The Six Nails of Tilopa: A Framework for Mental Freedom

In this episode of the Health Optimization Medicine Podcast, Boomer Anderson, Dr. Ted Achacoso, Dr. Jup Kuipers, and Dr. Scott Sherr explore:

• What are the Six Nails of Tilopa, and how do they offer a practical framework for changing our relationship with thoughts, mental distress, and everyday experiences?
• How can repeatedly recalling past events, holding grudges, and revisiting old grievances keep us emotionally tied to situations that have already passed, and how can we learn from the past without remaining attached to it?
• Why does imagining the future often become a source of anxiety, and how can we distinguish useful planning from becoming consumed by outcomes that have not yet happened?
• What does “don't think” mean in the context of the Six Nails of Tilopa, and how can we reduce our attachment to self-criticism, external validation, and the constant need to judge how we are performing in the present moment?
• How can excessive examination of our thoughts, feelings, and actions lead to analysis paralysis and perfectionism, and what is the cost of continuously monitoring our own mental state rather than engaging with life as it unfolds?
• Why can the desire to control every outcome become a source of anxiety, and what can we learn from recognizing the limits of our control over circumstances, decisions, and the unfolding of events?
• What does it mean to rest and relax into effortless awareness, and how can meditation and present-moment awareness help us experience thoughts without becoming attached to them or defining ourselves by them?
• How does chronic sympathetic activation and the overstimulating nature of modern life relate to mental health, and why might optimizing measurable health markers alone be insufficient if a person's lived experience remains unsatisfactory?
• How can the Six Nails of Tilopa complement the quantitative approach of Health Optimization Medicine by bringing attention to qualitative factors such as presence, perspective, relationships, and the freedom to respond differently to our thoughts and experiences?

What We Discuss:

00:00 – The Six Nails of Tilopa and Mental Health
01:45 – The RITEC R Mnemonic
05:38 – The Goal of Meditation Is Not No Thoughts
05:57 – Living in a Sympathetic Hyperdrive
06:59 – The Six Nails in a Single Breath
07:48 – Survival, Reproduction and Pleasure
09:39 – Sympathetic Activation in Clinical Practice
10:21 – Mental Health and the Last Bastion of Freedom
11:26 – When Perfect Health Measurements Don’t Equal Feeling Well
11:59 – Your Relationship With Your Thoughts
13:17 – Quantitative vs. Qualitative Health
14:00 – The Cost of Holding a Grudge
15:58 – Why Future Thinking Can Create Anxiety
16:36 – Predicting Future Energy Demands
17:00 – The Physiology of Imagined Threats
18:35 – Catastrophic Thinking and Negative Bias
20:01 – Don’t Think, Avoid Attachment to the Present
21:00 – The Problem With Judging Yourself in Real Time
23:02 – Perfectionism and Self-Judgment
24:37 – From the Attention Age to the Presence Age
27:05 – Learning to Let Go of Control
28:34 – The Free Will Debate
30:19 – Context, Biology and Human Decisions
31:41 – Relax Into Effortless Awareness
32:02 – Present-Moment Awareness
33:13 – The Happiness Game
33:57 – You Cannot Grasp Life With a Closed Fist
35:20 – Practicing Presence in Everyday Life
35:58 – How Long Is the Present Moment?
37:03 – Optimizing Presence

Full Transcript:

[00:00:00] Dr. Ted Achacoso: So the first is don't recall, right? Meaning don't think about the past. And this is more something to do with, of course, you have to deal with your memory when you have to do certain things, right? But this is to deal, do more with, like, grudges and things that you hold that were done in the past to you, and you're still holding yourself hostage to those situations that's already past.

[00:00:20] Dr. Ted Achacoso: It's just a memory in your, in your brain, and you still think that it's true, right? It's just like you had an argument with, uh, uh, you- with your brother, uh, the day before, and you're still arguing with him today, you know? So you c- don't recall

[00:00:39] Boomer Anderson: Welcome back everybody to a special episode of the Health Optimization Medicine podcast. Today we're gonna talk a little bit, or we're gonna take a different approach. Uh, this is a little bit back to the old style free willy, if you will. Um- 

[00:00:57] Dr. Scott Sherr: Great movie ... 

[00:00:57] Boomer Anderson: uh, today, today we have on the show [00:01:00] Dr. Ted Achacoso, we have Dr. Jup Kuipers, and Dr. Scott Sherr. I'm your host today, Boomer Anderson, and we're gonna be talking about mental health and the six nails of Tilopa I'm gonna volley it over to one of these guys to, uh, to just get a little bit into what are the Six Nails of Tilopa. Does anybody wanna jump in here and give me a little definition and perhaps explain it for people?

[00:01:22] Dr. Ted Achacoso: Okay, I'll take that. So the Six Nails of Tilopa is actually very well-known in the Buddhist teachings, right? And they're actually very good or excellent for mental health as I've found it in terms of being able to apply it in day-to-day life. So the first, uh, the mnemonic here, I'm gonna give you the mnemonic.

[00:01:45] Dr. Ted Achacoso: It's RITEC R, okay? And it starts with a don't except for the last R. So the first is don't recall, right? Meaning, so that's the first R, don't recall, meaning don't think about the past. And this is more something to do with, [00:02:00] of course you have to deal with your memory when you have to do certain things, right?

