Episode 24: Dr. Cameron Sepah, Professor of Psychiatry, Executive Coach and Investor

Han Tran Body Clock Podcast

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Dr. Cameron Sepah is a Harvard and UCLA-trained psychologist and UCSF Medical School psychiatry professor. He is also a team member and clinical lead of B2B2C digital therapeutics company Omada Health. Dr Cameron also is also a psychologist to CEOs and VCs.

Transcript

Dr. Haroon Kazem: Hey, guys. Thanks for joining us on another episode of the Body Clock podcast by Owaves. If you haven’t already, please remember to download the Free Owaves app on the Apple App Store. It’s the number one wellness app on the App Store. It’s fun. It’s easy to use, and it will allow you to effectively plan your day. It works great as a visual planner. And please remember to tell your friends and family. Also, if you’re enjoying the show, please do us a huge, huge favor and leave us a five star rating on your podcast app. As always, thanks for listening and hope you enjoy the show.

Dr. Sohaib Imtiaz: Hi, guys. Welcome to another episode of the Body Clock podcast for Owaves. Today, I’m lucky to be joined by Dr. Cameron Sepah. Did I say that right?

Dr. Cameron Sepah: That’s right.

Dr. Sohaib Imtiaz: Yeah, I think I’m glad I got pronunciation right. Who is tuning in from California, San Francisco, and I’m very humbled to have him on our podcast because he’s a very busy individual, who has a very promising career. He has been an academic and still is. He’s an executive psychologist to high performers and executives. He is also a venture capitalist. And he has many other roles, which I’m sure he can explain when he goes into his background. So thanks for coming on our podcast, Dr. Cameron.

Dr. Cameron Sepah: My pleasure. It’s great to join you.

Dr. Sohaib Imtiaz: Great. So could you tell the listeners about what you do and what your background is and what you’re doing at the moment?

Dr. Cameron Sepah: Sure thing. So, you know, I, like you trained as a health care professional. So, I’m trained as a licensed clinical psychologist and I still practice as a psychologist. I think the only difference is now my clientele are mostly executives. So, I work primarily with CEOs and BCs. That’s because that’s who I’m around here in Silicon Valley. It’s sort of my community of folks. And it’s obviously a higher functioning group of folks. I continue to teach as a clinical professor of psychiatry at UCSF Medical School.

So, I train the psychiatry residents there and really enjoyed doing that in terms of teaching and giving back. And then I spend the majority of my time as an entrepreneur and investor. So I moved out here to Silicon Valley to start health tech companies. And very fortunate to learn a lot along the way. I helped start a lot of health, which is a large about 30 or 50 person company now. I started at consumer nutrition company in Iquitos space that was acquired. And then now I primarily focus on the investing side. So I invest in consumer oriented companies. A lot of stuff in health tech and that keeps you more than busy.

Dr. Sohaib Imtiaz: I mean, I’m very intrigued by that because I, myself, am very interested in how wellness meets technology. And I definitely think that’s the future of health because it’s keeping people healthy for longer. And how can we optimize people’s health and with technological advancements occurring at the rate they are, I think that is the avenue we’ll have to take for that to happen.

It’s so interesting that you’ve been involved with all sides of the coin almost, and you’re still teaching as well, because it’s very easy when you become an investor to focus so much on one side of the game. But you’re giving back to students as well, which is our listener group. So I think a lot of people be thankful for that. You are passing your experience and knowledge onto other people. So what have you seen in terms of mental health in Silicon Valley?

Silicon Valley is seen as the place to be in the world right now for work. Tech gathers momentum. I mean, me being a doctor, in the UK, a lot of times when I’m getting involved companies, I mean, the word Silicon Valley really attracts me. So what would you say?

Dr. Cameron Sepah: Well, first of all, in terms of the future, I feel very fortunate and blessed that I got a wonderful world class education, myself, and in ways that I don’t think I even expected to. I never grew up expecting to go to Harvard. I was lucky enough to go there and sort of have a transformatived experience in terms of the world’s opportunities opening to me. I worked at McKinsey when I was 20 years old, which is a phenomenal opportunity.

I was treated like anyone else, not as a 20 year old. So, you know, those experiences I’m very thankful for at night. So I appreciate that very much. That’s a part of my impetus and in teaching and giving back and benefiting from the experiences that I was fortunate enough to do so. And so I still mentor a lot of folks, whether their residents in my program or just students that reach out to me.

I actually spoke at a conference to high school students. Lately, I just think it’s an important part of our sort of generational duty to give back to the next generation because from my observation, there is  such an interesting pressure that’s on Generation Z right now.

They’re the first, sort of, digitally native generation. I was fortunate to not have a cell phone until I was 18 years old and went to college. But now, you know, these kids are like essentially grown up with digital devices as their babysitter. So I think it’s definitely affecting their brains in different ways. Citing culture has changed. So I think if not now, more than ever, people need older role models and folks and hopeful that I can do that in a way that’s positive and beneficial to them.

So anyway, in terms of your question about mental health, there’s a huge interest in mental health right now in Silicon Valley. And I think there’s actually kind of a parallel to the education thing that I was talking about. Harvard has such a mystique, as an institution, that draws people from all over the world.

It’s very interesting when I travel and like, I don’t try to bring it up. But sometimes when people ask why I went to college, I am  not going to hide it, and I’ll mention it. People are always like wowed by Harvard, fairly or unfairly. And I think it’s the same with Silicon Valley. It’s such a mystique there because of obviously the amazing companies like Apple that have an HP that classically came out of the valley. And there’s some truth to that.

There is something sort of special in the air here, in the water, so to speak. And I think really that’s the, continual generation of entrepreneurs that have become successful and they kind of pass it down. It’s very similarly to what I was saying about mentorship to the next generation. It’s very easy here to find a founder who’s, quite frankly, started a company and had a successful exit that will not only mentor you, but maybe even provide angel investing, financial support, be an independent board observer. So many people that can help out.

While I imagine if, you know, if you’re in a place that doesn’t really have a ecosystem of entrepreneurship, you’re figuring it out on your own. And, you know, thankfully in the Internet, age is a lot that you can Google and find on YouTube. And people who are prominent entrepreneurs, investors blog a lot and you can learn a lot that way. But I don’t think there’s anything it’s replacement for for someone sitting there and, advising, mentoring, coaching you directly.

So I think that’s the special thing, but I think that’ll change, too. As more and more people move out of Silicon Valley and go back to either their their hometowns or their new Silicon Valley’s form, and I think there’s definitely that happening in different parts of the U.S. and all over the world. I think you’ll see a ceding of that in a lot of ways that you see with like multinational corporations that have 100 offices all over the world. Silicon Valley, I think, will continue to be an epicenter, at least for a long time. But there’s definitely going to be there’s up and coming places.

So I don’t I think it’s great to be here in order to be an entrepreneur. But I want to send the message that you don’t have to be here. There’s there’s lots of places to be successful. In fact, you may have a competitive advantage in terms of hiring and cost savings if you’re in other places. So I think there’s there’s more than one way to skin a cat. You should figure out what works best for you.

Dr. Haroon Kazem: That sounds like great advice, especially with the part of it’s not the be all end all, even though it’s an amazing place. And a place which fosters innovation, but also being such a saturated place, I’m sure, with mental health being on the agenda. I mean, Owaves is an app which advocates coaching for students for mental health. And you touched upon coaching, which is a very human element.

And it’s interesting that you studied psychology, which I feel is the most important subject going forward because it’s the hardest thing to almost automate because of that human nature. And now with artificial intelligence being such a buzzword and we’re trying to automate come up with apps which can almost make things a lot more seamless or replaceable or more convenient, cheaper. Where do you see the opportunity for treating people who are developing these mental health conditions?

Dr. Cameron Sepah: For sure. Well, I think the first thing is to recognize where the mental condition is coming from. As a psychologist, one of the great things about our field is that for the most part, we’re not really interested in symptom reduction. There’s not as much of a symptom focus. I would say as some other fields of medicine. That’s not to say that symptoms aren’t important or that a patient’s suffering is not valid. But if you’re not addressing the root cause of the etiology, as you know, of the disease, it’s you know, unlikely to have long term or lasting benefit.

I definitely think there’s a place, for instance, for medications. I would say a trained psychiatrist who are pharmacologist, and  they can play incredibly powerful and effective roles in an evidence based way and treat psychiatric conditions, particularly ones that may have a more neurological or neurochemical origin. But, you know, if someone kind of walks in and, they’ve been a normal, high functioning person, they lose someone or they lose a job and all of a sudden they become depressed.

You know, I don’t think the goal, for instance, in that example would be to just like treat their sadness per say. If they’re grieving something, then I would actually argue that grief is a normal process. It doesn’t need to be treated. It’s just helping the person sort of cope through that experience, right? That’s one of the important things to note is it’s just a better sort of conceptualization of what’s going on that’s causing some of the mental health crisis.

And  I won’t speak for the world. I think that’s a very complicated issue. And I don’t think there’s a single thing that we can point to. But at least observing Silicon Valley, it’s fascinating because as we were talking about before we started this podcast, it’s such a successful place.

People are inordinately wealthy here. Even if you’re not, you know like, rich. The majority of a lot of people here, I would say, who at least work in technology and have  regular sort of jobs in tech have six figure incomes. Now, that money obviously doesn’t go a super long way in terms of how expensive it is here, as I’m sure it is in London. But yeah, I mean, it’s very unaffordable as well. So you have this weird crux of people who are making a lot of money, except that money is not buying them very good quality of life. Most people here still have roommates. There’s a huge housing crisis. There’s a ton of homeless people in the streets.

There’s definitely areas, a lot of areas that are not safe. It’s overcrowded. So it’s not buying you like luxury for the most part unless you are ultra rich here in San Francisco. So that’s part of it. You still get sort of the stress and the grime and all the other parts of city life. But, you know, the other observation is that human beings are human beings and our needs fundamentally really haven’t changed after millennia. And so it’s great that, you know, when you make enough money, the research shows that after about seventy five thousand in income, it provides diminishing marginal utility in terms of your happiness.

