Dr. Steven Storage is a child, adolescent, and adult psychiatrist at Amen Clinics, where brain SPECT imaging is used to diagnose and treat conditions like ADHD at the neurological level. In this episode, he and Karena cover the four pillars of brain health, how social media hijacks your dopamine, why ADHD is both genetic and environmental, the seven subtypes of ADHD, what low dopamine actually feels like, and a simple cognitive technique to stop negative thoughts from running your day.

Dr. Storage breaks down the neuroscience in a way that's impossible to unhear, from why one bad night of sleep costs you 30% of your executive function to how your social media habit may be draining the same brain chemical you need to feel motivated. This is the brain health conversation that has been missing from the wellness space.

(00:38) The Four Pillars of Brain Health

• Sleep, exercise, nutrition, and avoiding toxins — the foundation for a functioning brain

• 20 minutes of higher-intensity cardio every other day shown to be as powerful as antidepressant medication for the brain

• What the brain is actually doing while you sleep 

• Food is fuel or garbage — why refined sugar and processed foods are inflammatory for the brain

(07:07) Social Media, Dopamine & the Addiction Loop

• Social media is engineered to produce a dopamine spike, and the crash after is real

• Doom scrolling depletes the same chemical needed for focus, motivation, and productivity

• Why students who decompress with video games before homework are setting themselves up to struggle

(11:59) ADHD Explained — Genetics, Perimenopause & What's Really Happening

• ADHD is one of the most genetic conditions in psychiatry

• ADHD as a supply-demand issue: blood flow to the prefrontal cortex vs. the demands placed on it

• Why perimenopause triggers ADHD-like symptoms 

• The difference between brain fog from perimenopause and preexisting ADHD — and why one makes the other worse

(21:04) ADHD as a Superpower — And Why Medication Isn't the Enemy

• Why traits coded as ADHD likely survived evolution 

• Creativity, hyper-focus, intuition, outside-the-box thinking — the real strengths of an ADHD brain

• The mismatch between ADHD wiring and traditional classrooms: why Dr. Storage doesn't view ADHD as a disorder

• Stimulants vs. non-stimulants — what Adderall actually does to the prefrontal cortex

• The goal isn't to eliminate the superpower — it's to modulate the brain so you can access focus when you need it without losing creativity

(32:35) Brain Development, Early Diagnosis & Rewiring Negative Thoughts

• The prefrontal cortex isn't fully developed until mid-to-late 20s — so how do you know when to treat?

• New MRI data: kids treated for ADHD before age 12 showed accelerated prefrontal cortex development

• Dr. Storage's three-step method for negative thought patterns

• Why meditation builds metacognitive awareness and helps thoughts pass like luggage on a conveyor belt

Thanks for the support from our partners, including: 

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Executive coach and bestselling author Amina AlTai joins Karena to unpack the hidden psychology behind burnout, overachievement, and what she calls the "ambition trap" — the exhausting space between feeling too much and never enough. After her own health crisis brought on by relentless overworking and undiagnosed autoimmune disease, Amina went back to study coaching, nutrition, and mindfulness, and built a practice helping high-achieving women reconnect with purposeful ambition. In this episode, they explore the five core childhood wounds that quietly shape our careers, how invisible labor fuels resentment, and the concrete steps to set boundaries, stop tolerating what's costing you, and find work that's truly yours.

Recognizing the core wounds quietly driving your hustle is the first step toward breaking free from the ambition trap and reclaiming a life that's actually yours.

(00:16) The Burnout That Nearly Broke Her

• Amina's origin story: marketing career, immigrant family pressure, and the relentless pursuit of achievement

• How two autoimmune diseases became the catalyst for an entirely different life

• Why burnout isn't just exhaustion; it's what happens when achievement becomes identity

(03:01) The Five Core Wounds Driving Your Ambition

• Amina's framework: abandonment, rejection, humiliation, betrayal, and injustice, and the masks we wear for each

• Why the control mask often leads directly to burnout

• Awareness is the first and most powerful step to breaking the pattern

(10:44) How Core Wounds Show Up at Work

• The withdrawal mask: avoiding opportunity out of fear of rejection

• Masochism and martyrdom as the blueprint for burning out

• Perfectionism (the rigidity mask) and why waiting for 110% keeps you stuck

• The real cost of micromanagement and what it signals about the betrayal wound

(16:07) Boundaries, Burnout & Invisible Labor

• The SBIS model (Situation, Behavior, Impact, Solution) for navigating hard workplace conversations

