In this episode of "Embark Sessions," Rob discusses the science of stress with Dr. George Slavich, Director of the UCLA Laboratory for Stress Assessment and Research, who has a Ph.D. in psychology. Dr. Slavich explains how his early childhood experiences with shyness led him to study psychology. Rob and Dr. Slavich dive into how psychology and biology are connected and how stress impacts our mental and physical health. 

Resources:  

UCLA Laboratory for Stress Assessment and Research 

California Stress, Trauma, and Resilience Network 

Related Blogs:   

Stress vs. Distress: How Do You Help Your Teen Navigate a Stressful World?

How Much Stress is Too Much? A Caregiver’s Guide

Related Videos:  

Personal Growth Through Social Support with Dr. Hansa Bhargava | Embark Sessions 

Deliberate Practice with Scott D. Miller | Embark Sessions 

About Dr. Slavich:  

Dr. George Slavich is an expert on the basic science, assessment, and management of life stress. He conducts research on how stress affects mental and physical health and provides expert stress consultation and management services to major public and private organizations. He is a standing member on several scientific working groups at the National Cancer Institute and National Institute on Aging and has also helped many large companies and universities design and implement brief social-psychological stress intervention programs using sophisticated, computer-based systems. 

Dr. Slavich completed undergraduate and graduate coursework in psychology and communication at Stanford University and received his Ph.D. in clinical psychology from the University of Oregon. After graduate school, he was a clinical psychology intern at McLean Hospital and a clinical fellow in the Department of Psychiatry at Harvard Medical School. He subsequently completed three years of postdoctoral training in psychoneuroimmunology, first as an NIMH Postdoctoral Fellow in the Health Psychology Program at UCSF and then as an NIMH Postdoctoral Fellow at the Cousins Center for Psychoneuroimmunology at UCLA. Currently, he is an associate professor and Society in Science – Branco Weiss Fellow in the Department of Psychiatry and Biobehavioral Sciences at UCLA, and a Research Scientist at the Cousins Center for Psychoneuroimmunology where he directs the UCLA Laboratory for Stress Assessment and Research

About Rob

Rob Gent, M.A. LPC, is the Chief Clinical Officer and one of the founding members of Embark Behavioral Health. Rob has been with the company for 15 years and has led the Embark organization in the clinical development and growth of numerous programs. He is the lead developer of the proprietary CASA Developmental Framework, which is pervasive throughout Embark’s programs.

Through his dedication to advancing clinical development, practice, and research, he has become a nationally recognized expert in the field. His specialization in clinical development is enhanced by his therapeutic expertise and has yielded such accomplishments as the development of; The CASA Developmental Framework, Vive Family Intensive Program, Calo Preteens, Canine Attachment Therapy-Transferable Attachment Program, and other specialized programs.

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Have a question for our experts? We want to hear from you! Submit your questions to: askatherapist@embarkbh.com

Well welcome everybody to another episode of Sessions,

our podcast here at Embark I am just so privileged and super

excited. I've known we're going to do this interview for a

while, and I've been doing some research and just catching up

and it just, like I said, ecstatic to have Dr. George

Slovic, with us today to spend some time with us and to share

in his story. Dr. slavit, is certainly renowned professor at

UCLA for psychiatry, and bio behavioral science. We're gonna

get him to talk about him being the founding founding director

of the stress assessment and research lab, also at UCLA. But

before all that, Dr. Savage, thank you so much for being a

part of this podcast.

Rob, thank you so much. And I'm a huge fan of

what Embark is doing. And I think, you know, in this time

and age we we need the world needs all the all the help that

it can get to, to manage mental health and stay resilient. So

it's, it's just a real pleasure to be able to talk to you about

that today.

Well, great. Well, as excited as I am to talk about

stress and all of your work. I did want to say that, as a side

note, being a little bit, you know, certainly given my age, I

was looking through some of your publications and one that stood

out to me, I smiled and it said 50 years of giving psychology

away an interview with Philip Zimbardo even though it's

written back in 2009, I just I wanted to ask you like, oh my

gosh, what was that like?

So the backstory is that I was lucky enough to do

my undergraduate at Stanford. I'm a Bay Area kid born and

raised. So you know, I traveled a whole 25 minutes away to

college wasn't that far. And, you know, at that time, that was

late, early 2000s, late 1990s. And, and Phil Zimbardo was one

of the biggest guys on campus. I mean, his introductory

psychology class would, you know, fill up and seven seconds

after it was made available on you know, on the course

registrar's website. Zimbardo is an amazing guy. I mean, he

studied shyness and, and mind control and obedience to

authority. And, you know, he's really his, his work is much

broader than just the Stanford Prison Experiment. But long

story short, you know, I, I took several courses from him ended

up being a teaching assistant from him. And and I think, you

know, the most indelible impacts that he's had on my own work in

life, is that is that, you know, transfer of content to students

is really important. But it's not going to be as important as

making other people really excited about learning and about

research. Because if you can make them excited about learning

research, that's something that they can take with them and go

off and make a career of their own. Whether or not it's in the

same thing that you study or not. And, you know, I still

finally remember him saying, you know, the most important thing

for us to do as teaching assistants is to get students

engaged, passionate and excited. You know, it reminds me of sort

of the NC to a advertisements, you know, it's like most of us

will, you know, you know, turned professional in something other

than sports. I think that was that's, you know, Phil's

approach to teaching. It's like most Stanford students will go

pro in something other than psychology. Right? And so the

best thing that you do for a student is really to instill in

them, you know, thirst for learning, passion, excitement,

and that has just really stuck with me.

