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

A Stoic Approach to Fear

Seneca: A Stoic Life

One of the things I admire about the Stoic philosophers is that they embodied the wisdom that they preached. Seneca, one of the three notable Stoics (along with Marcus Aurelius and Epictetus), used the philosophy of Stoicism to navigate the turmoil and uncertainties during his life.

Although he maintained a high status in ancient Rome as a politician and financial clerk, Seneca was forced into exile by Claudius, and ordered to commit suicide by his former student – the tyrannical emperor Nero.

In a typical Stoic fashion, on his death bed, Seneca urges his friends, family and followers not to fear death. Dying with dignity and courage, he argues that it is only through death and the ephemeral nature of our existence which gives life meaning. It is not the duration of one’s life that is of significance Seneca claims, but rather the endeavours and meaningful pursuits that one engages which makes life worthwhile.

In his consolation to his friend Marcia over the death of her son, Seneca writes that we should always be prepared for the unknown, directly confront our fears and cherish our existence. Nothing should be taken for granted.

That person has lost their children: you too, can lose yours; that person received sentence of death: your innocence too, stands under the hammer. This is the fallacy that takes us in and makes us weak while we suffer misfortunes that we never foresaw that we could suffer. The person who has anticipated the coming of troubles takes away their power when they arrive.
Seneca, On Consolation to Marcia

Letters from a Stoic

One of the more notable works left behind by Seneca is the Letters from a Stoic. Near the end of his life, Seneca wrote 124 letters to his friend Lucilius offering philosophical insight and consolation, highlighting many of the key themes in Stoic philosophy.

My favourite in this collection is Letter 13 – On Groundless Fears. In this letter, Seneca encourages Lucilius to practice resilience providing questions to consider when assessing the validity of his fears.

Many of our fears Seneca notes are unfounded. We can not control the external world, but we can control our interpretation of it. Much of what we fear are fabrications produced by our mind which, if properly evaluated and critiqued, have no basis in reality.

Even if unfavourable events do come to fruition, we do not know what the future holds. It may perhaps be a blessing in disguise.

To expand and identify these key ideas these I created a graphic which summarizes the questions and maxims Seneca urges us to consider when we are faced with anxiety or fear. In the thought bubbles are direct quotes from Seneca’s letter which speak to these concepts.

If you want to listen to an audio version of these letters I highly recommend Tim Ferris’ Tao of Seneca.

Title Image Source

Mental Health in a Time of Crisis: An Interview with Your Mind Matters

In some earlier blog posts I have written about the rising concern of the mental health crisis in modern societies. In particular, I argued that the malaise and discontent we experience in our culture can be partially attributed to the individualism and consumerism that is promoted and admired in the West.

On a broad level, our sense ‘common purpose’ has fractured, as we have become more polarized and divided by our politics and individual differences. The social glue that once held us together has begun to fade.

Modern societies are facing a set of interwoven crises which Professor John Vervaeke says are symptoms of our loss of meaning and connection to the world, and to others. We’ve seen the following mental health issues scattered through the news headlines over the past few years. [1]

These existing issues of course will be compounded by the current COVID-19 pandemic.

So, how can we cope during this difficult time? What insights can we learn from ancient wisdom and modern psychology?

I asked Vanessa from the mental health-based organization Your Mind Matters for some clarity. Part 1 of the interview is recorded below.

1. Tell me a bit about your organization and how you got started.

Your Mind Matters is a non-profit organization and mental health platform for mental health awareness, education and support. We provide information and resources to educate people about mental illness and provide peer support to individuals struggling, particularly youth.

I started it when I was in my undergrad at the University of Toronto and I was really struggling with mental illness and my own mental health problems and saw that so many others around me were as well. I then decided to start a student group on campus to raise awareness, inform students about mental illness and the prevalence for youth especially in a university setting, and provide resources on campus relating to mental health.

In doing this, I realized how important this work is and decided to practice mental health advocacy beyond university, so I turned Your Mind Matters from a student mental health awareness club into a non-profit organization.

It goes without saying, but my own struggles with mental illness fueled my passion for mental health advocacy and pushed me to start this organization.

Although mental illness sometimes knocks me down and pushes me around, it inspires me to make a change and keep pushing forward despite it all. It also keeps me going knowing how many people out there are struggling, and my own experiences have made me realize how hard it is and I never want people to feel that way, so I’ve decided to do what I can to help others.

2. In my personal experience, a lot of internal tension comes when you act in a way that does not align with your core values. What does the concept of authenticity mean for you, and how can we live a life that is congruent with our deepest belief?

Authenticity is so important to me and something I value very deeply on a personal level. To me, authenticity is stripping yourself down and taking off the mask and all those external layers and getting to the root and true essence of who you are, unapologetically and without shame or fear.