• Invisible labor = the unpaid, unseen work women carry at home and at the office

• How tolerations silently drain your energy and how to start raising the standard

(31:13) Reinvention, Purpose & the Passion Myth

• Why the idea of one singular career no longer fits how long or how fully we live

• The crucial difference between passion and purpose 

• Amina's five elements of purposeful work 

• Joy sparkers vs. fire starters: a practical tool for building more of what lights you up into daily life

Thanks for the support from our partners, including:

Guest Resources

• Get the book: The Ambition Trap — How to Stop Chasing and Start Living

• Visit Amina's website

• Follow Amina on Instagram
  
  

If this episode moved you, please consider supporting The Big Silence Foundation and exploring our resources:

Connect with The Big Silence Community

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In this conversation with Kenny Santucci — personal trainer, entrepreneur, and founder of Strong New York — Karena explores how growing up broke in New Jersey shaped his relentless work ethic, why he lost millions and kept going, and how fitness became his anchor through canceled deals, failed businesses, and a suicidal crisis. Kenny also shares his philosophy on building real community through fitness, what the industry gets wrong, and why he believes a healthier city starts one workout at a time.

Resilience isn't a personality trait. It's a decision you make in the dark, over and over again.

(00:46) Jersey Roots, Zero Hand-Outs

• Growing up broke in Newark and learning early that work was the only way out

• Why Kenny's never taken investor money

• How coming from nothing shapes your hunger as an entrepreneur
  

(03:15) The Fat Kid Who Became a Trainer

• Kenny's upbringing and the gym that changed everything

• How getting in shape shifted the way the world treated him — and what he actually thinks about that

• "If you want people to add to your cup, you need to give them some sort of value."
  

(13:57) From the Docks to the Gym Floor

• From the Port Newark shipping yard to New York City

• What television taught him and why he walked away

• Why everyday clients, not celebrities, are the ones who make lasting changes
  

(17:50) Getting Canceled and Going Broke

• Losing two gyms to bad partners 

• Being canceled and the dark spiral that followed

• How he climbed out by chalking up wins, leaning on family, and just going for a run
  

(32:57) What the Fitness Industry Gets Wrong 

• Selling aesthetics over community is the industry's biggest disservice

• The "gateway drug" approach: try yoga, boxing, Pilates — and don't marry any of it

• Why you push 30–40% harder alongside other people
  

(53:29) Strong New York, Plant Medicine & the Supplement Stack

• The mission behind Strong New York's September 26th event 

• Kenny's take on psilocybin, microdosing, and the mental health case for plant medicine

• His actual supplement priority list: creatine, protein, nootropics

• Why a brain isn't a brain without other brains around — and what AI therapy is getting wrong

Thanks for the support from our partners, including:

• Follow Kenny on Instagram (https://www.instagram.com/kennysantucci)

• Follow Strong New York on Instagram (https://www.instagram.com/strongnewyork)

• Strong New York on YouTube (https://www.youtube.com/@StrongNewYork)

If this episode moved you, please consider supporting The Big Silence Foundation and exploring our resources:

Connect with The Big Silence Community:

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In this conversation with Dr. Shefali Tsabary, clinical psychologist and author of The Conscious Parent, Karena explores how unhealed childhood wounds get passed down through generations, why traditional discipline doesn't work, and how the three-step process of awareness, acceptance, and action can help you break toxic patterns — whether you're a parent or not.

How do we stop unconsciously passing our unhealed wounds onto the people we love most?

The path to conscious parenting begins not with your child — but with you.

