The Melanie Avalon Podcast Episode #50 - Dave Rabin (ApolloNeuro)
Apollo is a new wearable that improves your body’s resilience to stress, so you can stay healthy and productive. Apollo’s clinically validated technology engages with your sense of touch, training your nervous system to bounce back more quickly from stress, going from “fight or flight” to “rest and digest”.
What does this mean for you? You can stay calm, focus, relax, sleep, and stay healthier.
Developed by physicians and neuroscientists, Apollo has been tested in multiple clinical trials and is proven to improve heart rate variability, a key biometric of stress.
The Apollo app features seven goal-based modes that let you choose how you want to feel, including Focus, Sleep, Wake Up, and more. Unlike using stimulants to stay awake or depressants to help fall asleep, Apollo is a natural, easy way to stay energized and focused throughout the day and to help you unwind to get the restful sleep you need.
LEARN MORE AT:
Get 15% Off Apollo Neuro At Apolloneuro.com/melanieavalon
2:20 - IF Biohackers: Intermittent Fasting + Real Foods + Life: Join Melanie's Facebook Group For A Weekly Episode GIVEAWAY, And To Discuss And Learn About All Things Biohacking! All Conversations Welcome!
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6:45 - Dave's History: Analyzing The Stress Response , Imbalances In The Body, Beneficial Vs. Burdening Stress
9:45 - Why Do People React Differently To Stress?
10:35 - Developing The Apollo Technology
12:05 - Tapping And Emotional Freedom Technique
12:25 - Parasympathetic Vs Sympathetic State And The Role Of Perceived Threat And Safety
17:15 - Flow State
18:45 - The Apollo Neuro Programs: Energizing Vs. Calming
21:45 - The Emotional Component To Chronic Health Conditions
23:45 - How Love, Gratitude, Forgiveness, And Self Love Trigger Safety
24:50 - Activating Feelings Of Safety From Bottom Up Vs. Top Down: How Do Meditation And Breathwork Make Us Feel Safe?
26:30 - The Role Of Soothing Touch
27:15 - SUNLIGHTEN: Get $200 Off Any Sunlighten Cabin Model Or $100 Off The Solo Unit (That Melanie Has!) AND $99 Shipping (Regularly $598) With The Code MelanieAvalon At MelanieAvalon.Com/Sunlighten. Forward Your Proof Of Purchase To Podcast@MelanieAvalon.com, To Receive A Signed Copy Of What When Wine!
28:45 - The Role Of Awe And Wonder
29:40 - Making Changes: Problems With Top Down, And The Role Of Fear
31:15 - Feeling Better With Hugs
32:30 - Feeling Safe And Making Change With Apollo
33:30 - Apollo Vs Meditation And Breathwork
34:10 - What State Does Soundwave Therapy Activate
36:55 - How Fast Does Apollo Work? (Shifting Biomarkers Like Heart Rate Variability In 3 Minutes)
38:15 - Apollo Programs
40:00 - Brain Re-wiring And Increased Effectiveness: Is Apollo Addictive?
42:40 - How To Wear Apollo
44:30 - The Left Vs Right Side Of The Body
46:00 - Using The Programs For Anxiety And Different Goals
49:20 - Prep Dish: Prep Dish Is An Awesome Meal Planning Service Which Sends You Weekly Grocery And Recipe Lists, So You Can Do All Your Meal Preparation At Once, And Be Good To Go For The Week! The Meals Are All Gluten Free Or Paleo, Which Is Fantastic If You're Already Doing So, But Also A Wonderful Way To "Try Out" Gluten Free Or Paleo With Delicious Meals, And No Feelings Of Restriction! Get A Free 2 Week Trial At Prepdish.Com/Melanieavalon
50:50 - Tackling Anxiety With Covid
51:30 - Wearing Apollo All Day: Comparison To Caffeine And Alcohol
53:10 - The Energizing Mode Of Apollo, And Tailoring Apollo To Yourself
55:40 - The Intensity Of The Apollo Programs
56:10 - Get 15% Off Apollo Neuro At Apolloneuro.com/melanieavalon
Melanie Avalon: Hi friends. Welcome back to the show. I am so, so excited about the conversation that I am about to have. I've been looking forward to this so much ever since I got the device that we are going to talk about. But I know on this show we talk a lot about stress, a lot about different techniques and modalities to deal with stress, all of which I am huge fans of, you guys know this, tapping, meditation, breathwork. They're such valuable tools. I do all of them, usually one of them every single day. But what if-- and this may sound too good to be true, but what if there is something now that could possibly let you turn on the states activated by those with the touch of a button? Let's just jump in.
I am here with Dr. Dave Rabin. He is a board-certified psychiatrist and neuroscientist and he actually specializes in the treatment of chronic stress. You created this device, Apollo Neuro, that we're going to talk about today that I currently am actually wearing. I;ve had it for a few days now and it's honestly a game-changer. I posted in my Facebook group about it, and I was like, “Guys, there's this new device, and it's incredible!” And everybody already wants to get it. But I was like, “I can't tell you until this episode comes out.” So, here is the episode. So excited. I have a lot of questions for you. But thank you so much for being here.
Dr. David Rabin: Thank you so much for having me. I really appreciate it. It's a pleasure to speak with you and share this with the world.
Melanie Avalon: I know. I'm really, really excited. So to start things off, would you like to tell listeners a little bit about your history and what led you to where you are today with your focus on stress, on the nervous system, and creating this Apollo Neuro device?
