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MDMA-Assisted Psychotherapy for Treating Chronic PTSD: Why I feel we can do better and the role of nutrition and amino acids like GABA

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You may be familiar with MDMA (3,4-methylenedioxymethamphetamine), also known as “ecstasy”, because of its reputation as a party drug. And you have likely seen some of the media reports on the new research and growing support for MDMA-Assisted psychotherapy for treating chronic PTSD (post-traumatic stress disorder). Due to adverse effects I’d like to share my concerns about this research and treatment and why I feel we can do better – by addressing nutrition and using amino acids like GABA and others.

In a recent press release, Colorado Study Shows Lasting Benefits of MDMA-Assisted Psychotherapy for Treating Chronic PTSD, the non-profit organization, Multidisciplinary Association for Psychedelic Studies (MAPS) reports these study results:

28 participants found that one month after their second day-long experimental session, 42.9% in the active-dose (100 mg and 125 mg) MDMA groups did not qualify for a diagnosis of PTSD, compared to 33.3% in the low-dose MDMA (40 mg active placebo) control group.

The results were even more notable 12 months after the third active-dose experimental session, which found that one year following treatment with MDMA-assisted psychotherapy, 76% of participants no longer had PTSD.

It is the largest U.S. FDA-regulated double-blind, placebo-controlled clinical trial of MDMA-assisted psychotherapy for the treatment of chronic PTSD and the results are impressive: 76% of the study participants no longer had PTSD after a year and 3 treatment sessions. I’m really happy for the participants BUT I believe we can do better because there are adverse reactions to this treatment and there are other safer approaches for recovery.

This comment about an acceptable risk profile and adverse reactions concerns me (and I suspect it concerns you too):

The study replicated previous research showing an acceptable risk profile for MDMA, with the most frequently reported adverse reactions during experimental sessions being anxiety, jaw clenching, headache, muscle tension, dizziness, fatigue, and low mood.

Adverse reactions one week following treatment included insomnia, low mood, irritability, and ruminations. Temporary elevations in pulse, blood pressure, and temperature were also recorded during MDMA sessions, and did not require medical intervention.

A common theme we see in the research on psychedelics is how effective it is for PTSD that doesn’t respond to therapy or medications. This paper states:

There is an immense need for innovative treatment options that improve outcomes, especially for PTSD refractory to psychotherapy and/or pharmacotherapies

I agree there is an immense need for successful treatment approaches, but jumping to MDMA from psychotherapy and/or psychiatric medications is skipping out the entire nutritional and biochemical step which is SO powerful and doesn’t have the above adverse effects. I’m concerned too many who have not seen benefits from therapy or medications are seeing MDMA as THE solution and are going to be harmed even further.

This paper, The Potential Dangers of Using MDMA for Psychotherapy, the author is concerned about the fact that “acute MDMA can stimulate the release of difficult feelings and memories, which may be distressing” and also the negative moods that occur after MDMA treatment:

This period of negative cognitions may be counter-productive, especially in psychiatrically vulnerable clients, for instance those with predispositions to anxiety, depression, or psychosis. For example, it could increase the likelihood of suicide in those individuals with strong post-recovery feelings of depression.

Because of this, I wholeheartedly agree with the author’s position:

it will always be far safer to undertake psychotherapy without using co-drugs. In selected cases MDMA might provide an initial boost, but it also has far too many potentially damaging effects for safe general usage.

In addition to psychotherapy, there are also so many nutritional and biochemical factors we can consider when it comes to PTSD. These don’t have any of the above damaging effects seen with MDMA. Here are a few to consider:

I feel it is these above approaches and others like this that we need to be using to address PTSD, rather than subjecting individuals who are already suffering to treatments that have adverse reactions AND are not addressing underlying nutritional deficiencies of low GABA, low serotonin, out of balance endocannabinoid system and overall health, to name a few of many possible underlying biochemical factors.

If this treatment approach is approved, I would hope that all the adverse effects and dangers are clearly explained and I’d also like there to be informed consent before it is used – so individuals know exactly what they are getting into. Hopefully, by the time it is approved, nutritional psychiatry will be more accepted.