Basically, once you’re like middle class to upper middle class in the US, it doesn’t really do much in terms of your your happiness. I always joke that, you know, like there’s some good research that like having sex more frequently is like the equivalent of making like something like fifty thousand dollars a year or something like that. But it just goes to show that our needs are way more human than it is making an extra bonus at the end of the year. Now in San Francisco, that figure is probably closer to a hundred twenty five thousand a year just because how expensive it is. But it just goes to show that after that, like, you know, people need people need relationships.

People need fundamental things that drive their life satisfaction and their meaning. And I think it’s hard to do that here because everyone is definitely a workaholic. Culture is definitely a hustle culture. Some people call it hustle porn because everyone is like pushing each other to, quite frankly, work harder. You know, there’s this huge demographic imbalances that I think make it difficult for people to find life partners.

And also people are too busy to sort of be seeking stability. I think San Francisco is the city next to New York that in which, women have the most delayed children. I think 32 is now the average age that a woman has a child here in San Francisco, where in some parts of the U.S. as early as 20, 21. So that’s why you’re seeing companies, for instance, offering banking options essentially for women so that they can they can delay stuff like that.

So it’s definitely extreme place. But, you know, I think no matter all what technologies that we come up with, whether that’s apps or opportunities to extend our fertility. It doesn’t change our fundamental needs as human beings, so sometimes I think, the irony of of tech is that we almost create tech solutions to problems that tech has created in the first place. And it’s gets this hilarious sort of catch 22. But I think that’s the reality that we live with. Technology is not going to go away. Sort of the modern workings cycles and city life that capitalism brings is not going away. So the best we can do is figure out ways of contending with it and the mental health issues that come along with it.

Dr. Sohaib Imtiaz: So we can’t be living in the blue zones, which are completely tech free to a degree and where longevity seems to be thriving. So it’s interesting because you point out how tech is kind of like a double edged sword at times. So we’re making solutions for problems we’re creating. But don’t you think in terms of… So I’m quite a avid follower of Singularity University and what they get up to there and they talk about exponential growth of technology and it leads to abundance. So for me personally, I would say if I can virtually connect with a patient, right?

It saves a for me costs travelling time. You know, I can have the flexibility of working from home. It almost creates time, which I would be spending either on admin, things like voice make that easier or travel time. So would you say that these time saving technologies could help make us healthier? Have those times for those relationships that you quite rightly mentioned as well?

Dr. Cameron Sepah: Absolutely. To be clear, I’m obviously pro-tech. But the thing is, I think the good thing is I kind of consider myself a Silicon Valley outsider, right? And I don’t identify as a techie. I identify a health care person, right? A, Because that’s my training but also because I think it keeps my orientation as very human, right? I’m always thinking in the end, like what’s the impact of the technology that I’m creating, why I’m investing in on a human being, right?

Because everything that I invest in or work on is essentially consumer oriented, meaning in the end, the product sits in the hands of a person, right? Whether it’s sold through directly to consumers or sold to the enterprise, it’s having an impact on people. And I fully agree. I mean, my practice is all virtual nowadays. I used to, in fact, have office space, but because like 80 percent of my clients are CEOs, they will never come.

They’re like, can we just zoom in through video because I’m travelling or I have like back to back meetings and I’m like, sure, OK. And I just realized that, you know, that ended up happening like ninety five percent of the time. So I just, you know, got rid of my office space and it was like, OK, we’re we’re just gonna have a virtual practice. It wasn’t my intention to do so. It was literally what my clients were asking for.

So I absolutely think that it can be time saving. It’s obviously increases access and convenience. That was, in fact, the whole thesis around starting a modern health. I used to run a digital in-person diabetes management program at a hospital working with veterans and, you know, was able to get, very transformative outcomes, working with very, very ill type 2 diabetes patients who were not complying with treatment. The challenge was they required them to literally drive to a hospital in the middle of nowhere once a week.

And so, as you can imagine, I can’t really get people to do that for more than a month or two. But, you know, when starting  Omada, we were like, OK, instead of synchronous treatment where we’re having a live conversation, we’re going to have it be asynchronous so people can literally do it any time at their own convenience, even if they’re like working, you know, night shifts, they can they can figure out a time to do it.

While in most in-person treatments, if you’re not there Monday through Friday, 9:00 to 5:00. Literally taking time off work, you cannot get treatment. And the second thing was obviously that we do it digitally so people can do it in the convenience of their own homes or any anyplace. So and as a result of that, you know, Omada has helped two hundred and fifty thousand people lose two and a half million pounds and cut their diabetes risk by a third to a half, which is way, way more than I could have done if I’d stayed in the hospital or even in private practice, right? So, you know, I say all that to say obviously technology, if it’s designed correctly, can be incredibly transformative.

The double edged sword, as you alluded to, is I think a lot of the technology that we’ve created is really the outcome that they’re optimizing for is not health. It’s engagement, right? So if we’re talking about things like social media, you know, they’re their goals to keep eyeballs on screens, right? And ultimately get those eyeballs to look at ads for them for a lot of social media and sell product, right? It’s very clear what the business model is.

The challenge, of course, with that is there are definitely benefits, I think, to social media. I’m obviously user and social media. You can follow me on Twitter, @DrSepah. And it’s been wonderful in terms of reaching out to, you know, an interesting, like community. People I’ve never would have talked to. In fact, like in the last 24 hours, this 19 year old who is starting a company in the fitness space reached out to me and is like, hey, can you give me feedback? And I was like, yeah, sure. Like send me your deck. I’ll give you some feedback. I’ve done some stuff in this space.

Probably someone I never would have, I don’t know, connected with in another world. And same thing, I last night realized one of my favorite writers, Walter Kirn, who wrote this beautiful essay I highly recommend called Lost in the Meritocracy. He’s on Twitter. And he was talking about his essay. It was about him going off to college at Princeton and he was talking about now his own kids are going off to college. And so I tweeted his essay, and I just told them how wonderful of a writer he was. And I felt very blessed to do that. I was like, what a world we live in that I can literally be a fan, myself and, you know, compliment someone who is a world away in some way.

The challenge, of course, with that is with all those benefits that I just mentioned. We waste an incredible amount of time, myself included, by the way, on social media. And so I think that if you have to look at everything as a net outcome. right? I actually think for the majority of people, it’s a net negative because all of the cost savings and all the convenience that you just mentioned is offset by the incredible amount of time that we waste and the incredibly negative effect in terms of our brains of this constant over-stimulation, especially in our sort of dopamine reward system that comes along with us. I think that’s in fact, what makes it so stinking addictive is because we are getting benefit from it. And we’re not realizing the costs are essentially outweighing the benefit for a lot of the time.

Dr. Sohaib Imtiaz: I mean, I’m guilty of that as well because you end up previously before Instagram, etc.. Probably when I was back in school. I could focus on work, probably get a lot more work done to a better level. Now you always have that temptation of you trick yourself into thinking when you’re on social media, either you’re branding yourself or you’re building your network, which sometimes can be seen as levers for progression. So you’re right and you’re always seeing different things and you always think, hey, why can’t I stop that? So I think in terms of innovation, I mean, social media has just sparked so many ideas in my mind, which wasn’t possible previously.

But then I struggled to focus. And I’m sure that’s probably the case with a lot of people. So how do you advocate people not being distracted? And, you know, because you’re hearing new stories of companies selling for millions or being acquired. So all the sudden you could say traditional job seem a long road to success almost. And you’re very tempted to, you know, take you don’t see the hardships of entrepreneurship as well. So, A, how would you advocate management of time as well as distractions? And how would you kind of navigate social media to avoid those.

Dr. Cameron Sepah: For sure. So, first of all, I have a very contrarian view on a lot of things, if you follow me on Twitter, you’ll get that. I always talk about contrarianism in the narrative violations. It’s not because I’m trying to be provocative. I think it’s actually a legitimate and authentic reflection of my personnel. As I said, I literally see myself as an outsider in Silicon Valley coming as a health care person. That kind of blends in tech. But I think it’s nice. I always like joke, I feel like an anthropologist on Mars or at least a psychologist in Silicon Valley being here, because, you know, I have a different point of view, right? It’s like I come from a world where E Q is more value than IQ. Where we’re here, it’s definitely IQ over EQ. And I think that’s beneficial.

So kind of be able to think from first principles as folks like Peter Thiel say, whether or not you agree with his politics, I think is his perspective on like, starting from first principles as correct, right? So first principles, I actually don’t believe in time management. Surprisingly, I believe in energy management. I think the secret to productivity is actually better at managing your energy and not your time.

And some of that actually comes from a colleague of mine a great psychologist named Ernest Rossi, who wrote a book called The 20 Minute Break, talking about essentially how, very similar to your app, not only other circadian rhythms, but there is ultradian rhythms every 90 minutes and our energy levels sort of naturally peak and flow throughout the day. And, you know, in order to optimize our productivity, the first part is just becoming aware of our energy.

That it’s not this stable, flatline thing throughout the day, but it literally cycles up and down. And part of what you can do is to naturally incorporate work and rest cycles. And the interesting thing is, you know, this this concept was actually popularized by Jim Loehr Tony Schwartz, in a book called The Power of Full Engagement, which I highly recommend to probably everyone I meet who asked me about sort of productivity advice. And so they actually work with professional tennis athletes. And, you know, if you work with athletes, as I have as a sports psychologist, you realize those guys train incredibly hard guys and gals.

But they’re obsessive about recovery, right? They know if they don’t get at least seven and nine hours of sleep, if not more, all the training kind of goes to waste because their muscles don’t recover their CNS system doesn’t recover from the hard over training and they’re not going to improve. Ironically, Kurt, a corporate athletes, as I like to call them, executives certainly work hard, but they don’t have that similar, you know, focus on recovery. I think a lot of people take it for granted and think it’s quite normal to not sleep sufficiently.

But, you know, it’s kind of a waste because all, you know, your memory doesn’t consolidate and you don’t sleep. Your energy levels are going to suffer. And in some ways, you need it even more than an athlete because you’re expected to work at least eight hours. If not, you know, God knows twelve hours a day certainly in Silicon Valley, right? That’s become the norm. You know, I think in Chinese culture, it’s called 9 9 6.

