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Guest Bios 

As one of the founding members of IFM, David S. Jones, MD, served as its president from 1999-2013, and under his leadership, IFM became a freestanding, independent, nonprofit, ACCME-accredited educational institute—a change that allowed IFM to focus entirely on its educational mission, free of any commercial connections. Dr. Jones facilitated the development of Applying Functional Medicine in Clinical Practice (AFMCP) and the Functional Medicine Matrix Model and was editor-in-chief of the Textbook of Functional Medicine. Today, alongside his continued work in his Ashland Family Practice Clinic, Dr. Jones has stepped into the role of IFM’s president emeritus, serves on the IFM board of directors, and continues his commitment to further the functional medicine model in primary care medicine.

Deanna Minich, MS, PhD, CNS, IFMCP, is a functional medicine nutritionist, researcher, and author. Her 20 years of experience in the nutrition field led her to develop an integrated approach to nutrition called Food & Spirit, a framework that integrates the physical, emotional, mental, and spiritual aspects of health. She is the author of five books on wellness and over 40 scientific publications and currently serves on the board of directors for the American Nutrition Association. She has trained in functional medicine for the past decade with the “father of functional medicine” Dr. Jeffrey Bland as her mentor and has served on the Nutrition Advisory Board for The Institute for Functional Medicine. Currently, she teaches as part of the Environmental Health Advanced Practice Module, with a focus on food and lifestyle approaches to whole-self detox. Dr. Minich has over 20 years of experience working in both the food and dietary supplement industries, with her last position as vice president of scientific affairs at Metagenics, Inc., and is currently working as a consultant in those industries. She is passionate about helping others to live well using therapeutic lifestyle changes.? 

Joseph Lamb, MD, is the owner of the Personalized Lifestyle Medicine Center by Metagenics in Gig Harbor, Washington. He works in partnership with his patients to create optimal health and well-being by using functional medicine approaches including lifestyle modification, herbal and nutritional therapies, and cognitive therapy approaches. Dr. Lamb is double board-certified in internal medicine and holistic medicine/integrative medicine and is a founding diplomate of the American Board of Integrative Holistic Medicine. In 2013, he achieved certification as an Institute for Functional Medicine Certified Practitioner. Currently, Dr. Lamb is the Principal Investigator of LIFEHOUSE (Lifestyle Intervention and Functional Evaluation: A Health Outcomes Survey). To date, Dr. Lamb has been the primary investigator in over 75 clinical studies. He also organized functional medicine retreats in collaboration with the Consilience Partnerships.

Michael Stone, MD, MS, IFMCP, finished his undergraduate and graduate degrees in nutrition prior to receiving his medical degree from University of Washington, followed with residency and fellowship completion at UCLA Ventura and board certification in family medicine. Dr. Stone was the IFM Linus Pauling award recipient in 2019. His interests include the developmental programming of health or disease, improving chronic disease, and encouraging chronic health and well-being. He is a writer, researcher, and educator and mentors undergraduate, resident, and practicing clinicians in systems and functional medicine. He is cofounder and medical director of Ashland Comprehensive Family Medicine, practicing in Ashland, Oregon.   

Transcript: 

Kalea Wattles, ND:
Hello, I’m Dr. Kalea Wattles, and on this episode of Pathways to Well-Being, we’ll discuss how our connection to self, to purpose, to community, and to our environment influences our health and well-being. A new article published in Integrative Medicine: A Clinician’s Journal, expands on the connections between lifestyle, behavior, and disease and proposes that a lack of connection to our authentic selves is a major obstacle on the journey toward healing. Modifiable lifestyle factors have demonstrated benefit in addressing chronic disease states, but many patients find it difficult to maintain these changes over time. I’m thrilled to welcome four of the article’s contributing authors, Drs. David Jones, Deanna Minich, Joseph Lamb, and Michael Stone, to discuss the importance of the therapeutic partnership and its role in helping patients sustain lifestyle changes. Welcome to our guests. What an honor to have you all together. 

Joseph Lamb, MD:
It’s a pleasure to be here. 

David S Jones, MD:
Very much so.  

Michael Stone, MD, MS, IFMCP:
Wonderful.  

Deanna Minich, MS, PhD, CNS, IFMCP:
Good morning.  

Kalea Wattles:
Well, I’m just so excited to talk with you all. And the paper you contributed to is titled, “Our healing journey: restoring connection, finding hope, and evolving wellness.” That has to be one of the best paper titles I’ve ever heard, and it really presents this interesting paradigm about a patient’s whole health picture. The abstract even states that health can be defined by five areas of functionality: metabolic, physical, emotional, cognitive, and behavioral. An individual’s behaviors are the outward expression of an inward integration of that metabolic, physical, emotional, and cognitive function in a fully actualized mind, body, and spirit. Wow, we have to dive into that. So, Joe, I’d love to start with you. Can you tell us a little bit about how those five areas of functionality affect our behavior? What implications do they have when it comes to behavior change?  

