Practicing Self-Regulation and Developing Neural Efficiency w/ Dr. Richard Hart

Jun 17, 2020 | Podcast, Science

Episode Guest

Dr. Richard Hart

Dr. Hart has spent a lifetime in Performance from national champion in freestyle wrestling and representing Canada Internationally to becoming an Oncologic Surgeon. Following General Surgical Residency and fellowship training in Hepatic Transplantation and Hepatobiliary/Pancreatic Surgical Oncology he was recruited to St. Joseph’s Health Centre, Toronto to develop and build this specialized surgical program. Within nine years the service was awarded the HPB “Centre of Excellence” by Cancer Care Ontario (CCO) having become the third busiest program in the province with the lowest Operative Morbidity and Mortality rates, all as a single surgeon.

He is passionate about teaching the principals and science associated with mastery and excellence, believing “the DNA for developing Elite Performance is a constant regardless of the domain”. For this reason, he has developed NextGen Surgery™ – the Science of Elite Performance — an innovative, cutting-edge platform and scientifically based approach to “Mind-Body Training”. It layers neurofeedback, biofeedback, learned self-regulation and advanced performance psychology to create the Mind-Body Awareness essential in developing Optimum Performance and Stress Resiliency. This platform can be applied to any domain where peak performance under pressure matters. It is his vision to transform how physicians and surgeons – elite performers who populate the world of health care – are trained for the cognitive, emotional and physical skills required to deliver Optimum Performance when it truly matters most, when human life is on the line.

In This Episode

 0:1:10 – Intro to episode + Richard

 0:5:43 – Dr. Richard Hart shares his experiences with burnout, mental health, and performance in the healthcare industry

0:22:57 – Why is this burnout so severe during a pandemic?

0:28:50 – Elite HRV users’ reactions to the pandemic

0:32:53 – Managing stress and the change in prescription drug behavior 

0:37:40 – coping with short term and long term stress

0:43:30 – self regulation and adaptability: developing neural efficiency and resilience

0:44:25 – breathing techniques for managing stress

1:01:43 – finding the self regulation method that works for you

1:03:40 – Conclusion

Episode Transcript

Welcome back to the elite HRV podcast. This is your normal host, Jason Moore. And today we have joining us dr. Richard Hart. Richard. Welcome.

Thanks, Jason. It’s a pleasure to be back.

As you’ve just mentioned, you’ve been on our show before and shared some really incredible information with us about the brain, about how the mind works and about things that we can do to self regulate. A lot has changed in the world since the last time we talked. And this is a really interesting time that we’re living through. And I’m incredibly glad that we, that you reached out to me, to share with me that you have some experience dealing with situations like we’re seeing in the world today, which we’ll kind of dig into a little bit, but, it’s something that I kind of want to preface this conversation with is that we have done two podcast episodes around Corona virus related subjects so far.

And one of them a perfect storm, we talked about me and the guests talked about, chronic health conditions and kind of how those relate to this acute pandemic situation and a listener kind of emailed and said that it sounded like we were downplaying the severity of the pandemic in favor of focusing on the chronic health condition situation. And, you know, that’s something that, you know, when you get that type of feedback, you, you really have to think critically about it. And, , that’s definitely not what I was intending to do in that episode. I’m just very passionate about chronic health conditions, but the reason why I’m bringing that up now is because that feedback was very powerful to me. And it corroborated some of the experiences I’ve been seeing in the world and some of the people who are dealing with lots of things like losing their jobs or dealing with health situations that present much more severe than they anticipated.

And then you reached out Richard and shared with me an incredibly powerful story about, some of your dealing with not only this type of pandemic situation like SARS, which we can talk about later, but also as a healthcare professional, how you dealt with stress and overload and, , trying to accomplish, and serve people in many different ways. And so that’s kind of where I want to start the story. And before I dive, if people can bear to listen to me just for another few seconds, I’ll just introduce Richard again, in case you haven’t heard the first episode that he,came on the show with us, I highly recommend it is called “Mastering Self-Regulation for Optimal Decision Making.” And a quick background on Dr. Hart is that he is a high performer by definition. He’s been a high performing athlete and a high performing surgeon and is recognized internationally in oncology specifically, and has created, he’s awarded the center of excellence by the Cancer Care Ontario organization, and has operated one of the busiest programs in the nation there.

And, you know, it’s just the reason why I kind of want to highlight all of that is because today, Dr. Richard has been very kind to share with us a little bit more about the other side, the kind of the behind the scenes of what it’s like being a high performer and still being human. And it almost makes me kind of emotional even just to say the introduction like this, because this is a very, a big moment of vulnerability that I want to just, express deep appreciation for Richard. So thank you so much for being here and, yeah. Welcome back.

Thank you, Jason. I mean, that’s incredibly generous and kind, and you know, I’ve always believed that other people tell you you’re good that you don’t tell people you’re good. So that was really special to hear.  You know, some of the things I’m going to talk about today, I’m not working in the front lines right now because of an issue I had been dealing with, you know, performance and burn out. And, you know, that’s the story that I wanted to share today, given what we’re going through. So as you really highlighted so nicely, you know, in our last podcast, the things that we talked about, you know, so I’m a surgeon athlete, right? I was an athlete before I was a surgeon. And as an athlete, I learned not just how to compete, but really how to compete at peak performance. And my coaches trained me.

