The Science of Mental Resilience | Dr. Tara Narula

Key Takeaway

70-80% of us are innately resilient, meaning we won't develop PTSD when bad things happen. Even better: resilience is a skill you can build. Start by accepting what you cannot change, then focus on what you can control—your response, your habits, your mindset. When something difficult happens, you won't return to who you were before, but you can still thrive and find joy. Move the goalpost, don't abandon the game.

Episode Overview

Dr. Tara Narula, cardiologist and medical journalist, discusses how to build resilience through evidence-based strategies from psychology and medicine. She shares eight key ingredients for becoming more resilient, emphasizing that most people are naturally more resilient than they realize and that resilience is a learnable skill. The conversation bridges the gap between physical and mental health, showing how doctors often focus on medical interventions while neglecting the crucial mind-body connection. Dr. Narula draws from both her clinical practice and personal health challenges to illustrate practical ways to bounce forward from adversity.

Full Transcript

Transcript of The Science of Mental Resilience | Dr. Tara Narula from 10% Happier. Auto-generated from episode audio; may contain minor errors.

The majority of us, 70 80% of us are innately resilient, meaning we are not going to develop PTSD if something bad happens to us. We're actually so much stronger than we even know. This is a skill that you can build. And I think that also was eye opening to me that it's not just set in stone. There is an incredible healing effect just by the belief that you can get better. We focus so much on these prescriptions around interventions and medications and we so often forget about the mind body connection.

Why are they so separate? It's kind of ridiculous. What do you tell your patients about actually doing this stuff? Dr. Tara Narula, welcome to the show. Thank you for having me. It's a pleasure to have you here. Um well let me start with some obvious questions. Uh the first is how and why did you get so interested in this subject of resilience? That's a great question. Um it's something that I think I've been fascinated by my whole life, but definitely being in these two worlds of journalism and medicine made me more interested in it because I feel like I'm seeing it every single day.

So, you know, clearly in the news we report all the time on stories um of people overcoming some sort of difficult life event or tragedy, whether it is a natural disaster like a hurricane or a school shooting um or a personal issue. And it just fascinated me about, you know, what is it that makes someone able to kind of come through that and continue on with their life. And then in the same token, I was seeing that in my patients. I have patients who survive heart attacks and are living with heart failure and strokes and still have a you know an attitude of being able to kind of proceed with their life and move forward and advance and have a wonderful quality of life despite having faced a very difficult situation.

So, you know, when I was actually approached by Simon and Schustster um in 2020 about writing a book, they asked me, you know, what do you want to write about? And I said, I want to write about resilience. And it was something that I had actually brought to CBS when I was there as well um as a topic that I was interested in and had done a few pieces there um in terms of reporting on the science of resilience. So, it's something that's really just fascinated me as a human being.

Um, myself and my own life and my family members, my friends, and then, you know, as as I said, in my patients and and the stories I was seeing on the news. I think, you know, a lot of us think that we're going to crumble and fall apart when something bad happens. And and one of the biggest things I learned in my initial reporting on resilience was when I interviewed those the psychologists who study resilience and they said you know the majority of us 70 80% of us are innately resilient meaning we are not going to develop PTSD if something bad happens to us.

That was really eye opening for me. And I felt like that's something that I wish everybody knew, you know, that we're actually so much stronger than we even know. And I think that's a huge win to just have that knowledge inside you that okay, if something bad happens, I have I am hardwired essentially evolutionarily, genetically, biologically to be able to get through this event and not fall apart. So that was really the first thing I really wanted to get out there. But then the second is that this is a skill that you can build.

And I think that also was eye opening to me that you know you're not it's not just set in stone. There are tools and tips and science there from the world of psychology that can allow all of us to be able to become more resilient. Um and what a great thing that is to know I just have to build this skill just like I would build a muscle. Um so the next time something happens I can actually face whatever that is even better and even stronger than I was when I initially faced something difficult.

We're going to get into how to build that skill. That's going to take up the bulk of our time. But just staying at a high level for a second, it it seems like one of your insights and maybe critiques critiques critiques um is that in the medical community, doctors are really focused on the diagnosis, what medicines, what what interventions are going to be required and not so much on the mental health of the patient. And and that's especially stupid given that the mental health, our mental health and our physical health are not divisible.

That's exactly right. I mean, and that is that is the crux of why I really framed a lot of this book around the medical world. I wanted this book to be applicable to anyone who's facing any sort of challenge in their life. But Dan, I think where I really see it coming into play is also in the medical field. And as you mentioned, you know, I'm a cardiologist. I see patients, you know, four and a half days a week and, you know, we talk a lot about, okay, we're going to send you for this test and I'm going to give you aspirin and this cholesterol medicine and we're going to do this procedure to open up your arteries and we focus so much on, you know, these prescriptions around uh interventions and medications and we so often forget about the mindbody connection and you know, I ask my patients, every single one of them, every time I see them, how is your mental health?

what is your stress level? Um because we know even in the world of cardiology that that is a risk factor. If your mental health is not a great place, if you are under stress that that is a risk factor for cardiovascular disease and you know cardiology is I would say has been a little bit at the forefront of of at least kind of guiding the way towards other fields recognizing that mindbody connection but even in my field of cardiology we don't do a great job asking about it and we certainly don't do a great job in terms of scaffolding patients with that kind of care.

And you know, my patients are often surprised when I number one ask about it, but number two say, "I think you should see a therapist." You know, um I wish that we had psychology built more into the the framework of how we treat patients. Um because it is so important for them to not only heal from what's happened, but to prevent and so much of disease is prevention as well. I have, and I'm sure you share this, I have a lot of empathy for physicians. they're working within a a system that's largely broken, that doesn't provide them with a lot of time to create meaningful connections with their patients.

And yet, um, this approach of just focusing on the sort of technical medical aspect without taking into account the psychological aspects which are which of of as we keep saying are are are indivisible from our physical health. Um, health. Um, health. Um, it's like uh going to a knife fight uh with a spoon and one arm tied behind your back. It's just like you're just missing a huge part of the flywheel of of human flourishing. Huge, huge part. Um, and you know, like I said, it's not even about prevention of disease, which of course is really the future of medicine.

