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Performance coach, detail-loving educator, big-thinking entrepreneur, podcaster, mama, passionate adventurer, and health optimization activist here to help people transform their lives, and reach their highest potential! All rolled into one.

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The Meaning of Pain, Effects of Cortisol, Aging as a Disease, Fear Mongering in Healthcare and Society, Learning from Elite Athletes and Hedge Funds, the Dangers of Obesity and the Fear of Failure with Multi-Specialist Osteopath Nick Potter

the Longevity & Lifestyle Podcast

Nick qualified from the British School of Osteopathy in 1993 and his extensive career spans co-founding The London Spine Clinic to working with elite track athletes, professional Golfers, Tennis players and Formula 1 drivers, as well as high goal Polo players and skeleton bob athletes.

Nick has worked as a Human Performance advisor for the Institute Biomedical Sports et Vie in Paris and VieLife where he set up a state of the art performance and biomechanics centre. He consulted to Jaguar, Jordan and Prost racing teams. He also helped to establish a Human Performance tracking/ measurement tool with WAIS in Western Australia.

Nick is passionate about the power of Osteopathy and has a compelling vision for the future of medical healthcare. Nick, as I, fundamentally believe in making treatment fun and as easy as possible, whenever possible!

In this episode we discuss the scientific art of osteopathy, what pain really is and how it can be relieved in under 10 minutes, the importance of breathing correctly and confidently, working with global hedge funds to improve performance, Hypermobility, the impact stress has on decision making and productivity, resolving chronic pain with simple shifts, how the healthcare system is failing and manipulating our society, AND more on Nick’s colourful background that has led him to where he is today, helping his patients to alleviate pain and begin living to their fullest potential!

About the episode & our guest

Our guest today is a powerhouse of knowledge and a true innovator in the space of preventative medicine, Nick Potter, a long-standing Osteopath also trained in medical acupuncture, currently Clinical director at the Princess Grace Hospital Orthopaedic Centre in London, and author of the book ‘The Meaning of Pain’.

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Nick Potter

Episode 19

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PODCAST EPISODE SHOW NOTES

  • Nick Potter is an osteopath with a special interest in stress management. He describes how stress is a response to our environment that we all share. Nick has found that, for hedge fund traders, cortisol release correlates almost exactly with fluctuations in the market. Nick explains how stress influences many areas of people’s lives, leading to them making GP visits and getting unnecessary medication. Nick takes a deep dive in the psychological and environmental factors involved in stress, and offers a note of caution regarding how algorithms use and perpetuate stress. (02.46)

  • Nick discusses the effects of COVID, and the true story of declining health in older people. Nick explains the importance of movement for health outcomes in people of all ages. He then provides a vivid example of how sales and marketing prey on our fears. (15.20)

  • Nick tells the humbling story of a patient who’s complete lack of self-confidence can be attributed to one mysterious event at her birth. Nick sketches the history of osteopathy while differentiating it from physiotherapy, and tells the story of his journey to where he is today. How did he earn the nickname “Nick The Neck”? (29.25)

  • As an expert in pain, Nick is well placed to explain why we hurt and how our approach to pain relief is misguided. Chronic pain is in fact a thoroughly complex and psychological experience, far beyond “pain pathways”. Nick shares the fascinating story of a patient with a breathing pattern disorder. What triggered her issue, and how did she solve it? (49.17)

  • Nick describes what it’s like to live with hypermobility and draws a surprising link between hypermobility and muscle tone. The true nature of long COVID is unveiled, and Nick introduces us to respiratory sinus arrhythmia and explains how stress affects it. Nick delves deeper into how stress is manifested in our brain, our digestive system, and our behaviour. (1.00.48)

  • Nick tackles the topic of obesity by detailing the progress of an acquaintance towards lower weight and a better health prognosis. How is fat like a parasite? Nick reveals his hack for getting to sleep. He considers the negative effects of alcohol, and the relationship between diet and body type. What explains the tendency for the best sprinters to be of West African descent? (1.16.19)

  • What three things that humans abhor did COVID unleash on us? Nick makes a surprising connection between perception and cancer. Nick then opens up about a big influence on his life who, on her deathbed, shared words of wisdom that Nick will never forget. He also shares the story behind learning that will to win should trump fear of failure, and reveals the moment he realized the dangerous inherited message he was sending to his own daughter. (1.28.36)

  • Nick talks about his exciting new invention to assist patients with breathing. Why were Edwardian women regularly fainting? Nick then leads us in a demonstration of the proper breathing technique for relaxation and stress relief. Finally, Nick discusses how he helps celebrities and high-performance individuals manage life at the highest level before sharing his hope that we can live with being scared of growing old. (1.42.28)







“I'm afraid don't always think the pharmacology companies are your friend.
They're not busy out there being heroes all the time. This is a market. It's money. And there's no money in curing people. It's a horrible truth, but there isn't. Make everybody better enough”
“We've also got to look at how many "diseases", in inverted commas, that we're treating, that actually aren't diseases. I mean, look at aging.”
“And that's the point, that's my point, so I want to be at 60 being hopefully lithe, free of arthritis.”
“We're a bit bored we're doing a lot of navel gazing and stressing about things we really shouldn't be.”
“Now if you had, and managed, a set of things, you've gone and worked, as I have, in Angola, which is a genuinely dangerous place. And, we had to fend off diseases and attackers and gorillas and those sorts of things. Coming to live in London is a walk in the park and you're going, "What do you mean London's a dangerous place?"”
“We are more stressed about our children going out on the streets, we bubble wrap them. We “helicopter parent” them. And we set up a low threshold, and tolerance, of stress, because we don't expose them to it. And, as parents, teach them to navigate the chaos, then we're not setting them up to face their futures. We're setting out to be anxious balls of fear.”
“Shoes are sensory deprivation devices for feet, that's it? And they're, your feet are incredible pieces of kit. They are your primary sensory system with the floor and they measure everything.”
“I'm very interested in the neck because it's completely different to anywhere else in the spine, mainly because it holds the head on, and integrates you with the world. It orientates your head in order to perceive and hear and those things.”
“Because there are plenty of kids in India who breathe pea soup for a living who aren't asthmatic. So don't tell me it's all allergy. And you ask any of the respiratory nurses I know, running, up in the north, where they see some really deprived areas, et cetera, where kids are in constant menace in their households, from domestic violence, etc. They will tell you, all of those kids have worse asthma.”
“Over time, pain can become a habit that the brain gets into.”
“Don't purge yourself, don't go on these manic fatty diet we all know what we like but we shouldn't be eating you know whether it's the extra biscuit or too many carbohydrates etc. Just to adjust a couple of things in your life that you permanently adjust and it will just drop off you, the underneath calories a day is I think eight kilos a year in weight is that really sort of as a biscuit that you didn't have?”
“ I have three meals a day. Pretty much Mediterranean diet, fairly low carbs, but I can't be without carbs and then we know that I mean, I even go for workout I've got I've had them somewhere in the last 24 hours. So I'm just like carrying a log. So I think it is, knowing yourself, self-regulation, though just because I was an incredibly fat kid. “
“I think humans need to have meaning and purpose, connectedness.”
“I can't say who she was but she was a wonderful woman. And she laid in her bed in the clinic in London and she said to me, Nick, I realized that health is a crown worn by the well that only the sick see.”
“Team sport is so important because it teaches you to be resilient, it teaches you to face to not getting the team to raise your game to get back in the team, fight your place, you know, respect your others.”
“Look after your health, because it may sound clichéd, but I spend too much time in my life, helping people who wish they had done things differently. And it doesn't take an awful lot. It doesn't mean you have to be this purging paragon of a person. You just have to be observant of certain things. But it's kind of about how you balance your life generally.”


MORE GREAT QUOTES 

Claudia: Welcome to the Longevity & Lifestyle Podcast, Nick, it's such a pleasure to have you on today.

Nick: Thank you. It's a delight to be here.

Claudia: So there's a quote that I'd like to start with, from you, and I'm going to read it out. "Stress is the biggest driver to illness in the world and 40 to 60% of people presenting to a GP or physician have a stress-related disorder. Doctors know this, but they only have seven minutes with you. And the quickest and easiest thing is to prescribe a tablet. I'm offering an answer that isn't drug-related. It's about recognizing what stresses you and understanding it." Can you talk a bit more about this, Nick?

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PODCAST EPISODE TRANSCRIPT

Nick: Yeah, it's a big subject but I'll try and keep it in a nutshell. Maybe I should just wind back a little bit. The reason I feel vaguely qualified to talk about stress is I worked in a hedge fund, I have done for 10 years, looking at stress relating to how people make decisions. And trading floors are interesting places because there are guys staring into a big load of chaos called the markets. And they're required to place glorified bets on something that they hypothesize is going to come right. So they're going to back a horse, as it were. But they're large sums of money and the downsides of big, and hopefully the upsides a bigger. But when they look into that chaos, they become mentally stressed. And that's what's quite interesting. And we looked at what happens in their bodies when they become stressed.

And it's absolutely fascinating. First thing to mention is that they don't know. So if we did mood scores with them, we said, how do you feel? They'd say, no, I feel fine. You know,

I'm looking at it. This is what I do every day. Well that's interesting because your pulse rate, your heart rate variability, your breathing rate, they're all telling me, rather like a lie detector, they're betraying you to yourself. And maybe that's something we could look at and monitor. Because you always have a physiological response. And the nice thing is that that's universal to every human organism, being, on the planet. Everybody has the same stress response.

Because stress, in fact, is a response. It is not a thing. So it's not the stressor, the thing that's stressing you, it's how you respond to your environment. And there are many elements and factors of your environment that stimulate them. So it could be a bad boss. It could be an unhappy marriage. It could be just, you know, the markets are bad that day. Or it can be the length of time you've been under stress.
But very quickly we discovered that when you stress people, they begin to change, they go into what we call sickness health, or health changes. So they begin to show the signs of this in their health. So the classic responses are that people can get gastric reflux, they can get neck and back pain. They can get visual disturbances, they can get rapid heartbeat, et cetera.

They get skin reactions, you know, all sorts of extraordinary manifestations of how stress affects you. It tends to be when stress has affected you for a long time, rather than just overnight. Because we're designed very cleverly to run from the saber tooth tiger when he attacks us. But we just don't want him doing it every day. That's exhausting and tiring.

So most of us live our lives, due to various elements of our environment, as if we're not just roaming the plains and we're getting chased, but actually that we just know the tiger's in the hedge. That's probably a better way of putting it. So it's not that we're immediately going to be eaten, but it's that there's the constant threat of doing so.

And the problem is that that's universal across everybody. And believe it or not is actually independent of personality. So it doesn't matter if you're a psychopath, or a lovely introspective individual in the corner, when you get chased, because we all get eaten no matter what we're like, you're going to have the same response.
And that was something that was quite original that I brought to the fund and said, look, I think we're wasting too much time on psychology, which is useful. But what psychology tends to set is the filter through which you see the world. So in a sense, how quickly are stressed by the environment. So anything that changes the threshold for which you produce a response, but the response is always the same.

Claudia: Yeah.

Nick: So we know that when people are showing these changes in their physiological parameters, we know that they're becoming stressed. So that's a baseline. And we looked at what it did to their nervous systems and what was gobsmacking to find was that not only did the cortisol, which is a stress hormone, which we produce automatically in the response to stress, not only did it get released, but it was actually correlating exactly to, I mean, 0.9, I mean it was extraordinary, with the fluctuations, or the volatility as we call it, in the markets. And nobody had, sort of, kind of, seen this before.

And we did that for 60 traders. And, so it was reliable, but also, well, not a huge global study, but it's more than most people had done. And it was really quite effective and astounding.

What was more concerning was that we also happened to be testing for inflammatory markers. These are cells, like cytokines in COVID, they cause big reactions in people. And they activate systems. And we couldn't believe that a thing called interleukin 1B, which is a funny little cytokine marker, which is actually pro-inflammatory, but it's also pro-tumorous. It tends to switch on genes that can cause cancer, was also tracking-

Claudia: Wow.

Nick: I mean, it was, so I said to these guys, do you realize you are witnessing your immune system tracking volatility? And they went: "No way, no way." And I said: "Yeah". That's what we said, and I said, I've never seen it before. And in fact, I don't think many people have, and I put this to rheumatologists who study this and they go: "God, that's unbelievable. You've actually correlated", yeah, I said: "To the same degree as the cortisol did".

What it says is that when people are constantly, I have to be careful about using chronic, because I think chronic sounds to some people, means really bad. What it actually means is over three months, let's say.

Claudia: Constant, yeah.

Nick: Constant. When you are constantly under stress, you undergo really deep and fundamental changes in your physiology, your DNA, you know, everything. At your cellular level.
We know that, you look at presidents, for example, who've been, you know, under pressure. Tony Blair, you know, all these people.

Claudia: Obama's hair went, really gray.

Nick: Exactly. Also, you know, they look baggy around the eyes and you can see, they just look, they look, they look-,

Claudia: Aged.

Nick: Aged. And that is the effect of cortisol. And so, um, I began to look into this and I saw it again in my practice life, which is where I particularly tend to specialize in chronic pain. Which is pain that, you know, has been manifested in people's bodies for much longer than the injury itself could have caused. So we say, why is that?

And the stuff that brings in daily musculoskeletal pain is this response to stress because it takes it out, particularly in your breathing mechanism and your breathing mechanism uses more energy and so on.

So the reason my slogan, if you like, which is that 40 to 60%, the reason that margin is very big is because it depends on which country you're in, and even where you are within countries. 'Cause obviously some areas, which are very deprived, will have more stress, and net wealth areas will have less. So, but in general, in that range, it was gobsmacking to me the data, which by the way, because I'd written this book, I had gone and spent hours reading, fascinating stuff that's out there that sadly nobody will ever read. You know, even PhDs, as a joke, they say that, you know, the average number of people who read your PhD is seven, one of which will be your mother, you know?

Claudia: Yeah.

Nick: And the study, that will get locked away in some esoteric journal of which there are way too many. So none of us can get to read it all. But I went and learned, and I've just got one of those brains that does, I kind of like linking stuff.And I realized, you know, this isn't actually, it doesn't need to directly correlate to see that, it's really obvious this is causing the problem. And I've spoken to GP colleagues of mine and said, you know, out of 40 patients you see in a day, how many of them are you doing something medically significant for?

You know, how many real does, and they said: "Five". And I'm going "wow". The rest is lifestyle, abusing themselves, eating, drinking, smoking, unhappiness at home, you know, these things. So it's stress. And the doctors kind of know this very often. It's not that they're malpracticing, it's just, if you have 7 to 10 minutes as an average number, time, to see a patient, you can't dig into it, and it's much easier, and they, they want gratification, they say: "Oh, I need treating, help me". And it's like, okay, well here's a medication.

Claudia: Here's a pill, yeah.

Nick: And I think the thing that's worth mentioning here, and it's not as if it's a sort of conspiracy, but I've also worked in around drug companies, and so on. And what is very concerning, and we saw this with the opiate crisis, certainly, is that, I'm afraid don't always think the pharmacology companies are your friend.
They're not busy out there being heroes all the time. This is a market. It's money. And there's no money in curing people. It's a horrible truth, but there isn't. Make everybody better enough.

