Why You Should Listen

In this episode, you will learn about "Sacred Psychiatry" and healing through the integration of heart, mind, body, soul, the biosphere, and the cosmos.

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About My Guest

My guest for this episode is Dr. Judy Suzanne Reis Tsafrir.  Judy Suzanne Reis Tsafrir, MD, is a holistic healer, activist, artist, and gardener with a private practice of holistic psychiatry, ketamine-assisted psychotherapy and psychoanalysis located in Newton, Massachusetts.  She is a board-certified adult and child psychiatrist and psychoanalyst, is on the faculty of Harvard Medical School and the Boston Psychoanalytic Institute and teaches and supervises at the Cambridge Health Alliance.  She has particular interest in combining spiritual and developmental approaches to healing, helping patients wean from psychiatric medications, and treating complex chronic medical conditions that present psychiatrically, including mold toxicity, mast cell activation, and Ehlers Danlos Syndrome.  She is a practitioner of a variety of energy healing and esoteric modalities including astrology, Tarot, Shamanism, Body Intuitive, and Reiki.  Spiritually, she is drawn to Animism, Kabbalah, Buddhism, Taoism, Wicca, and Quakerism.  Her practice is dedicated to healing through the integration of heart, mind, body, soul, the biosphere, and the cosmos. 

Key Takeaways

  • Why does allopathic medicine fail with chronic health conditions?
  • What is the connection between autoimmunity, inflammation, and psychiatric conditions?
  • Might attempting to improve our health be working against our "heavenly mandate"?
  • What are some practical things that can be done to foster connectedness?
  • Can acupuncture act as a connector to the spiritual realm?
  • How might rose and geranium essential oils support the limbic system?
  • Is there a place for psychedelics such as Ketamine in supporting mental health?
  • What foods contribute to neuroinflammation?
  • How do energy vampires promote sympathetic dominance?
  • How much of a focus on regaining health should be in the mental / emotional realm vs. the physical realm?
  • How important is working on the limbic system?
  • What is the connection between MCAS and mental, emotional, or limbic health?
  • Has COVID been another contributor to psychiatric conditions?
  • Does EMF play a role in chronic illness?
  • How often does mold exposure contribute to psychiatric conditions?
  • Do patients with EDS improve their symptoms with treatment?
  • How is autonomic dysfunction assessed and addressed?
  • - What is the role of LDN in the clinical toolbox?

Connect With My Guest


Related Resources

Sacred Psychiatry: Bridging the Personal and Transpersonal to Transform Health and Consciousness

Interview Date

December 13, 2023


Transcript Disclaimer: Transcripts are intended to provide optimized access to information contained in the podcast.  They are not a full replacement for the discussion.  Timestamps are provided to facilitate finding portions of the conversation.  Errors and omissions may be present as the transcript is not created by someone familiar with the topics being discussed.  Please Contact Me with any corrections.  


[0:00:01] ANNOUNCER: Welcome to BetterHealthGuy Blogcasts, empowering your better health. And now, here's Scott, your BetterHealthGuy.

The content of this show is for informational purposes only and is not intended to diagnose, treat or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice or as information to facilitate self-treatment. As always, please discuss any potential health-related decisions with your own personal medical authority.

[0:00:35] SCOTT: Hello, everyone and welcome to episode 194 of the BetterHealthGuy Blogcasts Series. Today's guest is Judy Suzanne Reis Tsafrir. And the topic of the show is Sacred Psychiatry. Judy Suzanne Tsafrir is a holistic healer, activist, artist, and gardener with a private practice of holistic psychiatry, ketamine-assisted psychotherapy and psychoanalysis located in Newton, Massachusetts. 

She is a board-certified adult and child psychiatrist and psychoanalyst. Is on the faculty of Harvard Medical School and the Boston Psychoanalytic Institute. And teaches and supervises at the Cambridge Health Alliance. She has particular interest in combining spiritual and developmental approaches to healing. Helping patients wean from psychiatric medications and treating complex chronic medical conditions that present psychiatrically including mold toxicity, mast cell activation and Ehlers-Danlos Syndrome. She is a practitioner of a variety of energy healing and esoteric modalities including astrology, tarot, shamanism, body intuitive, and reiki. 

Spiritually, she is drawn to Animism, Kabbalah, Buddhism, Taoism, Wicca, and Quakerism. Her practice is dedicated to healing through the integration of heart, mind, body, soul, the biosphere, and the cosmos. 

And now my interview with Dr. Judy Suzanne Reis Tsafrir. 


[0:02:07] SCOTT: Our mutual mentor, Dr. Neil Nathan, shared Dr. Tsafrir's new book Sacred Psychiatry with me. I'm honored to have her on the show today to share a very interesting perspective on psychiatry and chronic illness. Thank you so much for being here.

[0:02:21] DR. TSAFRIR: Thanks for having me, Scott. 

[0:02:22] SCOTT: First, let's talk a little bit about what draws you to do the work that you do today. Did you have a personal catalyst in your life that gave you the passion and drive that you have to help so many others? 

[0:02:34] DR. TSAFRIR: Boy, that is a really complex question. I mean, especially if you ask a psychoanalyst that. I mean, I could go back to my early childhood, and my family, and multiple family members who were very medically and psychiatrically ill. There was no real understanding of what was going on with them. The way that I would frame my understanding of their troubles today and believe that, with the tools that, I have I could possibly have been helpful to them in ways that they didn't get any help. 

It's a big thrill for many psychiatrists and psychoanalysts to be able to help people when you couldn't help members of your own family. I mean, this is all so multi-layered and multi-determined. But my dad was also a psychoanalyst and a psychiatrist. And there was nothing higher in his estimation that one could do besides those professions. That also played into the whole thing in terms of like a wish to be loved. 

I practiced as a quite conventional psychoanalyst until close to when I was 50 years old. I'm now 67. And at that time, both my parents died within 3 months of one another. And my marriage ended. And I had three young children at the time. I consulted with an astrologer for the first time. I was really kind of reaching for the stars about what was going on in my life. 

I mean, astrology was also something that was familiar to me because my dad was interested in it. But he kept it a big secret. He wasn't out of the closet about it because he was afraid for his reputation. Because it's something that our culture has very little appreciation or understanding of and actually quite a bit of contempt for and skepticism. 

But I was so amazed by my experience with the astrologer that I went back to see her multiple times to look at the charts of everyone in my life and decided that I wanted to learn to do this myself. And apprenticed myself to two well-known astrologers. Steven Forrest and Maurice Fernandez. And, I don't know, somehow the study of astrology opened me up in some kind of spiritual way that led me to be curious and to learn to incorporate other kinds of holistic modalities into my practice. 

I learned about sort of just regular functional medicine kind of stuff, like with the gut-brain axis. Eventually, I learned about Dr. Walsh's work with nutrient therapy for treating psychiatric illness. And I learned about treating mold toxicity. Just one thing led to another. Kind of organic unfolding, which eventually resulted in the kind of practice I have today which is a very holistic approach. Including treatment of the body but also the mind, the heart, and the spirit. 

[0:05:38] SCOTT: And we imagine a world where more psychiatrists are looking at things like mold illness. That would be beautiful.

[0:05:47] DR. TSAFRIR: Right. Because it's so totally common in psychiatric patients.

[0:05:53] SCOTT: You talk about the planet being in a time of increasing breakdown and collapse. I think we all are feeling that. What has your experience been with white lions as a potential protector in times when humans may be in grave danger? What energetic resonance do you have with white lions as protectors in your own spiritual practice? And what message do the white lions maybe have for us? 

[0:06:20] DR. TSAFRIR: I'm not sure that the white lions are protectors. They're only protectors in so far as they come with a message that is a warning to humankind about the way in which our relationship with nature is misaligned. And that we run the risk of extinction if we don't acknowledge that and get into right relationship with nature. 

