Chronic Pain, Focus, and the Brain Shift Psychedelics Reveal with Dr. Shimi Kang

[01:21] Dr. Linda Bluestein: Welcome back, every bendy body, to the Bendy Bodies Podcast. I'm your host, Dr. Linda Bluestein, the Hypermobility MD, a Mayo Clinic-trained expert in connective tissue disorders like EDS, dedicated to helping you navigate joint hypermobility and live your best life. Today's guest joins us to share expertise for those living with Ehlers-Danlos syndromes and HSD. Our conversation is unscripted and their views are their own, not those of me or the Bendy Bodies team. As you've probably heard me discuss, I have experienced chronic pain, depression, anxiety, ADHD, and so many more things that we discuss on this show. I'm so excited to have Dr. Kang, a psychiatrist, back on the show to discuss these really important concepts that can make a huge difference in how pain is felt in your body.
Dr. Shimi Kang is an award-winning Harvard-trained psychiatrist, number one bestselling author, and leading expert on motivation, leadership, and resilience. She is the author of The Dolphin Parent and The Tech Solution, and her work has earned her honors including the American Academy of Addiction Psychiatry Award, the YWCA Woman of Distinction Award, and the Queen Elizabeth II Diamond Jubilee Medal. A highly sought-after keynote speaker, her TED Talk on adaptability has reached millions. Dr. Kang also lives with Ehlers-Danlos syndrome, and her experience navigating chronic pain while sustaining a global career has profoundly shaped her perspective on adaptability, balance, and self-compassion.
[02:49] I am so excited about this conversation because I know that she's going to share so much information that we can all use in our daily lives. As always, this information is for educational purposes only and is not a substitute for personalized medical advice. Stick around until the very end so you don't miss any of our special hypermobility hacks. Here we go.
[03:11] I am so excited to be back with Dr. Shimi Kang. We talked before about adaptability and resilience, but since then I feel like there's been so many conversations about chronic pain, mental health, psychedelics, artificial intelligence and therapy, and so much misinformation. I feel like we had such a great conversation last time, but there was so much more I wanted to talk about. So thank you so much for coming back to Bendy Bodies.

[03:33] Dr. Shimi Kang: Thank you, Linda. It's a real pleasure. I learned so much from this podcast. It's like a lifeline for me. So always grateful for your amazing community.

[03:45] Dr. Linda Bluestein: Oh, well, that's wonderful to hear. I love hearing how much the podcast helps people, especially clinicians, because of course we can multiply that impact because we're working with other people. So that's amazing.
So I first want to talk about chronic pain and mental health because we know that those are so intimately connected, and I know that you live with Ehlers-Danlos syndrome and really significant chronic pain. I'd love to hear how that experience, or those experiences, have changed the way you understand the relationship between pain and mental health, both personally and professionally.

[04:23] Dr. Shimi Kang: Yeah. When I think about my journey, I feel like it was a very effective medical school and residency — by going through what I went through. Not my professional training, but my personal experience. It was like I had to relearn everything that I had learned in medical school and residency, or really see it from a different angle.
[04:47] So I started experiencing chronic pain when I was about 38 years old. I had my third child, and I had already been a psychiatrist for over 10 years. I was trained in a very Western medical model where the brain and body are kind of separate and you go to different specialists for different things. I was the brain specialist, and all of a sudden my body was falling apart and in pain, and I was really lost. I remember saying, of course the universe would give a psychiatrist a physical health breakdown, because I could probably sort out a mental health breakdown.
[05:28] But then for me, that experience was a medical education in holistic understanding — that there is no separation, that we are a holistic loop of mind and body. So to your question: chronic pain is a risk factor for depression and anxiety. And we know that it's not just a psychological response due to losses of functioning in the workplace or the home, or all your different roles and identity issues and psychosocial stress, but purely biologically, those signals are going to your brain that you're not safe, that there's pain, that you need to retreat into a cave — as I explain it.
[06:15] Initially, chronic pain leads to the freeze, fight, or flight response. And freeze is that anxiety, being stuck. The fight is irritability. The flight is avoidance or distraction — alcohol, drugs, shopping, eating. And then chronic pain leads the organism into a cave after they've tried to freeze, fight, or flight. They have cortisol, which impacts their ability to function. So we want to withdraw, and I say that's depression. I experienced both personally, and it was really interesting to see it in myself after having treated it in other people for a really long time.

[07:02] Dr. Linda Bluestein: I've experienced both as well, along with pain. And as an anesthesiologist — you and I have very similar medical school training, but very different residencies. I too worked in pain clinics. I never thought I would be a patient in one. It's really, really difficult, as it is for everybody. For me, there was a really significant period of shock, like, no, this can't be happening. Did you go through that?

[07:37] Dr. Shimi Kang: I did. I think I was in denial myself. And that was perpetuated by a healthcare system that really doesn't understand. There is stigma — and you look good, right? It's an invisible illness, so there's nothing really obvious happening. All of that led to, yeah, this feeling of shock. I think it's also part of the grief response: initial shock, denial, then anger, then depression, then acceptance. That was definitely my route, and it was almost practically linear through those different stages.
[08:10] It happened to me during a really busy time too. I had three young kids, I was writing books, I was at the peak of my career in research. It felt very unfair — like, oh, I'm finally ready to do all these things I had worked so hard to achieve, and finally they were there in front of me, and I was struggling just to sit at my computer and write my book. So it was a lot of emotional roller coasters happening all at once.

[08:47] Dr. Linda Bluestein: And what do you wish more clinicians understood about how chronic pain affects mood, motivation, identity, and even cognition?