Claudia: I mean, fasting is free, right?

Nick: Exactly.
So I think we've also got to look at how many "diseases", in inverted commas, that we're treating, that actually aren't diseases. I mean, look at aging. You guys are obviously very important, but if you look at the bell curve distribution of age now, and especially in Western culture, we're all living ridiculously long lives.
And that's great to a point. I don't know about you but I don't want to be, I mean, at 90, if I'm decrepit, I'm quite happy to go and push up the daisies.

Claudia: Yeah, but the point is to live well-

Nick: And that's the point, that's my point, so I want to be at 60 being hopefully lithe, free of arthritis, et cetera, et cetera. Exactly. But I think that we've also got to look at, for example, the NHS in this country is rapidly becoming broken, but, you know, it was never designed to be treating all of these conditions all the time, with so many, it was designed really to be somewhere you went for important operations, and big diseases, you know, and the rest was managed in the community.

So we're seeing all these kind of multi stratified influences that are happening on society, which is; dissociation from each other, we don't connect anymore. Because at the heart of a lot of this, every day in our lives as we're used to, since the turn of the century, we don't face existential threat. Now we've got sustainability, I grant you, but, you know, it's still kind of out there, isn't it? I mean, take Afghanistan. We saw these poor soldiers coming back, limbless. And we go: "Oh, poor, his poor Mum, his poor wife, and, you know, poor him, but then they, kind of, we moved on. It didn't affect us immediately although it was happening.

And I think that, because we don't have that in our lives, it's done several things. One is, we've got too comfortable to a certain extent. You know, we're a bit bored we're doing a lot of navel gazing and stressing about things we really shouldn't be. But also, going back to the stress thing, the marker by which you judge a stressful event in your life, has got to be judged by what your previous life expectancy is.
Now if you had, and managed, a set of things, like, you've gone and worked, as I have, you know, in Angola, which is a genuinely dangerous place. And, you know, we had to fend off diseases and attackers and gorillas and those sorts of things. Coming to live in London is a walk in the park and you're going, "What do you mean London's a dangerous place, you know?" We're all growing up and our kids are all-

Claudia: Compared to Angola, yeah.

Nick: Safer, healthier, more available to opportunity. There's more availability of opportunity than we've ever seen ever in the history of man.
Ever, ever, ever. And yet, we are more stressed about our children going out on the streets, we bubble wrap them. We “helicopter parent” them. And we set up a low threshold, and tolerance, of stress, because we don't expose them to it. And, as parents, teach them to navigate the chaos, then we're not setting them up to face their futures. We're setting out to be anxious balls of fear.

Claudia: Very true.

Nick: That's what I'm seeing in my own kids. And in other people's kids. And it's just, I had a lady in this morning and she said, well, you know, all the crime. And I said what crime? London? It's the safest city in the world other than Amsterdam or so, you know, I mean, some - yes, we get a bit of knife crime, that's mainly in gangs. Well, I don't see you pedaling drugs.

Claudia: Hanging out with the gangs, yeah.

Nick: Hanging out with the gang, I think a good example was the tragic episode.
The young lady in Clapton common, and it was, it was tragic and it was an appalling event, but when was the last time that happened? And I think that's why there's so much sensational factors. Cause, oh my God, you know what I've got, I've got young girls coming into my clinic saying, oh my God, it's the right culture.
You know, it's just men. And they've turned into this sort of fearful like that. Funny enough, you know, not all rapists and it's all turned into. And of course men do stupid things, but as long as we're sexual creatures, as all women, I see women doing stupid things too. You know, we've got to get a handle.
And the problem is we're letting that in tolerance to stress, you're making that, that margin, that bar constantly.

Claudia: And the media as well. Right? I mean, the media with fear-mongering. I mean, it's what sells. And, you know, social media, things like that. Another thing is that with the algorithms and the social media, I'm sure you've seen the Social Dilemma, they're tracking you.

So if you are spending more than a minute reading an article on rapists, then that's going to start tracking you everywhere and you think that's everywhere, as well, unless you know, better, right? So-

Nick: Well, also, the worst thing is the algorithms are trained to show you more of what you were searching for on the first place.

So you get sent literally down, Alice down the rabbit hole, you know, suddenly it's like, oh my God, everybody's threatening everyone, you know?

And then you go to Netflix. I mean, I don't know about you, but I am gobsmacked how much dark stuff, you know? And my teenage kids love this, you know, because it's sensationalist and it's exciting, for all those reasons.

But I remember the other day, my daughter, we were watching Luther, you know. Great series, but it's dark. It's serial killers every week, apparently, you know, they knock up everywhere. And she said, oh Dad, could you hold it? I need to go to the lavatory. So I said, yeah, okay, I'll hold on. And as she went out, under her breath, she said, oh, she said, God, people are so f-ed up. And I just went "what?" And she said, well, you know, I said, no, darling, this is the point. This doesn't happen.

Claudia: It's Netflix.

Nick: Right? It's Netflix.

Claudia: Yeah.

Nick: And this is a sensible 21-year-old, highly educated, young lass. But her perception is, because she's had no contextual experience outside that, that this is what goes on in the world. Well, I'd be terrified.

Claudia: And that's a really interesting point because also post-COVID, right?
So where everyone was just looking at screens as well. If you look at, sort of, the teenagers, early 20s, that have spent the best part of the last few years, watching screens. Like, what is their perception of the world and reality?

Nick: COVID is a really good example because it is the first thing that we thought was potentially existentially threatening to us. Despite the fact that, and I don't want to belittle anybody's illnesses, et cetera, but let's get a handle on this, right? For 97 plus percent, whatever that percentage is, it's up in the high 90s, COVID has been a deeply uneventful or non-eventful disease either to have, or to navigate. Okay? Because on the whole, it was generally only affecting a small part of the population, the very elderly, the unwell, the hypermobile, you know.

And that's tragic. But old people are old. 85 year old people are going to be less well, you know, they're not going to have as good immune systems. And, ironically, I found in my practice that they were comfortable with that. It was, kind of, us that were purging ourselves. Oh my God, old people are dying. In fact, well, actually the fit and the well ones, interestingly, aren't, you know?

The ones in nursing homes are tragic too. But your average life expectancy in a nursing home in this country is between 9 and 18 months. And what does kill in the end is pneumonia. That's what you die of. You don't die of Alzheimer's. You become increasingly immobile.

So I've worked in Australia. I worked in geriatric health. And I actually loved it. I didn't think I would, but it was, but, you know, it was always, we used to call it the old man's friend. Pulmo-pneumonia was what eventually got you. Because if you become static, you don't breathe, and your immune systems are shutting down. Bugs grow in your lungs, and you get pneumonia.

And, in fact, it's a very tolerable end because people then give you lots of opiates and morphines, you, kind of, go off into a wafty haze, and nature takes it's course. And I think we've got to be a little bit more honest about that. We've got to be more honest about what we can expect. And for people like you, you know, proselytizing that you can be a healthier older age.

I mean, I'd like to raise Captain Tom, right? Do you remember this lovely old guy, who's an ex, ex-military guy. Who's now been decorated and knighted and all this business. Well, let's look at what he did. He was 100 years old. He was sitting in a chair, pretty slumped. Interestingly, he was very deaf and he couldn't hear. And in fact he was slurring speech and he, you know, he was and to talk to and we all loved him because he was an avuncular old character.

And then one day his daughter said let's get him up and make him walk a thousand yards. That's basically what he did okay? On his zimmer frame, off he goes, okay? And as I watched the videos, it was fascinating, right? So this is the principle of rehab. Suddenly his muscles got stronger, and with his stronger, his posture got better. He started standing up.

And now because he's being multiply stimulated, sensorily, you know, his eyes, his ears, whatever, he's now getting all this attention, he's getting lauded and he's getting conversations and he's no longer disconnected. And he's not sitting in the armchair waiting to die. And suddenly he's got cause and meaning, and he's moving forward.

Even at a hundred, this guy became more linguistically capable. You know, he became, he was verbally much more empowered. He could hear better. Literally, because he told me, you know: "Wha? Wha?" He couldn't, you know, all of that had gone. And I watched him and suddenly when he receives his medal from the Queen, he doesn't need his zimmer frame anymore. It's there as a reassurance, but there is this guy, and what did he do? Did he take tablets? No. Did he do this, what did he do? He walked. Like Lazarus. He got up, and he developed his muscles. And then his brain switched on and all the little neural membranes in his brain switched on and went, Ooh, there is actually a reason to be around anymore. Well, let's learn about the world. So actually all these little cross bridges happened and his hearing got better and his vision got better, probably, who knows? But, you know, he switched on. And all that did it was exercise, and nobody really talks about it, but actually that's what happened. And you could ask why didn't his daughter do it when he was 90. But that's another question.
But I think, you know-

Claudia: Better late than never.

Nick: Yeah. And COVID, for some people has been amazing because I've seen patients of mine who really had the, kind of, slow shuffling, you know, overweight. But also the mood. And it was always moaning, you know? Yeah. Well, you know, if it wasn't the hip and the arm here. Suddenly, I said how about going, getting some Nordic sticks. Get out there with your wife. It's how you can meet your friends.
And this is the sort of story I love telling because they literally, I've got a couple who used to walk on Hampsted Heath. They're 92. And she, when I first, she had hip pain and back pain. I got rid of all that for her, I said right now, Lazarus, you know, go and rise up, get out there. She now walks every day.
She's now bought a dog, and she's now thinking of doing a half marathon.

Claudia: Really?

Nick: At 92!

Claudia: At 92.

Nick: This was a woman who was miserable and bad tempered and everybody was crap, you know. And all this, you know, in my day... Suddenly, boom, happy pills come on. I'm seeing the opportunity in the world instead of the negativity. These are not young people.
Brilliant.

But I've sadly got people at 50 who should be doing that. Those are the people we need to be speaking to.

And you know, I know what it's like, I'm, I'm 52 now. And I try and stay slim and fit and well. I have a back injury from my old rugby days, which I have to keep strong. But actually I think, you know, wait a minute. That was meant to be bothering me 10 years ago, and it hasn't. And I was meant to have had surgery and I haven't.
And, you know, it's a bit of self-regulation. Is it a pain in the butt? Yes. Doing your core, boring.

Claudia: You have to do something, right? Yeah, exactly. You can just sit on the sofa and hope that it gets better by itself. Yeah.

Nick: But there's a lovely study, which I must dig out somewhere, which I think is important to mention, which was done by the Americans. It was hugely statistically viable because, I think it was 200,000 people done across the country. And they did a retrospective study, well, it's kind of prospective and retrospect in the sense that what they did is they looked at all of the chronic diseases, heart disease, chest disease, COPD, arthritis, you name it.

And they said, let's take all the drugs that treat those and measure their outcome over time. And they set a time point, I think it was over a period of 12 years. And they looked back and they said there was only one thing, one intervention, that showed a high correlation of outcome, i.e it worked, okay?
So, statins, pretty low. All of these different things. None of them were over about 40%. I think. 75% was just two things, muscle strength, and ability to walk, which is effectively exercise. In fact, they were co-correlated. That was a 75% outcome, had the greatest outcome. And that was on cancer, not just, you know, chronic diseases. Cancer, diabetes, heart disease. Right?

Claudia: And it's so simple.
I mean, yeah, I think that that's such a phenomenal study, that, you know, should be more well known. That people, just simple, going getting out for walk and moving, and actually using your body for what it's for. People don't go running anymore. Children used to, you know, run everywhere if possible, you know, and we just, we're so

Nick: sedentary.
Well, we don't let them out because they're going to be either raped or beaten up,killed or sold for slavery as far as most, a lot of people are concerned. I mean, I don't mean to joke, but it really is. I had a wonderful pediatric consultant who trained me, who I rue the, sadly, he died now. And he was quite ruthless. If he had a young child between, you know, two to seven in his room, a girl or boy, he would whip up the front of their trousers to their knees and expose their lower legs.
And if, he said, if we don't see at least four bruises on each shin, you give the Mum a hard time because these kids are not playing. They're not playing, they're not developing, in multiple dimensions. And I thought it was so good. And I have a, quite a big busy pediatric practice. And I can tell you, sadly, I can't remember the last time I did see a bruise on a child.

Claudia: Really?

Nick: And that is mortifying.

Claudia: Mine have got quite a bunch, but we've been away. But I think also, and this will be your expertise, but, you know, having, even walking around barefoot, but for children to walk around barefoot. We once had a physio here helping one of my daughters with something. And he said, yeah, you don't want your child to have city feet.

And I had to laugh. And I said, well, what is that? And then he said, there's a clear difference between children born in the countryside and children born in a city. In the city, they're always wearing shoes and socks, they don't develop their feet properly, and have later back issues. Versus the country kids running around barefoot, they're actually using their foot as it's meant to be.
And I thought that that was really, sort of, an obvious thing, but, again, not really talked about that well.

Nick: But, do you know, what's extraordinary is, I mean, yeah. I mean, shoes are sensory deprivation devices for feet, that's it? And they're, your feet are incredible pieces of kit. They are your primary sensory system with the floor and they measure everything.

They have the five senses, touch, temperature, vibration sense position sense, and so on. And they feed that back to your brain. And the problem is that our modern societies, there's been a disjunct, if you like, really between our mental and physical bodies. And the mistake, I mean, Descartes did this, and in fact, probably until the late 80s modern medicine was still on the principles of Descartes that you've only had your head, and then your body, and that they were kind of, you know, they were two separate entities.

But we now know through studies of the nervous system that, you know, from the very moment that a child is born, all the little twitches that you see them do, all of, putting out a proboscis, even just nosing and pouting, and latching onto the mothers, is a constant sensory process. And the way that we map the world onto our cortices. And that's what people don't realize is that we spend two thirds of our brain function processing visual input, which has become way too dominant because of course we were on screens all the time.

You only know that you are who you are and where you are in the world, in fact, consciousness is made up of the fact that the other system, which is all the touch and all the other five senses, reinforce what you're seeing is to be true. So a good example, if I said to you, well, right now, Claudia, we're sitting in a room together and, you know, actually I'm a ghost and you go, no, you're not. And I go, well, I am. And then I start to worry you, you think this is possible, you know? Well, how would you reinforce it? You'd touch me. Because otherwise you don't know I really exist. I mean, there's you, that's why you start to doubt yourself, well, wait a minute, I'm only seeing him visually, maybe he is a-

Claudia: Avatar.

Nick: Avatar.
So when we talk about mapping, you need your physical body. And in fact, we know that in schools now, particularly in this country, we've taken away playgrounds. I mean, it's an ab- it's just mind-blowing to me that you could do that as a removal of education to children. And you could increase children's, by 20%, you can increase IQ by teaching them to learn to use their physical bodies.
That was the principles of-
Montessori.

Montessori. Thank you. Which in my, when I was a young man was, kind of, oh, a bit avant-garde, a bit out there, a bit airy, but now it's just fundamental to education, taken that long-

Claudia: And it's so easy for them to learn that way as well, right? The sandpaper and all the rest of it. Yeah.

