Chronic pain, depression, and anxiety are well known to anyone with an autoimmune condition: Nishant Patel, a psychotherapist and meditation teacher who has psoriatic arthritis himself, uses meditative tools to help his clients deal with all of the challenges that we face emotionally and mentally.

We discuss in this interview:

• Nishant’s first experience of his autoimmune condition at 17, and the deep impact it had on him at that age
• Biologic drugs and their relation with a correct diet
• How being diagnosed with anxiety and depression led Nishant to begin a spiritual journey through books and meetings with teachers
• The internal representation of events and how it influences emotions
• Developing the skill of recognizing emotions
• The importance of exercise
• Mindfulness meditation and being present in the here and now
• Learning to question our thoughts
• Aligning with reality
• Daily meditation practices

Clint – Welcome back to the Rheumatoid Solutions podcast. My guest today is Nishant Patel, he is a psychotherapist and meditation teacher and he uses meditative tools to support his clients who are dealing with chronic pain, depression, and anxiety. So we’re going to talk about those topics today. Nishant is going to share with us tools that he uses with his clients to help them in those areas and therefore empower them to be more proficient at dealing with all of the challenges that we face emotionally and mentally with inflammatory arthritis. And his empathy on this topic is immense because Nishant actually has psoriatic arthritis himself, And so he brings to this not just the education that he’s received through feedback with his clients, but also hands-on education in the trenches of having very, very serious and troublesome experiences in the past with his psoriatic arthritis. So we’ve got quite the expert today to talk about this and he’s going to share some tools and educate us on this topic so that we can live better lives and manage this condition much better. So welcome, Nishant.

Nishant – Thank you so much. Thank you so much, Clint, for having me. I’m very much looking forward to our time together today.

Clint – Yeah, so am I. It’s a topic that I love. I often go down this path with people myself when I’m working with them. I’ve put it in my materials, it’s in our training modules inside our programs, and it’s dealing with the mental or emotional side of this condition because I mean I forget the details from the science, but I think something like 86% of people who are surveyed with inflammatory arthritis report some degree of depression symptoms, anxiety related to their condition and so on. I mean, it really affects us in that way, doesn’t it?

Nishant – Yeah, and I definitely fall into that camp for sure. Just from the biological influence of inflammatory arthritis in the body, influencing, feeling depressed and anxious in my life. But definitely the psychological aspect of it as well.

Clint – Okay, great. Now, before we go any further, can you define psychotherapist for us? And just what do you do day to day in a very simple way, we can understand?

Nishant – Well, I’m a licensed psychotherapist in the state of New York, so that means that usually when people come to work with me and I primarily work with adults. If you’re a licensed psychotherapist, you can work with children, you can work with adolescence, you can work with adults. My focus is primarily working with adults that are dealing with anxiety and depression in their lives in particular. And so when people come to work with me, they’re looking for skills because I’m more of a skills based psychotherapist. There are other psychotherapists that work in different ways where it’s more of like a talking venting kind of therapy. But in the therapeutic approach that I take, it’s skills based while also having plenty of time to give our emotions a right to life and begin to see how we could shift our relationship to powerful emotions that we all experience, that we sometimes act like we don’t have. Whether that’s fear or worry or disappointed or anger, and all of those powerful, stressful emotions that show up in different contexts of our life, and how do we process that so that we can move more powerfully in our lives in different domains? Yeah.

Clint – Awesome. Okay. Well, we will get you to share some of the maybe a case study or two that you’ve helped with inflammatory arthritis people in chronic pain and so on. But why don’t we start with your case study, because you’ve been through all this and the strategies and tools that you’re going to share with us later in this conversation. Many of them you discovered out of necessity. I mean, you went through a lot of challenges, didn’t you? Can you give us the experience you had?