Joseph Lamb:
Well, if you think about it, our behaviors are what people see. And our behaviors, in many regards, are the acts that we think about after we’ve done them, right? We remember what we did. We may not remember what we thought, but we remember what we did. And so when you look at the four other areas of function, metabolic, kind of the micro level, the hidden level of a human being, the biochemistry that’s taking place, the epigenetics, the background, all of those pieces, the physical being, how we actually move our bodies, what we can see with the naked eye, the macro, cognitive being our thoughts, and emotions being what bubbles up for us in our daily experience of the world, all of those come together to be expressed outward as some behavior. My body’s doing things that I have no idea about right now, as I’m talking to you, and yet I’m talking to you. And so behaviors are what we judge, and behaviors are what we frequently want to change. And so that part about outward expression is actually borrowing from the definition of sacrament. And the definition of sacrament is the outward sign of an inward grace. And so this concept is, our behaviors are the signs, and they’re the expressed symptoms that we learn about as we explore life.  

Kalea Wattles:
Yep, that’s a beautiful description. And as we’re talking about blending this with the functional medicine model, David, I’d love to hear your thoughts on how everything Joe just described aligns with a systems biology approach. Because it seems like what we’re talking about here is almost like a bird’s eye view of systems biology. 

David Jones:
Well, it is. And as I often say, it’s impossible. As a practitioner, you sit with your client, and you try to understand them at the deepest possible level. And if you don’t take into consideration the issues that Joe described, then you don’t get a very complete picture of the patient. But you have to have some kind of technique to create, some kind of system to understand how to evaluate, quantify, qualify. We’re very much of the culture involved in quantifying the human. And so we wear all kinds of wearables, and we do metrics about all kinds of different parts of our physiology. We’re not so good at quantifying the subjective aspect of our life, but that’s very much wrapped into what we just talked about. Mental, emotional, spiritual is a very important part of who we are as humans and whether we have meaning in our life. And that was the real conundrum that we faced when, almost 40 years ago, we started asking the question, how do you actually evaluate people and not just get lost into what’s the diagnosis and what’s the pill or pharmaceutical that goes along with that particular diagnosis? How do you actually begin to unravel those aspects?   

And that’s what the functional medicine matrix is really about. If you look at the graphic, it’s extensive, and the reason it’s extensive is because when it was developed, some of the people that are here today and many more that aren’t here today wrestled with this every Wednesday for years. I called it headache Wednesday, because we didn’t have, we were looking for a format, a structure to actually quantify and qualify these questions. And that’s what the functional medicine matrix, and we have a graphic that helps people understand that, and that’s why we think that we probably have the best system for looking at these, because we took clinical cases, we took textbooks, we took anything that a clinician might face and developed a matrix of formalism where you could evaluate those. And first you’ve got to decide that those are ones that you want to include in your discovery process, and then, how do you do it? And we’re going to be talking today about how we develop a system for doing it, because it is so important. You can care about your patient, and if you don’t care about your patient, you don’t even have a starting place. But caring about a patient also requires a methodology, we call it a systems methodology for actually looking and discovering, and then integrating what the steps are with a patient-driven approach. The patient drives how we do that.  

Michael Stone:
I absolutely agree with that, so wonderfully said. My way over these last decades. And this paper encourages us to listen differently. And the matrix helps us see differently. So it allows us to, as we listen differently to the patient, how do you restore connection? How does a patient with chronic illness evolve well-being? What is their wellness? So often we’ve focused in our training, allopathic training, on these biomarkers, quick biomarker assessment, but all of us on this call has had a situation where the biomarkers have been normal and the patient dies. So what is that disconnect? Well, that disconnect is understanding and seeing differently how the patient’s journey is, listening differently. And then the functional medicine tools in the hands of someone who listens differently and sees differently. Suddenly, you see the connections that help you connect with the patient’s behavior. So the functional medicine tools are elegant. This piece, this article that Dr. Lamb spearheaded in bringing forward, really challenges us as clinicians to recognize the journey, think differently, see differently, and identify ways to change.  

Kalea Wattles:
Well, our patients are certainly full of complexity. Deanna, did you have something to add to that?  

