How to Recover From Decades of Chronic Stress

Stress researcher Dr. Elissa Epel explains why the goal isn't to eliminate stress but to get better at recovering from it. She says that a sharp, short stress response followed by real rest is the hallmark of a young, healthy nervous system. She breaks down the science of why chronic vigilance quietly ages our cells and shortens telomeres. Plus: why lying down can defuse an argument, how someone can recover from years of chronic stress, and why nature, ritual, and even a good nap belong in everyone's stress prescription. Dr. Epel's research reveals a central idea of the Perception Box, a framework developed by Elizabeth R. Koch for understanding the forces within us that shape how we see ourselves, relate to others, and move through the world. Elissa Epel, Ph. D., is a professor of psychiatry at UCSF, where she directs the Aging, Metabolism, and Emotions Center. She co-wrote the New York Times bestseller The Telomere Effect with Nobel laureate Elizabeth Blackburn, and her latest book is The Stress Prescription. A member of the National Academy of Medicine, her research has been featured on 60 Minutes, NPR, and in the New York Times and Wall Street Journal. Dr. Heather Berlin is a neuroscientist, clinical psychologist, and Professor of Psychiatry and Neuroscience at the Icahn School of Medicine at Mount Sinai in New York City. Dr. Christof Koch is Chief Scientist for the Tiny Blue Dot Foundation and the current Meritorious Investigator and former President of the Allen Institute for Brain Science. Join us for new episodes every Thursday. Follow the show on YouTube, Spotify, Apple Podcasts, Amazon Music, or wherever podcasts are found. Love the show? Write us a review on your podcast app, or tell a friend about the show. Visit unlikelycollaborators.com for more information. Chapters: 03:00 What happens in mind and body under stress 05:16 Why too little stress ages you faster 13:20 Is chronic stress damage reversible? 15:12 What a healthy stress response looks like 18:06 Tunnel vision: the Perception Box under stress 24:15 Building recovery into your day 27:37 The stress prescription, part two: practices 31:13 Deep rest as a gateway to transformation 32:38 Recovering from years of chronic stress 38:41 Highly sensitive people and anxiety 40:09 Perception Box question: what do you want people to believe about you?

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  The perception box is such a brilliant analogy to help us understand that stress is completely about the perception box constricting and making us have this tunnel vision we literally can't see in the periphery as much.

• 0:18Heather Berlin?

  Hi, I'm Elizabeth Koch. What's a perception box? It's this invisible mental box that each one of us lives inside, built from the material of our beliefs, life experiences, and the meaning we've made out of those experiences. You could think of it as a kind of reality filter that's constantly shaping how we see ourselves, other people, and the world around us. This podcast explores how, although the walls of this box are always present, they can expand in moments of curiosity, awe, and wonder, or contract in response to fear, anxiety, and anger. In each episode, we invite experts to share how to create lasting shifts in our perception.

• 1:03Heather Berlin?

  I'd like to introduce our esteemed hosts, Heather Berlin, professor of psychiatry and neuroscience at the Icahn School of Medicine at Mount Sinai, and Christoph Koch, chief scientist for the Tiny Blue Dot Foundation and former president of the Allen Institute for Brain Science. Welcome to the Science of Perception Box. This week, our guest is Dr. Alyssa Appel. Dr. Appel's work proves that stress isn't just the situation, it's how we interpret it. Whether we experience something as a threat or something we can face has less to do with the event itself and more to do with our hidden beliefs. Through the lens of the perception box, those beliefs are the key to how we feel,

• 1:47Heather Berlin?

  how we engage with others, and how big we're willing to dream. Christoph, how would you describe your relationship with stress?

• 1:56Speaker 02

  Unhealthy.

• 1:59Speaker 02

  No, I think as an older, I stress less, and I've always been a big believer in Marcus Aurelius, you know, Stoic, and in the Serenity Prayer that I learned a long time ago, which is something like, "Oh, God, give me the wisdom to change the things I can change, the serenity to accept the things I cannot change, and the wisdom to tell the difference between the two." And I think today, in these days, that's more important than ever. If I can't change it, I try not to worry about it.

• 2:28Heather Berlin?

  That's a good philosophy to have. But when you're, when you are stressed, what do you end up doing?

• 2:32Speaker 02

  Breathing, going outside for a walk, running, climbing, doing a lot of physical stuff because then you focus on your body away from, you know, this rumination.

• 2:43Heather Berlin?

  Your mind, because a lot of stress is in your mind. Right, well, we have an expert guest, luckily, to help us talk about and unpack all of this today. So I want to welcome Alyssa. So to start off, what's happening in our minds and in our bodies when we're stressed?

• 3:00Speaker 00

  Well, first of all, thank you, Heather and Christoph. So fun to be with you in person here. And so glad you brought up the Serenity Prayer, which really just holds so much wisdom within a few sentences. So a lot of what we'll talk about, we'll go back to that. So when we're stressed, when we have an acute stressor happen, we are shifting everything. So the first thing that happens, we're always asking, is this safe or not? Are you a safe person? Are you an other? Are you someone I need to be on guard and vigilant for? And that acute stress response is really beautiful because we constantly need to adapt to different environments

• 3:42Speaker 00

  and perform, get the motivational energy from the stress response. It oxygenates our brain. We get so much blood going to our brain when we're having a nice acute stress response. And when I say nice, I mean moderate, not extreme. And so there's that sweet spot of the acute stress response energizing us, motivating us, and giving us, in a sense, some superpowers to cope and problem solve better.