You’re expected to wear to work 9 a.m. to 9 p.m., 6 days a week. That’s just, you know, the standard expectation there. So if you’re working that kind of schedule, you need to sort of do if people might be familiar with like Pomodoro Method where you kind of have these work rest cycles. I kind of like doing it. Taking a 10 minute break every 50 minutes fits onto a calendar really well. And there’s some actual data behind that.

I think an app called Rescue Tim did it analysis of when people sort of naturally work because it’s kind of watching what they’re doing on a screen and when they take breaks and it was pretty close to that fifty-ten? I think it’s like 50 something 12. But, you know, it actually ironically maps perfectly onto the quote unquote, therapeutic hour.

So if you’re familiar with psychotherapy, even though we schedule with patients for an hour, technically the therapy is 50 minutes and then we leave 10 minutes at the end to actually do the note taking in documentation from the encounter and if there’s a few minutes left, then prepped for the next patient that’s coming ahead.

So technically, 50 minutes is a therapeutic hour, but I think it kind of gives that 10 minute break naturally. So I like that. Or the other way, if you’re gonna do it a little bit closer to the ultradium rhythm is to do about a 70 minute work sprint and then take a 20 minute break in between. So, a little bit of a longer break. So the question is, what do you do during those breaks? I think there’s kind of two approaches that you can take.

One, if I think if your energy levels are really low, maybe you haven’t slept enough or you’re kind of fatigue from whatever it is you’re doing. I am a big fan of naps. And, you know, the nice thing is if it’s in the 10 to 20 minute range, it’s not going to disrupt your sleep later on that night. But the other thing is, especially because most of us are sitting down all the time, is definitely get up and walk, right?

I think everyone should be aiming for 7,500 steps a day. The research kind of points out that that number is being effective. You probably get 2,500 literally just from even if you’re relatively sedentary all day from just moving around. So you want to get an additional 5000, sort of above your baseline. If you’re walking around every 10 to 20 minutes, that’s definitely, easily achievable.

So in fact, I actually don’t think standing desk are as necessary as people think. And, you know, you don’t need want to be standing all day anyway. We know from  occupations like barbers and other folks who stand on their feet all day and get varicose veins and other physiological issues, that it’s not actually great. It’s fine if any of you alternate between sitting standing. But I don’t think most people need to. I think all you need to do is just get up out of your desk and just go walk around every once in a while. And then that, I think, can do tremendous things for boosting your energy levels. And thus your attention and thus your productivity.

Dr. Sohaib Imtiaz: So you’ve outlined quite a few good strategies for people to implement. So how do you advocate things like no tropics or do you feel these supplements have an adverse benefit long term on people?

Dr. Cameron Sepah:  There’s so trendy in Silicon valley, though. I literally went to this bio hacking dinner the other day with some very, very sharp and influential people here in Silicon Valley and tried a bunch of these gadgets. And, you know, one of the questions that went around dinner was like, what are your top sort of like bio hacking tips? And, you know, I sat there and I thought about it in genuine honesty. And I was like, you know, I don’t like actually the term bio hacking and I don’t identify as a bio hacker. And, I would say some of my clients definitely are bio hackers. And obviously, I use the word optimization in my practice, but I think optimization is very different than bio hacking.

To me, a lot of the ethos or the motivation around bio hacking is to be supra physiological. It’s to be better than normal or to be like superhuman, literally,  right? And I think you start getting into dangerous territory when you’re sort of taking  modafinil weather illegally, as a lot of people do in the valley, or even under a doctor’s prescription. But I mean, unless you have legitimate narcolepsy, you know, it’s a little bit questionable. And we don’t really understand, quite frankly, how it works. You’re physiologically in what you know, who knows what the long term implications of taking this are, right?

I think of medications as a cost benefit analysis. Clearly, if you have narcolepsy, you know, modafinil can be a life changing drug and probably beneficial for all those patients. If you’re just trying to work 16 hours a day and are using a new tropic in order to enable it, I would encourage you to question, you know, a, your life, but B, that you’re not probably setting up your schedule and your energy to be optimal. You know, in fact, if you talk to a lot of high performing professionals, I think the best example are actually writers, right? Writers are tough because it’s definitely like a productivity thing. If you study like some of the top performing writers like Stephen King, they just they have a quota.

They just wake up the morning and I got to write like whatever it is, 100 pages or 500 pages a day, churn it out, right? At the same time, they have to be creative and good. It’s a quality thing as well. But, you know, it’s generally not beneficial, they talk about this in The Power of Full Engagement, to try to sit down, lock yourself in room for twelve hours and write.

In fact, I think one of the authors, when he was in the process of writing the book, said he’d try that strategy and and realize like he could get as much done with good quality writing in four hours a day, use in sort of proper rests and energy management as he could for 12. So the moral of all this is saying that I tell all the clients I work with and my family and friends that, you know, before you go off and try sort of drugs and devices as ways of like optimizing your health and performance.

I’m not against any of these things, but I would say the focus is on the foundations first, right? It’s silly to try to optimize with substances or sort of things that are not very evidence based, potentially have large side effects and are not very well studied or characterize until you’re taking care of the basics. And then in my opinion, the basics are four foundational health behaviors. So it’s nutrition, it’s exercise, it’s sleep and the last one is focus.

Interestingly, most people say stress is the fourth health behavior. I actually disagree with that because stress is a emotional and physiological state. And it’s not totally in your control, but your focus is in terms of where you place your attention. So I actually prefer that to stress because I feel like it’s an inadvertent way of dealing with your stress. If you focus on the right things, you will manage your stress. So that was part of the impetus for the dopamine fasting article that you alluded to. And I’m happy to get into that.

Dr. Sohaib Imtiaz: That’s what I was going to come on to. Exactly. So, I mean, I read the article. I found it so useful for myself as well, because I was networking like crazy, going to every digital health conference, getting involved with like a lot of things in the startup space whilst practicing. I felt I was developing symptoms of almost ADHD where I couldn’t keep attention on one thing, replying to a billion emails, trying to be members of infomatics societies quite early on in my career. So I read your article and it was something which not only resonated with me, but gave me a bit of a pause where I was like, what am I doing? And I mean, I loved it because it’s a good point.

I have actually I spent, since the article, three to four days literally isolating myself from my social circles. A lot of the stuff I was doing just to get some headspace because I fell into the habits of, you know, even socializing, I would kind of think that, OK, I have to have a network of, you know, so many friends so I can rely on one person.

I was almost emotionally hacking my existence to kind of learn from so many different people at once. And it’s just not natural. And your article revealed that. So I would love you to dive deeper into your article, but and also touch on how many relationships can we sustain successfully. Because that’s something I know I’m struggling with.

Dr. Cameron Sepah: For sure. For sure. So I’ll tell you a little bit of the impetus behind the article. There’s sort of two inspirations from actually the clinical practice. So one is from the addiction world. So I work with a lot of folks that have addictions of various flavors and to various degrees. And, you know, one of the interesting things is, you know, addiction span lot more than people realize.

When people think of addictions, they usually think about substance abuse or dependence, where people are sort of using recreational drugs. And obviously, with those things like if you are a cocaine user, you can discontinue using it. There’s no need to use cocaine. But what do you do if you’re a person that is a stress or emotional eater, right?. Certainly you can stay away from eating candy bars and snickers, but you can’t avoid food. We literally need it for our physiological sustenance. And I think that’s why food and media, or at least at least computers, I should say, are very, very tricky from addiction standpoint, because you have to feed yourself in most jobs.

You have to use a computer, even in health care, which is a very, very patient facing job. We still have to obviously document letters, sit in front of a computer probably, I don’t know, a quarter to a third of the time, unfortunately, nowadays. So it’s almost impossible to avoid it in sort of the modern at least if you have a white collar job in the world. So, you know, if you can’t be abstinent from a substance or a stimulus from addiction, well, the question is, how do you manage it, right?

And I think part of that comes from this philosophy of sort of harm reduction, which is like, look, it’s gonna it’s gonna have an effect like engaging in anything for hours a day has an effect on your brain, not necessarily in a negative or deleterious way. But obviously, it’s the dose makes the poison as pharmacologist say so, the excess of it and the way that it’s produced can be harmful. So, you know, taking breaks can be incredibly helpful.

And that’s part of that, for instance, I mentioned this in the article, as you know, an old school philosophy- It’s not done all the time, but it’s done sometimes. It was when children are put on stimulant medications like Adderall for their ADHD, they’re oftentimes told to take it for five days Monday through Friday, because that’s when they’re in school. And then to take a, quote unquote, drug holiday, meaning to take two days off during the weekends when that’s less important for them to focus and study and obviously have to sit there in a classroom for eight hours. And the reason for that is, A, it obviously prevents the build up of tolerance, right?

Where you’d have to take increasingly higher and higher doses of the medication to have the same effect. But also, you know, it made theoretically give the brain a chance to recover from literally being stimulated and hyper focused. And so I was like, you know, this is interesting.

We practice this with drugs, with pharmacology, and we know that, you know, social media, highly pleasurable, highly engaging things, probably work on similar neurotransmitter systems as stimulants, right?. They work on sort of the dopaminergic system. So why don’t we take sort of dopamine holidays or dopamine fasts? That was sort of the inspiration from for the article. The other inspiration actually comes from the anxiety world. So I’m an expert on anxiety disorders and I have a specialty in that. And one of the interesting things that I always say is, you know, anxiety is not necessarily controllable.

You know, like your thoughts about the future will pop up spontaneously. But interestingly, when you work with patients that have generalized anxiety, they actually engage in a habit or a behavior of worrying. And worrying is actually different, actually characterize it as a behavior. It’s not a spontaneous thought that pops up, but you’re actively sitting then ruminating about the future for like an hour or if not hours a day about, oh, my God, what’s going to happen to my company and what’s going to happen to my life? What’s gonna happen to my relationships?

And, you know, it’s actually in my opinion, it’s an avoidance. People sort of do it and almost this compulsive way. And one of the treatments that we do with these folks is it’s kind of a funny technique. It’s called the worry chair, where instead of having people like worry at all times of the day and all places, we say, hey, look, you’re probably going to be a warrior, right? Like the character logically. So we’re gonna try to just contain it.