Dr. David Rabin: Absolutely. I'm a psychiatrist and a neuroscientist, and I practice clinical psychiatry. Most of my focus has been on, for the last 15 years or so, on chronic stress as you said, but specifically focused on PTSD, depression, anxiety, and substance use disorders and things like chronic pain that are typically worsened by stress. Because chronic stress always stood out to me as something that we just weren't-- as humans or animals, in general, from a lot of the studies that have come out over the years, we were just really weren't built to deal with it well.
Stress that comes in a moment where there's a momentary action required on our part, we respond to the stress, we overcome it, and then we move on and then the stress is over, and we're safe again. We're pretty good at that. Our bodies have been designed neurologically to respond to that kind of threat very well, and that is a very well-circumscribed response. We actually see that response if we look back in the evolutionary biology work of Eric Kandel who won the Nobel Prize in 2000 for discovering the origins of learning and memory, and many other scientists who have worked in this area over the last hundred years and more. We see patterns of the way we respond to stress and threat on a short-term level.
I think the tricky part is when we start to see that stress recurs every day, sometimes every moment of every day. Thinking about where we are right now, our lives are superimposed with this constant threat of a pandemic, where we sometimes feel threatened or scared to be around our loved ones or scared to be around our friends, and to go to work and things we normally do, and it throws off our whole routine. That chronic stress sets off our sympathetic fight-or-flight nervous system in a way that we are not used to dealing with because it's continuous. It's continuously imbalanced. And what we refer to traditionally disease, mental health in particular, but also stemming into physical health, it's really talking about imbalance in the body. Imbalance between the nervous systems, the fight-or-flight sympathetic system, the stress response system, and the parasympathetic rest-and-digest recovery response system.
These themes always stood out to me because they form the core of our understanding of how we respond to stress in the environment, but also how we maximize our recovery so that when stress or threat comes, we can actually respond in the best way possible that gets us out of that situation to safety.
There are certain people who are really great at overcoming that and moving on and growing as a result of stress. There are certain kinds of stress that are more likely to help us grow. Then, there are other kinds of stress like chronic stress, which can become a huge burden that can result in chronic disease. My question that always fascinated me, in addition to the study of consciousness and why we think about and see the world the way we do, was also why do some of us grow with stress? And why do some of us get ill or diseased?
In medical school, it's a great example because we're constantly under stress. We're constantly working as hard as we can to try to get through and in medical training in general. You see the toll that it takes on people and ourselves. If anybody told you they weren't suffering a little bit while they were in medical training, they'd probably be lying. So, that really firsthand going through these different-- that being just one of many things in my personal life, it really gave me an opportunity to reflect on how we cope and what is resilience in these things. That really drove me into the space, and from that, we developed the Apollo technology, as you mentioned, which is a wearable that delivers gentle vibrations to the skin that activates balance in the nervous system, similar to deep breathing or tapping, but through the touch receptor system. It's probably more similar to tapping actually, or EFT as some people refer to it, but it activates the same pathway as breathwork and meditation, from what we can tell from the clinical trials.
I'm also the executive director and cofounder of the Board of Medicine, which is a nonprofit organization medical board based in the US that helps to train doctors and healthcare providers as well as individuals, regular folks like all of us in the regular world, to basically use more risk-free, noninvasive strategies to maintain our health, and which is effectively what the Hippocratic Oath stood for. The first part of the Hippocratic Oath we all take as physicians and care providers is do no harm. First, do no harm, then do everything else. So, if we remember that as our guiding principle for the way we deliver care to our folks in the real world, then we're always going to have better outcomes if we focus on the treatments or the therapies that provide the least risk first.
Apollo really emerged out of that as an opportunity to provide help to people to just feel better and feel more balanced in situations where we've been effectively trained to be under stress.
Melanie Avalon: Oh my goodness! So much there. Now, I think listeners can see why I'm very, very excited by this, all the potential here. And for listeners, I realized we're using the word tapping. Most of you are probably familiar, but if you're not, I have had an entire episode on tapping and emotional freedom technique with Nick Ortner. So, I'll put a link to that in the show notes. Again, the show notes will be at melanieavalon.com/apollo. Okay, Dave, some follow-up questions to everything that you just spoke about.
I actually haven't asked this to anybody before, but it's something I'm really wondering. The parasympathetic state versus the sympathetic state, so fight or flight versus rest and digest. Is that literally an either or on-off switch situation, or can there be colors of each state?
Dr. David Rabin: That's a great question. First and foremost, I just want to say this was taught very poorly to us in training, in medical school. I think we were taught that these systems just act in the background to do their thing, and there's not that much that we need to do to worry about them. I think that couldn't be further from the truth. I think ultimately the source of a lot of our strength comes from recognizing that we actually do have control over these parts of our nervous system.
I think the best way to think about it is-- let's go back evolutionarily. Let's go back 5,000 years, 10,000 years. When we're living in the woods, we don't have electricity, we don't have running water. We sleep in makeshift teepees or we sleep in caves. If we are in a situation where we are trying to recover and sleep with our families around or our tribe around, and there is a potential predator outside of our tent or outside of our cave, we would never want biologically our bodies to allow us to fall asleep. We would never want our bodies to allow us to become vulnerable in a situation where physically vulnerable as one example, in a situation where we could potentially be harmed or threatened or survival can be impacted negative way.
What happens is, in those situations, we have evolved, and this is again not unique to us. This actually goes back into almost all mammals and even probably back even further into-- If you look at Eric Kandel’s work, primordial sea snails from 300 million years ago. And when you look at the way that we respond to threat and safety signals, the body has these conserved mechanisms that are subconscious, I use that term-- I think a better way to describe it sometimes is beneath awareness, whereas conscious is within our general awareness. There's these pathways that are hardwired in our nervous system beneath our level of awareness most of the time that are active when we perceive threat, and that can be real threat, like a predator lurking outside our cave, or it could be perceived threat like traffic, or like our children screaming or work in our modern day.