Deanna Minich:
Well, I’m getting so inspired here, and I feel so privileged to be in the company of these wonderful allopathic physicians. I’m a bit of the outlier, I’m the nerdy PhD, but there is something that I’m hearing that is being said throughout what everybody is saying, and it is so much about communication. In fact, I had a social media post where I said that I challenge that all health starts in the gut. I think that all health starts with communication, whether it’s communication of hormones, neurotransmitters, through the therapeutic encounter. Somebody recently said to me that communication is the responsibility of the communicator. And as a clinician, researcher, scientist, friend, parent, whomever we are, and who we are speaking to and with, it’s really about cultivating that sense of the audience and really connecting in. And that’s where the psychology, I think, really bridges together with the physiology. And again, Dr. Lamb spearheading the paper, it was great, because what I was seeing was the integrative aspects of psychology together with the biochemical, metabolic, physiologic principles and making sure that those two worlds were coming together in that therapeutic encounter.  

Joseph Lamb:
Kalea, I think one of the interesting things that faces clinicians is how to perceive the goals that a patient has. And unfortunately, those goals don’t frequently come out in the conversation. I remember being relatively young and seeing a cartoon on my doctor’s office, he had bulletin boards in the exam rooms, and the cartoon was of a physician sitting there talking with a patient and saying, “You’re overweight and you’re out of shape. So run, don’t walk, run down to the corner store and get me a pack of cigarettes and a cheeseburger.” And that cartoon was still there 15 years later when I went back and joined my family doctor, Dr. Frank Carroll, in practice. He’s actually the reason, probably, I became a physician, because of his model, but I joined him in practice, and it meant something different to me at the time. It wasn’t just a haha, it was, how do I know what’s important to that person in front of me? How do I judge whether behaviors are good or bad? Because behaviors, ultimately, aren’t good or bad, behaviors are functional or dysfunctional. Functional if they lead us toward our goals and functional if they allow us to express who someone is deep inside. And as clinicians, that storytelling has to incorporate calling forth why that person thinks they’re there. 

Kalea Wattles:
Joe, one of the pieces of this article that I found to be most interesting was the discussion of brokenness. And I think that touches a bit on what you’re talking about now, our broken connection to self, to our community, to our environment. It really creates this feed-forward cycle of dysfunction and disease. Can you elaborate on this concept for us a little bit and talk about brokenness and how that might manifest in a clinical setting?  

Joseph Lamb:
We came through the 1960s into the 1970s with the development of the person being important. And personal development and diving deep is crucial to a person’s journey to understanding themselves. But it stalled kind of in a commercial message of the one who has the most toys at the end is the one who wins. The one who has the highest standing is the one who wins. The one who gets to the top or can drink the finest wine or wear the best sneakers, they’re the one who wins. And we are stuck in that. We don’t see the importance of the individual. And the individual doesn’t even see it in themselves, frequently. There’s a lot of opportunities for us to do comparisons to others, to people who aren’t real models of what we should be. And indeed, as a culture, we’ve really downplayed people who could be ethical leaders. We’ve labeled people, we’ve put people aside, we don’t have voices that call to us anymore. Not in any meaningful way, not in our divided way. And I think what people need to do is actually see why they’re here. I was touched years ago by a quote that’s on the back of Illusions: The Adventures of a Reluctant Messiah, by Richard Bach, and the quote says, “A test to see if your mission on earth is completed. If you’re here, it isn’t.”   

And so the question becomes one of, why are you here? And if we can help people see why they’re here and see that there’s something special about themselves, the next step that they take pretty much on their own is recognizing that there’s something special in someone else. And then the service that you’ve done them they extend to someone else. Because we really do owe each other all service, and if we become a community about interconnected people who recognize the importance of the other person, and we become a community that recognizes the importance of this planet where we live, and everything else that’s here with us, then we have some hope of giving something to our kids in the future and to our grandkids, and back to the planet.  

Kalea Wattles:
Yes, beautifully said, and as you’re talking, it makes so much sense to me why there’s a mental, emotional, spiritual component at the center of the functional medicine matrix. David, I know that was very thoughtful as you were spending those headache Wednesdays putting these tools together. And so maybe, David, I’ll put the next question your way. Something we hear from clinicians is they know why it’s important to understand the mental, emotional, spiritual components of a patient’s story, but they’re scared to ask about it, because they don’t know what to do if the patient says, “I’m struggling in this area.” It’s almost one of those things where we say, don’t run any labs that you won’t know what to do when you get the results back. And so many clinicians are just scared to go there. Do you have some advice in that scenario? 