• 4:09Speaker 02

  I remember when I was climbing on big walls. So you're, you know, you're on a big wall. It's granite, it's completely horizontal below you, 5,000, you know, way above the deck level. And then what happens? You get this Elvis Presley leg. You're fully highly aroused and stressed. You know, and you have to try to push down, and your mouth becomes incredibly dry. But I guess that does energize you and it really prepares you for what's ahead. It's beautiful, it's very arousing.

• 4:33Heather Berlin?

  There's that, like, it was the Yerkes-Doxson, you know, curve, where it's like, some stress is good, you know, moderate stress. But, and too little is like, not great because it's, you're not motivated. But then too much stress is also not great. So it's that sweet spot of where it can be motivating, but not, you know, too much where it becomes debilitating.

• 4:54Speaker 00

  Exactly, Heather. The Yerkes-Doxson, Doxson curve has so much wisdom in it. So when we are under-engaged, when we're not engaging in stress, we're really not engaging in life. We get stress sluggishness, which means we're hypersensitive to stress. We avoid it more, and it's related to faster aging, including cognitive aging.

• 5:15Heather Berlin?

  So you're saying too little stress is related to it?

• 5:18Speaker 00

  So people who report, you know, when they're monitored for several weeks, when they don't report any stressors, they actually age faster. And then, of course, there's, as you said, the more-

• 5:28Speaker 02

  It could be boredom?

• 5:29Speaker 00

  It could be. It often is, you know, social isolation, lack of engagement, avoidance due to anxiety. And then there's the other end, the more extreme levels of stress. And so you are experiencing a pretty hefty acute stress response that your body needed for that situation. We get cold, right? We get the vasoconstriction. We, we have a, sometimes our whole cardiovascular system vasoconstricts. And that's one way of increasing blood pressure. But that's actually a threat response. So that's what we do when we're fearing that we're going to be wounded and we want to prevent bleeding. We get that vasoconstrictive response.

• 6:13Speaker 00

  There's a challenge response, which is actually vasodilative. We have big cardiac output to the brain, lots of oxygen. And that's when the story we're telling ourself is one of positive coping, one of empowerment. So I do statements like, "I can handle this. I know I'll get through it. This is good for me. My body's excited." All of those types of appraisals shape us to have that more energizing stress response when we can still think clearly versus that deer-in-the-headlights response when we get tunnel vision, we're just looking at threat cues, and we're interpreting everything as stressful.

• 6:52Speaker 02

  We freeze.

• 6:52Heather Berlin?

  So it's not, it's the, so, you know, we have this physiologic response to stressors, but what you're really saying, it's our perception box. And how we perceive that physiologic response can be the difference between whether it has a detrimental effect on our bodies or it leads to more resilience.

• 7:10Speaker 00

  Exactly. So let's talk about that detrimental effect. Stress biology and aging biology are best friends. They overlap significantly. If we're living in that sweet zone where there's moderate stress, we're engaging regularly, we feel some control, and we have recovery, this is an anti-aging lifestyle. And the reason is that the short-term stress response, when we feel some control, is good for us, and it's good for our aging.

• 7:39Speaker 02

  So when you say it's good for aging, how does that show up at the level of the brain or the body?

• 7:44Speaker 00

  Yeah. At the end of extreme stress and toxic stress, when we don't have breaks, I call that stress acceleration of aging. And what's happening in the cells is that they're basically in a coping response, and they run out of resources, and they break down and can't clean up. So more specifically, we create a stress soup, oxidative stress, stress hormones like cortisol, catecholamines, inflammation, pro-inflammatory cytokines, and also metabolic stress, insulin resistance, so high insulin, high glucose. And those signals tell the cell to use up all its resources to try to cope and protect itself.

• 8:29Speaker 00

  And that leads to more of a wear and tear on the different mechanisms of the cell. So the, the proteins get damaged. There's a buildup of junk or lipofuscin in the cells that's not cleaned up by the autophagy, the Pac-Man, that, that gets junk and oxidative stress. And the telomeres, which we can talk about more, these, these tips at the ends of the chromosomes that protect us, they get worn down. We wear out our anti-aging enzymes like telomerase. And so we lose protection, and the cell can die, age and die early.

• 9:09Speaker 02

  Yeah, so maybe we can talk a little bit more about the telomeres, right, at the tip of the end of the, of each chromosome, because it's been claimed, and there's some evidence to back it up, that, that the number of cell divisions cells can undergo, chromatic cells can undergo, correlates to the length of those telomeres at the end that prevent the chromosome unraveling and helps the DNA repair mechanism. So I guess you're saying that stress will shorten those telomeres and thereby actively reduce the number of cell replications that those cells can undergo?

• 9:45Speaker 00

  Exactly, Christoph.

• 9:46Heather Berlin?

  You know what? I could just translate that also into an analogy that I like to think of with the telomeres is that it's like the shoelace. And, you know, at the tip of the shoelace is like that piece of plastic that keeps it from unraveling. And so, you know-

• 9:58Speaker 02

  Oh, that's cute.

• 9:59Heather Berlin?

  Right, that's my little visualization, right? And so if you have a shorter one or a degraded one, it's more likely that the shoelace is going to unravel, right? I mean, the question is, it's not, it's not about necessarily how much stress or how much prolonged stress you've been under. But really, you can have an impact on how stress affects you by just changing the way you think about it. So even if you're under chronic stress, it might not have such a negative effect on you if you can think about it in a different way.

