James Maskell:
Hello and welcome back to the Big Bold Health Podcast. I’m your host James Maskell and I’m here with Dr. Jeffrey Bland, my co-host as ever. Great to be back with you doc.
Jeffrey Bland: James, I can’t tell you how much fun we’re having. This is so great to have these great opinion leaders and what we’re learning from them.
James Maskell:
Well we’re super excited to bring female leaders charting a course to a more personal era in medicine and in health. And so we’re super excited to have Andrea Nakayama here. Andrea and I have been friends for a number of years and I’ve just seen you blossom into an incredible educator in our world, and helping thousands of practitioners really get on this wave that Dr. Bland was surfing since 1960-whatever.
Andrea Nakayama:
Yes absolutely.
Jeffrey Bland:
A lot of fall off the board though.
James Maskell:
So you know, I know for many people who end up in this world, there’s like a really powerful personal story and I know that you shared that on the functional forum before. And I think maybe that’s just a great place to start because it really has, I know, driven your work for decades now.
Jeffrey Bland:
And as Andrea gets into that, I just want to thank you so much for again your honesty, your openness, your leadership as it relates to teaching by example, by story. I think it’s the most powerful way to communicate if we’re willing to give ourselves over to that, and you’ve done it so elegantly. So I just wanted to, before you tell your story to thank you for it.
Andrea Nakayama:
Oh, I really appreciate that. I think it’s something that actually positions us as practitioners and also helps us relate to our patients when we’re open and honest without asking anything in return. And for me, sharing my personal story and my personal journey is really a way of sharing that I’ve been there. That I know what the hardship is like. And when we do that we are able to really relate to one another much better. So for me, my journey in health and nutrition was really catapulted by my husband’s diagnosis with a glioblastoma, with a stage four brain tumor, when I was pregnant with our son who is now in college. So it’s a long time ago and he wasn’t expected to live beyond six months, which was in those days, the prognosis for that kind of tumor. And it was a wakeup call in the biggest way, we were aiming to help him live and have some longevity as much as possible.
Andrea Nakayama:
They didn’t think he’d lived to see our son born. So we changed everything. We changed our entire life, all diet, lifestyle modification, habit change. We really looked at everything in our lives. We stepped back, we slowed down, we considered everything we knew to consider. And as a practitioner, I think of that time as my bootcamp. I had to learn a lot about the brain, and the brain and the gut, and how the brain functions, and what foods feed the brain, while also supporting my own body and a growing baby. So, that was a wakeup call in a lot of ways. Like I said, Isamu, my husband lived two and a half years, so he was there to imprint on our son’s life. And it really showed me that people are not their diagnosis, because everywhere we went Isamu was treated like a walking dead man. And that was a whole other sort of wake up for me in what is true about our medical establishment, and how attached we are or we get to an identification with our diagnosis, but also how that happens to us as patients.
James Maskell:
You’re stepping into some Jeff Bland territory right now.
Jeffrey Bland:
Yeah, I think that this whole question of what is a patient? A patient is a person who generally feels like a victim. And that there’s a rescue out there that’s going to set them up for potential disillusionment, because the rescue doesn’t actually come through that other person. So you are a wonderful guide in helping us to understand how we orchestrate a different script. So maybe you can tell us about then how you transform that into the orchestration of your pathway and now what you’re doing for many, many others.
Andrea Nakayama:
Yeah. Thank you. I am fascinated with the field and the story of the patient, and the role that the story plays in a patient’s journey into health, which I want to talk about. But a recent fascination came from my son and what he’s studying in college and sociology. And it led me back to the Chicago School of Sociologists who were looking at the field of medicine and looking at the journey of the patient, and what the difference is in a journey for a patient who has a chronic illness. So not an acute illness, not a chronic disease, but a chronic illness. This is back in the late seventies and eighties, but it hadn’t really made its way or hasn’t made its way fully to the realm of clinical care and how we are treated as patients. And when I say we, I have Hashimoto’s, I struggle with other autoimmune issues, so I get it myself.
Andrea Nakayama:
But this journey of not knowing what’s going on, not understanding what’s going on in our bodies, really searching for the person who’s going to label it. Getting very excited to receive a diagnosis cause this is going to lead to the solution, and then not having that solution and the distrust that comes from that journey is one that’s really fascinating to me and contributes to the state of health that we are looking for.