The interesting thing about these kinds of threats is that the body doesn't really know the difference between a predator and traffic. The body sees threat and the body responds to threat in this hardwired beneath awareness, subconscious, evolutionarily conserved way. That said, when we enter into a safe environment, that safety, that we can affirm is safe for us, that safety is supposed to trigger that parasympathetic rest-and-digest recovery response system that is supposed to then suppress the sympathetic system.
Going back one step into this state where we're in a cave and there's a predator outside, you don't want your body to allow you to become vulnerable when there's a predator outside. So, you want all of your resources, your blood, oxygen, going to skeletal muscles, the motor cortex of the brain, to the fear center, to keep us ready and prepared to act at any time. We don't want those resources going to the reproductive system. We don't want those resources going to our digestive system, or our sleep and recovery system as much because we want to be ready to escape or fight or flight, that is why it's called fight or flight. There's also a freeze response that comes in there as well, that whole playing dead response. All of those are connected.
That said, when we escaped or we've conquered the threat and we're now in a safe environment, we want that recovery response system to turn on quickly. We want that stress response system to decrease in activity. So, resources get rediverted back to sleep, recovery, energy conservation and repletion. And then, digestion and reproduction and creativity and all those things that we want our bodies to be doing when we're not under threat and that keep us healthy. These systems, the parasympathetic and the recovery response system, and the sympathetic stress response system act in what's called a Dynamic Interplay.
What that means is that when one boosts in activity in response to threat as, in the sympathetic case, it shuts down, not completely, but it shuts down mostly the parasympathetic recovery system. Similarly, the parasympathetic system when we are knowingly in a safe environment should mostly shut down the fear response system. That is the general pattern. But they are almost always never shut off completely. They're almost always coexistent together in some degree.
When we think about things like flow, which is something that a lot of people talk, about flow or obtaining nervous system balance, meditative states, things like that, these are states that are particularly interesting. Peak performance states is one example in elite athletes and folks who are elite performers in any capacity. These states are interesting because they have a close to equal level of sympathetic and parasympathetic activity. You have high attention, high arousal, high energy, but you also have high focus, high peak calm, and peak presentness or pause, you're able to be in the moment with whatever you're doing and have all of your faculties about you. So, it's a relationship between these two systems that is constantly changing based on our environment externally and also our environment internally.
Melanie Avalon: Okay, this is so fascinating. It reminds me a little bit of autophagy for example, if you're familiar with that. I'm also the host of The Intermittent Fasting Podcast, and we always get these questions about autophagy being turned on or off because everybody thinks it's either on or off. When really there's a baseline state of it ongoing, and there's different levels of it. So, it sounds similar to that, there's different, I guess, like colors and levels of the two systems, but they're at the same time also opposing in a way, like you said, feelings of fear versus feelings of safety affecting the other.
Yeah, the reason I was thinking about it, too, was I got the Apollo Neuro device, and we can circle back more to the actual device at the end, but it has different programs that you can run. And some of them, they seem very energetic in a way. It's like a clear and focused, social and open. So, I was just thinking like, “Oh, can you be in the parasympathetic state?" and it's also being the state that seems to be higher energy.”
Dr. David Rabin: That's more like a flow state like we were talking about.
Melanie Avalon: Okay, gotcha. And so, a flow state like that-- because it's equally balanced between the parasympathetic and sympathetic, in a way is that parasympathetic activation, mitigating what otherwise might be a more draining or taxing effect on the body when you're in more of a sympathetic state.
Dr. David Rabin: I think that that is still somewhat theoretical. I think we don't necessarily know per se. I think from the studies of biofeedback, deep breathing, meditation, yoga, massage, these kinds of things, it seems fairly likely that what you said is correct. If you just have sympathetic activated all the time, for example, in people with PTSD and chronic pain, and anxiety disorders is just one example, we see that there are all these negative consequences go along with that. They tend to have low heart rate variability, high heart rate, high blood pressure at rest. There are racing thoughts, negative intrusive thoughts frequently, things that are not actually threatening trigger the threat response because the threat responses become oversensitive or hyperreactive.
So, when the sympathetic system is relatively unopposed, that is the kind of phenomenon that we see. Whereas when there is a parasympathetic component to it, we see increased attention control, increased emotion control, increased focus, increased ability to relax when desired, and increased feelings of safety. Then, we also see that correlates with improved cognitive and physical performance. So, there's a definitely a link to-- it seems when we boost parasympathetic tone, which could be done by saying anything from what we described, tapping, meditation, breath, work, yoga, or Apollo and things of this nature, it gives the body a little bit of a balance to the nervous system activity that helps us to be more present in the moment and not be sympathetically active only which would convey a sense that we are only supposed to be focused on survival, rather than knowing that we're not having a survival threat right now, we are actually able to focus on other things.
It's the difference between-- sometimes, we talk about seeing the forest or the trees as the saying. It's the idea that when you are in a hyper-sympathetic state because of chronic stress, or burnout, or whatever it may be, any of these mental illnesses we're talking about, or often physical as well, you get tunnel vision. And that tunnel vision is centered around [unintelligible [00:16:15] survival. When we boost parasympathetic tone with any of these techniques, it expands our vision, not just our vision, but our sensation in general and our ability to listen to our environment, and take in a lot more information that can help us more accurately appraise what's going on.