How do we prevent? Um, but it is so much about the healing process. And I think that was the other big thing that became apparent to me is that, you know, I would send a patient, for example, for valve surgery or a stent and they would come back to see me afterwards and when I would walk in the room and say, "How are you?" The first thing I they would say to me is, you know, when am I going to feel like myself again? I'm so afraid.

I'm so fearful. I am so overwhelmed by what has happened. I don't know how to move forward. And it just became so glaringly obvious that the stress and the impact of a medical diagnosis or a treatment is on par with any other stressful event that we have in life. Um and again like this is an opportunity for us to intervene to and that's where I hope this book will come into play is to say you know yes this has happened to you but you can still thrive and here's how um because when they when my patients would look at me with that sense of fear and and almost paralyzed it's hard as a doctor you want to be able to help someone through that and there's like no guide book right now to how to do that and how am I going to get someone to take their medicines and start exercising and eating healthy when they're just overwhelmed by the mental impact of what has just happened to them.

And we just don't recognize that being told you have breast cancer or you had a stroke or you have liver failure is is a traumatic event. One last highlevel question here before we get into your very practical tips. Uh how are we defining or and I think you make the case for redefining um uh how are we defining or redefining resilience? Yeah, I think everybody has their own definition and that's definitely, you know, part of what I came across as I was doing research for this book and talking to different psychologists.

And I don't think you're going to find a universal answer. And, you know, for me, it was really this concept of when something happens to you, you are never ever going to be yourself again. And I think that is that is what I started to tell my patients. You are not going to be the person that you were before this event happened to you, but you can still be a version of you, a version of you that can enjoy life. And at the end of the day, that was what this was about for me.

It's about quality of life and enjoyment of life. Um, and how do I take who I was, who I am now, and be able to move forward. So it is this idea of sort of bouncing forward from what has happened to you, not reclaiming who you were, but taking what's happened and and literally still being able to suck all the joy out of life that you can um despite whatever challenge you faced because that's what people care about, Dan. That that's what they care about, you know.

They they want to be able to still be happy um even if something has changed. changed. changed. Yeah. So it's not snapping back to exactly what you were. It is, as you say in the book, it's about being able to work skillfully with the non-negotiable truth of change. Correct. And still find meaning in life and purpose and joy and hope and love and all of those things that make life worth living. worth living. worth living. Yeah. I mean this is where things to in my view and I'm going to get a little weird and Buddhisty on you.

Um but you know this is poignency of being alive that most of us overlook because we're programmed for denial. But we life seems like a solid movie. You know uh I'm I look the same as I did in the mirror yesterday and if I don't that's an emergency and I got to change it. Um, but but but we are not these solid nuggets moving unchangingly through time. We're more like a river. That's right. That's right. That's right. Um, a process that unfolds over time. Um, and Um, and Um, and happiness, flourishing, calm, all depends on our ability to live with this flux in in some sort of a quantumous way.

way. way. That's exactly right. That's exactly right. And that's why in the book, you know, I I use the example of Michelangelo sort of freeing the angel from the marble. You know, we are a work in progress. There is something always being chiseled out and created that's new, but something really amazing and beautiful if you can look at it that way. way. way. So, in the book, you've got these eight ingredients for resilience. And we'll see how much how many of them we can get through given the time we have aotted here, but I'll aim to get through all of them.

Uh the first is acceptance. What do you mean by acceptance and how are you drawing the line between that and resignation? and resignation? and resignation? Yeah, I think you know when I again when we were sort of figuring out the framework for the book um there are different psychologists that have different sort of tools or recipes and I think for me number one in the list had to be acceptance. meaning you can't accomplish any of the other things on your path towards resilience if you first don't accept what has happened to you.

Um and you know for me Dan like I like everyone else faced my own challenges in life and uh what my memory of h of learning acceptance goes back to medical school um which I talk about in the book when I lost vision in part of my eye and uh no one knew why. Uh I was very scared. I was in the middle of my training. I was like thinking I'm never going to be able to be a doctor and my whole life is over. And literally, like I said, my patients are I was paralyzed, almost paralyzed with fear.

And my mother, um, who's amazing, sent me a little card in the mail. And on the card, it had the serenity prayer. Um, which, you know, basically very quickly says, you know, God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. And she said, you know, why are you wasting all your time worrying about something that might never happen? and why don't you just enjoy every day and if it happens you'll deal with it and if it doesn't then you haven't wasted any time and literally it was that one card that one conversation that allowed me to say okay I can't take back that I've lost vision in my eye I can't change that I can't change the fact that I might lose my whole eyesight next month or next year and my whole life might change but for now I'm going to accept that this has happened so that I can continue to finish medical school and graduate and go on to the next step so this whole thing became very clear to me um when I was faced with my own health challenge and I that's why I made it really step one in this process because you literally cannot you know face your fears and exercise and find love if you can't just say this has happened to me bad stuff happens life is going to throw stuff at you and I have to accept it in order to be able to move forward forward forward I bump up against this a lot in my work um which is that I personally hate cliches and yet they are so [ __ ] true all the time.

And like the serenity prayer is a great example of that. You know, it's knit onto throw pillows and therefore to me a little bit annoying. And yet it is incredibly wise. Yes. Um and I will say on top of that, as wise and honestly as obvious as as it is when stated skillfully as the serenity prayer does, it's hard to do. I have hosted this podcast for 10 years. I live in this in this world of of embibing drinking the fire out of the fire hose of this wisdom and yet I still worry about [ __ ] I can't control all the time.

So did that one conversation with your mother really do it for you or do you have to remind yourself over and over? Yeah, I mean it's work, you know. I mean no like everything else in life, something doesn't change overnight. Um and it's a process. It's a process of rewiring your brain. I mean, that's where therapy for a lot of people comes in, right? You don't suddenly make a change by one session in therapy. It's a pattern and a, you know, that pathway that you're continuing to kind of hammer down over and over again.