Nishant – Sure. Yeah. So just as a reference to the listeners, I’m currently 37 years old and my autoimmune journey started when I was 17 years old, so I was a senior in high school. Just your normal senior high school went through the struggles of that environment, the high school environment. And one day I woke up and I felt bumps on my head and my face started turning really red and kind of fast forward just a little bit. A short period of time after that initially started, my mother took me to a dermatologist and the dermatologist looked at me. And so there’s white scales and patches on my head. The bumps kind of turned into that and had redness in my face. And, you know, at that age, you get a pimple in high school, you think your world’s ending essentially. Like no one’s going to like me, I’m a monster here, you know? And so that felt very real so to have this all of a sudden happen was very confusing because in my life and my family life, my father and mother don’t have any conditions that relate to autoimmunity. I have one older sibling, he doesn’t have it. Aunts, uncles, grandparents don’t, cousins don’t. There’s one cousin recently that I found out has some kind of digestive autoimmunity issue going on, but throughout my life there was no one that had anything. So I was confused where this came from. And when I went to the dermatologist. I still remember to this day I’m sitting there, my mom is over there and the dermatologist walks in and he says, You have something called seborrheic dermatitis, that’s why your face is so red and psoriasis. And for the kid that I was, I was like, Great, give me the medicine and it’s done right? And then he goes, you’re going to have this for the rest of your life, and I was just devastated as a kid. I was 17 years old and my world shattered. And I still remember I was so devastated in that moment. And the thought that came to my head in that while I was in the doctor’s room was, No girl is ever going to want me. That what came up like relationships came up in my brain and that started making me feel kind of depressed because like I said, you get a pimple at that age and it’s like and you think of being attracted to the opposite sex and things like that, and that was very hard on me at that time.

As I started the autoimmune, they just gave me creams and, you know, shampoos and everything like that. I was like, okay, this will probably take it away, right? Barely did anything for me at that time. And so, um, as I was heading into university and college and dealing with that environment and trying to deal with school and academics while still having this. I just felt more and more depressed because to walk around with a white scalp to, to deal with redness in the face, that was just really hard because I would get so many thoughts come up in my head, like people are going to look at me, they’re going to judge me. I started comparing to other people. And I remember to like looking in the mirror in college and this thought came up where it was like, I’m a gargoyle. That’s essentially basically my self-esteem was shot, and I thought I was ugly and I was a monster kind of thing. Even if I heard compliments like, you know, you’re handsome, you’re a good-looking guy, and like, it just ricocheted off. It just bounced off because the belief that was underneath that was just overriding it. That was certainly for me in my, you know, late teens or early 20’s that I had to deal with a lot of that that came up psychologically.

Nishant – So it wasn’t just about the skin and dealing with that. It was just the psychological impact that an autoimmune condition like, let’s say, psoriasis has on you and how you view life was just so heavy for me. And psoriatic arthritis came more so when I was 21 ish towards the tail end of my college days where it hit me in my Achilles tendons, both of them. So I was barely able to walk like you could even see it on the Achilles tendon started turning like almost like a it was bruised, it looked. And then I have an older brother who’s actually a cardiologist now, and he had mentioned that, hey, you should see someone called a rheumatologist. And I’m like, What’s a rheumatologist? I don’t even know what that is. And he’s like, They deal with autoimmune conditions. And I went and that’s where I learned that I had arthritis and that, you know, that that was a part of I thought it was just skin stuff that I’d have to deal with. But then I learned that for some people, like 10 to 30%, I think it is something like that deal with the arthritis component of that. And then I headed on to getting on to biologics at that time and dealing with that. That was actually very supportive at that time.

Clint – Did the biologics help both arthritis and the psoriasis and to what extent it did?

Nishant – So here is the interesting. I was a perfect candidate for a biologic in the sense that it worked, and it worked for a long time. So it took away my psoriasis and it took away my psoriatic arthritis for years. Now I knew nothing at this point about diet, I knew nothing about nutrition. Just to give you a little bit of background, probably for much of my life, at least a minimum of, I Don’t think I’m even exaggerating. Like 60% of my meals are fast food, I drank a lot of soda. And I just thought that was as silly as this might sound now, looking back, I thought it was just food. And when you drink a soda, that’s just a drink, you know, and. And you kind of know it’s bad for you, but it’s more of like the, oh, that’s just not good for you in general, overall health. But I’m just a, you know, guy in his 20s and can just eat and drink and I’ll deal with that or have a donut or something like that. You know, I didn’t know at all that at that time that it can increase inflammation. It could be a primary source of autoimmunity and why I’m experiencing what I experience. So for many years the biologic I was on worked really, really well and ate whatever I wanted. I ate pizza, I ate junk food and things like that. But then it slowly stopped working. I didn’t know that, I didn’t know that my body could build resistance to the biologic.

Clint – Well, hang on a second. The way that I put this is, the biologic can only work so long against the awful onslaught tide of the bad diet. So I don’t view it and I could be wrong here but if we position this as look we’ve got this expensive medication that’s been researched to the wazoo and it’s designed to be highly effective. But if you continue to drive dysbiosis through obvious like the stressors obviously that you shared with us earlier, as well as the massive impact of those processed foods, high fat foods, high protein foods with very little nutrition, how is the biologic going to continue to hold off that inflammatory process? So that’s how I view it. We need to support that drug and we need to get behind that drug and to create as much microbiomes Stability and diversity as we can and reduce inflammation as much as we can. So it has an easy job. I just wanted to jump in and share that thought.