Well, what if it struck me I don't know if other

people is just I was like, Oh my gosh, and so I opened it up and

I I had no idea that that said that actually, him and Stanley

Milgram, were actually classmates in high school.

There are so many wild stories I mean, human

standard, Milgram were were classmates, you know, in the

Bronx together. Zimbardo moved almost 40 times before he

graduated from high school because he grew up in poverty

with no TV in his house living above a laundromat you know,

almost died from double pneumonia at age six days before

pennants at post MSL and so, you know, his his own personal story

is really is really one of strength and resilience. And I

think, as you said at the at the top, just, you know, giving his

work away. Yeah.

Well, it sounds like that profoundly affected you in

such an amazing way. But if I can ask I know this. To many of

our listeners, there'll be certainly psychologists and

therapists themselves, looking for a deeper understanding is

why I love to do this. So thank you for sharing your story. But

in a similar way, if you don't mind sharing us, you know, you

mentioned being from the Bay Area, but what was your early

life? Like? And how did that shape your goals of psychology

teaching, if you don't mind sharing with us weak,

fascinating.

Yeah, and some of that not to compare myself to

Zimbardo. But as I've learned over the years is some some

similar elements around shyness, and we'll try to talk about but

no, I mean, I grew up in his only child, my parents

immigrated from Croatia. And I was, let's say, painfully shy,

growing up, I remember not not feeling confident enough to ask

to be able to go to the bathroom and preschool, I just couldn't

get the courage to approach people I, I just couldn't sort

of tolerate the anxiety, it was, it was really pretty bad. And I

suppose I funneled my efforts into things that I could control

and that were sort of predictable. So you know, work

in school are good places to focus your efforts if you're, if

you're a shy kid, because you can sort of put your head down,

you know, close there, close the door, put your head down. And,

and just, you know, work on whatever it is that you feel

passionate about. And, and I still remember in college,

having, you know, studying for tests, and just having so much

anxiety that, you know, I felt like I was almost causing ulcers

for myself. And, you know, it was, it was never debilitating,

not like that. But I, but I certainly felt that it was

something that I didn't, you know, it was not pleasurable,

let's say. And then, you know, at some point, the pain just

becomes too much. And you and I should speak for myself decided

to try to do something about it and just go a little bit easier

on myself and take some chances. And, you know, the funny thing

about being shy, which Zimbardo also talks about in his 919 76

book about shyness is that, you know, shy people essentially,

are prisoners of their own minds. So a lot of links between

the shyness work in the Stanford Prison Experiment work. But

essentially, if you're a shy kid, you you don't lean into the

world, you have thoughts that other people don't like you or

won't accept you or that you'll make a fool about your of

yourself that you'll say something stupid. And those

thoughts prevent you from testing those hypotheses. You

don't engage in, you don't engage in social relationships,

you don't go and approach people at parties. And other shy people

probably will resonate with me when I say this is that you

never put those beliefs to the test. Right? You never, you

never approached somebody, and then have the experience that it

went well. And therefore, if you don't have the experience that

it went, Well, you never have the opportunity to revise the

belief that it wouldn't have gone well. And so yeah, long

story short, I grew up as a shy kid and didn't didn't quite

shake that until college and, you know, have just been trying

to lean into social relationships ever since?

Well, I appreciate this so much. And I can't help

but ask certainly with your acumen and all your research and

your personal experience. What would you say for those couching

into shyness? What is the ultimate fear? Because you're

like, boy, that just being afraid that they're not gonna

like you? If we unpack that? What is the fear underneath? Oh,

my gosh, I mean, at a very fundamental level, you

know, fear, for me assumed some amount of cognition about the

thoughts. I mean, you know, for me, in the beginning, it's

really about temperament. You know, I mean, I was too young to

sort of think about, obviously, what fear meant, or, you know,

you just feel inhibited. You know, I'm, and I'm talking

about, like, when I was, I don't know, three, four, and five, you

know, you, you just, you feel like you are not socially safe.

You don't feel like you can approach you don't feel like you

have necessarily a voice. You don't really know how to use

your voice because you haven't had the opportunity to practice

it quite enough. So you know, when you get older, it sort of,

for me became explicit thoughts, like, other people won't, you

know, other people won't, you know, like you other people will

laugh at you those kinds of things. But I think early on,

it's not so explicit, you know, early on, it's just really

feeling inhibited.

And I just, we could expand forever. I don't mean to

Yeah, shyness. For me, it's fascinating, you

know, to think about how your how it can change your life life

course. Right?

For sure. And as you know, just my, in my own field

of, you know, my career, it's been one of attachment focused.

So I, immediately I'm thinking, Wow, I wonder how this

insecurity is that how does that relate to some attachment? Is

there a connection? And is, how does shame play a factor? You

know, what I'm saying? I, my mind is really going along the

continuum,

all of those things. I mean, you know, for

me, I felt very securely attached to my parents. I don't

think it came from their although, although my mom is

more, let's say, introverted than my dad is my dad is very

outwardly outward and gregarious, my dad is a little

more introverted. But you know, when you're three years old, you

haven't done a ton of social learning yet. A lot of it's also

just genetic predisposition. And I suppose that's what that is

what mine was. But you know, us, us shy people have superheroes.