Nick: It's a neurosensory process. That's why I, I mean, again, swaddling children. Why would you do that?

And there's no evidence. You go and look it up. Do we have the contented baby, when I had my kids, and it was all about, eat this and do this. And if you don't do this, you're an evil person. And I just went, why should, you need to swaddle your babies? 'Cause it's like the womb. It's like, no, they've left the wound, and they need to learn to navigate the world and the early form of that is to be multi-sensorally excited.

And it's like, oh no, but you need to, and I think the excuse was that Indians, you know, papoose their children, Navajo Indians put them in, yeah. They put them because they're nomads and they need to move around the world. So they put it in a papoose because they need to have their hands free. They don't sleep them in them, you know?

And again, going back to stress, right? I see a lot of pregnant ladies. And I reckon 90%, that's an arbitrary figure, but a majority of the market of pregnancy is literally based on fear. So I went with my goddaughter to John Lewis, and we looked at all the car seats. And there was the good old Britax that I had when we had babies. I think there was only five on the market. So far my kids are still alive, you know? And they go for, like, £100 to £3000.

Claudia: Insane.

Nick: And I think there was one, it wasn't that much, but I think it was nearly £900. And I said, oh, what does this one do? He said, oh, it's got an air bag.

Claudia: It's got an airbag?

Nick: An airbag, wow, that's cool.

Claudia: Oh, I didn't realize.

Nick: And I said, can I ask you something? And I know you're only the salesman, but, a) what's the evidence that babies die in car accidents? And by the way, it's really, really really, really, really small, so much so that it's probably not even, it's an aberration because actually car accidents are all time low, babies who were involved in accidents, then the car seat was never going to save them anyway, bless them.

And, in fact, the amount of babies who are, is less than nothing. So then I said, I'd love to know how do you test an air bag on the baby's face? Anyway, well I don't know, I'm just telling you the price - I said, no, no. What you're doing is telling my goddaughter, who hasn't got the money to have it, that she's a lesser person and parent because she's not buying the £1000 item.

And that, oh my God, You know, babies die in crashes, which they don't really, and, secondly, you know that an airbag's a good thing. In my view, I've seen the car accidents where people's air bag goes off and they take noses off notices. Yeah? They survive, don't get me wrong, but I'd love to know how in testing, you actually got to do that because I don't think they did. I think they had plastic dolls, you know.
So somebody somewhere thought this was a good idea and because we had airbags in cars, it probably got through some testing system because it's quite a good idea. And it's safe. It's like, well yeah, but you know, not sure about that one. And so, but that's what I mean about the fear. So it's selling to you as, if you don't do this, you will be either a lesser person, lesser mother, or you put your baby at risk.

Claudia: Yeah. It's fear-mongering, especially in new-time mothers, it's such a life change. And I think for many companies, I think it's such an opportunity to actually target women in that phase because they're completely adjusting themselves or thinking, okay, now it's not about me anymore. It's about a child and it's just marketed at them.

And what works best is fear. Right? So you're not a good mother, if you don't do this. So you start believing it. Yeah.

Nick: And you're catching a woman at the most neurochemically vulnerable, but apart from either her, probably her period or menopause, she will ever experience, right? You know, even, I see all these lovely corporate women that come see me and they go, oh my God it's true, I've got brain mush! It's universal. And it happens because you get all the fundamental changes towards caring and empathy that you need for your child. So they're literally going ooh, lovely, right? Pregnant lady. They see the bump, it's like oh, bing bing!

Claudia: I remember when I was little, I mean, you know, my mom used to drive us around, back of a car myself and my sister used to have games sliding back and forth. I mean, there were no car seats to be heard of. And we thought it was a fun game. And, you know, thankfully we weren't in any car accidents, but, you know, there were many, many years where car seats weren't even a thing.
Nick: We were going to die of lead poisoning 'cause we all had lead in the paint on the walls and it's like, okay, well, you know, my liver's still-

Claudia: Survived that one.

Nick: We did break bones, that's how you learn not to do the silly things in life. But you get better, they heal.

Claudia: That was a warning system, exactly.
Nick, you've been humbled by some of your clients. I'd love to have you talk a bit about that experiences, and the wealth of clients that you've seen. What are some of the most impacting experiences you've had?

Nick: That's a really good question. I think sadly there's too many of them, but I think I can give you probably one or two examples. One was, yeah, this is a good example, cause I think it's a, kind of, sort of multidimensional thing. This is a nice, very nice lady. She's Jewish. It matters for reasons I'll qualify. Came to me, very self-deprecating lady, kept going on about how neurotic she was and how she, looked for everything. And she had this neck problem that wouldn't go away and she had headaches and various things. But I noticed that when she was talking to me very slightly looked to me, sort of offset. And I said, oh, is your vision all there?
And she said, well, actually I'm blind in my left eye. So I said, okay, that's quite a big thing. How did that happen? Well, she said, I was very lucky to survive my birth. I was quite premature. And, in fact, they never gave me a birth certificate. They sort of, kind of wrote me off at birth and my mother, kind of, just thought I was going to die.

And, you know, anyway, I made it. I think she was four pounds when she left the hospital. And I said, so when did you lose the vision? She said, well, it was all very weird. It was something to do around my birth. And I said, okay. Well, I went to school when I was two and was behaving strangely and I wouldn't settle down and whatever.

And then they suddenly discovered that I had a bit of a squint. But hey, you know, so they put a patch over my eye. What they didn't do is test whether or not she actually could see through the squinted eye. So they covered her good eye. So she had less than 10 well, I think it was 5% vision in the bad eye, she's basically blind. So she used to try and sit there and, kind of, do this to look at the board and see what anybody wanted her to do.

I mean, honestly, it's tragic. So then somebody said, I think there might be something wrong. They took her to an opthalmic surgeon who looked into her eye, and said, ooh, that's very strange, very rare condition, need to write this up. And it turns out it wasn't, it was a piece of plastic. And to this day, she doesn't know how the plastic got into her eye embedded itself in her retina. And then she underwent a whole lot of scarring. And nobody seemed to answer the question, sort of, so how does a baby get a piece of plastic embedded, without bleeding or without
 somebody raising the alarm and they think it was the top of the cap. There's no way you can go that and it will bury itself and back, anyway.

So this girl's grown up with all this adversity, lack of intellectual, anyway, but then she sort of says to me, well, I do this really weird thing in bed, I always have to insist on lying in the middle of a single bed. And my husband thinks it's really weird. I said, well, that's really obvious why. I said, well, because from an early age, if you couldn't see half the world, then everything on the left side of your world is threatening to you. Your nervous system can't see it. So it's gotta be constantly vigilant to it, which is why you twitch all the time. It's why you can't keep still. But also if you're lying in a bed, you need to know where the left bit is, and am I going to fall out of bed?

So she said, yeah, I do. I kind of use my hands to work out where the side is, I said there you go. Does that make sense? Aw, she said, I just thought I was weird. I said, no, I don't think you're weird. I think you're incredible. And then as you went on about, oh, my kids, get really cross 'cause when they walk on my left side, I just get really ratty. I said, well, because you're programmed to protect them. And if you can't see what's going on over there and you don't always know what you're not seeing, yeah, it's going to agitate your nervous system. And that's why you're tense. And that's why you hyperventilate, which is causing your neck pain. and your headache.

But this woman who had gone through life really with very low self-esteem, basically thought she was a bit crap, neurotic, lucky that some bloke had married her, you know. She just needed some confidence. And she's a different person now, she, now she understands what she's doing. But it was interesting because it wasn't until I probably raised it, probably crassly, but did nobody ask why you had a piece of plastic in your eye?

Claudia: Yeah.

Nick: You know? I'd be looking at the nurse first. I think that's very sinister. And we do get sad cases where nurses do strange things but, you know, to have this thing so embedded that you couldn't not bleed from your eye, and the baby was screaming and howling, and nobody reported it.

Claudia: Incredible. I mean, I assume this was a few years back, but-

Nick: And I just think actually, and it doesn't seem immediately obvious, but if you think about how she's had to navigate the world, with her nervous system, how she's managed it, how she's had kids, she's found a way through it. She's got through an educational system. And her parents had kind of given up on her.
You know, I think she's done incredibly well. And I think that's why I love hearing people's stories because it's a story it's not just a life, it's a set of stories.

Claudia: And how she adapted also.

Nick: And you have to dig into it. I would never have known. I could easily have said, oh yeah, I'll give your neck a rub, off you go. Do a bit of this. Keep her coming a hundred times, take a fee off her. But actually let's go and see why her muscles are so tense. Why does she offset her head? Why is she doing that? You know, that's tiring. How can you help her with it? Give her strategies, that sort of thing.
Fantastic.

She'd never met that before. I don't know anything more interesting than people? I defy anybody to tell me something more interesting than humans. Because they're bunches of chaos, walking around they're governed by a few laws of physics. You know, it's a miracle that we even stand up straight.

Claudia: And I think everyone has an interesting story, right? If you ask the right questions, and people tend to open up.
And speaking of necks, you have an interesting nickname: Nick The Neck. Where does that come from, Nick?

Nick: That was nothing more than it rhymed but actually I had a particular interest in cervical spine injury. I'm very interested in the neck because it's completely different to anywhere else in the spine, mainly because it holds the head on, and integrates you with the world. It orientates your head in order to perceive and hear and those things. And also I, kind of, defined a thing called the upper cervical syndrome, God, 20 years ago, I'm not by any means claiming it, but I, kind of, put it on the map a bit with that I studied it, and it's a very, very dangerous area of the neck at the top. And I learned the technique to use safely.

And it causes, you know, migraine, headaches, dizziness, waftiness, disequilibrium, strange hearing changes. The relationships between the neck and jaw that we see a lot of people clench their teeth and get all sorts of strange, I think, way too much surgery is done on jaws, and it's completely unnecessary.
So the integration really of the neck with the brain and also with your vestibular system, which is your balance system. So I was seeing some quite interesting, weird, things coming in, which I had to navigate and negotiate, but it just kind of works. And it grew. And so, of course, it was "go and see Nick The Neck".
And of course my name being Potter. It's either go and see Nick The Neck or Harry, which is, we haven't heard 50,000 times, but-.

Claudia: I'm sure you have, yeah.

Nick: But if it sticks in people's head, you know, whatever.

Claudia: Yeah.
Let's jump to the topic of osteopathy and you're a keen advocate of the scientific art of osteopathy. But, for people who are perhaps unfamiliar with osteopathy, what it is exactly, what it is not, perhaps you can talk a little bit through what is osteopathy, and the different advantages of it.

Nick: Osteopathy. I love it. I do also wish we could get rid of this thing because, it's an "alternative therapy". I mean, there couldn't be more science in osteopathy. And do you know why? It's medical health companies. They want to keep us away from physio and things because we're Jesus sandals and wooden beads stuff. And we're all a bit wacky. And we use our hands, oh my God! We touch people.

I think it's very simple. I've actually been part of the governing body that we have, kind of, define osteopathy, which I always think is a bizarre one. I mean, define medicine. Healing people? I don't know, you know. Basically its function, actually. It's really simple. We know, we tried to write this big paragraph - "it's a system of, system of diagnosis relating to musculoskeletal blah, blah, blah.

And in its loosest sense that's right. But in real terms, what we do - I can't change somebody's anatomy. You could argue that a surgeon can to a certain extent. So you can't change that. What you can do is change the way it functions, you know? Nature knew, Darwin, you know, dictated that everything that is in us was selected into us. It's meant to be there for a reason. It helps us in some way, we have a few vestigal things left over that, sort of, are being phased out genetically. But in real terms, you know, form is governed by function, if you need to stand up and use your hands, then the shoulders change positions and joints, you know? So we've, slightly imperfectly we've left our primates, a little bit.

But basically osteopathy had three basic tenets. And, in fact, the more old-fashioned you go back, the more beautiful it becomes actually, in that it believed in things, what it called the role of the artery was supreme, which is circulation, supply, oxygen. The bottom line was see if things are blocked. Well, you gotta remember that in our musculoskeletal system, that's not just muscles and tendons and ligaments, but through them, and integrally related with them, are nerves, blood vessels, veins, you know, receptors that are buried in us.

And they feed back into our nervous system. And our nervous system analyzes them and then produces a suitable response. That's what we were primed to do. We were never primed as animals to think actually. We were designed to move.
The way I look at it is that neurologists are hardware specialists, or let's say neurosurgeons are hardware specialists, neurologists are software specialists. And we, kind of, make those two link. We're the engineers in-between.

The next question we always get asked is, well, what's chiropractic and what's physiotherapy? The simple answer is they're morphing. They're becoming very similar because everybody realized that we all needed a bit of everything. And every chiropractor in the world, and every physio in the world, may be sitting there going, you're wrong. You're wrong. You're the evil man.

The way I perceive it. If you look at it historically, believe it or not, it started with osteopathy, actually, in Missouri, with a guy called Andrew Taylor Still. I've got a wonderful picture, I think a lot of us have, of him in a Quakers hat, holding an enormous bone, you know, like he'd just, sort of, beaten someone over the head, examining it.

And they were the original bone-setters. And they were guys who had manipulative techniques they realized worked. He, in fact, sadly had lost three children in a meningitis epidemic, in the early 1800s. And he roamed around, and he had a little group, and they built up and whatever. And then somewhere along the line, the chiropractors broke off because they said, oh, it's not all about soft tissue and function, whatever, it's all about alignment and things.

So they became the, kind of, the crackers, and they were famous for manipulating you at different levels. Which I have issues with. I manipulate people. I really, but it's to achieve one specific thing. I think some of the techniques are a bit aggressive and it tends to be that they're a one-horse show, whatever, pony, whatever it is, pony and trap. But they've morphed to, they used to be just spines. My argument with them was I had a four-year medical training before I started. And that was very helpful. But I said to them, look, so you keep taking these x-rays and talking about little tiny, millimeters off, well, first of all, there's no such thing as a symmetrical body. Secondly, it's a frozen moment in time, so it could just be volume. But, more importantly, can you honestly tell me that if I take an x-ray after your treatment, it'll be any different? And that's where they begin to wobble.

And that bothered me. And I looked at it and I've been to lectures with them. And I think some of their techniques are brilliant and useful, and I use them myself. I've learned to use them. So I think multiple trainings is the way forward. Anyway.
So then in, kind of, a late, probably 50s or 60s, physio came in, really. I mean, there were people, you know, who called themselves physios, but, and it started at St. Thomas' hospital in London. And there was one of them a man called Cyriax. He looked like Alfred Hitchcock. I, in fact, in very early years, managed to get one of his last lectures. He was an incredible guy.

But he said, look, we don't need it to be spinal surgery. We need to be manipulating, mobilizing whatever. So he invented all these brilliant techniques. And we still look at his textbook.

But he said exercise. So physio, kind of, morphed more into exercise therapy. There's a lot of electronics. So Faradayisms, zapping working wapping, you know, ultrasound. I didn't find it very useful personally, but, you know, some patients like the placebo that it gives. But let's not underestimate that, you know, I openly use placebo. And some people say that's contentious, but it's not.