Nishant – Well, that’s what I appreciate so much about you and your program because you have such a balanced view on that. You’re not saying get rid of your biologic, you’re not saying get rid of your steroids. You’re saying use it in addition to this and use them together to serve and to work. Because certainly for me, even when I went through when the biologics stopped working, um, you know, I needed I rebelled against it. You know, once I learned that nutrition was a primary influence, I started juice fasting and thinking that was the answer, but I was already so inflamed. And I wish I had your program years before when I started learning. I learned that nutrition played a role in autoimmunity through a very popular documentary. This was many, many years ago called Fat, Sick and Nearly Dead. Yeah.

Clint – Joe Yeah.

Nishant – Joe Right. And I didn’t know anything about juicing at that point. I didn’t know that, hey, I can go into juice fast and that might impact the body. And because I’m getting nutrition and it’s bathing in my cells and that could be of support. The only thing is when I did do a 60-day juice fast and that was my first experience of doing it, the only thing is I was already inflamed or I got even more inflamed. And I was so, oh, I could heal my body without medicine. Because I was so inflamed, the juices just certainly didn’t work at all, I was losing a lot of weight. I don’t know how much it is in kilograms, but I was I went from basically like 150 lbs, which is kind of my normal to 125. And I was bones, I was skinny, I was walking with a cane.

Clint – You lost 11kg. Yeah,

I lost a lot. And I was holding on to this idea of this is the answer. This is the answer because I had fear of getting back on biologics or side effects and then, oh my gosh, this biologic no longer works inside of me. I did get an anaphylactic reaction to the biologic that I originally started with. That’s actually what led me to get off of it, which I didn’t not know was going to happen either. Um, but it was time. And so, um, but throughout all of that, mentally life started getting really, really, really heavy and depressing and, you know, walking with a cane and, you know, being skinny and bones. And when I was on just as a kind of different thing, I was very, um, at a certain point in my 20’s, I really enjoyed bodybuilding. I enjoyed going to the gym, I enjoyed lifting a lot of weight. I think that was part of my psychological way of counteracting what psoriasis had kind of done to my self-esteem. And I really loved it so much and enjoyed the love of bodybuilding and things like that. And I was no bodybuilder or anything like that, but just for me being a kind of short guy and being able to lift it was such a big accomplishment for me and it took a lot of pride in it. But then once the autoimmune condition kicked up, all that kind of got wiped away. And so I’m walking around barely with any muscle, definitely can’t lift as much as I used to. And that was that was a big part of my identity and what I was trying to put forth into the world. And that got taken away. And I think that’s what happens for a lot of us dealing with whatever autoimmune conditions is our identities kind of get taken away, whether it’s around the body, around relationships, or around career, because now you’re in pain and you have to somehow function while in pain. Unless you’ve been on the autoimmune journey, people don’t really understand it fully. They know you’re in pain, but until you’re in it, it’s hard to really understand it and still have to put a smile on your face, so to speak, and say, Hi, Hello, how is your day going? It’s like that becomes really heavy and hard and challenging at times too, you know?

Clint – Oh, no doubt. I mean you’ve, so you’ve been told that you’ll have this for life originally and that and you’ve thought no girl will want me. Then you’ve gone on to these medications and that’s that that has really worked for you which has been excellent. But you’ve continued to sort of drive the underlying processes through lifestyle. You’ve gone to the gym and found passion with that. And you mentioned that it was something you really enjoyed. I think all men should work out and I would probably extend that. Now, let me just rephrase this. I think all men need to work out because, I mean, we’ve not given sort of athletic shaped bodies to just sit around at a desk. And I think that all women should be doing exercise as well. And it doesn’t have to be maybe so much working out, but all human beings should be physically active, right? And so we all feel good when we look better and stronger and women, too. So I think we all need to be doing that. And it is our self-esteem, and it is our self-confidence, and so on. And then you’ve had that taken away, you’ve then done a juice fast and it hasn’t worked for you and you’ve thought that was the answer. Now you feel like you’ve got no options, no hope because there’s what you thought was going to work, didn’t. You’ve lost the thing that you love. You’re now, with all your regular workouts and so on. No wonder you turn to like, what can I do to deal with this emotionally? Like you’ve set the ideal platform for, oh my gosh, like mentally, how do I get through this?