• 10:26Speaker 00

  Yeah, and I would, I would break down what you're saying into when you're under chronic stress, let's talk about the, what's happening in your life. So the exposures. So you may be in a really stressful job, or relationship, or political environment. And the question is, what story are you telling yourself? The story is determinant of our stress response. And we have some control over the narrative. We can look very closely at the narrative. So I think this idea of, well, how do we cope with stress? You can try that practice and that practice. See what works and feels good is, is very superficial. Underneath that-

• 11:09Speaker 00

  Stress resilience is about understanding the mind, both the science of stress as well as really looking at our, what stresses us out, what are our thoughts? Like really being mindful and using metacognition to say, what story am I telling of myself? Like just sitting here right now and anyone listening, just ask yourself, what is your body expecting? Open the door, look inside. Am I worrying about something? Did I walk in here carrying, you know, heavy burden of chronic stress? Because I've been trying to problem solve a situation? Or I'm worried about someone else? So we're always carrying unconscious stress.

• 11:52Speaker 00

  And our body keeps record of that. Body keeps a score, you might say. And so we can be tense and vigilant and not really be aware of why or notice that.

• 12:03Speaker 02

  Listen, but how would this help? So let's say I'm a caretaker, right? I have a child on age parent and I'm in constant stress. Because how practically, how does this wisdom help me know that myself? I know I'm in this situation. I know I'm stressed.

• 12:18Speaker 00

  Yeah.

• 12:18Speaker 02

  Because the same thing happened for the 20th time.

• 12:22Speaker 00

  Yes.

• 12:22Speaker 02

  So what do I do now to reduce my stress level?

• 12:26Speaker 00

  Caregiving is a great example. There's no switch to turn off stress. And we'll probably talk more about this, but there's no measure in the body, one biomarker of stress in the body or brain. There's many, it's so multi-dimensional and complex. When we are a caregiver, we are in a situation with a chronic stressor. We are feeling some level of chronic stress. And so then this question of, well, how can we manage that? Becomes so critically important. Caregivers need much more self-care, resources. And if they don't have that, they are on a speedier track. But every day matters.

• 13:08Speaker 00

  We can reverse stress aging biology within minutes, hours, days, months. Nothing that we've talked about is permanent and irreversible.

• 13:20Heather Berlin?

  I really want to get into the reversibility, because I know a lot of people under chronic stress, patients I have that are very worried that they've already done all this damage and they're going to live shorter now and there's nothing they can do. Or take a child who's had, you know, a traumatic childhood, not under their control, but they were under chronic stress throughout their whole, you know, early years of development. You know, can you reverse that? So I want to get into that. But what you said is so important with like caregivers and, you know, having two young children myself, is that self-care is so important. And I think I often say to people, you know, when they say you have to put on your mask first before you help the other, you know, you're not going to be a good parent, a good caretaker, unless you've taken care of yourself as well. And you have to make time for self-care, whether it's going for a walk or whatnot.

• 14:01Speaker 00

  Yeah.

• 14:01Heather Berlin?

  But the other thing is the how you, the story you tell of stress. When I was very young, my mother said to me, I was nervous to do a play. And she said, those butterflies, it's not nervousness, it's excitement. And that one reframe, when I felt the jitter, you know, in my stomach, and to this day, if I'm doing some big event or whatever, I will say, no, it's not, I'm excited. And that's a good feeling. And so when you reinterpret it, the physiology, it can really make a difference. So those are the points really. I think self-care is so important, taking time out for yourself. And, but I do want to get into the, how do you reverse this? Is it reversible?

• 14:36Speaker 00

  Okay, let's talk about that. But what you just described is so beautiful, because it describes the essentialism, the magic of the stress response. We want a good acute stress response. So what people don't understand about stress is they think all stress is bad. We want a big, strong mounting of the response, a big peak and the quick recovery. And that is a healthy, young response. That's what we see in young organisms. And we see the breakdown of that with chronic stress and with aging. We see a sluggish response, we see a slow recovery.

• 15:12Speaker 02

  Time skip, we're talking about minutes here, right?

• 15:14Speaker 00

  I'm talking about the short-term acute stress response within minutes. We want that. We want to be able to mount that. And in a sense, you know, rise up, perform, meet the moment. And when we get dysregulated and in some clinical conditions, we don't get that beautiful, sharp stress response and recovery. We get kind of a high baseline and a sluggish recovery. So that idea of like, I feel my heart racing. This is good. My body is doing exactly what it knows to do. And I don't need to fight it, I can go with it. This is, you know, my evolutionary response is going to happen. And it's to help me.

• 15:54Heather Berlin?

  Yeah, I think that's so important for people to know that. And with patients too, with exposure therapy. You know, I'm always telling them, avoidance is not good. Don't avoid the thing you fear. In small doses, sit with the uncomfortableness.

• 16:05Speaker 00

  Beautiful.

• 16:06Heather Berlin?

  Sit with it until it resolves and then push yourself to the next level and the next, until you can move through life. And it gives you much more freedom.

• 16:13Speaker 02

  So trigger warnings actually can be dysfunctional.

• 16:16Heather Berlin?

  Absolutely, yeah. The whole thing with trigger warnings and safe spaces and whatever. No, I think, you know, you don't throw someone who's afraid of, you know, spiders into like, you know, a spider cage. That would be flooding and that would be too much. But little steps, you don't want to, I think one of the biggest problems, you know, is that we've sheltered young kids so much that they can't deal with any like opposing views or anything that makes them feel uncomfortable. And that's not healthy.