Melanie Avalon: Okay, gotcha. It's so fascinating. You mentioned, for example, people with chronic health issues, chronic pain, things like that. Is it possible that if a person has a chronic health condition, if they have an emotional stress that's not addressed or some sort of trauma, is it almost-- I don't want to say impossible, but would it be really hard for them to ever really overcome that chronic health condition because there's not a feeling of safety that's required for healing?
Dr. David Rabin: I would say that, yes, the current scientific evidence and theories support that. They support it from mostly looking at things like heart rate variability, looking at the epidemiological, the population-wide reports and certain large scale studies showing that people who are-- whether you're physically stressed out, emotionally stressed out, mentally stressed out, and to a large extent, let's not forget, socioeconomically stressed out, legally, financially. All of these kinds of things. If we have those stressors in our lives, then we will not feel safe. And if we don't feel safe, then we do not allow our recovery response system to turn on to allow the healing process to happen at a more rapid rate.
It doesn't mean we can't heal. It just means that the healing process becomes much slower and more delayed, because our body, literally our nervous system is not allowing us to divert resources to that healing recovery response system, to heal us from whatever it is we're struggling with or suffering from, because it's perceiving threat.
A lot of the techniques that I use with my patients and a lot of my colleagues use that are the most successful and actually probably a big part of why psychedelic psychotherapy is so successful when done properly, is it really taps into amplifying the safety response. And when you amplify the safety response, you allow the body to divert resources to heal it.
Melanie Avalon: It's interesting because I do a lot of work with like mantras or things like that. Oftentimes, I want to pick mantras like, I love myself or things like that, but maybe my mantra should be I am safe.
Dr. David Rabin: Well, love is a trigger for safety. This is a different segue, but really interesting and relevant, if you don't mind me going this direction. But in Eastern tribal in plant medicine and tribal traditions that don't use plant medicine, one of the most fundamental traditions-- they call it lots of different things in different cultures, but they all center around the same four principles, which are self-gratitude, self-forgiveness, self-compassion, and self-love. These are the four most fundamental skills that we need to practice to build a sense of trust in ourselves, the foundation of trust on which we can then feel safe with ourselves, to love ourselves, to heal ourselves. Does that make sense?
Melanie Avalon: No, it does. I love it. I wrote them down. This is amazing. So actually, to that point, activating these feelings of safety, of love, gratitude, trust, what is the difference in activating it from a bottom-up versus a top-down perspective? With meditation and breathwork, how does that make our body feel safe?
Dr. David Rabin: I love that question. That is something that I think is really important to understand at the core of all this. Thinking about breath, just taking a step back. Breath, when we take a moment-- and many of us have been in the situation, I would assume probably all of us at some point our lives have been in a situation we're really stressed out. And in the moment, we take a walk out for a minute and we take a deep breath, and then we go back to it-- or a couple of deep breaths. What happens is why this works and why it's worked for thousands and thousands of years, is because as we start to feel, the feeling and pay attention to the feeling, intentionally a breath, coming into our nose and our mouth and going down our windpipe and into our lungs and filling our lungs and then exiting, and then repeating that and paying attention to that feeling, it instantly sends a signal-- from the moment that we pay attention to that breath coming into our bodies, it instantly sends a signal subconsciously beneath our awareness to our emotional cortex of our brain and the amygdala being part of that, the fear center being part of that, which says, "If I have the time to pay attention of this air coming into my body in this moment, I can't possibly be running from a lion right now." So, this is no different than with soothing human touch or soothing touch in general, or soothing touch from Apollo, or soothing touch that we provide ourselves or soothing music.
If I have time to devote my attention, in this moment, to listening to this wonderful music that I'm listening to or that's going on around me or to feel the touch of someone next to me that is a friend or a family member or something like that, if I have time right now in this moment to pay attention to that, then I must not be running from a lion because if I was, my nervous system would not allow me to take that time to pay attention to the stimulus. So, that is the most fundamental way that all of these sensory, present-focus techniques work in common to bring us back into the moment and restart diverting resources to that safety pathway.
Melanie Avalon: I love that. Is that the reason that the experience of awe or wonder is so incredible to experience? Because you have time to feel safe-- if you're paying so much attention to something so wonderful, you have time, so you must not be running from a lion. And then on top of that, you're likely experiencing some sort of heightened emotion. Wow, that's very, very cool.
Dr. David Rabin: Yeah. There's also more stuff going on in those kinds of situations that make it even more powerful to experience. Not every situation is filled with awe and wonder. But at the core of those experiences is what I just mentioned, because the awe and the wonder is within our awareness, whereas what I was describing is the bottom-up stuff. That's getting back to what your original question was, is what is the difference between bottom-up versus top-down? Top-down is the traditional way we've practiced Western medicine for a long time. If you come to me and you say, “I'm feeling sad,” and I say, “Well, if you're feeling sad and you felt sad for months, here's a list of things that you can do to change your behavior to feel less sad.” That requires you to make a decision to change your behavior and actually put energy and resources into changing your behavior and changing the way you think about yourself, which is important, and it does work if we practice it. But the fundamental problem with that is, that technique of top-down learning, which is a way that we've all been taught our whole lives pretty much for the most part, is that when we're afraid or stressed out, it directly inhibits our ability to embrace change.
Change in and of itself becomes scary to us when we are already primed for stress or in a perceived threatened state, a sympathetic state. And so, top-down learning becomes very, very difficult. I'm sure there's tons of you. I cannot force myself to deep breathe or meditate when I'm in-- it's very, very difficult. There are rare times when I'm able to muster the energy to be able to force myself to deep breathe or meditate in a time where I'm feeling like completely overwhelmed and distraught and stressed out. It's very hard. This is known throughout the literature.