You’re gonna pick a chair in your house and from pick a time, a day could be like six or seven o’clock in the evening. You sit in that chair and you worry to your heart’s desire, right? Because a lot of people especially think worrying prevents the bad thing from happening because they’re planning for that bad. Yeah.

I mean, like. All right, we’re gonna run with that. Sure. But we’re gonna contain it. So 6 or 7 p.m., you sit down and in that particular place, in that particular time, you worry to your heart’s content. But then as soon as 7 o’clock hits and you leave that chair, you’re not allowed to worry anymore. Worry in terms of the behavior of ruminating. And it helps people tremendously to be able to contain that, right? And not just have it profusely impact like their day. And so from both of those things.

You know, I was like, it’s the same thing with the hyper stimulation that we have. We can’t avoid it. And in some cases, as we talked about, it’s useful to use social media, to use Internet and obviously is very beneficial in a lot of ways. But we absolutely, I think, need to create boundaries and containers for it so that it’s not this 24/7 thing where it’s the first thing that you touch when you wake up in the morning, the last thing that you see before you close your eyes.

Maybe even your dreaming of it, right? It’s just become excessive. In the first paragraph, the article I talked about how Americans spend a whopping eleven hours a day engaging with media. Eleven hours. When I first read, I didn’t even believe it, but I was like, you know, I guess you can you count like just screen time and radio and music and all kinds of media. It’s probably true. So, you know the antidote to that. So I’ll get into sort of the philosophy of dopamine.

Fasting is first of all, it’s important, I think, to recognize what are the behaviors in your life that are sort of problematic or prone to addiction. Now, it’s kind of controversial whether things that don’t have clear physiological withdrawal are addictive. So, you know, some people prefer they use the term sort of problematic, right? Because people would get into this whole debate of like is using the Internet too much addictive?

And are we overusing that term? I was like, you know, let’s not get into a semantic game. The clear issue is, is it a problem for you or not, right?. Is it causing an impairment in your health? Is it because you’re not going to the gym? is it causing you to feel drained? Is it causing you as to feel lonely or disconnected?

If it’s not causing a problem, then don’t worry about it. But in my experience, walking around Silicon Valley, talking to friends, colleagues, associates, I think 80 percent of people plus I would venture would say that their relationship with technology is probably excessive in some capacity and causes some degree of problem that they would probably wish to improve upon. So if it’s problematic in that sense, I think it’s important to recognize things.

I generally find that there’s sort of six categories of things that are generally problematic. So the first I alluded to earlier was just like pleasure eating. A lot of people will obviously eat because they’re hungry, angry, lonely, tired or bored. And obviously, you know, that’s why 70 percent of people are overweight or obese or certainly at least a contributing factor to it. So that’s one category. The second category is obviously Internet, but also gaming. In fact, the DSM-5, which is the psychiatric bible of diagnoses, actually added Internet gaming as a disorder.

There’s a controversy around that but, you know, if you’ve worked with people who spend nothing but their entire lives gaming, you realize, it’s addictive as anything else. The third category is sort of gambling and shopping. Interestingly, these are a little bit gender norms in this sense. And men gamble more and women shop more, but actually categorize them together because they’re very similar.

If you think about it as spending large amounts of money in order to hit a payoff, whether it’s a jackpot or finding the next great Louis Vuitton or whatever it is, but obviously can be very draining both financially and emotionally. The fourth is sort of porn and masturbation. And I always caveat this by saying that, you know, if we’re going to just put the social, cultural issues aside, but on an individual basis, its not the porn or masturbation is evil.

In fact, there is interesting research on masturbation reducing, you know, health issues, but it’s the compulsive or the over use of these things in a non sort of healthy way. And there’s a lot of people where, you know, you talk to where it does become sort of excessive. The fifth thing is sort of what I call thrill or novelty seeking.

So a lot of people try to characterize this as like adrenaline junkies. Thrill seekers could be like motorcycle riding, roller coasters, bungee jumping, and it could be. So some of that is the extreme kind of sports. But oftentimes it can be more subtle things. It could just be the constant seeking of novelty like, oh, my God, I have to try a new restaurant or find this new book or listen to this new podcast or it’s constant, the novelty more than the thrill.

And I think that’s sort of under appreciated. And then six and finally, obviously, we’re talking about recreational drugs, which are the classic things that people are addicted to. But I encourage people to actually think about the relationships with caffeine and alcohol as part of recreational drugs. They’re absolutely drugs.

They’re just the most use drugs in the world. They absolutely do kill people. Certainly alcohol, at least lots of people. And caffeine probably actually contributes because it’s the main substance that is used to mask sleep deprivation. A majority of workers sort of use caffeine in order to stay awake and deal with their chronic sleep debt.

So I think if you find yourself with any of these six categories, realizing that you’re overdoing it and it’s potentially problematic, you may want to consider using dopamine fasting as a way of containing these things and sort of dealing with them without having to necessarily be abstinent or give them up altogether. So I can get into that. I just wanted to pause.

Dr. Sohaib Imtiaz: I mean, that’s something with the novelty seeking, and I think that’s novel in itself because I haven’t come across that one before and that’s something I realized on the road to innovation. I was trying to place myself in so many different experiences and locations just to kind of get some type of inspiration.

But it became a bit of an obsession where I think in the Instagram generation as well, people get bored of the same thing. How many times can you, to quote-unquote, insta story, the same thing, right? Because right now a novelty for your followers is wearing off. There’s always this rush of-OK, I got likes for this or I’ve got responses for this.

Now, what’s next? What’s next? I think it’s driving a lot of people crazy. So I actually kind of ponder this where I thought in terms of, OK, maybe Instagram is driving certain people to be more social because they want to come across a certain way to their followers or friends or network. But in actual fact, would they be behaving like this on Instagram wasn’t the thing. And it’s actually quite telling that people are behaving differently because of what they want to show themselves as being. So I find novelty seeking a very pertinent point, especially for today’s generation and even myself. I think I’ve fallen into that trap.

So dopamine fasting. So I mean, because I remember growing up and having similar routine school, you know, going through the motions and became part of life, but entering what we call university college in America. Everything becomes a bit more down to you. You know, you are trying to.

Which lectures you want to go to and then you start thinking, OK, wait, I can learn this quicker myself and you get lazier. Or you may think that certain things are a waste of time. And I know a lot of people might think that way. And because of that, you can not only end up being lazy, but you start maybe trialing other experiences and stimulating a doping me in a bit more. And now we now, as you’ve outlined, that these behaviors can become kind of habits.

Dr. Cameron Sepah: Yeah.

Dr. Sohaib Imtiaz: Would you say when you see these isolation periods of dopamine fasting, how long would you recommend? Kind of just going to normality to try and get this focus?

Dr. Cameron Sepah: Yeah. So one one note on novelty seeking. Human beings are probably intrinsically wired to seek novelty, right? There’s actually one of the big five personality traits is openness to experience, right?  People who are high on this tree are seeking new novel. Interesting experience. All of us do. And I think we get too much into a rut or routine. We do literally get bored. So it’s not to discourage people from novelty, but it’s everything is a degree of access, right? Same thing. It’s like caffeine isn’t intrinsically evil. It’s just how much you use it and what you do with it, right?

If you’re drinking a cup of coffee a day, you’re not drinking with a bunch of sugar, you’re getting enough sleep, there’s no indication that’s harmful to your health. In fact, it may be salubrious in some way. Obviously, if you’re pounding lots of cups of coffee, getting four hours of sleep and, you know, a jittery, nervous mass, it’s a different thing. So it’s the same thing with novelty in terms of I’m talking about the excess novelty seeking.

And this is actually important because if you think about most careers, right? If you think about world class athletes because they’re in the top 1 percent of the top 1 percent. It’s literally a grind. You have to sit there for like hours and repeat the same shot.

I just sit there, shoot free throws, hundreds of free throws over and over again in order to perfect this thing. So you have your your tolerance of like mundane, repetitive stuff must be incredibly high in order to grind it out. And same thing as an entrepreneur, you’re going to do a lot of stuff that’s quite frankly, not fun. It’s repetitive, it’s a grind and you can do for years. So it’s less, I think, seeking novelty.

But it’s it’s if you’re obsessed with novelty, you don’t have the patience and the wherewithal to sit there and engage in the grind and do the same things over and over again. So I think that’s part of the impetus for sort of toning down the novelty seeking, because you have to be OK with, quite frankly, being bored and being OK with repetitive things, because quite frankly, it’s part of success in any sort of field. So how do you actually do it? We talked a lot.

We talked a lot about why you should do it and the philosophy behind it. But the idea is to take sort of different periods of breaks in different periods of time in order to just kind of let your brain recover. And by the way, one caveat to this is it’s not to say that dopamine is evil or anything.

It’s a very necessary neurotransmitter and is, you know, as being a doctor, patients have deficits and dopamine, whether it’s ADHD or Parkinson’s of various degrees, you know, benefit, in fact, from dopamine, urgent drugs. So it’s more about sort of rebalancing or we’re kind of reengaging in homeostasis or equilibrium. And I think kind of, you know, doing this helps a lot. So a suggested schedule that I have is basically try to have some time at the end of every day.

I kind of suggest one to four hours, depending on how heavy you work and family demands. And the reason I get a range for that one is I actually think it’s probably better closer to four, right?. But the reality is, you know, especially in the Silicon Valley culture, you know, trying to get my clients to not touch technology for four hours is pretty maybe unreasonable. So I’m like, look, find, find whatever works for you if it’s a minute.

Then we’re gonna start with that and then we’re gonna extend outward. But I think one to four hours is pretty reasonable. Anyone can do an hour. And the idea is to not engage in any problematic behavior. That’s very, very pleasurable, rewarding and potentially problematic and addictive, right? And so, you know, I didn’t come up. By the way, with a concept of dopamine fasting, what I try to do is to popularize it, but also to provide it with a lot more nuance, because I think the previous iterations are articles that I’d seen out. There were a lot more like these are the list of things that you can do.