David Jones:
Well, in functional medicine, you’re constantly, once you decide to take that dive into really listening and trying to understand what the origins of the problem are with your patient, you’ve got to take some chances. And I can say that there’s not an iceberg chance in hell if you don’t take that chance. Because you have to generate hope. If people don’t realize that you’re there in an authentic way, and you’re going to metrics, what’s your cholesterol? What’s your weight versus your height? I mean, then you got to start someplace, and that shows that you’re at least interested in their physical form. But when the time the patient will open up, if you personally commit to actually listening at a place where you step in and say, this isn’t working, let’s try something.   

I know I was two years into practice when I had a patient come in, she had a serious colitis with bleeding. Well, we went through all the different things that we were learning about, the gut is where everything happens. Tried all those things, nothing worked. She came in a couple times, and in her third visit, I sat down with her, and I said, “Do you know what the word ‘flummox’ means?” And the response was, “I don’t know what it means, but it doesn’t sound good for me.” And I said, well, in a way, you’re right about that, because you see in front of you a doctor that’s flummoxed. I don’t know how to help you. And it just so happens that Dr. Green is in the office today, and Dr. Green knows all about this problem. So I’m going to go out and ask him. Would you mind talking to him? So I stepped out and came back in and introduced myself as Dr. Green. And I said, Dr. Jones asked me to come in and talk to you, and my first question is, “What haven’t you talked about to Dr. Jones that I can convey to him? What do you think is causing the problem? Has he asked you that question, what you think?” And she said, and she really told a heartrending story that she and her husband had some real difficulty financially, and they were having a “me too” kind of experience with doing cleaning at night, and the owners of some of the buildings had come onto her. And I said, well, what are your choices? What are your assets? And she said, well, we have a business plan, but no one will do it. I said, well, I think the prescription for me is get on the phone and talk to my banker, because right now, if you’re a woman and you leave your husband out of the negotiation, you can get a loan. She got a loan and started a business that almost 30 years later still is running here in this valley. She never had another bleeding episode.   

Now, how do you find that out if you don’t ask the question and listen and realize what you know and what you don’t know? And if you don’t get to the heart of it, you don’t get any kind of hope generated. And without hope, there’s no electricity, there’s no energy. That’s true for me, that’s true for you. If you don’t have hope, that’s the starting point, and it has to be a legitimate, authentic hope. And that’s why we’re there, because we know a lot about a lot of things, but we don’t know what is true, and what has been said so far has been, how do you go about that process of listening in a real deep way? Because if you don’t get to that essence of what it is, you’ll never get to the origins of whatever the diagnosis is. So we’re going to talk about the functional medicine GO-TO-IT way of looking at the interaction, and there’s a whole way of looking at that that helps with that that I look forward to us getting to.  

Michael Stone:
And isn’t it interesting, just encapsulating your story, David, that, think of all the downstream effects, all the way down to the genetic level, the enzyme level, the physiologic level, the functional level, that bringing that single four-letter word of hope and options out of this situation created. And it wasn’t, as you often say, a pill for that ill. But it was listening to what was causing suffering, what was changing purpose, what was changing hope in that individual. And this center, the cognitive-emotional-behavioral component, as we know, changes physiology all the way down to gene expression, as long as we live, from in the womb to our last breath. And so to be able to take a step back, recognize that, and then take a step forward with the uncertainty to help engage that with your patient, with your client, to help change the cycle of their perception and their perspective that they will bring forward is the key to breakthroughs in healing and well-being.  

David Jones:
Well, I would say that there were two people that engendered hope. Because at the beginning of that, I was flummoxed, I was truly flummoxed. I didn’t have any idea where this came from, and none of the things that we do, none of the molecules we changed in her life, had any effect at all. And I came out of this with hope. I don’t think I actually, I never left the room and reintroduced myself, I never tried that one again. But certainly, it made me at the time say, David, you’re flummoxed. Why don’t you ask the legitimate, authentic question to this person instead of you being the answer man? Because we’re trained to be the answer man or woman. That’s what we’re trained to do. And then come up with a pharmaceutical or a procedure that will help the process. How ignorant is that?  

Michael Stone:
Yeah.  

David Jones:
And inadequate, worse than ignorant is inadequate.  

Michael Stone:
Teach your tongue to say, “I do not know.” As Maimonides would say.  

Joseph Lamb:
Oh, sorry, Michael, go ahead. 

Michael Stone:
No, no, I was in a poignant ‘um,’ so you could jump in.  