What we thought was, okay, top-down learning, the traditional learning, requires the person to actually consciously within awareness, do something. But there are all these other things that we're surrounded by in our day-to-day lives that are soothing things, like breathing, music, soothing touch that without actually having to think about doing anything-- when you're having a terrible day, and somebody you like gives you a hug, you instantly feel better, and you don't have to do anything. That is so interesting. You don't have to change behavior. You just have to receive the hug.
It's the same with music. You could be having the worst day in your life and you walk into a room and all of a sudden, your song is playing and the lighting is nice and it's a comfortable environment, and instantly you've forgotten how stressed out or uncomfortable you are, at least for a brief amount of time. The reason that happens is because of this subconscious, beneath awareness neurological pathway in our bodies that is literally hardwired from our skin to our brain and from our ears to our brain -- also, actually for smell, it's very powerful in the olfactory smell pathway too, because these pathways convey emotional information to the brain extraordinarily rapidly beneath our awareness. Before we are actually consciously aware of what's happening, our brains have already been conveyed information that we are safe.
So, that is bottom-up learning. That's why we developed Apollo is because I work with people all day and I can give them the best advice in the world based on decades of knowledge and say, “This is how you heal yourself. This is what you need to do.” I would say less than 50% of my patients are able to actually implement those skills on a regular basis because they are so chronically stressed out and afraid. They don't feel safe enough to make changes in their lives.
When we started implementing Apollo into the process, people started to say, “I feel safe enough to break change,” and then the change starts to happen naturally. That was really the goal, was how do we help people feel safe when they leave the office? In the office, I can do that by making good eye contact and being an empathetic listener and working with you in the office, but how do we give people something that they can take home afterwards that they can then use to help them feel safe in any moment that would be threatening to them potentially in their day to day lives so that they can really have agency and autonomy over the way that they feel and the decisions that they make without falling back into these past habits and coping strategies that may not be serving us.
Melanie Avalon: I love this so much. Speaking to everything you just said, something like meditation does have profound effects, but like you said-- so I'm not discouraging people from doing it, I do it. I think it's wonderful. But it does require getting into a practice, doing it consistently until it starts to have effect-- or breathwork, I guess is slightly more visceral in a way, but you still have to sit down and do it. And like you said, it can be hard to do it depending on what state you're in, compared to-- I mean, if I go get a massage, it just happens, for example. I'm always so blown away by it.
The Apollo Neuro device uses sound wave therapy, I believe, to activate this. When this is activated, does it instantly create this state with the sound waves? Is it a similar state as these other practices, or again, is it there's colors of the state and intensities of the state that can be activated?
Dr. David Rabin: That's a great question as well. For those of you who aren't familiar with the Apollo or haven't tried it yet, it is a wearable about the size of an old Apple watch that could be worn on the ankle or wrist. It has no screen. It just has two buttons that can activate it with or without your phone. It delivers these gentle soothing vibrations that feel like an ocean wave washing over your body or a cat purring on your body, that fairly rapidly helps to nudge the body into a goal state.
It's not a magic button by any means where it's instantly going to transform your life, but say you are somebody who has trouble going from waking up in the morning to actually getting on with your day. Or you have trouble going from being stressed to meditating, or being stressed and working to spending time with your family and calming down or falling asleep at night when you're wide awake and you have a lot to think about. These energy transition states can be very difficult for us because shifting from high energy to low energy or low energy to high energy states is a pretty big shift. We don't really think about that in our day-to-day lives because our lives are so dynamic and there's so many responsibilities that we have all the time, and there's so much going on and the news is so crazy and all this stuff is happening around us in the world, that we just feel we have to go with it. We don't really think about how many times we shift states of energy or states of thinking or mood in our day-to-day lives, but it's actually quite a few for most of us.
One of the ways that we're able to do that naturally, again, is with things like music. Many of us use this all the time. We play faster, louder music when we work out or we go dancing, or we are spending time hanging out with our friends. We play soothing, calming music when we want to meditate or sleep or have a relaxing experience. Breathing is the same. You can breathe rapidly and intensely, and you can induce more of a sympathetic state in the body, or you can breathe slower and much deeper, like the way that Zen Buddhist monks breathe, which is something two times a minute, and you can induce a very deep, relaxing state.
I think that we've been taught for a long time that there's black and white, and that's where we spend most of our time thinking about the body, but in reality, there's not really such thing as black and white, it's almost always some form of gray. The gray area is really where everything becomes more interesting because that's where we find ourselves most of the time, is in between the black and the white. It's not on one extreme or another.
In our clinical trials at University of Pittsburgh, we saw on doing very rigorous double-blind, randomized, placebo-controlled clinical trial and healthy subjects, that we could reliably shift biomarkers of the body like heart rate variability in a positive direction within three minutes under stress, and within three minutes that correlates with improved performance under stress. What we've seen since then in the real world and in subsequent clinical trials is, the more stressed out you are when you put your Apollo on, the quicker you typically see results, but there are people who it sometimes takes a little longer to work for.
The shortest time we see some people there that will respond to it immediately. These people tend to be people with posttraumatic stress disorder or depression or chronic pain, or one of these disorders where stress clearly make symptoms worse. Kids with autism, ADHD, rapid responses, it's incredible. However, when you're just trying to give yourself a little bit of a boost here or there, it might take 10 minutes, it might take 15 minutes, 20 minutes. It might take a little bit longer for you to experience an effect that you notice. But again, experience an effect that you notice has a lot to do with how aware we are of our bodies. The more aware we are of our bodies, the more we practice self-awareness techniques, the more likely we are to see a difference.