So, no, it was not as simple as it was, okay, she sent me the card and all of a sudden I was on the right path. But that was so eye opening for me. So that every time I started to kind of go in that direction of worry and fear, I would think about it, you know, and then the more time that would go on and nothing happened, I said, "Okay, I'm a little farther away from this event and nothing's happened. I feel a little more comfortable." Um, and that's something that I, you know, I tell my patients, too, which is, you know, time, you know, it does it's it's very helpful because if you can just put one foot for in front of the other, the farther away you get from the event, it never is going to go away.

But that kind of intensity of the worry and the fear will diminish a little bit. So yes. Yeah. I mean it's hard work to change your mindset just like it's hard work to eat healthy and to wake up every morning and exercise when you don't want to and to pursue your dreams and your career. I mean nothing comes easy. Um but just knowing that that's like the first key step I think is really is really valuable because you can keep going back to it, you know.

And I think having role models for people who have done that and that was another thing that was important to me when that happened to me was I don't know how I stumbled upon it but I came across Richard Cohen's book blindsided. Um Richard was Meredith Vieier's husband prolific journalist himself. uh and he talked about his his life and what he had faced with multiple sclerosis diagnosis and colon cancer and hit after hit and how he was able to still have this beautiful life with his wife and children and work in a career that he loved.

And so for me it was again it was reading my mom's letter and reading Richard's words and and having time pass and realizing I I can accept that this has happened even if I don't know if it's going to happen again. you recommend some some modalities for helping us work with anxious or self-pittitying thoughts. Uh and and those include both mindfulness, which we talk about a lot on this show, and ACT or ACT, um acceptance and commit and commitment therapy. Um, I'm not going to ask you, unless you really want to, to give an entire explanation of what mindfulness and act are, but are there specific tools from either or both modalities that that you think would be useful for the listener?

I think everybody's different, Dan. I mean, I think for everyone, you know, different types of therapies work differently and depends on who you are and what resonates with you. Um, I will say, um, you know, I was first introduced to mindfulness and meditation through Jeff Warren. um and using um his meditations on the call app and then introduced it to my husband who is a type A surgeon and said I could never meditate and I said yes you can listen to Jeff he you know he's relatable and it's quick and you can do it and we would do it together and so you know for for me I discovered that through him um and I loved it so you know that was helpful I've been in therapy I have family members that have been in therapy you know I think cognitive behavioral therapy is extremely powerful because you know like ect it really provides you with tangible ways to take your thoughts and kind of work with them.

Um, so I I'm just a huge advocate for any technique that works for you as a person. And for some people it may be, you know, DBT or ACT or CBT, you know, there may be different modalities, maybe all those modalities. Um, but it is a personal thing. But I encourage people to be open to trying them because, you know, again, what might work for you might not work for someone else. Um, and I know what worked for me, uh, which was definitely CBT, uh, over, for example, talk therapy.

So, therapy. So, therapy. So, and so CBT, cognitive behavioral therapy, helps you kind of notice when you're in stuck in recurring repetitive thought patterns and and to break out of them. them. them. Correct. Yes. Yeah. And again, I, you know, I had never done therapy until my 30s. Um, and now, you know, I'm a huge advocate. That's why I said I'm [clears throat] a huge advocate for I think everybody should be in therapy. Um, because I think we all can work on our mental health and we all need help.

um based on our own life experiences and our upbringing and everything that's happened to us along the way. Just for those who have never heard of Jeff Warren, um very close friend of mine um and uh an amazing meditation teacher who's done incredible work over on the comm app, he's also on my app um and um in my life in a deep way. And so I hear from people all the time who found Jeff either through my app or through comm and just you know what a positive impact he's had.

So go Jeff. Um, okay. So we've we've talked about the first of your eight ingredients uh for developing the skill of resilience. Uh the first is acceptance. The second uh picked right up on this notion of thinking and it is uh um uh flexible thinking or embracing flexible thinking. What do you mean by that? Yeah. So, you know, in the book, um, again, another another incredible woman that I interviewed both for CBS um and and her work ended up in the book is Lucy Hone, who is a resilience researcher herself.

Um, and she lost her own daughter tragically in a car accident. Um, and so the woman who studied resilience had to implement it in her own life. And in one of my interviews with her, she talked about this idea of basically having a goal in your mind, having a goalpost and then thinking when something happens, okay, I'm going to pick up the goalpost and move it somewhere else. And I just thought that analogy was so simple to understand that we can be going down a path of where we think we're headed and something happens.

And that doesn't mean that you're derailed. It means that whatever your vision was, you have to have that flexible thinking to say, I'm going to move my goals and put it somewhere else. And so for her, her she talks about her, you know, life's path changed when her daughter daughter Abby died, but she realized she still had her husband and her sons and she had to be there for them and a new create a new life without her daughter Abby. So the goalpost moved and I think, you know, that's like the easiest way for me to explain that concept of flexible thinking.

It's the ability to rework your vision of what you thought your life was going to be um and create a new vision for where your life is going to be. When the holidays wind down and we're starting a new year, one thing I crave is to be comfortable. Holidays are a busy time. We've got lots of parties to go to, lots of entertaining to do. And for me, the holidays this year were particularly busy because I was on a deadline for finishing the latest draft of my never-ending book project.

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Refresh your routines with comfort that makes every day feel like a new year. I believe in the chapter on flexible thinking you also talk about um harnessing the placebo effect, right? So we talk a lot about that in medicine. um you know, how is it that if I give some if I tell somebody here's a pill that's made of sugar and here's a real medicine and I give them the sugar pill, they actually might do better. Um and there really is a science there that just our beliefs that we're getting something that is actually helping us can actually help us.

Um and that is again speaks to what you spoke about earlier which is that mind body connection which is extremely powerful and that Dan goes back to what we talked about in the very first chapter which is the stress response. And so you know when something happens to you you release you know you have this whole pathway from your amydala to your hypothalamus to your adrenal glands and adrenaline and norepinephrine and cortisol and all these stress hormones. And so um the converse is that if we are able to change that and rewire um we can change a stress response to a resilient response.