[00:02:03] Dr. Ted Achacoso: But this is to deal, do more with, like, grudges, you know, and things that you hold that were done in the past to you, and you're still holding yourself hostage to those situations. Those are the past. It's just a memory in your, in your brain, and you still think that it's true, right? It's just like you had an argument with, uh, uh, you, with your brother, uh, the day before, and you're still arguing with him today, you know?

[00:02:28] Dr. Ted Achacoso: So, k- don't recall. And the argument that you're having with your brother is just all in your mind, right? So the, the second one is don't imagine. That's the I of RITEC, right? Uh, so don't, don't imagine, meaning don't think about the future. So, you know, when you're thinking about the fu- of course you have to plan and, and, uh, do all of this, but thinking about the future means, like, "Oh my God, you know, I think I'm gonna fail," and this and that and that, and you're already projecting all of these things about your future.

[00:02:53] Dr. Ted Achacoso: And, you know, it hasn't even happened. It's just a plan that you have. But remember all that the past and [00:03:00] the future are all occurring in the present moment. There's no such thing as a true future. It's only all everything in your head. The next thing is the T, uh, so RITEC. It mean don't think. And it doesn't mean that you don't think, exercise critical thinking or judgment, right?

[00:03:13] Dr. Ted Achacoso: It only means that you do not get attached to what's happening right now, right? So it's, it's like, uh, it's very common to us that we're looking at something that we're doing, and then there's that martinet inside our head that just keeps criticizing on what we're doing, right? It's very exhausting because the martinet's always negative.

[00:03:30] Dr. Ted Achacoso: "Oh, you didn't do that perfectly," or, "You're," or, "You're doing this," right? So don't think. And then the other one, then the E is don't examine, right? Uh, you know, this is actually more of overanalyzing things rather than just analyzing things. You get into what's called analysis paralysis of the cause and effect.

[00:03:48] Dr. Ted Achacoso: Right? So you're looking at, uh, for example, uh, the cause of a particular cause and event, which is actually chained to another cause before it, and another cause before it, another cause [00:04:00] before it, right? It's just, it's just like, you know, you accidentally drop the glass in your hand, uh, goes away to, goes to, uh, the, the infinite cause of you not being able to choose your genes to become yourself, right?

[00:04:12] Dr. Ted Achacoso: So the, the causes of this are just a, a chain of, of, uh, of events and, uh, uh, and things that you have no control over, which brings me to the next one, which is don't control, right? You're, you're planning, you're executing, and then you're still doing, trying to do micromanaging everything when, when, when everything is already manifesting the way it should according to your plan and it's executing that way.

[00:04:36] Dr. Ted Achacoso: Remember that when the something is exe- executing, the circumstances also change. Even what you're executing actually changes the context by which the execution is proceeding, right? So, uh, it's just like, uh, for example, uh, when you're doing a surgery or something like that, there are things that are actually

[00:04:54] Dr. Ted Achacoso: that can happen that are beyond your control, right? And you do your best to, uh, to do that. [00:05:00] So the last is the one that doesn't have a do- don't, right, is to rest and relax in effortless, in, in, in, in effortless awareness. And this is the value of meditation, right? You essentially learn to quiet your mind, to calm your mind.

[00:05:16] Dr. Ted Achacoso: The, the goal is not to have any thoughts. In fact, there's no goal, uh, in, in, uh, mindfulness. If there is any, it's the non-attachment to, to the, the thoughts that come, right? The best, uh, um, uh, imagery that I have with this is that, uh, the, uh, you know, what Sam Harris like to say, thieves coming, uh, and entering an empty house.

[00:05:38] Dr. Ted Achacoso: There's nothing to steal. It also, uh, reminds me of, uh, a haiku where, you know, the, the thieves came to steal everything, and yet the master said, "Well, you know, the window with the moon, they failed to steal it." So th- these are the kinds of things that I think helps calm down the mind, puts us in a more parasympathetic mode.

[00:05:57] Dr. Ted Achacoso: And as I like to say, we've built a [00:06:00] highly sympathetic world, right? Uh, it's like we're in sympathetic hyperdrive, right? It's not just an overdrive, it's a hyperdrive. We just push everything, you know. Um, just because we invented light, for example, doesn't mean that we shouldn't sleep anymore. Right? And what we've done is actually cut down actually dramasti- uh, drastically.

[00:06:18] Dr. Ted Achacoso: That's why there is now a phenomenon called phototoxicity, right? So, uh, so you could see all these things that we have done. And even in our kids, you know, uh, you know, we, we, we blame genes and everything else for the ADHD. We should also take a look at the context, but we're-- by which we're raising them.

[00:06:34] Dr. Ted Achacoso: It's a hyper-stimulative environment, right? So, uh, you know, and all of this, um, uh, these six nails, right, uh, are-- have been, uh, they are, uh, thousands of years old. They're extremely useful even just to remember what they are in a single breath, right? To relax at e-every moment that you feel an irritation, an anger that something is not getting executed the way you want to.

[00:06:59] Dr. Ted Achacoso: You know, you [00:07:00] said, "I said do this," right? But you, you go and you say, "Okay, things are mani- uh, are actually unfolding the way they should." And I love the term, you know, uh, that, uh, things unfold the way they should. So those are the six nails of Tilopa. We're gonna go through them one by one. You know, so it's RITEC R, don't recall, don't imagine, don't think, don't examine, don't control, and relax, right, into effortless awareness.