These are things that are absolutely prohibited, right? And I don’t think there’s a lot of thought to it. So, for instance, one piece of nuance that I said is not all technology needs to be sort of dopamine faceted. Like if you’re sitting there with a Kindle paperweight, which is like a little tablet, there’s no light emitting from it. And you’re just reading a long book. I wouldn’t actually consider that to be super addictive. There are some people out there who might read to excess, but for the most part, you know, reading a long form book in a device that has no distractions, you can’t go and browse the Internet on it. It’s probably fine.

It’s very different when you’re sitting on a web browser, you’re clicking through articles and, you know, you skim through like 17 different articles. And I think it’s the constant switching right between them and the novelty seeking. And oh there is a link in this one. Oh, they mentioned this. Let me go on Amazon and check it out. that’s going down the rabbit hole, that that’s sort of the colloquial term.

That’s the part that I think is the the addictive kind of stimulating part. So that’s why I encourage in the article to sort of think about what are the behaviors that are addictive for you. And one of the ones that are, quite frankly, OK. I think it’s OK, theoretically, to eat during the dopamine if it’s just like regular food that you’re having and it’s the same kind of food that you have and it’s healthy and, you know, life promoting. Great.

Then go eat now. But obviously, if it’s like you’re binge eating junk food, then obviously that you want to sort of stay away from. So the idea is one to four hours at the end of the day, you know, generally stay away from, you know, things that are addictive, the social media, digital devices that are overstimulating and all the other categories of behaviors are six categories that I mentioned.

Now, extending that outwards to the week, I recommend generally one we can day a week, whether that’s a Saturday or Sunday to try to, you know, change your routine a little bit and not engage in any of these sort of problematic or addictive activities. So ironically, of course, there’s a precedent for this, which is like from religious traditions, we have a sabbath, right?

A Sunday or day of no work. So this is a little different in the sense that it’s not just about not working. That’s part of it. But if you’re not working on a Saturday and then you’re just like, you know, on your computer all the time, you know, going down a different rabbit hole, I’m not sure that’s truly restful or recovering. You just kind of swapping one addiction for the other.

In my opinion. So the idea is to like do something different, spend it outside, spend it reading, spend it engaging in quality time with your friends and family, the things that actually make life satisfying and worth living. And this is, by the way, totally feasible. I know so many actually CEOs in Silicon Valley, who they definitely work a lot, but they allow themselves one day off a week from work and run very successful, very large companies. And like I said, even in China, there has definitely that hustle culture. It’s 9 9 6. It’s not 9 9 7. Even they get that their workers one day off a week.

I just think culturally, historically, you know, there’s a reason that we’ve done this. And it’s important to do the addition that I am sort of adding is that it’s not just the taking off of work, but it’s kind of giving your brain a chance to recover altogether, right?  So there may be like no social media, for instance, on one day week, you can go use it  the other six, but at least give yourself a break from the constant stimulation. Now, extending that out further every quarter, that kind of fits in with the corporate world, try to take an entire weekend off.

You know, that could be a little local trip, going camping, traveling a little bit. Even a staycation is fine. You don’t necessarily even need to go anywhere. But it it’s giving a little bit of a longer break for your brain. And then the last and final one is, you know, I recommend one week a year go on vacation like a true vacation and unplug. Which I think is feasible for for almost everyone. Most people can at least take a week, a week off a year, no matter what you do. But the important thing is to use that vacation wisely. Unfortunate. I think a lot of people, because of the constant delayed gratification that we have.

They do the opposite with their vacations. It becomes this huge hedonic thing, right? They go to some beautiful old place. Way over drink, you know, and engage in a lot of vices, which, like I said, not nothing intrinsically wrong with it, but it’s the degree and the overdoing where you’re obviously not going to come back very recovered if you have a wicked hangover, you haven’t slept, you know, you didn’t engage in like a lot of healthy things.

So it’s not to say that you can’t have fun, go have fun. But maybe you want to spend one week of your whatever, two to four weeks off a year, a little bit purposely under stimulated in order to undo some of the damage that’s theoretically happened over the course of the year.

Dr. Sohaib Imtiaz: Would you say equally it’s important to expose yourself to stress as well? Because if we start avoiding stress, we get incapable of handling stressful situations and B, we start avoiding it more and more. And that’s not good for our health or is actually a bit of stress. Do you think good for us?

Dr. Cameron Sepah: Yeah, it’s a great question. And we look into the article, I talk about this concept of hormesis or a hormetic responses is this concept. It’s quite a buzzword, but it’s this concept of like little tiny bits of things that may actually be harmful, right? Whether it’s like a toxin or a stressor in small doses may be beneficial because it kind of primes the system like an immune response, right? Like getting small amounts of like a dead virus in the form of a vaccine stimulates our immune response and obviously protects us against various agents, like the flu.

So I think the same thing with stress as well. Now, the nuance, I should say, that I add to it is I think if you are challenging yourself and pursuing things that are important to you, you will naturally encounter stress from taking on responsibility and pushing yourself to your personal, you know, reasonable limits that I don’t think you probably need to go and seek out stress, right?

There’s definitely this whole culture of like take cold showers and other things from the bio hacking world, which may or may not have some benefits. But I just think if you’re really challenging yourself and you’re pushing yourself and you’re trying to learn and grow, you’re going to encounter enough stress in your everyday life that you don’t need to go dump some more on your head, in my opinion.

Now, like I said, it’s a little different if you’re talking about the 1 percent and, you know, professional athletes who do all kinds of crazy stuff. But I generally think for most people like, life is harder and stressful enough that if you approach it instead of avoiding it, you will have probably more stress than you know what to do with. So I don’t know. I guess that’s a little bit of a contrarian view.

Dr. Sohaib Imtiaz: Would you say that with the wealth and with time, because sometimes wealth can lead to time in terms of would you advocate people who get to a certain level of wealth to cut down their hours of work? And does that happen in Silicon Valley or people just chasing more wealth? Because I think happiness to a degree is tied to a time off as well. I mean, if you can work three days a week and a relatively good living for some people, that’s very attractive.

Dr. Cameron Sepah: Yeah, absolutely. You know, I tweeted the other day, I said “I’d be ruthless with your time.”.

Dr. Sohaib Imtiaz: Yeah.

Dr. Cameron Sepah: “Be thoughtful with your money, but be generous with your affection.” So I think time is by far obviously the most valuable resource. You never get it back. Interestingly, though, if you observe people who have sort of made it, quote unquote, financially, well, they probably don’t need to work anymore. And I find that actually has very little to do with how much they end up working afterwards. I think everyone has this sort of fantasy that, you know, the first thing that you do when you become a millionaire or find a financially independent is to stop working.

Ironically, it’s the type of people who become financially independent that are the least likely to stop working. Because the reason they do it, a lot of times, obviously, it is for like freedom and financial independence, but there’s a lot of other reasons that people become entrepreneurs for ego gratification to prove something to someone because they, quite frankly, would be bored doing nothing. So I see a lot of people who don’t need to work, who absolutely work.

They work a lot. And in fact, they probably work more than other people who need to work because they either enjoy it or or quite frankly, they’re compulsive about it because they don’t know what to do. They would just be sitting on their hands and feeling unproductive.

So I think that tells you something about human nature in that human beings do have an intrinsic need to be productive, right, or generative in some way. Now, that may be in the context of work and maybe in a different way. It could be, you know, raising a family, it could be doing community service. There’s lots of ways. But you definitely can’t sit on your hands, you definitely can’t lay on a beach.

Even the people who love laying on beaches, myself included- you can’t do that. Like, imagine literally laying on a beach for a week. You’d be bored out of your mind. You’d enjoy doing it for a few hours, maybe a day. But literally like twelve hours a day, seven days a week. No. You’d be like you go out of your mind.

So, you know, I think that’s the bigger thing is to engage in genuine self-reflection about what your motivations are and what your values are in life. Right. Where, you know, once you’re at a point where you’re like, okay, it can be a little bit less pragmatic about how I work because I have financial independence. You know, I think you can be in this very blessed place of opportunity where you can think about- okay, I still need to be productive in some way.

I still have time and energy left in my life to, you know, contribute in some way. And how am I going to spend that? So I find a lot of people, in fact, continue to work. I think the important thing is to just realize that if you if you’ve been very driven, extrinsic, which a lot of people are, that that may need to change and engaging in, you know, some therapy and working with someone can help someone even recover from that, because otherwise the tendency is you end up becoming a workaholic. I knew an entrepreneur, you know, anecdotally who I asked him, like, you know, just kind of half joking, like, what’s your number, right? It’s kind of a thing for the finance world about. Like what point? Oh, you know what?

At what point do you quit or do we retire from the game? And he’s like, I literally don’t have one. I love the game so much that I know I would work forever, you know, he’s like I’m never going to quit. And part of that, I think, was the genuine passion. Part of it was definitely like this ego driven, like, you know, money is a scoreboard and I can win this competition, which to me seems a little excessive.

So I think if you’re engaging in that kind of thing where there’s there is no end unless it’s again, like a mission driven thing or it is a value driven thing, that’s a different sort of thing. With that, you can definitely do it the rest of your life. But if it’s like this hyper-competitive keeping score kind of thing, then yeah, it may be useful there to reflect a little bit about a different way going forward.

Dr. Sohaib Imtiaz: And Professor Ashley Williams actually from Harvard as well, she says about outsourcing things that save you time if you can afford too, of course. And kind of some economies of scale. So the mundane. I mean, how far do we go? Because if we thought, like you said, avoid the mundane by, you know, having maybe help, et cetera.  Do we find those type of task more difficult and then I guess we use that time for more thrill seeking?

Dr. Cameron Sepah: Yeah, I mean, I think it’s a blessing. Like I said, like I don’t think there’s anything wrong with. Sorry about that. You know, outsourcing mundane, you know, you know, whether it’s house cleaning or chores or things like that. You know, especially with a lot of the clients that I work with, they make many hundred dollars per hour, if they can outsource that to someone else. And also help them make a good living and be generous about that, I think there’s nothing shameful about it.

I think it’s actually really tough because a lot of folks that I work with also come from humble beginnings, right? They definitely didn’t pay someone to do their laundry or growing up or even as an adult. But now that they have the opportunity to they feel weirdly guilty about it. And part of the work I do is just helping them overcome them.  Look, it’s like if you don’t enjoy it, you can obviously pay someone to do it.