I was introduced to the white lions in 2013 when I traveled with an astrology teacher of mine to Timbavati, which is a region of South Africa, which it translates something like where the sky lions fell down from the stars. Something like that. And there's a legend, a Shangaan African legend that the white lions first appeared on the earth during the Ice Age and they helped teach humans to hunt and how to survive in the cold. 

And then when things were safer they disappeared again and they said that they would return if human beings needed them. If they were in danger again. And then in the 1930s they started to be born again. The genetic mutation, it's a difference that creates like a white lion and they started to be born again. 

And there's an African shaman who's no longer alive named Credo Mutwa who said that the lions just have this message for us that either we bow to the primacy of nature or human beings will not be able to continue living on the earth this way. 

I mean, I call upon them. Lions, in astrology, the archetype of Leo is about courage. And it's about being heart-centered. And it's about caring about the future, and the children, and generativity. And so, when I feel in need of courage or I want to access my heart, that's an energy that I will call upon to kind of amplify those qualities.

[0:08:26] SCOTT: You talk about the dread that so many face now as a result of the COVID pandemic and its ongoing consequences. And how allopathic medicine has little to offer with "standard of care". Why is it that allopathic medicine fails with conditions like cardiovascular disease, cancer, autoimmune conditions, fibromyalgia, chronic fatigue syndrome, chronic Lyme, mold illness? 

[0:08:54] DR. TSAFRIR: Well, the conventional paradigm is identify symptoms, make a diagnosis, and then follow an algorithm that eventually ends in the prescription of pharmaceuticals or a procedure. And there's no awareness or priority placed upon looking for root causes or for measures which are preventative, which might prevent those types of conditions. Many of them that you mentioned are driven by inflammation. There's no attention paid to diet, or infectious things, or toxins that create these things. It's just identifying symptoms. Suppressing them with pharmaceuticals. 

And the pharmaceuticals aren't a free lunch. Very often they have side effects. And in psychiatry, often those side effects are treated with yet another pharmaceutical. And there's not a holistic perspective. I mean, the system is broken and the paradigm is broken. And doctors don't have time to be thoughtful. They're allotted a very small amount of time to meet with each patient. And the requirements made of doctors in terms of the paperwork and the medical record leave them no time for anything besides to decide which medicine. 

And there's so many other factors that go into healing a person besides prescribing a medication. I mean, that would be unnecessary where someone potentially to attend to an anti-inflammatory diet, or to help a person develop a spiritual practice, or to emphasize with a person the need for them to find community, or to get out of a toxic relationship, or to recognize that they may be living in a building which is damp and which is moldy and they are suffering from the consequences of having mold toxicity and treating that. Or mast cell activation. I mean, there's so many treatable things besides suppressing a symptom with a pharmaceutical.

[0:11:14] SCOTT: As you noted, conventional psychiatry often seems to be more of an exercise of matching a patient with a drug and often little more. How often do you find that conventional treatment options for psychiatric conditions are the full solution for patients that are struggling with their mental, emotional health? 

[0:11:33] DR. TSAFRIR: That's kind of hard for me to say because those kind of patients don't come to see me. And in fact, if someone calls me and says my psychiatrist is retiring and I need someone to prescribe my stimulant to me. I'm like you can find somebody else to do that. That's not a good use of my time, or my expertise, or my interest. I don't really see patients like that.

Patients come to see me because they have kind of failed with conventional psychiatry in general and they've seen many other psychiatrists previously and none of – and they've been put on a lot of medications which are making them feel ill. And so, I mean, I'm sure there are people for whom they're depressed, they take Prozac and it helps. And that's it. But that's not who is the population that I work with.

[0:12:25] SCOTT: You talked about the connection between inflammation and psychiatric conditions. We could maybe extend that and say autoimmunity as well. And it as a driver of inflammation. How often would you say that a psychiatric condition could be more biological and less mental, emotional? 

[0:12:44] DR. TSAFRIR: I think it's hard to parse it out that way. I mean, a person may have tremendous anxiety or depression due to mast cell activation or to toxicity. But usually, that's not like the whole story. They may have an immune system that is in some kind of way dysfunctional because they have an experience of adverse experiences in childhood and their autonomic nervous system is on high alert. 

I've heard about patients who have the genetic condition of Ehlers-Danlos Syndrome. But then when you treat mold, their Ehlers-Danlos Syndrome gets better. I think that it's very hard to just divide things up. It's all so interpenetrating and one thing affecting another thing. 

I mean, in my experience, a person has great difficulty feeling spiritual connection or feeling a sense of expansion if for instance they have a very poor diet and they're inflamed. The body is so intimately connected with the spirit and the emotions are so intimately connected with the spirit and with the body. I'm just repeating myself. But it's very hard to divide it up in my opinion.

[0:14:18] SCOTT: Why is your goal as a psychiatrist not to return the patient to "normal"? Why is normal no longer optimal, or healthy, or good enough? 

[0:14:30] DR. TSAFRIR: A normal diet like the standard American diet. It's been also named the SAD diet. Because it's a diet that is often full of processed foods and foods that have high pesticide residues. And normal is to have no spiritual practice. Normal is to spend hours and hours in front of a screen. Normal is to not spend time in nature or to recognize the consciousness that is all around us. 

I mean, normal is a prescription for alienation, and depression, and anxiety. I would like to help a patient feel able to work and to love but not to be leading a lifestyle that is average. I mean, a normal is sort of equated with average. And average is very toxic. 

[0:15:37] SCOTT: In the book you talk about heavenly mandates that we come into this lifetime with. Might chronic illness and the learning from that journey be part of our heavenly mandate? And might attempting to improve our health be working in opposition to what our man mandate is in this lifetime? 

[0:16:00] DR. TSAFRIR: I mean, I'm sure it's possible. It doesn't seem to me likely. For sure, illness and suffering is an experience that often for many people catalyze maturation, and spiritual growth, and development. But I don't think that anybody is it's their mandate to be ill. 

I mean, very often, adverse adversity creates – I mean, not always. Sometimes it creates bitterness and fear. But it can create a great deal of compassion. Yes, adversity creates compassion and psychospiritual growth very often. 

[0:16:47] SCOTT: Totally agree. And in my own experience, I'm sure early days of my own chronic illness, that fear and all of that, dread, and hopelessness, and whatnot probably were more dominant. And now I think I focus more on the gifts and the new perspectives that I've gained from my own challenges and ultimately my recovery from chronic illness. And so, I do think that as challenging as it can be that there are lots of gifts. 

[0:17:12] DR. TSAFRIR: I also would very much view this podcast and the work that you do as a gift of what you have been able to make of your experience of chronic illness. I mean, the podcast definitely feels to me like a heavenly mandate. Like you're sharing something with the world that has the potential and I'm sure does make a great deal of difference for a number of people.

[0:17:39] SCOTT: Thank you. Thank you.

What is an archetype? And how does that influence our behaviors? Our experiences? How much control do we really have to change our existence? 

[0:17:55] DR. TSAFRIR: You ask these amazing philosophical questions. An archetype is a pattern of experience, or a structure of experience, or an energetic kind of constellation. For instance, the planets represent archetypes. Like Jupiter is an archetype associated with expansion, and abundance, and potentially excess, and blessing, and good luck. It has a lot of positive connotations. 

Saturn, the archetype is associated with mortality, and limitation, and fear, and structure, and maturation. We all tune into these different archetypes all the time and they structure our experience. When we are – there's different cycles in astrology. For instance, when a person is 29 years old, they're having their Saturn return and they may have some kind of awareness of their maturity and the passing of time. And that they're no longer a child. And what are their responsibilities? And how do they want to structure the next chapter of their life? They're sort of partaking of the archetype of Saturn. 