It's just a belief mechanism. So, you know, you set up an environment where people want to be healed and you've already, they're giving themselves to you, they're setting up the potential

Claudia: They're opening up to you.

Nick: You're peddling to be, absolutely. And I'm very about, you know, in my clinic, everything from the lift, the smellies on my top floor, the light that I chose, my floor looks unbelievable that you literally can, kind of, get, oh, you know,this is calming.

Claudia: I feel better already.

Nick: And we're looking professional, you know, we all wear scrubs and we're all clean. And COVID obviously, but I mean, before that everybody wore white coats, and it was very, not clinical and imposing, also everyone was friendly, and "Hi", and I'm really interested in you. And, you know, what's your problem? You're scared, you're in pain. I get that, you know, I've had it, by the way. You know, I get that. It's a bitch, you know, let's sort it out for you. And let's find the story behind what it is, and let's - I hope that the moment, the end of the building. I've probably got a 20% response in them seriously. And I'm anal about the pathway they go through. We look at the imaging and half the time I should say that is irrelevant, you know, way too much imaging done.

And everybody has bulging discs, you know, at a certain age, the worry about that. Don't have the fear of God put into in rushing to an operation. For me, osteopathy was I loved using my hands and I could feel a lot of things. I've always been very manual, funnily enough I come from of touchy, feely family, which helps.

Claudia: Not very British of you.

Nick: No, not very British, I know, I know. My Mum's very, kind of, Italianate though, lots of love and hugs.

Claudia: Great. Perfect.

Nick: But also, and Dad actually, my father is very like that too. So I'm very grateful. I then went and did rehab medicine in Germany, which was much more, kind of, getting behind the more difficult stuff, and a lot of neuro rehab. I was lucky enough to be involved in the Australian Olympics.

And I've always had two sides to my life, which is performance medicine, which is, kind of, what I do at the hedge fund now. But before that was Formula One and elite athletes. And looking at how we can take what we learnt from that and into what we can do now. And, and, kind of, that's now a bit, de rigueur. You know, people are doing that. But in the late 90s, early to, nobody was looking into athletes. No one was tracking them, isolating them, increasing performance. And actually more importantly saying, why are they injuring? Not how do we make them faster?

Women was a good example. We did a study into why were more women athletes, sprinters particularly, why were they injuring more, you know?

The flack, the flack we got for that. Oh, you just want to show up why women are weaker, it's like, no, but they're not the same. In lots of ways, they're not the same. So we called it the similar, but not the same study. And we discovered strangely enough that when women ovulate, so when they're not menstruating ovulate, their soft tissue softened, you've probably noticed that yourself, you suddenly noticed that you retain water at certain times of the month.

And in fact, you feel your tissue feel bulkier. They just feel more squeaky. And what it does, it weakens ligaments generally. So you'll call it.
The menstrual cycles of the athletes and Hey Presto, when they were going food days, 11 to 12 to 15, the weight slowed, particularly we simply way offloaded it during that little period. And we saw an exponential drop in injuries, just understanding that women do different things to men and all testosterone on trading floors makes us do unbelievably stupid things.

Probably most women in the world of experience. It makes us take more and more risks than we crash. And then cortisone kicks in and a lot of wives out there will know the husbands and partners that when they resolve, when they're stressed and libido drops well that's because it suppresses testosterone.
It helps to understand that I'm not, I haven't got a problem. I just, I need to get through this. Yeah.

Claudia: And how to counter balance then as well for a healthier, more balanced lifestyle.

Nick: Yeah, medicine did for me was it certainly taught me functional anatomy. I mean, doctors still are taught where things are, but not what they do.
And that's a big problem in the system. So it was a systems approach, not a reason anatomy approach. It was always integrative, which I found incredibly exciting. And my worry is in some of the schools now that we've tried to, in order to be sort of accepted by the medical profession, we've kind of moved more towards a more traditional approach to teaching it.

But I think what I got at med school compared to what I got there, um, chalk and cheese in America, Dio doctor of osteopathy is in fact a well respected, further qualification, which a lot of provincial doctors do because it helps them when provincial practices dealing with orthopedics and sports injuries, et cetera, but it's function.

How do I change this? Person's function such that their body can better able regain control and heal itself. And we have everything in us. Yeah.

Claudia: And supporting that as well, which is completely my philosophy, which I really love as well in front of the longevity and lifestyle one as well. My understanding of the U S is actually to become an osteopath.
You need a full medical training, so they're very hands off, actually.

Nick: Yeah, that's the problem. And sadly, I just found out that I could, I have some amazing physio colleagues, and I have some amazing chiropractic colleagues. I'm "dissing", if you like, as they say, certain elements of their training. The tragedy, I've just found out, is that the physio training here now, as far as I'm told, doesn't have any manual therapy in it at all, so they don't touch their patients, effectively, which I think is, they're doing their students some serious damage.

So I think if they want to do, it may be financial, but I know that if they want to do it, they have to pay for it as an extra module, which is a disgrace, in my view. They're selling their students short in a big way.

I'll tell you where it comes from, it comes from NICE, you know, National Institute of Clinical Excellence, because what they do at NICE, and I get the reason, they need to be there. They need to look at whether things are viable and expensive and can we afford them and are they effective. The problem with, and I think this is an important point, is that if you look at randomized controlled studies, or blinded controlled studies, which are seen as the gold standard of empirical science. I totally agree. They are. The problem is they don't lend themselves to humans. So if you are going to, they did a famous study, where they did, does cracking a bat, does manipulation, heal a disc problem. Well, I can tell you now, no, because we wouldn't use it for a disc problem. It's like saying would antiinflammatories help dementia.
No, well, funnily enough, they do actually, it's a bad analogy, but you know, it's not comparing like with like. And also the multidimensional thing of it so we do that, we do that manipulation, but then we look at the mobilization. None of that can be studied as an independent variable. That's the problem. So we whittle it down to one parameter that says, well, no, this doesn't actually work.

It's like spinal injections. I get colleagues to use them all time. If a patient is incredibly flared up and the reason you can't touch them. Then they have a little bit of steroid injection, it can have an incredible effect, but you would never do it without then more physical therapy. If you look at spinal injections only, they're only about 40% successful.

Well, those don't work, well no, no, they are a vector to allowing me to do this. But if you independently study them. So the first thing they said is, oh great. We don't have to pay for those. We're not doing those, so insurance companies, you know, whatever.

And I think that there's a lovely thing by Jung which I like, and I try and explain to students. Which is that, he said, if you go to a pebble beach, and you square off, let's say, 10 feet of pebbles. And you took every one of those pebbles and you studied each, the dimensions of each pebble. And you divided by the number of pebbles and found the average pebble. You'll never find that pebble on the beach.
'Cause it doesn't exist.

There's no such thing as an average pebble. And that's exactly what humans are like. So we take this very, kind of, you know, gunshot approach, slingshot approach, at treating everybody. Many of them will settle out of that and won't be helped. And we've got too reductionist about how we approach it. And that is, I do put a lot of the blame for that at governing bodies, et cetera. But also drug companies. You know, I've invented a breathing monitor recently, I'm fascinated by breathing, spent 20 years studying it.

But if I say to the world, asthma is not a disease, it's a breathing pattern disorder in stressed kids, okay? They literally won't have me speak at any of the conferences, because what I'm saying is don't give them hormones. Don't give them puffers.
So, and that's real. I've not really experienced that. And it's scary.

So anybody really with new creative ideas that doesn't directly lead to a financially beneficial drug, doesn't get a look in. In fact, positively gets suppressed. And that's a worry because you say to these physicians, sorry, can you tell me, why do you give a child with a breathing pattern disorder, a stress hormone to treat it, right? Salbutamol is cortisol.

Claudia: For life as well, by the way.

Nick: For life. They've become inured to their own cortisol, that's why. And of course they become more inured, so what happens is we need to give them more and more. Oh, the other one, ventolin is an adrenaline agonist. It opens up your airways. Okay, yeah, I get that it's necessary. But why are they opening up their airways in the first place, and it's nothing to do with allergy. Allergy comes second. Right? If you breathe badly, you get increased mast cells in your airway. That's where the allergy comes from.

Because there are plenty of kids in India who breathe pea soup for a living who aren't asthmatic. So don't tell me it's all allergy. And you ask any of the respiratory nurses I know, running, up in the north, where they see some really deprived areas, et cetera, where kids are in constant menace in their households, from domestic violence, etc. They will tell you, all of those kids have worse asthma.

Claudia: There's a direct correlation there. Which is very sad. Yeah.
I'd love to talk about pain. You're quite the expert in pain and relieving pain. How would you define pain? And you've an interesting analogy, we spoke about when we first met, on why we feel pain and what are the typical types as well. And some of the myths and misconceptions.
Can you walk a bit through that?

Wow. Yeah. Obviously I did a book two years ago and the idea was to say there are not, it's been very poorly explained to people what pain is, why we hurt. And, partly because we didn't know, partly because, again, drug companies want to go down the route of, like, you know, you have these pain pathways and we block them with drugs, and they're clever, and they're whatever. Which actually is just a complete lie, right? There are no pain centers. There are no pain fibers, or pathways, that transmit pain anywhere in the body. Right? That's true. Even doctors aren't taught that. Okay?

There are two types of pain. You've got what we call nociception, I'll try to explain very simply, is any stimulus to the body.

Nick: So if I take a pen, with a sharp end, and I put it into my finger, okay, to a certain press. My brain is starting to get, ooh, hello, you know, something's touching my finger. It's no threat to me. It's okay. If I keep pressing, my body has learned over a number of years through my nervous system of examining things, that past a certain point, pressure, that that will penetrate my tissues. That's a danger to me. I'm going to get infection. I'm going to bleed. Okay?

So what do I do? I respond by retracting. That's it. Sensory input, motor output. Perception in - retract, that's all it is. It's that simple, and that tends to happen at the level of the spinal cord. So it's, burned my finger, feel something I don't like, oh squidgy, yuck, you know, all those sorts of things.

Claudia: Move it away.

Nick: That's just save yourself from being eaten, penetrated, infected, et cetera.
So we learn to do that, but it's all about threshold. So, even when I feel pain from the tip of my finger, from this thing being very sharp, okay? There's no pain message. It's just a threshold of input, it's saying that there's now so much pressure to this small area of skin that I know, from my experience, that that's going to cause me harm. That's all it is. And that's just a number associated - and that's it. So that, that's like "holy sh*t", take it away. Okay?

Claudia: What about, though, heat, or something like that?

Nick: We have temperature receptors in our skin. And you know, when you're running your bath and you're feeling the water, oh, lovely and warm, and then I'll have it a bit warmer, and then suddenly like, ooh, ah, put it under the tap.
So what is it? Sensory input. We know, our brains know, that if you go roughly over about 40 degrees, you know, you're going to retract your arm because why, because proteins denature at 40 degrees.

Partly through experience, and partly through engramming, that's been put into and things. You just know that certain inputs are going to be a danger to you. Because even babies obviously will retract if they feel heat. So we know that that can't be learned. That must be in there as an engram, which I think is fascinating.

So then we've got the second type of pain, which is the really interesting one that I spend most of my time treating, which is chronic pain. Chronic is literally a name. It's a name given by medics because they had to give it a label, and they set it at three months. It was an arbitrary figure. Why? Because, in general terms, most injuries and things that happen to us will heal within, let's say a broken bone, it will heal in six weeks. So we allow it a full three months for complications, et cetera. But in general terms, most things will be healed within three months. Okay, so if it's healed, why are they still getting pain? That's the big question. And those are the people that we look at and are so interested.
So, what we've learned is that, over time, pain can become a habit that the brain gets into.

Okay? So, going back to, quickly, the pricky finger thing, the retraction is linked, but it's also designed to give you an unpleasant sensation. So you don't do it again. Otherwise you just wouldn't really retract. It's a combination of an experience with just a motor response.

So that is now logged. That pressure equals that unpleasant experience. Not going to do that again. That means, it's like going to an avoidance strategy, I go into, sort of, oh I don't really fancy doing that again. So, in a bigger case, I've broken my arm, but actually it's healed. But it could take something like I had with a young Russian lady yesterday, where she'd been told that she was at risk of fracturing 'cause of some cancer therapy she's on. And I said, look, the doctor's not wrong. But if that was the case, you'd be walking on the road, fracturing bones. 'Cause she's literally moving herself like this. Just relax yourself, you know. She couldn't be rubbed because she thought her ribs would break.

So she'd got this massively heightened fear, and in less than 10 minutes, her pain had gone. Just by telling her that. Relax. Breathe. By the way, of course you can do it. You know, this is the level. Do you want to go around humping pianos? No. Can your sister give you a hug? Of course. You're, and she's quite a big lady. And I said, look, if you take your body mass and you turn yourself in bed, you're putting more pressure with your muscles on those bones than anything I'm going to do to you.
Yet they haven't broken yet. So the evidence would suggest she's not right. So she's right, in one sense, but she hasn't given you a level at which to worry. So she was walking around in like a China cup. Muscles ache-

Claudia: And it causes issues.

Nick: Holding her breath, dizzy spells. So suddenly she thinks she's sick in a whole new way. Teach her to rebreathe, relax. I mean, literally, that's all we did with her and she's a new person, you know? So the trouble with pain experiences is that they're actually felt with a whole network of elements.

I'll give you another analogy. You're walking down the street and it's an autumn day. You can smell burning leaves in the background. It's a wet street. You can hear street noise. You know, certain, and you're taking in all sorts of sensory information which you're mapping. And then suddenly a mugger comes out of nowhere, smacks you on the arm, breaks your wrist as you fall down, takes your wallet, luckily, no more than that, disappears. Now that whole experience, the actual injury you've had is a broken wrist. Your brain has quite quickly made the unreasonable association, which is 'muggers cause broken wrists, okay. Mugging is unpleasant, he could have done something much worse to me, et cetera. But you've set that injury into your brain, you're gathering information about it. You're sending healing molecules.

But the funny thing is they come in and say, I'm still getting pain from my wrist six months later. And weirdly, it seems to be worse. Well, that happens for two reasons. One is your mood always decreases. When you look out the window, you see the rain outside, you're immediately turned off. Yeah? So that opens up the opportunity for pain. But also, it could be, you smell on a train, the aftershave of a guy who happened to be the same aftershave wearing that the mugger was wearing.

And literally pain will come on. Why? Because it's a fear response. Trigger. This will harm me or this involved in any part of the experience. It could be the smell of the leaves. It could be a wet surface of a thing. It could be what's walking down that street again, And that's the heart of PTSD to a certain extent, you know, with much bigger traumas. It is, rather than just being able to say, oh yeah, but you know, I was unlucky and it's, kind of, like, oh my God, all streets, basically, that are wet, dank, smell like this.

And every time I smell that aftershave, I'm going to break my wrist. That's the association the brain has made. So it's quite interesting. But so a lot of it is psychology. It's kind of neuroscience. It's explaining that to patients, why they don't have to be fearful. But the real definition of pain is that it is when your subconscious brain needs to let your conscious brain know that there is something to be feared or that something is causing harm.