Joseph Lamb:
Okay. I think it represents kind of a basic thought. We aren’t physical beings having a spiritual experience. We’re spiritual beings having a physical experience. And that deep endowment of spirit that we all share drives a lot of what takes place. And when you leave room for spirit, and most importantly, when you leave room for the way patients define spirit, use language that’s relevant to them in the conversation, get to know them well enough that you’re not alienating them, that you’re not judging them, that you’re not limiting their spirit, when you do it that way, you get the answers that David sought, and many of us try to continue to find with our patients or clients or whoever we want to call the other important person in that room.  

Kalea Wattles:
Well, before we move on from this topic of the therapeutic partnership, we know that many studies have looked at the effectiveness of patient-practitioner communication. And when we see communication styles that are more dictatorial in nature, those tend to be associated with poor health outcomes for the patient. Deanna, I want to loop you in on this conversation and hear your thoughts on, how does the functional medicine model really support that healthy patient-practitioner communication, especially when it comes to making these lifestyle or behavior changes that can be hard over a large span of time?  

Deanna Minich:
So many neurons are firing in my brain right now, listening to everybody. And it’s so true that the science is very supportive to suggest that we need a different way. That just having that dictatorial framework is not going to work. And in fact, when I first started in clinical practice, I actually took that approach. My father was a policeman, my mom was a health nut. I put those two things together, and I became the nutrition police. And I would walk into that room, and I was very structured, and I was very strict. And I was thinking that that was how you got results, was that you laid it all out just as you saw it. And there wasn’t a lot of that storytelling, I would say, or even where I eventually got to was really looking at the art. My path and my journey clinically also paralleled that of my personal story. And I noticed that for me, I held a lot of constriction in my own body. So having a lot of that rigidity, that idea that it’s one way or the highway, and then eventually realizing that there are many paths up that mountain to healing and that perhaps I needed to embrace more of the flow element in conjunction with being more rooted and grounded and structured. And what I see right now is that so many people are in that rooted element of looking at biochemistry and labs and numbers. Even the terminology, the language that we use around healing in medicine is “private practice.” And I’m thinking, well, what happened to healing arts? What happened to the art of healing?   

So as I’m listening to your story, David, one of the things that came up for me too was how we can help patients and clients to look at their own journey in the way of symbolism. Caroline Myss talks about how symbols are the language of the soul, the connection to spirit. And how do we see the colitis, the issues with guts, or with brain, or with anything, in a very symbolic sense? Because it takes us out of the micro and puts us into the macro to give us perspective. So just to add to this whole beautiful conversation of bringing in communication and listening, I would say also to bring in the aspect of symbolism to take us into soul and art. 

Kalea Wattles:
Yes, thank you, Deanna. I love that you’ve all highlighted storytelling, or this concept of narrative medicine. And the article states, which I love this quote, “We do not see nor can we measure accurately an individual’s inner experience.” Wow. “Instead we attempt to objectively listen, take detailed histories, do physical and laboratory evaluation, and in functional medicine, tell the person’s story back to him or her.” Functional medicine has several tools to really help with this retelling of the story. It’s something I really appreciated as a new clinician. And these are many of the tools that Dr. Jones helped to create. So, David, can you tell us a little bit about some of your favorite tools for retelling the patient’s story, the timeline, the matrix, the GO-TO-IT mnemonic? Those are all so valuable, and I’d love to hear about them from your perspective. 

David Jones:
Well, I could go on for an hour, and I’m not going to do that, because I have a tendency to do that, and I promised myself I wouldn’t do that. But I would say that the GO-TO-IT is really an incredibly powerful tool, because what we did, we had been doing the functional medicine matrix in terms of what I would consider kind of a primitive way compared to what we do now. But part of it was, we had everybody that came to that retreat was a practitioner, and they had to get up and explain how they used the different tools. And one of the things that was left out was telling the patient’s story. And so finally we went back and we put that in, the “GO-TO-IT,” the to it, GO is gathering, O is ordering the information you gathered, T is then turning around, and in as humble a way as possible saying to the patient, I am going to tell you back the story that you told me in the most accurate way that I possibly can. And you’re going to interrupt me every time I make a mistake. I didn’t realize how powerful that was going to be. That’s when you change the dynamic about who’s the expert. The expert is the patient. They live in that body, and that soul, and that spirit every moment of their life. And when you first do that, it’s like the patient doesn’t believe it, because they’ve heard that people do this and they come back and they say, “I’ve been thinking about what you said, and you’ve made some mistakes in telling my story.” And it could help, it’s kind of like the woman that we talked about, a flummoxed doctor.   