[00:07:25] Dr. Ted Achacoso: All right? 

[00:07:26] Boomer Anderson: Okay. So before we go through them, uh, you know, unlike most podcasts, we kind of give the solution up front this time. But I wanna give a little bit more context to why this matters. And for that, I need to tap Mr. Sympathetic p- Spiral himself, uh, here in terms of what you see clinically that comes through, uh, you know, your practice when it comes to the sympathetic nervous system activation.

[00:07:48] Dr. Scott Sherr: Well, thank you, Boomer, for asking. I appreciate it. I think that what it comes down to is something that, you know, Dr. Ted has actually kind of instilled in all of us as faculty here, is that what humans are really [00:08:00] doing is survival and reproduction and looking for pleasure, I would say, too. The hedonistic side of things, right?

[00:08:08] Dr. Scott Sherr: Um, does that go into more survival or reproduction? I don't know, Ted. Probably one of the two, right? So, uh- 

[00:08:12] Dr. Ted Achacoso: No, it's a mechanism. So pleasure- Yeah ... pleasure is a mechanism for you to want to continue to survive and for you to want to continue to produce. That's why- Right ... orgasms are pleasurable because the genes- Right

[00:08:22] Dr. Ted Achacoso: want to, want to reproduce. Like, "Yay, let's- Yeah ... let's, let's keep this behavior," right? So pleasure is just, uh, one of those, um, uh, rewards that you get. The-- but actually it's doing the process of survival and reproduction. "Hey, this food tastes good. Okay, it's pleasure." It's the 

[00:08:38] Dr. Scott Sherr: reward of it, right? Right. It's the reward of, of actually keeping yourself alive and surviving, right?

[00:08:43] Dr. Ted Achacoso: Gain, pleasure, avoiding pain. It's a, it's a re- it's a reward by which you continue-- It, it pushes you to continue to survive and- Right ... reproduce, right? Yeah. It's a mechanism. It's not a reward. It's a mechanism to keep you- I see. I see ... reproducing, right? Orgasms are pleasurable. They keep you reproducing, [00:09:00] right?

[00:09:00] Dr. Ted Achacoso: Uh, uh, uh, f-food, food, food is good and pleasurable. You keep on eating, right? And so... 

[00:09:07] Dr. Scott Sherr: Yeah. 

[00:09:09] Dr. Joep Kuipers: But McDonald's- Yeah ... is pleasurable, but that doesn't make me survive better. How does that work? 

[00:09:12] Dr. Jup Kuipers: Yeah. All right. It's the moment. It's the moment though. That's the deal, right? Which is like the moment where you're thinking of your survival in that moment, and that's the challenge, right?

[00:09:22] Dr. Scott Sherr: Like having humans think about life in six months, a year, six year intervals is very, very difficult because of these drives. And the way society is set up is for instant gratification of our survival and reproduction and our hedonistic needs that are mechanistically helping us survive and reproduce, as Dr.

[00:09:39] Dr. Scott Sherr: Ted just said, right? And so what we see in clinical practice is people that are just-- they're strung out on, on sympathetic activation. They're always in fight or flight. They don't know how or what even felt like to calm down. But they come into the office and their HRV is five and they say, "I feel fine, but my HRV is five every night and I don't know why."

[00:09:58] Dr. Scott Sherr: And that's a very common [00:10:00] scenario to understand these people have been in sympathetic overdrive for long periods of time. And, and this has a significant, uh, impact on our biology and our physiology and, and it depletes hormones and nutrients and, and our mitochondria get significantly depleted and energetically try to survive in a, in ways that keep them alive, but not making you feel that way.

[00:10:21] Dr. Scott Sherr: And so in clinical practice, a lot of what we do from a, uh, from a supplement perspective, from a diet perspective, it really requires a, an effort at looking at, you know, their mind and what's actually happening in that last bastion of freedom, as we like to say, right? It's not very free for most of us, so...

[00:10:41] Boomer Anderson: All right. So now I wanna get into those six nails, and we'll go through each one by one, and we'll kind of volley through them. Don't recall. Do the Elsa-- d- do the Elsa and let go of the past. Um, have no memories or regrets. Uh, who wants to take this one? Dr. Jup Kuipers. 

[00:10:58] Dr. Joep Kuipers: Well, what comes to [00:11:00] mind for me, and it, it feeds a bit into what Dr.

[00:11:02] Dr. Jup Kuipers: Sherr just explained, was a client I had, a patient. And by all standards of measurements we have, all the metabolomic tests, hormone tests, HRVs, he was perfect. I did my thing for two years on him, and all his scores were optimal. But him sitting in front of me at my desk, he still said then, "Why don't I feel well?"

[00:11:26] Dr. Jup Kuipers: And that's because he was-- he just couldn't let go of this event that happened to him in business where he felt slighted by his partner. And Everything we measured his health was optimal, but because he kept recalling this incident, his experience of life wasn't. And I think that's very powerful here to, for health optimization medicine practice practitioners and doctors to realize we've become very good at optimizing the outside world, controlling everything on the outside.