You can make more money doing something else. You’d enjoy doing something else more often. I mean, it frees up your time and energy to do other value driven things like you spend more time with your family because you’re not folding clothes. You don’t feel guilty about that. Like, obviously, it’s just restructured.

You’re thinking so you don’t feel guilty about that. And in fact, you find it very positive values aligning and affirming because you’re spending more time with your family or contributing to the economy and society. So obviously there’s certain things you shouldn’t outsource, like when it comes to relationships, like no, obviously quality time and other things, as you know. And we have to be mindful of that with obviously children.

There’s probably a delicate balance between, you know, helping with child rearing and obviously you need to spend some quality time. I don’t think there’s a clear, easy answer to that one, but I’m a big fan of outsourcing and figuring out ways to do that as much as possible. So you are spending your time on the things that are more aligned with what you’re doing. If you have the opportunity to and like I said, it’s definitely a privilege.

Dr. Sohaib Imtiaz: So in terms of building personnel, did you think people who’d been through struggles strive for higher work ethic and that leads to success?

Dr. Cameron Sepah: Well, it’s certainly a path, right? There’s a lot of folks that I know are first generation immigrants. People who come from very humble or, you know,  lower class beginnings, who, you know, part of their journey into entrepreneurship or academia or whatever successful path that they pursue is to essentially rise out of poverty, make something of themselves, give back to their families.

And that can be incredibly motivating. I think a fact Silicon Valley would not exist without immigrant entrepreneurs. Half the companies here that are huge are started by immigrants. So we should definitely promote that and encourage that, because that’s literally the American dream.

It’s the dream all over the world just to better yourself and your family in some way. And it’s incredible that we live in a place that allows that. And I certainly hope that we will continue to do so regardless of your politics. So but I don’t think it’s the only way. There’s certainly a ton of privileged entrepreneurs here, who grew up with very wealthy and resourceful circumstances. And they can be just as driven.

But it’s maybe a little bit for a different reason, right? For some people, for instance, that I know and I work with. It’s to maintain their family’s status and privilege and credibility, right?  Some people feel incredibly grateful and lucky that they were born, sort of, with a silver spoon.

They’re like, you know, I’m not going to waste this opportunity, right? I mean, I’m very privileged to have all these extra opportunities. And I’m going to, you know, leverage them to the best effect and, of course, try to give back as much as I can. And so, ironically, you know, you can be very driven coming from two different worlds. One is to make a name for yourself. And the other white might be to just maintain, you know, your family name and not embarrass the family, right, by becoming a loser in some way. So, you know, you obviously have to be careful about that. In terms of how extrinsic that is.

But I think everyone, no matter where they come from, can find some reason, some drive, some edge that motivates them, hopefully more intrinsic. But I’m not actually against extrinsic motivation altogether as long as you’re aware of it and you can kind of diffuse from it when it’s necessary is the way that I kind of use it. If it’s overly tied in with your identity , right? Like give your self-worth is completely contingent on your professional success.

That’s a very dangerous line to walk, because obviously if you fail and most entrepreneurs do like even the successful ones have failures under their belt. Unless you’re so lucky that you first hit, you had a grand slam. But most people, it’s not like that. We just kind of sweep the other ones under the rug.

You know, you should be able to disengage with that and see yourself as more than an entrepreneur, more than an executive. You’re still a complete worthwhile whole human being who at the same time is striving for something. And I think holding that dialectic is is part of the  the secret to success.

Dr. Sohaib Imtiaz: So, that is the way to overcome that fear of failure that we’re often sought by. But do you think that in terms of hours, is it more about working smart than working hard or is it both? Because if someone can I mean, say you have a 9:00 to 5:00 jobs. All right. In that day, a lot of the hours you may just be wasting in terms or may be…

Dr. Cameron Sepah: Absolutely.

Dr. Sohaib Imtiaz: Spending it, socializing with people you don’t necessarily want to spend time with. You know, you’re going slow because you’re in an environment where you’re not incentivized to go any quicker. Whereas if you’re more in control, could you almost replace that work in a short, like Tim Ferriss’s four hour work week. Kind of a bad example, but it’s kind of condense things and is not a way where you could probably sustain this high performance work less and still make a similar income.

Dr. Cameron Sepah: Yeah, it’s theoretically possible. I think, though, if you really wanna be successful, you do have to work hard and smart. There’s no ifs, ands or buts about it. Like it’s it’s a hyper competitive economy. And unless you’re in a super defensible sort of sphere, which a lot of businesses aren’t. You know, even if you’re successful someone’s going to come along and eat your cake along the way.

If you’re sort of resting on your laurels, at least in the long term. So I think you really have to do both. It doesn’t mean, you know, working at all hours of the day. If you’re genuinely productive with your eight hours, which as you pointed out, most people aren’t certainly they’re not. You can get an incredible amount of stuff done. In fact, the first company I started, one of our co-founders, had three kids along the way, right?

Dr. Sohaib Imtiaz: Wow.

Dr. Cameron Sepah: Which seems incredibly tough and it absolutely was. But, you know, he managed it. He generally was in the office like 9:00 to 5:00, would go home, take care of his kids, family, feed them, tuck them in, and then, you know, when the kids are in bed, would get back on his email and work. And that worked for him. I’m not sure it works for everyone, but there’s always a way, I think, of managing.

If you are blessed, then you get a lot of support as well. It’s why extended family can help support that process. But that’s the smart part, right? Is thinking about, OK, well, how can I kind of garner support and other resources around me to help support that-where I can be a good father, and it was clearly very important to him, and be a good entrepreneur at the same time.

That company is obviously really successful. So, you know, I think it’s being thoughtful. But, you know, something was interesting about what you said was if you don’t have incentives to work hard, I think that’s such a trap, right?  There’s certainly jobs.

You know, as I listen, I worked for the federal government. I see people like who cannot be fired and not not work hard all the time. But I think you have to push yourself, like even if you can get away with not working hard at a 9 to 5 job. Because you’re doing a good enough job or it’s not gonna make a huge difference in terms of your performance for you.

You are the CEO of your career, and you are your own manager. So I would never do that. In fact, I remember during my fellowship, so we were supposed to study for our licensure exam because I was the last year of our training. And most people, you know, took the whole year to study for it. And then you take it at the end. I did it in the first three months because I was like, look, I have some extra time as we’re ramping up our sort of patient load.

And so if I had free time and between patients, I was sitting there studying and I got like, you know, the first person to finish my exam because I was like, I’m going to get this done. I’m going to go on and then move on to other things. And the blessing that that provided me is that the rest of the year, while my, you know, co-fellows were frantically studying and trying to get this exam.

I was thinking about, OK, well, I’m done with this, you know, what am I going to do next? And that’s how I started to think about starting a company and getting into opportunity, because I literally had the free time and mental space to explore other things. So I would encourage everyone, no matter what kind of good job that you do, is to figure out a way of just out of a sense of personal pride being productive or at least being efficient with your time.

Don’t don’t sit there on Facebook. You know, if you’re out of work, you should be sitting there growing and reading and figuring out some way of improving yourself, whether personally or professionally. Then obviously do that in a way that’s that’s constructive and allowable with your work.

Dr. Sohaib Imtiaz: Good contrarian thesis. So I gonna say I was at Imperial Business School for a year and I had a session, well it was a module I did- health care challenges, management challenges in healthcare. And we had a professor who was also an M.D. and he got into consulting and he told us something which kind of struck me for reasons then He didn’t mention the lean philosophy, which most startups do, but he said, unless you can reach, I know this is not probably something not good to say on the podcast, but what he said was unless you can reach the next grade. So what he was like: Past, merit, distinction.

Dr. Cameron Sepah: Mm hmm.

Dr. Sohaib Imtiaz: You won’t have value. So it’s better to pass by one mark, right? Because on paper it would be the same unless, you know, you can get the next grade and work that hard. If you work hard and you miss out on the next grade, then that effort was futile. And that’s something he said to us in terms of like energy management, I guess you could say.

Dr. Cameron Sepah: Totally. Yeah, I’m on board with that. If you think about most people’s philosophy towards work outside of the extreme sort of end is, you know, most people are very rational. They do just enough to get by now that whatever that just enough is maybe different for different people. If you’re very ambitious, you’re just enough may be a very high bar, right?

But you’re going to hit that bar and at some point you to get comfortable and be like, OK, I’ve achieved what I wanted to achieve. For other people, it’s a much lower bar. They are like as long as I keep my job, quite frankly, I will do the minimal amount of work necessary to to maintain this job, essentially.

You know, I feel like that there’s nothing intrinsically wrong with that and that like there’s obviously different cultural points of view in that if you see work as a means to live and not you’re not living to work, I understand where that’s coming from. But this is why I kind of talked about the sort of personal pride thing. I know when I was a Katzenbach, I helped contribute to a book called Why Pride Matters More Than Money about motivating employees.

That was written by John Katzenbach. And that was one thing I took away from that book and from that experience is that, you know, money obviously motivates people, but pride and satisfaction in your work do a lot too. Because what you tell someone is like a factory line worker at a car plant, right? He’s not doing the most prestige job. It’s very repetitive. It’s hard work. I mean, I have been their dream job as a kid, but they can take pride in saying, hey, you know what?

I put I put the wheels on these cars and these cars help family get to where they need to go every day. And I take pride and satisfaction in doing a great job in that. So I think a more bountiful and positive point of view is that you should always be trying to improve in some capacity in your work or in your life. And it’s not to rest on your laurels that that doesn’t mean that you need to be this like hyper-competitive, dissatisfied human being. I’m not talking about that at all.

It’s more of a concept of kaizen, which is from the Japanese sort of tradition, is this idea of a little bit of continual improvement every day will, you know, over the long term make incredible gains, right? And I think if you have that kind of, you know, cumulative generative philosophy of like, I’m going to come into work and yeah, I know what I’m doing and I can do a good enough job and there’s no consequence either way. But I’m going to take pride in the fact that I’m a do my job 1 percent better. Only one new thing on a stretch myself in one way today. You end up being more engaged , right?