And so, you know, I think what I've tried to do in my career is

is superpowers, I should say, and, you know, I think my, I

suppose my career and my scholarly work is just about

finding how that social sensitivity can be, you know,

flipped into a strength instead of a weakness. And so I think

some of that is represented in my work, and certainly the type

of the types of things that I study. And, you know, as the the

joke saying, goes, you know, researches me search, and I

think there's a little bit of a little bit of truth in that if

you look at the things that I focused on.

Yeah, I noticed one of the more than one, but one that

I noticed was really talking about, you know, the social

impact of stress and health and how that impacts and so your

must be a living example of a case study, if you will, of, you

know, being more social and interpersonal healthiness is

really

connected. Yeah, you know, the social, and I

can't claim to have experienced that much, you know, true

adversity in my life. I I'm very lucky in that sense. But, you

know, overcoming, as Zimbardo would say, sort of being a

prisoner of her own mind, you know, is in and of itself, a

challenge that I think resonates with a lot of folks.

So, thank you so much. And I'm curious, so you're, you

grew up in the bay area, maybe the shyness is related, but you

certainly must have been performing academically had a

focus in order to say, Hey, I'm going to a couple of minutes

down the road to Stanford, that that in itself is a pretty good

accomplishment.

Yeah. And my life, I think, in a lot of our

lives, whether we recognize it or not, is, is, you know, some

combination of being hard working and being prepared, you

know, that that, again, is saying, you know, Chance favors

the prepared mind or the prepared person. And, you know,

again, just to talk about my own personal experience, I wasn't a

great student, in elementary school, and, and, and mill

Middle School, I'm young for my class age, my birthday is in

September, so I'm in at least in California, I'm right on the

cusp of whether you sort of start early or wait a year, and

that probably also has something to do with, you know, whether or

not the shyness was compounded over time. But, but long story

short, I joined a swim team and high school I, it was really

small swim team, we had six swimmers only, and one of those

people on the swim team was just an incredible role model. And he

happened to be a senior and was preparing and then during the

swim season, found out that he was going to Stanford and I was

really curious to learn more about what that looks like. And

he just seemed like he had his life. So well put together and,

you know, also sort of preparing yourself or something in the

future felt very controllable and sort of predictable to me,

and he just had a huge influence on my mind, you know, on my own

approach, and really, sort of taught me what it what it would

take, you know, to have a chance to get in, you know, to a school

like that. And just, obviously, on a swim team, you have a lot

of time to ask people questions. You know, you're going through

the season together, etc, etc. And so, you know, that's, that's

what I mean about the serendipitous part is that, you

know, I easily could have focused on something else, if it

wouldn't, just off chance had been that I met him and, you

know, he really taught me a lot about what it meant to sort of

prepare yourself in a scholarly way. You know, fast forward to

Stanford and I grew up in a business family of my my parents

were owned and operated a hardware store when I was

growing up. So since age three or four, I was sounds

ridiculous, but mixing paint, cutting glass threading, pipe,

all the things you do in hardware store, it was honestly

the best sort of socialization and fun that you know kid could

have. And when I got to Stanford, I really thought I was

going to I was going to be a business major. Well, again,

sort of as chance intervene, Stanford didn't have a business

major. They had, and they have an economics major. And so I

took, you know, introductory economics, and absolutely hated

it. You know, it wasn't grab that the graphs wasn't what got

me excited. Turns out that wasn't the part of business that

I really enjoyed. It was really sort of psychology of business

and people and I suppose marketing at that time point, in

any case, I, I had a great friend in my dorm who was taking

a introductory psychology course at the time. And I said, What

the heck, I don't know anything about psychology, I never had

psychology in high school. What I do know is that it's economics

is not where it's at. For me, Stanford doesn't have a business

undergrad, so it's not going to be business. So I'll try

something different. I took introductory to psychology. And

I had the experience that I didn't want to read anything

from my econ textbooks. And when I opened up my psychology

textbooks, I couldn't stop reading. And you know, the

biggest joy in life, I think, is to just find something that you

love so much that it doesn't feel like work. And that's what

it was for me. So, again, it's I would not have ever, you know,

gotten to Stanford if I wasn't prepared. But if you want to put

the pieces together, I could never say that I ended up with

this particular career, because I was somehow preparing myself

for a career in psychology or clinical psychology, all of that

is totally attributable to these chance events of, you know,

Stanford not having a major me meeting somebody else in my dorm

who introduced me to something that I just happen to fall in

love with, and doing well in it. And I suppose also, that topic

being a particularly good match for my DNA helps.

It's so fascinating. So very advantageous how things

worked out, you use the term serendipitous, it's so

wonderful. So you're in your you're in college, and you start

focusing it, I assume, at some point time you make it you

major, and you really harness that. Yeah, I'd be curious to

hear, you're getting towards the latter part of college, what's

the plan for you? So

that just to put this sort of on a chronological

timeline, that was I was an undergrad from 1996 to 2000. And

I did a master's in Stanford and in 2001, so I was there from

1996 to 2001. And, you know, incredible, incredible time to

be at Stanford. So the 9096, on the earlier side of things was

Yahoo, Netscape, you know, really the first and moments of

the internet coming to life in the Bay Area, but also, I think,

worldwide, you know, graphic web browsers, AOL, those things,

around 9097 9098 was the beginning of Google. And, you

know, the Google founders. The first search engine, some of

your listeners might know, was, you know, google.stanford.edu,

they were graduate students at Stanford, right? So the whole

PageRank system and figuring out the DNA that ultimately became

Google was all done at Stanford, and, and it was, you know, you

would be sitting at a lunch or dinner table and hearing people

talk about the.com industry and them selling their company to

Yahoo for $30 million. And these just these crazy stories, and I

really didn't know I suppose it was just a 5050 chance being

from the Bay Area, do I sort of go and try to get a job at

Google or Yahoo, or one of these companies just down the road? Or

do I do an honors thesis and you know, try to take my stab at

putting, you know, putting an independent research project

together? I suppose your listeners can be the judges of

whether I picked chose chose wisely or not?