They taught me, they pushed me, we never stopped. And then I applied those lessons and work ethic to my surgical training and practice. And as you said, it was highly regarded, right? I’m extremely goal driven and results oriented, which is exactly the same as everyone right now. Who’s currently working in the front lines of healthcare, first responders, but actually all sectors in society right now where there’s a high risk to reward ratio, be it in business or, or all these people homeschooling right now, their kids and trying to raise responsible, loving children during, right.

But I reached out because if we only speak about our successes and shape our narrative in a certain way, we really provide a skewed view of what life is like. And I think it can be harmful and we can seem really unrelatable at times, right? If we look at social media, everyone looks great. So we ended up looking like we’re, we’re comparing our life to someone else’s highlight reel because in order to succeed to truly succeed, right, you you’re going to go through a ton of failures and I’ve had many, you know, if you show me someone who’s never failed, I’ll show you someone who’s never done anything, or isn’t telling the truth. What I’ve come to learn is that it’s in our darkest moments where we actually find the blueprints for our next success. So I’m going to share this story today, which I never imagined

I’d talk about publicly, because of the situation we find ourselves in now with coronavirus, and if telling it can help prevent one person from going through what I did, then hopefully I’ve provided a service because I’m really concerned about all of the people who are currently working right now. And the follow that surely to come later, because this, this, this, this moment that we’re in is not a moment. It’s not a sprint, right? It’s a marathon. And we need to personally be prepared for that marathon. So, you know, my surgical training was in the era when we didn’t think about physician wellness, 100 plus work hour weeks, where the norm with on-call duties. And then as a transplant fellow, I was on call every day. You know, throughout those times, I can recall going to the hospital on a Friday morning and effectively not coming back until a Monday night, because the several hour breaks that we may have had would have been lost to travel.

So it was just easier to sleep on a sofa or an emerge bed, rather than traveling and well, it wasn’t healthy. It felt normal. It’s what we all did. And I didn’t think I suffered from it at the time, but the culmination of all those experiences of pushing my mind and body beyond healthy limits with no recovery in sport and surgery was having a huge impact on me, but I just didn’t realize it. So I had set up my life in such a way that I was continually taking on increasing tasks and never saying no to get ahead, because the external validation that I was getting from that was filling a void. And unfortunately it seemed more important to me than whether I had internal satisfaction. So stretching myself in all directions was something that I’d normalized. Now, I’m not unique in this. And it’s far more common in healthcare than people know.

And I’m concerned that this crisis is going to further increase the rising global epidemic that we’re seeing in flame out there, which is temporary exhaustion, burnout, and mental health concerns. But for context, this is really no different than the person who works seven days a week, or brings their work home with them, or is actually in active military situations, right? It’s not specific to healthcare, but it’s the lens from which I view it because critically, naturally thriving on challenge, doesn’t make one immune to the effects of overwhelming unchecked, continued stressors, right? I always say there’s no stress in any situation, but only how you perceive that situation. And while I still believe that that’s critical and important in a moment, right, you need that to perform optim . But if that is repeated over long periods of time, it can become detrimental and actually maladaptive. And for me, it caused me to lose the awareness of what my body was telling me.

I mean, we’re dealing with life and death situations daily and taking care of critically ill patients. And we have tools and skills to change lives. It’s what we’re trained to do. But unfortunately in oncologic surgery or net, what we’re seeing now with COVID, there’s the added stress of oftentimes not having anything we can offer people. This takes an emotional toll across time. So well, some people look at it and say, we save lives. I’m going to tell you that I never imagined that I’d ever have needed to get on a plane, to go somewhere, to save my own.

You know, I’ve always demanded an exceptionally high bar of my own performance and strive for perfection, but perfection is elusive and it can create a mental state or a perception that no matter how well you’ve done or how great a case goes, you just don’t seem to be satisfied. You can find fault in your performance, that void continues to be empty. And then when you couple that with a competitive nature, if someone said something couldn’t be done, I would work twice as hard to prove them wrong. So I felt like I was always in competition to be perfect or to be the best yeah. That competition wasn’t with other people. It was with myself, you know? So while I had a passion for complex surgical surgery and critically passing that knowledge on and teaching residents, so they could be the best that they could be in any given moment.

When I look back on things now I see, I didn’t always get those personal interactions, right? Because while having high expectations is appropriate, I don’t think I was able to convey my desire for excellence in constructive ways. And they see, you know, it was a function of how I was feeling at times it was wrong because I maintained an aura of invincibility, even when I was struggling. Like the culture’s not about showing vulnerability and that you pointed out in the beginning that this was about vulnerability and you’re right. You know, I wrongfully felt that it was a display of weakness instead of it being a display of courage and compassion. You know, I remember early in my surgical practice, , a gastroenterologist who was at the end of his career, he told me, rich, you need to work at a pace you can sustain for 40 years.

And that concept was foreign to me. I had one pace, relentless pursuit, regardless of what I did. Right. I didn’t understand the role of pacing myself or work life balance, you know? So from the outside it looked like I had it all. I had a busy surgical practice, social interactions, finances, great bond with my children. You know, I put everything, all my efforts into everyone, but ultimately that came at the expense of my own self preservation, physically and mentally, you know, but I couldn’t see it. And I was too into, I was right in the moment. I didn’t want to hear it. I didn’t listen to anyone because I didn’t perceive their concern as an effort for help. Right. Burnett was something that was never going to happen to me, I thought, but I couldn’t have been more wrong. Right. I saw asking for help though, as potentially career ending. So I kept quiet. And, you know, in our first episode we talked about coping mechanisms and strategies for optimal performance. And I certainly had all those from sport that I transferred to surgery and they enabled me to continue to perform at a high level, but ultimately I exhausted those skills. And then I eventually abandoned them, right. Two critical mistakes. My situation overran my capabilities to self-regulate.