Or if someone has what feels like a stroke of great good fortune, and things are really going their way, and they may feel as though they're connected with the archetype of Jupiter. I think we have tremendous amount of control. I mean, we do and we don't. I mean, there's many, many things that are not within our control. 

But I don't see the astrological chart as something that's predictive. It represents patterns of energy and kind of invitations to us and themes that we're invited to address in our lifetime. But I was just mentioning Saturn. The invitation from Saturn in its highest expression would be to be realistic, and to be mature, and to take responsibility. 

But, I mean, one could express or partake of that archetype by being very fearful or by feeling unnecessarily limited by things. There's different ways that one can respond to an archetype. And I think we use our consciousness to choose how we're going to react to things. 

I mean, the more conscious one is the more one is able to have some choice about things. And the more one works with one's mind and trains it to not be reactive and to have more equanimity, the more one is able to have as much control as possible realizing that there are so many things that are not within our control. 

There's just huge forces going on in the world now like with the climate and the rise of authoritarian governments all over the world. This is nothing that I can personally have much impact upon, and control, and may be very much at the mercy of. But I can do my part in my own small sphere and affect what I can affect. 

[0:21:21] SCOTT: What is the overlap between the Greek mythological figure Chiron and your person Chironic journey and your heavenly mandate to be a Chironic psychiatrist? 

[0:21:33] DR. TSAFRIR: Well, the myth of Chiron. Chiron was a centaur. And he had a very traumatic beginning. He was the product of a rape. I think it was Zeus changed himself into a horse. And this was because the nymph that he lusted after had changed herself into a mare and he raped her and Chiron was born. And he was half horse and half human. And Philyra, the nymph, was utterly disgusted by this creature that she had born and she rejected him and abandoned him. And he was subsequently adopted by Apollo who took him in and who educated him. 

And centaurs mythologically are very vulgar, crude, rambunctious, rowdy creatures. But Chiron was very refined and very highly educated. He was an herbalist. He was a healer. He was an astrologer. He was a musician. He was multi-talented. And actually, the kings sent their sons to be educated by his him. He was the mentor and a great healer. 

And the myth has it that Hercules – there's many different versions of the myth. But in one version, he accidentally shot an arrow at Chiron that was the tip was dipped in the blood of the Hydra and it created this wound in Chiron's thigh, I think, that couldn't be healed. And Chiron, despite all of his enormous skills, just suffered endlessly with this. 

And it goes in parallel with the myth of Prometheus who was chained to a rock and an eagle came daily to peck out his liver. And Chiron offered to change places with Prometheus. Because Prometheus was suffering so much. Chiron, in an act of altruism, exchanged places with Prometheus. And the gods then were so moved by Chiron's compassion that they released him from that position and put him up in the sky as a constellation. 

And so, he's an archetype that talks about both the capacity for healing and to be a great healer. But also, the limitations of it and being unable to heal oneself. And also, the power of compassion and altruism. And Chiron had a very shamanic beginning. He was rejected by his mother when he was born. I resonate with that. 

I talked in the book about the fact that my mother was very depressed when she was pregnant with me. And when I was born, said I was an ugly baby. And went on to be psychiatrically hospitalized. And that's a wound that I have carried with me my whole life. 

And, boy, I've spent a great deal of energy and time in healing it. And I have transmuted it a great deal. But it's never entirely healed. It's never entirely healed. And the whole process of writing the book was very challenging in terms of some kind of way. I needed to work with myself to not anticipate that my book would be an ugly baby. 

And to get over my fears of rejection. And to be able to promote my book. To talk about myself. To be on a podcast. This was all like a huge piece of spiritual work for me. An ongoing piece. And, I mean, it's interesting that you asked me that question. Because at first I was like, "Oh, my God. It's such a hard question." But it's a wonderful question. And I feel as though I deeply resonate with that archetype of Chiron. And I think there's ways in which we probably all do. There's certain things that have happened to us during our lifetime. Or maybe it's also past lives that you can't just like entirely get over. 

Ram Dass, who's a famous spiritual teacher had this saying about becoming a connoisseur of your neurosis. That you kind of know yourself and you know what your deal is. It's not like you're going to disappear them. It's not like it's going to go away that certain things have happened. But you become more and more skillful at dealing with it. 

[0:26:20] SCOTT: How does a lack of interconnectedness further fuel more dread? More alienation? More hopelessness? And in the book you talk about many practical things that we can do to feel more connected within our natural world, within the universe, and with our spiritual existence. What are some of those tools that can help us feel more connectedness? 

[0:26:45] DR. TSAFRIR: The first chapter of my book is I think titled something like Developing A Multi-Dimensional Sense of Yourself. And if we don't have that sense of ourselves as more than just our physical body, more than just our personality selves, life can be very scary. And it can be – people can feel very alone. 

And with everything that's going on in the world, that is like the last thing that we need. We need to have a sense of connection with one another. We need to have a sense of connection with the natural world. We need to have a connection of sense of connection with all that is. And that is what is really fortifying and strengthening to not be feeling confined to the small self. 

In that chapter, I talked about a number of practices that can help one feel connected. For instance, I talked about creating an altar. And an altar is just like a little sacred space that one creates. You can take – it doesn't need to be a whole room. It can be a corner of a room where you take a pretty cloth and put it down and maybe set a vase of flowers there. Or collect some objects that have some kind of special meaning to you. It could be a picture of a place that you love, or a person that you love, or a special rock, or crystal, or a feather, a candle. Something that reminds you of your connection with something larger than yourself. 

You can set that up. And it should be tended. It shouldn't be just allowed to sit there unchanging forever. It may be that something that you put on there a week later no longer speaks to you. And so, you change it up. That you tend to it. And it's a reminder that there is more to you than just your physical body and your personality. 

I talked about practices like drumming. In like the Native American cultures, I think a drum can sometimes be referred to as a spirit horse. And so, one can drum and the rhythm of it takes one out of oneself and helps shift the consciousness. I use my drum daily. I have like a practice for clearing my energetic field that I do every morning and every night mostly. Not 100%. But mostly, I do it. 

And sometimes I'll already be in bed and I'll like, "Oh, no. Where's my drum? It's down in the kitchen." I'll go down and get my drum. I'll beat the drum and I'll say, "I ask that any energy that's in my field that doesn't belong to me be blessed and transformed and sent back to whom it belongs." And then I'll say, "I ask that any energy of mine that has been left elsewhere be blessed and transformed and returned to me." I'm always morning and night clearing my energetic field with the drum. And this, again, is like a practice that reminds me that I have an energy body and I have an energy field. I'm not just my 3D reality. There's so many practices. 

I quoted Angeles Arrien, who was a cultural anthropologist. She died in 2014. And she was a wonderful thinker and wrote some wonderful books. She talked about a practice called The Blessing Way. She went around the world and she studied cultures all over the world. And on the basis of what she observed, she named three commonalities that she saw repeatedly in cultures throughout the world. 

And the first was that every culture had some kind of form of prayer. Prayer is something that many patients today have no clue about how to do. And they in fact are even allergic to the word because it has so many oppressive associations from growing up in the family where religion was practiced in a way that like didn't feel uplifting and felt in some kind of way aversive. But prayer is really asking for guidance. 

I did quite a bit of training with the Foundation For Shamanic Studies. And in my training we were taught that the spirits like to be asked. They don't interfere without our asking. And they like to be even asked out loud. It can be so helpful to say "Help me. Guide Me. Show me the way. I'm willing. Help me trust. Please show me the way. Show me what do I need to do." 