[08:53] Dr. Shimi Kang: I would say something really important — and I need to remind myself of this as well, because I see patients with chronic pain — is that neuroinflammation really hijacks our prefrontal cortex. If we want to be really technical: there's this area of the brain called the prefrontal cortex, and this is where our motivation, our planning, our problem solving, our optimism, and our adaptability all come from. It needs to be healthy, and we need to move forward from this region.
[09:45] But when we have chronic pain, this area is being overridden. It's our brainstem, our threat response, that freeze-fight-flight. And right there you can see a mismatch between what's happening in your body and what you're feeling — but also in the skills that you need to navigate a complex health condition that is misunderstood, stigmatized, and really doesn't have clean protocols where you can say, oh, person has X, let's give them Y.
[10:19] So I think that's a big mismatch, and it's important for clinicians and patients to understand: when a patient is sitting in front of them and they don't look motivated to do their physio or eat healthy, or they're irritable, or they're having difficulty with problem solving or mood or depression — it's not just depression or lack of motivation. This is part of a syndrome, a mind-body syndrome. What we're seeing in those cognitive abilities and skills is a symptom itself of the Ehlers-Danlos, the hypermobility, the bendy body condition. That's really key, because we try to separate it and say, oh, they're depressed, so they should go see a psychiatrist — when that depression is no different than the hypermobility we're testing in our clinical interview. We need to really bring the mind and body together and see this as a holistic person. Connective tissue conditions and chronic pain affect every aspect of our organism.

[11:27] Dr. Linda Bluestein: I'm fascinated by that, and thank you for showing the brain. If you're listening right now and you have not been watching on YouTube, I would encourage you to go to YouTube so you can see what Dr. Kang was pointing to. And as soon as you mentioned the prefrontal cortex, I was thinking: so many people with hypermobility and connective tissue disorders have ADHD, which also affects the prefrontal cortex. What role, if any, does ADHD play into all of that?

[11:57] Dr. Shimi Kang: Yeah, and I recently saw your article on being a physician with ADHD — bravo, it was so helpful and interesting. I also have ADHD. And I want to talk more about what you think explains why ADHD and hypermobility go together. I don't think we've found a common gene or etiology, but when you have pain, you're constantly distracted. And so when you have neurodiversity, it's very hard to focus as it is — you're already on an outlier for focus, concentration, and executive functioning. And now you have this alarm firing in your brain. So if you have attention deficit, it would get worse.
For some patients I've seen in my own practice — who probably were borderline or may not have fully met that diagnosis — the chronic pain actually tipped them over, and now they definitely do meet criteria. Usually, when we give a diagnosis of ADHD, we look for childhood and adolescent symptoms, and we often don't diagnose in adulthood unless we see that history. But in my 25 years of practice, what I started to see — especially with women and mothers, and also with the brain changes that happen through PMS, pregnancy, postpartum, and menopause — was almost not a new onset of ADHD, but a discovery or worsening of executive functioning and attention deficit where I would now treat it and prescribe and give the behavioral strategies. That is something I learned that is different from what I would have been taught in my medical training.

[13:53] Dr. Linda Bluestein: We deal with this really challenging narrative that if pain is linked to mental health, then it must be, quote, in someone's head. So how do you help patients reframe that without invalidating their physical reality?

[14:10] Dr. Shimi Kang: I have my own take on this, which is: everything is in our heads, because our brain really is everything. So rather than getting reactive to that statement, I try to accept it — because our brain is the most complex thing in the known universe. There are 100 billion interconnections, and it influences absolutely every aspect of our being. So number one: let's not get offended if something's in our head. Let's really understand the power of this organ and our responsibility to take care of it.
Then step two is thinking about it as actually a beautiful saying, because your thoughts are in your control. So when life is feeling very out of control — my knees are swelling, I have serious pain in my neck, I'm cycling through a chiropractor and physio — the approach I take is something I can control: my thoughts. That does give us some power and agency.
All of those clichés — where focus goes, neurons grow; think positive; find the silver lining; be grateful — I was so sick of them. But as I think back, they were absolute medicine for me. I took antidepressants — I needed them. I went through duloxetine, which is Cymbalta. That was the first one I was prescribed because I had severe knee pain. I had side effects from that. I tried other serotonin medications. Wellbutrin helped me the most — that's bupropion — maybe because I also have ADHD. I took sleep medications too. So I took all the pharmaceuticals, but I also really had to work on training my brain.
[16:21] So if I was going to physio, instead of being resentful and hating traffic and rushing there, I would think: at least I get to go to physio. At least I can afford it. At least I can find this person. There's some temporary relief. All of those mental strategies — gratitude — release endorphins. And I'm like, okay, I am in a lot of pain, I need some endorphins. So a gratitude practice is going to give me that. This wasn't easy. It took me 10 years. I went through all the stages, but I finally was able to move into more acceptance.
[17:01] And then I was able to use my body as an instrument for endorphin, which is a painkiller — endogenous morphine, that's what endorphin is — and for oxytocin, which is a painkiller and brain optimizer as well. So I would be grateful for my husband who would drive me somewhere. Really using my internal pharmacy was a key point. For everybody listening: we have this ability to release these powerful molecules. For me, the three were endorphins, which came from breathing and mindfulness; oxytocin, which came from gratitude practice; and serotonin, which came from adopting a curious mindset. Instead of being resentful, I became curious. How amazing is our body, and collagen, and connective tissue? That mindset shift was hard, but it did allow me to make those molecules that helped me carry forward during really, really dark times.

[18:18] Dr. Linda Bluestein: I love what you just said, because I'm also thinking about social connection and how often when we're in pain, we isolate ourselves. I definitely did that, and that also really hurts our internal pharmacy, right? When we spend time with friends and hug people, that's when we release more oxytocin. Those kinds of things are so important.