(00:23) From Psychologist to Conscious Parent: The Origin Story

1. Why Dr. Shefali's work applies to anyone who has ever had a parent
2. Her journey from clinical psychology to meditation to motherhood
3. How unhealed childhood baggage gets projected onto the people we love most

(06:55) Triggers, Boundaries & Breaking the Cycle

1. Why nothing outside of you is truly the trigger, only the match
2. Why real boundaries are internal actions, not instructions to other people
3. The three-step path forward: awareness, acceptance, action

(11:12) Screens, Mental Health & the Disconnection Crisis

1. “Screens are the worst thing to happen to children."
2. Anxiety in girls has doubled; suicidality in boys is at an all-time high
3. The real culprit: Overstimulation and disconnection from the present moment
4. Connection is the antidote to all emotional disease

(15:10) Control, Happiness & the Wake-Up Call We're All Avoiding

1. Why the need to control comes from having been controlled in childhood
2. The numbing epidemic: Netflix, dead-end relationships
3. What it takes to honestly say "I don't like my life"
4. How compliance in children (and adults) leads to eventual breakdown

(23:11) Role Reversal, Self-Love & the Books That Can Change Your Life

1. A community question on growing up as the caretaker and what happens when you need care
2. Karena shares her painful experience as her mother's caretaker in her final five years
3. Dr. Shefali's truth: "No one can love us the way we need — that's everyone's ultimate lesson."

Thanks for the support from our partners, including:

1. Visit Dr. Shefali's website
2. Get a 30-day free pass to Dr. Shefali's community! Email her office and mention The Big Silence
3. Order her books
4. Follow her on Instagram

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Connect with The Big Silence Community

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In this conversation with Dr. Marc Brackett, founder and director of the Yale Center for Emotional Intelligence, Karena explores the science of emotional regulation, the RULER framework (Recognizing, Understanding, Labeling, Expressing, and Regulating emotions), and why traditional approaches to handling feelings often fail. Dr. Brackett shares his personal story of childhood trauma, discusses the unique challenges men face with emotional expression, and provides practical strategies for dealing with grief, anxiety, and everyday emotional overwhelm.

How do you actually deal with your feelings instead of suppressing them—and why is emotional intelligence the key to better mental health, relationships, and longevity?

Understanding how to regulate your emotions isn't about fixing or judging them—it's about building the vocabulary and tools to recognize, understand, and work with what you're feeling.

(01:23) The RULER Framework & Navigating Grief Without Judgment

1. How to be present for others during loss while protecting your own well-being
2. Becoming an "emotion scientist vs. emotion judge" during difficult times
3. Emotionally intelligent time travel: recognizing temporary circumstances and taking space when needed

(07:18) Why Men Are Drowning in Suppressed Emotions & The Uncle Marvin Story

1. Gender differences in emotional expression are socialized, not biological
2. How "toughen up" culture teaches boys to deny and suppress feelings
3. Dr. Brackett's childhood sexual abuse, bullying, and why suppression creates emotional debt

(15:42) From Trauma to Yale: Building Emotional Vocabulary & Understanding Anxiety

1. How childhood pain sparked Dr. Brackett's career researching emotional intelligence
2. Why precise emotional vocabulary matters
3. Building emotional granularity to better understand your internal state

(27:35) Realistic Optimism, Toxic Positivity & Six Strategies for Dealing With Feelings

1. Why "everything will be fine" is dangerous
2. Learn to deactivate your nervous system through meditation and breathwork
3. The biology of regulation: sleep, nutrition, and movement directly impact your ability to manage emotions

(38:46) The Dealing With Feeling Wheel: Monthly Check-Ins for Emotional Health

1. Monitoring self-talk, breathing practices, reflection, and social connection
2. Assessing sleep quality, nutrition habits, and movement patterns
3. Why all these elements work together for mental health and longevity

Thanks for the support from our partners, including:

In this conversation with Dr. Wendy Oliver-Pyatt, a board-certified psychiatrist specializing in eating disorders and founder of Within Health and Galen Hope treatment centers, Karena explores the life-threatening reality of eating disorders as serious mental illnesses that claim one life every 52 minutes in America. Dr. Oliver-Pyatt explains the biopsychosocial foundations of eating disorders, shares her personal journey from ballerina to eating disorder specialist, and discusses the warning signs in athletes and high achievers. She reveals the controversial truth about GLP-1 medications and eating disorder risk, and provides actionable tools for reframing your relationship with your body through self-compassion and intentional self-care practices.

Understanding that weight stigma is trauma opens the door to compassion—and real recovery.

