they can be physically distant, and have often never met in person. Consequently it can be more difficult to create the strong emotional ties required to build high-performance teams. And that connection is important. Kress says connection among coworkers determines how productive they'll be together. "There's no need to be best friends with everyone at the office, but there is a need to have a relationship where you can know and understand each other." That said, virtual team building can be effective. "There are benefits to virtual," Kress says. "Certain types of content for training and team-building works really well, because you can have that, you know, short, 90 minute hit on a fairly regular basis…. But I believe that should be interspersed with some in-person training." [07:29]

2: A high-performance team is set apart because they can consistently achieve their goals in difficult circumstance. "We've all seen teams that have achieved their goal, but they almost killed each other in the process," says Scott. "Sometimes we get lucky. Sometimes you persevere, you tough through it, and you get there. But generally… once you achieve your goal, the team falls apart." Strong leadership and resilient emotional connections can help a team to find its common goals, allow its members to connect with one another and in turn, strengthen its ability to reach its goals every time. "If you want to go fast, go alone," Kress says, quoting a proverb. "If you want to go far, go as a team." [15:48]

3: "A leader has huge influence over the culture of their team," says Scott. Every subculture within a company is a reflection of that team's leadership. It's been proven that the members of a team take on the values, beliefs and priorities of their leader, and so it is essential that the leader takes responsibility for the way the team communicates and functions. "You want to have a very clear vision…You can't expect anybody to live up to expectations unless they know what those expectations are," he says. "So you need to have a clear understanding of what it is you want to create, and then how are you going to share that with your team." [20:38]

4: High-performing individuals don't necessarily make great leaders. "Often we get promoted into leadership roles because of individual performance," says Scott. However, not everyone is cut out to be a leader, even if they're great at what they do. "And if we are going to be put into a [leadership] role, then maybe we need to have some training and some coaching to help us really understand what is the difference between being a high performance individual and being a successful leader." [23:32]

5: So what does make a great leader? The title's got nothing to do with it, according to Scott. "Leadership is about an attitude. Leadership is about action….if you see yourself as a leader, you're going to do things differently than if you see yourself as a follower." While a follower listens to instructions and waits for direction, a leader is proactive. "They're looking for things that need to be done…they're looking for people that need support and help." Want to build a strong team? Build a team of leaders, Kress says. [25:55]

6: Kress has three tips for leaders looking to create high-performing teams in hybrid work environments. The first is the importance of vision—"your vision as far as what are your achievements... your goals, all of that stuff." In the remote work environment, Kress suggests considering, "what's the vision of who we're going to be as a team? And then how are you going to communicate that to the team?" Second, Kress underscores the importance of leaders doing more than walking the talk. "I need to take what I want the team to do, and, and take that a little bit further." Basically, Kress says, you have to run the talk. Finally, and particularly for teams working in hybrid work environments, leaders have to create real-world opportunities for social cohesion. "We're still seeing each other, we're talking back and forth on the computer, but it's not the same," Kress says. "And that's where the team-building comes into play. You want to have those formal sessions led by, you know, those external professionals who are going to guide you through some type of a team-building experience. But you also want to have the informal as well: have dinner together, spend time talking together… You have to really focus on it or you're going to lose that team connection pretty quickly." [29:01]

What's the difference between getting through the day and performing at your absolute best? A whole lot, argues Dr. Greg Wells—and he wants to help you get there. Dr. Wells is a physiologist, senior scientist at SickKids hospital and the president of Wells Performance. He takes the latest training techniques from elite athletics and applies them to corporate executives, to help CEOs and management teams perform better in their jobs. His latest book is Rest, Refocus, Recharge: A Guide for Optimizing Your Life. Dr. Wells argues that we all need to move past non-stop "hustle culture" and toward a more holistic focus that acknowledges the importance of recovery to long-term optimal performance. On this week's episode, Dr. Wells joins host and Medcan CEO Shaun Francis to discuss the benefits of recovery, why we all need to be thinking about how to sleep better and how to optimize our lives for the best results.

Episode 82 webpage.

LINKS

• You can find Dr. Wells online at his website, Instagram, Twitter and LinkedIn.
• Learn more about his latest book Rest, Refocus, Recharge here.
• Check out Dr. Wells' blog post summarizing how to achieve optimal performance in life and sport. You can also get more similar content by signing up for his newsletter here.
• Dr. Wells has also appeared on several podcasts, and has spoken at UofT's Tedx event.