• 16:40Speaker 00

  Yeah, yeah. And so I call that, that's stress unfitness. Stress fitness is when we stay actively engaged in small stressors that we can learn from, grow from, thrive. And so that doesn't mean just relaxing and staying home and being chill all the time. We absolutely need more restoration recovery. That's critical stress resilience. But we need that, that kind of daily peak and recovery. So like if we were taking shots of coffee all day, or sorry, if we take a shot of coffee, we feel good, we get a benefit. If we take it all day, we're feeling anxious, worn out. We don't get the, we've developed a chronic stress response.

• 17:24Heather Berlin?

  What is the stress prescription? And how do we know when it's too much? How do people know?

• 17:29Speaker 00

  Yes.

• 17:30Heather Berlin?

  Where is that sweet spot?

• 17:31Speaker 00

  So the stress prescription is partly helping us understand how the mind works. So that's both science and introspection. There's some universals of how the mind works. The perception box is such a brilliant analogy to help us understand that stress is completely about the perception box constricting and making us have this tunnel vision we literally can't see in the periphery as much. We're looking for threat cues, we miss safety signals, we miss smiles.

• 18:06Heather Berlin?

  But depending on where you're at, you're going to interpret that one way or the other, ambiguous.

• 18:09Speaker 00

  Ambiguous uncertainty. We are living in a world of VUCA.

• 18:15Heather Berlin?

  What is that?

• 18:16Speaker 00

  VUCA, V-U-C-A. Kristoff has heard of it.

• 18:19Speaker 02

  VUCA, no.

• 18:19Speaker 00

  Okay, so it's used in the military, it's used for businesses that are trying to cope with an environment of extreme uncertainty, change management. V is for volatility. We are living in a highly volatile world right now. Things can change dramatically, day to day. And of course, with the ecological crisis and political situations, we see that. That's no mystery. We have high volatility, which means change, which means stress. We need to adapt. The U is for uncertainty. We hate uncertainty. Most people, as a universal for how our brain works, we want predictability, we want control.

• 19:01Speaker 00

  We want to know what's going to happen next so that we can relax. And we don't need to stay vigilant. There's a scale I love called intolerance of uncertainty. It's a great predictor of anxiety and depression. We studied people during the pandemic. The more they were brittle or intolerant of uncertainty, not knowing what tomorrow holds, the more likely they were going to develop depression or anxiety symptoms during the pandemic. So that's the VU. This, the C is complexity. We're living in systems. We can't always see the systems and the interrelationships. So there's a complex world out there that we can't fully understand and see. We have this limited perception box.

• 19:42Speaker 00

  And we can, we see when we're stressed, we lose the complexity. Things become very simple. And we see things in more black and white. And the A is for ambiguity. So we're in VUCA times. And we need stress resilience skills more than ever. And we're just not taught that in schools, in our society. Everything's kind of working against us to make us more anxious. Of course, the information overload. So the second part of the stress prescription is really thinking about, how do we, given that we can understand stress, there's short-term good stress, and we also need restoration. How can we take control when we can?

• 20:25Speaker 00

  And downshift or upshift to a positive stress state? So that's this range that we should have every day. Acute stress, there's yellow mind states, true relaxation, green mind states, and then depressed.

• 20:37Heather Berlin?

  Oh, is this the proportion in which we should have it? Or is this just a cover?

• 20:41Speaker 00

  So that's a question for all of us. What percent of the time do we spend in red mind a day? What percent of the time do we spend in yellow mind? What's yellow mind? I would say that it's the most common state. We walk around in a state of residual stress. We are still holding on to unconscious stress, even though nothing is happening. There's no fire in this room. But we're ready to run. And we need to actually say, okay, right now, we're safe. I can relax. It's okay to relax. It's very important to tell ourselves that in words. And then do a mini mindfulness release.

• 21:22Speaker 00

  So even as simple as breathing in, softening. Breathing out, releasing. That took a few seconds and it slows things down. And our body needs to go slower. So if we can kind of have this range during the day and control it and say, right now, I'm going to reach a green mind state. I'm going to go, I love all the green in your office. I'm going to go look up close to a plant or go outside and look at the skyline, the ocean. Or if you have some sensory experience you can engage in, if you have pets.

• 22:05Speaker 00

  There's nothing like that kind of exchange.

• 22:09Speaker 02

  Stay off news and social media. Because news and social media will tend to get you up there.

• 22:15Speaker 00

  Even if you're numb and you don't even notice it. There's no question that that is keeping us in, maybe not acute mounting a stress response, but yellow mind state vigilance, persistent, low-grade chronic stress. And so how can we get out of yellow mind? So your question about where do we spend the day? It's really a question for each of us. How much during the week, I'm going to give you a break and say instead of each day, how much during the week do you reach a deep rest state? So there's relaxation and there's something more important, which is a mind-body state of total release.

• 22:49Speaker 02

  You said deep sleep? I mean, would deep sleep be here?

• 22:52Speaker 00

  Absolutely, yes.

• 22:53Speaker 02

  Delta.

• 22:54Speaker 00

  Deep sleep is our most restorative state. Now Heather, you and I both monitor our stress state with our biosensing rings. And the algorithms that measure resilience, daily recovery resilience, and then kind of long-term stress, they're all about recovery.

• 23:12Heather Berlin?