So the only place I felt good was in the operating room where I could hyper-focus compartmentalize and perform, but operating was only 30 to 40% of what I did. And then once outside of that environment, I felt as if I’d lost control, right? Everything else began to feel like a chore or mundane and irrelevant. And I started to resent some of the work I had to do, and it was emotionally exhausting. And it got to a point that I couldn’t see any of my personal achievements as even being relevant or worthwhile. And this was more pronounced in my personal life because I didn’t focus more and more of my attention on the only area I felt positive in the operating room, right. But to the detriment of everything else and ultimately everything I knew and thought was my ideal life had fallen apart too, I was burnt out. I was overwhelmed. And while there may have been many circumstances in life that led to that, ultimately it was me in me alone, who made some poor choices. And as a result, I developed an addiction that for a short period of time consumed me, right. I thought it was filling a void, but what it really did is nearly take my life from, you know, I lost virtually everything that mattered to me. My surgical career was put on hold because I took a medical leave, finances, friends, family kind of gone critically.

My own self respect and my self worth evaporated. You know, I’d lost my compass. And yet I was trying to deny this health crisis I was in, thankfully now I’m well, on the other side of this and going back to surgery and I’m grateful, right. I can honestly say it was the hardest obstacle that I ever had to overcome. One of the toughest challenges I ever faced. And I still learn lessons every day, right? Just like surgical wounds. We need to heal from the inside out. You know, I’ve come to learn that if you’re struggling, which is increasingly common, especially in this time, anything we placed before our mental health or your recovery you’re going to lose.

Yeah. I was fortunate. I was able to get through this. Yeah. It was a significant amount of hard work and help of medical professionals in the community of support that I’ve come to develop. But then I coupled that with reapplying, all the self regulation strategies that I previously had and abandoned or lost in that moment to now rewiring create new neural networks, right. To get back those healthy behaviors that I had when I was optimally performing. Right. But perhaps I think the most important tool I now possess is the ability to ask for help in a time of relentless stressors before I reach crisis. So I’m telling this story because of where we are right now, and I’m strongly urging everyone to have tools and people in place to help them independently help and assess how they’re doing. Right. It’s one of the reasons I’m so passionate about what we’re trying to build with next gen surgery, because while it’s for optim performance, it’s also for health. And, you know, I know we’re going to discuss some of those things today. So first I want to thank you for the chance to tell that story and it feels good to actually have said it out loud like this for the first time.

And it’s things like this, that in a weird way, give you hope, give one hope. And  a small feeling of warmth when in this dark time for many, an uncertain time for everyone that people kind of come forward and are helping each other and are willing to help each other. And I think that I want to highlight a couple of phrases that you said in there. And one of those, and this is sort of the backbone, reason why we’re talking about this today and why this story is so relevant to everyone today versus any other time is because you were overrun by the situation that you found yourself in, and that situation overran your ability to self regulate. And that is what a lot of people are finding themselves in today. That situation where, you know, they may have already been juggling a lot of things and they’ve, and this is, , kind of up ended a lot of the things that they were, , had been working on in their life, or even more specifically, somebody may be listening to this or may have a loved one or a friend or a family member who is a healthcare professional and is either already overrun by this situation or is about to be overrun by this situation and is going to have to make some really tough decisions about how to cope with that, get through it and not cause a lot of long-term damage to themselves or even short term damage because overrun like this, depending on where you’re at and what you’re facing can happen very quickly.

And then the last part that I want to highlight of your story is that right at the end there, you said one of the most critical things that you’ve developed out of this really trying experience and time in your life is the ability to ask for help. And I think that kind of comes back to what I’m saying is sort of heartwarming is that right now, I think the world realizes in general how much hardship a lot of people are in either economically or just through general stress or dealing with really you know, acute and severe health situations, either as a practitioner or even being unwell yourself. but the ability to ask for help and those willing to give it is important as important now as any other time. And, you know, again, I highlighted at the beginning of this conversation that this situation is very severe.

I want to, before we dig into some of the ways that people can get help in the way that they can help themselves, which is another thing I’m excited to kind of extract from you, Richard, which is, I really appreciate that severity. You know, why are we talking about this right now? We kind of, I’ve said it’s severe. You know, some people realize it from firsthand experience, others see the news and they see what people are talking about, but maybe don’t quite understand why it’s such a severe situation. Maybe you could give us a couple sentence overview of why the situation is so severe before we dig in.

Certainly,  you know, first I should say, I mean, I’m not a public public health expert and I’m not an immunologist or virologist, I’m a surgeon. So I mean, critically, if people have questions, I think the most important thing to do is go to reputable websites to get their answers, right? These are, this is a unique and unprecedented time that we’re in. And you know, it’s a scenario for many people to be working or not. That is going to create an awful lot of stressors. , if they’ve never been involved in, in a similar response, you know, I work through SARS, this is worse than SARS and you know, well, this may not be the most lethal virus that the world has seen. This virus is exceptionally stealthy and efficient in its ability to transmit because it can do so at a time when we’re asymptomatic. Right? So while people are thinking, they may, they feel great, they may actually be infected. So that’s what makes this significantly more scary. Right? I mean, I think there are a lot of things that people can do. I mean, we’re at home, so the TV is on all the time. Right. And you know, if we just take general things, right. Minimize watching, or reading or listening to news about COVID, right, because that’s going to cause you significant feelings of anxiousness or distress, you can only take information from reliable sources, right. Look at scientific data and then find practical steps to prepare and plan to protect you, your family, but also your community, right? Because this sudden stream of news like near, constantly, right, is it would cause anyone to feel worried, right. We need to learn to distinguish fact from r or because facts minimize fear.