Andrea Nakayama:
So for me the story is a critical part of understanding the patients ourselves, our journey to health. What our genes, yes, but what’s happened in our lifetime? What are the stresses? For me, looking at the fact that I was going through a tremendous amount of stress while my hormones were changing so much. That is a terrain in which a lot is going to go wrong. And then the mediators, as we look at in functional medicine, those ATMs, the antecedents, the triggers and the mediators. The mediators are a place of ownership, they tell us what works for me, what doesn’t work for me? And I like to remind patients that’s where our health starts, when we start to be able to identify for ourselves, this works for me, this doesn’t work for me. That’s when we get the controls back.
Jeffrey Bland:
So as you’re counseling people, and I mean this is a brilliant strategic way of using stories in a therapeutic context, how do you start that journey with the person so that they will become their own story?
Andrea Nakayama:
Yeah, that’s a great question. And I think there’s a lot of amazing leaders like yourself and Dr. Leo Galland, who really positioned for us in the realm of functional medicine, what story means. And I’ve tried to take that and amplify it in the clinical relationship. And it really is about a therapeutic relationship that sees the patient. As patients, we want to be seen. We want all of us seen and we want those connections made. So for us, in our clinic at the Functional Nutrition Alliance, what we’re doing is spending a lot of time in that area of motivational interviewing.
Andrea Nakayama:
So we’re taking that intake, we’re mapping it on a very extensive timeline. And we’re going deep into the inquisition of what else was happening in your life at that time that you started to experience that symptom? And what did that feel like for you to not be heard or to be searching for something that you weren’t getting? Or what was happening in your life and your family life or in the stressors in your life? And just that conversation starts this wake up process where people start to come back to themselves. I like to think of it as going from, “Why me?” To, “Oh, me. That’s my story.” And when we take that ownership, we make these connections and we actually get back in control, because we can see this isn’t happening to us, it’s happened along the way.
Jeffrey Bland:
Well, I think that’s really a brilliant context. I think about James and I, and our advocacy for Big Bold Health and we’ve talked many times about why did we choose the terms or the words big and bold before health? And it’s because I think many times people are either apologetic, or condescending, or dismissive, or feeling they have no control over, therefore their locus of control is completely lost. And so health for them is a femoral thing that sits out there floating, of which they have no direct ownership. And now what you’re really talking about through the story is a sense of re-energizing the individual, the fact that they are actually in ownership and they should be very bold about their ownership and they should be big in their advocacy. And you can just get that from the way you contextualize and you communicate this. It comes across to me. You’re talking about being big and being bold about the ownership of your health.
Andrea Nakayama:
Yes and I believe that also extends into understanding how our body works. So we understand our story, but there’s a huge educational element that we as patients deserve in understanding what’s going on in there? Why is that happening to me? What are the connections that, “Oh that digestive distress is actually connected to my anxiety?” And we as patients are missing that understanding and that depth that comes into connecting our story with what I like to think of as the soup of what’s going on in the body, and how we make those connections so that we make decisions based on that understanding. So that boldness extends to, “This is my life and this is my vessel. And I want to know all of it in the big, bold way to bring me forward.”
Jeffrey Bland:
Well said. James that’s what we’ve been trying to get across. I think we have Andrea doing our communication message for us.
James Maskell:
I mean absolutely. I mean I think that really, the ownership of that part cannot come from anyone else and no one else is responsible for it. What are some ways that you found to really reinforce that way of looking at things, which is not the typical way that we’ve been taught in society?
Andrea Nakayama:
Yeah. I’m a big fan of systems. So for me, when we have a system, we know where to start with ourselves. And I think that a lot of us as patients get stuck in looking for the one fix. That might be a pharmaceutical agent or it might be a nutraceutical agent. We’re tuning into things where we hear about a symptom and a resolution and we go for it. So there’s a lot of self-prescribing to get to the fix. And this is all influencing the epigenetics. And so I like to think of the three tiers to epigenetic mastery or nutrition mastery as tier one, the non-negotiables. Tier two deficiency to sufficiency and tier three dismantling dysfunction.
James Maskell:
Jump into those.
Jeffrey Bland:
Yeah, those are big, help us.
Andrea Nakayama:
Yeah. So oftentimes we want to skip to tier three. We want to dismantle the dysfunction. “Oh, it’s Epstein BARR virus. It’s Clostridia, let me just nail that. Or it’s Lyme disease. This is what I’m going to do.” And what we see in our clinic is that oftentimes, people’s body isn’t ready for that intervention. And the tier one and tier two work is how we ready the body. So non-negotiables are different for each of us. They are really individualized and I can say with anybody coming into our clinic who’s what I call a big, big. So a big health issue, and I’ve already made a big bold effort, but they’re still not getting better. That person, maybe they have to be off of a number of foods, there’s an elimination diet that’s in place. Oftentimes they’re going too far down the realm of elimination and we have to make sure their diet is more broad. So what are the non-negotiables for each individual?