The only way you’re going to get to the essence is to empower the patient by saying, you’re the expert, we’re going to do a discussion here where I take all this data we gathered, and I’m going to try to tell a story about you. And what were the antecedents, what are the different areas of the matrix that are important? But you have to promise me that you will stop me and say, “Nope, you heard that, but that’s not what I meant.” Because we will never get to first base, let alone a home run. It’s the idea that you will never get to the real essence unless a patient becomes not information-driven but patient-driven, and they get to say what the story really is, because they’re the ones that are desperate to get the peace and calmness and bedrock healing that can occur if that process goes on, and you can be part of that, and it just used to put shivers down my back when I knew we were there because the patient told me, “No, Dr. Jones, you didn’t hear this.” It was like, “Oh, now we’re going to go someplace.” So then GO-TO-IT is so important to follow through with each one of those, what does each letter mean? Because it’s a process, it’s applying systems biology in a very prescribed way that’s quite different than the discipline of how I was taught to use information. 

Michael Stone:
That’s exactly true, and using that heuristic and the timeline becomes so important because you keep reflecting back on that. And tying the timeline to functionality, the five areas of function, where you can begin to see where “normal” function begins to drop off. And it leads to more questions. And then even some of the things we do in the clinical room, just having somebody stand and balance, or showing an altered function by checking vibratory sense. Suddenly, when you begin to bring in all these piece…parts of physical, metabolic, cognitive, emotional, behavioral function versus dysfunction, you go back to the timeline and you ask different questions, you see differently. And the connecting of a patient’s timeline and story to them, an enzymatic cofactor, is us telling the story back and allowing the patient to correct us. And then they begin to ask why this function has changed. And this function leads to their change in spirit. It may be tied to their ego. It’s all wrapped up in that yarn ball of their healing journey. 

Deanna Minich:
I would like to say, too, based on what you said, Michael, and also David, the ways that I’ve used the timeline clinically have varied. So, first of all, thank you for creating these tools. And I have used my sense of intuition and art in order to tailor them to different clinical audiences. So, for example, being that I’m a nutrition scientist, one of the ways that I’ve used the timeline is to have patients make an eating timeline. What were the top 10 events in their lives? I’ve also used the timeline to create a, I call it a toxic timeline. What were all of your toxic exposures? Let’s get into that. And then thirdly, I’ve also done workshops where I’ve had women create their own heroine’s journey. What are the hallmarks within their own personal journey that they want to recognize throughout that timeline? And that parallels some of Maureen Murdock’s work. We talked about that in the paper, the book, The Heroine’s Journey. But this concept of the journey I know underpins everything that each of us on this podcast do, right? We are living our own journey, we’re witnessing others’ journeys, we are also being an active participant in helping with telling that story or that recollection of that journey and where it’s taking us.  

Kalea Wattles:
You know, you mentioned the workshop, I think, Joe, that in the consilience partnership workshops, you focus, there’s been really a focus of having people draw their journey of the past to the present and imagine their journey from their present forward. Yeah, I’d love you to tie in some of that building on what Deanna’s said.  

Joseph Lamb:
Yeah, I think it’s an interesting exercise. People, as Deanna has alluded to, art can be a gateway to soul. And people express themselves differently when they draw. And so we’ve asked people to draw their past, to draw their present, to draw themselves with their biggest problem, and to draw their future. And we do those drawings at the beginning of the workshop and we do them at the end. It’s really based upon some work, what I learned at Jim Gordon’s Center for Mind-Body Medicine, which came out of some work, I think, that he borrowed or learned about from Bernie Siegel of “Health Healing” and whatever that book was called way back when in the late ’80s, early ’90s. And I think it allows people to express themselves differently, because as we talk about self, it’s the self who has the behavior. But ultimately, there’s all these subcomponents. If you look at a Jungian model of personality, there’s all these subcomponents of who we are. And in a sense, ego is that kind of isolated, endangered me that works to protect myself from the world. And soul is more of the transpersonal, relational me. And as you talk about people’s aspirations in lives, getting them to make that distinction, this behavior came from my ego, or it came from my soul, and how does spirit infuse that underlying dynamic and kind of bring out the hidden, the energetic, so that our selves can express a behavior? And sometimes pictures tell you a lot about that.  

Kalea Wattles:
Joe, I think you might be touching on this a little bit right now, but connecting back to this concept that our outward behavior is a reflection of those inward areas of functionality, what have you found to be some of the main barriers for patients and for practitioners when it comes to behavioral changes and those modifiable lifestyle factors?  