(01:13) The Deadliest Mental Illness You've Never Heard Of

1. Eating disorders kill one person every 52 minutes in America
2. Why they aren't classified with "serious" mental illnesses despite being more lethal than many
3. The confusion between societal pressure and actual mental illness diagnosis
4. Understanding the biopsychosocial foundation: biological, psychological, social, and spiritual factors

(04:47) From Ballerina to Eating Disorder Psychiatrist

1. Growing up as the child of a Holocaust survivor with a mildly autistic mother
2. How ballet and puberty collided to create impossible body standards
3. The danger of narrow frameworks about what's "acceptable" in our bodies

(18:32) Athletes, Perfectionism & the "Healthy" Eating Trap

1. Why high-achieving athletes and fitness enthusiasts face elevated eating disorder risk
2. The difference between disordered eating behaviors and diagnosable eating disorders
3. How orthorexia disguises itself as "clean eating" or "wellness"
4. Warning signs to watch for in competitive sports and fitness culture

(32:47) What Real Treatment Looks Like

1. The biopsychosocial-spiritual treatment model that addresses all aspects
2. How nutritional rehabilitation and medical stabilization work together
3. Family-based treatment approaches for adolescents and young adults

(47:36) The GLP-1 Controversy: Ozempic, Wegovy & Eating Disorders

1. "It's asinine there's no eating disorder warning"
2. How rapid weight loss medications trigger and worsen eating disorders, especially in teens
3. The danger

In this conversation with Bizzie Gold, founder of Break Method and creator of brain pattern mapping technology, Karena explores how childhood experiences create predictable patterns that shape your relationships, career, and mental health—and how understanding your source belief pattern can help you break free from self-deception and build a healthier life.

Understanding your source belief pattern is the first step toward breaking free from self-deception and building the life you actually want.

(02:05) Brain Pattern Mapping & Bypassing Your Story

1. How Bizzie created a predictive algorithm with 98.3% accuracy
2. Understanding childhood experiences as a "distortion filter"
3. Helping people see their own blind spots

(06:16) The Sweet Spot of Trauma That Makes Great Entrepreneurs

1. Why childhood instability creates self-trust and self-efficacy
2. Developing situational awareness to stay safe and how it translates to business
3. Being able to "think five rings down" when others can't see what's coming
4. Attracting chaotic people because you have too much empathy
5. Why workaholism is easier than intimate relationships for abandonment patterns

(13:47) Enmeshment Patterns & The Right Side of the Spectrum

1. The struggle with self-trust and decision-making
2. Why enmeshed patterns need to learn to disappoint people
3. Understanding why some people can't say no

(27:18) Self-Deception & Why Your Brain Lies to You

1. How childhood patterns create self-deception mechanisms
2. Why Bizzie keeps giving chances to people with bad intentions
3. The lesson: don't let empathy destroy your business from the inside

(40:33) Growing Up with Psychiatric Illness & Finding Your Drive

1. Bizzie's experience with an unstable, abusive childhood
2. Activities and achievement as a distraction from chaos at home
3. Why self-preservation instincts don't come naturally for some patterns

(49:08) Self-Care for Workaholics & Pattern Opposition

1. Why self-care is actually mental health work for go-go-go people
2. Doing things that make you feel accomplished in self-care
3. For avoidant patterns: the opposition is to just...

What if your worst childhood trauma became the gateway to your greatest gift?

In this profoundly moving episode of The Big Silence, Karena sits down with Susan Grau: soul healer, grief and addiction therapist, and Hay House bestselling author. Her near-death experience transformed a childhood marked by extreme trauma into a life devoted to healing. Susan had a childhood that most people can't imagine surviving. But she’s transformed unimaginable pain into a life of powerful healing. Now a grief and addiction therapist who works with spirits from the other side, Susan shares how she learned to survive by becoming her unstable mother's "ally," how codependency became her survival strategy, and why she believes therapists need lived experience to truly help people heal.

True healing comes from walking through the fire, not just studying it from afar.

(02:43) A Near-Death Experience That Changed Everything

1. Susan's story of being locked in a freezer at age 5
2. Growing up with sexual abuse and trafficking
3. How childhood trauma shaped her entire life journey and awakened her abilities
4. The beginning of her connection to the spirit world

(05:51) Growing Up with a Mother with Mental Illness

1. Susan's mother: borderline personality disorder, seeing spirits, and extreme inconsistency
2. Learning how to stay safe
3. The confusing duality: loving and giving one moment, frightening and abusive the next
4. Why Susan became her mother's "ally" while her siblings didn't understand how
5. Understanding codependency as a survival strategy for children of mentally ill parents