Nishant – Exactly. And so like my search, you know, because I was actually diagnosed at the age of 20 with anxiety and depression and so and kind of dealt with it throughout my 20’s because of a lot of variables and factors in my own personal life, but also because of autoimmunity and dealing with the condition and everything like that. And so I was trying to understand kind of a general thing as to why we humans suffered and what we could do about it, psychologically speaking. And that kind of led me into learning a lot about spirituality was always in the bookstore, I was always trying to read. I read hundreds of books, trying to self-help kind of books, trying to understand how to take care of the mind and how to deal with it. And a lot of scripts just kept talking about how the mind created a lot of our suffering, meaning our thought processes and belief systems. And through that journey I met a lot of different spiritual teachers and they taught me a lot about how our thoughts influence the way we feel and the way we show up in the world. And for me, I always thought, no, my body is this way or have this condition or this thing happened in my relationship or this thing happened in the past, or this thing is going on in my career and that’s why I feel the way I feel. Because it just feels natural in our human journey that something external is occurring, which is why I feel the way I feel. And what I learned in my own personal journey was that it’s an internal game, it’s an internal thing that’s going on. And that it’s what we’re believing and thinking while we’re on that journey that influences the way we feel and a lot of what goes through our minds, meaning the thoughts that go through our mind feel very real and true. But they’re lies.

Clint – Is this the interpretation of the event is the event?

Nishant – Yep. Yeah, exactly. It’s the interpretation, right? It’s your beliefs, your perception, your interpretation, how you see it and um. Yeah. And how that influences your emotion and so forth. I didn’t know that. I mean, that’s a skill you kind of learn. It’s a skill I teach my clients, um, you know, with whatever they’re coming in with.

Clint – I first crossed that with Deepak Chopra when he talks about the physiological impact of cortisol and adrenaline and so on when they analyze a group of people who go on a roller coaster. And those who found the roller coaster scary, developed pro-inflammatory molecules in their body. But those who found the exact same roller coaster exciting and fun and wanted to go back on it they had endorphins circulating in their blood that were anti-inflammatory. So you’ve had the exact same experience these groups of people, yet one has a pro-inflammatory experience and the other has an anti-inflammatory experience and they’ve had the exact same experience because they’ve interpreted it differently.

Nishant – Exactly. Yeah, exactly. That’s the essence of it. And then it’s a skill to begin to give the emotions that you’re feeling or right to life because the emotion just doesn’t typically just happen on its own. There’s usually an interpretation that we’re not so conscious of, sometimes we’re conscious of it. And so we can begin to learn as a skill, to give an emotion, a right to life, begin to see what’s the interpretation behind it, and then question it and help us see that, hey, maybe what I’m thinking and believing isn’t necessarily true. And that’s kind of most of the stuff that goes through my head in general is not necessarily true, but because our minds are meaning making machines, they’re just cranking out assumptions and it’s not a bad thing, it just kind of what it does. And sometimes those assumptions, they can feel very real and impact the body and impact the way we show up, but it may not necessarily be true. And so it’s important to learn how to take power back from that.

Clint – Yeah, this is fascinating. So can you now teach us? Tell us some things. We didn’t quite finish your story, but I’m wondering I’m really interested to hear what you have to say now about your teachings and so on. Why don’t you just tell us, like in a short summary, how you are today, how things are going if you’re back on the drugs, how you’re managing this in really sort of bullet point and then begin to educate us what we can do on the mindset and the emotions and stuff.

Nishant – Sure. So right now am on a biologic and it works really well and I’m pretty much on a 95% plant-based diet. The only thing I might cheat with is dairy, but that’s just more of a need more discipline in my life around that. And I sometimes allow myself to cheat, I guess you could say it’s mostly a sprinkle of cheese here and there kind of thing. Um, that’s where I am right now. My body’s doing really well. I was in the gym earlier today and I was able to work out. I function, you wouldn’t be able to tell that I have autoimmunity. I still deal with something I’ve dealt with throughout the journey of autoimmune is fatigue. I do get that and feel tired at times more so than I would say other people. Um, but that’s getting a bit better overall. I just have to, you know, take care of my sleep and, and make sure I exercise. Exercise is kind of a number one thing that’s like mandatory. Out of everything I think that that’s been the most beneficial is getting into. Even when I’m in pain, surprisingly like it’s the most beneficial.

Clint – The exercise?

Nishant – Yeah, the exercise component of it because that just hasn’t for whatever reason, my body has an anti-inflammatory effect for sure, and I think that’s true for probably all of us.

Clint – So much so, so much so. And I keep harping on about this because once you get into a debilitated state, it’s going to be the last thing people want to do. Oh, for sure. They’ll eat buckwheat all day, but they just won’t go to the gym, they won’t get it. And it’s because they just can’t see beyond the pain. Okay, well, thanks for sharing that.