Deanna Minich:
I’ll chime in on this one, because it’s coming up strong, and my community has told me this, it’s actually community, it’s support, it’s having an infrastructure, and not just a financial infrastructure but a social structure that really supports a sustained, long-term change or modification. Many people fear, and I’ve asked this question, I’ve actually put it out to people over and over again. And that’s why they’re longing to do more of these online groups and programs is because they actually get more than just the information, they get the infrastructure, they get the support. And I think that we underestimate, in some respects, perhaps some of us, the power of that tribe, or that community, of the people that are there with you in that experience. And so that’s why I have made a shift, even in my clinical work going from one on one into groups, because I realize I’m not doing much, it’s the power of the group, the group heals the group. They share recipes, they share hacks, they share just words of wisdom and even emotional support. So I would say that people are really longing, in this time of a lot of divisiveness, for unity and really to feel that connection to something greater through that sense of people.  

Joseph Lamb:
And Kalea, I think part of it is safety, that’s part of what they get in a group. But they need to feel safe in expressing who they really are. So many of our identities, we have a work face, we have a face that we have as parent, we have a face that we go back to a high school reunion or a college reunion, and we want to present ourselves in a certain way. We have a face, that’s that ego. And all of us growing up were challenged at some point. The innocence of the world was broken. Our dreams were broken. If you ask a little child about what they want to be when they grow up, they want to be an astronaut, they want to be president of the United States. They want to be a firefighter, they want to be all sorts of things. They all are dreaming large. No one ever thinks about being the fifth row back in the fourth cubicle over. That’s not what they see for themselves. They want to be part of something, they want to contribute to something, they want to grow. And then elementary school happens. Your fourth grade music teacher tells you to stand in the back and not sing because you’re so bad, just mouth the words, and suddenly you’re less than. And that’s where your ego starts protecting you, and sheltering you, but it’s not bringing you true safety, because it’s not allowing you to be safe in expressing who you are. So the group, if it’s handled, a therapeutic group, and if it allows us to bring forth what’s hidden in people and allow them to feel safe when they do it, then they know about where they’re going, and then all of their decisions, all their behavior change becomes easier if it actually fulfills that goal.  

Kalea Wattles:
Gosh, as a parent of young children who dream big, that was very good to hear, so thank you for that. And on this topic of safety, the article actually says, “Lacking energy, time, and resources for behavioral change represents a failure to satisfy basic physiological and safety needs.” And I think this is really valuable, and there’s so much depth to explore here. Michael, I know you had some takeaways from thinking about this concept of safety. Will you talk us through that a little bit as well? 

Michael Stone:
Absolutely, and I think that this is, in the article, it really highlights and brings forward some of the work that Dr. Jones and his colleagues did in listening to story and trying to map a healing journey that was in British Medical Journal. And it talks about people are wounded. We focus on, frequently, we very much recognize wounding that occurs during accidents in the acute setting. But how is that wounding, how does that transition to suffering, and how there’s then a suffering transition to healing? And it requires, as pointed out by many, it requires, and pointed out here, that there has to be safety and persistence and group and understanding to help alleviate suffering. And suffering alleviation may include, how does your perspective of hope change? Or how does your perspective of purpose change in this new reality since that initial wounding? And then how is pain perceived, and how is the perception of pain, and how is a perspective of pain and suffering change? 

And so all that can occur in safety. You can take this to any situation, any situation in the world right now, or even any situation in the house, in the home, in the school, when can people express themselves? It’s when there’s respect and reverence. It’s a safe place that you won’t be attacked. There are many things that come into safety, adequacy for us to thrive, and that’s a whole nother conversation. But when we think of safety and its role in the healing journey, it takes us back to recognizing, where was the wounding? Where was the suffering? How can healing occur? Where’s the community? How can that community be persistent? How can your safety be persistent? And then you begin to change everything down to genetic expression, biomarkers, how you can walk, how you can breathe more deeply. Safety allows us to really thrive in a greater extent.  

Kalea Wattles:
Great. And building upon this whole concept of safety, Deanna, I’ve heard you talk in the past about compassionate listening, how that plays into this therapeutic partnership. So thinking about tools like motivational interviewing, like I said, compassionate listening, how does that play into this equation of creating a safe space where our patients can make healthy behavior changes?  

Deanna Minich:
So when it comes down to the tactics of, how do you create that safety? I do think looking at the physical environment, looking at space, so whether it’s the clinic itself or whether it’s the venue that a workshop or retreat is held in, how safe is that space? What colors are being used in this space? The lighting, I like your room, Kalea, it looks very warm and inviting, something along those lines to really cultivate, first, the incubator, the sacred container. And then to really reflect on, and I remember having a conversation with Joe when I was working more closely with Joe in the clinic setting. Remember, we were talking, and even Michael, actually, I think we had a lunch, and we were talking about just even the process to undergo as a clinician before you walk into the room. So did you clear your own energy, did you get grounded? I think one of the things that I see many people are able to do very quickly and effectively is just get grounded, get earthed, get present. And as Michael mentioned, having that nice, deep breathing that can help to establish better autonomic tone and really get brain and heart into alignment. So just even doing some simple practices as a clinician before walking into that sacred space. And I think that that sets the energetic tone. You’ve got the space together.   