For anybody working, you know, feeling pressure is a normal experience at this time. Right. I mean, it’s absolutely normal stress in the feelings associated with it though are by no means a reflection that you can’t do your job or that you’re weak. Okay. And I think that it’s important to remember that our mental and psychosocial wellbeing during this time is as important as managing your physical health, maybe because your physical health is, has a direct impact on your mental and psychosocial health. But the other is also true, right? In the first podcast, we talked about training the body to respond to the mind and the mind to respond to the body. And so, you know, these may sound like motherhood statements, but it’s critical to take care of yourself, to rest recover, sleep, eat healthy, engage in physical activity and be in contact with people. I think, I think the biggest hardship that people are facing during this time is, is they feel socially isolated, you know, physical distancing and sheltering in place. Isn’t the same as social, social isolation. And, you know, my concern is that people will adopt or engage in unhelpful strategies to help them get through this like alcohol, tobacco, other drugs. Right. But in the long run, that’s going to worsen your psychological and physical wellbeing. That’s why I told the story that I did. Cause it’s, it’s a situation like this that can easily overrun us then, you know, 

Richard, I want to highlight there real quick is that, you know, if, as I think about this, I realize we’ve talked about the Corona virus briefly and you know, COVID-19, and, , we’ve talked about healthcare professionals a little bit and you know, if I’m, if I’m not a healthcare professional and I haven’t had COVID, then I’m thinking, okay, like what can I do to, , help with this? And one of the things that I kind of want to highlight here as we get into this is that, , we at elite HRV kind of started when we started to see this whole situation unfold, like many companies, especially companies that are in, , trying to help people be healthier and more well and more fit and achieve higher performance and stuff. Think how can we help with the situation? Right. And, , so we put out a little survey to our users to see what was on the mind of our users with regards to this situation.

And, you know, it was about a month ago or so that we did that. And certain areas of the world were already being directly impacted by the virus. Other areas had not really seen much action yet. And, we got about 2000 responses to the survey at that time. Only a very small percentage of those people thought that they had been potentially exposed to the virus directly. And by any means, but about 85% or more, I have to look at the exact numbers. But the vast majority of the responses to the survey said that they were stressed about the situation and about 90 to 95% of those people said that the stress was directly related to coronavirus. And so even people who had not been directly exposed to it and maybe didn’t even, weren’t even sure if they would ever get exposed to it directly, we’re stressed about the situation.

And, you know, I want to say too, obviously there’s biases on who responds to surveys and all of that type of stuff. But I think one of the things that was kind of clear from that survey and then also from my interactions with people all over the globe, because we have a global network at elite HRV, is that there’s an underlying theme of stress where everybody is feeling it and the people, but everybody kind of wants to do something to help with the situation. Right. Well, one thing is obviously, you know, I won’t go too deep into this, but you know, do your physical distancing, you know, don’t get near other people unnecessarily. , you know, where your masks wear your gloves, wash your hands, do all of the basic recommendations. These are easy things to do that have very low downside to do and can help tremendously with the spread that Richard was just telling us about how efficient, , COVID-19 is at spreading.

And then the other thing you can do is be there emotionally and, , socially virtually for your friends and family and loved ones and, and the medical professionals and healthcare professionals in your area, anything that you can do to help those people, , that is where you can really help. And it’s, and it also comes down to the fact that if you’re not directly impacted by this, but you’re feeling a little bit of stress about it, just imagine the level of stress that people are feeling who are directly affected by it, either getting ill themselves, having a loved one ill or being a healthcare professional, or being, having lost your job or dealing with all of the above. Maybe some people have to deal with every single angle of that. What I just described. And that’s where, you know, on the one hand we really felt that we could make a difference.

So we actually just published a free course, free to those in need about how to manage stress and uncertain times. But I’m going to digress from that because I just wanted to kind of tie a bow around what it is that we’re talking about as something that everyone can really experience and also contribute to helping with. And you’ve seen it already, to corroborate this change in prescription drug behavior. And I think you shared a fact with me yesterday. I’d be happy to hear that again. You can share it with the group.

Yeah. I mean, I, you know, I’m, I’m, I’m not on the front line right now. I’ve been as, you know, trying to build a venture, but you know, I am going to go back to surgery in this time, because I took an oath and I think it’s my duty to serve. And it would be potentially irresponsible not to, , given what we’re going through, but, you know, we’ve said, yeah, everyone’s feeling it. You, you, that survey that you talked about, you know, church surveys are biased, but I think that, you know, I, I found data, you know, that shows in the United States an increase use of prescription drugs from and I from, from February 16th to March 15th. And I’m talking about anxie Lytics or antianxiety medications, antidepressants and medications for insomnia, right. It increased 21% for prescriptions filled peaking the week ending in March 15th, which was when COVID was declared a pandemic.