I say yes,

emphatically you chose, right. Yeah, you know, it

was probably 51% Do the honors thesis and go to graduate school

and make a career out of that versus 49% sort of take my

interest in psychology and apply it, you know, to tech Health

Tech in some way and 51% one out so I did my honors thesis,

graduated with honors and then at the time happened to be doing

a honors thesis with with a wonderful wonderful A professor

at Stanford, Ian Gottlieb, who was collaborating with an

amazing gentleman at the University of Oregon, Scotland

row at the time. And so then the transition to the University of

Oregon and becoming a Oregon duck was sort of an easy

decision for me since my, my soon to be advisor in Oregon was

already a known quantity to me, and also being I suppose, only

child wanting to stay a little bit closer to my parents, the

West Coast felt very attractive. Yeah.

Can I ask this? Because I have what was the

dissertation title?

Yeah, cognitive mechanisms of stress

sensitization, which feels a little bit like a mind mount

mouthful. I'm glad I could remember it. So thanks for the

memory, check it out. But the the basic idea there is we know

that if you know each individual person, if they come to

experience a major life stressor, like a divorce or

getting fired, there are different thresholds that will

put each of us over the edge and lead that stressor to turn into

a depressive episode, or anxiety episode. And I was really

curious, you know, what, what is it that sort of lowers the

threshold for somebody to become depressed, you know, once

they're faced with a major life event, and that dissertation

really work really focused on something that the cognitive

behavior therapists in the audience will know a lot about,

which is, you know, negative thoughts, they dysfunctional

thoughts and attitudes, negative core beliefs, and how it is that

our, our thoughts and our perceptions of ourselves, other

people in the future, can really, you know, make certain

individuals to become more vulnerable to in the parlays of

the dissertation, sort of sensitize us to stressors when

they occur, that then allows a major life event to, to turn

into a depressive episode for one person, whereas it might not

for another.

So fascinating. And, I mean, obviously, I don't wanna

jump ahead, but but studying stress has been a continual,

even though there's a plethora of I mean, you've expanded your

scope of research. It's tremendous. It's just I know

that this concept of stress has been a variable throughout your

work.

Yeah. And that was that felt like a harder

thing to sell before the pandemic, especially in the

United States? Because a lot of Americans, let's be honest,

where stress is a badge of honor. So you know, in 2000, we

all say, Oh, well, stress is not a problem, you know, I mean,

yeah, we're all stressed out. Sure. But we're also functioning

well, but I'll be honest with you, Rob, you know, the pandemic

has changed all of that, you know, we've all been through the

washing machine. And, you know, priorities have also shifted,

and I think one, one thing that the world has come to realize is

that, you know, feeling stressed out is no longer a badge of

honor. It's, it's, it's not always, certainly not always

advantageous to be stressed out. I mean, there is positive

stress. But what I mean to say is that I think we've all come

to realize the collateral damage on our mental health and our

physical health from from being stressed. And I'm also I think,

happy to say that we've all had a little bit of an awakening, in

terms of work life balance, to say, Yeah, I'm willing to be

stressed out, but only so much, you know, or only willing to

take that so far, you know, I, my mental health is also

important to me. So I hope in this country, we've had a little

bit of an evolution in terms of our relationship to stress and

how stress we're willing to be before we say, you know, enough

is enough.

Well, you bring up such a fascinating point,

because I know, especially myself as a psychotherapist and

all the people listening as, as therapists, they think it's been

hard for we get parents and adolescents, even the parent

construct. There's no There's this awareness issue of like,

I'm not even sure when it's helpful stress or over stressor,

I've just been, I'm the frog in the boiling water, right? Like I

just, we just in so maybe speak to like, how do we how do we as

therapists can even give them a barometer of what's healthy

what's not How do you know when you're overstressed?

Yeah, it makes sense that it's it's you know,

that's that feels to me like a like a one week intensive

workshop. We get first all of that, when I think about these

things in overly simplified terms, but, you know, is stress

working for our patients or is it not Right is are the families

that the families that we work with, you know, mate, some of

them may be high octane high functioning, you know, parents

families, right, the dad or the mom is traveling all the time,

they're coming back to, you know, throwing the stuff on the

table, eating dinner scarfing dinner, you know, they get, you

know, an hour or two of, you know, time with the kids before

the kids go down. And then they, you know, sit down for an

enjoyable evening, whatever it is, right read, reading the

news, watching a Netflix show, whatever it is, you know, I

think some families thrive on that. And if you really get to

the bottom of it, they feel like they have meaning in their life,

they feel joyful. They feel they really, truly feel well

connected to their children and to each other as spouses. And

you know, it just, it feels right. And they would say that

it is right. You know, other families may say that everything

is going well. And then you scratch the surface a little

bit. And you realize quite quickly that what they mean is

that their work, life is going well or whatever it is, but that

they don't feel connected to their kids. Their kids don't

feel connected to them. If you ask them what their kids have

been up to, they wouldn't be able to tell you really? Do they

feel connected to their spouse? Do they feel like they really

have meaning and passion and joy in life? Do they feel like

they're, you know, living their dharma, their their, you know,

purpose in life? It's so, you know, the first answer is, yes,

everything is hunky dory. But once you sort of open the hood,

you realize that everything is going awry, and that you know,

they're not really functioning as well as they you know, maybe

initially let on that they were but also that there's no there's

no joy meaning passion connection. And so obviously I

think that's where as therapists psychotherapist myself being

included, can help people reconnect with you know, meaning

enjoying and and what it is that it they feel like they they want

in their lives.