And so you have to imagine if you can release all those stress hormones in response to stress in that pathway. If you have a placebo effect might you be able to have the beliefs and release you know for example anti-inflammatory lower your stress hormones or reduce them or decrease inflammation. So the mind body works both ways and I think you can't just say it's bad. You have to understand that if you're the mind body is working in a negative way. You can also harness it to work for you in a positive way simply by believing that something you are doing is going to make you better.

For example, if people in the wake of a um difficult diagnosis or the loss of a loved one or um or this the worried well who uh who are you know don't there's there's no catastrophe in their immediate uh uh past but you know they're they're spending a lot of time uh wearing down their resiliency by being mired in in um useless rumination. they can um go do uh a form of therapy or go do meditation and the and just having the belief that this an evidence-based belief because there's evidence for all of these that this is going to help me it it kind of kicks in it it brings online um uh the parts of our nervous system that are helpful in healing.

That's right. That's right. I mean there is an incredible healing effect just by the belief that you can get better, that you will get better. It's just so helpful to be reminded of that. that. that. Yes, it's very easy to forget. Again, it's it's so we we just don't do a great job teaching people about the power of the mind body connection. And you know, to me, that was really so important with this book was linking the worlds of psychology with clinical medicine because no, no one's really doing that.

There's no bridge. they need to be connected um in order for us to really heal our patients and to help people. Why are they separate? Why are they so separate? Um it's kind of ridiculous. So yes, uh the mindbody connection works both ways. both ways. both ways. Another aspect of flexible thinking is uh denying future certainty. So like not not having this fixed view that um whatever has just whatever diagnosis you've just gotten or whatever has just happened to you um is a guaranteed shitow. Exactly.

Exactly. It's it's denial used in a in a positive way. For example um and we talk about actually Richard Cohen in that section but um yeah I mean I have and I and again as a physician I see this all the time. you know, people who have, you know, 10 stances in their heart and they look at me and they say, "Oh, this means I'm going to die tomorrow. I'm only going to be able to live till 60." And I tell them, you know, that's that's not true.

I have patients who live till they're 90s. You know, this is not something that is, you know, a death sentence for you. Um, what has happened to you is not a necessary outcome from this. Um I have patients who you never think would live more than one or two years because they have endstage heart failure and they live five, six, seven years. Um so nobody has ins nobody but God if you believe has insight into you know what the future holds for you. And I think anyone who says otherwise in medicine or elsewhere is is just not correct frankly.

I'm close friends with this great kind of legendary meditation teacher Sharon Salsberg who has this riff that I've heard her go on many times about certainty and that most of us kind of subconsciously or consciously embrace certainty because it it's a bull work against a chaotic world but but it's a fool's errand because actually certainty makes you feel worse. It's curiosity. It's openness. It's optimism as long as it's not like um you know harmful uh um optimism. Like I for example, believing that I'm going to join the NBA for um is is probably not good optimism, but like it's curiosity and openness that feels much more soothing than fixed views about how things are going to go.

That's right. That's absolutely right. And I think for so many people who struggle with anxiety, for example, um I mean that is it is this fear that you that you know things should be a certain way and if they're not that way the whole world's going to fall apart. And it's really recognizing that no there is no certainty that things can fall apart and I'm going to survive. Um it's a it's a totally different mindset. It's again it's an acceptance that something may or may not happen.

We don't know and I can live in that state of uncertainty. I think that is really the hallmark of how so many people deal learn to deal with anxiety is learning to accept the uncertainty. uncertainty. uncertainty. Third ingredient in uh Dr. Maru's uh resilience toolkit is get fit. Um you know we've all heard this but the way you put it is really interesting. Uh you say exercise is medicine. It is just like food is medicine. Um there is just so much power in the movement of our bodies.

Um getting our heart rate up, our muscles working. Um how we approach fitness. Um whether that's cardio or muscle or yoga or Pilates or whatever it is that that that is medicine that helps us. We've seen it in a million ways and research, you know, that exercise helps with cardiovascular disease and cancer and our bone health and dementia risk. I mean it's the list goes on and on. Um but it is it is hard for people to again I think recognize how powerful exercise is just like it's hard for many people to understand how powerful nutrition is.

Um you know they think how could food really be that powerful in terms of changing the course of what might happen to us physically but but it is um and it's the same with exercise. What are hope molecules? Yeah, hope molecules. Hope molecules. Molecules that are released that basically when endorphins sort of when we exercise that allow us to kind of feel better almost like endorph like endorphins essentially. essentially. essentially. It's really cool to know that just getting your body moving can have all these kind of magical uh physiological and psychological effects as well as you know um eating well.

And in this in this part of the book, you also talk about prioritizing quality sleep. Yes. Yes. Yes. And yet and yet we all know this and most of us don't do it. Um Um Um Yeah. Yeah. Yeah. So what what do you tell your patients about actually doing this stuff that is is super obvious but under subscribed? Yeah. I mean I think the first is obviously educating people about how important it is. I mean for example sleep. You know, we I think we all take it for granted and I was just having this conversation with someone the other day.

I mean, I ask all my patients about sleep and exercise and diet and stress and mental health and for many of them all those other things are in line and it's like 90% of people tell me like the sleep is where they fall short. Um, and it's the easiest thing to sacrifice. You know, I I'll just stay up later and do this. and we don't recognize that that time where we're out so to speak, there's so much happening inside our body um that is beneficial. So I think for a lot of people it's just understanding the the biology, you know, that that there and that's and we don't again do a great job teaching this in terms of how antioxidants in the foods we eat or the endorphins we release with exercise or how we're able to process blood sugar better when we're exercise or with sleep, the fact that you're clearing toxins out of your brain.

We don't we don't explain the biology and I think people if they understood the biology more it would make sense and they might be more willing to do it number one but number two I think it has to be a priority and it's hard work just like we said I mean it is not you have to say I am going to make it a priority to try to get my 7 to n hours of sleep every night if that means I'm going to you know not get something done that I would have get done you have to make it a priority I get up every morning at 5 try to go to the gym I hate it um but that's the only time I can do you have to make it a priority to read the nutrition labels.

