A Model of Resilience: An Interview with the Stoic Doctor Matthew Galati of the Brain Changes Initiative

I interviewed Dr. Matthew Galati, founder of the Brain Changes Initiative, to learn about his remarkable recovery from Traumatic Brain Injury (TBI).

In the interview, Dr. Galati offers us a reminder of the importance of resilience and perseverance in overcoming obstacles in order to reach your goals.

Readers of the A Life of Virtue blog will find resonance with Dr. Galati’s timely Stoic wisdom of acknowledging that while we may not be able to control external events, we always have the power to make the conscious decision of how we can respond to them.

It’s not what happens to you, but how you react that matters
Stoic philosopher , Epictetus

Dr. Galati’s story serves as an inspiration to us all. Through his work through the Brain Changes Initiative, he advocates for a wholistic approach for assisting TBI survivors through awareness, advocacy and support.

For more information on the Brain Changes Initiative please visit: Home (brainchanges.org) or on Instagram at @brainchanges

1. Tell me a bit about your story and how you got started with the Brain Changes Initiative?

In 2013 I was driving back to the Schulich School of Medicine and Dentistry in Windsor in bad weather conditions when I hit black ice sending my car out of control resulting into me crashing into a tree.

The accident left me unconscious with brain bleed, multiple fractures and sent me into a three-day coma. Upon waking up, I realized my cognitive abilities were severely damaged. Basic everyday tasks became a challenge. I initially couldn’t walk or talk.

Nine years ago, the research being done on traumatic brain injury was still in the early stages. The predominant view was that as one matures into adulthood, the brain remains static. Doctors initially told me that the chances of full recovery were slim.

After receiving acute care for my injuries, I enrolled in an intensive rehabilitation program at the Toronto Rehabilitation Institute. In addition to my rehab work at the institute, I took the initiative in working on my recovery. I focused on activities that engaged different aspects of my brain.

To achieve this goal, I did of a host of different physical and cognitive exercises including:

running 5km every morning;
reviewing my notes from medical school;
learning guitar;
practicing mindfulness mediation;
proper sleep hygiene; and
eating a healthy nutritious diet.

I took inspiration from the insightful book Spark: The Revolutionary New Science of Exercise and the Brain by John J Ratey. In the book, Ratey who is a MD, presents new scientific insights that demonstrate that an active ‘lifestyle approach’ can be helpful and provide positive outcomes in healing from TBI. He presents a study that looks at the effects that a school districts’ revamped physical education program had on academic performance. Of note, the study demonstrated how aerobic exercise can prime the brain for learning.

When I communicated my ambition to complete my medical school degree, I was met with skepticism and hesitation from my academic advisors. Determined to prove the magnitude of my recovery, I demonstrated improvements in my cognitive abilities by rewriting and receiving better marks on my medical school exams than I previously did in the past.

After graduating and completing my residency I began research on traumatic brain recovery, and the potential of a lifestyle approach on brain health.

This led into the Brain Changes Initiative, a non-profit which I created in 2019 that funds ground-breaking research to improve the standard of care for TBI recovery. The goals of the organization are threefold:

Raise awareness about the possibilities for TBI recovery in the community
Provide education through our webinar series on the benefits of a lifestyle approach to brain health
Support research aimed at finding the ideal dose of intensive physical and cognitive exercise to optimally heal the brain after TBI is sustained

2. Your recovery is an example of what we can achieve through dedication, effort and hard work. I was wondering if you can impart any lessons or advice on how we can cultivate more resilience in our lives?

My experiences have taught me that in life it is important to be adaptable. You have to anticipate that things will not always happen the way that you intend them to.

We should always believe in our potential. Be your best advocate. There is a mantra that I like from the basketball star and Toronto Raptor Fred VanVleet – ‘bet on yourself.’ Despite missing the NBA draft, VanVleet’s hard work and determination eventually led him to signing the largest contract as an undrafted player in NBA history. In subsequent years he was a key component in the Raptor’s 2019 NBA championship.

Ultimately, we can’t control external events. For me, I couldn’t control the accident and resulting brain injury. However, I could control how I reacted to the situation. My determination to improve and reach my goals through research and taking an active role in my recovery is on me. No one except yourself and your family is going to care about your situation.

It is up to you to keep on pushing forward.

**Ryan Holiday, The Obstacle is the Way**

3. The rehabilitation process required a lot of consistent physical and cognitive exercises. One thing that I personally struggle with is getting into a routine when I am trying to develop new habits. Any suggestions on how we can stick to our planned goals and reach those elusive New Year resolutions?

For those who experienced TBI, it is common to fall into a state of apathy. This occurs when an individual loses hope resulting in feelings of indifference or a lack of interest in their environment.

There were two key activities that were instrumental to my success and recovery, affirmations and scheduling.

Affirmations are positive statements that boost self-confidence, provide motivation and help you overcome negative thoughts. I would post affirmations on my wall, repeating the goals I hoped to achieve. The more often you do this, the more you reinforce these positive thoughts which help you actualize your ambitions.

Another thing that I did was keep an agenda and planner. This helped me keep track of my progress on completing the daily tasks and routines that I set out for myself such as aerobic exercises and tasks for cognitive development. Implementing a schedule is an important tool for developing strong habits.