Well, I really appreciate your giving us this,

tying it into one of the litmus test is this interpersonal

relationship and how we're doing with you know, being connected

to our kids and how we're doing that is a really good barometer,

if I'm hearing you, right, what a wonderful thing.

And I think, you know, the COVID pandemic has

been the best demonstration of the importance of social

connection and belonging that we ever could have imagined.

Because, as we all know, one of the main things the pandemic did

is cause complete upheaval of our social and relational lives,

right? We were, we showed up to work every day, we had regular

routines, regular roles in our job situations, as did kids, you

know, who also showed up to school and had relationships

with their teachers and with their peers. And the pandemic.

You know, blew all of that up in a matter of months. And I think

we're still quite honestly reconstituting our social lives,

you know, we're just starting to return back to our work

environments for some people and the kids are now back in school,

but they have a lot of ketchup to do with friends and also with

schoolwork. And I think we're still now in that transition

period where we're trying to put our social lives back together

and really feel grounded. I don't I'm not why should speak

again, for myself. I don't personally feel there. But I

feel like we were getting there again.

Yeah, I appreciate that. Especially, I mean, from

our business, I mean, Partial Hospitalization and Intensive

Outpatient and these resources. Yeah, have been super necessary.

Certainly, during and after the COVID It's been fascinating

because for lots of kids returning to schools, it's taken

on new meaning. It's been tough. It's been hard to go from COVID

to back to life as normal, and they need some supports, which

has been really fascinating for

us. Yeah. And there is such a rich literature

showing that you know, interpersonal major

interpersonal stressors are some of the strongest precipitants of

almost every major mental health outcome you can think of

including anxiety disorders, depression, psychotic breaks,

schizophrenia, you know, many of first onset psychosis events and

even schizophrenia are precipitated by major life

events involving high degrees of interpersonal stress. So, um,

you know, and that's when people end up in partial

hospitalization programs as you as you well know, and hopefully

seek out therapy. So there's a lot there for us to understand.

Yeah, but thank you so much for that I just to go back

because I I love to ask and then so you can you go from Oregon to

McLean and working at the Harvard Medical Center just so

fascinated about that experience.

Yeah, you know that my my big trip to the east

coast you know was for a clinical internship in McLean is

fantastic place one of the best years of my entire life was was

working in McLean Hospital. If you haven't, if your listeners

aren't, aren't aware of McLean, it's a fascinating read, Girl

Interrupted is all about know patient's history at McLean

Hospital, that's one of the top two or three oldest psychiatric

hospitals in the country and has a rich history of seeing some of

the most amazing, creative artistic people that have ever

lived. The people at McLean who are incredible have some of the

deepest understanding of the nature of the human mind, both

what it means to function well mentally, and psycho socially.

And also how people transition from feeling mentally well to,

to where sort of pathology psychopathology develops. And

then also to bring sort of the mind back from the state of

being psycho pathological to be Well, again, and, you know, I

think, the richest understanding of certain that line between

abnormal, normal and abnormal thinking, you know, I learned

incredible amount working with the clinicians, and the health

care providers there. So it's was an amazing, amazing

experience. And, yeah, I'll be forever grateful for that. And I

think for all therapists, you know, the things that we all

hope for, is to learn from, from people always who are much, much

better than us, you know, sort of the experts at understanding

the mind. And so, for me, that was a really incredible

experience.