You end up feeling better at the end of the day because as you feel like you grew or stretched yourself, you got a little bit more than you ever thought you could have. And that’s how people improve. That’s how people, you know, literally from the sports world improve, right? In weight training, have a concept of progressive overload.

You add a pound of weight or two pounds of weight every time you lift. And that’s that’s what makes you incrementally stronger over time. So I find that to be incredibly helpful and my sort of personal and professional development encourage others to think about that as well, because I think it helps both stave off the boredom and monotony if you are kind of coasting at your job. But it also allows you to find ways of being more engaged and perhaps even ramp on to something bigger and better if that’s your aspiration.

Dr. Sohaib Imtiaz: And with that, what do you say about social relationships, how many successful friendships can you maintain or is healthy?

Dr. Cameron Sepah: Yeah, it’s a great question. Point of view when it comes to that. So there’s some research and I wish I could find the original source for this, but it kind of resonates with my clinical experience as well. You know, I’ve read that essentially outside of your family and your co-workers, there’s only three levels of relationships and you can kind of do this as an exercise in your head, which is how many people do you contact? Are you keeping contact with on a daily basis? Doesn’t it matter if it’s calling, texting, or seeing them in person.

But if you really sit there and think about it, for most people, it’s only one of the two people. And that’s usually a significant other, if you have one, and maybe a best friend, right? So there’s only like one to two people that you’re super, super close with. The second layer is how many people do you contact with on a weekly basis, right? So every single week, pretty consistently, except for maybe one week of vacation when you are dopamine fasting, are you in contact with? For most people, it’s three to five people. That’s it. Those are those are kind of, in my opinion, true friends that provide instrumental support. Instrumental support is like, they’ll drive you to the airport.

They’ll do, you know, some real stuff with you. And then the third layer is literally everyone else, right? So what that tells me is that, you know, despite, you know, all this network, hyper networking and social networks that we talk about, stability is achieved with one partner and three to six real friends. That’s it, right? You literally get a handful of people that are true friends.

But I actually think that’s a positive thing in the sense that it reduces the pressure on your part to be like, oh my God, I need to create this like crazy network. No. You need you need a handful of friends who are real friends. They’re ride or die. They’ll do almost anything for you within reasonable bounds. And they’re deep, and they’re meaningful, and they’re sustainable relationships. And that may change and evolve over time, especially if you’re, you know, upwardly mobile individual that moves around.

You know that unfortunately, you know, you may have to swap some of those people out because it’s hard to keep in weekly contact if you’re not in the same time zone. But, you know, I think this comes from a longstanding cultural tradition. I you know, I tweeted a while back that in the fourth century, B.C. Scythian warriors had this concept of blood brothers.

So a lot of people are kind of familiar with that, that old custom of like, you know, you’ve cut yourself and, you know, we wound yourself. And I think they let the blood drip into a cup with wine and drink it together as a symbolic oath of their loyalty. Very, very gladiatorial. But that’s not the interesting part. The interesting part, though, was every man was limited to having us at most three blood brothers.

And the reason and the logic for that was interesting, because to be a blood brother at that time, we had a serious consequence, meaning like if you went off into war and you died, your blood brother was be responsible for taking care of your family, right? So,you don’t take someone on to be your blood brother unless you really trust that person, like literally would I trust this person with my wife and children? So as a result, guys were literally almost like court or date one another.

It’ll be a lengthy period of affiliation and friendship to be like, are you good enough to be in my top three? Literally, because I’m going to trust you with everything that’s, quite frankly, important and valuable. And if you have more than three, you have too many loyalties and you can’t really be loyal to any one person, which is a really interesting philosophy. There’s like more is actually negative in that period of time.

So I think obviously modern days is a little bit more flexible. But I think my philosophy is if you’re talking about personal relationships. Yeah. You should probably, you know, aim for a handful or two. If you  can’t count them on your two hands is probably too much, in my opinion. Now, professionally, it’s a totally different thing. I think you can have, you know, thousands of people that may be useful professionally. Certainly as a venture capitalist, you know, I know thousands of people and it’s useful to hear from those people, but that’s a different purpose and it’s a different game to do that.

Dr. Sohaib Imtiaz:  I think nowadays, I think, people are switching friends quite quickly because we meet so many people online, as well. So I think that’s a very important point. And with that. Similarly with opportunities now, there’s so many things coming our way. How do we decide? Like, do you focus on your main career first? Or do you grab an opportunity? Can we can we be doing two or three things at once? How do we split that time? What’s a better time investment? How do we work that out? I mean, obviously, one thing suffers.

Dr. Cameron Sepah: It often can. It often can. But I think that’s why I really love this philosophy. It’s it’s kind of embodied in the dopamine fasting. Is that you always try to maintain the routine, even if you need to truncate the time, right? So if you’re like, you’re just like, you know, living this crazy schedule and you I don’t have an one to four hours a day, like I said, a minute, five minutes like.

But you’re maintaining the habit of doing it every day. It’s the same thing. When I encouraging clients, for instance, to take on a meditation practice. They don’t have time. And I’m like, you don’t need to sit there for 30 minutes a day onto a cushion. If it’s like, you know, three minutes that you have in between a meeting, you can sit there and watch your breath. And that’s it. But you’ve maintained the streak of doing that for the five days a week. That was your goal. Then great. Then that’s phenomenal. That’s the most important thing.

I think people get into a trap when they’re continually overworked and behind. That they can’t take on anything new or they can’t address other portions of their life. They absolutely can. But they need to do it in these little like micro periods of time, right? Where if you have a huge priority to your work and your family, it’s hard. It’s going to be hard to make new friends, right? But you can figure out one way of doing it.

And it may be like literally going to dedicate, whatever, 30 minutes a week. Thirty minutes a month to either rekindling an old person who was probably in that top three to six or potentially putting myself in a place. Or maybe I’ll go to, like, I don’t know,HOA meeting and maybe I’ll meet someone in my building who might become a friend, right? There’s always a way of doing it. If you make it a priority and I think literally everyone can. It’s just a matter of like finding the smallest enough unit of time that you can make a regular contribution to it and eventually that’ll happen.

Dr. Sohaib Imtiaz: That’s a very good strategy for a lot of people to adopt to keep that habit going. So would you not be someone who is a fan of people taking 2, 3 months out to travel and or just, you know, introspect?

Dr. Cameron Sepah: It depends on the purpose for it. First of all, I think I want to emphasize, you know, a lot of the things that I recommend and encourage are a way. It’s not the way. There’s many ways of doing things. But I speak from both my personal experience, my clinical experience and as much as I can from the research, literature, and experience as well. And in the recommendations that I make in terms of- oftentimes these things work.

But certainly I think, for instance, the concept of sort of like longer vacations or almost like mini retirements, as you’re alluding to, have been talked about. And that interesting model, too, you know, you see this increasingly in Silicon Valley where back in the day, you know, you took too much time off work. People would think that you’re like a vagabond. They’re like you’re not a trustworthy person that’s going to stay.

But now, you know, you have people who are exiting companies and these kind of walk into a large sum of money and they’ll take a year off to go travel the world. And here in Silicon Valley, that’s acceptable. Like people would be like, oh okay, great, you traveled the world.

You ready to come back and be a product manager? Absolutely. Come on. Come back on board. And there’s no, like, shame or judgment about it. For the most part, I would say, I think it’s an incredible opportunity and privilege that never existed before. Where before if you had a gap in your resume, it was like there’s something wrong with you unless you were older or had a legitimate reason. So I think it’s a relatively new concept.

I think it’s great if people sort of take advantage of it. But what I would encourage is for people to be intentional about it, right? I generally find that like hedonism 24/7 for three to 12 months is not as satisfying as people wish, like. Or is. Like even I when I personally travel, if it’s like more than four weeks, I start to get a little antsy.

It’s because like, don’t get me wrong, I enjoy my pleasures in life. But, you know, I’m not a hedonist. I feel like, you know, my life is sort of purposeful, just walking around, eating good food and staring at beautiful buildings all the time. So that’s one thing. I’d be a little bit cognizant where I think is a little bit of a mistake people make in effective forecasting, which is like a just a fancy word for saying that people are really bad at predicting their happiness, right? When you’re in the middle of a slog and you’re being in an office all day.

Of course, you’re going to visualize being on a beautiful beach or ship pacing around Europe and how wonderful that would be. And it is. But the thing is, if you think about literally doing that 365 days in a row, I’m pretty sure after like a day 30, you’re going to get a little tired of it. Because that’s the huge experience. That’s the hedonic treadmill. So we don’t predict. We don’t do a great job of sort of predicting and realizing that even we get tired of fun, too. So first and foremost, the second part of it is this very like eat, pray, love thing that you’re talking about. With like finding yourself. Look, like some people when they travel certainly do. They have transformative experiences.

They get exposed to different cultures, different ways of life, different ways of thinking that can be transformative. I think it’s hard to programmatically create that outside a very specific sort of rituals or exceptions. But I would encourage people to think that, like, you don’t need to go to an exotic place to find yourself, right? You don’t necessarily do. I mean, I’m a fan of traveling for other reasons.

And I think it’s a lot more, in my opinion, to do a sort of cultural exposure and getting outside of your bubble. But in terms of the sort of like personal growth seeking kind of thing, because I work with a lot of clients who kind of fall into that realm. I often find that the reason that people want to travel to quote unquote find themselves is that there is an underlying issue that they’re not addressing.

Like in Eat, Pray, Love, they were going  through a divorce or other things where I think, quite frankly, a lot of people would be better suited and like whether it’s going to therapy, whether it’s actually staying at home and dealing with the underlying issue or, you know, finding a different way of addressing that. The danger, in my opinion, is that it can become very escapist..

Dr. Sohaib Imtiaz: Yes, exactly.

Dr. Cameron Sepah: The temptation of traveling and saying, oh, I need to have this like euphoric, mind blowing, transcendental, psychedelic experience in order to find my way. And Certainly, there can be. Like I said, I want to knock that. Like sometimes people do have transformative psychedelic experiences, but it’s not the only way. And I in fact, there’s a great book by Dan Millman that I love called Everyday Enlightenment. And he tells a story in it about this guy who was one of these characters.