I’d love to hear your thoughts on this research and treatment approach. Is it something you have considered or would possibly consider in the future – you personally or with patients?

Or do you have similar concerns that I have?

Have you already tried MDMA recreationally (possibly for therapeutic reasons) and what were your experiences like?

Mental Health Month: anxiety, nutrition, gluten, GABA, leptin and fluoroquinolones

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egg-asparagus-salad

Since 1949, Mental Health America and affiliates across the country have led the observance of May is Mental Health Month by reaching millions of people both online and locally. They share this:

This year’s theme for Mental Health Month is – Life with a Mental Illness – and calls on individuals to share what life with a mental illness feels like for them in words, pictures and video by tagging their social media posts with #mentalillnessfeelslike (or submitting to MHA anonymously). Posts are being collected and displayed at mentalhealthamerica.net/feelslike.

I love that they say that spreading the word that mental health issues like anxiety, depression, bipolar and other disorders is something everyone should care about.

I’d love to educate and inspire many of those individuals who have already posted on social media using #mentalillnessfeelslike and have yet to find a solution. There are so many of them and it’s heart-breaking. You can go to mentalhealthamerica.net/feelslike now and see what is being said.

Here are a few examples:

Severe anxiety feels like you are lost in a big city where no one else can speak your language and you are trying to get home.. #mentalillnessfeelslike

#anxietyfeelslike #mentalillnessfeelslike a never ending battle to keep worry from creeping in to your every thought. Trying to be present

Anxiety Attack #mentalillnessfeelslike: I’m swirling in a cyclone while also being constructed by a Boa

#MentalIllnessFeelsLike Worrying About Passing This Semester Causing Your Anxiety To Mess Up More Although Your Anxiety Put You Here

And this profound quote by MentallyAbnormallyNormal (you can find her here on Facebook)

mentally-abnormally-normal-meme

I encourage you to participate if it feels ok to you. I’d especially love you to share how nutrition and nutrients like GABA, tryptophan, zinc, vitamin B12, and/or vitamin D have helped you. You can also respond directly to the posts others have made.

Here are some links to my prior blog posts on some of the many nutritional (and biomedical) approaches so feel free to also share some of this information and use it if you’re still on your healing journey to overcome anxiety, panic attacks, OCD, insomnia and other mood problems:

I’ll be adding to this last blog during season 4 of The Anxiety Summit which runs June 6th – 16th. As I continue to interview experts I learn more about the myriad of possible underlying causes of anxiety:

For some of my clients, eliminating anxiety (and other mood disorders) can be as simple as switching to a real whole foods diet, eating to balance blood sugar, quitting sugar/gluten/caffeine and adding some key nutrients like zinc and vitamin D. Many benefit immensely when using targeted individual amino acids like GABA and tryptophan. And some need to dig deeper to find the root cause of the anxiety.

But let’s always keep looking for that root cause or causes – find YOUR root cause/s – and address it/them.

My heart goes out to you if you are still suffering and still seeking a solution (and to everyone tagging themselves with #mentalillnessfeelslike and #anxietyfeelslike).

I say let’s aims to change this to the past tense so instead of #mentalillnessfeelslike let’s get to #mentalillnessfeltlike. Or how about #anxietyfeltlike or even #nutritionfixedmyanxiety ?

It truly is possible with food and nutrients! Do you agree? What has worked for you? Feel free to share in the comments and tag yourself on social media.

And do join us on The Anxiety Summit next month and share this during the Mental Health Month of May.

 

The Anxiety Summit – What if… Nutrition could Treat Anxiety and Depression?

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Julia Rucklidge PhD, Professor of Clinical Psychology in the Department of Psychology at the University of Canterbury, Christchurch, New Zealand, was interviewed on the Anxiety Summit by host of the Anxiety Summit, Trudy Scott, Food Mood Expert and Nutritionist, author of The Antianxiety Food Solution.

Julia has over 75 peer-reviewed studies and is passionate about helping people find alternative treatments to medications for their psychiatric symptoms. Her current research interests can be found at the University of Canterbury site here.

What if… Nutrition could Treat Anxiety and Depression?