So I would imagine is you're finishing up at, at your

internship at McLean, how is that developing? And boy, what

is like, what am I going to focus on? How is that shaping

like, Okay, here's what my next step is,

ah, I, that was 2006 I, my last year of my, my

internship, and you know, at that point, fMRI was really only

on the scene for, I don't know, six or seven years or so. And,

and a lot of psychology, clinical psychology was still

very behavioral. I mean, I'll use an example from my own work,

like we were doing interviews, stress, like stress interviews

with depressed patients in and trying to understand how it was

that different life stressors, were impacting risk for

depression. So you know, if you're thinking about that, in

terms of like a mechanistic model, A to Z kind of story, A

is the stressors, and z is the depressive episode. But in

between the depression in between the stressors and a

depressive episode, are all of the other letters of the

alphabet. And you know, all of those other letters. In my mind,

psychology wasn't doing a great job at grappling with primarily

because we didn't yet have the tools. We were just starting to

understand the use how fMRI could be used to image changes

in the brain that occur while individuals were depressed, or

when they experienced a particular type of stressor. So,

you know, we were still in the early days of understanding what

the neural mechanisms of the impact of stress on depression

were, we would still in the early days, for example, taking

blood samples from individuals who were depressed versus non

depressed. I mean, there were some people who were doing this

work very well. But that really was not adding in the biological

piece was really not where psychology was, you know, in

2000 2005 2006. So, really, in terms of my own training, what I

realized was that if I didn't know anything about biology,

then I wasn't going to have a career. Because I thought I

figured we knew at that time, kind of as nuts as we needed to

know that stress was important and that it increased people's

risk for depression. But we didn't really know why or how I

looked to see who could teach me something about psycho biology

that I thought would be useful for my work. And I found an

incredible person who is since retired, but who was at UCSF in

San Francisco at the time, Margaret Kennedy Kemeny, who was

a clinical psychologist played by training, but who had

retrained in immunology, and I learned about her work and

really what she was doing, was trying in her own way grapple

with how stress was impacting the immune system. And then I

learned a little bit more of that. And then I learned that

the immune system is, was presumed to be involved in

depression. So, and then that, for me was walawe. So here, I

know that the immune system is connected to stress, the immune

system is connected to depression in some ways, we

didn't really fully understand that. But I said, that's who I

need to. That's who I need to work with. So I, I came back to

the West Coast, I lived in San Francisco for two years, worked

with Margaret Kemeny, and the other incredible people at UCSF,

Nancy Adler, and Alyssa apple and home team of other folks,

and really just spent those few years trying to understand this

field called psychoneuroimmunology, which is

a really fancy word for connections between psychology,

neuroscience, and Immunology. And in really, what I've been

trying to do then is just apply this psycho neuro immunological

perspective, to stress and, and health. And so that's, I suppose

that's what I've been doing. Since then. That's the story.

But I appreciate so much knowing the story, because

there's such a pro flip lithic just deep well, of publications,

and so much stuff that you've done, and, and to get into that,

and maybe separate, uh, how do you get into teaching, and I

mean, it all goes together, but what leads you in the path of

the teaching and all of that stuff, if you don't mind

sharing,

it goes back to I think your opening, your

opening comments about early mentors, I mean, if, you know,

if we're so humble, to look back on our own lives, and to

understand how we got into the positions that we did, then

hopefully, we realize that other people played a great role in in

all of it, you know, not not just teaching us the content

that maybe we're interested in, let, as I said, and in the

context of describing my relationship, and the impact,

Phil Zimbardo has had just more fundamentally making us excited

about learning or whatever it is. And so, you know, I've just

always been the type of person to want to give away what I've

received. I have I owned at a very early age, in my own

professional career, how much I owe to other people who got me

to where I was, you know, and at that time at Stanford there,

Phil Zimbardo was active, but so was Al Bandura, you know, the

father of social cognitive theory and Dorsey and yes,

social modeling. And I think I just really came to feel that,

you know, if, if any student in their career has the opportunity

to be excited by somebody else. And if that other person can

show them how it's done, and give them a little bit of a

path, a little bit of a kickstart, then they can go

pretty far. And I think that my own story is somebody who

benefited from other people really taking an interest in me

as a scholar. And, as I said, not just teaching me some

content, but also teaching me how to be excited and passionate

about my work. And that was the greatest gift that was given to

me, and I suppose I'm feel compelled compel, times 100 to

you know, pay it forward and do the same for my students.

I normally don't say this, but I'm gonna say this, I

just, you have this wonderful balance. This is why I love to

do this podcast is because you have this beautiful balance of

academia, and humanism, like you're also human, along with

all the power.

So this is also Bandura influence, which is what

he would say, you know, we're all agents of change, right?

Yep. Yeah, we are all agents in our own life history, but also

in our work. And I think, first of all, you know, taking the

agent out of scholarly work is, you know, would be sort of to

try to disassociate to things in a way that doesn't really make

sense, right? Because all scholars, poets, any, you know,

philosophers, musician, musicians, right, our products

are all they're all a product of our mind. So like, what can we

talk about, about the scholarly work if we're not giving, you

know, if we're not acknowledging ourselves as agents in that

work, so

Yeah, terrific. Well, thank you so much. I. So I mean,

I just love to know that so you're teaching and doing this

and then there's I love to ask this There's so many amazing

publications that you have I love to ask the question. was

such a robust library of publications? What are a few

that were most meaningful? And why to? That's probably a loaded

question. But

yeah, you know, you're making me choose between

my children.

I, well, you've got hundreds of children. So I know

that's a tough, that's a tough lot to choose.

Yeah. No, I haven't, I had a few clear

favorites. I mean, you know, one paper, which was early, early

paper in 2013, about human social genomics that I that I

wrote with a good friend and collaborator of mine at at UCLA,

Steve Cole, you know, Steve, Steve's work has really

pioneered our understanding of how the human genome is impacted

by different social experiences. And in that first paper, you

know, we coined the term of this field that has since come to

emerge called human social genomics. And the idea there is,

is sort of more simple than it sounds at first, you know, the

idea there is that as we grow up, we come to understand our

biological selves as being pretty stable across time. And

across situations, you know, we all have appreciation of DNA, we

know we get sort of half our DNA from our mom and our dad, and

that over the course of our lives, that DNA remains

relatively unchanged. And, of course, we don't experience

changes in our DNA from moment to moment, because we have no

way of experiencing the genome, right, we can, we can feel

changes in thoughts and emotions, but we can't feel

changes in genomic activity. And, you know, the biggest

discovery in the field of human social genomics is this idea

that the activity, not our DNA, but our RNA levels, the

expression of those genes changes on a moment to moment,

hour to hour, week to week basis, not just as a function of

sort of internal biological processes, but also as a

function of our experience of the social world. And for me,

that is just a game changer. That, you know, explains how it

is that if we're chronically stressed out for one week or two

weeks, why do we get sick? What, you know what, why don't we come

down with a cold, the moment after the the, the the, the test

is finished, you know what I mean? We've been holding it

together for two weeks, we're doing well. But during that

time, our genome has, has really reduced our antiviral activity

at the level of the genome, we've sort of held it together.