And so everybody's slightly different, but I can say that overall we see roughly a 95% response rate to the settings or the modes that are in the app which are everything from energy and wake up, which is the most activating, most energizing setting at the top. Then social and open, which is a calm, clear, creative, social flow. That's really great when you're interacting with others, particularly when you're tired. Then, clear and focused, which is like deep, intense focus, also great for public speaking, which is my favorite, we were talking about earlier. Then, rebuild and recover, which is basically bringing the body down post workout or post-stress of any kind. Some of us have a lot of hard time calming down after intense stress or intense workout. We've seen in clinical trials at the University of Minnesota and also at the University of Pittsburgh and elite athletes that this helps the body rapidly calm down within just two minutes post exercise.
Then, once you go below rebuild and recover, we start to get into the much more parasympathetically dominant modes. These are the modes that induce deep meditation or deep relaxation or sleep. Those are the three modes that exist on the other side. Depending on what your goal is, the Apollo will help nudge you closer to your goal and make it easier to achieve that goal.
It's not going to magically make the coffee you drink at 3:00 PM not work anymore. If you drink coffee or caffeine or did something that made you wildly stimulated before bed, it's not going to instantly make you fall asleep. But in conjunction with a healthy lifestyle, it can provide pretty radical improvements in the way that we adjust our day-to-day structure, our schedule, our circadian rhythms, and just in general how we adapt to stress.
Melanie Avalon: Do you find that the longer a person uses the device, do you think there's any sort of additional brain rewiring that would occur based on-- I don't want to say like the placebo effect on top of it, but basically starting to anticipate those changes? Does it become more effective the longer you use it?
Dr. David Rabin: It actually does. Again, one of my focuses in psychiatry is addiction. We didn't want to make addictive technology. When we were looking at this, when we first started doing our experimentation a couple of years before we really made a commercial product that we released to the world, we watched people over time use this. What was really interesting is that it actually seems to have a pattern of use that's very similar to the learning effect we see with meditation and deep breathing. When you first start practicing meditation, deep breathing, you're trying to calm your mind, we have lots of intrusive thoughts, like, “Did I leave the stove on?” “I have all this work to do.” All these thoughts flood our minds and it can be really, really hard to feel like we're really entering a deep state of meditation or calm when we first start practicing these techniques. We have to practice them a lot when we first start.
What's really interesting is over time, as you practice these techniques, you get better at achieving the goal state more quickly and you become more sensitive to the techniques, so that you can take fewer breaths and get to your meditative state or your state of ideal calm or flow more quickly than you could when you first started. That learning effect is literally rewiring our nervous system to show us that we can through the technique of breathing or as an example, rapidly induce a state of safety in the body in a situation that we previously might have found threatening.
Apollo works in a very similar way and we designed it based on this, and we're hoping that it will work the same similar way-- because we designed it based on the understanding of these techniques and also the understanding of how cognitive behavioral therapy with exposure works, which is the leading psychotherapy treatment for PTSD, where you have a therapist with you when you're stressed out, when you're triggered and being exposed to things that set off your stress response. You have a therapist with you that reminds you that you're safe because you are and then helps you to-- what we call recondition the neural pathways to favor safety in a situation that might have previously been perceived as threatening versus that trained fear response. It is, as you said, literally rewiring our brains.
Over time, we can see this because people who use Apollo over time get benefits that come on more quickly as they use it more often. Those benefits tend to last longer, and they need it less.
Melanie Avalon: That's fantastic. For listeners, like we discussed, you can wear it as a wristwatch or on your ankle. Actually, that's a quick question. Are there specific receptors in your wrist and ankle? Why did you choose that part of your body?
Dr. David Rabin: Originally, we chose those parts of the body because they're just the easiest places to wear things. Our original clinical trial, we compared a couple different locations in the body and in our original case studies, we compared a bunch of different locations in the body. We really tried to see, was there any significant difference between the areas. We really couldn't see that much significant difference. The easiest places to be able to wear it was the wrist and the ankle.
What's really interesting, though, is that fast forward, I think, a year after we originally did those studies, we were meeting with a fantastically interesting person, Segyu Rinpoche, who was Steve Jobs meditation teacher, and he's a traditional Tibetan monk who's a very strong lineage of Tibetan Buddhist monk, and he tried our technology. And he asked us the same question, “Why did you choose the wrist and the ankle the way you did?” We told them the same thing that I just told you. And he said, “Well, I want to show you something.” He pulled out this book of ancient Tibetan medicine. He showed us that from thousands of years ago, the Tibetan monks, in their eastern tradition, mapped out pathways directly from the wrist and the ankle that go specifically to the emotional cortex of the brain before they go to the rest of the brain.
They go to the emotional beneath awareness part of the brain, which would be exactly as we predicted from Western science, before they go to our awareness conscious part of the brain. There's probably multiple reasons why this works so well on the wrist and the ankle, but originally it was just for convenience. Now, we know there may be other things going on.
Melanie Avalon: That's incredible. Actually, question to that which you might not know the answer at all to this, but have you done any research on-- if you put on the left versus the right side of your body and how that might correlate to like the left and right part of your brain?