[18:42] Dr. Shimi Kang: Yeah, absolutely. And all of this was happening to me when I was writing a book called The Dolphin Way, which became The Dolphin Parent. The big premise of that book was: we are social beings. Humans — we are dolphins. We are meant to be social, meant to live in a community, in a pod. We're meant to be curious and playful. I was really advocating for what I call getting back to being human. I use the animal as a metaphor for how our mammalian brain and being is developed. We are exquisitely social — and not just social, but bonded animals. We humans don't just need socializing; we need depth of bonding. Because oxytocin is a powerful antidepressant, mood stabilizer, problem solver, and brain optimizer, and it comes from bonding and trust. Not just socializing.
So I was stuck in this situation where I'm preaching and giving all the science and going around telling people this information, but myself feeling more and more isolated. And that's why podcasts like Bendy Bodies, I think, are just — as I said at the start — so very important to manage that feeling of loneliness and isolation.

[20:06] Dr. Linda Bluestein: I cannot tell you how many times people have said to me, "I thought I was the only one. I had no idea this was a thing." It's just incredible. And I love that you talked about the depth of connection, because just having a bunch of social interactions where every single time you're stating what you do for a living or whatever — I can see how that would be very different.
[20:36] And also, when you were talking about "in your head" — that's where we sense everything, right? We sense everything in our brain. The important distinction I try to make with people is there's a huge difference between "in our head" and "made up." You're feeling it in your head, but that doesn't mean you're making it up. And I think so often when we get gaslit by other people, we gaslight ourselves. At least I did. When my doctors were doubting me, I started doubting myself — maybe there's really nothing wrong with me and I'm just being weak. I think a lot of people do that.

[21:18] Dr. Shimi Kang: Yeah, absolutely. And I think that's a real sign of our own transformation when we can be in front of someone who says, "This sounds like it's in your head," and we're not reacting and taking it personally. We're finally able to observe that as not about us — oh, that doesn't affect me anymore. That comment is about this person's inability to understand this condition, or their own life experience, or their mindset within a system that doesn't get it. And we don't react. We're like, okay.
[22:02] To me, when I could start doing that, it showed me I had evolved and transformed, and actually in some ways conquered — and I still have issues, I'm having surgery in three weeks — but it was that moment where I felt I had conquered the suffering of having this condition and had really come to acceptance. In psychology, we call it the locus of control: where do you feel the control center of your life sits? If it's out there, then what someone says, what someone does, the weather, a good review, a bad review will constantly have you swinging between happy, sad, and angry — hijacked by all these external factors. When the locus of control becomes fully centered within — that I decide how I feel, I decide what my mood is, not what some doctor says or some physio says or what I hear on a podcast — that is true self-reliance, self-agency, self-sovereignty. And we know that is connected to better mental health, better physical health, better social health. It's a psychological construct we can all work toward. I've felt it and I have it, but I can lose it again. These things are sacred and important and they're part of our daily work.

[23:43] Dr. Linda Bluestein: Wow. Locus of control — I love that. And that makes so much sense, that we're not giving our power away to other people. But it can be so hard to do. We might have to have a third podcast conversation about that, because it's really fascinating. And I love that you admit that you might feel that way right now, but that doesn't mean you're going to feel that way every single day for the rest of your life, right?

[24:19] Dr. Shimi Kang: Yeah, and I think we live in a culture where, because of social media and consumer culture, we're constantly comparing ourselves — even though we know not to. It's really hard when you see someone else who isn't in pain, or isn't suffering, or is able to do that workout or go on that vacation. And then we start to really let that affect us. We're in a time and era where we are constantly comparing ourselves to other people's fake, filtered lives. That actually gives up our self-sovereignty, our locus of control. Because once we start comparing, we've given it up — we're comparing to these external things and it's impacting our health and wellbeing.
[25:11] There's so much happening right now, and I think perfectionism is on the rise. When you're unwell and don't feel good, that perfectionism kicks in. It's like, why me? Why am I the one that can't have the career, be the mom, make the homemade bread, have my house look a certain way — when we're struggling just to take care of ourselves? Studies show perfectionism is on the rise, and it's linked to anxiety, depression, and lower life achievement. So I think that's a really important factor intertwined with mental health and illness — the role of perfectionism and our relationship to that phenomenon.

[26:05] Dr. Linda Bluestein: That makes sense. And I love that you were talking about some of those different sayings — what fires together, wires together; gratitude practices, and so on. We also hear about toxic positivity. Adaptability is so important, but not necessarily in a "I have to push through it" kind of way. So how do you define healthy adaptability for someone whose body has significant limits?

[26:41] Dr. Shimi Kang: That's a really good question. I'm going to give a little tool — I call it a mantra. It's a cognitive tool you can use when you're struggling with being positive but also feeling pain. It's a two-part tool.
[27:04] Part one is: name it to tame it. Whatever you're feeling, you can't just deny it and say, "I am healthy." That's why affirmations don't work a lot of the time — because you know you're lying. So part one is name it to tame it. Tell your brainstem you hear what's going on. You say: I'm feeling anxious right now. I'm feeling depressed right now. I'm feeling a lot of pain right now. I'm feeling hopeless. Whatever it is — name it to tame it. That settles down your brainstem.
Then part two is: where focus goes, neurons grow. Pull yourself into that cortex where optimism sits, and forward thinking, and problem solving. So then you find something positive. It could sound like: I'm feeling a lot of pain right now, yet I know it will pass — because let's say your pain fluctuates. I'm feeling really depressed right now, yet I have a treatment plan. I'm feeling really hopeless right now, yet I know what to do — I'll call my doctor and talk about this. So it's a two-part tool. And when you add breathing to it — on the inhale, say your name it to tame it, and on the exhale, the yet — now that's not toxic positivity. That's an evidence-based, proven tool that will settle down your nervous system and allow you to move forward.
I've given this to so many people and used it myself. It's very simple, but simple is not easy. Sometimes we look for complex things, but this is just how our mind and body work, and we can use that as an instrument for our own wellbeing.