INSIGHTS

• The way we approach performance in sports has shifted dramatically over the past few decades. In the '80s and '90s, the training philosophy was to train as much as possible, regardless of injuries or your mental health. Olympic-level swimmers would spend hours and hours per day in the pool. According to Dr. Wells, this started to change in the late '90s and early 2000s. Now, we see more of a focus on intensity training: athletes will train in their sport at a very high level for only a few hours a day, and the rest of their time is focused on other activities, such as recovery and nutrition. The shift from quantity of training to quality of training is resulting in better performance and, often, longer careers. Dr. Wells observes that he's seeing a similar shift happen in the business world. "Regeneration is becoming a lot more accepted," he says. "We're moving out of this hustle culture into what is more of a performance-based culture, which is super important, because along with higher performance comes much better mental, physical, emotional and spiritual health." [03:44]
• Getting a good night's sleep is one of the most important things we can do to achieve optimal performance, Dr. Wells says. Luckily, it's easier than ever to track our resting cycles and work on proper sleep hygiene thanks to the development of wearable tech, like Fitbits and Apple Watches. But with great tech comes great responsibility. We don't want these devices to become a clutch, or a potential trigger for anxiety. "We've got to build a balance... It's the idea of intention versus compulsion," says Dr. Wells. "If you're intentionally using wearable technology to get data so that you can make decisions, that's fantastic. If you're compulsively looking at your data and it's actually making things worse, then you need to throw it all away." [12:41]
• At the same time, we have to be careful not to become dependent on other sleep aids, like medication, to help us get some shut eye. Sleep medication can and should be used temporarily in some instances. "But use them as a bridge to get better sleep habits," says Dr. Wells, explaining that long-term consistent use of medication to get people to sleep has been associated with shorter lifespans. Attempt other techniques, like exhausting yourself during the day with exercise, blackout blinds and journaling, to see what else you can do to help improve your sleep. [15:06]
• Dr. Wells talks about the need to defend the last hour of sleep. "That's creating a digital sunset," he explains. "You don't want to have the same level of activation before you fall asleep. You want to use the last hour of your day before you fall asleep to downshift, slow down, relax, decompress, reflect, deconstruct, build relationships and take care of ourselves." He recommends following the 20-20-20 pattern—basically finding three calming, mindful activities you can do for 20 minutes each during the hour before you go to bed. [19:03]
• Of course, nutrition is also a key part of optimal performance. Intermittent fasting is a hot topic of discussion at the moment, as it seems to help the digestive system go through its own restorative process. But, according to Dr. Wells, you don't have to do the typical 16-hour fast — intermittent fasting for 12 hours a day achieves about 80 percent of the same benefits, including boosting the body's ability to repair and regenerate and a reduction in inflammatory markers. "Basically, after dinner, no more snacking is the easiest way to think about it." [20:49]

Remember when everyone thought things would be back to normal by September? Instead, children are returning to classrooms with caseloads climbing. So how should parents prepare kids for the return to in-person schooling? Is it safe? Would they be better off being taught virtually? And when should we expect vaccines to be approved for those who are under the age of 12? For guidance, we turned to a pair of Medcan experts: Dr. Janice Weiss, director of child and youth, and Dr. Jack Muskat, clinical director of mental health.

Episode 81 webpage.

LINKS

• Dr. Janice Weiss provides further guidance for parents in this short YouTube video.
• Here's the Ontario COVID-19 Science Advisory Table brief that suggests, "barring catastrophic circumstances", that kids should be educated with in-person learning.
• Learn about Medcan's Child & Youth Assessment, designed to provide parents with tailored strategies to help children reach their potential.
• Dr. Weiss and Dr. Muskat's guidance, that children are better off in school compared to virtual learning, is supported by Sick Kids' president and CEO, Dr. Ronald Cohn. "Schools should not only open in September, but need to stay open," says Dr. Cohn. More here.
• Some good context on the risks to children of attending in-person schooling in the fourth wave in this Globe and Mail story by Wency Leung.
• Virtual schooling is thought to have contributed to the doubling of youth depression and anxiety during the pandemic, according to new analysis from JAMA Pediatrics finds. This CNN story spells it out in language for laypeople. "One in 4 adolescents globally are "experiencing clinically elevated depression symptoms, while 1 in 5 youth are experiencing clinically elevated anxiety symptoms."