[00:11:59] Dr. Jup Kuipers: But the [00:12:00] relationship we have with our own thoughts is something we neglect, and that's something they're much more experienced in in the East, like with these Eastern old philosophies like the Six Nails of Tilopa. And I think the goal here is not to, um, stop having these negative thoughts or thoughts you label as negative, but to have more freedom into responding to them.

[00:12:26] Dr. Jup Kuipers: And so don't recall means the past has already happened. It's not here anymore. It doesn't exist anymore. And it just keeps recurring, giving you this negative sensation of anxiety or fear. You have to realize that those thoughts aren't you, and you don't have to feel that every time you think about it.

[00:12:48] Dr. Jup Kuipers: The most useful thing for people to realize here is that they are not their thoughts And it's okay to let go of all the negative [00:13:00] shit that happened to you in your life. It's hard, but letting go allows you to live in the now again and to have a much higher quality of life. 

[00:13:11] Dr. Jup Kuipers: One thing I, I also wanna point out there that Jep said is that the importance there of qualitative factors versus quantitative factors.

[00:13:17] Boomer Anderson: You can optimize for all the quanti- quantified self stuff that you ever wanted to, but if you ultimately feel broken in some way, it might-- One of the things that the Six Nails with Tilopa has done, at least for me, is kind of freed you from some of those aspects of your past, your future, et cetera. And, uh, as clinicians, we have to al- also keep in mind sometimes those stories do stick.

[00:13:40] Boomer Anderson: And so how do you free yourself from those stories? 

[00:13:42] Dr. Ted Achacoso: There's a actual common saying, right? There's no, no use crying over spilled milk. But we do it all the time, right? And that's why there's that saying is because we do it all the time. One other aspect of this that I wanted to put out there is, you know, the more common thing that people do is to bear [00:14:00] grudges, right?

[00:14:00] Dr. Ted Achacoso: And an example that I have here is that, uh, one of my dearest friends before thought that I was sending a really, really, uh, nasty email, which is actually a boilerplate email coming from a lawyer, you know, as regards some legal stuff that had to be done. But then, you know, even nine months later, you know, he was reminding me that he-- I sent him a nasty email, and I couldn't for the life of me remember what it was.

[00:14:23] Dr. Ted Achacoso: And it was already a grudge at the time, right? Um, he sta- started being offended by everything that I was saying and so on, didn't wanna deal with me. And I realized that was actually a boilerplate email sent by the lawyer with my name on it for him to sign. So, uh, you know, um, guys, you know, you know, you make sure that if you bear a grudge, I mean, better not if, if you don't bear any grudges, but make sure that you bear a grudge, you bear the, bear the right one, right?

[00:14:50] Dr. Ted Achacoso: So, so otherwise, you know, you just look, like, extremely foolish. Like, like, uh, uh, you know, you're-- had a grudge over what? You know? And, and [00:15:00] so, um, and that's a very common form of, uh, recall, right? Learn your lessons from, from, uh, learn your lessons from the past, but don't bear a grudge. The situation was a gift for you to learn the lesson that was there.

[00:15:13] Dr. Ted Achacoso: And then, uh, and then, you know, you focus on the pro- uh, uh, on the present. We don't say we move on, right? You don't move on. We cannot move on without you first actually learning the lesson that you had to learn from what was presented to you in the past, and now you're a better person because of it, right?

[00:15:30] Dr. Ted Achacoso: So 

[00:15:31] Boomer Anderson: All right. Yeah, next nail of Tilopa here. Don't imagine. Let go of what might become. 

[00:15:38] Dr. Scott Sherr: Okay. Um, the future. The future, I see it and it's vague. This is what Dr. Ted- You're using my line ... likes to say. I'm going to give you credit, Dr. Ted, of course. And, you know, there's, there's classic if you- if you're liv- living in the past, you know, you're, you're, you're depressed.

[00:15:58] Dr. Scott Sherr: If you're living in the future, [00:16:00] you're anxious. Well, I can certainly relate to this, as many of you that are likely listening as well, right? If you're thinking about the future, you're thinking about things that may or may not happen. And what is it? Is it, is it the Tom Sawyer reference that, you know, all the things that I thought about never hap- most of them never happened anyway, right?

[00:16:14] Dr. Scott Sherr: There's a Tom Petty song like this, is most of the things that I worry about never happened anyway kind of deal. And, and I think that's what this is all about, right? It's that, is, is, is taking away that sort of future thought anxiety that some of us Maybe some on this call, some of so many people that are listening as well that are, that are here, you know, that, that also have, uh, going on a lot of the time.

[00:16:36] Dr. Joep Kuipers: What I, I remember when I had a friend who was very much into Karl Friston, the researcher, and he explained that the measure of anxiety is a prediction for the amount of energy you're gonna have to expend for something. So if you're imagining, for me, let's make it personal, giving a talk on a big stage for a lot of people, you get very anxious because your body's thinking about how much energy it's [00:17:00] gonna have to expend.

[00:17:00] Dr. Jup Kuipers: And they did these measurements, like these lactate measurements, where they saw that the lactate rose very high, like some people up to 20, if they imagined, like, a conflict with their boss. So there's a very real physiological event or reaction from imagining threats that might happen in the future. And so that has health effects.

[00:17:22] Dr. Jup Kuipers: That's why people get stressed out. The blood gets more acidic. Cortisol rises. So we all know that imagining things or bad things going to happen to you have real negative physiological consequences. But the thing is, you're not sure it's gonna happen, and that's where things go wrong, right? Every time I used to give a lecture, you're always mi- uh, thinking about, oh, am I gonna say the right words?