Like no one wants to sit there and read the labels, but how are you going to know how much fats in your food? So all of this is effort, effort, effort. Um, and it's not once you get in the habit, once you get in the routine, it becomes easier like everything else. The more ingrained, the more you do it, the more it becomes part of your routine. Okay, I'm going to this is my daily time to exercise. This is how I'm going to eat. I know I should go to sleep, so I'm going to go to sleep.

But it has to become routine and habit. um and you have to you know make it a pattern. So I think it's to answer your question I think it's understanding the real biology behind why it works but number two really making a concentrated effort to do these things in your life even when it's difficult. It's much easier to take a pill. It takes two seconds to pick up your water bottle and swallow a pill, you know, or have surgery. You I mean it's not easy to have surgery, but you go in an hour, you come out, something's missing.

Um, it's much harder to do these lifestyle choices that require, you know, mental effort. You're sacrificing maybe time with your family or time doing something else to go to sleep. You're sacrificing, you know, eating a pizza for eating something. It it's you're giving up something for the goal of something that you maybe can't see that's happening internally. And that's also very hard. I think too, think too, think too, one thing that's been really helpful for me, uh, and I've thought a lot about habit formation, and it's it is, as I often say, diabolically difficult.

Um uh and we've done plenty of episodes about how to um how to adopt healthy habits. In fact, I'll drop a link in the show notes to a a solo episode I did where I kind of laid out uh all the best tips from from uh the researchers who um look into how we can um adopt these healthy habits despite all of the internal and external uh obstacles. But the one thing that that that for me has been very helpful and this is an evidencebased evidencebased evidencebased assertion I'm making here but um is self-compassion which sounds a little dopey a little soft but is one way to think of it is just the ability to talk to yourself the way you would talk to a good friend to have that's right that's right that's right to establish and develop an inner coaching relationship.

coaching relationship. coaching relationship. So, the the kind of supportive voice that says, "Yeah, it's 10:00 at night. I would like to stay up and watch three more episodes of Parks and Wreck, but um I will feel so much better if I go to sleep. Just, bro, just the Parks and Wreck will be there tomorrow. Uh you're, you know, you're you're better off going to bed." And then when you inevitably screw up, because I screw up all the time, I often I often think that there there there needs to be some word in English for the special shame that we feel for for making the mistake that we know that we thought we had figured out um and that we always make and that we know better than than to make and yet continue to do a million times over.

We we need a special word for that like compound [ __ ] that that is like so common for most of us. But what I have found what I don't have the word for the thing but what I have found as a remedy for the thing is just talking to myself like yo this is f millions of people are having this same shame spiral right now. It's it's all good. You you know you you get this is like a golf game with a million mulligans. You can start over as much as you want.

That's exactly right. And I think that's what I And I think that's what I was going to say when you said self-compassion is I think so many people beat themselves up when you know they thought they were going to exercise three days a week and they only did it two days a week or they you know went out and had a dinner that they didn't and then it sort of throws them off completely and they're like oh my god it just ruined everything and then you start to kind of spiral and you know we're human like we're allowed to fall here and there and then we just pick up the pieces and move on.

you know, one misstep here and there is not going to change the trajectory, right? So, it's the overall overarching road that you're on. You know, you veer off a little bit, you veer back on, you veer off, you veer back on, but you're going in the same direction. And I think, yeah, if we have a little bit more compassion for the fact that we're human beings and we're not always going to get it right and and do it, you know, the way we should, but that's okay as long as we have the vision of kind of where we want to be and we're trying to to stay on that path.

path. path. Ingredient number four is face your fear. say more about that. Yeah. So, I think this is this kind of speaks to, you know, what I said when, you know, people are really paralyzed in that moment of something happening and like I was when I lost my vision and it's this idea of like how can I even begin to approach life when I'm so afraid that something might happen again. And you know this is what I've heard from my patients who've had like for example a minstroke or a stroke and then it's like well what if tomorrow I have another stroke or what if I like am out somewhere and you know I can't suddenly move or what the the fear is like overwhelming that whatever it was that happened to you is going to happen again that health anxiety and I see it with people who've had cancer who've had you know whatever the medical issue is you name it people are afraid and again in order to be able to kind of heal and move forward we have to face those fears and um you know I think one of the best ways to face it is through therapy I think that's a very helpful way to actually tackle that number four of facing your fears because I think working with someone who can help you identify why you feel that way how you can approach you know when you start to feel afraid what you can do in those moments.

Um, reworking your vision of you know what has happened to you and how processing it. I think therapy is immensely important for that number four kind of tool. But um, in order to kind of progress, we h we can't run away from what's happened to us. We can't let it overwhelm us and consume us. We have to deal with it um, to be able to then move forward. So therapy can be great for validating the trauma and uh which as you write about is is really important.

You you know you have to acknowledge what's happened in order to um you you want to be seen. Uh and that's a huge part of the healing. Um and then we have to start facing it. Um and therapy can be helpful uh for this as well. You use this term in terms of uh the when it comes to the the the facing of the fear stepwise exposure. Yeah. Yeah. I mean, so obviously in therapy that's used a lot, for example, exposure therapy. So you're afraid of, you know, heights and so maybe you go and you walk up one flight one day and you kind of get used to that and then over time you're able to walk up two flights and walk up three flights.

Like this is a proven technique in therapy um for people with anxieties in particular and phobias. And it's the same concept, you know, with health anxieties or something that's happened to you. Um, and I use the example in the book of my brother-in-law actually who um had uh a heart issue and ended up with a stent and a heart attack. And he was a outdoorsman. He loved being in the wilderness in the woods in the middle of nowhere um without anyone around ex, you know, except the animals.

And after this happened to him, he was afraid to go hunting again, to go out into the wild. And you know, it was it was sad for all of us who knew him to to see that medical issue take away something from him that was so incredibly important to him and his lifestyle and who he was. And so we had a lot of conversations on the phone. He lives in upstate New York where, you know, we talked about, okay, you know, again, time is going to be helpful in terms of your healing.

And you take baby steps. So, you know, don't go out into Alaska, you know, to go on a hunting trip tomorrow. maybe uh go uh you know for a drive into the state park a little bit, you know, with your dog and and walk around. Um and then maybe in a few months, you know, you go on a trip somewhere else more locally, so if you need to be near the hospital in Syracuse, you're close enough that you can get there. And little by little, this is this is what he did.