That's it. That's all the message is. And that opens up a huge thing. But what I find fascinating is that we all feel pain. Men, women, cross-culturally, everybody, because it's actually a language. It's a process, if you like. It's a purely subjective experience because it comes in lots of ways and forms, and you will experience less or more than I do. And our thresholds will be different. But the way that we express it is that there is, it's a way of us expressing, rather, there is a dissonance. There's a misrepresentation between what you perceive to be the case and what is actually the case. And that's when you get the chronicness, that's when you get this pain that just won't go away.

Claudia von Boeselager: So how do you? You were saying with the breathing! Patients come to you saying my hips are hurting every time I walk, or my knee? Where do you draw the line between, it's they're not breathing correctly, they have some psychological trauma, perhaps around an injury or something that happened and then actual physical misalignment that needs to be corrected, how would a typical session let's say with somebody who would consider themselves suffering chronic pain, hip, ankle, whatever the case may be? How would you solve that?

Nick Potter: A really, really good case history. So the story, and I'd take them way back then, why is this person, but again you can make a number of subjective decisions about people that come in, they won’t be judgmental, but the average person who's highly worrying and anxious, they're not going to wear immaculate makeup, or they're going to wear the perfect suit and their hair is well kept and their facial, they will just leave everything and, then these tidy people make a neat night bed. Anyways, those are people who don't really ever come outside the box, and when they're forced to. It's really, really, really scary and they haven't got control over it. So, what do they do, they get stressed. So those people are increasingly in society, we're seeing more and more of those. Good example, I had a patient who had a big breathing pattern disorder, and instantly it got much worse at certain times of the day on the first day, and it was always very weird, and he was wearing a breathing monitor. I said, Blime, you know what happens at 3 o'clock? Because you are panting, what's going on? And she said, that's really weird, that's my catch up meeting with my boss. And I said, oh, dear, is he a real nightmare? Sure. Well, not really. I just don't really like it. And going back in history, she had an alcoholic father, and her mom was timid and tended to make the kids dance around dad’s bad temper. So she'd always grown up with a fear of confrontation. So she said, yeah, I do feel confrontation with this guy. So, but you see, you don't talk about the awkward things with him? Well, no, because I think he's got a temper. Does he remind you of your dad? And he went, yeah, I suppose some elements. Yeah, he had a temper too. I go, okay. But that's it. So your primary response was to go around it. But interestingly, so I said, you're going to have a beer, you're going to take the initiative, and you're going to take him out and say, look, I feel we don't get along great. And I think the company is noticing it, and we're not moving forward. And he burst into tears. Apparently, he was threatened by her. He thought she was really able and charismatic and was after his job. They both ended up drinking too much, hugged. And so this, and literally overnight, the whole company noticed, and ever since the breathing rate back to normal. So, strategy is.

Claudia von Boeselager: You’re a match maker.

Nick Potter: Yeah, I wouldn't have gotten to that level! But I think the point was that, they're at loggerheads with each other for two perceived ideas.

Claudia von Boeselager: Because of their beliefs, right?

Nick Potter: Because of beliefs, yeah. And he had a thing, probably he had a thing called…

Claudia von Boeselager: Imposter syndrome.

Nick Potter: Imposter syndrome, right! He come up through the ranks, he hadn't gotten the degree that everybody else has got, his perception was he's going to be found out and so they over manage and they under delegate, and then they take on too much and feel threatened by people. So that's just one example. But that was what was causing her stress. So you could have coached her in lots of other ways, and missed it.

Claudia von Boeselager: Yeah.

Nick Potter: But her breathing was a direct indicator of when she was becoming stressed by something, and if you know what…

Claudia von Boeselager: Yeah, I'd love to dive into that shortly as well. But before we do, we'd love to talk about hypermobility and then move on to long COVID. So with the hypermobility, it's something that you and I share.

Nick Potter: Yeah.

Claudia von Boeselager: And I understand it's a massive interest area of yours. Can you talk a bit about how it affects the rest of our body? And why is hypermobility, such a thing to be wary of and control, I guess?

Nick Potter: Yeah. I like that we share that, it's a thing. I think that it's an amazing phenomenon that I think it just never gets enough attention. Going way back in primary care, and I used to work in Fulham in London. Mums and babies and whatever, you know, we were starting to see this and we were noticing, for example, that actually a lot of the hypermobile women were primary women, but what we noticed, for example, was that they lost momentum to have valid problems in middle age. And so I said this, have you ever noticed that, they went no, I haven't. But then they started noticing I went Oh, okay. So actually, if you've got a hypermobile lady sitting in front of you, and she's 45 saying, I'm getting overweight, and my moods bad, and I'm shouting at the kids. Then just check her thyroid, because the indicators are there, all the associations are there. And I think now with the hypermobility, or who we have who are brilliant, they're been to rheumatologists. They're gathering this stuff and we all know it in clinic. It's just the randomized studies haven't been done yet. But we know that in two years’ time we'll hear that there are more calls in office, as they call them, they have tend to have more bleeding disorders. But why I'm so interested is that when I do my, I do a lot on the BBC and we do the surgery and it's extraordinary the response we get, because we know that 28 million people are suffering with chronic pain. But what is extraordinary how many people their chronic pain is underpinned by their hypermobility.

Claudia von Boeselager: Wow.

Nick Potter: And it's really quite obvious. So going back to it, it's a collagen disorder is very simple. So its Flexi people, hypermobile people are double jointed is the other word. The first thing in the morning they can do [Unintelligible] pretty much flat on the floor. There is a test called Beighton score, which is extending your finger to 90 degrees on both sides, elbows, knees and go back and touching your hands whatever. Also stretchy skin. It comes in a number of guises again so it can be you can have stretchy joints, and ligaments. You can have stretchy skin without the others. You can have some joints that [Inaudible]. It's a spectrum disorder, so bit like autism, you can be very autistic or you can be mild, but also the bad end of it. There are some disorders Marfan syndrome, Ehlers-Danlos Syndrome, EDS, as it's called, which I think is also actually over diagnosed, but anyway, which are the poor people who are kind of they're very blobby, they have no tone in their muscles, they tend to put on weight very easily, and have real problems actually, and it's really sad and then they'll don’t be sporty and they don't join the social group now, but again, if we could find them as kids in my way, I would have all children assess must basically perform an early age to pick up scoliosis, to pick up joint problems, foot problems, etc. Most importantly, if they're hypermobile, it's much more commonly associated with ADD (Attention Deficit Disorder). So, they're kind of hyper vigilant all the time and also anxiety. So if you know that, then you've got a child who won't sit still, don't give him a hard time and put him at the back of the class but not really being disgraced say, because if you need to, you can get up and move. Hypermobile and people like us need to move to think, it's really important, okay? Because they're uncomfortable in their bodies and the main reason for that it took me ages to work it out. But with a psychiatrist and neurologist, we sat down and realized actually that something somebody said on a podcast like this, that Oh my God, that's why this happens is, if you've got squishy soft tissues that are more like marshmallow than they are like cold chewing gum, that's why cold chewing gum is normal, okay? And you bury in that chewing gum mechanoreceptors, which are receptors that pick up movement, the flexors, that's how we balance. Okay, so your joints move, as my finger joints going up and down, its sending information to my brain, but it's up down route, he knows where it is all the time.

Claudia von Boeselager: Yeah.

Nick Potter: If those receptors are buried in Marshmallow, then you have to have a much bigger deflection of movement to register a thing. Yeah. So think that in this way, I think bing, bing, bing, bing, much smaller movements. So you have a much finer tune system than if you have the marshmallow. Why is that important? Because going back to what I said, we are mapping the world visually. So we see the world the way we think it is. We relate it to how we map it physically. So is it over there? Yes, that correlates there. The problem is, that's great if you're actually looking at something, but most of us use our peripheral vision to sport for example, we're looking at the guy who's going to tackle us. And we're relying on knowing where they are pretty reliably to put our hand or foot in a place that's not going to be. The problem with hybermobile is we’re clumsy, you may have noticed that yourself, it's not gross, but you tend to knock over glasses of water, you tend to sort of just trip your foot up, when you’re eating, no matter how many times you know the coffee tables, you’re still not fitting on it, that sort of thing. And it's just a mismatch thing. But it means there is a disjunct between your eyes are telling you and what your body position is telling you, the systems telling you and they say it's just off by half an inch. But that's quite significant, because it means that if your toe isn't coming over something pointy, it's going to hit it and you're going to trip. Now, go back to the Sabre toothed Tiger world, which is we're still primed to do.

Claudia von Boeselager: Yeah.

Nick Potter: And you couldn't trust your body to take you away from that source of threat without tripping over the tree stump that's in front of you, the world's a dangerous place to you, because you're hyper vigilant, because you're always looking for what's new, because you might have the bigger you have to be that much more careful than everybody else. That's where the ADD comes from, and the anxiety because if you're constantly looking for novelty, which is the only thing that can ever do a certain harm. And by the way that fits in your peripheral vision. Our peripheral vision picks up novelty, because that's what's new. So you map the world you feel comfortable about a room because you know it, you've mapped it, and there are no areas of danger. What you are looking for, your peripheral vision is looking for all the time that you just don't know. There's something that's changing in the room, and that's usually movement. So if you're consciously looking for movement, hey presto, you're not finding it very easy to focus. And that's what happens in the classroom. Their nervous system is constantly looking and also twitching, moving. Where am I? Where am I in the space because my receptors are moving out? It's like having a constantly shifting system. That's why they love dance. It's why most contemporary dancers are hypermobile. It's why a lot of ballerinas are hypermobile. And so they find movement because it also gives them the tone that they naturally lack

Claudia von Boeselager: And with the tone and this muscle strength counterbalance or support that let's say!

Nick Potter: Your friend in hypermobility fascia, which is the deep membranes inside your body that pass through and permeate all of your body and hold you together like a kind of system. We call it tensegrity and osteoporosis, are things that hold you together. And if you don't establish your body develops or reinforces itself, so you know if you're a terribly sporty person, your bones thicken. They have to, to give you more support your muscles thicker Your ligaments thicken because of low current load, your body develops thicker joints, if you get those in early, so that's why I would have all kids who are hypermobile playing sport and doing multiple exercise all the time, then you develop that thick fascia. And that helps you in adulthood, because when you then go to desk work, etc, etc, and you do naturally lose the tone that you had, you're not going to … and that's what I was lucky enough to do playing rugby, etc. I've always had that internal fascia system, my resting tone. I'm always envious of the guys in the gym who are ripped, because I know I'm never going to have it you know, do you look at lovely guys, guys with those amazing but their resting tone is incredibly high. That is genetic. You know, that's what produces the witness. And of course, my lovely ladies who come in and say, oh my God, you're doing all this working out and I'm still not getting that well done. Well, you're never going to get it because your resting tone naturally learn what they tend to find is they feel really toned for two days because they've got a heightened tone, because that wallows away. That's why they go straight back in the gym thinking they're going to get it more. They'll get nice, defined muscles, but they'll never have that ripped shredded look, unfortunately, but it's just you have to accept that.

Claudia von Boeselager: Okay, interesting. Let's talk about long COVID coming out of hopefully the pandemic, I'm optimistic at the moment, but what's the best way to treat it in your view? You've seen a lot of patients also with this, right?

Nick Potter: Yeah, well, again, partly for this research, I was doing the 3D model and working with two amazing guys from Imperial who have brains as a planet. And what we kind of realized was that this long COVID that we were seeing, and there's you have to be careful here, because sounds like you're kind of dissing it as a concept is nothing to do with the virus, okay? In real time, so if you've got longer, you have not got a nice little weevil running around your system. Okay, so that's a lot of it. But it's a fair thing to have, I still got it, I'm going to get rid of this disease. And it's an anxiety based response. There is definitely a profile of patients, many more female, I'm afraid we haven't set back on these things, you ought to be careful, but there’s a reason for that. And then also, they tend to be quite Taipei characters in the first place. So again, they were kind of pre warriors. The reason that's important and without getting into too much science, there is a fundamental relationship in the human body, called very long term work with RSI, respiratory sinus arrhythmia. Now, that is the gentle coherent relationship between your pulse rate, your breathing rate, and your blood pressure. And it's the kind of understood relationship the brain has and the heart has, because they talk to each other in real terms, but through nerves, that when you are breathing, you have to adjust for the drop in pressure in your chest, otherwise, you faint. So what should happen is when you breathe in, your pulse rate should go up, okay? When you breathe out, your pulse rate should go down and we should listen to that, most doctors don't know why they listen. Okay? What you're listening for is to hear the coherence and the bonding of those three things. What we've discovered is stressed patients, and this is really a key. In fact, I shouldn't be telling you this, because it's a huge secret of my business. But anyway, stressed patients lose that coherence. And we think it can be as early as 10 years old.

Claudia von Boeselager: Okay, wow!

Nick Potter: So it shows that it's a kind of socio cultural effect. It's not just later on, and if you lose that coherence, you lose the body's ability to maximize and optimize circulation of oxygen around the body, for the fewest numbers of pulse rate beats. That makes sense, because the body is always looking for efficiency is an incredible thing. It doesn't want to be stressed. It wants to return to a lower energetic state. So it gets stuck in this cycle. And if you look at a lot of people who are quite stressed, they often hold their breath. You're doing it now. Okay, holding your breath.

Claudia von Boeselager: In fact I’ve trying to breathe.

Nick Potter: Often when they're intense, or when new things, things they need to concentrate on. Okay, so it's like [Inaudible].

Claudia von Boeselager: Yeah, no, but I do, I hold my breath. Yeah, as you know.

Nick Potter: Well most people can do it out there listening is if they when they hold the breath, or if they hold it in and then hold it out. Right, then they gets [Breathing Sound]

Claudia von Boeselager: Why is that?

Nick Potter: Because of two questions, we think we've got the answer. But bottom line is because you're used to holding an inspiratory tendency. So, hyperventilated warriors tend to breathe too quickly and too shallowly. They also tend to do it all up in their neck and chest. So not only are they wasting energy, because instead of just using their diaphragm, okay, they're having to jack up against gravity, so called Robocop, they walk around like this. See, they kind of just don't move their shoulders down.

Claudia von Boeselager: [Unintelligible] putting my shoulder down as we speak.

Nick Potter: And interestingly, actually, when you first if you say drop your shoulders, they get, they can’t because they didn't know that they've got to breathe out first. The other sinister thing that it does, which is weird is it actually fires all of the small motor end units. Now those are the little tiny nerves that come into your muscles and tell them when to fire. What we found is an in special beat ones, it turns all of their tension up. So when people feel tense, they are this because they're priming to run effectively. And those are patients who can't relax like, and so then you get them to do the breathing in the muscles just go boop. And what happens is so breathing is the only thing that we have that we can monitor easily. That gives us access to what our subconscious brain is doing, and all the control mechanisms, etc. You have no idea what you're consciously doing. But what it does, and then it teaches the brain to calm, to return to that coherence. But more importantly for forebrain, you thinking brain switches back on. You can think more rationally. So you can think of self out of stress. But most of what your vagus nerve, which is the nerve that teaches you to relax and digesting, I mean, IBS, it's just stressed people's bowels, right? So it's not bio rubbish, right? If the nervous system shutting down your belly, because when you're going to feed from the Sabre toothed tiger, you don't need to be digesting.