  • The increasing prevalence of mental health problems and medication side-effects
  • Why diet is so important when it comes to mental health (anxiety, depression, ADHD and even schizophrenia)
  • Nutritional medicine as mainstream in psychiatry and ISNPR (International Society for Nutritional Psychiatry Research)
  • The problems with food: pesticides, soil quality, Roundup
  • Micronutrient research for ADHD, anxiety, bipolar and PTSD
  • The emerging field of nutritional mental health: Inflammation, the microbiome, oxidative stress, and mitochondrial function

Here are some snippets from our interview:

Why is nutrition important? As a scientist I can just say because the data says it’s important. So if we start with the wonderful work that has really been spearheaded from Felice Jacka and there are other people in Spain and in Japan who have published similar studies showing that the more you eat a processed, western type of diet, the higher your risk for mental illness. They’ve published data on depression and anxiety, but also other mental illness as well. And the more you eat what we call, a prudent or a healthier Mediterranean type of diet, the lower your risk for depression and anxiety.

How long is it going to take our society to pay attention to the research that shows that suboptimal nutrition is contributing to the epidemic of mental illness? Are we just going to sit around and ignore this evidence to our peril? Or are we going to start paying attention and start to invest in the really important research that needs to happen?

Here is an earlier blog post I did on Dr. Rucklidge’s excellent TEDX talk: The surprisingly dramatic role of nutrition in mental health

Here is part of the recent paper titled “What if nutrients could treat mental illness?”

We are at a tipping point in psychiatry.

The growing body of literature on the effect of nutrients on mental health is compelling enough and consistent enough for us to pay attention. It is time to revisit the role of diet and supplementary nutrients in the treatment of mental illness and to invest in this line of research.

Here is the smoking and cannabis study we talked about: Use of micronutrients attenuates cannabis and nicotine abuse as evidenced from a reversal design: a case study.

This case adds to a growing body of research supporting the use of micronutrients in the treatment of psychiatric symptoms and suggests it may extend to substance dependence. Micronutrients, by assisting with mood regulation and reductions in anxiety, may assist with successful cessation of drug use.

We discussed this earthquake paper, a favorite of hers: Shaken but unstirred? Effects of micronutrients on stress and trauma after an earthquake: RCT evidence comparing formulas and doses.

This study supports micronutrients as an inexpensive and practical treatment for acute stress following a natural disaster with a slight advantage to higher doses

If you are not already registered for the Anxiety Summit you can get live access to the speakers of the day here: www.theAnxietySummit.com

Missed this interview or can’t listen live? Or want this and the other great interviews for your learning library? Purchase the MP3s or MP3s + transcripts and listen when it suits you.

You can find your purchasing options here: Anxiety Summit Season 1, Anxiety Summit Season 2, and Anxiety Summit Season 3.

Nutritional medicine as mainstream in psychiatry

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Home-made grass-fed burger, greens/basil, avocado, sprouts and cheese
Home-made grass-fed burger, greens/basil, avocado, sprouts and cheese

Psychiatry is at an important juncture, with the current pharmacologically focused model having achieved modest benefits in addressing the burden of poor mental health worldwide. Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology. Evidence is steadily growing for the relation between dietary quality (and potential nutritional deficiencies) and mental health, and for the select use of nutrient-based supplements to address deficiencies, or as monotherapies or augmentation therapies.

I’m excited to share this groundbreaking publication, “Nutritional medicine as mainstream in psychiatry” which was published just last week in the mainstream journal Lancet. We have members of The International Society for Nutritional Psychiatry Research, also known as ISNPR to thank: Jerome Sarris, PhD, Alan C Logan, BA, Tasnime N Akbaraly, PhD, G Paul Amminger, MD, Vicent Balanzá-Martínez, MD, Marlene P Freeman, MD, Joseph Hibbeln, MD, Yutaka Matsuoka, MD, David Mischoulon, MD, Tetsuya Mizoue, MD, Akiko Nanri, MD, Daisuke Nishi, MD, Drew Ramsey, MD, Julia J Rucklidge, PhD, Almudena Sanchez-Villegas, PhD, Andrew Scholey, PhD, Kuan-Pin Su, MD, Felice N Jacka, PhD.