INSIGHTS

• Dr. Weiss and Dr. Muskat both believe that children should return to in-person schooling. Like many experts they approach the question from a cost-benefit perspective. "The issue really boils down to, what are the real physical risks of being at school versus what are the mental health issues from virtual learning?" Dr. Weiss asks. Children 12 and over have had the opportunity to be vaccinated. And statistics show that the vast majority of children under 12 who catch COVID-19 will be either asymptomatic or will have mild cold- or flu-like illnesses. Less than 1% of children who get COVID require hospitalization, according to Dr. Weiss. Serious complications, such as multisystem inflammatory syndrome in children (MIS-C) are extremely rare, at less than 0.03%. Comparing the low physical risk with the much larger likelihood of mental health problems caused by virtual schooling (anxiety, depression, eating disorders, social isolation), Dr. Weiss and Dr. Muskat both conclude the analysis suggests children should be physically present. [01:35]
• One suggestion from Dr. Muskat: During back to school, recognize that kids pick up their anxiety from their parents. Children will benefit if parents can convey a strong, confident approach toward back to school. One approach? Be straight with them. Life has risks, but we can take precautions designed to minimize danger. Analogies can go a long way toward assuaging the anxiety of young people. The sort of risk-benefit analysis that suggests kids are better off with in-person schooling is applied in many other settings as well: We go swimming in lakes, even though there exists a risk of drowning. We go for a bike ride, wearing helmets to minimize risk of injury from a fall. "We cannot create 100% safety, nor should we, because life has risk," Dr. Muskat says. "But what we want to do is go in with knowledge. And with confidence." [08:35]
• To ward off the "re-entry anxiety" that some kids feel over back-to-school (similar to the anxiety that some adults feel over back-to-the-worksite), Dr. Jack Muskat suggests creating low-stress situations where you and the child rehearse what will happen on school days. Walk them to the school ahead of time. Set up "buddy" relationships with older family members or friends. Make a school lunch so that the child has a better idea of what they'll be eating on that first day. Pack the backpack in advance with the water bottle and mask in appropriate pockets. The idea is to reduce the uncertainties that swirl around back to school as much as possible. Make these experiences fun, so that the positive atmosphere spreads to the act of in-person school attendance. [10:11]
• When will vaccinations be available for children under the age of 12? The medical community expects news to come in the fall on that front, says Dr. Janice Weiss. Efficacy and safety data is expected to be published for Pfizer and Moderna toward the end of September or in October. Depending on the results there, health authorities may elect to make the vaccine available to the next younger age bracket, which would be for children aged 5 to 12 years old. So vaccinations could be coming for more children before the school year is out. [16:32]
• Some parents are reluctant to send children to school if schools are just going to close down again anyway. Does Dr. Janice Weiss expect schools to shut down during the Delta variant's fourth wave? "It depends on the virulence and the seriousness of the variant of concern," says Dr. Weiss. "So if you get a variant that escapes the vaccination, then that would be concerning. If we see huge trajectories upwards of community infection, hospital admission, ICU admission, that would be a concern. So I think you have to look at local transmission variance of concern. It's a multifactorial decision." With those qualifications in mind, Dr. Weiss believes that a shutdown is unlikely in the next few months. "I think that for what we're seeing so far, prediction wise, yes, schools will stay open," she concludes. "When the community transmission and rates are low, the general infectivity raised within the school will remain low. And that's why we're really strongly encouraging everybody... get your vaccination, that is the best protection for society for your children." [18:24]
• Finally, Dr. Jack Muskat suggests going a bit easy on your children over the next little bit. The situation is evolving, the world is a bit strange with everyone in masks, so consider not putting the usual amounts of pressure on children over things like performance in school. Dr. Muskat uses himself as an example. "I'm finding it's taking me twice as long to get things done when I'm wearing a mask," he says, "because I don't have as much peripheral vision. I'm finding that I want to do four things in a day. And I can only get two done." There's a fatigue factor as well, he says. "One of the reasons people quit habits and routines — they set goals too high in the beginning." Apply this to the school year by making things comparatively easy for children. Then, once they're settled, you can focus on things like homework and good grades. [21:17]