Think of it like an onion: you peel the layers one at a time and it makes you cry. But, when you strip all those layers and get to the root of who you are, you’ll find our who you are at its core and hopefully learn to accept and love that person underneath all the layers.

Authenticity and to be fully yourself is the most vulnerable form of bravery, but to me it’s the only option. It means knowing who you are and what you stand for and not straying from it or compromising yourself or your values. It’s having a clear sense of what your values are and upholding them however and whenever you can. To live a life that is congruent with our deepest belief, we first need to dig deep and learn about ourselves.

Photo by eberhard grossgasteiger on Pexels.com

We need to fully understand what these beliefs are and why we have them. We need to discover our intentions and our deeply rooted core beliefs about ourselves, others and the world. And then we need to decide how we’re going to live a life that is congruent with our beliefs. It means doing things for yourself and not fearing judgment or ridicule and letting go of shame and guilt. Some people will not agree with us or like us for who we are, but that is okay. It is better to be who we are than to transform into someone we’re not just to satisfy someone else.

This means getting to know yourself and liking the person you are and then it’s being that person as much as you possibly can. It requires not really caring what anyone else thinks because your foundation is so strong and your values are so clear and concrete that no one can shake the core of who you are.

Authenticity is doing things because we’re intrinsically motivated, not extrinsically motivated. It’s not having ulterior motives except being who we are and doing what we believe in on a fundamental level. It’s saying, “this is me, take it or leave it” and not caring if they “leave it” because you know that it’s their loss and that decision is more about them than it’s about you.

Being authentic is so hard these days and not easy to come across, but being an authentic person is such a valuable and coveted feat. There’s something so empowering, so powerful and so attractive about someone who knows who they are and sticks to it at all costs. We do this by learning to love ourselves and the person we see in the mirror and then being as much of that person as we can no matter what.

To use another metaphor: it’s like a tree with roots that run so deep and that are extensively intricate and no matter how hard you try and shake the tree, it will not move. It is so strongly rooted and firmly planted in the ground that no external factors can shake it. That’s authenticity to me.

Having such a strong foundation that no one and nothing can shake. When you have roots that strong, it’s hard to be inauthentic. I think it’s important that we start appreciating authenticity as being the strength that it is, because it’s not seen often but it is needed so badly to create a world of more honesty, compassion and deeply rooted and upheld values.

There’s something so empowering, so powerful and so attractive about someone who knows who they are and sticks to it at all costs. We do this by learning to love ourselves and the person we see in the mirror and then being as much of that person as we can no matter what.

3. Social media has us constantly comparing ourselves to others. It is easy to fall into the trap of judging our lives and our accomplishments in comparison with our peers. Do you have any advice on how we can be more accepting and kinder to ourselves?

As a disclaimer, I’d like to state that I should not be the authority on this topic because I absolutely am one to fall into the trap of comparison via social media. However, it’s something I am trying to unlearn. Self-compassion and acceptance are two big focal points of most of my therapy sessions and have probably become the overarching theme in most of them.

One thing I learned and have implemented that’s pretty life changing is talking to myself the same way I’d talk to a friend. It’s not easy, but if you think of it I’m pretty sure you’ve said some pretty mean things to yourself that you’d almost never say to a friend or someone you love. So then the question is, why do we say these things to ourselves? We need to start holding ourselves up to the same standard and treating ourselves with the same love and respect as we treat those we love.

I also think learning to forgive ourselves is an important part of this equation. We tend to be really hard on ourselves and are our own worst critics. It’s important to remind ourselves that we’re doing the best we can with what we have and know and that’s enough. We’re bound to make mistakes and be imperfect. What matters is that we learn from them and move on. Let yourself let go of the idea that you are inferior or less-than for whatever made up reason you’ve concocted in your head.

Also, a note about social media: it’s all fake and nothing is at is seems. Trust me, I used to post nicely filtered pictures of me travelling and eating and acting all happy and like I was “living my best life” (a myth that I will not get into right now because then I’d never stop talking) when really on the inside I was hurting so deeply. It’s important to note that what’s on social media doesn’t actually represent people’s real lives at all and it’s harmful to think it does. The grass isn’t greener on the other side, it’s a filter. And one last thing while we’re on this topic: comparison is the thief of joy. Don’t do it.

You can compare yourself today to who you were yesterday and that’s it. Comparing yourself not only to someone you’re not but someone you’re only seeing little curated and filtered snippets of through a screen is a recipe for unhappiness and low self-esteem. Look in the mirror often and learn to like what you see (and I’m not just talking about looks). Look inward. That’s where you find love and acceptance and self-compassion. Don’t expect anyone else to do this work for you.

I also think learning to forgive ourselves is an important part of this equation. We tend to be really hard on ourselves and are our own worst critics. It’s important to remind ourselves that we’re doing the best we can with what we have and know and that’s enough.

[1] Of note, I won’t get into the statistics here, but I will link to the relevant studies if your interested that show these trends.