The abstract concludes as follows:

We present a viewpoint from an international collaboration of academics (members of the International Society for Nutritional Psychiatry Research), in which we provide a context and overview of the current evidence in this emerging field of research, and discuss the future direction. We advocate recognition of diet and nutrition as central determinants of both physical and mental health.

You may recognize some of these people from my prior writings and interviews.

Dr. Marlene Freeman is also the author of an editorial, Nutrition and Psychiatry, published in the American Journal of Psychiatry in 2010.

It is both compelling and daunting to consider that dietary intervention at an individual or population level could reduce rates of psychiatric disorders. There are exciting implications for clinical care, public health, and research.

This is one of my favorite quotes! If you’ve ever heard me present I’m sure you’ll recognize it! This was in 2010 so we are making progress with getting nutrition recognized in the mainstream mental health world and I couldn’t be happier.

Here are a few select quotes from the new paper (which will shortly be released as an open-source document).

Mental disorders in general, and major depression and anxiety disorders in particular, account for a large burden of disability worldwide. Rapid urbanisation, and an overall transition from traditional lifestyles (concerning diet, physical activity, and social structures), which are some of the most pressing global and environmental issues of our time, have both been linked to increases in depression and other mental disorders

The mechanisms by which nutrition might affect mental health are, at least superficially, quite obvious: the human brain operates at a very high metabolic rate, and uses a substantial proportion of total energy and nutrient intake; in both structure and function (including intracellular and intercellular communication), it is reliant on amino acids, fats, vitamins, and minerals or trace elements.

The purpose of this Personal View is to provide a platform for robust debate in the specialty, particularly regarding the need to move towards a new integrated framework in psychiatry, whereby consideration of nutritional factors should be standard practice.

Diet and nutrition offer key modifiable targets for the prevention of mental disorders, having a fundamental role in the promotion of mental health. Now is time for the recognition of the importance of nutrition and nutrient supplementation in psychiatry. Nutritional medicine should now be considered as a mainstream element of psychiatric practice, with research, education, policy, and health promotion supporting this new framework.

This is so powerful! I commend the efforts of these authors and thank the researchers for all the groundwork which has led to where were are today…recognizing the very powerful connection between what we eat and how we feel. It’s exciting to be part of this movement!

 

The surprisingly dramatic role of nutrition in mental health: Julia Rucklidge at TEDx

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Julia Rucklidge

Julia Rucklidge, PhD, researcher from New Zealand, recently did this amazing TEDx talk called: The surprisingly dramatic role of nutrition in mental health

I love how she opens with:

what I’m going to share today may sound as radical as hand-washing sounded to a mid-19th century doctor and yet it is equally scientific. It is the simple idea that optimizing nutrition is a safe and viable way to avoid, treat or lessen mental illness. Nutrition matters. Poor nutrition is a significant and modifiable risk factor for the development of mental illness

Here are some real gems from her talk:

A well-nourished body and brain is better able to withstand ongoing stress

When people get well they get well in all areas: improved sleep, mood stabilization, reduction in anxiety and less need for cigarettes/cannabis/alcohol.

My research and other research from around the world show 60-70% of people respond to micronutrients – this shows just how powerful this intervention is

We should focus on food and lifestyle changes and exercise first, then therapy and save medications for when these approaches don’t work

I’d like to share the ending of Julia Rucklidge’s talk. She shares the story of how limes on ships in the 1600s eliminated deaths from scurvy but that it took 264 years for the British government to mandate the use of citrus on ships. She closes with this profound question and challenge:

How long will it take us to recognize that that sub-optimal nutrition is contributing to the epidemic of mental illness? Nutrition matters!

Bravo Julia! And thank you for all the great research you’re doing! We appreciate you!

UPDATE: June 8, 2018

I have decided to update the blog and share it again because Professor Rucklidge is sharing powerful research-based evidence about food-as-medicine for mental health and her talk is being flagged/censored by TEDx and this is not acceptable!

Professor Bonnie J. Kaplan, PhD, from the University of Calgary shared this information with me via an email:

There have been almost 900,000 views of Julia Rucklidge’s TEDx talk on nutrition and mental health, with many complimentary comments. Last week, however, the TED organization inexplicably “flagged” the video with the following comment:

“NOTE FROM TED: We’ve flagged this talk, which was filmed at a TEDx event, because it appears to fall outside TEDx’s curatorial guidelines. There is limited evidence to support the claims made by this speaker.”