And the greatest increase was seen in anxiety medications at 34.1%. For prescriptions filled. So that really corroborates sort of what you were seeing in your non randomized, you know, collection of, of, of responses. it’s not surprising. And, you know, first of all, I want to congratulate and all of the primary healthcare physicians  and specialists across the board, who’ve had to change the way they work and transform everything over to virtual care, to still be able to take care of their patients and well, not being able to interact face to face, you know, they’re doing it through video conferencing or on the telephone, and they’re all trying to help. So, you know, when someone calls you and is distressed, you know, you’re gonna try and give them something to help that we know that they’re getting so many calls that I don’t know that they have time to go into psychotherapy in depth.

And so we’re finding an uptick,in short term treatments to help manage and mitigate the stress. And, you know, the problem in the end with that, and this is not appropriating blame anywhere is that no one, most people don’t know how to actually quiet their mind and or to self-regulate. So, you know, maybe we can look at this as an opportunity to change behavior, right? Well, medication is certainly necessary for a lot of people in the short term, you know, in the longterm, it can potentially create, create problems for us. Right. That’s sort of one of the reasons that I shared the story.

So I think that maybe this is a time where we can look for ways to focus on larger, longer term functional capacity rather than short term crisis interventions to help us build resiliency.

And I think that to your point, well, I want to actually add to the point, I guess, is that coping with stress is not only about the long-term. And I think you’ve kind of said this already before, and I just kind of want to package it with this part of the message is that the people turn to, you know, I think we’ve seen actually, even in the, in the previous episode that I talked about this with Paul and Phil was that alcohol sales have had seen a significant uptick, junk food sales have seen a significant uptick. , and you then added to that message, that prescription medications for anxiety and antidepressants and things like that have seen a dramatic uptick. So people are, are coping or preparing to cope with a lot right now. And specifically there are things that you can do to help cope and to better self-regulate today that don’t have so many potential negative side effects and, , health compromising side effects, because I think that’s actually one of the things that sort of, maybe it didn’t come out in my message, , in the previous episode or it hasn’t come out in a lot of messages.

Is that when you take these sort of natural approaches, if you will, to dealing with stressful situations, you actually compromise your immune system more. And, , actually I believe, , my colleague Vivek and Dr. Patrick Hanaway talked about this on two episodes ago, about sort of the immunology side of the equation. But, , there is an immediate, actual downside to coping with stress with those situations and what we’re want to, , cover in the last, you know, section of this episode is what are some of the self regulation techniques that we can use that aren’t, that don’t come with so many downsides and create both a short term benefit and a longterm benefit, right?

Yeah. I mean, that’s great. I mean, the way, the way I look at it is, you know, we need to find skills. And first of all, if people need medication, they need medication full stop, and there’s nothing wrong with that, but we need to find the skill, right. That are helpful, that can immediately lessen the effect of stress, you know, while one is currently in a stressful situation or brief self regulation strategies, but also take the opportunity, then do some skill learning, right? Or deep self regulation skills to enhance your ability to stay mentally and, , physically healthier. So, you know, for us, we look at it as, you know, de-risking, , decisions, right? We do psychophysiologic profiles, right? That ties the central nervous system and autonomic nervous system, , together, right. To try. And in this time find the map right to de-risk decision-making and provide tools, you know, help people.

De-risking the moment to perform the best when they need it most, right. Because performance is tied to error and risk. So we’re looking at improving effectiveness and efficiency, right? Because stress affects both your technical and nontechnical skills in whatever you’re doing, right? The non technical skills, meaning, you know, leadership, communication, teamwork, or situational awareness. So, you know, I think there’s three things that should be looked at one is personal awareness. You know, how am I feeling or behaving now, versus when I’ve been at my best, right. Try to anchor yourself to PR to past successes. The second thing is the awareness from other people and get feedback from colleagues or family, you know, how am I doing now or behaving compared to when I’m at my best. And those are the subjective things. And then finally, there’s the objective measures and tracking, right? That’s the psychophysiologic assessment where we’re looking at people, baseline stressors and recovery, right?

How is my mind and body coping and, you know, heart rate variability is huge for that. You know, similarly heart rate is  peripheral temperature. Not everyone has access to EEG, so you can do something simple like [inaudible] right. Cause you’ll get a significant decline in your ability when you’re stressed. Right? And it’s important to have these objective metrics and objective data because those other two subjective metrics can be quite discordant to what we see in the data, because it’s based on self perception and self reporting. So, you know, EEG is, is a way of looking at the brain directly. Let’s not worry about that. And this time HRV though is simple and impactful, right? It’s an indirect way of affecting both cognition and emotion, right? It’s the bottom up aspect of our platform, right? Remember we said, last time you need to train the body to respond to the mind and the mind to the body and integrate the CNS and autonomic nerve central nervous and autonomic nervous system in the service of self regulation and adaptability, right? Developing neural efficiency and resilience. So, you know, that’s, those are the sort of the three ways that I approach it. And then there are different strategies that we can use in those situations, no training. When we’re talking about it, you want to take people from controlled to uncontrolled situations and provide transfer skills. So do you want me to get into that stuff now?

That would be great. Yeah. I think that this is like the perfect moment because I’m primed to dig into some of it. And I have to admit to that. I have personally been feeling some of the things that we’ve been discussing today, although I have to say I’m grateful that I believe it’s to a lesser degree than many others, but I’m pumped to hear some of this, some of this as well. , so yeah, let’s do it.