And then coming back to what everybody has been saying, David, Michael, and Joe, about listening. I do think that listening by itself is a sacred, safe space verbally. So you have the physical aspects, you have your emotional/mental that we need to really clean up and accommodate, and then we walk in, and then we’re ready for more of that spiritual interface. And I’ve always felt, I must be honest, this might be a little bit of a disruptor comment, that the mental, emotional, spiritual aspect of the matrix is not emphasized enough. I call it, personally, I call it the heart of the matrix, depending on my audience, I might call it the nucleus of the cell. It is, to me, the cornerstone, and I was talking with Michael and with Joe on Friday, and I was mentioning how, in the middle of mental, emotional, and spiritual, we have consciousness. And consciousness is really, again, that connection to the big macro. And as we pull up that spiderweb, looking at the great big hole. So I would say there are lots of different tools, and people have to choose what really works for them, but I do like what Michael said about breath. It’s so simple, it’s free, it can be done on the fly, in the moment, and it brings you in the moment.  

Michael Stone:
And everybody on this call, I think, really recognizes how sacred and unique being able to listen to a person’s story and having a patient see you, and you see them, it really is a sacred opportunity that not many people will bring their story and will be listened to. And so I appreciate that about everybody on this call, that it really is, how do we make sure and remember that that interaction in the midst of busyness is truly a sacred time? What am I supposed to hear? What am I supposed to see in this patient’s journey? 

Joseph Lamb:
The trust that our patients and clients give us is amazing. When you think about it, we do this all day, every day. That a patient walks into the room and completely reveals themselves, and if our questioning is safe and inquisitive and curious, they say things about themselves and about what’s going on with them that they may have shared with no one. And when you think about it, it goes a step further. They eventually let you touch them, physically touch them during the exam in ways that very few people touch them as adults. And they have given us a huge gift. And our return for that is to be present. And we open ourselves up when we leave the negative energies of the day behind. Like if it was a previous tough encounter, we need to leave that encounter in the previous exam room and walk into this exam room open to what’s going on. Not thinking about deadlines, not thinking about what else is happening, because ultimately, in that space that we create, it’s at least my belief that we’re not just there with the patient, there’s more. There is some sort of energy that can also infuse that space and can give us insight if we’re willing to listen. I have found myself in certain settings saying things that I didn’t even know why I said, but obviously I had perceived something in that space. And what I said ended up being the little tap of a hammer on a chisel on an egg that allowed us to see interiorly to something that was needed.  

David Jones:
I don’t think it could be better spoken than Joe just spoke to it. The presence that you take into the room has an incredible effect on what can emerge. And I’m not going to try to improve on what Joe said, because I agree with every little bit of what he said, that that’s the space where hope could be generated.  

Joseph Lamb:
Thank you, David.  

Kalea Wattles:
And David, you mentioned in the beginning that oftentimes as practitioners, we go through our own journey of self-discovery and reevaluation and trying to find our purpose. And that’s how many of us discover functional medicine, I think, as we’re on this journey of self-discovery. This model does a great job of building on those tools for clinicians to self-manage and prevent burnout. But I’m curious if you’ll share some insights about how practitioners cultivate that sense of self-worth and self-awareness and how that shows up in the treatment room.  

David Jones:
I’m flummoxed how to respond to you, to what you’re saying. I think that each one of us finds ways. I could just say, for example, one of the things that occurred to me as Joe was speaking was one of the most powerful experiences I went through was getting trained in presenting the information of adverse childhood experiences. Are people here aware of that research, where at the institution, in the San Diego area, they looked at the studies of 17,000 of their Permanente patients, and then they tracked them because they had the records, they tracked them for 50 years and they found that certain traumatic experiences tracked to chronic illness faster than the normal arrival there by the general population? And one of the things that came out of that for me was, the most aberrant the patient’s coping mechanism is in terms of their behavior, that’s what we started the whole discussion of behavior, the more aberrant it is, the more I feel like I have to help examine that history, that timeline. Because if that seemed to them to be a way of handling problems, what that research showed was, if they hadn’t done that, they’d probably be dead. So instead of saying, oh man, they are really dysfunctional, it turned my whole view around and became a real benefit to me to understand that the more aberrant it is, the more difficult it is to change that, but you would never even begin, you would just say, well, do you have aberrant?