Claudia von Boeselager: Yeah.

Claudia von Boeselager: Okay, you're fat, unpleasant there is a lot of humans and also animals actually deprecate, they actually evacuate their bowel when they're acutely stressed a well-known phenomenon, we think it's probably just to offload weight to use, for example, if you have policemen, they'll tell you the first time burglars are so nervous, they very often prove themselves, and they smear it on the wall as protests. But we know that animals do it, etc. So point a phrase, he shot himself, literally, it's a primitive response. So the reason that we think that you typically see a profile of patient is because these guys were already preset, to have the lack of coherence. So they tended to be hyperventilating worried as poor sleepers, etc. And what we discovered was that COVID causes this cytokine shower, as we all know, right? Which is a huge shower of inflammatory molecules, and they're the ones that what they particularly affect is blood vessels, they cause inflammation, it's a vasculitis because an inflammation of blood vessels, and that's everywhere. That's why I'm afraid very large people particularly suffered because they have more blood vessels, more blood, and they have a much bigger allergenic… it is actually an allergenic response, it's not really the pneumonia that kills you. It's this huge allergy response that you get in conjunction and your system before your system can fight the bug, the allergy system has already done for you. So that's why being big was dangerous for people. Anyway, going back from COVID, what we think happens is that the cytokines change the permeability, the leakiness of blood vessels, and they can leave them not permanently, but for an extended period, they can leave them leaky. And so what happens is that relates to the blood pressure, so they lost. Some did get pooling of blood into the legs and the venous system.

Claudia von Boeselager: Okay! That we're getting dizzy and things like that.

Nick Potter: Yeah! But of course, that they also got palpitations, and that that their heart was constantly adjusting and trying to cater this, so then they got dizzy or whatever. But interestingly, most of the ones I've seen are also hypermobile. Don't forget your blood vessels or slack if you're hypermobile, that's where you get more unfortunately venous changes in your legs, you get bigger legs, and whatever, and you get retention of fluid, because you dumped your fluid in your legs. So that's one of the reasons we give them compression tights to wear as anti COVID. Because what happens is it means they don't get the dumping of pressure, they can readjust their central system. They don’t get the dizziness. The breathing really teaches them coherence and then they can take exercise, and so they can move as long as they’re not like bedridden. And then fear was that oh my God, no, I'm permanent, I have to do it for the rest of my life is all this going to catastrophe-ization was feeding into it. But touchwood I've had phenomenal success with it, and I work with this wonderful guy called Dr. Boone Limit at Imperial and he is a cardiologist who specializes in tilt testing and doing things around blood pressure. He's been gob smacked how we can, we also tend to give them some time, some empty histamines for a short while because that inhibits the effect that cytokines have and mast cells have on leakiness of blood vessels. Don't panic. Okay, not the rest of your life. If you're hypermobile, that's what's not helping and understand that better, and hopefully we've helped here today, but most importantly, get to somebody who has a long COVID profile protocol because it works.

Claudia von Boeselager: Excellent! Talking about obesity, you mentioned before as well, obviously a lot of difficulties. I think the American that has a statistic that now over 73% of US adults are overweight, of which 42% of American adults are obese. And I think in the UK, the figures around 28%.

Nick Potter: Yeah.

Claudia von Boeselager: Why in your view is obesity so terrible for our health, and how can people overcome the epidemic of obesity?

Nick Potter: Where do I start because I'll be accused of fat shaming and all sorts’ things? I think what we've got to… Okay, I'm going to tell you a little story. So I was out walking during COVID with my daughter with two other. We were abiding by the rules and having a fresh air walk, and she was very, very nice friend, who were called Emily, and she is probably two or three stone overweight.

Claudia von Boeselager: People who don't know what a stone is. It's 14 pounds, and then divides it by 2.2 to get to the kilos. So yeah, that’s stones, not everybody is familiar with this.

Nick Potter: It’s significant. A lot of it's around us. Why isn't that Tommy? And anyway, we're walking on the road and she likes good debate. She knows I'm a strident, opinionated individual. And she said to me, they were talking about rights and this, and she said, well, it's like this COVID fat thing and otherwise it can be fat, I don’t know. She said to me, you know, don't tell Mr. P. Oh, when do you really want the answer that question? And she said, [20:11]. Because yeah, in absolute terms, you have the right to be as heavy as you want to be. And I'm not going to judge you for it, it's your choice. But can I give you the other side of the story? And she said, yes. I said, look, for every, I think it's about two pounds of extra fat you carry, your heart has to pump the blood around your body an extra seven miles, right?
Claudia von Boeselager: [Unintelligible]

Nick Potter: In real terms, because inside fat are tiny capillaries, blood cells, right? Thin as my hair! Millions and millions and millions of it because it's fat is the way that when we are under stress, we can quickly mobilize energy. So we have to have the motorway system to go and pick up that fat and get it to us quickly. So it's full of blood, and it has to be sustained and supplied oxygen. But the problem is, it has to be supplied with oxygen. So inside those blood vessels are also many, many more millions blood cells, you're carrying not just weight, but a whole lot more blood, blood has to be moved, and the main thing that moves that is your heart. So to increase the movement of blood around your body, you have to put your pulse rate up, well, let's say 10 to 15%. That's great. But if you're doing millions and millions and millions of beats a year, and you have to put that up by 20%. That's many, many millions of beats. That's a strain to your hearts, where's your heart to it's like any muscle becomes thicken, okay, there's a fundamental ratio between the inside the size of the heart chamber and the size of the heart wall. Lung saturation ratio is lost, it's really serious. Okay. So then what happens is, the pulse rate goes up, then your breathing rate has to go up. So you've got to oxygenate that blood, you've got to get rid of the extra side effects of metabolism because everything's going to just go up 20%. That's fine when you're 25, okay? But then what's going to happen is particularly keep putting on weight is you're going to become diabetic, because your poor pancreas is desperately trying to convert all that fat to energy, etc. It's going to start saying, Hey, dude, I'm tired and fatigued. This is really hard work, okay? And you're going to become pre diabetic. And anyways, you'll know that it's because you keep getting throat infections and you feel tired all the time you go along the doctor, she says, Oh, yeah, your blood sugars are up and here, what they're going to do, they're probably just going to give you stuff for Metformin, right? Which just pushes the coping mechanism, it doesn't cure you. It just helps support your pancreas a bit, but it will drop off a cliff and then you'll become diabetic. And then they'll put you on to insulin injections and lots of other things because they were they really want to cure you, they want to keep you on the drugs, okay? She rang me two days later, and she said, I've got on a diet. I thought what you said to me had never been explained to me before. I told her one thing I said treat your fat as a parasite, because it is attached to you and it is sucking, you have the very life force that you need for the rest of your body, and it's called oxygen. It's that simple, and if you're happy with that, no problem. I will not judge you for it. But don't let anybody tell you that they didn't tell you. And so go away with it. And so I said you'll be fine at 25 but at 45 will be diabetic, you'll get inflammation in your joints, you'll get inflammation everywhere. You'll get horrible varicose veins in your legs, and you will feel horrible. Your personal hygiene may suffer but also just your personal work and your physical identity. Anyway, I'm pleased to say she's lost two of those three stone but it was brutal. It was brutal. It was a horrible thing to put on. I think my daughter nearly beat me over the head with the log, but I got the call maybe somebody else would have said yeah, he's a Nazi. I'm never going to get to see him again. I hate him he's made me feel horrible. I'm sorry but don't ever say I didn't tell you the truth

Claudia von Boeselager: But I think because you could explain it in a medical term as well. That’s, it just triggers a different sensitivity and point from it as well.

Nick Potter: I think the parasite thing was quite effective.

Claudia von Bosealager: Yeah.

Nick Potter: Trapped you, sucking you have like alien You know, when that terrible moment in the film when there's things inside of you realize it's been eating you alive.

Claudia von Bosealager: And it's easy.

Nick Potter: Don't purge yourself, don't go on these manic fatty diet we all know what we like but we shouldn't be eating you know whether it's the extra biscuit or too many carbohydrates etc. Just to adjust a couple of things in your life that you permanently adjust and it will just drop off you, the underneath calories a day is I think eight kilos a year in weight is that really sort of as a biscuit that you didn't have?

Claudia von Bosealager: And also a bit of exercise movement as well, right? The combination! Couple of rapid fire questions, and do you have a particular morning routine to start your day as a success?

Nick Potter: Actually, I work unfortunate very long hours. I'm definitely kind of ADD brain a bit. So, I find it that previously but I have actually worked enormously on I'm using my breathing and I really do tend to, and my wife and I do and literally by eight we're easily gone. [Unintelligible] [25:00].

Claudia von Bosealager: You don't seem the type to get an ADD.

Nick Potter: No, no, I'm not a kind of I mean, I can't academically work. But I just know my brain is not firing properly after certainly kind of 11. I try now to be in bed by 10:30, which is a struggle, but it is. And I'm up quite early I commute, but actually, I thought kind of 5:30. But I'm also lucky, I get good sleep. So it's not the length of time, it's easily. But I definitely know. And as a corollary of that, I've definitely drank less alcohol, and just completely stopped, we recommend athletes that they ruin their performance by 20% for one beer, so that's big. So I think booze is a big thing we all need to realize about and I think over COVID, there was a kind of everybody either kind of just drunk themselves stupid, or just kind of like, I'm never drinking again, there was not much in between, I definitely went to drinking two glasses of wine at night, more than I probably ever used to. So I've done that on the head, I as a sort of Mediterranean diet. I think what I am convinced about and this is the difference between the Americans and us, which came over here, we actually did a study ages ago into rats, where we fed them sugar, and they didn't get fat, and they should be fat but they didn't get fat. When we fed them anything that was fried, and sugary. So much like the American diet, oh my God, the results were horrendous. [Unintelligible] Lost all the way, because their metabolism never gets used to processing one thing or the other, and I think again, that's evolutionary because if you look at let's supposing you took Africa, which is nice contrast or dry on one side and tropical on the other, if you look at the distribution and body types across man as well, West African’s tend to be kind of smaller, squats are much stronger. Afro-Caribbean are amazing at speed, because it mostly came from West Africa's they're very strong, fast twitch muscle fiber. And then you get the Ethiopians and the Kenyans who are long the leaner but I suppose because they grew up eliciting in dry and arid land, and literally had to travel further for their food. But also in dry arid areas, you don't naturally get crops, you don't get carbohydrates. In the mass, they actually drained that from the beasts of cattle, and high protein. So I think that what we found is that and obviously different metabolisms do different things. But I think for me, in general terms, if you're going to have puddings, a sweet thing, you know, make sure it's just sweet or just fatty, but don't do both. So this is why things like muffins, oh, my God that just in our plate, donuts have an amazing how you eat them up into tiny parts, and then they reform around your waist in amazing capacity.

Claudia von Bosealager: Exponentially growing. But I would argue, though, that with sugar, I mean, there's so many health, toxins and issues around sugar as well. And wasn’t there a study with the mice as well there with cocaine and sugar? And they were, it was similar effect on them, I think as well, right?

Nick Potter: So I think it's a bigger thing than that. I think you're right. So I'm not saying go and eat sugar. What I'm saying is generally though. I try and just have one square of chocolate. Now I knew. But I also know, if I was an addictive character, I say to patients just don't have it in the house. Because you're never going to have one square chocolate, you're going to be tempted in all of it. Look how your mindset is around eating. I think that you have to remember that when we're stressed. It's more interesting, this is true. When we're stressed, we look for comfort foods. So we tend to look for sugar, right? Because we need sources of energy, that's what stress is about mobilize energy, mostly in order to run in, to prime yourself for healing and to be ready. So that's true, and that's why men particularly were very stressed, they tend to get the big bellies and the stick like legs. But that's the distribution of fat that happens with causes, and that is so much more dangerous to your health than just distributing it over your body. So they're the ones I really haven't gone out about stress because they're storing all that inside their abdomen, and it chokes their organs as well. So that's, and I think that I would say, look, genuinely just reduce your carbs, you don't need it. We're not doing enough in life, to warrant you eating lots of carbs, and offset it somewhere in the day if you do get tempted. But I mean, I don't think its rocket science, all of these diet books, really whatever they are. They've glorified changes in calorie intake and they suit you. My father in law loves fibrous diet, why? Because he's not a control eater, so he'd rather go with nothing for two days, and have three days of you know, and that suits him. For me, if I have nothing during the day, I'm literally falling over by the time I get to four o'clock in the office, I can't do it and I have to burn too many calories with my patients in the day. So I've got to have something but I have learned not to have any snacks in my drawer. I can't reach for them. I want to nibble. I have three meals a day. Pretty much Mediterranean diet, fairly low carbs, but I can't be without carbs and then we know that I mean, I even go for workout I've got I've had them somewhere in the last 24 hours. So I'm just like carrying a log. So I think it is, knowing yourself, self-regulation, though just because I was an incredibly fat kid. I just you should know. I was….

Claudia von Bosealager: Really? You were eating the donuts?

Nick Potter: My mom and I liked food. Admittedly, she loved me too much, and I had to lose it when I stopped my rugby career. But then I turned it all to muscle and whatever but for certain clothes 14 so I know what it's like to have to lose weight. And also how it felt I was the fat kid. And I think deep down I fear going back to that. I'm very honest about it. I think you know, even now if I enter into a room of people that I don't know, I'm kind of back there feeling self-conscious, pulling to my shirt away from man boobs, you know, always little of this behavior and I get that. And I think probably I never want to go back there. No, it's tough. And we're in a society where we need both for me, because we're stressed, because it suppresses dopamine. So if you look at where you know all the coffee shops, does anyone can see why there’s so many a coffee shop, and well, because it stimulates the dopamine pathways. It's not just about the more you're there. So we're drifting from coffee to sugar, to vape, to fags to food, to coffee, to sugar to vape to fag, if we keep doing that, why? Because we exist in an artificially elevated level of dopamine, and then we're all told we should be happy all the time. Sorry, not true.

Claudia von Bosealager: Not going to happen.

Nick Potter: You know, being happy is a lucky thing and it's actually what you achieve by growing and achieving things is the processes. That's why so many billionaires they make the money and they've got it and they're happy that they're getting there. But actually, they sit there and then what now, you know, because they're not achieving anything forward. It's kind of very, like, you know, some of the Jordan Peterson stuff I quite like I think he's actually right, I think humans need to have meaning and purpose, connectedness. And just very quickly, I think which is worth it. The COVID was fascinating, because it did to us the three things that humans most fear and run away from, one isolation, horrendous. We're social animals, we needed to survive, and people die very quickly if you keep them isolated. That's why we torture people with it. Secondly, it’s uncertainty. Now that's different from anxiety, anxiety is worrying about a specific task or thing that you've got to do and all the worries around it, uncertainty means you have to worry about everything. Okay, because you don't know where the danger is. So in a sense, you have to be I found that I couldn't read things I wasn't taking things in, I was just distracted all the time. But the third that I think is the most sinister. It is actually not the stress that you're in but it's the perceived inability to change it, and in my view, that's what gives people cancer. And that's the research that I've done, because it's the crap marriage, crap boss, I've been passed over, nothing in my life is changing, I can't move up the hierarchy, no matter how much I, you know, I can't get the chance I need. And that, and again, in rat studies, it kills them, it gives them cancer in a month. If you put that in cages next to cats, they'll get cancer in a month. If you give them escape cages, literally only a meter apart, they don't get the cancer and they don't get fat, and that is their perception is they can do something about it.