Marianne Williamson talks about a prayer that she says every morning, "Where do I need to go? What do I need to do? What do I need to say and to whom?" Prayer is something that is common to cultures around the world. And the second practice that she identified was gratitude. 

There's been lots of very evidence-based research done on gratitude that people who write down three things every night before they go to bed about what they're grateful for are measurably happy when they are administered these happiness scales than people who don't do that. 

Our brains are Velcro for things that are scary. It's like an adaptive way that our brains are created. That we pay attention to what causes fear or threat in our environment. But we're more Teflon for the good experiences. Cultivating gratitude helps one cultivate an awareness of like the good things that are happening during the days, "Oh, that is something that I could write down. I feel so blessed that that that happened." Just increasing your awareness of what is good. There is so much to be grateful for amidst all of the suffering that is going on and all of the craziness. There's no doubt that there's a million things to be grateful for every day. 

And then the third thing that she identified was taking action. Doing some kind of sacred action. It's not enough just to pray and be grateful. But you need to do something. Do some kind of act of service. Some kind of act of kindness. Make a donation. Do something to increase the amount of beauty and goodness in the world. But really, to like take some action. Those are – that was Angeles Arrien's blessing way three-fold practice. 

I was also trained in the practice of making offerings, which is not something that we do in our culture. Spirits don't only like to be asked. But they like reciprocity and relationship. Ask for guidance and take a handful of rice and throw it and say thank you. Or lentils. Or flower petals. Or whatever. But just some kind of act of give and take. 

There's just a million things that one can do throughout the day to remind oneself that one is a multi-dimensional being and not just confined to a body which may not be feeling well or a personality which is feeling angry and upset. Or depressed. Or whatever. That there's something larger that we can tap into and which expands us. 

And this is just not – these are not skills that are taught to people in our culture. And patients come to see me in my practice and I'll ask them about their spiritual practices and they don't have one. But they want one. But they don't know how to do it. They're just, "I would like to. But how do I do this?" And just giving some tips like that, it makes a difference. They have something concrete to do. Just like might say to someone, "There's a lot of evidence that getting outside early in the morning and getting that morning sunlight is something that affects the pineal gland and resets the circadian rhythm and the nervous system. And it's just really, really good for you. They know what to do. There's things to do.

[0:35:35] SCOTT: How might acupuncture or essential oils be helpful tools in working with some of these higher levels of healing? I think we think of acupuncture points as working with the physical body, as working with the energetic body, working with the meridians. But can some of these acupuncture points or potentially work with essential oils, can these be connectors into the spiritual realm as well? 

[0:35:59] DR. TSAFRIR: Absolutely. And that's one of my favorite topics and something that I am – it's kind of my leading edge now of like what I'm learning more and more about and what I love. Something that I learned about in this energetic training that I did called Body Intuitive was these spiritual portraits of the energetic points. 

And actually, I mean, I didn't learn that much about that in that training but I subsequently got a couple of books. One was by a woman named Marie Gervais, the Spiritual Portraits of the Energy Release Points. And one by an acupuncturist named Lonny Jarrett. And there's the third person, Lorie Deshar. And the points, it's just very fascinating. 

What I learned was that when Mao, during the cultural revolution, he wanted acupuncture to be Western medicine, and to be evidence-based, and repeatable, and provable. And so, he completely kind of lopped off all of the spiritual aspects of those points. 

For instance, there's a point that's like at the head of the sternocleidomastoid muscle underneath the jaw. And I believe it's small intestine 17. It's on one of the energy meridians. And stimulating this point is thought to like burn away suffering. How amazing is that? I mean, I don't remember what the point is. If it's for the sinuses, or for the headache, or whatever the physical things are. But this is like to burn away suffering. Or there's points underneath the occipital on either side of the spine. They're the points that are called like windows to the sky. And stimulating these points helps a person have like self-confidence and to like reach their head up towards heaven. Or there's this point on the chest that's called conception vessel 17. It's on the breastbone between where – on a man, it would be the nipples. And it's called the heavenly storehouse of inner light. And stimulating this point amplifies a person's capacity to give and receive love. 

Especially Marie Gervais' book, it's just so – this description of what these points can do spiritually is just beautiful. And if you just give a patient like a single point that helps them manifest their heavenly mandate and you can give them the text to think about what's all the meaning of this point. And it's a way for them to focus their energy and their intention. And it's very beautiful and very rich. And an endless exploration. 

[0:38:52] SCOTT: I've worked with some Bach flower essences, some Australian flower essences that can be helpful for supporting mental health, emotional health. When you suggest specific essences for your patients, is this more academic matching? More intuitive? Or do you use some other senses to match the essence to the person? 

[0:39:15] DR. TSAFRIR: Well, I mean, I think that underneath it is kind of knowledge that I've just learned about different essences, and their qualities, and how they can work. Or not how. But what is their – the way that they work. But then I sort of intuitively arrive at the idea. But I think there's a lot of learning that's gone behind it that informs the intuition. I don't use any kind of muscle testing or anything like that. 

[0:39:43] SCOTT: This Body Intuitive system then incorporates energetic healing, medical intuition, work with the chakras, work with essential oils. What's the patient experience of a body intuitive session like? 

[0:39:59] DR. TSAFRIR: I have an exchange partner who every two weeks either I give her a session or she gives me a session. And I think just like in any kind of healing, it has a lot to do with match. And I think we're very well-matched. There can be a feeling of being like very much understood. Also, sometimes, there can be a feeling of surprise. Of, "Wow. What this person is coming up with? This wasn't what I anticipated." And yet, as you kind of feel your way into it, like, "Yeah, that is really interesting and has maybe something to offer that I hadn't thought about." 

But, I mean, basically, I prepare in advance before I do a body intuitive session. I tune into the person and I use astrology. I use oracle cards. I tune into them energetically. And I have something prepared when I meet with them. And then I may or may not make use of what I prepared depending upon what they tell me and how the session unfolds. 

The practitioner describes to the patient what she is focusing upon. And then, eventually, when the session is activated, the patient themselves – because I've only worked virtually with this. Stimulates the points on themself. Also, there's a technique that's called a sweeping breath. And it has to do with like emotional release. It has to do with focusing, and breathing in, and turning the head, and focusing upon something, and releasing something. 

And then, eventually, the whole session is activated by tapping on – it's basically the three major energy centers on the head, and on the chest, and on the belly. And very often, there'll be homework. Like, repeating the stimulation of some of the acupressure points or some combination of points that is like a reset for a particular chakra or a reset for an element. It's very interesting. I find it quite remarkable, honestly. 

[0:42:18] SCOTT: You talk about rose and geranium essential oils to calm the limbic system. I'm very interested in limbic system-related work. We know that's one of Dr. Neil Nathan's big areas of focus with his patients as well. We know of tools like DNRS, and the Gupta program, and Primal Trust, and so on. But I hadn't really thought too much about the use of essential oils for calming the limbic system. If we're looking at rose and geranium essential oils, where might we apply those oils to calm and overactive or hypervigilant limbic system? 

[0:42:53] DR. TSAFRIR: Well, I mean, a great place is that point that I mentioned, CV 17 on the heart that's on the breastbone between the nipples. The center of the inner storehouse of light. Because if you put rose oil on that point, you're amplifying your capacity to give and receive love. You're not going to be like in a state of sympathetic arousal. That tunes into like some kind of heart-opening. 

And even like just smelling the essential oils on your fingers. The smell of the rose. The smell of the geranium. Those floral scents, very, very calming and uplifting. I think aromatherapy has a lot of potential for calming the limbic system. And I like combining it with the acupressure points, the acupuncture points and having in mind the spiritual portraits of them.

[0:43:46] SCOTT: If I remember right, Rose is also one of the highest-vibration essential oils. It's pretty amazing.