  So often when I look at my biometrics, I have a lot of hours in the day where it shows that I'm, my physiologic response shows a high stress. But you were saying I'm actually very resilient too. And so it's not just about how much stress, it's how much you can recover from the stress.

• 23:27Speaker 00

  So important, yes. So I try to get less concerned about and obsessed with my daily arousal, which is all over the map, up and down, or on stressful days, just high in the stress zone. And look at the resilience and the cumulative stress. Because that's about both daytime recovery and nighttime recovery. And that is where stress resilience comes in.

• 23:52Heather Berlin?

  That's exactly a perception box issue. You're saying rather than we're focusing on how much stress do we have, let's focus on how much resilience that we have to counterbalance that stress.

• 24:03Speaker 00

  But we can't get away with just saying, I'm going to have every day be totally engaged and go, go, go.

• 24:09Heather Berlin?

  Right.

• 24:09Speaker 00

  We have to actually build time for the deep rest during the day and then we'll get more deep sleep at night.

• 24:15Speaker 02

  So what do you do besides deep sleep and protecting sleep? What else do you do to promote those bluer states? Or what else can you do? This caretaker, we talked early on. What could that caretaker do?

• 24:27Heather Berlin?

  I am that caretaker, so tell me, yes.

• 24:30Speaker 02

  And so what is it?

• 24:31Speaker 00

  We all, like even just caring for our own bodies these days, like this is a hard job. So Kristoff, part two of the stress prescription are practices. And the question is, understanding the principle. For example, a mind-body practice is going to bring us into blue mind state. So rather than saying which is the best and

• 24:55Speaker 00

  the question becomes, there's a whole lot of things you can do to truly let go. What works, what do you like? What works for you? What will stick within your day, in your routine?

• 25:06Speaker 02

  Dogs.

• 25:07Speaker 00

  Yes, I knew it and me too, right? So I wake up, I have three dogs, I give them each, you know, like, and they give me a lot back, right? They're each getting a lot of love and hugs before I even start, before I even leave the bedroom. So that is, you know, bringing me into a sensory state. I'm getting out of the ruminative mind and loops. And I do want to hear from, you know, you guys about the neuroscience of what is the, how does the salience network and the default network map on to stress states and meditation or deep rest states? That's what people want. And I know it's much more complex than that. In the body, it's very clear, there's no one metric of stress. Heart rate variability is a pretty good one.

• 25:51Heather Berlin?

  We want higher heart rate variability, right? That's our heart's ability to respond to changing things in the environment. So you want it to be very responsive.

• 26:00Speaker 00

  Right.

• 26:00Heather Berlin?

  That's healthy.

• 26:01Speaker 00

  Right. So we need these practices. We need ritual. Ritual is the foundation of relaxation.

• 26:08Speaker 02

  So by ritual, you mean some sort of practice, meditative or prayer or spiritual practice that would calm us down or a walk?

• 26:17Heather Berlin?

  Everybody's different, going for a walk.

• 26:19Speaker 00

  Keep going, these are all great.

• 26:21Heather Berlin?

  Painting, doing something creative. I mean, I think it's very similar to, I, you know, I think a lot about getting into flow states and letting go. When I think about, you know, from the neuroscience perspective, our prefrontal cortex, when it's in overdrive, that's where you're getting all the rumination and the anxiety and overthinking. And when we can turn that part, parts of our prefrontal cortex down, we get into these kinds of flow states where we lose our sense of self and time and place. And people have different ways to get there. Like with Kristoff, for you, you would describe climbing sometimes. You'd be like very in the moment and everything else melts away. It's very hard to be anxious, both anxious and in the flow state at the same time. Because the rumination turns down, your inner critic is turned down. And so everyone gets there differently.

• 27:06Heather Berlin?

  Sometimes I'm in a zone of just like writing and getting in the flow. You know, and the time goes by, it's like, I forgot to eat, I forgot to, my coffee's gone cold. And it's almost like you can't be anxious in that state. And that's been an escape for me. Or maybe, I don't know if I want to call it an escape, but a really positive, sometimes I need that time to reset or going for a walk in nature. Or, so I think the prescription is different for everyone, right? It's just, how do you get to that state? And then you should find your own state and get there more throughout the day.

• 27:37Speaker 00

  Absolutely. You guys just gave about 20 different ideas. And they're things that we like to do. We find joy in them. And so the stress prescription is climbing, running, walking, push-ups, rock climbing, anything that's vigorous. We then recover and that recovery brings us to a lower baseline of vigilance and chronic stress. And then of course, it is the deep rest states. I'm not sure how you, you know, the deep sleep is absolutely great. You should, you could try, Kristoff, during the day, what does it feel like to lie down and listen to a guided audio, like a yoga nidra?

• 28:21Speaker 02

  I fall asleep.

• 28:22Speaker 00

  I will say, sorry, he'll sleep.

• 28:24Speaker 02

  I fall asleep.

• 28:25Speaker 00

  And that's okay.

• 28:26Speaker 02

  At the end of the yoga, you know, when you go in dead man's pose, I always fall asleep.

• 28:30Heather Berlin?

  You call it dead man's pose? Isn't it called, what is it called when you're in?

• 28:34Speaker 00

  Yeah, shavasana.

• 28:35Heather Berlin?

  Shavasana.

• 28:35Speaker 00

  Corpse pose, yes.

• 28:36Speaker 02

  Corpse pose, I always fall asleep.

• 28:38Speaker 00

  So part of the stress.