And little by little, he realized that even though he had a stent and he had survived the Widowmaker heart attack, he could still have a life that he loved and enjoyed. He could still go hunting. um and he could still be out in the middle of nowhere. Um and so that was really, you know, that was like a great example of kind of that step-wise approach to little by little building back into your life things that you like to do and not allowing the fear to kind of overtake you.

you. you. Another aspect uh that you write about uh when it comes to facing fears is uh cognitive reframing and you talk about an exercise called the identity pie. Yes. So that that was so when I in the process of researching the book um I spoke to a lot of psychologists and one in particular um who works at Mount Sai who's wonderful Dr. D. Kiro I thought this was an amazing example of really recognizing like we are not just what has happened to us. we we are so much bigger and he you know used the example of drawing almost like a pie and cutting it into pieces you know and so in one piece you are the wife or the husband and another piece you are you know the journalist and another piece you are uh the sister and maybe you're an athlete and there's a part of that pie that is you know the survivor of whatever has happened to you but that is not the whole identity of who you are um and I thought That was such a great way to help people understand um that that is not what defines you.

That is like a part of who you are. And actually this just came up. I I just I don't know if you just read um uh Tatiana Schlashberg's article uh on her cancer. And you know she in the article said exactly that in one line that I am not my cancer. You know I am not this is not who I am. This does not define me. And I think it's very easy for us to allow something that's happened to us to overtake us and that becomes who you are.

Um, but I am not just a cancer patient. I am a wife and a mother and this and that and all of these other amazing things. So again, it's it's taking a step out and looking at yourself from a almost like, you know, floating out of your body and from a bigger perspective. Um, and it's very easy for us to kind of be stuck in the in the weeds of of uh what has happened and and and and that's why I love that identity pie example.

I like it too. Ingredient number five, number five, number five, connections. connections. connections. Not a thing most doctors uh prescribe uh although they should. Yeah. I mean, so um one of my close friends and my former resident at the Brigham was VC Murthy uh who has been, you know, extremely uh helpful in terms of reframing how we think about loneliness and connection in this country through his writing and his speaking about it. Um and you know we are finally beginning to recognize that you know how involved we are with other human beings actually has an impact on our physical and our mental health and that it is important for us to cultivate that.

And so I do talk to my patients a lot of them are older um and maybe have lost a spouse or a living alone and about you know well maybe you could join you know what is it that you love to do? you have a hobby, maybe you could join a group where you could do that hobby or a walking club or if you have a religion that you, you know, are part of something with your church. Uh there obviously now with, you know, Facebook, there's all kinds of groups people can join on social media.

Um people who are survivors. So, for example, in my world of of cardiology, the Go Red for Women campaign has been incredibly helpful for women who are survivors of heart disease to see other survivors to talk to them, to share their stories. So, you know, there is so much power in whatever those connections are, whether it's a big group, whether it's people who, you know, have the same interest as you or whether it's one connection, you know, one person, just one friendship. Um, but that is healing and that's really important.

um we are not meant to be, you know, singular alone creatures in our own little world. Um and so yes, I think it should be prescribed to everyone to cultivate that, to foster that and again in whatever way feels right for you depending on who you are and what you love. Um but it is important important important to be Harvardentric Harvard centric for a second. You you mentioned the Brigham Brigamin Women's Hospital which is a Harvard hospital in in um in Boston where my dad happened to work for 30 years.

Uh he was the head of radiation oncology there. Oh my gosh. Well, that's where I did my residency. You might have seen him shuffling through the hallway. Um, he's not there anymore. Um, anyway, also at Harvard, uh, there's the very famous Harvard study for adult development, which has found that the number one variable for longevity is not, uh, how much you're sleeping, how good your exercise game is, it's how how how healthy your relationships are. And so, isn't that amazing? Yeah. And it it's it's increasingly amazing when you consider that it's not a thing most doctors recommend to people or even inquire about.

Yeah. Well, we talk a lot about things in my exam room that probably a lot of people don't talk about, but good for you. That's great. Literally, good for you. Um uh so along those lines on connections, um in terms of the howto, because this is this is a thing. This is yet another thing that people often hear. Oh, we're social animals. We need to have healthy relationships. But how do I do that? You actually do talk about the how. Um there's a phrase you use.

I'd be curious to hear you unpack it. Find, remind, and bind. Yes. Yeah. I think, you know, finding like things that you love, reminding yourself of that, and then finding others who really can you can connect with in that way. you know that [clears throat] that is it's sort of like relooking at yourself like who am I what do I love what is my identity reminding yourself of those things and then finding others that you can cultivate those connections with that may have similarities with you and I think that's that's ultimately what people that's why I said you know if there's something whether you're an artist you know maybe an art club or you're a writer or you like to read you know go to library so in order to build those connections sometimes it just starts with sort of understanding what it is that you enjoy, what it is that makes you tick, and then seeking that out in others who will share that with you.

you. you. Another thing you recommend, which is much less ambitious, much less um it it takes less, you know, get up and go, um but is incredibly impactful, is just to engage in small acts of kindness. Um just say a little bit more about that if you don't mind. Yeah. Well, this just came up actually this weekend. my again my mother um was in town for Thanksgiving and uh she said to my daughters, you know, do you ever do like little acts of kindness around the holidays?

And my my daughters said, you know, well, what do you mean, Grandma? And my mom explained, you know, sometimes when I go to the grocery store, if someone's in front of me in line, I will, you know, pay for their groceries or, you know, if I see someone that needs help, I will, you know, help them through the door or little things that are totally unexpected. And, you know, she said to my daughters and and we said to her, you know, well, that's so great that you do that.

And she said, you know, I I it's great for everyone else, but it's great for me, too. She said, it makes me feel good on the inside to do these things for other people. And I think, you know, that is so much a part of the small acts of kindness. Obviously, you're extending yourself to someone else and helping them, but it does release those same sort of feel-good hormones in you. Um that to be compassionate and caring in that way uh and make those small little connections.