But as soon as after we're finished with the test, all of a

sudden, now we're susceptible to those viruses that we picked up

probably along the way. You know, likewise, how can how can

a life history of chronic stress lead to increased risk of all of

these inflammation related disorders like rheumatoid

arthritis, cardiovascular disease, asthma, cognitive

decline, Alzheimer's disease, you know, all of that really is

explained by this really critical, critical process of

changes in human gene expression occurring as a result of

positive and negative social experience? So that paper is

certainly bigger than just, you know, to others. I'll mention

quickly we, a few years ago, wrote a paper which is called a

meta analytic review, some of your listeners will be aware of,

you know, that's when highly masochistic researchers like

myself, look at the entire literature on a particular

topic, and try to analyze data across all of those studies. And

what we did in that paper was really a meta analysis of all

the studies that had looked at connections between some kind of

psychosocial intervention and immune system function. Because

the question is, you know, here we are, as therapists, we're

doing cognitive behavioral therapy, dialectical behavior

therapy, you know, Mindfulness Based Stress Reduction, to what

end? You know, do those kinds of interventions have a concrete

impact on the function of the immune system? And if so, that

feels like pretty concrete, empirical evidence to say, Yeah,

we should use cognitive behavioral therapy or

dialectical behavior therapy or some kind of stress management

to improve both mental and physical health, because we have

this demonstrated Association in randomized clinical trials that

individuals who are randomly assigned to get CBT versus some

kind of active control actually show improvements in immune

system function. And if we can show that then, you know,

hopefully we can get a little bit more traction for getting

payers,

yet. That is amazing. Yes, yes. Wow.

You know, I love that paper because it provides a

really robust empirical demonstration that CBT group

CBT, you know, reduces inflammation has other positive

immune benefits, and I feel like that is something that, you

know, we need in our arsenal of arguments for why pipe payers

and insurance companies should, should should cover psychosocial

interventions. So fantastic. And then the last one is just, you

know, what my work is really congealed into, which is the

social safety theory, which basically says that, again, as

we started out social relationships are, are the

fabric, you know, that that, that keep us together social

relationships buttress our, our lives, they provide us direction

and meaning and, and really make us feel grounded. And so whereas

positive social relationships can imbue us with resilience,

and meaning and direction. Negative social relationships

can degrade our sense of self worth, can feel as though we're

not, you know, moving or progressing in our lives can

make us feel as though we're a flag waving in the wind. And

although we're working really hard, there's just something

that doesn't feel meaningful about our lives. And so this

paper about social safety theories to really try to

understand what are the types of positive, negative social

experiences that impact our mental and physical health? And

also, what are the neural and immunologic and genomic

mechanisms that translate positive and negative social

experiences into health and well being? And then finally, if we

know what those mechanisms are, how can we use therapeutic tools

in our toolbox like CBT DBT, stress management interventions

to reduce risk for negative health outcomes, but equally

importantly, to build in a positive experience of ourselves

and our social world to really keep us resilient at the

individual and collective level? And so? Yeah, that that's

something that's near and dear to my heart as well.

Yeah, of course, it's so tremendous. I know, You've

piqued the interest of not only myself, but all of our

listeners. So I want to make sure they gain access to that I

am smiling at your last description. I'm like, oh, so

Martin Seligman was on to something all those many years

ago about positive psychology and all that stuff, just so

wonderful. Like,

yeah, you know, and it's, he certainly has had

an incredible impact on the field. And I think, you know, to

your point, one of the most important impacts, I think he

had was to remind us all as therapists and as researchers

that the goal here is not just to get patients from negative 79

to zero, right, you know, that's disease risk reduction, that's

reducing psychopathology. There's also the other end of

the scale, which is to get patients from zero to positive

79, or whatever it is. And I think positive psychology

certainly had a huge impact on reminding us that, you know,

studying and understanding character and virtue and meaning

in life, and life satisfaction is just as important as is

reducing risk for depression and anxiety. Because just

eliminating symptoms doesn't mean that you're doing well.

Right?

Well, I just hear it Embark, we use the term, we use

the term purpose to Trump actually passion. So I would say

if it's fair to say for you, there's some clear purpose

driven life here for you, Dr. Savage, just thank you for

sharing it with his holy cow. It's an amazing,

and I I suspect that that's nothing special to

me. I mean, I think every, you know, therapist, you don't you

don't become a therapist, because you're financially

driven, right? You become a therapist, because you feel like

you have a life that involves giving back and, and helping to,

you know, keep other people resilient. So, I think I've done

that in my own way. But I think that's probably something that

resonates with a lot of your listeners as well.

Yeah, of course. Well, would you mind telling us about

your current project? I know that the stress lab is doing

some amazing things, if you mind sharing that with us would be

wonderful.