Claudia von Bosealager: Any type of cancer in particular?

Nick Potter: No, I think the kind of [Unintelligible] so probably prostate, and breast. I can't really say it's across the board, but you don't really get cancer on the 40. Right, you know, we already do we get the childhood cancers, you might know somebody 39, but in general terms, but the genetically, we're not determined to get it before then. And then after that, you've got the epigenetic effect. So like I told you the interleukins that are feeding away at the per unit each, and the outcome is you get uncontrolled gene expression, which leads to uncontrolled solar expression, you know, it causes breast to do it, why it was I don't know, I've got if I did, I wouldn't be here, I’d be a billionaire having cured cancer. But I think we're getting closer to realizing that people can have a much greater effect on cancer than they really think. And it's not just about smoke, even within smoking, believe it or not, they never actually found could actually say it caused cancer. So they can never prove that smoking caused cancer. What was more interesting was that of the cohort that smoked and got cancer, if you personality profile them, they were all much more stress people have much higher anxiety levels, lower aspects and mood. That's why they smoke because they wanted the dopamine from the nicotine. But actually, the ones that if you like, we're guaranteed to get the cancer had the profile of smoking and being stressed, which I thought was much more so because our body's quite good at getting rid of crap.

Claudia von Boeselager: It's good.

Nick Potter: I’m not saying everybody rushes out and smoked 20 a day. What I'm saying is ‘it's not quite as simple as you think it is, and a bit of self-regulation, a bit of realizing that you have to put aside what you want now for later. It's a rule for life. Whether it’s money, food, you know, everything in my…. ride or die is called everything in moderation everybody, it's what granny always told us, isn't it? It's just, have a little bit of everything because it's all but we even know that meat isn't quite such a sin that we think it is. But yeah, if you're having 40 burgers a week, you're an idiot.

Clauda: Yeah, I mean there's grass fed meats. Exactly, there's quality meat and non-quality meat as well.

Nick Potter: Yeah!

Clauda: Nick, do you have a favorite quote or piece of advice that has been a real game changer for you?

Nick Potter: Yeah, I have lots of. I've been so lucky to work with so many people. I'll tell you the first one sadly, was a woman and it was only two years ago who had pancreatic cancer and she died sadly, she was a very, very big influence, which is a writer I can't say who she was but she was a wonderful woman. And she laid in her bed in the clinic in London and she said to me, Nick, I realized that health is a crown worn by the well that only the sick see.

Clauda: Wow!

Nick Potter: Which really, as you can tell, it's never left me. It's a crown worn by the well, but only the sick can see.

Clauda: Isn't?

Nick Potter: And from a dying woman, which is very sad, and she kind of did more than anybody, she didn't deserve to really, she said so much more to give. But anyway, and I think for my own personal lessons, I went to go and play rugby in New Zealand. And I met an amazing coach who said to me, you're a good player, be another great player, and I was quite open to public school was full of myself, I was either a big muscle making movie, I thought I was the bee's knees. And I went out there and he said ‘would you like to be a good player? Of course I would. He said, well, you're a two dimensional player. He said what you do really, really well. But you won't step outside your sticky zone. Do all [35:53] but the Kiwis are famous for this. And he said, you went to a PA school, didn't you? So I said, yes. He said public school? I said, yes. He said, the problem with them is that they breed a fear of failure, and it's true. You're castigated for it every time you fail, you fear it. Because you somebody gives you Oh, you know, you drop there. So you did that? Oh, you idiot, you know. So I had to have the tattoo. It would be what he said to me then which was your fear of failure is greater than your will to win. And it slipped my head forward, and he said, if I can help you change that, you'll be a great player. But if you don't use it, you might as well be back on the plane home. And I think he did. I didn't ask him because I broke my back. But I grew more in that season, not only in as a player, but also as a person, because it taught me to see really, what he was right! And we see that here at the trading floor. Sadly, this that posh people who go to posh schools, interestingly, they're not on the trading floor because they have too much to lose, they won't take risk, because they're taking risk is potential failure and failure is unacceptable. And you get a law school saying to kids, oh, we teach our kids to embrace failure. But they don't, because they don't set up a culture and that's what was different in this training camp was that every time I did something that I tried, I was in my sticky zone trying to learn a new thing. And then I fluffed it, the whole line would just reset nothing was said there was no comment, there was no sign, there's no rolling of the eyes, they just reset. They knew you were in your growing zone, you got to five times somebody will come out to you and say, hey, look, maybe if you did like this, this is what I find works for me and I had to be big enough to take it from a CEO. Okay. I'm not doing but then what we realized was this massive reciprocity between us, we didn't see each other as competitors to be beaten, we were just healthy rivals with different tasks to do, you might have a skill set that we could share. Very rare, you find that in cultural environments, and no better place to learn it in team sport, because you will be found out while you're playing friends or the crowd, they will see it.

Clauda: Yeah.

Nick Potter: And that's why to me, team sport is so important because it teaches you to be resilient, it teaches you to face to not getting the team to raise your game to get back in the team, fight your place, you know, respect your others. Most importantly, I think we're brewing a society where we see other people's people to be beaten all the time. It's about me my career, me I very I orientated led by social media. But as a result, we're becoming more disconnected because we see our neighbor or worker or friend, as a competitor, not a sort of healthy rival by which to judge the bar. It's really unhealthy. I'll go back to my old school I saw this all the time. It's a very academic school, it's become intensely aggressive there's a kind of almost menace in the air. I think it's certainly in America. I think, you know, the elitism is awful. Further from west coast, some of these guys have high IQs on the west coast, etc. Eventually, they're very nice to each other.

Clauda: It's so competitive as well, and interesting with failure. I had an interesting story. At the weekend, I was attending an event. It was about the founder of Spanx, which I don't know if you'll know, but many.

Nick Potter: I know, some of my patients wear them. It's quite exhausting to get them off, but!

Clauda: Exactly. But it was very interesting, because they said that, you know, she was the youngest female billionaire at one stage, she's been beaten down by one of the Kardashians. However, at the dinner table every night, six o'clock, the father would ask his children, so her included, what did you failed at today, and it was required to have something so you're programmed yourself every day to fail at something because then you learn from it. And it means that you've progressed and you've tried something that you're not good at, and you've got out of your comfort zone. And I found that so fascinating, and like one of mentor told me once I said, you have to get out of your comfort zone every day. And I was like, oh, if I can get out once a week, but even just having that in the back of your mind thinking, Okay, what am I going to do today to push myself out of the comfort zone and you see it just programs the brain differently. So this is really interesting. Also, you're…

Nick Potter: I think you can say in a separate way does away with laziness, because it's kind of like you could walk, I could tell that lady, she's just dropped her wallet, but because it's a social interaction. I've got to she might think I'm a weirdo. You know, all these things and you're telling yourself in your head instead of just being helpful. And also just you've got to bend down, pick it up, I'm getting late, and I'm with you. But it's the first, what I could do that. But actually, this would be the kind of thing to do. Very quickly, somebody else, somebody said to me, and I've extended off to lots of my peoples people, whatever, is when somebody dissected and broke down the elements of kindness, and why it shows such a high level of intelligence, which I thought was really interesting. And he said, because he could tell, he said, kindness shows three types of intelligence. One is the empathy to know that somebody needs something from you, or of you. The two was self-awareness that you are empowered to do something about it. And the third was self-sacrifice, because you may have to miss the bus to help the old lady or whatever, however you turn that, but it was so interesting to have that broken down into its elements, and people go what kindness is? I will tell you what is kindness, and you certainly, and I think this is what it shows, is that your intelligence across three domains that you previously hadn't thought about. That's why it's, where kids get that as a surprisingly early age. They really do, it’s extraordinary. So if nothing else, it's not just your client will also tell you, you're clever. Oh, great, because I coached for eight years doing rugby to juniors and I found this very helpful. And an old coach said to me again, he said, don't praise the outcome, praise the work put in.

Clauda: Correct.

Nick Potter: The only interest is, did you get the medal, because what happens with kids is interesting, it's about how kids perceive what you're saying, not what you're saying. And of course, what they do is, you didn’t fail my little Einstein, well done, you got 100%. They now live in fear of losing that label to anything less than that is unacceptable. And then they get anxious about it to get any grade less than that. So that's why you must never if you can see, so long as they put 100% into it, then the feel it is good enough.

Clauda: Yeah, and so that correlates really nicely until the point before around failure, right? So if you just focus on the outcome, they think they always have to get that grade as well. And I've heard this from a lot of high-performance, as well, that their parents or whatever growing up, it was all you know, you put in a lot of effort, well done, and you did it. And it was more about the effort put in than actually the end result, and you've tried your best and that is what's plotted.

Nick Potter: So it can be even more subtle, in that my father is a huge influence on me, and I adore him. But I remember doing to my daughter one day, what my dad I now realize used to do to me, and I used to ring up one day and say dad won a star in this essay I'm really proud to go on. It's amazing. He was full of adulation. But he would then read it to me and I'd read it to him, and then he'd go, just in paragraph, brilliant, brilliant, but just in paragraph three, you know, could have said this. So I thought, God yet again, he never actually just said, well-done, he's a post degree or whatever, and I was 15. He's applying all those. And I realized one day were my daughter going to do exactly the same thing and I went... she said, what? I said nothing. I thought, Oh, my God, I'm about to do it. The perception of the child is nothing you do is good enough. That's how children perceive it. Which adult doesn't, by any means me…?

Clauda: Yeah.

Nick Potter: But it's actually how the child reads it and I realized I did the same to my daughter. And I thought I saw is it like, I'm helping her improve to be better. But that actually translates saying nothing she's done so far is quite good enough.

Clauda: Yeah, and so many parents who have received it. I mean, I have a very strict father that was always about correcting things as well. And to grow up with that thing, that no matter what you do is never enough. Yeah, exactly!

Nick Potter: Never make perfection the enemy of good, that's a good line, too. And I think that's what we as parents want all the time. It's just, it's unrealistic. But that causes stress, and these two. And I’m not joking, that's the sort of stress in early childhood which will give you asthma. Let's be very clear. It will give them anxiety, just sort of girls anorexia, they can't control their environments enough because they don't think their performance or they control [Inaudible] exactly.

Clauda: Yeah.

Nick Potter: So the Association of cells, they do it through their body, and it's poorly treated. And then what happens is ‘they get sent back to that environment out of the clinic. So some people just need appendectomy as I call it, but you know, parents necessarily know they're doing it. We're all pairs. We're all fallible. But I think if we all as parents said, you know, I'm not doing this, what do you do with your kids? How often do you really get people saying, you know, how do you approach this? He says, it's because like, you know, you're expected to know and, yeah, it only breeds liars, hiders and fakers, and that's very sad. We see that in the financial industry, a lot guys who, go as they're putting off a whole good thing going on, but actually because they don't know, they don't let you know. And they don't know, ask, and then they have to lie. And they fake it because they don't know the answer. And that leads to all sorts of problems everywhere to certain extent, but I think it's particularly in those sorts of parts, which are very competitive because you can't share. You can't be vulnerable. You can't be open to emotional responses. So we make people into sort of automata, which I thought was an anachronism of the 80s. But hey, it still seems to be going on.

Clauda: It's still there. I'd like to touch on breathing. We talked about a bunch of different aspects but you've developed a device to assist people with breathing. Can you talk a bit about that?

Nick Potter: Yeah, I'm really very excited about it at the moment, we've called it x Halo is all about the outbreath. Nobody had produced a piece of kit that would actually measure breathing, there are certain things Fitbit that will take average respiration time. But this will give you real time input into your breathing pattern, and also your breathing rate. And it goes on your belt, and you don't even know it's there, it talks to your phone, and it’s not another Fitbit, because that's boring. The worried of welfare as I call them, who got everything and they're just obsessing, and then they get more stressed, and then they get more stressed and it gets weird. Now, this is the I think, the answer to normal approach, because what it will do is give you feedback all the time, about where your breathing is, therefore where your brain is, and therefore why am I getting stressed and so all it does, it will buzz at you and tingles. It buzzes you and tingles.

Clauda: And where it is?

Nick Potter: It’s only a waistband. So it will go inside your pants, with women, it will go on, they can go on inside their bra is going to be inside, but I'd love to have them put into all bras, I think it'd be fantastic because then people get feedback all the time. But also it will check if they're expanding their chest and ribs, and so on. But a very good prototype, it works. Hallelujah, the amazing team. And the great thing is the medical board behind it at Imperial are really excited because we've also put it into lots of studies, we're going to hopefully do with a big bank, who wants me to make loads of them and give them out because we want to move away from screening people's health when kind of it's too late. You know, by the time you need to go and have a test to scan, you're already sick. Preventative health, in my view is the way forward and that's catching on, which is good. But I think that if you could get everybody wearing these in large cohorts and ignore anonymized data, you can say, well look, why is this particular group of people or four of them are stressed? Was the whole department stressed? Is this just a terrible manager? Why was the whole bank stressed? In which case, we've got a bad culture, and also say to people, because individually, the phone will say, Look, you've had a particularly tense day here. We're friends with all the meditation people because we're linking them because actually their retention rate in things like headspace and calm is actually not very good. It's kind of three months, and they always say, Look, you've had a really bad day today, particularly, don't just do the breathing, go and do you know, yoga or your whatever, because as you need a more powerful distress agent, but also can be a coach, like that lady with the boss. So what happens at three o'clock? Blimey, you know, sometimes we found that a trader here that Monday mornings, he shouldn't trade at all, certainly because his marriage was a meltdown, and he the stress levels he came in with on Monday. Well, because he was unhappy at home, so we helped him manage that, you know, so that's the great thing. So its nonspecific, we're not peering into your world, but we're just saying, hey, dude, and it's a nudge. That's the really clever thing about this. Your breathing is wrong, and you learn it. So we teach you to breathe with the app, we teach you how to do it, right, and we teach how to recognize it with lots of lovely content, about why it's bad for you, but most importantly, and you'll be able to gamify it, so you can put it in your hand that has an oximeter on it, which will measure your pulse rate. So if we say Look, you're about to have a panic attack, or you're about to do those presentations you really hate you know, that you blush, you know that you lose your way and you lose it. And of course, you become less articulate and your memory goes to go into the loop, put it in your hand, and you breathe your pulse rate down, which is very powerful. And then for brain switch. I mean, listen, I've got a couple of comedians who've been using it and they said, Oh, my God, I'm just like this, because now I know that my brain is opening up, and you provide the stage frame.