[00:17:47] Dr. Jup Kuipers: Is it gonna be received well? And after the lecture, you think, oh, this went horrible. And then the feedback comes in, and people actually really love it. So every time you make a prediction, that's not [00:18:00] true. That's not the way things play out. And so that l- teaches you that there's no use in predicting outcomes until the event is there.

[00:18:14] Dr. Jup Kuipers: Yes, you have to plan for things and be strategic, but you can ask yourself, is there something I can prepare or do now? If there is, what is it? And if there's not, there's no need to keep rehearsing the scenario in, in your head. This distinction is to... is not present mindedness versus ambition. Is this purposeful preparation versus becoming absorbed in a prediction?

[00:18:35] Dr. Jup Kuipers: Um- 

[00:18:35] Dr. Ted Achacoso: Well, there's also, there's also a thing that we do as humans, right? And we know this. It's called catastrophic thinking. When you're looking at the future, it's like all we see is because the brain has a negative bias, and that's what made us survive in evolution, right? So we always have this cat- tendency towards catastrophic thinking, that things will go wrong, and, you know, it's gonna rain during the event, and this and that.

[00:18:58] Dr. Ted Achacoso: You're worrying about things that we [00:19:00] have no control of. You have no control of the weather. You have no you know, you have no control of, uh, uh, you know, of a lot of things that's going on around you. And so you have a, you know, and then you, you bind this to a negative bias with brain, so you think of a catastrophe.

[00:19:13] Dr. Ted Achacoso: And it, you know, that's a very well-known phenomenon for us humans to have catastrophic thinking about, you know, giving a lecture in, in a crowd or undergoing a, a surgery, for example, or a pr- or medical procedure. You always have catastrophic thinking. Right? And, well, you could see the catastrophic thinking actually memorialized in the waivers that you sign in your medical forms, right, before you get a procedure.

[00:19:36] Dr. Ted Achacoso: So those, uh, you know, you also see the catastrophic thinking in the insurance documents that you sign, you know, before paying your premiums. So those are, those are the kind of things that, uh, basically ensnare us into a basically unhealthy mental state, right? Because you're thinking of, uh, things that have, as, uh, Dr. Jup said, uh, things that, uh, have not yet happened, and it's probably not going to happen, right? If you're, if you did [00:20:00] everything that you can prepare for something. 

[00:20:01] Boomer Anderson: All right. So catastrophic thinking brings us on to the next one, which is don't think. Avoid trying to label what's happening right now or overanalyzing what's happening right now.

[00:20:12] Boomer Anderson: Uh, Dr. Ted, you kind of merged these two, but let's go to you for this one. 

[00:20:17] Dr. Ted Achacoso: Don't think means that when you, when you're actually... So this is, uh, one of the things that I do, right? I plan my day for only, like, 30 minutes to an hour in the morning, and then the whole day is left for execution. During the time of execution, I don't think anymore because the time for thinking is over.

[00:20:33] Dr. Ted Achacoso: Really, in all of these rules that, uh, we have in RITEC, except the R, in, in all of these rules, there is one thing that's actually prevails on all of them. It's the attachment to all of these thoughts, attachment to the past, attachment to the future, attachment to the outcomes of the present moment. If you're acu- uh, uh, you're executing something and you are, you are at the same time thinking, "Is this being [00:21:00] well-received?"

[00:21:00] Dr. Ted Achacoso: It's like in, in, in real time you're actually judging yourself, and the ego is very good at this because it does j- judging, you know, uh, all the time. And you see this is in comedians. You know? They hear it whether the audience is laughing or not, and the external validation that comes. If you keep on thinking during that moment, you're gonna fail as a comedian, right?

[00:21:19] Dr. Ted Achacoso: You go and, and execute your set the way you're, you have rehearsed it. And if not, then the next time you're going to adjust it according to your audience. You know? The, the Scottish audience may be less, uh, receptive to your jokes as, uh, would be the American audience. So you could see that the, uh, that there being attached to what you're thinking at the moment, actually you're, uh, basically s- uh, y- steering something or, uh, i- uh, that's cooking that's not supposed to be steered.

[00:21:46] Dr. Ted Achacoso: It's supposed to actually go and cook by itself without, uh, without any, any, any additional steering. So don't think it's that. You know, don't get attached to the, uh, what's going on at the moment. Yeah, you could take a look, you know. If anything goes wrong, you [00:22:00] do the, the minor adjustments, you know, that, that you know that are go- g- going to need to get done.

[00:22:04] Dr. Ted Achacoso: But don't be wedded to the outcome of what's going on in terms of, you know, what's going on, right? And we are also always wanting to, to a- attach ourselves to, like, yes, you know, I want this to be so successful that I'm gonna judge myself at each minute that I'm doing a lecture presentation to a group of people to which I'm anxious, uh, of, of doing, right?

[00:22:24] Dr. Ted Achacoso: So the- these are the kinds of things that, that you, uh, realize that I am so attached to the outcome of this. And when you are, when, when you're doing that, you know, it's, it's more likely that you fail in, in your delivery rather than, uh, you know, not, uh, not, uh, thinking or even overthinking the process, uh, of doing that.