Healing work works best when we're in a parasympathetic state. We've touched on that quite a bit. What are some of the tools that you find most helpful for your patients for getting people into a parasympathetic healing state? 

[0:44:07] DR. TSAFRIR: Well, you mentioned the Gupta program. I recommend it to almost everybody. And in fact, when I'm talking to patients before I agree to work with them, I assess their level of motivation. Are you willing to spend 40 minutes a day doing like a mind-body practice? Because if not, I doubt that I'm going to be able to help you. Because it's just – that is such a wonderfully clear, structured, accessible method that anybody can implement to calm down their autonomic nervous system. 

And then there's practices like being in nature that is also very calming to the nervous system. Hugging is very calming to the nervous system. Pets. If you love your pets or if they're not creating havoc, that's very calming to the nervous system. Animals. Creative work. 

I mean, anything can cause stress. A pet can cause stress. Or getting frustrated with something you're trying to make can cause stress. But it can also potentially be very soothing and calming like knitting, and crocheting, and needle work, and handiwork. Any repetitive kind a meditative motion, all of that can be very calming. Housework can be calming. 

Truly, if you're like washing the dishes and cooking. Cutting vegetables. Anything that you like that you enjoy that you feel comfortable and competent at and feel relaxed doing it, it like calms down your system. 

[0:45:51] SCOTT: I need to be smiling more when I'm scrubbing the toilets is what I'm hearing. 

[0:45:56] DR. TSAFRIR: Well, I mean, anything can be adverse. I mean, the cats can drive you crazy when they knock something off and break something that you love.

[0:46:03] SCOTT: Tools like ketamine, or ayahuasca, or psilocybin, those seem to lead some people to making great strides in their healing. On the other hand, I sometimes wonder if they can be overused or used as another crutch or maybe even another addiction. What has your clinical experience been with psychedelics in how they can support our psychiatric mental, emotional health? 

[0:46:31] DR. TSAFRIR: Well, so far, at least in Massachusetts, the only legal psychedelic is ketamine. I did a training in ketamine-assisted psychotherapy at the end of May, beginning of June, and have been doing a lot of it in my practice and have been having a number of very, very positive experiences with my patients. And being able to help people that even though I have been able to be very helpful before I did the ketamine training, somehow, I'm able to accelerate things. 

I'm thinking of one man who was addicted. He's 48 and he was addicted to marijuana since he was 16. And he's not smoking anymore. And he couldn't stop by himself. It can be very helpful for addiction. 

 Another man who just tremendous kind of ruminative depression. A great deal of suffering. The ketamine just really, really shifted him. And with him, it's been necessary to have some booster sessions. It's worn off after a few months. But that's okay. The difference that it's made is so great. 

It's not legal for me to do NDMA or psilocybin with patients. I think that's probably going to change pretty soon. And I'm interested in being able to use those psychedelics to help people. I think there's tremendous potential. I mean, I did my psychiatric training in the 80s. I started my residency in 1986 and finished in '89. And basically, there's – and Prozac came out during that period. There's been like very few advances besides the psychedelic since then. 

I mean, this is just a revolution. And so helpful for PTSD for some patients. I mean, I'm not worried about the addictive – I mean, I'm sure anything can be abused. Human beings have the capacity to abuse food. Yeah. I mean, you can abuse anything. But I think the upside and the therapeutic potential so far outweighs the risk. 

And I think it's important to do it in a sacred and ceremonial way. And I really don't like the way that these ketamine clinics have sprung up around the country and people are given high doses of ketamine without any consideration to set and setting. Without any kind of setting a framework of doing something sacred. Something soulful. I don't appreciate medicalizing these medicines. 

And then, I mean, NDMA and ketamine are chemicals. They are pharmaceuticals. But there is a way to make use of them in a very sacred way. 

[0:49:20] SCOTT: I love that. It's an area that I've not personally explored much. But I definitely need to learn more about it. Thank you for sharing that.

[0:49:28] DR. TSAFRIR: I mean, let me just say something more about the ketamine. It promotes neurogenesis. It promotes neuroplasticity. Our default mode network that generates our repetitive thoughts that often are not progressive. They're just same old – like a rut. Our brain is like a ski slope that has all these tracks going down and it's just very easy to get into the same rut. But the ketamine allows for some new pathways and some new ways of thinking to develop. It supports that. I've heard it described as like miracle growth for the brain. And it feels that way to me that there's something not for everybody, but for a number of patients in my practice. 

And I like to combine it synergistically with the Gupta program. Because in the Gupta brain retraining, patients are asked to recall some kind of time where they felt really whole. Where they felt really good. Where they had some kind of uplifting experience. Something very, very positive. And to recall that as a way of kind of entraining the brain to be in that kind of state. 

Well, sometimes with the ketamine, patients have experiences of tremendous heart opening, and of bliss, and of connection. And so, I'll say, "Remember this. Remember how you're feeling." And then when they do the Gupta brain retraining, they can recall that ketamine state. And it's something that works very synergistically together.

[0:51:06] SCOTT: Wow. Beautiful. I love that. In regards to climate catastrophe, you say in the book that a type of planetary near-death experience is what will be required for there to be a collective awakening of humankind. How close do you think we are to this awakening? And is it an awakening that potentially goes even beyond the climate conversation and to a much broader rebirth? 

[0:51:32] DR. TSAFRIR: Well, first of all, I don't know, the way that you said that. You said something like that it will require. I don't know that. I wonder that. I don't know what's going to happen. It seems like that's what it seems like. But I don't know what's going to happen. 

I mean, the way it looks from the perspective now is that there's little capacity for any kind of global cooperation, which is what is needed in order to avert disaster. Everybody needs to get together but there's so little will for that or so little capacity. It looks like we're headed for catastrophe and collapse. But who knows what will happen? 

And it does seem also at the same time that there is some kind of acceleration of consciousness. There's more and more people who have like an awareness of our interconnectivity and interbeing than ever before. There's more and more talk in the news about UFOs and extraterrestrial intelligences. And that there's a lot that has been kept from the public. 

And I don't know what to make of it. But it feels as though there's just enormous change of foot. And even with things that we can know more about, like the advent of artificial intelligence and the way it's going to change everything entirely like more than things have changed with the advent of the internet. It's just supposed to create some kind of quantumly different experience. All of this is putting so much pressure on us to change and evolve. And people can evolve, and become more mature, and more conscious. Or I guess also become tremendously traumatized, and reactive, and fearful, and violent. Both are happening. 

There's a quote by Joanna Macy that I love. What she said about this time. This is how I feel. It's walking the razor's edge of the sacred moment where you don't know, you can't count on, and comfort yourself with any sure hope. All you can know is your allegiance to life and your intention to serve it in this moment that we are given. In that sense, this radical uncertainty liberates your creativity and courage. 

That's what it seems like to me. There's something – the intensity and the extremity of the moment is calling forth something also like extraordinary in us. Extraordinarily good and extraordinary awful like what's going on in the Middle East.

[0:54:35] SCOTT: In the book, you talk about energy vampires. Some call them chi suckers. How might we know when a relationship is toxic and in our best interest to bring it to some closure to some end? How do energy vampires contribute to sympathetic dominance and negatively impact our other healing efforts? 

[0:54:55] DR. TSAFRIR: Well, I've never seen – I've really never seen it that a person is in a relationship with someone that has no sense of reciprocity. No sense of fairness. That it's all about them. And the other person is just there to meet their needs. And they're treated with a lack of respect. A lack of dignity. A lack of compassion. That is just an enormously stressful situation to be in close contact and relationship with someone who treats you in this way. And it creates like a constant state of fight or flight. And that creates a constant secretion of cortisol, which results in inflammation in the body and the brain. And a person just feels anxious and depressed. 