It's uh it speaks to I think many of us have this view conscious or subconscious that there is a bright line between self-interest and altruism. altruism. altruism. There's it's just like trying to divide physical health and mental health. You can't do it. And and so altruism is good for you. for you. for you. It is exactly that's exactly the point. So it is good for someone else but it's actually also good for you. Okay, chapter six, uh, or or recommendation number six is, um, it picks right up on connections.

Um, it's about love, seeking out love. So, I'm curious like h how are you delineating between love and connection? connection? connection? Yeah, it's different. Um, and I did, you know, that was important for me to put as a separate chapter in the book because connections are, as we said, you know, it's a little more distant, right? It's a a friend that you go for a walk with, someone that's at your church, someone that you um you know play ma jang with uh or talk to on the phone.

It it it elicits a different um reaction than love which is that much more intimate connection. And I think for me the chapter on love wasn't just also about love with someone else. It was about love for yourself. And that was very important too. um was again in order to do anything we have to be able to love ourselves. We're not going to be able to accomplish or be resilient if we we are hard on ourselves. So it's giving ourselves that grace and that self-compassion that you just talked about.

So it is both selflove and it is also seeking out that very close love that I have seen again help patients heal. Um, and you know, that's why for me, you know, these chapters were born out of what I see every single day in the patients that I treat, and I see the husbands and wives that come in together to support each other and how they've helped each other through whatever the diagnosis is, or the mother and the daughter who come to every appointment together. Um, or the sisters.

I mean, it is it is there is no question that having that connection that is deeper. um allows people to you know heal but also to prevent you know again it goes back to prevention and treatment. So um you know there's a reason why they say married couples live longer. Uh there there is no doubt that that being so intertwined in that way helps you take those steps to prevent like we're going to exercise together, we're going to eat healthy together, we're going to take our medicine together, we're I'm going to go to your doctor's appointment with you that I know you don't want to go to.

Um, but then when something does happen that's difficult, having that person by your side to be there with you no doubt helps people recover and heal. I haven't I don't have the data to hand here and I may be remembering this incorrectly, but it aren't the health benefits of marriage disproportionately conferred upon men. I don't know. I don't think so. But maybe it just feels right. Whether it's right or not, it feels right. I will say that it is more often the wives sort of bringing their husbands to the appointments than it is the other way around.

So it may very well be. A side note, what is going on with Ma Jang? You mentioned Ma Jang. Like I remember my Jewish grandmother playing Ma Jang at Polynesian Gardens, her her like condo in Plantation, Florida, uh like 50 years ago. And now ma jang has taken my wife's social circle by storm. It's it's it has a it's having a renaissance rebirth. renaissance rebirth. renaissance rebirth. Moving away from maong though there's one little thing I want to ask you about in the realm of love.

Um and it's oxytocin which many many of the listeners may have heard of but just give us a a primer or primer I never know how to pronounce that word on oxytocin. oxytocin. oxytocin. So this is sort of what we call the bonding or the love hormone. So, for example, it's released when we classically think about it when mothers breastfeed. Um, and you release oxytocin when you're breastfeeding your baby. And clearly, it's that moment of bonding. Um, but it's also released when we are intimate with someone, you know, when we are physically close to someone.

And so again showing that there are chemical reactions in our body and hormones and things that happen simply by you know touching people and being close to them physically and affectionately and and that is a very power that can be a very powerful thing. Um so you know it's again important to explain that the the biological underpinnings of a lot of what we just don't recognize is even there. Um, but oxytocin is is is the love hormone we call it. If my wife's mad at me, which is not an infrequent occurrence, uh, can I get the oxytocin from the cats?

You might. Uh, okay. Ingredient number seven, hope and faith. Yes, this is something else a lot of uh physicians sort of steer away from but um I actually feel you know very strongly about that we need to talk about in terms of helping our patients heal and be resilient. Um you know I I give the example in the book of when I again was in medical school I had an attending who was an oncologist and she told all of us medical students a very a story that stuck with me um about seeing a patient who had endstage cancer um and but could have probably lived for at least another year or two.

Um but a different doctor came in the room and in front of the patient and in front of all the residents who were rounding made a comment saying, you know, well, you know, he failed this round of chemo. He's probably only going to live, you know, another few months. And she said, you know, it wasn't shortly after that conversation in front of the patient that the patient died. And she said to us as medical students, you know, it's very important that you never take hope away from a patient and how powerful hope can be.

And I never forgot her words. And so I use them to this day, you know, and my and and we talked about this with certainty and uncertainty. So, you know, when people say, you know, what does this mean? I've just had a defibrillator placed. I had a cardiac arrest. You know, does this mean my life is over? You know, the answer is always we we don't we don't know. We're going to, you know, we're going to approach this day by day. We're going to do everything we can um to help you through this, to help you quality of life.

Um but no one can really predict. And I think that's the truth because nobody can. And when we think we can, there is that again biological reaction that is so powerful that literally by telling someone this is this is it people something turns off inside. Um and so taking away hope is is is not a thing I think we should be doing in medicine or ever. Um and faith sort of the counterpoint to that you know um again you know I think we steer away from talking to our patients about their spirituality and their practices but for so many people that is what keeps them going and so there is a whole body of science and medicine around a spiritual history.

So for example, making sure we ask our patients, you know, what is your faith and what do you practice and patients people surprisingly want to talk about this? They want you to understand this very huge chunk of their identity as we talked about and who they are and how that plays into their life and it does. It plays into how they are going to approach whether they want to have surgery or if they take their medicines or if they, you know, want to be resuscitated with, you know, chest compressions when they go into cardiac arrest or they want a defibrillator.

So, how do you take that out of how you're caring someone when it's so intertwined with for so many people in the choices that they make? And so, again, if you really want to understand the patient as a whole, the person as a whole, you have to understand what is important for them in terms of faith. And for some people there there is no there, you know, they don't have a strong spiritual faith. And that's fine. But that's important to know and understand. And in the same way for others, it is really what carries them through a lot of these challenging.