Andrea Nakayama:
And they’re going to be different with the foods. They’re going to be different with how we seek pleasure and joy and sleep. We can’t just say, “You have to sleep.” We have to say, “What’s going on with your sleep? Let’s actually assess this before we recommend. Track how that’s going for you.” I like to say that if we’re not sleeping, we’re not pooping, and our blood sugar is not balanced, then it’s hard to pass go. So those are some non-negotiables. But what that looks like is going to be different for each and every one of us. Your way of seeking joy or pleasure may be different than mine. Where does laughter fall in our life, relationships, community, what do we need? And there’s a uniqueness in there. When it comes to deficiencies, deficiency to sufficiency.
Andrea Nakayama:
I like to think, yes we need to test not guess, and look at vitamin D and B vitamins, and hormone balance. But we also need to look at deficiencies in stomach acid or in love, or in other things that actually, optimism. Do we have a deficiency in optimism? And we know the relationship between optimism or lack of optimism and heart disease. So how do we take this approach and say, “Am I really addressing personally, my non-negotiables? What is a non-negotiable for me?”
Andrea Nakayama:
I know I need to tune into podcasts and listen and always be learning. It’s a non-negotiable. I know I need to spend time in nature and be in the forest and hike, you need to be out on a boat. What are the non-negotiables and how do we make sure that we are infusing those in our lives, even before we show up to get other therapeutic help? And that’s how we also bring our story into the picture. We really know ourselves and make sure we’re tending to those things.
James Maskell:
So maybe wherever you’re listening to this or watching this, maybe it’s a good time to press pause and just write that down. Because I think that ultimately, typically most people’s sort of entry point to even having that conversation is in the disease cast system where something’s already gone wrong. And ultimately here at Big Bold Health, we’re starting with that. We’re starting with these concepts of what does health mean to you? That’s the story. And then talking about these non-negotiables. And I think it’s such an important part and ultimately, Jeff’s vision here and, and where we’re heading is to, to make that just a part of human experience, right?
Jeffrey Bland:
Yeah. And as you’re speaking Andrea, I’m thinking, what about this obesity epidemic that we’re experiencing right now? And I think about food as being potential energy, right? So we consume this potential energy and then it’s trying to find a home in our body to do the work that we want to do. But if you’re blocked on all these things that you’re just describing, your story is all congested. It has a difficult time going from the potential into its energy of use. So it gets stored for a rainy day that never comes. So now we call that obesity. So someone says, “Well, you’re talking about a behavioral relationship to obesity?” I’m saying, “Yeah, it’s not just an eating disorder.” It is a metabolic, a symphonic mal-orchestration that we’re talking about because the story got blocked.
Andrea Nakayama:
Exactly. I like to think of it as, “Yes, and.” There’s always an and. And this is where the notion of -omics comes in and all the connections. And for me that importance of the epigenetics, really understanding that the terrain, everything we do matters. Lunch matters and how we eat lunch matters. How we think about lunch matters. It all matters, and I don’t say that as pressure. I say that more as you get to choose. And everything matters.
Jeffrey Bland:
Yeah. I think that that concept you just stated, if a person deeply feels unworthy of good health, they have a psychological sense of, “I’ve not got a lot of attribution, I’ve not got a lot of support, I’ve not got a lot of love, I’ve gotten not a lot of sense of being appreciated. Then maybe I’m not worthy.” And that unworthiness then really can work the story, can’t it? And it sends you on… kind of a, I know you talk about the roots and the and the limbs. So now you’re really affecting how energy travels through the tree of life.
Andrea Nakayama:
Absolutely, and when we’re tending to a tree, I think we can also just focus on those roots. But really what influences those roots is the soil. And the soil is that everything matters. All of those things are bathing those roots. And that’s what’s influencing the expression of those branches.
Jeffrey Bland:
So as you get to this in the clinical world, knowing that there is some kind of an interruption in the story flowing out to the sea of goodness, how do you then assist that person along this journey so that they can reacquaint themselves with a positive nature of their being?
Andrea Nakayama:
With a lot of empathy. So we take the pause, we really take our time to assess who is this? Who is this and what do they need? So instead of imposing a protocol that is the same on every individual, “Oh, this person has autoimmunity or Hashimoto’s or lupus or whatever it is.” And saying, “Here’s the protocol, here’s what we always do.” We say, “This is a person. This is a person who had a number of things that added up to a tipping point that is that diagnosis, or that sign or symptom.” And we want to figure out, who are you? And how can we best serve you and do it at a pace that’s appropriate for you. And I think that this is a lesson we need to remember for ourselves as well. We’re often rushing ahead and I love that Dr. Ben Lynch always says, “health is a four-letter word: work.” We’ve got to work for it. It can be big and bold and we can own it, but we do need to do the work. And sometimes we’re wanting the quick fix even when we realize it doesn’t exist.