I mean, I think what I've come to see is that it's only when a person can truly accept that the person that they are with is not going to change. That there's nothing that they can do. No way that they can get it right. No way that they're going to be able to fix it that then they're able to finally liberate themself from a relationship like that. 

And often, that involves a lot of grieving. Because they need to give up the fantasy that it's in some way in their control that they're going to be able to get this person to behave in a loving, appropriate way with them.

[0:56:23] SCOTT: In the book you talk about Accelerated Resolution Therapy. How is Accelerated Resolution Therapy different from EMDR? And do you think there's a place for EMDR in the type of work that you do as well? 

[0:56:37] DR. TSAFRIR: Well, I'm sure there would be a place for it. I'm not trained in it. I've been like very impressed with the effectiveness of ART. The way that I understand that it differs from EMDR is that, with EMDR, a patient really tells the therapist a lot about what it is that they're working on and in a way that it becomes like a shared experience. They're talking about the trauma. And it's my understanding that it sometimes can be quite activating and sometimes re-traumatizing. 

The ART is done entirely internally. The patient doesn't even need to tell me really about what they're thinking about or what they're really working on. I mean, we may decide that they want to work on their fear of flying or that they want to work on a time that they were held up and assaulted. But they don't need to tell me the whole story or they're doing something internally as I'm giving them prompts. And they're doing eye movements at the same time as they're thinking about their various scenes. 

And then there's a whole opportunity to, in fantasy, create replacement images, and replacement scenes, and replace placement experiences in imagination in conjunction with the eye movements. 

And really, mostly patients who I do ART with walk out of my office smiling. Because it's a very uplifting positive experience. As I understand, EMDR, it can be upsetting. You can be undone by it. Not that it's not helpful ultimately. But ART I think is, at least in the moment, much less stressful for patients.

[0:58:37] SCOTT: When we consider chronic illness at a higher level, how often would you suggest that there is a mental, emotional contributor? Some conflict or trauma that may have set the stage for the development of an illness? How much of our focus on regaining our health should be in the mental, emotional realm versus solely focusing on the physical realm? 

[0:58:57] DR. TSAFRIR: I think they're all just interconnected and interpenetrating. I think on that ACE study, adverse childhood experiences, there's people who have mental illness, people who have chronic physical illness, huge percentage of them have adverse experiences in childhood. It just is very formative for the neuroendocrine immune system. And so, it creates like a vulnerability or a lack of resilience. 

I see them as all just so intimately connected. And there may also be things that we can't really identify and know about at least not with my skill set. About past lives that are contributing to karmic things that are contributing to a person's health and illness journey.

[0:59:53] SCOTT: One of my mentors, Dr. Klinghardt has said that it can be difficult to move past chronic illness when one is on certain psychiatric medications. Klonopin potentially being one of them. Do you find that some psychiatric medications make it more difficult to treat a person for the physical contributors to their condition? And do some people potentially need to wean off certain medications to support their longer-term overall healing process? 

[1:00:22] DR. TSAFRIR: I don't really know. I mean, I have a sense that the psychiatric pharmaceuticals are in general not healthy for people. The antipsychotics, many of them cause metabolic dysregulation and insulin resistance, which then increases inflammation. The anti-depressants, very often, a person feels in a certain kind of way wrapped in cotton. So, that there's a certain numbness that they're just not as reactive. I mean, it can be seen positively is there some kind of floor underneath them. 

And in my training, I was taught that that sometimes a person is able to do psychotherapy once they're on Prozac in a way that they were just too flooded and overwhelmed before taking Prozac to be able to do the work. But I think, conversely, it's also true that you take a person off of an anti-depressant and, all of a sudden, they're listening to the radio and their eyes filled with tears when they hear all of the sad things that are happening in the world. And that would have never happened had they been on an anti-depressant. 

How that in turn in terms of like interfering with physical healing? I really can't comment exactly upon that. But in general, I mean, there are certain pharmaceuticals that I really appreciate, such as ketamine or low-dose Naltrexone. That's one that I use a lot of and is extraordinarily helpful. But in general, I try as much as possible to avoid my patients taking pharmaceuticals. If it's possible for there to be some other kind of natural substance that would work as well, or diet, or mind-body practice, or sunlight would substitute in terms of them not feeling so depressed, or anxious, or distraught.

[1:02:24] SCOTT: We're going to come back to the LDN conversation. Because that is one of my favorites as well. But few questions before we get there. When we think about neuroinflammation, you talked about the SAD diet. What are some of the foods that are most contributory to that neuroinflammatory state? And what are some of the foods that are more supportive or reducing that inflammatory state in your experience? Is there a specific test or way that you like to explore those less obvious food allergens in your patient population? 

[1:02:54] DR. TSAFRIR: Yeah. Well, I have never been particularly impressed with the food sensitivity testing. I feel as though it often yields false positives. It yields false negatives. And if a patient is up for it, and let's say they are really symptomatic and they have a lot of autoimmune things going on, the gold standard in my mind can be like an elimination diet. Like the paleo autoimmune protocol. Where all of the top allergens are eliminated. And that means gluten, and dairy, and eggs, and soy, and nuts and seeds, and nightshades. 

And then symptoms are identified that are troublesome. Let's say headache, or rash, or joint pain, or whatever it is. And then stay off of those foods for two or three months and then systematically reintroduce them and observe. Eat them for breakfast and lunch on two consecutive days and observe for five days to see if there's any kind of recurrence of those symptoms. That's the gold standard is to do an elimination diet. 

I mean, many patients aren't up for doing that. But, I mean, gluten and dairy, at least for many psychiatric patients, are a big cause of psychiatric symptoms. And then it really depends on the person. Another diet that I prescribe extremely frequently even more often than the paleo autoimmune protocol is Terry Wahls' diet. She has a cookbook that's called Cooking For Life. And she has a food pyramid and the bottom of the food pyramid is all like nine cups of fruits and vegetables. 

[1:04:42] SCOTT: Yeah. She's been on the podcast. Very, very good.

[1:04:46] DR. TSAFRIR: Yeah. It's just excellent. And she eliminates eggs from her protocol. But that can be a very healthy food if you're not a person who has reaction to eggs. I asked patients to eliminate it for a month or two and then reintroduce it to see if they tolerate it. But, I mean, for most people, as far as I can tell, gluten is never like a healthy food for someone. It's just not delicious. But it's not healthy. 

[1:05:18] SCOTT: I don't know how many years it's been since I've knowingly had gluten. But I think, fortunately, there's lots of good alternatives these days that to me at least don't seem particularly like I'm giving up a lot. 

The other piece that I find interesting when people are more universally reactive on some of these food tests is maybe that's a sign that they have intestinal hyperpermeability, or leaky gut, or fungal overgrowth, or parasites, or something else. And the food really is not the core issue. It's more the gut health overall.

[1:05:53] DR. TSAFRIR: The gut health or – also, mast cell and limbic system dysregulation. They're just reacting to everything.

[1:06:00] SCOTT: Let's talk about that then. You talk about mast cell activation in the book. We know that can be a powerful contributor to inflammation. Do you see a connection between activation of mast cells, the creation of histamine and other chemical mediators and our mental, or emotional, or even limbic system state of health? What role does mass cell activation play in your work? And how do you approach treatment in your patient population? 

[1:06:24] DR. TSAFRIR: It's just huge. I mean, to me it seems like the final common pathway for so many different underlying ideologies. A person may have mold toxicity but they have mast activation. A person may have chronic Lyme but they have mast cell activation. They may have long COVID that the mast cells are very involved. 