Okay, so great. I mean, so if we look at sort of on the job or briefs, self regulation strategies for success, right? This is sort of in the moment of performance, right? It’s the uncontrolled environment and probably the two most impactful things there are, are your breathing technique and self-talk okay. So I know we talk about breathing all the time on the podcast. You guys talk about breathing all the time, and I think it’s important to highlight the critical aspect of breathing to enhance parasympathetic activity or tone. And it’s really all about the exhale, right? Um, so the technique that we like the most, or, I mean, and there’s tons of techniques, let’s let’s there’s no, no, no one thing is right, but it’s what works for you. But to slow down, you know, we, we implement the technique of, of your exhale being twice as long as you’re in here. Right? So if we think about it, we go in two, three, four, pause at the top, we don’t do a breath, hold know, breath holds great. It’ll increase your HRV. But if you’re just starting out with this, you don’t want to do that because it’ll tighten up everything else and you won’t get the benefits that it derives. Right. And then, so you just pause at the top and then double your count out two, three, four, five, six to let go.

And you know, how long does that take? That’s 15 seconds. You do that a couple of times in the moment and you will start to relax. What we have is another thing we call awesome. It’s a technique to add into that breathing pattern. And so at the top, at that pause, what you want to do is, is think about release the tension in your face and shoulders. So soften your forehead, Slack in your jaw, drop your shoulders, and think about soft, warm hands. As you’re breathing out, all those things, go back to your brain and say, I’m relaxed. And that takes, you know, you do that twice. That takes 20 seconds, right? And you can do that while you’re working. Nobody would know you’re doing that right. To do some other things. You know, you can’t sit down and meditate in the middle of a, of a, of a cold or when someone’s crashing, but this you can, right.

I mean, I like to say I’ll use surgery, but you can put any word in there. Surgery is a series of small steps done, technically perfect. And each has its own beginning and its own end. Rachel, in focus, you can do that for anything and put that in there and use a short technique like that self-talk is hugely important, right? If you’re feeling negative, no psychological study show, see a stop sign and know that, or, or pick a key action word that works for you, right? That’s the whole notion of slowing down to speed up, right. To refocus on what you’re supposed to be doing. Right? Those all relate to different brainwave speeds, you know, um, you know, rumination, negative self talk, intensity, try too hard. You know, that’s the brainwave speed, low beta. Okay. About 18 to 22 Hertz, you know, you can slow that down.

Okay. In the operating room, I used to say, when things were going perfectly, I’d say what’s wrong with this operation when nothing was going wrong. When people look at you, like you have three heads, but the answer is it’s going to well. Cause when it’s going to, well, the mind starts to wander, right? So you use that to help you refocus and that will help you in these situations. And in that situation then if you’re overwhelmed, which is probably happening with most people, you know, use positive affirmations. I mean, you know, it’s okay. I can get through this. People benefit from my work. I anchor yourself to your past successes. You’ve done this before a thousand times when, when you didn’t feel as stressed and it’s no different than doing it now, right? It highlights the whole use of deliberate practice and intention. I used to say, practice doesn’t make you perfect.

A perfect practice makes you perfect, but that’s not true. It’s deliberate, perfect practice makes you perfect. And so do it perfect every time so when you have to you can, I mean, that’s how and why elite performers can always perform in the moment because they do the same thing every single time. And then that frees up neural energy for us to look and take in other things. Right. And be able to process for information while still performing. Okay. I mean, those are just simple. Those are performance techniques. So those are things in the moment when you’re off the job, that’s what we consider the controlled or the non-performance environment, right? This is building better, a better mind and body or mind, body integration to a sand stressors, right? Deep self regulation, rest recovery sleep to learn how to shut down a busy brain, which is a trait found in most elite performers.

That’s a hot, that’s high beta, higher brain waves speeds. Okay. So the 23 to 35, and you know, these are things like getting away and I don’t mean going away cause we can’t travel right now, but just finding a quiet space, 20 minutes to an hour, if you can go support people, right. Timeouts, right. Things like that, do nothing, but do it. You can do during the day, even if it’s for a few minutes, but do it often physical exercises, you know, I’m sitting here, we’re talking, but every, you know, 20 minutes to an hour, get up and do something, I’d be a pushups, sit ups, you know, squats. And then some techniques that we really like are our muscle releases because the body and the mind are interconnected. Right. And to be able to get that awareness of what your muscles feel like when they’re tight and when they’re loose, because most people don’t realize that they’re actually tight because they don’t have that awareness.

That sort of, you know, we use things like surface muscle tension of the trapezius to be able to show that when people say, Oh, I feel great and relaxed. And, but your surface muscle tension is, is up through the roof. And when you create that awareness for people, you know, you take something that’s covert that we’re unaware of and make it overt for them, then they understand, Oh, there is a difference. So there are simple things that you can do. Um, an example, just say your arms, okay. Slight tension. You don’t make two fists bend at the wrist, bend at the elbow and gently hold that for about five or 10 seconds. But keep breathing, use that breathing technique we talked about before so that the rest of your body stays relaxed, right? And after five to 10, 10 seconds, let go and feel your muscles in your arms, relax in length.