• 28:40Speaker 02

  My wife nudges me, you're snoring.

• 28:41Speaker 00

  Part of the serenity prayer and what we want to do is to understand how we can get out of the trap of stress, this constricted perception box. My late mentor Bruce McEwen called it the hostage brain when we get into the

• 28:58Speaker 02

  The hostage brain.

• 28:59Speaker 00

  The hostage brain, that chronic stress loop where we get into these positive feedback loops of turning stress on and keeping it on. How do we control stress and control what we can in our environment? And then how do we also discern when we cannot control the things that are stressing us out? And then the answer is to let go, to release. And so this corpse pose is the practice of letting go. And we can think of that physiologically, like just let your body literally do its thing, do nothing and guide your attention. We're now controlling our attention to release. And we can also think of that as, can I let go of something that no longer serves me?

• 29:44Speaker 00

  What am I holding on to? That kind of expectations of the future, naming it and letting it go. So using the body is this huge way to get out of the hostage brain. And the, you know, the lore of like 80% of the, you know, neural pathways are from the body to the brain and only 20% from the brain to the body. Would you say that that's pretty well substantiated in physiology?

• 30:07Speaker 02

  There's more coming in than going back.

• 30:08Speaker 00

  Yeah. So let's apply that and use the body more rather than thinking we, the main job is to think our way out of stress. That's the hard path. We need both and we need to use the body more. So lay down, everything changes. You can't even feel the anger response as much physiologically when you lie down.

• 30:26Speaker 02

  Really?

• 30:27Speaker 00

  Yeah. There's been beautiful research, Wendy Mendez and others on embodiment of emotion.

• 30:32Heather Berlin?

  Just immediately lie down.

• 30:33Speaker 00

  If you're going to have an argument with a friend or a partner, lie down. Let's agree to lie down.

• 30:38Speaker 02

  It's difficult to make an argument if you're now lying down.

• 30:41Speaker 00

  So I view deep rest as the gateway to.

• 30:46Speaker 00

  A life, the examined life, a gateway to transformation. It's the step to getting, expanding our perception box. If we can relax, we can change how we see and feel, to have expansive emotions, to rather than just see tunnel vision, to actually see the beauty, the joy, to pay attention to the larger reality, rather than the threat signals.

• 31:13Heather Berlin?

  But can I ask you a basic, I mean, this is like going back to basic, I'm thinking like Psych 101, but you know, there is these different theories about emotions. One is like you feel something first and then you put a label on it of what this is. The other is, you know, reverse. So, so, but what you're saying, because you're saying just, you know, kind of calm down. Which direction, you know, are we, is it the body is feeling something and then the mind is top down going to control it? Or do we calm our physiology first by breathing? And then that changes everything, or both?

• 31:46Speaker 02

  Yes, I would say both.

• 31:48Speaker 00

  Both, yeah.

• 31:50Heather Berlin?

  Right.

• 31:50Speaker 00

  So there's both, it's completely bi-directional, right? The mind and the body are intricately connected, but we've got a stronger highway. Like one of your freeways here in LA, it's this five-lane crazy monster. So like you, this is the major highway of body to mind. That's why breathing, slowing our breathing, works instantly like that. And other somatic techniques. That's why the science hasn't caught up, but that's why the world of trauma therapy and mental health is using the body. You don't even need to evoke the narrative or relive the trauma in some of these cases. And then the San Francisco freeway is just like this, it's another freeway, but we've

• 32:32Speaker 00

  got two lanes instead of five, and that's the brain to the body. That's our top-down control.

• 32:38Speaker 02

  Would say you're much more relaxed in San Francisco than in LA?

• 32:42Heather Berlin?

  I think that makes sense. The, but I want to get back, you know, this idea that stress can be wear and tear, but it also can be a source of resilience. And I want to talk about how, a lot of people have been under many years of chronic stress. And then they're worried, it's stress about stress, you know, they're worried about the fact that they've been stressed and they can't, now they're going to prematurely age and all this. So can we recover from chronic stress? And, you know, and how long does that recovery take?

• 33:10Speaker 00

  Well, I'm happy to say yes.

• 33:12Speaker 02

  Yes, you can recover.

• 33:13Speaker 00

  You can recover from chronic stress wear and tear. And we can change, you know, from minutes to months and years. We're, our biology is iterative and we can change it. We have neuroplasticity in the grain, in the brain. So if we had time, I would ask you guys to lie down and we would do some deep rest within like 15 minutes. But even just two minutes of breathing, we can change our autonomic nervous system balance toward parasympathetic dominance, higher vagal tone, slowing our breathing. It will change how we feel. I'm such a better and happier person when, let's say, after yoga class, you know, when

• 33:58Speaker 00

  I'm invested in, in keeping up my practice, that's my favorite practice. We've kind of lost the idea of the siesta or that we need breaks. And we, you know, culturally, it's our perception box is.

• 34:10Speaker 02

  Siesta in an office is totally unacceptable in the modern environment, right?

• 34:15Speaker 00

  Oh, yeah. Some offices have, have nap rooms. I don't know how well used they are.

• 34:20Heather Berlin?

  Well, I mean, when you go to like, you know, a lot of Silicon Valley, go to like Google, Google campus, whatever, they have these rest rooms where they're encouraging people, because you know, research also shows that.

• 34:31Speaker 02

  Most people use them to make those private phone calls.

• 34:34Heather Berlin?

  I mean, there are people going, my, my daughter's school.