We must constantly remind ourselves that anything is possible. Numerous people told me that my goals were unrealistic or unattainable. However, no one should compromise their dreams and aspirations.

The brain is truly the most remarkable and complex things on the planet. We can achieve anything that we set our mind to.

We must constantly remind ourselves that anything is possible…no one should compromise their dreams or aspirations

4. You talk a lot about ‘neuroplasticity’, what is this concept and why is it important?

Neuroplasticity is the brain’s ability to adapt, heal and change. It is the way we learn new skills. The more you do something over and over again you begin to build stronger corresponding connections in your brain.

Again, this concept runs against the common thinking years ago which claimed that the brain is a static organ unable to change once you mature.

It was through the possibilities provided to me by the neuroplasticity of the brain that enabled me to achieve this remarkable recovery.

5. I’ve been intrigued to learn about the lifestyles of those who live in the Blue Zones which are regions where people generally live the longest. Research attributes their life span their diets (mainly plant based), exercise, limiting alcohol consumption, getting enough sleep and having good spiritual, family and social networks.

There are a lot of similarities with these characteristics and the five-pillar approach for brain health that you advocate for.

Do you think there has been a shift in recent years in the medical community towards more holistic approaches to wellbeing?

In Western medicine there is a strong emphasis on symptom management. Of course, this is very important to treating acute care conditions.

A consequence of this approach however is that it can overlook the significance that one’s lifestyle and habits play in their wellbeing. This is the missing element in dealing with chronic conditions.

As part of my studies, I did some training on functional/environmental medicine which emphasized a wholistic approach to health. Rather than just focusing on ‘band-aid’ reactive solutions, it is shifting attention to the root causes of the illness.

That is to say it is preventative rather than reactive.

These changes to my habits and lifestyle are what ultimately healed me. The longevity of those in the ‘blue zones’ demonstrate how being active, embracing a strong sense of community and making healthy life choices can lead to longer and more wholesome lives.

6. My blog, A Life of Virtue, is about exploring about the deep philosophical questions about meaning and purpose. What do you want to get out of life, and what makes life meaningful for you?

My journey to recovery gives me a lot of gratitude and strength. Yes, I suffered traumatic brain injury but I was able to turn my life around through hard work, perseverance and dedication. You always have the ability to reframe your thoughts. You can turn your weaknesses into your strengths.

The lessons that I learned throughout my healing journey have been invaluable. As a doctor, I want to be able to help others with the lessons I’ve learned.

This has become my mission.

You always have the ability to reframe your thoughts. You can turn your weaknesses into your strengths

This interview has been edited for length and clarity

Shaking the Snow Globe: A Theory of Psychedelics

Admittingly, I was first hesitant to write about psychedelics. For better of worse, these substances have become associated with the anti-establishment and counterculture movements of the 1960’s. Consequently, psychedelics carry a lot of stereotypes and cultural baggage from the past. Nonetheless, after reading Michael Pollan’s fantastic book, How to Change Your Mind and looking into additional research I became convinced of the potential of psychedelics to bring about transformative experiences. If used under the guidance and supervision of trained medical professionals, psychedelics have been shown to have significant positive effects in mental healthcare.

Psychedelics which include substances such as DMT, LSD and psilocybin (magic mushrooms) produce altered states of consciousness resulting in temporary changes to cognition. At a rudimentary level, psychedelics appear affect the brain’s serotonin system, fostering new neural pathways in the brain.

You may still be wondering, how one experiencing these peculiar and strange altered states of consciousness can have lasting effects on one’s perspective of the world, and effectively address a range of mental health issues.

One of the leading theories that seeks to explain how psychedelics affect the brain is Robin Carhart-Harris’ Entropic Brain Hypothesis. The theory develops a model in which different states of consciousness are ordered based on their level of entropy, or rigidity they encompass.

Many mental illnesses including depression, post-traumatic stress disorder, obsessions and eating disorders are characterized by inflexible thought patterns and fixed narratives we develop based on how we conceptualize the world. These illnesses narrow of perspectives, in which we become terrorized by our own destructive ‘egos’. Our incessant fears or past traumas become filters to how we shape our lives and view reality.

On the other end of the spectrum are high entropic states of consciousness which are embodied by chaos. These states are characterized by disorder and flexibility. Examples of high entropy mental states include infant consciousness, sensory depravation and psychedelic states. A basic diagram depicting this model can be seen below.

Robin Carhart-Harris Entropic Brain Theory

Psychedelics are particularly useful for individuals with on the ‘low entropy’ side of the spectrum. They help disrupt negative patterns of thought which have become ingrained in our minds by introducing more flexibility – more entropy. Observed by scientists, when an individual is on psilocyn “thousands of new connections form, linking far-flung brain regions that during normal waking consciousness don’t exchange much information.” A visual representation of the difference between a placebo (image A) versus a brain on psilocyn (image B) can be seen below.