And people can have mast cell activation following a car accident or any kind of trauma. It's just the immune system and the limbic system are just very dysregulated. And very often, with something like the Gupta program, it affects mast cell activation. Because when the limbic system is activated, the mast cells behave in a disorganized fashion. When the mast cells behave in a disorganized fashion, it activates the limbic system. There's like a feedback loop between the two of them. 

I don't do laboratory studies to diagnose mast cell activation. It's a clinical diagnosis in my mind. And I use mast cell stabilizers. I start with non-pharmaceutical things like quercetin and luteolin. I also use the over-the-counter antihistamines and Pepcid. But when those are not sufficiently effective, I may use pharmaceuticals like Ketotifen or Cromolyn sodium. But mast cells is super, super common in my practice for people who are medically ill.

[1:07:58] SCOTT: Yeah. And with Ketotifen and Cromolyn, I don't really think of them in quite the same way as a lot of other pharmaceuticals. Meaning that the side effect profile seems to be more minimal as compared to some other medications. Would you agree with that? 

[1:08:12] DR. TSAFRIR: Yeah. I mean, it seems in general they're well-tolerated. 

[1:08:15] SCOTT: Yeah. Have you seen a worsening of some people's mental, emotional health after having had COVID? And how has COVID been yet another layer in its contribution to chronic illness? 

[1:08:29] DR. TSAFRIR: Yeah. I definitely have seen that. And I always want to know if there is a relationship between a worsening of the symptoms and COVID infection. Because as I said, I think a lot of long COVID, which can manifest as depression, anxiety, and fatigue is related to mast cell activation. 

And it seems that there's something about the infection with COVID that also can just stir up other latent infections. Other viral infections that were dormant or viruses that were dormant and then become activated when the immune system has been harmed by the virus. 

[1:09:15] SCOTT: Yeah. I totally agree. Bartonella seems to be another one that seems to become activated in some people after COVID as well.

You say that all of us are sensitive to electromagnetic radiation and it has a deleterious effect upon our health. How important is EMF hygiene, EMF mitigation in your patient work? 

[1:09:35] DR. TSAFRIR: Well, it really depends on the person. I try to remember to give my EMF lecture to everybody that I see as a new patient. But it seems like people are very different in terms of the level of their overt sensitivity to it. I mean, I don't doubt that all of us are impacted and not in a good way by all the electromagnetic frequencies. But certain people are just enormously sensitive. 

I'll tell patients don't put your cellphone up to your ear. Put it on speaker phone and lay it on the table. Laptops shouldn't go on your lap. There's like a rule that there's an inverse relationship between the closer it is to your body, the stronger the impact it has upon you. Don't walk around with your cellphone in your pocket as like a radio tower receiver going on and off all the time. If you have your phone in your pocket, put it on airplane mode and check it. 

I mean, I don't do all these things all the time myself. I know that I'm – turn off your router at night if you have an option to do that if you're in a freestanding home. Particularly, it seems to be an important thing to not be sleeping with extra electromagnetic frequencies. But it's so hard to avoid them in any kind of general way unless you would go to some kind of green zone in West Virginia where you're not being exposed to cell towers. They're just everywhere. 

[1:11:05] SCOTT: I know someone that went there actually to that green zone in West Virginia.

[1:11:09] DR. TSAFRIR: And did it make a difference? 

[1:11:12] SCOTT: Ultimately, that person, Michelle, if I remember correctly, ended up doing DNRS. And that was what was made the big difference was working on the limbic system. Yeah. Quite interesting. 

[1:11:23] DR. TSAFRIR: Right. 

[1:11:23] SCOTT: I think the EMF hygiene is important. I do as much as I can to minimize it, mitigate it, turn the router off, all of those things. I'm experimenting a little bit now with the Pranan device that Dr. Nathan has shared recently that Dr. Roger Billica has been talking about. 

And so, historically, I'm not too terribly excited about a lot of the harmonizers. I think we do need to reduce the actual exposure. But those are other tools that people can potentially explore as well. 

Speaking of our friend, Dr. Neil Nathan, he's raised awareness around mold as a potent contributor to illness. We know that it can be a top trigger for mast cell activation.

How often in your patient populations do you see mold as a contributor to psychiatric conditions? 

[1:12:12] DR. TSAFRIR: Super frequently. Super frequently. Especially these patients that have gone from psychiatrist to psychiatrist and nobody can seem to get the right combination of medications to treat their anxiety or depression. It's very, very common. And usually, in those patients, it's not just the depression and anxiety. They have some digestive symptoms. They'll have some sinus symptoms. They'll have other kinds of medical symptoms that will make me think that there's something in addition going on. That it's so common. 

I mean, in my intake paperwork, I have a very, very extensive health history form that goes into all kinds of things. But I have these additional forms that are like a mast, a mold toxicity checklist. I have it from Jill Crista actually.

[1:13:04] SCOTT: Yeah. Yeah. She's amazing.

[1:13:06] DR. TSAFRIR: Yeah. I use her likelihood of mold. Or I have a checklist that's about connective tissue disorders. Because these are just things that I see so much of. And even if you can't cure it, it can be extremely helpful. Or the mold, you definitely can treat and make a huge difference. 

But the symptomatic support with Ehlers-Danlos, you don't like cure it necessarily. But it just can be very helpful for people to have a framework for understanding why am I having all of these problems for so long? 

[1:13:41] SCOTT: You bring up the perfect transition. My next question, speaking of some of these collagen-related disorders, hypermobility, you've said that Ehlers-Danlos Syndrome is fairly common in your practice. Why do you think it's so common in your patients? Why do you say that EDS is a spectrum disorder? And do patients’ symptoms improve? Or do they even recover from their Ehlers-Danlos once you treat mold, or Bartonella, or other factors that they're dealing with? 

[1:14:10] DR. TSAFRIR: I call it a spectrum disorder. Because, I mean, some people – I feel like I have it. But I have the very mild version. I can touch my thumb to my wrist. That kind of hypermobility. But my joints are not constantly dislocating. And I mean, some people have terrible problems with their eyes, or with their teeth, or their organs are prolapsing and their joints are constantly dislocating. But still, there's something, some abnormality of the connective tissue. It's degree of severity. Just like Asperger’s and then full-blown autism. So, spectrum. But it's still the same family. 

And I don't know what all goes into this. I don't know if people who have connective tissue disorders, if they have more problem detoxifying than other people. And therefore, they are more vulnerable to mold toxicity. And therefore, they do have more mast cell activation. I don't know what the mechanism really is. 

But all that, definitely, Ehlers-Danlos patients have a lot of depression and anxiety very often. And many physicians are not aware of that diagnosis. I mean, they may have learned about it in medical school. But it's like, "Oh, yeah. That weird connective tissue thing." But they don't realize that they're seeing a lot of patients who have it and that it's causing a lot of symptoms. 

And I wrote a blog post that got one of the most emotional responses than anything that I've ever written that was about, basically, this is not a primary psychiatric disorder. This depression, anxiety is due to other causes. And that when these patients see conventional physicians and they can't figure out what's wrong with them and they send them to a psychiatrist, it's very invalidating. This is like not all in your head that you're having all of these psychiatric symptoms. It's due to something else.

[1:16:14] SCOTT: Yeah. And I think uh there's been some conversation with Stephanie Seneff on some of these hypermobility conditions where maybe glyphosate is substituting for glycine and then incorporating itself into some of our connective tissue as well. Probably multifactorial. 

We see more and more autonomic dysfunctions since the start of the pandemic. More POTS. Postural Orthostatic Tachycardia Syndrome. What are some of your go-tos for assessing and addressing the autonomic nervous system dysregulation that many patients experience? 