Yeah. So I'm, you'll probably post this

somewhere, but all the work that we're doing is available in the

life on our UCLA a laboratory for stress assessment and

research, you know, which is UCLA stress lab.org. One of the

things I'm most excited about is that in the state of California,

we've put together this statewide network of

stakeholders, clinicians, healthcare providers, scholars,

and and working on now insurance companies and benefit companies

to come together to the table to really address this issue of

health disparities and moving toward health equity. And that

project is California stress trauma and resilience network,

Cal star network for short, also creatively at Cal star

network.org. You know, that really, that really, I think,

tries to the goal there is to really to bring the science of

stress and resilience to bear on our understanding of what

healthcare providers and other stakeholders can do to reduce

health disparities at a population level, and to

hopefully move us a little bit toward health equity. So some of

the things we're not really particularly well poised to deal

with the structural issues, you know, being a clinical

psychologist or, you know, well, you know, reducing the

structural drivers of racism are, of course, the most, you

know, social stratification, you know, are probably the most

important things that we can, you know, we could, as humans

spend our lives doing, you know, the purpose of the network is to

focus more on the public health issues related there, which is,

if we know, for example, that early life adversity or adverse

childhood experiences have a huge impact on lifelong

trajectories, lifelong opportunity and health

disparities, which we know that they do in the state of

California, for example, almost 20% of California's experience

for more adverse childhood experiences. And, you know, over

70% of these health disparities are linked back in one way or

another to early life adversity in the state of California,

again, almost $112 million per year, you know, can link be

linked, excuse me billion dollars per year can be linked

to stress related health outcomes, you know, this is not

just the cost of health care, but also, you know, lost days of

productivity, etc. And, you know, the focus of the of the

stress trauma and resilience network is really to bring the

science of stress and resilience to understand which aspects of

scholarly work and stress and resilience can be used to

understand how we can transform healthcare. You know, if

healthcare providers do not know, what kinds of stressful

life experiences their patients have had, then what hope do we

have for a health care provider to take stress as a treatment

target? You know, yes, if you don't assess it, you can't

address it. So if you have a patient in your room, therapy

room who has been traumatized, it's going to be quite difficult

to turn those experiences into treatment targets, if you don't

know that they've been traumatized in one way or

another. And so we've developed some tools for assessing

lifetime stress exposure, along those lines that help you know,

healthcare providers, really put major life stressors on the map

on the radar of both patients and providers so that they can

work collaboratively to really turn those you know, those

experiences into treatment targets to hopefully, again, not

just get not just reduce their disease risk, but you know, you

know, build resilience, hope, resilience and purpose in their

lives.

Well, tremendous. Thank you so much for raising

awareness, right? I mean, I love to hear you say cash where the

ACES is, is an amazing assessment tool to use even to

access that trauma and how it's related to all the related

mental health problems and physical problems. It's just as

fascinating in your efforts,

that aces questionnaire you know, I say

tongue in cheek that stressors don't stop when you're AJT aces

questionnaire has been around for a long time but we've really

taken a life course perspective on that and you know, your

listeners can can go to the Lab website and and look at the tool

we've developed the the stress and adversity inventory or

strain, which is really a life life, an assessment of lifetime

stressors across the entire life course, from early age up until

the date of the interview, because I really do believe that

you know, it is the case Is that early life adversity is

tremendously impactful. But like I said, stress doesn't stop when

you're age 18. And in some cases, you know, they're the

things that our patients really come into the room with, or

things that have happened after that, you know, most most people

don't get divorced before age 18, for example, you know, they

get divorced, after age 18. And so I think it's really important

just for all of us as, as, as a therapist and healthcare

providers to understand that life course, history of stress,

just tremendous. So it's, I think I know the answer,

but I always love to conclude our time together with what

legacy will you leave? It's clear, you have a legacy to

leave, and you've got it. But I'm curious to hear a quick

response.

Now oh, gosh, you know, it's it. I'm not sure

if you think it's going to be psychology related. You know,

what, what I think is that every, you know, all of us

deserve the opportunity to live, to live a life that, you know,

marries our personal passion, and our occupation. You know, I

don't think that I would be as successful as a psychologist,

if, if my DNA and my temperament and my own personal experiences

didn't provide me with rich information about my work life,

if that makes sense. You know, I think I'm good at my work life,

because I can rely on my personal experiences and my

passion. And I think, you know, the legacy that I, that I would

love to live is to help as many people as possible, you know,

suss out what their personal, their personal experiences and

the personal passions are. And honestly, if it's in psychology,

then I can help a lot, because I can help them professionally.

But if it's not, I suppose I also really want them to know

that, because it's, you know, there's no worse nightmare than

to be stuck in a job that when you go home every day, you

realize it's not for you. So, you know, I hope to teach as

many students about science and psychological science and

psychotherapy as possible, but I suppose, I hope, also hope that

the others fail quickly in psychology and go on into other

things. And of course, pursue their passions, whatever it is,

in whatever area of life, you know, really, maps on most of

their, you know, their personal, as you said, personal purpose

and meaning. So, you know, helping as many people realize

their dharma and pointing them in that direction would be

something that I would love to be able to give back.

Well, you've given me a gift in our time together, you

certainly have given the readers a gift. Thank you for this

really living and exemplifying exemplifying this integrated

life, if you will, that's certainly what I like to call

it. So just invaluable. We will certainly be able to, you know,

your website and all that. We'll certainly post it on there. I

want to thank you so much for your time. I've just I've got a

million more questions, but I'll riff I'll refrain from doing

that. But to our listeners, just thank you for joining us. Please

access this podcast where every how and how you access podcasts

would be wonderful. And again, I want to just extend my deepest

gratitude for spending time with Dr. George Slavic. Thank you,

everybody. See you next time.