[29:12] Dr. Linda Bluestein: I love that tool, and I love pairing it with the breathing. That's really smart. And what about helping people differentiate between self-compassion and avoidance, especially when they might need to rest or modify their activity? How do you help people with that?

[29:31] Dr. Shimi Kang: If we go back to that tool, you would say: I'm feeling really tired right now. Or, if it's an avoidance situation: I'm feeling really overwhelmed right now, and I just need some rest, I need a reset. You can use that same two-part method.
And really, self-compassion is the key. Thinking of my own journey: if I had listened to my body earlier, I wouldn't have ended up cycling through antidepressants to the same degree or having as much suffering. It was the lack of self-compassion, the pushing — maintaining this level of functioning, not allowing myself to rest — that actually put me further behind. My anxiety about falling behind in my life, my career, all the things I wanted to do, and fighting the illness, actually made me fall further behind. Whereas if I had just accepted it earlier and taken some time off, I think I would have been in a much better place. So it's really important to practice and work on that — and to ask yourself honestly how you're doing with it.

[31:05] Dr. Linda Bluestein: I really appreciate you sharing that. And when it comes to truly holistic mental healthcare for somebody who has a connective tissue disorder and chronic pain, what do you think are the elements most often overlooked?

[31:20] Dr. Shimi Kang: In our model, we tend to jump to pharmacotherapy a lot — and there's nothing wrong with it, I prescribe these medications — but we really need to look at nervous system training. We have an instrument and we can use it. So when I give a prescription for medication, I also give a prescription for what I call breathing, connection, and play — the POD prescription. The D is downtime: rest, breathing that releases endorphin. The O is connection with others that releases oxytocin. And the P is play: take a curious mindset towards what's happening and you'll get that serotonin.
Having that framework is absolutely key. And then of course psychosocial support, looking at the individual within their holistic environment. What accommodations might they need at work? Even simple things — for me, changing my chair and having better ergonomics helped greatly. Sometimes you're the only one, whether you're the mental health provider, the primary care doctor, or the patient, who's really looking at all of it. So really looking at all the different aspects: if you're a single parent, how are you managing all the tasks in your home?
[33:06] A big one that is often missed — and people get very reactive to it — is the question about trauma. When you get that question, you might feel judged, like there's an assumption that what's happening in your shoulder isn't related to what happened in your childhood, or that your pain isn't real or isn't physical. But the question of trauma is really important, because pain and disability and everything we go through can be what we call a trauma reactivation. If you have a negative experience with a healthcare provider that really affects you — yes, that experience is real and it really happened. However, if there was a history where you experienced a feeling of neglect, betrayal, or misunderstanding prior to that, it's going to reactivate that nervous system and those pathways that wired and fired together.
[34:23] I'll tell you a little story. Dr. Gabor Maté is an incredible clinician — many of you may know his work, The Myth of Normal and When the Body Says No. He's a mentor to me as an author and a friend. When I had lunch with him while writing my book and was talking about what I was going through, he asked me: "Well, Shimi, what about your trauma in your life?" And I got really offended, because at that point I believed this was all physical. Now in retrospect, I see what he was trying to do — he was trying to help me open up an area I didn't want to deal with. Because yes, we do get reactivated. Our amygdala holds those memories. If we were bitten by a dog at age four, that is still there, and it might determine how we feel when we go for a walk in a park trying to move our body, because our unconscious mind has that fear of dogs. Some EMDR might really help us get to the park more and unwind all that. So I think that's a big missing piece.

[35:37] Dr. Linda Bluestein: And what do you do when a patient says — and I imagine this has happened to you, as it has to me — "Breathing doesn't work for me"?

[35:48] Dr. Shimi Kang: Yeah, and it didn't work for me initially. But if you are a human — and now I'll grab my friend here, I call this little model George, he has lungs, so if you're not watching on video, picture a human model with lungs — there are receptors in the top and bottom of your lungs, and when they are stretched and held, they send a signal to your brain that you are safe and okay. That is just how the human body and mind are connected. So if you are a human, eventually, once you get the practice and develop some competency, it will work.
The problem is that when you're in the middle of a panic attack, your adrenaline is firing. This is a million-year-old instinctual system. It's really hard to override a panic attack with breathing if you're trying it for the first time in that moment, or you're only doing it when you're already firing adrenaline. We have to practice these tools when we're calm, when we feel safe, to get the wiring and pathways going so that they can kick in when we need them. It's like learning the piano — you can't learn the piano during an anxiety attack. You have to learn it when your brain is receptive, and then you can play it when you're feeling nervous or anxious. So it's a matter of learning. It's a hard thing to do, especially when you're in that sympathetic drive. But it's definitely worth putting the time in, because it's a lifelong tool.

[37:35] Dr. Linda Bluestein: And you always have it available to you. It's free, right? And as long as you're still alive, you always have your lungs readily available. So that's so important.

[37:47] Dr. Shimi Kang: Exactly. And sometimes the science helps, and they're like, yeah, but I can't get that stretch. And then I'll say, well, you have a vagus nerve, right? That old yoga breathing is called the Ujjayi breath, where you constrict the back of your throat. It's the Darth Vader breath, or fogging the mirror — if anyone has been to a yoga class or heard of this. We know that actually helps activate our vagus nerve, which stimulates our parasympathetic system, which helps reduce adrenaline and the perception of pain. Whether it's science or ancient practices, if something has endured 4,000 years, there's a reason it works. Having an open mind and finding a teacher or someone who can help coach you through it can be very helpful.