• 34:36Speaker 00

  I don't recommend that as your, I mean, use it if you have the room, but really, being in nature is going to do a lot of the work for you. Yeah, like chapter five is let nature do the work.

• 34:47Heather Berlin?

  And that's our natural environment.

• 34:49Speaker 02

  Forest bathing, as the Japanese call it.

• 34:52Speaker 00

  Yeah.

• 34:53Heather Berlin?

  The, but research shows that you're actually more productive if you actually take rest or a nap during the day. It doesn't even have to be asleep, but just like 15 minutes of relaxation and rest will make you more productive, more creative than just powering through and drinking a coffee. So I think it's like, like part of the prescription. It's important to like make yourself take these breaks as part of your routine for mental health.

• 35:19Speaker 02

  I worked for many years with Francis Crick, British molecula scientist who discovered the double DNA structure. And he always said, so he said, on weekends, I don't work for that reason. He always religious took vacation. And he said, the great institution in British labs was tea, you know, afternoon tea. Everyone always came to these teas. It was very social. This is really gives your mind a break. We've gotten away from that. Francis liked shanty.

• 35:45Speaker 00

  I love that.

• 35:45Speaker 02

  Gotta work, gotta work, gotta work.

• 35:46Speaker 00

  So the social tea is, you know, is an, is part of the infrastructure or ritual during the day. I will say, if we're wearing our ring and we're having social tea, we are going to be on very high stress arousal. But it's good arousal. Aura, for example, is found with thousands of users that one of the, it's very stimulating to be in social interaction.

• 36:07Speaker 02

  Or see, stimulating.

• 36:08Speaker 00

  This is the question. Good arousal, yeah.

• 36:10Heather Berlin?

  This is the, I mean, I mean, when you're making love, you're very aroused. It comes up as stress.

• 36:16Speaker 02

  This is for friends.

• 36:16Heather Berlin?

  Or, it's for friends. On the aura ring, it comes up as stress. And so what, maybe sometime in the future, there'll be a way to differentiate between positive and negative arousal, because the.

• 36:28Speaker 00

  Yes, I know. No, no app, no biomarker, we cannot distinguish between positive and negative arousal.

• 36:34Speaker 02

  Well, this is impossible in principle.

• 36:36Speaker 00

  It's what you said, you have to ask people.

• 36:38Heather Berlin?

  It's subjective, that's, so the physi, I, I see this again with patients, I'm like, the physiologic response is going to be the same. It's how you perceive it as negative or positive and how you interpret it that makes a difference.

• 36:50Speaker 00

  We know so much about what arousal and orgasm does to the body with oxytocin, with blood pressure. Of course, there's the relational aspect. We have found that in couples who report more sexual intimacy, they have longer telomeres and lower metabolic stress.

• 37:09Heather Berlin?

  Oh, I like this a lot. That's smart. And it doesn't have to be with a couple too, you can be by yourself.

• 37:14Speaker 00

  Absolutely.

• 37:15Speaker 02

  Well, I mean, we do know that married people live longer on average than a single.

• 37:20Heather Berlin?

  But they might not be having lots of sex.

• 37:22Speaker 02

  No, no. I think we're talking about older people.

• 37:25Heather Berlin?

  Right. Companionship is another.

• 37:27Speaker 02

  But companionship is a protective element for.

• 37:30Heather Berlin?

  And it could be because it's the opposite of loneliness too. Because loneliness, we know, has a detrimental effect.

• 37:35Speaker 00

  So for caregivers, it's very lonely and isolating. And I do think that the, that the loneliness aspect of being a full-time caregiver is really one of the ways that stress gets under the skin. We've done this with caregivers of children with developmental disorders, teaching some basic mindfulness for their emotion regulation, for holding the emotions of their child. And we found improvements in the gene expression away from pro-inflammatory states. I think it goes to this point of like, you may not be able to stop being a caregiver or get out of certain situations that you don't want.

• 38:15Speaker 00

  But if we can develop some tools to do short restorative breaks every day, as well as the social nutrition or social support, thinking about who is deeply relaxing. Instead of being an energy vampire, who around you makes you actually feel ease, support, loved?

• 38:40Heather Berlin?

  And spend more time with those people.

• 38:42Speaker 00

  Interceptive awareness. I think that, you know, a certain number of us are highly sensitive, period. You know, at least 20% of us. And anxiety sensitivity.

• 38:51Speaker 02

  Meaning those 20% are more able to sense the body states than.

• 38:56Speaker 00

  Well, so that interceptive awareness is separate, but I, I will say that what comes with being a highly sensitive person is being a deep processor and being permeable to our environment, being very sensitive to what's happening and being sensitive to our own body signals. So it's probably related to or a good friend of anxiety sensitivity. That means when we start to feel anxious, we can more easily spiral into a panic. And so there's a different curve. So slow breathing for someone who's anxious has got to be dosed very slowly and sensitively, almost like a trauma-sensitive intervention, because it can make you more anxious at first if you start to slow your breathing.

• 39:38Speaker 00

  Because if you're highly anxious, you're already on a hyper, subtle hyperventilation state. So starting to slow breathing and, and get to six breaths per minute, but not at the, not immediately. And so with the self-monitoring, I think it's the same. You don't want to overdose on it.

• 39:58Heather Berlin?

  Every episode, we ask a question designed to expand our own perception boxes. And this week, Christoph has selected the question. Alyssa and I have no idea what he picked, so here we go.