[00:22:45] Dr. Ted Achacoso: But the attachment, uh, to the thinking process is actually the thing that will get you. 

[00:22:49] Boomer Anderson: All right, so next one. Moving, marching right along here. Don't examine, don't try to figure anything out or judge your own mental state. I, I think I can step in and take this one. So [00:23:00] a common one here is analysis paralysis, right?

[00:23:02] Boomer Anderson: I- in the sense that, uh, you try to think of almost a Monte Carlo type situation, simulation for, uh, what's going to happen next. Uh, and then you proceed to judge yourself. A very common trait of this particular nail is, uh, perfectionism, right? And so Dr. Ted just alluded to the consistent judgment of one's self while you're presenting something or even, uh, while you're executing a particular project.

[00:23:33] Boomer Anderson: How did you hold yourself? Did you get off that call and present yourself well? That's exhausting, uh, as somebody who has, uh, suffered from perfectionism for most of their life. But It's also, uh, quite a distraction from just being. And so one of the ways, you know, uh, as Ted alluded to in how he h- sets up his day is it's very similar how I set up mine.

[00:23:55] Boomer Anderson: It's write down your handful of priorities, and there's probably no more than three priorities of what you [00:24:00] have, uh, to start the day. And the rest is execution. And just one of the things that I like to do is only schedule 60% of my time if I can, and that way the 40% is up for variable, uh, tasks because ultimately there's gonna be some fire to put out, some, you know, the baby's not gonna sleep the night before, or you're going to have to deal with something unexpected.

[00:24:22] Boomer Anderson: And so that examining, that analysis paralysis actually takes you out of that state of being present. And since we're moving from, I guess they call it the information age to the presence age, or actually I think it's the attention age now to the presence age, I think th- this is a good nail, uh, to focus on.

[00:24:37] Dr. Ted Achacoso: No, you mean attention hijacking age. 

[00:24:39] Boomer Anderson: Yeah. Yeah. It, I, I saw a good headline that it's like we're now transitioning from the attention age to the presence age because we're going so much in the way... Like, we've gone so far in the way of attention hijacking. 

[00:24:52] Dr. Jup Kuipers: I heard this other podcast the other day, and it was about iatrogenic psychological [00:25:00] damage that we see, like the younger generation these days have a much higher incidence of depression and anxiety.

[00:25:07] Dr. Joep Kuipers: And this psychologist was explaining that a possible explanation for this is that they're constantly, uh, evaluating their inner state. They're encouraged to see a counselor to talk about their feelings. And if you just keep asking them, "How do you feel? Are you depressed? Well, how did that make you feel?"

[00:25:26] Dr. Jup Kuipers: Then yes, you're gonna feel slighted by someone or depressed or anxious. Instead of if you're just not thinking about monitoring your state and you're engaging your activities, there i- there are no thoughts about, "Oh, this is shitty. I feel horrible." So we're overanalyzing our internal state, and it's possibly actually harming the quality of our psychological, well, health.

[00:25:53] Dr. Jup Kuipers: Well-being. 

[00:25:54] Dr. Jup Kuipers: Well, uh, that analyst is probably going to be hated by two, two pharmaceutical companies, right? [00:26:00] Makers of antidepressants- ... and makers of ADHD medications. So I, I am not kidding. So... 

[00:26:08] Boomer Anderson: Yeah, the attention hijacking economy has benefited, uh, quite a few people. Um- Pharmaceutical, always ... so let's, uh, let's dive into the next one, guys, shall we?

[00:26:16] Boomer Anderson: Don't control. Uh, don't try to make anything happen or force a result. Uh, let me go over to Dr. Sherr. Uh- 

[00:26:25] Dr. Ted Achacoso: Who is a control freak. No, actually. 

[00:26:30] Dr. Scott Sherr: Well, the, the thing about control is how little we all have, and this became very- 

[00:26:35] Dr. Ted Achacoso: Oh, you mean how we don't have any. 

[00:26:37] Dr. Scott Sherr: Uh, yeah. I mean, micro-control, you know, maybe.

[00:26:41] Dr. Scott Sherr: If you wanna call it, we're gonna go into the free will argument here. We could go there, you know. That's the other piece that's overhanging this entire- 

[00:26:48] Dr. Ted Achacoso: Yes ... 

[00:26:49] Dr. Scott Sherr: nail, okay? But the idea for me came very much forefront, Boomer has this experience now of having a new child, right? If you have a baby that's crying [00:27:00] and won't stop crying no matter what you do, you feel like you're helpless.

[00:27:05] Dr. Scott Sherr: And, and you realize that this lack of control isn't everything. It was just coming to a head in this particular case when I was 30 years old with my first child, and realizing that what I thought I had control over, I had no control over, right? And, and over the years, that, uh, that, uh, as we get older, for most of us, we realize that we wind that down to very minute things we actually have control over, like maybe the time of day we brush our teeth.

[00:27:31] Dr. Scott Sherr: Um, but you could say that that was predetermined by your thought processes and everything else that came back before it. Um, and that's the real i- real idea here is the idea of free will, right? Which is how much actual will do we have to make decisions? And- The, the, what, what the crux of this is that we have very little.