And I've had so many patients tell me, you know, when they've been hit with hit after hit, pancreatic cancer and then they have this and they have that and I look at them and they say, you know, it's my faith and I see it. You know, they have their cross around their neck or whatever it is. We talk about that very openly in my exam rooms because I know how much it matters. I'm not even sick, but I feel like I would benefit from spending some time in your exam room.

Well, you're welcome to come. Everyone should get a cardiac screening. So, but you should come in for your cardiac screening, Dan. screening, Dan. screening, Dan. Yeah, I may take you up on that. Uh, okay. We we're actually we've made it to the final of the eight ingredients, and that is purpose. Yes. So, again, this kind of goes back to that goalpost moving. that when something's happened to you and you need to keep going and you want to keep going, having a purpose or having something that you are aiming for, that you're fighting for, that you're living for, can become really valuable and helping you thrive.

And that is going to be different for every single person um what that purpose is. For a lot of people, when something has happened to them, their purpose becomes engaging in that particular thing that's happened to them. So, for example, in my reporting on gun violence as a public health issue, I interviewed um parents who'd lost children to guns um either died by suicide or in school New Town Sandy Hook, another woman who I interviewed whose son was playing with a gun with another boy and the gun went off accidentally.

And all three of these parents became involved in working to find solutions to ending gun violence and understanding that it is part of how we need to approach public health. Right? So that was their purpose. For other people um I interviewed another woman who had bipolar and was um in and out of the mental health care system for years and misunderstood and she wrote a book and now she's traveling across the country donating her book to raise awareness about bipolar and mental health and suicide. um for my patients who have heart disease, many of them want to join, you know, the campaign for the American Heart Association to help others.

So for everyone that's going to look different, but I think for so many people that force that's like it's inside of you saying, "I still have so much I need to do. I have a purpose here on this planet. So I know this has happened to me. It's changed my trajectory. It's scarred me in some way, but I am still going to keep going um because this has now become meaning for me." And that's why it was really important for me to have that be the last part of the ingredients because I think um it is like the vision of your future and what where you are investing and where you're going and what's driving you driving you driving you and there's some physiology here that that um people who have a clear sense of purpose um have uh they experience less intense bodily responses to stress.

Exactly. Okay. So, it's it's again it's as we talked about kind of like there's the stress response that can cause negative reactions and then by having purpose and you know practicing some of these other techniques we've talked about you are turning you're dialing down the inflammation you're turning down the the adrenaline response and the cortisol and all of that. So again it works both ways and that's what we have to start to understand the the same way that the stress can be negative we have the power in us to actually harness our body to do the opposite.

um whether it's releasing oxytocin you know or the hope molecules or any of these things inside of us um dialing down inflammation that that's in our power um and and that's I think what's so um we we talk a lot about this in cardiology that 80% of cardiovascular disease is preventable by what you do in your life right so we have so much power in our hands to help ourselves to heal ourselves we just have to know how to harness it and how to do it it it another aspect of um purpose uh links back to your uh one of the previous ingredients in the resilience toolkit uh of getting fit.

U having purpose as I understand it can help you do these behaviors that are healthy but annoying if you're for example you know every time I can't believe I do this cuz I have long made fun of people who do prayer hands but every time I like get on the spin bike or sit in the sauna which is really uncomfortable um I'll do I'll just make a little prayer hands be like but yeah I'm doing this so that I can be stronger and happier. That's right.

That's right. That's right. So that I can make other people stronger and happier. That's right. And that [clears throat] that top spin um helps me, you know, get on the bike or get in that ridiculously hot room. You're right. And and and I will say like for a lot of my patients, a lot of their purpose revolves around family. And so for many of them, you know, they will say to me, I want to do this because I want to walk my daughter down the aisle or I want to see my grandkids graduate from college.

And so they find that drive to exercise and to eat well and to lose weight um and to manage their stress and to sleep because they want they have a purpose. They want to see that happen in the future and they know that that's how they're going to get there. So you're absolutely right. You use a phrase in this closing section of the book, give your gift away. Yeah. Yeah. Yeah. What does that mean? So actually I have that um so funny. I have it uh sitting here.

So this, you can't see it probably, but this is the quote sent to me by my patient, one of my patients who it's a quote that says, "The purpose of life is to discover your gift. The work of life is to develop it. The meaning of life is to give your gift away." Um, and so he is an artist, my patient, and he um created a beautiful he makes cards and he created one for me and inside he gave me this and wrote a beautiful note and I keep it on my desk always because I think again it speaks to that purpose, right?

All of us in my opinion are here um because we have something to do and I and in my opinion it's to to learn to love ourselves and others. I think at the end of the day that's what our purpose is. Um, but hopefully it's to also leave our mark in terms of bettering the world. And I think for each of us that's in a different way. And so when we can recognize that we each have that gift that we need to give back, that becomes a driving force that allows us to be resilient despite whatever happens to us.

Um, so again, it is that kind of altruistic thing that we that that we talked about um where you're giving your gift away, but it's also benefiting you. Dr. Dr. Dr. before I let you go, can you just remind everybody of the name of your book and any other stuff that you're making that we should know about on social media or elsewhere? elsewhere? elsewhere? Um, yes. So, the book is The Healing Power of Resilience, and it's um going to be published January 20th, 2026. Uh, and I am very excited to finally have this child be born.

I've had two two real ones, but this is the third one. Um, so I'm excited for it to be out there and I I truly hope that, you know, this helps people through any challenge, Dan, that they have in their life, whether that's medical or other. Um, and I also hope that it opens the eyes of those in the medical establishment to understanding that we should be creating resilience training programs for our patients and building them into how we practice medicine in every single medical school and hospital in this country.

that the mind, body, psychology, physical has to be woven into how we help care for patients and how we help people heal. Amen. Uh and you can also catch Dr. Nurula on this random obscure news network called ABC News. Oh yeah, that yes, you can find me on ABC News mostly on Good Morning America and on social media um at Dr. Tara Narula on um Instagram and Facebook and LinkedIn and X and you know all of the above. But above. But above. But Tara, thank you.

Great job. Really appreciate it. appreciate it. appreciate it. Thank you so much Dan for the opportunity.