[38:40] Dr. Linda Bluestein: And it's so clear that when we are in fight or flight mode, we just don't think as clearly. That's why pilots do simulator training, and anesthesiologists do simulator training too — because in the heat of the moment, it's so much harder to know what to do. We practice those severe, life-and-death type situations that we might never encounter, because we know you need that knowledge ahead of time. In the same way, you need those skills before you have a panic attack or anxiety attack.

[39:10] Dr. Shimi Kang: Absolutely. I do prescribe Ativan, because we want to be compassionate and we know it can help in the moment. But I always provide it with instructions to work on certain tools, and then at a certain point, use the tools prior to using any kind of prescription.
There are also a lot of herbals that can be relaxing. People are using things like GABA, valerian root, passionflower, ashwagandha. And nature is extremely relaxing. We are what I call biophilic — we belong outside. Maybe take your practice outside or look at the scenery. Everyone's unique, and just because something someone swears by doesn't work for you doesn't mean that you're hopeless. It just means you have to find your own unique neural fingerprint that will help your body feel better in those moments when you're firing that adrenaline.

[40:17] Dr. Linda Bluestein: I love the comment about nature. I know I feel that way — if I can go for a hike or a walk outside, it feels so much better than walking inside on a treadmill.

[40:28] Dr. Shimi Kang: Yeah, and music too. Music is also universal. When we think of what our brain developed in, it was outside in nature, moving, walking in groups — for 70,000 years we were hunter-gatherers — and then music and storytelling. So I use music as medicine, and I often tell my patients to create three playlists: one that calms them down — that's the downtime endorphin — one that helps them feel connected — that's the oxytocin — and one that energizes them — that's the serotonin. Using these many things around us as medicine and tools to help us.

[41:10] Dr. Linda Bluestein: I love that. That's another super concrete thing that people can do. Thank you for sharing that. We're going to take a quick break, and when we come back we're going to shift gears a bit and talk about psychedelics. I'm sure Dr. Kang is going to give us all kinds of other great tips and tools. We'll be right back.

[42:53] Dr. Linda Bluestein: We are back with Dr. Kang, and we've already gotten so many great tips and tools. I love the breathing and the mantra and creating three playlists. If you didn't catch those, you might want to go back and listen to that part again, because those were really, really great tools. Now I want to talk about psychedelics and what your experience is. I know there's so much interest in using psychedelics for mental health and for chronic pain. From your perspective, what is promising, and what concerns you?

[43:33] Dr. Shimi Kang: Oh my goodness. We are in what's called a psychedelic renaissance, meaning that these molecules — which have been around for thousands of years in indigenous cultures — psilocybin, DMT, and others — are receiving new scientific attention. I'm currently the principal investigator of a study on DMT and treatment-resistant depression. I'm also studying psilocybin — the psychedelic mushroom — for treatment-resistant depression and PTSD, and I completed what I believe was the world's first study on psilocybin and addiction.
[44:07] It's really interesting that these molecules have been around so long. We had an initial wave of psychedelics in the 1960s with LSD and ketamine, and then everything went underground for decades. Now we're in this renaissance for a variety of reasons. Whenever I talk about psychedelics, I always want to start by paying acknowledgment to those wisdom keepers who have been holding the reverence and science of these molecules from the beginning of time — our indigenous healers and the champions who have been saying, we need to look deeper into why these molecules have been a key part of human culture.
[45:11] So let's talk about how psychedelics affect mental health and chronic pain. Ketamine was kind of the first psychedelic to be used in a chronic pain setting, and you would know more about that than me, Linda, as an anesthesiologist. It's a dissociative anesthetic, but used as a psychedelic it creates a mental state where what the psychedelics are essentially trying to do is almost shut down our neocortex — the thinking brain. We are Homo sapiens; sapiens means thinking. We have this top layer of the brain which allows us to make tools and language — it's fabulous, but it's full of chatter. The psychedelics help quiet that down. And that allows the emotional brain — that limbic layer underneath — to emerge. If done well, we can then reprocess some of the wiring and firing loops that may have been established between the brainstem and the emotional brain. That's where therapy comes in: psychedelic-assisted therapy.
[46:46] A great example: American veterans who have suffered with PTSD, alcohol dependence, depression, high rates of suicide, and opioid addiction. What really opened up the psychedelic conversation were studies on those veterans where we were seeing major benefits, even remission from PTSD and depression, within three or four sessions of psychedelic-assisted therapy.
That's the intro in a nutshell. But I have many concerns, particularly because it feels like a bit of a gold rush — everyone's trying to get in on this renaissance. And as I've said many times, the brain is the most complex thing in the known universe, and we have to treat it with deep reverence. These molecules are extremely powerful. I am already seeing PTSD being caused by psychedelic journeys that weren't done well and weren't managed well. Like anything powerful, it has the power to heal and also the power to harm.

[48:02] Dr. Linda Bluestein: When you're talking about these studies with the veterans and ketamine — I was actually going to start doing ketamine infusions in my practice just before COVID. I had literally just gotten the pumps, the ketamine, all the supplies. I was ready to start. And then the pandemic happened, and I thought, people can't come in for something like this, plus I knew we were going to be moving soon, so it wasn't a good time to launch. But as I was doing my literature review and digging into the research, it was very clear to me that there were a lot of different dosing protocols being tried. From your experience, if you were to write a protocol for people with trauma, what type of dosing would you recommend?