[1:16:47] DR. TSAFRIR: Well, I mean, my biggest go-to is the Gupta program because that just like calms a person's autonomic nervous system down and helps them regulate their dysregulated system. But if a person has like a lot of orthostasis when they stand up, you can recommend that they increase the salt in their diet. I haven't really done much with herbs or pharmaceuticals to treat that. How about you?

[1:17:16] SCOTT: I mean, I kind of feel in some ways like POTS, I think of it similarly to mast cell activation, which is while you're maybe doing things to intervene from a symptomatic perspective that you have to look for the triggers. Or as Dr. Horowitz might say, the nails in the foot. Or as Dr. Bredesen might say the holes in the roof. I think there's something that's triggering whether that is a chronic infection, or a mold exposure, or something. And that while we maybe need some symptomatic relief, that we also have to be digging deeper to find the root causes of the autonomic dysregulation. 

[1:17:52] DR. TSAFRIR: That makes sense.

[1:17:52] SCOTT: I'm a big fan of low-dose Naltrexone as well. It seems to have maybe even a larger role now for immune dysregulation triggered by COVID. I think it can be helpful for people, with autoimmunity, with immune dysregulation, with inflammation, with pain. I'm wondering if you find it helpful for people that are dealing with symptoms that might be conventionally deemed more psychiatric in origin. And if you could maybe talk to us about low-dose Naltrexone as a tool in your clinical toolbox. What types of symptoms or conditions do you find it helpful for? 

[1:18:29] DR. TSAFRIR: It is so helpful sometimes. So enormously helpful. And it's unpredictable if it's going to work. But sometimes when it does, it's like nothing short of miraculous. I have a patient who developed a weird collection of neuropathies after an inoculation. And it included burning mouth. Like terrible burning mouth syndrome and this weird burning sensation on his forehead. And within a few days of taking the low-dose Naltrexone, it just went away. And that's the kind of thing that I see. 

I mean, here's like a – it sounds kind of silly. But I had a little dog who I adored who died the June before last. And he was a little white dog. Fluffy white dog. And he would lick his paws. And so, his paws were all brown from this like constant licking. And I had tried everything. I tried diets and homoeopathy. And I was trying low-dose Naltrexone for myself. And I'm one of the few people who doesn't tolerate it at all. It causes insomnia no matter how low the dose for me. 

But I was opening up the capsule to lower the dose. And so, I decided to give it to my two dogs. Within like short order, a few weeks, he stopped licking and his paws became snowy white again. And it never recurred. It's unpredictable. 

I mean, for some people, another person extremely low-dose. 0.25 milligrams. She feels as though her symptoms of mood instability are gone. Nothing previously was as helpful as that for her up and down moods. And some people find that it helps them sleep. Anybody who has any kind of autoimmune, anything, I think it's definitely worth trying and it's stabilizing to the mast cell. It's helpful for many, many different kinds of conditions in patients. It can be. Not for everybody.

[1:20:46] SCOTT: That's where I was going to go next. Because I think we often think of burning mouth syndrome as connected to mast cell activation. And so, for that patient, you had where Low-Dose Naltrexone helped. I wonder if it was because it had some mast cell stabilizing effect. 

One of the observations that I've had over the years is that many of these mass shootings in our country, they seem to be increasing. We almost don't even pay that much attention to it anymore when we see these things on the news. Because they just seem to be so common. 

I've often wondered how much of a role environmental toxicants, neuroinflammation, infections like Bartonella, mold exposure, how much these things might play in the unfolding of some of these events? And if we could work up these patients clinically with the lens that you have, what are your thoughts on some of the commonalities that we might find? 

[1:21:42] DR. TSAFRIR: I haven't really thought about it in terms of that it's so much about the biology like in terms of environmental factors. Though I don't doubt that they can be playing a role. Very often, when you learn about these people, they people who were in some kind of way tremendously alienated. They were very angry. They had histories of being bullied or family situations that they were in some kind of way in a rage and maybe had some post-traumatic stress disorder themselves. 

I've thought about it more in terms of psychological factors, loneliness, isolation. Psychosocial factors. But as we've been saying repeatedly throughout our conversation, I don't think you can like divide things up so evenly. Neatly, I'm sure that these psychosocial ills are fueled by poor diet. And by toxic environments, literally toxic environments. 

I mean, I don't know. I don't know the answer. But I have been impressed like when I learn about anything about the background of many of these people just how the handwriting was on the wall in terms of how alienated, and lonely, and miserable, and angry they were prior to committing these acts. 

I mean, there's so much fear and there's so much – I mean, I don't know – people talk a lot about the role of social media and the fueling of hatred. And like a lot of these shootings are racially motivated and based upon fear and hatred. 

[1:23:26] SCOTT: Some of us will think of BC and AC as Before Christ and After Christ. I think others maybe think of it now as Before COVID and After COVID. I think we're living in traumatic times. Uncomfortable times. What advice can you give to listeners for how we can all best navigate these times more skillfully? 

[1:23:48] DR. TSAFRIR: Well, I think just exactly as we've been saying, that we need to attend to our bodies. We need to support ourselves holistically as much as possible with diet that's right for us, anti-inflammatory diet. With getting good sleep. With getting movement. With all the kind of things that make our bodies feel good. And that we need to support ourselves emotionally. Be in relationships that feel supportive, and nurturing, and loving. And have friendships and not be lonely. And be part of a community and engage in acts of service. And feel connected. And to engage in spiritual practice. We need to support ourselves from every angle to surf these waves of change that are so accelerating and enormous. And it's like only by creating the greatest resilience possible are we going to be able to kind of successfully or most successfully adapt to really challenging times.

[1:25:01] SCOTT: Beautiful. My last question is the same for every guest. And that is what are some of the key things that you do on a daily basis in support of your own health? 

[1:25:09] DR. TSAFRIR: Well, I mentioned that I drum every day. Yeah. And I do lots of different kinds of spiritual practice. I use the oracle cards almost every day, which is like cards that have that one pulls and they have messages. And I think about the messages and what the universe is trying to tell me about. 

I spend time with my pets. I make art. I get together with my friends. I try to eat well. I mean, it makes a huge difference for me, my diet. And makes a huge difference for me the timing of when I eat. As I've gotten older, if I eat a lot closer to bedtime, I don't sleep well. It's like super important. 

The older I've gotten, the less resilient my body is when I do things that it doesn't like. I have to be mindful like that. And I think those are like – my children. Cultivating good relationships is like enormously important to me. Creative work is very uplifting to me. Walking in nature. All those things. 

[1:26:26] SCOTT: Beautiful. Yeah. If eat enchiladas late on Friday, Saturday morning my Oura ring will say, "Did you eat too late?" 

[1:26:35] DR. TSAFRIR: Well, yeah. I have one too. I have one too.

[1:26:39] SCOTT: And I'm always like, "Ah. Darn it." 

[1:26:41] DR. TSAFRIR: Yeah. Yeah. Yeah. No. Totally. Totally. Your heart rate is elevated. Yeah, heart rate elevated. It's really fascinating, isn't it? It's so clearly correlated. So clear. 

[1:26:54] SCOTT: It's pretty amazing. This was such an amazing conversation. Such a deep conversation. It just flowed so well. I absolutely loved it. I'm grateful to our mutual friend, Dr. Neil Nathan, for connecting us and suggesting that we have a conversation. And to people listening, I really urge you to get the book Sacred Psychiatry. If you thought this conversation was a little deeper than some of my normal shows, the book goes into even more depth, more detail, more tools, more things that you can do to really support yourself. 

And so, with that, thank you so much for being here today. It was absolutely wonderful to have you.

[1:27:35] DR. TSAFRIR: Thank you, Scott. I really super enjoyed our conversation.


[1:27:39] SCOTT: To learn more about today's guest, visit JudyTsafrirMD.com. That's JudyTsafrirMD.com. 

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