And if you repeat that multiple times with submaximal contraction, you’ll, you’ll feel the difference between when you’re tight and when you’re not right, you can do that with your core, with your legs or your face and your head and neck. So for your face, head and neck, you know, gently pull the back of your neck towards the wall or the bed or whatever, wrinkle your forehead, squeeze your eyes together, squeeze your lips, right by down on the back of your teeth, gently that you don’t want to crack anything. Now hold that for five to 10 seconds. But again, keep breathing in that, in that pattern where the exhale is twice, as long as the inhale, you know, to stay relaxed, then let go and feel those muscles relax, right? Let them go. You know, and then, um, at night you can do the deep relaxation.

You know, we do like a guided meditation, but that uses, um, first the breathing to, to just get relaxed, then progressive muscle relaxation, then autogenic exercises, you know, to completely get into a deep relaxation. And then as we talked about the critical aspects, the objective metrics, right, to be use your HRV daily because by tracking it, you, you, um, you, you can see your pattern and, and it’s the objective data that become critically important. I believe, you know, be it the EEG or your heart rate variability because by showing changes on a computer screen or a tablet or a smartphone in front of you, right. It produces what we call aha moments because seeing the physiological features on a screen is extremely effective because elite performers and most people spend their time looking for and believing measures that show changes towards success and the ability to control those biofeedback measures like your HRV reinforces a sense of personal control, which is very powerful because we all have a history of outcome experience, right? We have a history of knowing what happens when we properly control our thoughts, emotions, and behavioral patterns. Right. That’s what I was saying before about anchoring your attention to the past. Remember what that looked like, felt like in a time of, of high performance, right? And by doing the types of things we’re really creating and developing behavioral stillness, you know, which is similar to mindfulness flow, quiet mind, or what we call an ideal performance zone.

Hmm. I liked that too, is that kind of almost relates back to what you might hear from some Eastern kind of philosophy, which is either a still mind and moving body or a cool head and warm body and those types of things, rather than being a hot head, uh, with a cool body or, uh, you know, a racing mind with a still body. And, uh, and so in a sense too, like I think one of the underlying themes that you’re getting at here and you’ve even said is, especially during times of elevated stress and overwhelm, it’s really difficult to just analyze yourself, um, of objectively and to introspect is a challenge anytime. But especially during stressful times. And I, I have firsthand experience of this. Um, the past year plus has been some of the most stressful times of my life, um, for many good reasons, um, like having a baby and a thriving business, but, um, but also just, you know, uh, trying to deal with a lot of different things, trying to it kind of, uh, feel a little bit of, um, empathy in your, in the story you shared at the beginning about trying to be a high performer in so many ways.

And, but when I kind of am getting at here is that I have also felt like my ability to kind of look inward and say, this is the state that I’m in. This is exactly what I need and I’m just going to do it. And that life would be so much easier if we could all just do that objectively and accurately, but a couple of different ways that you can figure out and create checks and balances and systematize your introspection in a way is to outsource some of it and, uh, you know, look to your loved ones and get feedback from them and look to these really neat pieces of technology that we have, which obviously I’m biased because I’ve helped create one of those pieces of technologies. But, um, but mainly because it’s also a passion of mine and it seemed like something that I could personally use as much as anyone else and measuring HRV or measuring other markers, if you have, or even just kind of, um, like you said, doing a Sudoku puzzle and seeing how your brain’s performing as a baseline.

Uh, but all of these things give you deeper insight and more accurate insight into what’s going on on the inside. Um, and you don’t have to take on the mental burden of trying to figure it out all by yourself as well. Uh, and then that immediate feedback loop, uh, you know, you mentioned biofeedback being a really powerful tool, obviously, too. I’m a big believer of, that’s why we’ve built a bunch of new features around that in our app too, but it’s, it’s a, it’s such a tool that kind of can like help you remove yourself from the situation, focus you in, uh, on what you can control in that moment and create that ripple effect to the rest of your life, you know, create a routine around it.

I agree. I mean, I don’t think that people realize how much personal control they have over their situation, right? I mean, yes, you can’t control what’s going on around you. Um, with others, you can’t control what’s coming at you, but we have the ultimate control of how we react or respond to any given moment. And if we take the time and it takes time, I, this doesn’t happen overnight. But if we take the time to engage in these practices, then we will ultimately be able to serve ourselves. And more importantly, others in times of crisis and stress and the objective metrics are critical because they’re, they’re the true measures of how we’re doing, right. We can fool ourselves into believing anything. Um, but the data doesn’t lie, right? I mean, I find it funny, you see people on TV talking about anecdotes, but the plural of anecdote is not data.

that’s it. That’s true. That’s a good one. You have to put some lighthearted things in there. Yeah, it is. It’s um, it’s, you know, I think that’s one of the things to those, like, um, not to take things overly serious, obviously there’s a lot of serious stuff we just talked about over the past hour, but the nice thing about some of these techniques, and I just want to kind of reiterate them at a high level is that, um, you know, you talked about, uh, gaining self awareness and gaining it through introspection also from feedback from your loved ones and objective markers like HRV. And then you talked about, you know, different techniques like breathing techniques and self-talk and muscle releases and things like that. And the neat thing though, is that during all of these serious situations, you don’t have to take the process. You don’t have to treat the process as some type of stressful process, right.

When we’re looking at breathing and self-talk and muscle relaxation, there’s, there can be even a sense of worry of whether or not you’re doing it right. Or whether or not it’s actually working for you. And I think the message that you kind of helped, uh, depict, um, you know, we can reiterate here is do what works for you, right. And find things that work for you. Like you said, if you need a moment to just relax and decompress, obviously you can’t maybe go fly to an Island right now or something like that. Well, I don’t know. I can’t usually do that anyways, but, um, the, uh, you can go to another room, you can just get a moment to decompress and, um, and you know, the self-talk thing is find the message that works for you. It could be some people like to self talk in a very kind of almost aggressively motivating way.