Dr. David Rabin: That's a great question. It's also a very difficult study to do. We have not seen significant differences in laterality, one side or the other. We have had-- and not in our clinical trials at all, or in a significant amount of case reports. We now have, I think, something like 7000 people who have used the technology over the last couple of years, and we have had occasionally someone who typically has a background in meditation, typically, who has been practicing self-awareness techniques for a long time. And they will say that they sometimes notice a difference between left and right, that sometimes they'll put it on the left for a while and they'll switch it to the right. I haven't personally noticed a difference and we don't get that report commonly. From what we can tell, it's predominantly personal preference where you wear it or how you wear it. But, yeah.
Melanie Avalon: The reason I'm so interested is, I'm fascinated by the split left-right brain studies and then on top of that, I've also felt my personal body's nervous system like-- it's weird. The whole right side of my body is where I feel everything is off and not the left side. I've always been very aware of the left versus right side of my body. When I've been playing around with it, I've been experimenting with trying different sides. I'll keep you updated if I find anything with myself. I'm also really glad that you explained a little bit more about the individual programs in the app. Just out of curiosity, if a person is experiencing a moment of intense anxiety, which program would you recommend for that? Would the rebuild and recover actually work for that since it's you're trying to come down from a state?
Dr. David Rabin: I think it depends on the goal. Rebuild and recover, when you see the app, you'll see that there's three higher energy states, which are the clear and focused, social and the energy and wake up. And then there's rebuild and recover, which is in the middle. And then there's three lower energy states which are meditation, mindfulness, relax and unwind, and sleep and renew. In general, the rebuild and recover is a great middle ground if you don't know what to use and you're feeling really stressed out and you don't really know whether you want to be wide awake and you don't really know whether you want to be sleepy, you just want to be calm, rebuild and recover is a great one. Particularly, if you're trying to calm down from an immediate stressor, mental, physical, emotional, what have you. Something just happened, you just got off a really terrible flight, lots of things like that, it can really help to just rapidly bring the body down into a calmer state. We see this in heart rate and heart rate variability measures and respiratory rate. There's even been some early findings with blood pressure that are very interesting.
I think that the best guidance I can give you is to steer the choice-- almost all of the settings can reduce anxiety and it can reduce stress. The ideal is to match your goal. If you're stressed out because you're about to have a conversation with somebody that you anticipate might be difficult, putting on something that's going to reduce your energy going into that situation is unlikely to be of great help, because it might calm your anxiety. But if you start to feel tired, when you're having a conversation with somebody where you need to be alert, then putting on one of the calmer settings is probably not the best choice. So, that's why we actually organized it by goal. Because while almost all of the settings-- except for perhaps energy and wake up, which doesn't really help with anxiety so much unless your anxieties associated with fatigue, which happens in some chronic illnesses, all the other settings tend to reduce anxiety, but it's just dependent on a goal.
As an example, if you have anxiety in social situations, the social and open setting is a huge, huge game-changer. If you have anxiety with public speaking or anxiety about sitting down and being able to focus doing very intense work of any kind, the clear and focused is incredible for that. If you have anxiety associated with calming down after work or anxiety about just being able to fall asleep or things like that, the meditation and the relax and unwind and sleep help with that. So, the goal is really important because the goal guides the way that you use the technology.
The best way I can describe it is, Apollo is like music that I compose based on the neuroscience of our bodies that our bodies all have in common for the most part. But it's music composed for the skin receptors rather than for the ears. You wouldn't listen to music that is helping you, that gives you energy to work out when you're trying to calm down and go to bed. You wouldn't listen to that fast music. You would listen to something that's more calming and soothing. Similarly, you wouldn't listen to calming soothing music when you're trying to work out or focus.
Melanie Avalon: Yeah, this is so brilliant. For example, with COVID and quarantine situation and everything, I'm sure a lot of people have perpetually extended levels of anxiety. Rather than there being a quarantine COVID button, you just address it for the state that you want to exist your life in at that moment, and it can still be addressing that underlying anxiety in a way.
Dr. David Rabin: Exactly. It's about mindful presentness. It's really tapping into these ancient Eastern and tribal techniques that have been around for thousands of years for good reason, because being present makes us better.
Melanie Avalon: Okay. I want to be respectful of your time. I have some quick, rapid fire questions with me just using it and questions that have come up for me. Can I wear it all day and use it all day?
Dr. David Rabin: Yeah, absolutely. Part of the reason we developed this was originally-- for now, we know it works for lots of different people. But Originally, we developed it for vulnerable populations that were otherwise reliant on medications or more invasive treatments, and they weren't necessarily the best candidates for those invasive treatments. We developed it to be safe enough to be worn all day. Most people wear it all day and then they set it to a setting they like during the day. As an example, when I'm working, I just set it in the morning to clear and focused and then I leave it on clear and focused all day. Then, every time I need a boost instead of drinking a cup of coffee, I'll just press the buttons on the device, and then it restarts a half an hour or an hour of clear and focused, I'm in the zone for that time. Then that lasts typically-- I should also say the effects from about 15 minutes of use, typically lasts for 30 minutes to two hours after, which is about the same amount of time the touch lasts for, 15 minutes of soothing touch.
You can use it for getting a little boost of energy or a boost of focus or a boost of calm. Then, for most people, you can get a little bit more out of it after that. Then, if you need a boost later, you can do that without necessarily having to rely on substances that could stay in our bodies for a long time and impact our ability to fall asleep or impact our ability to wake up in the morning, which we see with things like caffeine and amphetamines, used as stimulants commonly and then things like alcohol and benzodiazepine and sleep aids used for falling asleep at night which impair our ability to recover and get good restful sleep.
Melanie Avalon: Exactly. Well, I'm a slow caffeine metabolizer, fast alcohol metabolizer, but I have either way, gut issues. So, anything that I can do that's not taking that route, this is just wonderful. Another really good question. So, the energy and wake up, is that also stimulating the parasympathetic, or if it's energizing?