[48:53] Dr. Shimi Kang: I would refer to the MAPS website for protocols. MAPS is the Multidisciplinary Association for Psychedelic Studies. Rick Doblin was one of the original founders, and they have done, in my opinion, an incredible job of creating protocols for different presentations — PTSD, depression, chronic pain — and really moving the research forward. The research is constantly changing, but that would be my recommendation.
[49:29] If there is a history of trauma, what I've seen is this: I had a woman in my practice who went to Costa Rica and received ayahuasca, and another colleague of hers received psilocybin. Both of them ended up in a bad trip — severe flashbacks and PTSD from the experience — because their cortex was shut down too much without proper support, preparation, or integration, and their flashbacks and memories were too much for their bodies and brains to handle. One of them is still suffering from what we call a persistent hallucinogenic perception disorder — visually experiencing those flashbacks. That's exactly what you don't want.
If you are considering a journey, number one, check the MAPS protocols. MDMA is the molecule also known as ecstasy, or the love molecule. I oversee clinical trial research — I don't personally conduct these journeys — but what I've seen and read is that when given in a small initial dose, MDMA helps the individual, particularly one with trauma, feel safe. You've gotten some oxytocin, you feel bonded, you feel safe. After that, the more dissociative molecules like psilocybin, ketamine, or ayahuasca can be given. Those protocols make sense to me scientifically — you're putting the person in a place where they feel held, supported, and safe before shutting down their cortex and opening up whatever might be there.
It's very sophisticated. There are all kinds of different protocols. People who have a history of psychosis, or anyone who has had a recent concussion or head injury — these are contraindications in my opinion. And having a thorough psychiatric assessment as part of your plan is really important. Now, a lot of psychiatrists will say it's not approved or legal, and I'm not providing these journeys myself — but I will do an assessment and see if your brain is in the right position, if this is the right time, what you need to do to prepare and integrate, and how to have a healthy experience. I would encourage anyone to talk to a psychiatrist who is open to this before initiating a high-dose journey.

[52:47] Dr. Linda Bluestein: Thank you so much for that balanced perspective. I will definitely link that website in the show notes so people can see the protocols, because that's really important. And any other links you have about your research would be great to share there too. What worries you most about how psychedelics are currently being discussed on social media?

[53:13] Dr. Shimi Kang: I think it's that gold rush mentality again. There are people who truly have deep reverence and respect, and there are others who see this as an opportunity to make money or gain fame as the latest guru on whatever. That concerns me, because these are very powerful molecules. People think: it's a mushroom, how bad can it be? But DMT — which I'm doing a study on — is part of toad venom, and also something the brain makes naturally, and you can have a very rapid and intense experience.
I would also say that sometimes the people who are most charismatic and influential online are very good at selling, but not necessarily good at understanding the underlying science. The person who deeply understands the molecules may not be the best communicator on social media. So just be wary — there is a lot of misinformation out there. Go to credible sources.
I'll briefly mention microdosing, since we haven't touched on that. Did you want me to cover that?

[54:47] Dr. Linda Bluestein: Yes, please do.

[54:50] Dr. Shimi Kang: The journeys we talked about are megadoses that shut down the neocortex and allow for emotional processing and integration. The other way psychedelics are being used is called microdosing — sub-perceptible amounts that you don't really notice. The goal is that people microdose and go to work, drive a car, and don't feel altered. There are studies on psilocybin and LSD microdosing and neuroplasticity — meaning the ability of the nervous system to learn and change — and in particular, chronic pain. I'm hopeful and interested to see where that research goes.
For precision in dosing, LSD may have an advantage because it's synthetic and you can be more exact. Psilocybin is a natural molecule, so there's more variability. There is actually quite good research behind LSD microdosing and chronic pain. Time will tell where all of this leads.

[56:11] Dr. Linda Bluestein: And I think part of the challenge with social media is that someone like you — who is extremely knowledgeable, also super charismatic, but presenting information in a very nuanced way — it's often not as engaging on social media as someone who comes out and just states things like they're absolute fact. Especially if they say something shocking. It makes it really hard when we're trying to stick to what we know scientifically and trying to be super responsible, as I know both of us are. People love sound bites, and they love what feel like answers.

[56:52] Dr. Shimi Kang: Right, and this comes back to self-regulation — the breathing practice, the connection practice, the curiosity. If you're going on social media looking for information, you don't want to be in freeze, fight, or flight, because then you're more likely to get sucked into misinformation. It promises that quick fix. You want to regulate first — use those tools, remember your play, others, and downtime — and come from your cortex. Then you have a discerning eye, a critical mind, a curious mindset. Of course we need better algorithms, social media regulations, and industry accountability, but really the only protection from misinformation is your own mind being in that place where you can discern credible information from non-credible.

[58:00] Dr. Linda Bluestein: I love that. Misinformation spreads so easily, especially when it comes to chronic illness and mental health. Are there other things you want people to know about consuming social media responsibly?

[58:18] Dr. Shimi Kang: Oh, wow. That might be a whole other topic.
[58:21] My last book was called The Tech Solution: Creating Healthy Habits for a Digital World, and I looked deeply at this question. Misinformation is on the rise, and in health it's one of the biggest areas of concern. Those of us with bendy bodies and chronic pain who feel misunderstood by the healthcare system are sitting ducks for misinformation. I have been there myself — I've gone down rabbit holes, I've bought devices that attach to your head with money I didn't have, that really weren't based in science. I couldn't believe how boldly some influencers would state that something had been proven, quoting studies, citing research that didn't exist or was based on hallucinated AI output. And I got sucked in. If I — a scientist who has done phase 3 FDA clinical trial research with 25 years as a psychiatrist, and who genuinely believes I have a critical mind — have been taken in so many times to my own harm, then no one is immune. We are all at risk of this, particularly when we're in pain and desperate. That's my biggest message.
[59:52] That's where having your pod of support comes in — asking others you trust and who are knowledgeable. And we have to understand that the first iteration of the social media industry was described internally as a race to the bottom of the brainstem. The industry knew what they were doing. Stress was the number one health epidemic of the 21st century — I was part of the research at the World Health Organization that declared that. So there was this convergence where people were functioning out of their brainstem, and platforms were designed to attract and keep that brainstem engaged.
[1:01:01] This next iteration — ChatGPT, Gemini, the AI platforms — the industry is calling it the race to intimacy. You're going to go to ChatGPT now to ask questions about your health, your back pain, which supplements to take, which foods to eat. There's some great information there, but these tools are also designed to be flattering, to be friendly, to make you want to return to them more than any other source in your life — more than your friends, more than your doctor, more than your partner. That's what I mean by the race to intimacy. And that's where we are. It's really important that people know.