Like he’s like a seeker, always going to some Ostrom in India and trying to find enlightenment. And for him, he was like, you know, I think what you recommended to the guy was like, I think you’d be better served learning a practical skill and just living an everyday life. Because you’re the opposite extreme of everyone else in society, who’s just kind of doing their 9 to 5 and not exploring outside of their comfort zone.

You’re the opposite extreme. All you do is go explore. You’re outside. So maybe for you what you need is the opposite. So he ended up becoming a chef and learning how to cook, and he found a sort of purpose and meaning in life and serving other people in a very humble way. Yeah. He’s like, I make people food that I make people healthy. Food helps support their health. And I have a practical routine and stability that I never had as a sort of this like wandering traveler in my youth.

And so for him, it was actually the opposite of travelling. It was actually coming home and finding a skill and becoming a useful member of society. So that’s a long way of saying, I think it’s important to realize what it is that’s missing in your life and address that root cause, and travel may or may not be a part of that.

Dr. Sohaib Imtiaz: I think you’ve answered that quite eloquently and now coming on to your routine. How would you like to live your day? What’s your kind of basic day plan?

Dr. Cameron Sepah: Yeah. You know, I’m always little hesitant to talk about my personal habit, not because… I’m a very open book and I’m happy to share. But the reason is because, you know, I get asked this all the time and the same thing on social media. Like, what do you eat? Like, what’s your routine? What’s your exercise? As if it’s like the blueprint or the answer to everything.

It’s not like a, first of all, I don’t know everything. I know a lot. But I know that I’m constantly evolving. So when people ask me, I do answer. But I caveat it and say, look, I’m a work in progress and I’m always experimenting. And so I’m trying different things that I may not stick to. And so if you asked me once and then you think like, boy, that’s the answer and then I’m going to do this for the next ten years.

I’d be like, I’m probably in ten years not gonna be doing the same thing. So take it with a grain of salt. So now that I’ve sort of caveat that, I’ll tell you sort of more principles that I think are useful in some of the habits that I think I’ve probably practiced long enough that I do think they’re beneficial. So starting out, I have a philosophy.

This is another contrarian view that if you’re waking up with an alarm clock, you are by definition sleep deprived, right? Because your body literally is like, I want to sleep more and you’re interrupting it, right? So obviously the antidote to that is you need to go to bed earlier, right? So a lot of the work that I do with clients actually is like focusing on bedtime routines, not wake up routines.

And, you know, I think everyone should be getting 7 and 9 hours. I think the literature generally supports that. And I certainly if you’re doing heavy physical or mental activity, it should probably be on the latter end of that spectrum, maybe closer to eight to nine hours. I actually don’t think there’s too much sleep outside of medical conditions that are promoting things like hypersomnia.

If you exclude that, you know, medical or psychiatric complications, your body kind of knows how much sleep it needs. For the most part, and like again, assuming you don’t have some sort of circadian rhythm disorder or other issues, you want to get to bed early enough so that you’re waking up without an alarm clock. So I for the most part, unless I have a very early meeting, try not to have an alarm clock, and my body gets someone needs, which is great. Because I get, you know, generally get over eight hours of sleep. So that’s the first sort of tip. Second tip is I tried to walk outside.

I’m fortunate to a terrace where I live. I walk inside and try to get some sunlight on my skin and my face. I think that helps reset their circadian rhythm. And you don’t have to be out there long. It’s just enough that you get light exposure. And I think that helps sort of regulate the circadian rhythm and the melatonin cycle. So that the body is like, okay, we’re starting the day and and getting ready.

So I think that’s a big part of it. I’m pretty fastidious about my diet. So I try to eat in regular intervals. And then I try to use that. So I’m focusing a little more on the principles than the what. But I try to use mealtimes as natural periods of rest or break, right? So I’ll give you two examples of this. So let’s say generally I’m eating in some form, hypothetically at nine, twelve, three, and six o’clock, right? So kind of four meal times that are spread out between three hours, right? That provides like natural anchors through the day.

That allows you a, first of all, it tells your body like if you eat pretty much at the same time, it also regulates your circadian rhythm. And then, you know, your appetite naturally arises at those times because you’re kind of programming your body to do that. And then you can piggy back really good habits on top of those. So I’ll talk about one of them. So for instance I wrote an article on the Keystone Habit, that I encourage everyone to read.

And the Keystone habit is essentially a meta habit, in my opinion. The reason that most people struggle with behavior changes is they don’t have a structure or a process in place to essentially keep track of the behaviors that they’re trying to change and constantly iterate on them, right? It’s very easy to set goals, but you should be constantly monitoring and being vigilant of like when you fail to do them, why you failed, what were the barriers they got in the way and what you’re gonna do differently next time. And in my opinion, the best way in my experience, is you’ve go to do that regularly. So I generally find that spending four minutes. That’s it. That’s all you need during those meal times.

Like, you know, nine, twelve, three and six o’clock allows you to kind of check in and essentially make a plan of like what I’m going to do for the next few hours. And looking back, you know, if you weren’t very productive in the morning and now it’s like noon time and you’re like, boy, I waste the whole morning to take a reflection and not ruin the rest of the day. And say, okay. Like, that didn’t work.

Let’s try something different. Let’s do it. Call an audible and we’ll change the game plan so that at least I’m going to do something different this afternoon. I’m not going to waste the whole day away. So that’s one thing that I that I naturally sort of do, is I try to do those little keystones right around the meal times in order to plan ahead for the next few hours and also reflect on the last few hours and keep doing the stuff that works and eliminate that stuff that doesn’t. So that’s one thing. Go ahead.

Dr. Sohaib Imtiaz: That’s a very good way of kind of running your day. You have these keystone habits which kind of anchor your day and then you revolve everything around that.

Dr. Cameron Sepah: Absolutely. Any other thing I wanted to add? This is very relevant to the dopamine fasting. As you know, we’re obviously in a very connected society where it’s very hard to not check your phone. Especially if you’re talking about texts, calls and emails. My clients struggle with this all the time, especially if you’re running a company, you’re a clinician, you can’t kind of turn your phone off all throughout the day. People expect you to respond. So this isn’t feasible for everyone.

But for a lot of people, you can also piggyback onto those sort of natural meal or rest times. Periods to check your phone. So I try to do this. I’m not perfect about it, but I try to limit when I’m sort of checking my phone to those mealtimes as well. So if I’m doing like, for instance, the Keystone Habit before the meal times. After I have my meals, I’m going to say, okay, now I’m going to give myself a few minutes. I’m going to check for any text messages I have. I’m going to check for any emails that I have. And yeah, if I want to check my Twitter or tweet a social media post, I’ll do it then too. But I’m going to try to, again. It’s almost like the worry chair.

I’m going to try to constrain that to basically a few minutes after meal times. And this is a really important reason why it’s because it reduces the impulsivity around it, right? There’s nothing wrong with like going on Twitter, but I do think there’s something wrong when you’re doing it when you’re feeling anxious. And then you go on it as an avoidance of the anxiety. Because the moment that you do that, you reinforce the anxiety, right?

Your strengthening thing that connection your brain that, I can’t tolerate anxiety, and I need to engage in some sort of avoidance behavior where I distract myself from anxiety by going on Twitter, right? That’s the pernicious part. So it’s not the Twitter is evil. It’s the way that we use social media to promote emotional avoidance.

That’s dangerous. Now, the way that you get around that is by doing it in a scheduled way, right? If I go on Twitter because it’s 12:30, and I just finished my lunch, then I’m not doing it out of an emotional avoidance period. I may or may not be anxious at 12:30, but in that moment, I’m just going on because this is my regularly scheduled, you know, social media time.

And that way I’m breaking the stimulus response connection between anxiety and avoidance and saying, okay, I’m going to use social media. But now the intention and the function that it’s serving now is totally different. So I find that to be incredibly helpful and useful in my own life. Now, it’s hard to obviously stick to these things, but I think that’s part of the effort. And that’s the continual journey of improvement that we’re all on.

Dr. Sohaib Imtiaz: I mean, this has been quite a master class and all things psychology, mental health, tech, Silicon Valley. I learnt a lot from this. And where can people follow you?

Dr. Cameron Sepah: Yes, you can follow me on social media. I have an active Twitter account, which I will try to practice what I preach. Right now it’s @DRSEPAH. You can also follow me on Linkedin and Medium. The long form essays and articles like the dopamine fasting one that I mentioned is posted on those. So you can follow me there and my contact information is on those sites as well.

You can e-mail me or DM me. I always love engaging with people and always appreciate feedback too. Like I said, you know, I’m always taking the best from, you know, the research literature, the best from high performing athletes and executives in the best that I’ve sort of learned from my personal and professional experience and sharing that with people. And I love hearing from other people in terms of how they implement these things, how they iterate on them and even make them better.

Dr. Sohaib Imtiaz: It’s been absolutely brilliant. And you’re someone who possesses so much knowledge. It’s quite astounding how you can keep all of that and formulate so many more hypotheses and kind of keep exploring and keep being so driven and motivated, and you know, delving into of subject matter that you are an expert in, but then maybe things that you’re not comfortable with and it seems like you strike a really good balance.

And that’s great for our listeners and especially students, which always is targeting. So I think there’s been so many great explanations of everyday feelings and emotions that we all go through as humans and the human experience and how we can navigate them or best prepare ourselves to navigate life. So I have to say thank you for coming on.

Dr. Cameron Sepah: Well, thank you so much for hosting me. Like I said, I feel incredibly lucky in my life to be where I am. And I never anticipate it sort of, you know, the journey that I that I took. So, you know, I feel very fortunate to learn what I’ve learned. And if I can share that in any way, I feel very fortunate to.

Dr. Sohaib Imtiaz: Thank you. You’ve been awesome.

Dr. Haroon Kazem: Thanks for listening to another episode of the Body Clock podcast by Owaves. If you enjoyed the show, please leave us a five star rating on your podcast app. Please also remember to download the Free Owaves app on the Apple App Store. Please tell your friends and your family. It’s a great tool to help you optimize your life and to effectively plan your day. Thanks, as always, for listening and I hope you join us again next time.