Clauda: What's the right way to breathe, Nick? So many people learn from me, especially women, we were talking about before as well, don't breathe properly. What is the right way to breathe? And how can you correct it if you breathe from your upper chest, for example?
Nick Potter: So really easy, but what we call it high lows and put one hand on the chest, you put one hand on your belly, you ladies particularly tend to spend more time holding their tummies in because they don't want to go out with their tummy, you know, we all went away. But the problem with that if you only tell me, and you invert your breathing pattern which is the same as Edwardian women, and that's why they fainted all the time. I think they were wearing corsets that held their breath and prevented them. So, when somebody did upset them, they will have the vapors and it was all like this, but that was real. It wasn't just histrionics. It was really real pulmonary chemistry at base, and all because they had to have tiny waist. But anyway, so first of all, let it all hang out. Just accept the truth. It's bigger than it should be, and you've had babies and that's amazing, but you probably left the six packs behind maybe! So, maybe hang out and then breathe it down. Imagining your tummy is like a bag and you paralyze your upper hand the chest so you don't. If your chest heaves your breasts come up underneath your chin, you're doing it wrong. It’s that simple, Okay? What should happen is your belly should come out. That's why Buddha is always depicted with a big belly. And then you take a long, slow breath, nose only in and out. Send it into your abdomen, make a big belly, what you're experiencing is your diaphragm descending and pushing the belly out. That's why the bed is important. Long and slow. Generally, the rule is five seconds in, seven seconds out. There are lots of variations, pranayama, fu, fu, fu, you know, they're all there to achieve more than but most of the time, the five sets of ten breaths a day is good. Ten in the morning, ten min morning lunch and so on. As long and slow diaphragm breathing. By five, you'll often hear your tummy gurgling, which tells maybe your vagus nerve switched on and your digestion to come back on. So your whole nervous system in the rest digests. It’s quite reliably fine. It's what I do with patients who don't even hear [gurgling sound]. Engaging will cure your reflux in your digestion problems overnight, certainly any of you who get a bit of IBS. Honestly, if you keep it, you got to do it daily for two weeks more high…

Clauda: Five times a day?

Nick Potter: Five times a day and ten breaths. That's it. You don't have to be lying down. You're better if you can, but don't worry, you can do it sitting at desk. If you catch yourself breathe holding, yawning or saying, those three indicators that you've gone back into naughty breathing. Put on yourself on the top of your computer, breathe, breathe, breathe, check every 10 minutes, say am I breathing regularly.

Clauda: I have this from something else.

Nick Potter: It’s born for breathers and use your outlook get it to ping every 15 minutes and check your breathing, even with a sniff. If you breathe in, your chest comes up, you're doing it wrong. If you breathe in, your tummy comes out. You're in good breathing. Let's get the coherent breathing going five times.

Clauda: It's actually a good hack. Yeah, thank you for sharing that. I want to talk about human performance, Nick. I’m having such a great talk, and I realized that it's getting a bit late now. But you're all about optimizing and improving but you have high performers among strictly I can tell! What are some of the strategies and tools that you recommend to them, when they say I want to have the better mental capability? We talked about the breathing and things as well. Is there a sort of standard recommendation that you say, oh, how do you assess and give advice for high performance?

Nick Potter: I think the simple and probably not very fair answer is I really do treat them like any other patient in the sense that they're people. They have a story. They have childhoods, they have high performing lines, and if you actually look at whether it's Elton John, whether it's elite athlete, or black, high level corporate athlete, as I call them, because their function is. The two things that happen most of these people are jealous of you. Yeah, it becomes thin at the top. It's not very nice. People kind of want to see you fall and you know that and getting up there isn't the answer, it is staying there. Its repeat performance actually, is what I'm more interested in. So okay, you've done that, that's great. But now we need to keep you there and actually be accepted. You don't want to be at your peak all the time you want to peak at certainly that's what we do with athletes when you peak them when they need to perform otherwise, it's constantly exhausted. Teach them that and there's personalities of those people tends to be Taipei, go getters, obligatory very often guilt sufferers, etc. driven, find what their demon is. Everybody has a demon, I have lost of them. They are what drive you, and there's nothing to be frightened, but turn it into a thing that worries you into a thing that makes you want it more. But also learn to tame it. You know, there's nice Nick, there's nasty Nick. It's Yang and Yang and the ancients knew this, you know, but there's kind of nasty Nick, nice Nick, and you keep them at bay and keep them at balance all the time. And sometimes it's good enough, the next good thing, it's what gives you ambition, it's whatever, but learn to control it. Don't let the current turn into anger, and emotional lability, get hold of your sleep. You can't always have friends when you're at the top. Because again, people are jealous of you, etc. But also if you're in a high level ranking position in companies then you’re going to attack them, you're going to fire them. You're going to tell them they're crap at their job. So you lose your so the higher you go up there, the thinner the air gets that's so really, it doesn't matter who you are, saying, well, shooting expert gymnasts, tennis players, the issues are all the same. And by the way, cool thing is if you're trying to get those net games, as they always call it, it's either drug. Which sadly has crept into all sports, we're kidding ourselves, but it has. Or it's those little extra gains that you squeeze out and most coaches are up to that. But I find a lot of it's emotional. So find out what's going on at home. How they’re constantly… you look at a lot of athletes and players, they will genuinely wobble when they either get married or have a child that's just because they're being emotionally tethered. It has nothing to do with energy, and it's lovely and they seem to fall into that. Federer is very good about being married and then he find that the anchor, other players will find that it's a kind of emotional hassle if you like or element into their life that they previously didn't have to worry about that they now have to slot in the course, why does Oregon said you've been away three months and you know, the kids aren't seeing [Inaudible], which you don't get if you're not married, and it's the same for married women players, female players, they've got husbands that need them and want them around otherwise, what's the point kind of this thing and there also should be enormous source of support. And I had a lovely guy and today actually he's [Unintelligible] as when he said his great thing is behind every great man is a surprised woman, which I thought was quite funny. But he still got his wife, his partner. Let's be clear about this. And gay couples again, you tend to find that they slot into those roles and once support, one goes out there, but then on the whole, you can't have two alpha characters all the time, and they don't clash. And you've got to find that balance in your life, whether it's relationships and otherwise, and it's helping them. So I think it’s being a confidant genuinely, and I am unbelievably discreet about my whoever my famous patients, I don't really care doesn't matter. But I'm discreet about every patient, so they've got to trust you. Because they know you can go make 50 grand from telling somebody who's going to go off his game, or the Queen has got piles, you know, that stuff makes headlines, it's ridiculous. So it's trust, it's not getting fazed by what you see it's experience, but I think it's knowing that actually, wherever you are, in whatever domain, if you're at the top of it, it gets harder not easier. Nothing ever great was easy, it's the way of things and they can't keep it up for too long. You've got to explain to them you know, you are going to peak even CEOs probably have a life of two to four years in one job, but expect that and accept it that's the way the world and don't get anxious about it then over control people. And I think it forms connections, go speak to other CEOs that always see them as your this is what you see graduate a lot of them quietly have other friends who are heads of companies that they trust them that they're not going to get rid of secrets and all they're in a different industries and they go and share that stuff, and don't think you have to put the burdens of the world on your shoulder. Because you're going to buckle doesn't matter how good or intelligent you are. You will buckle.

Clauda: Yeah.

Nick Potter: I think you know Arianna Huffington is a great example of that. She buckled and then she discovered this whole new world.

Clauda: Yeah.

Nick Potter: Particularly in the health world about thrive, it was all about that. I couldn't do it. I'm amazing, but I can't juggle three children and a daughter that wants me and a husband that does or doesn't and I'm a single mom and I haven't got that support. Where do I tell myself? You've got to find the balance, it’s not really easy. But ask people, never be afraid to ask and I think a lot of people are.

Clauda: Yeah.

Nick Potter: It's a weakness.

Clauda: Such wise words! Closing up shortly, but I’d love just in the longevity space make what are some of the trends that you find most exciting that you see coming out of this, in devotee and improved health span?

Nick Potter: I'd like to see people being contempt to get old. And what I mean by that is that they've been given to being elderly. That's a very different thing. I'd like to have society stop telling, I reached 52 years two ago, and I got so sick of humor. Beginning of the end, you know what it's like, you know, he's going to go south. And I said, well, as you know, I stay quite healthy. Okay, I stay slim. I eat well, sleep well. I've got a lovely wife, she’s amazing. And I've got two happy kids. Hopefully, they're not taking drugs. That's what I can judge it by so far, they don't get complacent. But I feel mentally 30, might still work out, the level I'm quite proud of. So why should I give in to this concept that being a certain number is how I should feel. Your biological age is quite frankly, is how fit and while you are, and how long you've done that for? I think that it's very difficult to tell teenagers Oh, you know, don't smoke because at 70, who gives a cost about being 70? When you're that age, you know, I think it's a great tragedy of the world that you lose youth in return for wisdom [Unintelligible]. That's a really interesting one, I think just to have some balance and raise your body's quite good at looking after itself, it the service just don't abuse it. It's a miracle that you've been given and don't assume, by the way, there's no correlation between age and pain. Amazing how many people say what do you expect from your 70s? Well, you know, pain, no! It’s not correlated at all. You don't lose performance. Again, marathon runners, they compare 70 year old over five year logs, and they show that actually 75 year olds showed the best year on year increase in fitness and speed for year on year, marathons.

Clauda: Wow!

Nick Potter: Even better 25 year olds. So it’s all rubbish that you can lose everything and we keep telling them, because don't forget what sells a product is to scare the bejesus out of you.

Clauda: Yeah!

Nick Potter: Yeah, you're going to lose 10% of your cognitive ability in the next 10 years or like, well, that's not really been proven yet. And then how do you judge it? And what do you measure, you know, hey, but if you take this vitamin, it’s going to kill your brain problem. And so, prove yourself on one side of the thing, but take this great product, which by the way, there's a load of crap, and it’s going to make a difference. You're going to do better to move all the time, eat well, or be a good lover. Men who don’t ejaculate regularly get prostate cancer, you don't use it or lose it. We don't like to put it like that, but that's the truth. So that doesn't mean you dive [Inaudible] every five weeks but don't give up on it. Be in your relationship happy, be attractive for each other. It’s amazing, I've got a friend who puts on five stone and now said his wife [Inaudible]. Are you surprised? The sweaty, big belly that is panting all the time [Unintelligible] well I don't blame her, and you'd be the first be going and pitching her bums [Inaudible] saddlebags there. I mean, yeah, all right. Okay, it's a partnership and I have relationships. I mean, all the evidence shows I'm very like this, I love my friends, I love spending time with them. They can be my biggest source of critic as well as my biggest support, and family. Look at everybody that goes into nursing homes, the reason they die quickly is because you take them out to the family.

Clauda: Yeah.

Nick Potter: We don’t see Asian women nearly as much in nursing homes, why? Because they're kept in the family and their family don’t leave them either.

Clauda: Exactly.

Nick Potter: So I think, yeah relationships may become too self-obsessed. I think some of this stuff is getting a bit narcissistic. And you know, fillers, okay! You know, Botox again, but I mean laughter lines on a woman's face are, they are everything! I think men are much less bothered by this stuff than women are, I promise you. I mean, all women think that men know it, and they do other women do it for other women, which is sad all the time. Who cares? But I think it's everybody ages differently. [Inaudible] is the biggest pager of all time, I think 96% of skin ageing is actually signed. So, I think it's sad that we're seeing 25 year olds Botox-ing and using fillers. I think, it's their need to do. So, I think as long as you what you're doing is kind of natural, and you're sustaining things, and you're using products that sustain natural processes, I think it's fine, I get a bit worried about some of the testosterone stuff that I'm seeing going on in kind of over 60 year olds, and I think we're going to see, sadly, a very big increase in cancers, if we're not careful, just as the estrogens can cause it. I think we need to be careful and then find time to do things that you find fun, these things have a much bigger outcome on anything that you can do with surgery.

Clauda: The art of saying no, to make time for things that you actually want to do, right? Nick, for my listeners who are interested to understand osteopathy more and optimizing their health, what online resources or books would you recommend they start with?

Nick Potter: It depends on kind of what angle. I mean, I'm a big fan of Gavin Murphy and people like that. I think that his stuff is great. I'm a big fan of the body keeps score.

Clauda: The Body keeps the Score?

Nick Potter: Yeah, that one. But that is not for everybody with trauma. But I think it's a wonderful, he verbalizes in a very good way. For so many good books out there, I thin I think also just read for pleasure. I read a lot of fabulous stuff that can be life changing that isn't technical. You learn things from good writers, they teach you stuff. [Unintelligible] So I think it's, for my book, oh God, I must have read. I think I read 37 books in a month or so at one stage, and it was just [Inaudible] and we could lose sight, I found out I've got much more interested in going out and finding lovely nuggets of really interesting stuff. Like one thing I learned was, only hollow organs feel pain, I went, Oh, my God! I've never been taught that in every procedure I did, and it's true, because you don't need to have a high level of vigilance around organs that don't have contact with the outside world. So, that sort of stuff I just found somewhere.

Clauda: Yeah, and you retained it as well. Amazing, Nick, where people can learn more about what you? So are up on social media or websites?

Nick Potter: I am a university professor and I probably at my age, I am terrible at social media, I do have an Instagram post, etc. My website is really amazing, which is actually the Centre for physical medicine, which is just on Harley Street. And I'd love you all not because I want to make money from it. But I'd love you to actually read my book, because I think it's good. I don't mean that arrogantly I spend a lot of time doing it.

Clauda: And would you tell me the name of the book?

Nick Potter: Meaning of Pain. In Italy, it's called, our heart, how our bodies speak to us, which is actually much more poetic, and apparently better. So whoever translated me is, is more passionate. And I think it's kind of why we had and it links a lot of the societal stuff, and explains that I hope in a way that doesn't get me trolled, because that happens. You people don't like how you're putting things but just listen to what I'm saying. Don't jump on it. I think touchwood I haven't had too much of that. But I think it's really important. And I'm quite proud of it, and I think it will help people. And there's a lot of good reading. I put a lot of good Bibliography in there for people to read if they want to. It starts to depend on the subject.

Clauda: Very helpful, thank you! And then any final advice or recommendation or parting message from my audience?

Nick Potter: Yeah, look after your health, because it may sound clichéd, but I spend too much time in my life, helping people who wish they had done things differently. And it doesn't take an awful lot. It doesn't mean you have to be this purging paragon of a person. You just have to be observant of certain things. But it's kind of about how you balance your life generally. If you live well and you need to then your relationships are good too. And that helps as well, and I treat a lot of billionaires for example. And the biggest single thing they know they can't buy is their health. So they're obsessed about it. I get very stressed about it and sometimes that's because they've worked ridiculous long hours and abused themselves in the past to get there, and now realize that perhaps that wasn't such a good idea. Probably just remember that saying actually, health is a crown worn by the well and only seen by the sick and don't take it for granted.

Clauda: Beautiful message to end with. Thank you so much, Nick for coming on today. It was such a pleasure to have you.

Nick Potter: Lovely to talk, thank you for having me. It's been great.




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