[1:01:59] Dr. Linda Bluestein: Oh my gosh, thank you so much for sharing that. We will definitely have to do a part three and discuss your book in more detail, because this is really important for people to know how to navigate this space. I refer people all the time to EDS support groups on Facebook — I think they can be so helpful — but I've also heard that there are people who are paid by companies to create accounts, show up in those groups pretending to be patients, and talk about how great their experience was with a certain product. And they're smart about it — they're not going to be obvious, so you can't easily identify them. Unless it's someone you know in real life and have reason to trust, it can be really challenging.

[1:02:59] Dr. Shimi Kang: I'm so glad you brought that up. Stress is the number one health epidemic of the 21st century, and loneliness is predicted to be the next major one. So you have these two factors — stressed and lonely — and then you have the most sophisticated neuroscience on the planet embedded in these platforms and devices to keep us connected to them. It is very, very hard to resist spending more time online than in real life, and we are seeing that increasingly.
[1:03:46] But we also don't want to throw it all out, because there is healthy tech. This podcast — places where information is accessible that never was before. In The Tech Solution, I talk about the tech diet. Consume healthy tech that is going to help you and your wellbeing. Be careful of junk tech — those sound bites that seem really attractive but are sugar, dopamine hits, pleasure. And be aware of toxic tech — with AI, deepfakes, and scenarios like you just described, there is more and more of it. But it's a menu of choices, and we get to choose.

[1:04:31] Dr. Linda Bluestein: There are also AI therapy tools now, right? Knowing everything we've just discussed, what do you think about those — maybe just give us a teaser for what we've clearly got to talk about next time?

[1:04:50] Dr. Shimi Kang: I had to think deeply about this. When it comes to AI, I'd put it into those three categories. Healthy use of AI is using it like a book — as a resource, a reference. You're getting information from credible sites, and it can be so helpful. Junk use of AI platforms is cut-and-paste: you get a dopamine hit because AI did something for you, but you didn't actually learn anything. No real growth happened through it.
[1:05:25] The toxic use of AI is using it for anything personal — including therapy. Anything you would ask of a human being, getting into your personal human space — that, in my opinion, is toxic use of AI. There are many reasons for that, including the rise of loneliness and stress. So use your AI for information. Do not get into asking AI personal questions about your life, your friendships, your relationships, because the algorithms will keep drawing you back to do that. AI should not be a therapist. It can assist your therapist with ideas and strategies, but it cannot replace one.

[1:06:18] Dr. Linda Bluestein: Before we wrap up, I want to come back to where we started — chronic pain and mental health. If there are other tips you want to share before we close, I'd love to hear them. And of course, we're also going to do a hypermobility hack. You've already given us lots of hacks, but hopefully you have one more. For people living with chronic pain who are feeling exhausted, discouraged, misunderstood — what do you most want them to hear?

[1:06:47] Dr. Shimi Kang: I would say that the mind and body are fully connected. We are one being. If you've lived with chronic pain, there is a very good chance it's affected your mental health. That's just how the human being works — because those signals of pain release cortisol, and cortisol is what drives us into that cave. And that cave is withdrawal, low motivation, difficulty problem solving, sleep disturbance, lack of interest, low energy — the symptoms of depression. So first of all, be kind and gentle with yourself if you are experiencing that. It's part of your condition. It's no different a symptom than the pain itself, or a swollen joint. Depression is part of it — watch out for it, don't have shame around it, and talk about it just like you would a swollen knee. Because it is treatable, and treatment can work, and many, many of us have been there.
[1:07:57] The mental health aspect of chronic pain — I hope you don't experience it, but I would say almost expect it if you're living with a chronic condition, because that is how the human being is built. And let's work together to help you get better.

[1:08:15] Dr. Linda Bluestein: Yeah. I had to bring it up to my rheumatologist, who was basically managing my symptoms at the time — I didn't know I had EDS yet, but I was definitely very depressed. I finally said to him one day, "I feel like I'm depressed," and he wasn't picking up on it. I was prescribed duloxetine — that was the first antidepressant I tried as well — and similar story with the side effects. I was very underweight at that time, and everyone thought I was super fit. It's funny that you mentioned you look good, because I had people literally saying to me, "Oh my gosh, are you running a lot? You look so fantastic." Because I was super, super thin. It's just fascinating how other people respond when there is a stigma — there's a stigma with EDS, there's a stigma with depression, and it's so challenging. But that's why these conversations are so important and so impactful. I'm so grateful to you for taking the time to chat with me about all of this, because it really can make such a huge difference in people's lives.

[1:09:23] Dr. Shimi Kang: Thank you, Dr. Bluestein, for asking such incredible questions. This podcast helps so many people, and I know there are people out there who are struggling with mental health issues — they are rising in our world. If you're listening and you do experience that, it is not your fault. Be careful of the misinformation, and know that these conditions are treatable. In fact, some of these mental health conditions are more treatable than our hypermobility and chronic pain conditions. So there is a lot of hope.

[1:10:02] Dr. Linda Bluestein: Absolutely. You've already given us so many great hacks — I love the mantra, the inhale naming what you're feeling and the exhale with the "yet." That was such a great one, and the three playlists, and so many other things. Do you have one more hack for us?