[00:27:50] Dr. Scott Sherr: So if you want to have less anxiety, then release this idea that you control anything, because they're very much intertwined, as [00:28:00] we all probably know as we think about it. Because if you try to control something, you can't. Things happen a different way. You get more anxious about it, and it's this perpetual cycle of thinking we can control things that we cannot.

[00:28:11] Dr. Jup Kuipers: What's 

[00:28:11] Dr. Joep Kuipers: the 

[00:28:11] Dr. Jup Kuipers: quote you always give, Ted? "When I was young, I wanted to change the world. When I was old, I wanted to change 

[00:28:18] Dr. Joep Kuipers: myself." "When I was wise, I wanted to change myself." Mm. That's a Rumi quote, right? "When I was young, I wanted to change the world. When I was wise, I wanted to change myself." So my quote there that follows, that's why I usually like following quotes of, uh, well-known people, is, "Change myself, change the world."

[00:28:34] Dr. Jup Kuipers: But I would like to add on to something that Scott said there. It's like you think you have some control, you actually have, don't have any. You don't even know why you decided to, to do something, right? And, uh, the dis- the discussion of free will, you know, I belong to the, I used to belong to the, hey, you know, we, we can have, you know, the, uh, it's the, the Dennett interpretation of things.

[00:28:56] Dr. Ted Achacoso: Mm-hmm. Mm-hmm. Like, uh, you, you, you, you can, you can actually have free [00:29:00] will as long as you don't do these things, right? It's like, what, where the fuck is the freedom in that, right? Where's the free will in that if you, as long as you don't do these things, it's still a set of rules, right? And so, and that's my main quarrel, uh, with, with, uh, or with, with that whole, um, movement.

[00:29:16] Dr. Ted Achacoso: But for me, uh, it, it's like, uh, you know, it's not even a, a, we have an illusion of control is what I say, right? What we have is an illusion of control. But free will itself is not an illusion. You know, there's a difference between an illusion and something does not exist, right? A mirage is an illusion, but it does exist.

[00:29:36] Dr. Ted Achacoso: A rainbow is an illusion, but it does exist, right? So, uh, you could see there that, uh, you know, is it, the, the question is different when you say, uh, does free will, uh, is, does, does free will exist? Is it an illusion, or does it not exist, you know? And, um, you know, I belong to the do not exist camp, essentially, because if you study the, the issue long enough, you know, [00:30:00] you will see that, that everything is...

[00:30:02] Dr. Ted Achacoso: You're like an LLM, right? You're very context sensitive. You respond according to context, and the context is not only according to what is coming to you or what you perceive is coming to you. There's also, uh, you know, internal proprioception, that you're constipated, you're irritated, right? So you're hungry, you're angry.

[00:30:19] Dr. Ted Achacoso: Like, it's like you, you don't even, uh, you cannot even control these things. They just arise naturally. It's just like, you know, what beats your heart or, you know, uh, you know, what makes you breathe when you're asleep, right? There's, there's no control over this, right? There, there's no free will, uh, over those things.

[00:30:34] Dr. Ted Achacoso: You didn't choose your genes. You didn't choose your parents. You know, those are old arguments. But I have actually, um, you know, a, a shorter one Right? For me, the ego or the self is an illusion, right? And, and an illusion cannot have A free will, right? So, so j- an illusion cannot have free will, uh, uh, b- because it's an illusion, right?

[00:30:57] Dr. Ted Achacoso: So, so, so you, you can see- Well said ... [00:31:00] that that actually- Yeah ... uh, this is the first time I actually said this in a podcast. It's what I've been thinking all along all these years to, to make the argument shorter that there's no free will. If the self is an illusion, then the self doesn't, doesn't have- the free will doesn't exist, right?

[00:31:14] Dr. Ted Achacoso: So, uh, that's the, that- that's my shorthand argument to, to everything. Rather than writing tomes of book about it with Sapolsky and, you know, uh, Harris- 

[00:31:24] Boomer Anderson: I, I was just gonna say, like, Sapolsky and Sam Harris, uh, albeit if you like science, Sapolsky might be the better read for this one, um, are good references for people to dive down that very large wormhole.

[00:31:38] Dr. Scott Sherr: That's the first, that's the simplest you've ever said it, Ted, on a podcast. I like that. Yes, 

[00:31:41] Boomer Anderson: yes. All right. All right. Uh, I wanna wrap things up with rest. And so, uh, the last R, and I think the most appropriate person to talk about this is Dr. Ted, so we'll go right back to you. 

[00:31:54] Dr. Ted Achacoso: Well, um, you know, the relaxation that we are talking [00:32:00] about it is the present moment awareness, right?

[00:32:02] Dr. Ted Achacoso: With that, that which is thought during, uh, meditations and, uh, you know, and, and all of that. True, they have all of their physiological benefits, et cetera, but I encourage people not to do it because of that, you know? And when you're, uh, rested in awareness, it, it means that you are, you, you can just consider your body and everything that's in it as just another thing that's arising in awareness, right?

[00:32:29] Dr. Ted Achacoso: So you begin to detach from your identity as the ego, that I'm the doctor, I'm the teacher, I'm the this, I'm the that, right? And suddenly you're just one of the things that's just floating in space, right? Uh, you're, you're just that space, you know, where the, where the Dr. Ted arises, where the Boomer arises, where Dr.