Julia has attempted to educate the TED people regarding the fact that over 35 peer-reviewed publications could hardly be described as “limited evidence,” and that her interpretations do not go beyond the data. But they are not interested in her evidence.

The whole thing seems so strange: isn’t TED supposed to be all about innovation? But clearly, some lobbyist has convinced them that a non-pharmaceutical treatment should not be respected.

I’m sharing it again and updating the blog so you can watch it again or watch it for the first time and be inspired and have hope!

We’d like to ask for your help in please sharing too. Let us support her work and all the nutritional psychiatry researchers at ISNPR and around the world!

  • Even if you have already watched it, please click on it again and watch again (click on the video link above or use this link)
  • Share the youtube video and/or this blog with others, through Facebook or email or twitter or word of mouth (or all of the above)
  • Comment below the youtube video and/or comment on this blog of mine
  • Ask your friends, family and colleagues to do the same

More about Professor Rucklidge’s research interests

Professor Rucklidge’s research interests are centered on the role of nutrition in the expression and treatment of mental illness, from ADHD to depression to stress following natural disasters. Research methodologies include single case research designs, open label trials and randomized controlled trials.

  • ADHD
  • Child and adolescent clinical psychology
  • Clinical psychology
  • Learning disabilities
  • Young Offending
  • Earthquake research
  • Nutritional interventions
  • Mood Disorders

Some of her publications on micronutrients

Overall, people from the general population who suffer from mood and anxiety problems may benefit from improved nutritional status achieved with nutritional supplements.

Micronutrients improved overall function, reduced impairment and improved inattention, emotional regulation and aggression, but not hyperactive/impulsive symptoms, in this sample of children with ADHD. Although direct benefit for core ADHD symptoms was modest, with mixed findings across raters, the low rate of adverse effects and the benefits reported across multiple areas of functioning indicate micronutrients may be a favourable option for some children, particularly those with both ADHD and emotional dysregulation.

 

 Nutritional medicine as mainstream in psychiatry

Professor Rucklidge is also a contributing author to Nutritional medicine as mainstream in psychiatry which I blog about here

Psychiatry is at an important juncture, with the current pharmacologically focused model having achieved modest benefits in addressing the burden of poor mental health worldwide. Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology. Evidence is steadily growing for the relation between dietary quality (and potential nutritional deficiencies) and mental health, and for the select use of nutrient-based supplements to address deficiencies, or as monotherapies or augmentation therapies.

As you can tell I’m a big fan of her research work and what an honor it was for me to interview her on one of the Anxiety Summits: What if… Nutrition could Treat Anxiety and Depression? She shared wise words then than seem very relevant to this censorship of her TEDx talk:

How long is it going to take our society to pay attention to the research that shows that suboptimal nutrition is contributing to the epidemic of mental illness? Are we just going to sit around and ignore this evidence to our peril? Or are we going to start paying attention and start to invest in the really important research that needs to happen?

It was a thrill to then finally meet her in person last year at the ISNPR conference.

Julia Rucklidge and Trudy Scott
Meeting Julia Rucklidge at the ISNPR conference

This nutritional psychiatry work is widely supported by many practitioners

This nutritional psychiatry work is widely supported by many practitioners. Last year I interviewed Dr. Mark Hyman MD, creator of the Broken Brain series and author of What the Heck Should I Eat? In our interview he talks about somatopsychic medicine i.e. mental health symptoms caused by bodily illness and shares this about when he started to make this connection years ago:

I was just treating people’s physical systems, fixing their gut, helping their immune system, cleaning up their diet, optimizing their nutritional status, balancing their hormones, and all their mental problems would get better.

Their anxiety would get better, their depression would get better, and I wasn’t actually treating the depression or anxiety. Autism, ADD, memory issues, dementia, all these things would start to get better

And I began to realize that the body was driving a lot of this brain dysfunction, and that if you fix the body, a lot of the brain disorders would get better, that it wasn’t a primarily a mental problem, but it was a physical problem.