• 40:09Speaker 02

  Alyssa and Heather, what is it that you want people to believe about yourself?

• 40:14Heather Berlin?

  What do I want them to believe? I mean, I'd like them to believe these things because they are true.

• 40:20Speaker 02

  What is it you'd like them to believe?

• 40:22Heather Berlin?

  I want people to believe that I am a kind person. I think kindness is just such an important thing. So some people think like, oh, I want people to think I'm really smart or I'm successful, whatever. And that's not what's important to me. It's that they think and/or know that I'm a kind, good person.

• 40:42Speaker 00

  Can I borrow that?

• 40:43Heather Berlin?

  Sure, you can be kind, too.

• 40:45Speaker 00

  Yeah, I really feel like I want people to believe that I'm doing my best because I am trying. And so when I hurt people or don't respond to an email or, you know, make a misstep, I hope for a get out of jail card. I hope for benefit of the doubt.

• 41:05Heather Berlin?

  That's beautiful.

• 41:07Speaker 02

  Thank you.

• 41:08Heather Berlin?

  We've been talking about stress for a while, but to lighten the mood, we're going to play a quick game called, "Is this stress or is this just life?" So I'm going to give you a few different scenarios, and you can explain whether it's just life or chronic stress. Feeling tired at 3:00 PM, is this stress or just life?

• 41:27Speaker 00

  Modern life.

• 41:28Heather Berlin?

  Modern life.

• 41:29Speaker 00

  Chronic sleep debt.

• 41:30Speaker 02

  No siesta.

• 41:31Speaker 00

  No siesta.

• 41:33Heather Berlin?

  Yeah, we need that.

• 41:33Speaker 00

  It's normal. When I ask a room of people, "Are you exhausted at the end of the workday?" Most people raise their hand. If they're in that kind of category of working people, there's different stages of life. I mean, retirement has its own different types of stress. So it's not that fatigue stress.

• 41:50Heather Berlin?

  Being annoyed by small things, stress or just life?

• 41:53Speaker 00

  Temperament and then stress as an enhancer of that irritation response.

• 42:00Heather Berlin?

  So what do you mean by that temperament?

• 42:02Speaker 00

  Well, I think being our tolerance for annoyance is something we carry, you know, in our temperament.

• 42:12Speaker 02

  So you mean it's genetic? Some people just are more likely to react to other people.

• 42:16Speaker 00

  Yeah, more hostile, more distrusting, you know, attributing, making negative attributions. That's where I think the stress comes in. When we're stressed, we have depleted our reserve capacity. And we don't have that layer of compassion or tolerance or really insight into someone else's mind and why they might be doing something that's irritating to us.

• 42:43Heather Berlin?

  What about feeling overwhelmed by choices? Stress or life?

• 42:47Speaker 00

  Can I say both? Because we're so overwhelmed by stimuli. Stress does impair our executive function and our decision making. So there's no question that stress can make it harder for us to make decisions or especially make good decisions. You know, if we're making decisions while we're stressed, we're more likely to regret them. So writing an emotional email response, saving that draft is going to save a lot of stress rather than sending it right away. I'm sure we've all experienced, oh, I wish I didn't send that or say that. So that, you know, the heat of the moment decisions are tough. Indecision, I mean, it's also part of depression when we feel like it's hard to decide

• 43:29Speaker 00

  because we're feeling less clear and feeling anhedonia, you know, less pleasure in the different choices.

• 43:39Heather Berlin?

  Waking up and feeling that you're already behind, is this stress or just life?

• 43:44Speaker 00

  That's stress, and hopefully that's not your life.

• 43:47Heather Berlin?

  Yes, I would like that, hopefully to not be my life.

• 43:51Speaker 00

  Countering that by waking up, knowing that it's very easy, it's almost default mode, to have a big stress response, thinking about the day ahead and your to-do list, to just allowing yourself, even if you've already checked your phone, allowing yourself to close your eyes and do one thing. Maybe it's slow breathing. Maybe it's thinking about, what's one thing today I'm looking forward to? Or who's someone I can make smile today? I can show kindness to.

• 44:18Speaker 02

  You know, there's a simple practice I discovered. You don't put your phone next to your bed. You just put it somewhere else.

• 44:24Speaker 00

  Oh, don't be ridiculous.

• 44:26Speaker 02

  You actually have to get up. It's so much more relaxing.

• 44:29Speaker 00

  So that's like a mini, let's say, a mini tech detox, but during the critical windows. So going to sleep, the period before sleep, the period right after waking, our nervous system is absolutely vigilantly monitoring, is it safe? How much do I need to calibrate, you know, my cortisol up? So we could go to sleep and still have a high-stress night. We know that, you know, we can look at our metrics now and see that. But protecting our sleep is probably one of the most important parts of stress resilience, as well as exercise and the positive stress fitness, getting the positive arousal.

• 45:08Heather Berlin?

  I want to thank you, Alyssa Apple, for joining us today. This was really insightful. Wonderful for you to be here with us. And if you'd like to learn more about your own perception box, spend some time this week answering the same perception box questions that we asked our guests, and check out other questions on our website at unlikelycollaborators.com.

• 45:31Speaker 02

  You can also subscribe to our YouTube channel and watch a show, listen to wherever you get your podcasts.

• 45:37Heather Berlin?

  This has been Science of Perception Box, created by Unlikely Collaborators in partnership with Pod People. I'm Dr. Heather Berlin.

• 45:44Speaker 02

  And I'm Dr. Christoph Koch. Thank you.