And other people prefer to, to say, you know what, it’s not even self-talk, it’s just me reassuring myself that everything’s going to be okay. Right. It’s not like telling yourself what to do. It’s more of just saying, uh, you know, that thing doesn’t have to affect me so much, or it doesn’t have to be so important as I’m treating it. Um, and I’ll, and all the things like that. So I just kind of want to iterate that the process of focusing on breathing and self-talk and muscle relaxation and getting away, these are all about you. So make them the way that they work for you. Right.

Exactly. I mean, I couldn’t agree more. I mean, that’s sometimes the problem when people talk about only one technique or, you know, it may not work, that technique may not work for you. So by providing people with a series of different things, they’ll be able to find what works for them, because what works for me may not work for them. You’ll note, when I talked about, you know, I do a deep relaxation at night, I do a guided relaxation and I use progressive muscle relaxation. And autogenics, well, that may not work for you, but that doesn’t matter because ultimately we’re going to the same state, right? The state of mindfulness and being present and able to perform, but how we get there is going to be different for everybody.

And that’s, that’s just as important as, as sharing that there are techniques that you’ve seen in your practice and over the years of, of your experience and that I’ve seen in my, uh, business and through our network and through my practice in past years, that are great starting points. And you’ve shared some of those today, such as increasing your exhale to inhale ratio so longer, slower exhales, things like that, using HRV biofeedback to see how your nervous system is responding. All of those are powerful techniques. And, you know, as we kind of wrap this discussion up, I want to share again, uh, you know, first of all, big thank you to you, Richard, for sharing your personal story, to help frame this conversation. But also that we talked about how people can help and you are stepping up and, and being a great example of that, sharing your story, sharing some vulnerability with the world.

It doesn’t have to be on a podcast to thousands and thousands of people you can share and be vulnerable with just one loved one. Right? And you can also share these techniques with your loved ones or your coworkers or people around you, um, breathe together, take, take a time to, um, decompress together if you want, or just share this information with that. Right. So that’s another part of our goal. And I also want to highlight too, that I know, you know, Richard, you’re here just to share your story and in a time that you’ve felt a high degree of motivation to kind of bring it to the public because you know, it could help people and, um, that people, you know, I, I do this anyways on the podcast, but I just want to highlight again specifically here is that, uh, people I’m speaking for you, so please let me, uh, correct me if I’m wrong, Richard, but, uh, people can reach out to you directly if they’re looking for help or just encouragement.

And especially people who have, uh, like me a network or a company of people that could benefit from your message. Um, you know, you have a lot of experience and expertise and high-performance both in business surgery and sports. And so picking your brain is something that you’re available for is I guess what I’m trying to get at here is that correct. And to come and give talks a hundred percent fantastic. Yeah. And what’s the best way for people to find you for that? Uh, probably on LinkedIn, we’re just starting to build the website for, for the venture. Uh, so I would say LinkedIn is the best way to get me perfect. Yeah, I’m there. Okay. And we’ll, we’ll link to you, um, on our show notes as well for the podcast. So everybody who listens knows that it’s elite, and look for dr. Richard Hart, where we’ll have notes from all the things we’ve talked about and links to him on his LinkedIn and where you can find more information and talk to him about potentially speaking or sharing some of his experience with you or your organization or a group. And, uh, but Richard, you know, we’ve covered a lot of ground here and I’ll kind of want to book in the conversation, uh, and just thank you again for your personal story and being willing to share that with us and then encapsulating some really hands on techniques that people can start implementing right. In this moment. Um, is there anything else that you want to part, you know, share with the group before we part,

You know, I just want to say probably to everybody stay safe, stay, well, we will get through this. It’s going to take a long time though and follow the science. And as Jason said, there’s do the simple things, wash your hands, you know, practice, uh, distancing sheltering in place. I mean, it’s easy to get worried. I mean, but we have a health crisis. We have a humanitarian crisis, we have an economic crisis, but it will get better and trust in that.

I would like to say to all the people who are working on the front lines, in any industry right now, How valued you are, how critical you are and how much respect I have for you all. And then on a personal note, you know, I want to thank Dr. Wilson, who is my partner in the business, who was my mental performance coach when I was competing internationally. And so I’ve known her for over 35 years. And a lot of the things I talked about today, you know, were things that she taught me and the things that she’s taught international athletes dating back to the seventies. And I wouldn’t be able to talk about all of these things on the level that I do if I hadn’t learned them from her and continue to engage with her. So, you know, it always sounds like it’s me talking, but, but I’ve had people teaching this stuff to me. I didn’t come, come across it all on my own.

I appreciate that. Yeah. We all have, we all have people whose shoulders we stand upon at some point or another. And I think that just kind of echoes again, the message of don’t be afraid to get help and ask for help and use help when it’s available to you. And if you know, somebody that could benefit from hearing that message, then you know, reach out to them because now more than ever, people are open to receiving help as well. Well, thanks everybody for listening and we’ll wrap it up there. Thanks again, Richard, for joining and sharing your message with us and be safe, be well, and you know, smile too. Right? Smiles are powerful.

Thank you, Jason. I appreciate the opportunity to talk and I look forward to doing it again.


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