Dr. Nicole Beurkens, clinical psychologist and board-certified nutrition specialist, shares this about the talk:

This is an extremely important evidence-based talk on a topic that is moving the field of mental health forward. As a clinical psychologist and board-certified nutrition specialist, I see daily the positive impact that nutrition can have on mental health for children and adults. More than medication and talk therapy is needed to reduce symptoms for many people with these challenges, and nutrition is an accessible research-based option. I often recommend this video to patients and their families.

Dr. Beurkens is also speaker on a prior Anxiety Summit. It’s now in it’s fourth season and I’ve the wonderful opportunity to interview and share the nutritional psychiatry wisdom from over 70 practitioners, researchers, mental advocates and clients.

So much wonderful feedback from study participants

There is so much wonderful feedback in the comments below the youtube video. I love this comment from a study participant from New Zealand, Deidre Fraser:

I’m a pretty ordinary Kiwi, not particularly alternative. I don’t have a big appetite for risk. But I have participated in one of Julia Rucklidge’s studies and my family has benefited hugely from the introduction to, and continued use of micronutrients. Could we have achieved the same result using a pharmaceutical medicine? Some behaviours would have likely been addressed, but and it is a big BUT, one of the side effects (unexpected) would NOT have been improved happiness and self-worth, which resulted in better friendships – pretty basic things we all want from life!

We also got increased focus and the noticeably different academic performance that we thought we wanted (We just hadn’t realised that should be the secondary objective).

I don’t really understand the science behind it all, but the empirical research and published journals are there to support micronutrients as a valid option with verifiable research outcomes.

And SP Hancock shares these compelling results:

I’m so grateful for this presentation. It compelled me to find a medical doctor who looks at symptoms of mental illness from a perspective other than traditional psychiatry. He helped me heal my gut so that I can get the micronutrients I need from my food choices. 2 years ago I was using the micronutrient supplement Dr. Rucklidge had diligently researched for more than a decade. Today, I no longer need supplementation because my gut can absorb micronutrients from my food. I have been off medications for three years now–completely stable using only food after having lived for nearly two decades with acute symptoms of refractory schizoaffective disorder bipolar type with catatonia. Thank you Dr. Rucklidge for your structured, independently funded studies. Your hard work and sound research methodology gave me the courage to find a doctor willing to look at my symptoms from a fresh perspective. Keep up the exceptional work!

I hope this has inspired you to keep seeking a solution if you are still on your healing journey or and even if you have found your solution. Either way we’d love your help in getting this message out to more people so please share share and share!

Professor Bonnie Kaplan says: “Let’s see if we can quadruple the views to 5 million or so.” I’m sure we can! Thank you!

The Anxiety Summit: Nutrition as a Foundation for Other Therapies

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nicole b

This is day 10 of the Anxiety Summit. Dr. Nicole Beurkens, PhD, Licensed Psychologist, Certified Brain Injury Specialist, Certified LENS Practitioner, is interviewed by host of the Anxiety Summit, Trudy Scott, Food Mood Expert and Nutritionist, author of The Antianxiety Food Solution.

Nutrition as a Foundation for Other Therapies

  • Why good nutrition status is important for people with anxiety and other mental health issues
  • What kinds of nutrition changes are encouraged
  • Challenges with helping parents and families make nutrition changes

Here are some great gems from my interview with Nicole:

Many parents are not even aware that food can affect their kids”

We should keep our minds open to the idea that what you eat can impact how your brain works”.

Here is a recent article from the Horizons website: The Nutrition-Anxiety Link in Children with Learning, Mood, and Behavior Challenges

Get your free gift from Dr Nicole Beurkens:  Horizons Healthy Brain Diet (RED/YELLOW/GREEN foods)

If you are not already registered for the Anxiety Summit you can get live access to the speakers of the day here www.theAnxietySummit.com

UPDATE: the summit concluded on Tues 6/24 – season 2 of The Anxiety Summit will be in November 2014. If you’d like to be on the notification list just sign up here www.theAnxietySummit.com

Missed this interview or can’t listen live? Or want this and the other great interviews for your learning library? Purchase the MP3s or MP3s + transcripts + interview highlights and listen when it suits you