(14:18) Addiction, Alcoholism & A Household of Dysfunction

1. Growing up in a home with addiction, alcoholism, and abuse
2. Her brother’s schizophrenia
3. The unpredictability of never knowing which version of your parent you'd get
4. How dysfunction becomes normal when it's all you know

(27:33) Her Brother's Suicide & Choosing to Become a Therapist

1. Why that loss pushed her toward becoming a grief and addiction therapist
2. The importance of therapists having lived experience with trauma and loss
3. How walking through darkness prepares you to help others find light

(38:13) Why Your Therapist Needs to Have Walked Through Fire Too

1. Why Susan doesn't want to see a therapist who hasn't experienced real trauma

What if gratitude isn't just something you feel, but something you create more of every time you practice it?

In this grounding Mental Wellness Month meditation, Karena guides you through an 8-minute practice designed to help you reconnect with gratitude for your body, your breath, and your journey. Using breathwork, visualization, and mantras, this meditation invites you to pause and give thanks for all that has carried you to this moment. Perfect for finding beauty in the everyday, shifting your perspective, or simply celebrating all that you have and all that you are.

Gratitude is a practice. And every time you acknowledge it, you create more of it.

(00:00) Finding Your Peaceful Place & Connecting to Beauty

1. Settling into a quiet space, either indoors or in nature
2. Recognizing that you are surrounded by beauty
3. Pausing to give thanks for all that you are and all that has carried you here

(03:30) Bringing Gratitude to Mind & Holding It in Your Heart

1. One thing you're grateful for today
2. Gratitude for your body, your breath, a loved one, a lesson you've learned
3. Understanding gratitude as a practice, a perspective, a way of living

(06:00) Mantras & Radiating Gratitude Outward

1. "I am grateful for my body. I am grateful for this breath. I am grateful for my journey."
2. Letting your gratitude radiate outward into your life and everyday
3. Celebrating all that you have

If this episode moved you, please consider supporting The Big Silence Foundation and exploring our resources:

Connect with The Big Silence Community

1. Order: The Big Silence Memoir audiobook
2. Shop The Big Silence Self Love Collection
3. Subscribe on YouTube
4. Donate to The Big Silence Foundation
5. Find exclusive offers from our supporters: https://thebigsilence.com/pages/our-podcast-partners

Show Resources:

1. VISIT THE CHALLENGE...

What If Your Gut Could Heal Your Mind?

In this deeply personal episode of The Big Silence, Karena sits down with functional medicine pioneer and bestselling author Dr. Will Cole. From growing up with a bodybuilding dad in the '80s to building the first functional medicine telehealth clinic, Dr. Cole shares his unconventional path to becoming one of the most trusted voices in holistic health. He opens up about the gut-brain connection, why psychiatry still ignores the organ it's treating, and how he practices what he preaches. If you've ever felt dismissed by traditional medicine, struggled with anxiety, or wondered why your mental health and digestive issues seem connected, this conversation will validate everything you've suspected and give you the tools to finally heal.

(00:00) From Bodybuilding to Functional Medicine Pioneer

1. Growing up in the '80s with a Gold's Gym-owning bodybuilder dad
2. How his childhood of "crunchy granola" health became his life's work
3. Starting the first functional medicine telehealth clinic 16 years ago

(08:00) Why Doctors Told Karena They "Don't Deal With Mental Health"

1. The devastating disconnect between mental and physical health in conventional medicine
2. Why psychiatry is the only field that doesn't test the organ it's treating
3. The gut-brain connection: how inflammation, microbiome imbalance, and stress show up as anxiety and depression
4. Breaking down the stigma and siloed approach to healthcare

(15:00) The Shame-Inflammation-Trauma Loop No One's Talking About

1. How toxic shame inflames your body and destroys gut health
2. The science behind stress, trauma, and autoimmunity
3. Why unresolved emotional pain manifests as physical symptoms
4. Dr. Cole's personal struggle with anxiety and overthinking
5. The tools that work: vagus nerve stimulation, peptides, nature, and movement

(25:00) When Everything Hit at Once

1. His father's sudden death
2. The "Gwyneth bone broth" controversy
3. Navigating professional chaos while grieving

(33:00) The Real Tools for Anxiety, Stress & Staying Grounded

1. Transcutaneous vagal nerve stimulation: what it is and why Dr. Cole wears it daily
2. The role of peptides in healing and stress management