[1:10:22] Dr. Shimi Kang: I'm going to give the concept of watch your life diet. What I mean by that — and I've alluded to it a few times — is that we are our most powerful pharmacy. It's not just the saying "you are what you eat," but you are also what you do and what you think. So: try to consume the POD. Try to consume a play mindset where you're approaching things with curiosity. Consume connection with each other — that's the oxytocin. Consume serotonin with learning, trying, and being open to new things. Consume endorphin with rest, breathing, and mindfulness.
[1:11:17] Be careful of the sugar of the life diet — the quick fix, the dopamine hits, the misinformation, the rage. Even the anger at someone else — those are dopamine hits and they're like sugar. They feel good in the moment, but they're addictive and they don't sustain us.
[1:11:37] And avoid the cortisol. We don't need the stress unless we're being chased by a tiger. Whether it's the extra stress we add on ourselves from perfectionism, or those small choices that create stress — too much blue light, checking emails before sleep, not enough sleep — be mindful of those. When I think of the life diet, I boil it down to five ingredients: avoid cortisol, be careful with dopamine — it's sugar — and really try to get those other three: endorphin, oxytocin, and serotonin. The choices really are up to us. It sounds simple, but simple is not easy. This is what we do every day, and it is our daily choices that matter.

[1:12:28] Dr. Linda Bluestein: I agree that it's so powerful to recognize that what we think and how we think can influence our body and how it feels. When I first learned about pain catastrophization, I realized, oh my gosh, that's absolutely what I'm doing. But at the same time, I was excited about it, because I thought: this is something I can change. I can change this more than I can change what's happening in my tissues. Those are really powerful things you've taught us.

[1:12:58] Dr. Shimi Kang: Exactly. We are what we eat — food nutrition is important. We are what we think and how we think. Every experience is metabolized into those five molecules. So we can have a big impact on our health just by the choices we make in our thinking.

[1:13:18] Dr. Linda Bluestein: And maybe sometimes these things can be more subtle. For people listening right now, you might think, I can't just suddenly make a 180-degree change. But since you've been talking about connections in the brain and neuroplasticity, if we just start making some small changes, success might build on success. Is that also true?

[1:13:43] Dr. Shimi Kang: Yeah, absolutely. I have my brain mug here — I look at it every morning with my coffee. We all have this incredible thing, and there's a word I love: neuroplasticity is a six-syllable word for hope. It means we can always learn, we can always change. Our nervous system is incredible. We have neuroplasticity until the moment we die. So remember that gift from Mother Nature — that six-syllable word for hope, neuroplasticity, belongs to us all. Let's use that tool more.

[1:14:26] Dr. Linda Bluestein: Amazing. I'm sure there are a lot of people listening who are thinking, I want to buy some of these books, I want to learn more about Dr. Kang. Where can people find you?

[1:14:37] Dr. Shimi Kang: My website is drshimikang.com — D-R-S-H-I-M-I-K-A-N-G dot com. I'm also the founder of an organization called Future Ready Minds, where we teach people 21st century skills — how to manage the trends of disease, disruption, and disconnection. That's futurereadyminds.com.

[1:15:01] Dr. Linda Bluestein: Wonderful. I'll have all of your books linked as well. I think they're already on my Amazon list, but people can go check there. You've written three books — is that correct?

[1:15:14] Dr. Shimi Kang: The first book is called The Dolphin Way, which became The Dolphin Parent. The second — which I consider more an iteration than a new book — was called The Self-Motivated Kid. And the last one is The Tech Solution: Creating Healthy Habits for a Digital World. So there are three publications, but I say I really wrote two.
[1:15:32] But thank you for doing that. A lot of them are geared towards parenting and young kids. The tools came from my world as an addiction psychiatrist working in motivation. They're very science-based but also have a lot of personal stories and anecdotes.

[1:15:57] Dr. Linda Bluestein: Wonderful. Well, thank you so much again for sharing your vast wisdom and knowledge with us. I'm just so grateful to you for taking the time to talk with me again today.

[1:16:09] Dr. Shimi Kang: Thank you, Linda. Thanks to your incredible team. I look forward to your next podcast — it's something I look forward to every time it releases. Thank you for your work.

[1:16:19] Dr. Linda Bluestein: Wonderful. I look forward to it too. That's going to be fun.

[1:16:49] Dr. Linda Bluestein: Well, I really enjoyed that conversation with Dr. Kang, and I hope that you did too. I bet you found a lot of really great tips and tools in there to discuss with your own doctor and medical team. Thank you so much for listening to this week's episode of the Bendy Bodies Podcast with the Hypermobility MD. I have lots of other resources, including my newsletter The Bendy Bulletin — check out my website hypermobilitymd.substack.com. You can help us spread the word about connective tissue disorders by leaving a review and sharing the podcast. This really helps raise awareness about these complex conditions.
[1:17:23] Did you know that I also offer one-on-one support for both clients and healthcare professionals? Whether you're living with a connective tissue disorder or caring for someone who is, I've got your back. Check out my coaching and mentorship options on the services page of my website, hypermobilitymd.com. You can also find me, Dr. Linda Bluestein, on Instagram, Facebook, TikTok, Twitter, or LinkedIn at hypermobilitymd. You can find Human Content, my amazing producing team, at Human Content Pods on TikTok and Instagram. You can find full video episodes up every week on YouTube at Bendy Bodies Podcast.
[1:17:56] As you know, we love bringing on guests with unique perspectives to share. However, these unscripted discussions do not reflect the views or opinions held by me or the Bendy Bodies team. Although we may share healthcare perspectives on the podcast, no statements shared on Bendy Bodies should be considered medical advice. Please always consult a qualified healthcare provider for your own care. To learn about the Bendy Bodies program disclaimer and ethics policy, submission verification and licensing terms, and HIPAA release terms, or to reach out with any questions, please visit bendybodiesbodcast.com. Bendy Bodies Podcast is a Human Content production. Thank you for being a part of our community, and we'll catch you next time on the Bendy Bodies Podcast.