Homological scaffolds of brain functional networks 2014

A hallmark of the psychedelic experience is ‘ego dissolution’, the disappearance of our sense of ‘self’, and a feeling of ‘oneness’ with the universe. Michael Pollan describes his experience with ‘ego dissolution’ on psilocybin

The sovereign ego, with all its armaments and fears, its backward-looking resentments and forward-looking worries, was simply no more. Yet something had succeeded it: this bare disembodied awareness, which gazed upon the scene of the self’s dissolution with benign indifference. I was present to reality but as something other than my self. And although there was no self left to feel, exactly, there was a feeling tone, which was calm, unburdened, content.

From a neuroscience lens, psychedelics decrease activity in the default-mode network which is considered to be region of the brain which is synonymous with ‘the self’ or what we call ‘I’. When activity in the default mode network falls off, the ego disappears temporarily liberating us from the excessive and unproductive ruminations of the mind. When this occurs, we can rid ourselves of destructive stories and ideas we hold dear, and have the opportunity to craft new narratives.

Psychedelics may be a shortcut to achieving what long experienced meditators have been training years to attain, the relief from what Buddhists call the ‘monkey mind’ or the ‘no-self.’ In this state we are liberated from attachment, and the separation between subject and object disappears. At a minimum, psychedelics show us that there exist many different forms of consciousness and unique perceptions of reality that we can experience throughout our lives. This offers us a unique opportunity to view the world from a different lens.

To quote William James in his book The Varieties of Religious Experience,

Our normal waking consciousness, rational consciousness as we call it, is but one special type of consciousness, whilst all about it, parted from it by the filmiest of screens, there lie potential forms of consciousness entirely different. We may go through life without suspecting their existence; but apply the requisite stimulus, and at a touch they are there in all their completeness

William James: Author of The Varieties of Religious Experience

These are no doubt powerful substances which if used in the wrong context can have negative repercussions both on an individual and societal level. Nonetheless, if used in as a medicine rather than as a recreational drug in a safe and regulated environment, psychedelics can perhaps give us a momentary glimpse of enlightenment.

Next time I’ll explore in more detail what the clinical trials are revealing about the therapeutic use of psychedelics in mental health care.

Till next time,

Gazing into the Telescope of the Mind

For some, the term ‘psychedelics’ may illicit images of the strung-out hippie at 1969 Woodstock or the madman hallucinating, on the edge of losing self-restraint. Yes, like many other drugs or tools developed by mankind, psychedelics are a double-edged sword. Used in an improper context amongst individuals with specific mental illnesses, these drugs may exacerbate symptoms and lead to erratic behaviour. However, a renewed interest and modern renaissance of research is emerging about the potential of psychedelics to address a host of mental illnesses ranging from depression, end-of-life anxiety and addiction. Used with caution, psychedelics can be important tools for psychiatry and self-exploration, and their use extends far beyond their stereotypical image of a ‘party drug.’

Psychedelics have been described as ‘telescopes for the mind’ giving users the ability to explore the depths of their subconscious. Through this voyage people can escape the every day realities of their normal waking consciousness, and gain new perspectives and insights into how they view the world. Few personal accounts of psychedelic use have received more notoriety than that of the English intellectual Aldous Huxley. Describing his experience on mescaline, Huxley writes in The Doors of Perception,

To be shaken out of the ruts of ordinary perception, to be shown for a few timeless hours the outer and the inner world, not as they appear to an animal obsessed with survival or to a human being obsessed with words and notions, but as they are apprehended, directly and unconditionally, by Mind at Large—this is an experience of inestimable value to everyone and especially to the intellectual

To filter the immense amount of incoming information from the external environment, our brains have evolved to become ‘prediction machines.’ That is, they attempt to make sense of the present moment by comparing it to similar experiences in the past, and making predictions into how events will unfold. While this may be evolutionary efficient for our species, it can inhibit us from experiencing the joys of the present moment, leaving us in a perpetual state of anxiety.

What psychedelics seem to do is to momentarily alter our perceptions of reality. They ‘shake the snow globe’ in our minds suspending the mental habits and ruminations we have developed over the years. That is to say these experiences allows us to view things from a different light, through a new lens, and to redefine our associations we have with our thoughts. In fact, in one study 66% to 86% of these participants in these psychedelic trials noted that their experience was one of the most meaningful in their lives These altered states of consciousness can lead to can lead to feelings of awe and wonder. As Michael Pollan eloquently notes in How to Change your Mind,

One of the things that commends travel, art, nature, work, and certain drugs to us is the way these experiences, at their best, block every mental path forward and back, immersing us in the flow of a present that is literally wonderful—wonder being the by-product of precisely the kind of unencumbered first sight, or virginal noticing, to which the adult brain has closed itself.

I want to explore what the recent literature in psychology and neuroscience are telling us about the value of psychedelics in mental health as well as the insights they can provide into spirituality. I am not writing from practical experience, and the research does make it clear that the psychedelics are not for everyone. Moreover, the experience is contingent on an individual’s own inner mental landscape, and the ‘set’ and ‘setting’ of the event.

However, perhaps what psychedelics can do for us is change our glasses of perception, open new doors and allow us to get a glimpse of new alternatives modes of consciousness which we could strive towards. And maybe, just maybe, they can help us change our minds.