Dr. David Rabin: Yeah, that's a great question. Energy and wake up is the only setting and mode that we developed that-- all the modes were developed to induce parasympathetic activity, at least a little bit. The energy and wake up mode is developed specifically to induce wakeful states in the moment. You're on a long drive, you need to stay awake or wake up. Don't want to drink coffee or more liquids, because it's going to increase how many times you have to stop to go to the bathroom. It's perfect for that. Perfect for people who struggle to get up in the morning or have fatigue. It's a calm energy boost.
But again, because it's an energy boost, we all have to tailor that a little bit to ourselves. Some of us are more sensitive to that than others. Myself as an example, and my wife too, Catherine, who's the CEO of Apollo, we are incredibly sensitive to the energy boost frequencies. So, we almost never use them unless we're on really long drives or we're in really boring meetings. But when we use them, we use them on a very low intensity for only like a five-minute burst because any more than that just starts to give us like a little too much energy, almost like having too strong a cup of coffee. But as soon as you turn it off, the effect basically fades away, pretty quickly, at least the jittery part of it. A lot of this is understanding how to tailor it to ourselves. It's just like breathwork. Not all breath techniques are the same for everyone. Not all meditation techniques are the same for everyone. A big part of learning breathwork and learning meditation is, let's teach ourselves and learn from ourselves what works best for us.
Melanie Avalon: And then also to that point, the intensity. Is more intense more potent? Or is it a matter of playing around like for yourself?
Dr. David Rabin: Yeah, that's also a great question. The intensity is also about finding your sweet spot. Typically, what we recommend is-- the goal of the Apollo technology is to help us be more present. If the vibration is so intense that it's distracting us, then it's taking away from our presentness. We always recommend that you keep the intensity level low enough that you can feel it and you know it's there, but it's not distracting. Eventually, it fades into the background. It's still working, but it fades into the background and it should never be distracting you. It should always be helping you to stay more focused and more present.
Melanie Avalon: I have a huge question about that fading into the background. If you run like a long program, do some of the programs get less intense as it goes on?
Dr. David Rabin: Yes, some of them do.
Melanie Avalon: Okay, because I wasn't sure if it was me just not noticing it more or if it was the program, I guess it probably depends based on the different ones. For listeners, do you understand why-- I'm going to give this to everybody, all my friends and family for Christmas, I swear. I'm like, “How can I give this to everybody now?” You can get your own Apollo device. I cannot recommend it enough. You can get it for 15% off. So, you can go to apolloneuro.com/melanieavalon to get that 15% off. That's A-P-O-L-L-O-N-E-U-R-O dotcom, forward slash, Melanie Avalon. I'm just so excited. I've been dying to release this episode.
Last question, I promise, I want to be really respectful of your time. But it's just because I realized how important mindset and gratitude and love and everything is. The last question I ask every single guest on this podcast is what is something that you're grateful for?
Dr. David Rabin: I love that question because I think gratitude is probably the single most important thing that we all need to be focused on right now, particularly at a time of such collective stress. It's also a little bit of a hard question to answer because I try to practice-- for me, gratitude is such an important practice, I try to practice it a lot. And so, I'm grateful for a lot. For just as an example, I'm extraordinarily grateful to be able to have in the moment this conversation with you and share this with your audience because any opportunity to share hope with our community right now is so important to take advantage of, and just to share with people that there is an opportunity for us to heal ourselves, particularly when we are in a somewhat-- overwhelmed or situation that sometimes seems like there is no hope or that it tends to squelch our hope.
And so maybe the best answer to your question is, I'm grateful for the ability to hope. I'm so grateful that we have things we can hope for and that being able to have the privilege of doing the research on this technology at the University of Pittsburgh and now being able to bring it to market and see the incredible responses that people are having with it, it gives me so much hope, and I think it sheds so much light on the way that our healthcare system could be improved and the way that we all truly do have the capacity to heal ourselves. Apollo is just another tool like breathing techniques and all these things we're talking about, meditation, tapping. These are all different techniques that help remind us that we have the ability to heal ourselves and what could be more hopeful than that?
Melanie Avalon: That is so beautiful. Thank you so much. Because I'm always looking for these different healing modalities, fostering hope, fostering peace, calm, gratitude, and there's been so many things, like I said, tapping, meditation, breathwork, and they all go together. I'm huge proponents of them. But this was like the first time that it was like you're creating it in a physical, implementable, easy-to-use tool that has that-- I know, like an on-off button, as we discussed, it's not really an on-off button, but it provides something physical that somebody can actually put on, use, and see these effects. I'm so grateful. Listeners, you've got to check out this device. It's wonderful. Are there any links or other resources you'd like to put out there for listeners if they'd like to learn more?
Dr. David Rabin: Sure. I mean, if you want to connect with me and learn about my clinical practice, you could find me at drdave.io. I also am the executive director of the Board of Medicine, which is leading a charge for less risky treatments in medical care, and you can find us at boardofmedicine.org or theboardofmedicine.org. If you want to reach out to me directly, I'm always happy to chat, and you can find me on Instagram at @drdavidrabin and you can find me on Twitter at @daverabin.
Melanie Avalon: Well, thank you so much. For listeners, I'll put all that in the show notes. I should probably spell the show notes, melanieavalon.com/apollo, A-P-O-L-L-O. Well, thank you so much. This has been wonderful and we'll have to stay in touch and talk again soon.
Dr. David Rabin: I would love that. Thank you again.
Melanie Avalon: Bye.