[00:32:48] Dr. Ted Achacoso: Scott or Dr. Jup arises. And, uh, it's very easy to do this. You know, it's, uh, been, been, um, uh, uh, written up, uh, many times by the glimpsing process [00:33:00] of Loch Kelly or even by the, the short, um, uh, meditations by Sam Harris, right? They, they do this. They, they glimpse in the present awareness. Like as you're opening a door, you know, you are just opening the door.

[00:33:13] Dr. Ted Achacoso: You're not arguing with someone inside your head. So feel yourself, of, you know, uh, hold the door handle and open it without thinking of anything. In fact, I do this to my patients. I call this the happiness game, right? Uh, I, I tell them, it's like, "Okay, let's play the happiness game." I said, uh, "When I say now, you know, tell me how many seconds is it before your actually have a mind has a thought.

[00:33:38] Dr. Ted Achacoso: When your mind has a thought, let's repeat it back to zero," right? And, and it's a game because they, they realize that they could not for, for even just a few seconds have, you know, have a rested mind as a mind That does not, is not thinking about anything. Look, there's nothing wrong about thinking. It's being attached to the thought that actually does it.

[00:33:57] Dr. Ted Achacoso: So for me, relaxation [00:34:00] means, you know, uh, i- relaxation here means that, uh, uh, the visual that I usually give, uh, when, when, when I'm, uh, when I'm, uh, trying to explain this is that you cannot grasp on water. Life is always flowing. You cannot grasp life with a closed fist, you know? You allow your hand to open, and life flows through Right?

[00:34:21] Dr. Ted Achacoso: So, uh, essentially, you, you're not, you're, you're not basically swimming against the current. You, you relax, right? You relax and that the current, uh, the, the current will know where to take you. So even in the smallest of things, like I find myself walking downstairs, and there's-- Boomer calls me up for some fire that has to be decided on, right?

[00:34:43] Dr. Ted Achacoso: And then I'm walking down the stairs, and I have all of these images of the catastrophe that will happen if this decision is done or that decision is done, like. And then I remind myself, "I am just fucking going down the stairs. Why am I thinking about these things?" Right? The present moment is what it is.

[00:34:58] Dr. Ted Achacoso: There is a time and place [00:35:00] for thinking of solutions, which is at your planning stage, 30 minutes, uh, in, in the morning. That's where you, you, you, you put it all, right? And there are mental habits that you can develop, right? Uh, in fact, uh, someone has written about atomic habits in a, in a book. Like small little things that, that-- little mental habits that you have that can be switched, right?

[00:35:20] Dr. Ted Achacoso: Uh, that could be changed, uh, to something else. But the, the biggest practical exercise you could do is just feel what you're doing now, right? If you are talking to your child or you're talking to a loved one or you're talking to a friend, be there 100%. Don't think about, "Holy shit," you know, "I have a meeting coming up," right?

[00:35:41] Dr. Ted Achacoso: Uh, and I have to wind this down very, very quickly. You look at the clock, and you gracefully know that that's your time, but you have to be present for the persons there because that, that, uh, that time will never come back to you, right? You have the-- either you're present now or you're not present at all.

[00:35:58] Dr. Ted Achacoso: The next moment-- [00:36:00] You know, Scott, you said we should mention about the two pi seconds. When I was younger and in my, in my, uh, late 20s, uh, I, I, I, uh, co-authored a paper that was presented in Guadalajara, Mexico, on how long the present moment is. Um, when I came out to-- The present moment actually computes about two pi seconds, right?

[00:36:20] Dr. Ted Achacoso: The paper was written all in Spanish even before trans-translations were available. Um, but the Italian group, I think, came out with about seven seconds, which is, uh, close, close to our approximation. So you could see, uh, the, the, the visual of actually, uh, a present moment is very simple. If you are on a train, seated on a train, how long is that window before the scene completely changes?

[00:36:44] Dr. Ted Achacoso: So it's a running train, and how long is that, uh, how long is that? And from my calculation, it's two pi seconds if you want to do a calculation of present moment. For, for, uh, a lot of people, that's a travesty to compute it, but, you know, we have-- You know, in, in health optimization medicine [00:37:00] Qua- quantitation is the core of what we do, right?

[00:37:03] Dr. Ted Achacoso: We have to measure everything before we can say, "Okay, this is how we optimize it." So what we're d- optimizing he- here is your presence in those two pi seconds that will never return to you, right? And in that process, you are actually more present with your friends, your patients, right? Uh, you're genuinely, you genuinely express your empathy, uh, towards them, uh, you know, especially your cognitive empathy, uh, towards, uh, what they're going through, right?

[00:37:28] Dr. Ted Achacoso: And you're able to make, uh, better decisions, you know, as regards their, um, health and wellbeing. 

[00:37:35] Boomer Anderson: All right, guys. We gotta wrap this up. Um, Dr. Ted- Time to rest ... Doc- yeah, Dr. Scott, Dr. Jup. Uh, really a pleasure. I always enjoy these sort of fun side conversations away from our typical format. But, uh, a tool for everybody out there to re- relieve yourself and others of mental angst, the six nails of Tilopa.

[00:37:56] Boomer Anderson: Uh, this has been a fun episode of the Health Optimization Medicine [00:38:00] podcast. If you're watching this on YouTube, uh, smash that like button, click subscribe, leave a comment. We read all of them, and we'll see you guys next time

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