Jeffrey Bland:
Yeah. It just reminds me of a conversation I had just a couple of days ago. I had to kind of bite my tongue a little bit because I was tending to go into being preachy. And so this person who is a very well informed person, very big health advocate, was giving this story about one of his good friends who had four autoimmune diseases. Four different diagnoses, and that they found a treatment through lifestyle, intervention, through nutrition, that was able to treat all four autoimmune diseases. And of course I wanted to say, “There weren’t four autoimmune diseases. There was just a disturbance of the immune system that manifests itself into a symptom cluster that could be put into these names.” That wasn’t they had four diseases. They had a major disturbance of their immune patency, which by getting rid of the blocks and filling in the holes, the Sid Baker model, take away the bad stuff and give the good stuff, it corrected. So I think your model is so sane, it’s so logical, but sometimes logic is difficult to get across.
Andrea Nakayama:
It is. And I think it brings me back to the original story and what I experienced with my late husband and seeing him treated like his diagnosis. For me, he was my love soul mate, a man who was about to be a father, and a brother, and a son. And we would walk into doctor, after doctor, after doctor, and they would whisper I’m pregnant. He has a brain tumor, stitches in his head and sometimes not even speak to him. Which I was thinking, “This is a standup guy, you want to talk to him.” But they would talk to me like he wasn’t even in the room because of his diagnosis. And that was really that wake up, that we are individuals, we are not our diagnosis and we all get to that diagnosis for a different reason. And that diagnosis even manifests in different ways. So how do we bring in patient-centered care and bring that attention to ourselves so that we’re recognizing, “I’m Andrea, I’m not my Hashimoto’s.” So that really starts to reframe how we care for ourselves.
Jeffrey Bland:
So James is this not actually the manifestation of what we say in Big Bold Health?
James Maskell:
Yeah, absolutely. That’s one of the reasons why I really wanted Andrea to be here, because I’ve felt that energy coming through from the years that we’ve known each other. And I just feel like she’s such an incredible advocate for this. And ultimately, what I see is that we’re all involved in building the army of people that can really be the transformative agents for health. But on the other side of that, and who we’re talking to here today with the podcast and otherwise, is that the army’s only here to be a reflection back to you, right? That’s a new kind of an army. It’s a different kind of an army. But just be prepared for what it’s going to be like when you come into contact with the army that we’re sending out there. Because ultimately, the work, as you said, the four letter word really is going to be done by everyone who wants to live a long and healthy life.
Jeffrey Bland:
Sometimes the word work sounds very grueling. It sounds very imposing, but actually work can be uplifting. It can be releasing, it can be freeing. It can be achieving your sense of self-actualization opportunity. And so it should be work that really creates the magic of living. And I think that is the greatest gift that we ever can have is to pass over that threshold for more where we feel a victim to where we feel the master of our own health.
Andrea Nakayama:
That empowerment that we can have when we embrace health as a big bold opportunity in our lives. And each of these challenges that we all experience are opportunities. And I know it can be hard to look at it that way, but when we have the right mindset, the right support system, and mindset is definitely part of the terrain, part of the epigenetics that influence everything. When we’re able to have that reframe, we really can look at what’s happening and make a different change into work being life.
James Maskell:
Well, I think that’s really the reason why I’m here is because what I recognize, is that transformation is what’s essential for humans to reach their potential. And in no other way apart from health, are you poked into that journey that everyone’s always poked of. And so you always have an opportunity to start to see things differently. And so, that’s the future that we’re all building together. So it’s been an absolute honor and pleasure to have you here.
James Maskell:
I wanted this to happen for a long time and I knew that there would be great chemistry between the two of you and all that.
Jeffrey Bland:
Thank you.
Andrea Nakayama:
Thank you.
Jeffrey Bland:
So we’ve been with Andrea Nakayama. You can find out more about her work at the Functional Nutrition Alliance. We’ll have all the details in the link below. She is building an army of practitioners ready to reflect back all the things that are necessary for this transformational moment in health and creating this big, bold health world that we all are aiming for. It’s been an incredible pleasure to be with you. Share this with someone who needs to hear it. I’m your host James Maskell. We’re here with Dr. Jeffrey Bland. We’ll see you next time.