Nishant – Can I share a quick story about exercising the anti-inflammatory effect I had on my body. Just a quick story. So usually my psoriatic arthritis affected my Achilles tendons and then different tendons in my back and in my shoulders. But there was an experience I had a few years ago where it swelled up my right knee and I don’t really get any inflammation or anything like that. And so I said, I’m going to take myself to the gym, and it was really hard because it’s like I’m hobbling and it’s uncomfortable and it’s swole pretty big. I knew I had to get to the gym and exercise to help it out. And so I went on the I don’t usually do the bicycle, the recumbent bike, but that’s what I could do because my knees were literally swollen. Probably day after day after day, within like three days, the swelling had reduced dramatically. And even though exercise, I wouldn’t say necessarily made such an impact on like the Achilles tendon or other tendon, but I saw a direct effect of doing exercise on my knee and it really helped the healing process to get rid of that. I don’t deal with knee pain in particular. My arthritis doesn’t impact it in that area, but when it did, the exercise really helped it out a lot more so than anything.

Clint – Awesome. 2 little things from my experience to add to that. Number one, after our wedding, I got on a stationary bike every single day for the entire month that I was staying at my mother in law’s house in Florida. And at first I had zero resistance and I had the bike height, the sorry, the seat height as high as possible because I just couldn’t put any pressure through an acute angle of the knee. And I might have done five, six minutes with no resistance on day one and then, seven minutes, no resistance, day two. By the end of the month, I was not awesome, but way ahead of that and was able then to walk around the neighborhood which was impossible for me when I first arrived at her house. And when I had to have a knee replacement then like 12 years later, um, I basically the prehab was just to get on a stationary bike all the time and just, and go through that process. And that was the physical therapists’ standard approach for people who are approaching knee surgery is to get on that bike and it was a recumbent bike. The other bike I used was a regular stationary bike, upright seat, which is my preference based on my physiological makeup of my body. I prefer that. But people should explore this definitely if they have knee problems. So thanks for sharing that.

Nishant – You’re very welcome.

Clint – Let’s tap into your expertise here.

Nishant – Yeah. So one of the things that and, you know, I could spend hours talking about this, but I’ll kind of just brush on top of the main points here is that one of the things that very much supported me in my journey of anxiety and depression and autoimmunity in general was learning meditative tools. So I’m also a meditation teacher and a lot of the more modern psychotherapies that have been clinically researched kind of offer a kind of meditative mindfulness kind of approach to things to in dealing with chronic pain, number one, but then also in dealing with the mind and how our minds have what I would call a constructive component and it has a destructive component. So when we human beings acquired a language a long time ago, the ability to language essentially we gained the ability to think. And thinking can serve the being that we are or it can destroy the being that we are, essentially. Just to make this simplistic, it’s like even though you’re just a human being sitting in a chair and I’m a human being sitting in a chair right now, our thinking process can pull us into a future that’s not here yet. About later today or something ten years from now, or go back into the past, you know, ten years ago. And one of the things that I love, there’s a saying that I got from a woman named Byron Katie, which is a meditative tool that I’ll share about in just a few short moments. She said, you know, if you want guilt and regret, get a past. And if you want fear and terror, get a future. And I remember when I first heard that, I was like, Yeah, that’s kind of right. When my thinking goes into the past, it’s not like the happy-go-lucky stuff. Or when my mind projects out into the future it’s never lighted up bright rainbows and sunshine, it’s usually fear-based or worry based and so forth. And so one of the things that I found very valuable was to learn how to be present in the here and now and to begin to take my power back from my by learning to question it.

Nishant – So when I was going through chronic pain, you know, at different stages of it, I noticed that I would have these thoughts that I think are common in general with people dealing with autoimmunity. Some of them might be like, it’s going to get worse, or I caused it or, I’m supposed to be productive, let’s say even something like that, or it’s going to be bad. And those kind of thought processes that come up inside of us can make it exponentially harder just to deal with the pain that we’re dealing with in the moment and compassionately be with whatever showing up, right? Because sometimes it is I can’t move today and I got to compassionately deal with that, right? Or I can go to the doctor slowly but surely, or I can get to that exercise bike and move in a direction that serves me as best as I can, as the moment dictates, as is needed. But when this comes at you like that, it can make it very depressing and make it very hard or exponentially harder to deal with that.

Nishant – There’s kind of two different angles that can come here, like when dealing with the actual chronic pain that you’re dealing with from an emotional-mental component is the more you resist it, the more it tends to persist, psychologically speaking, right? So from a psychological pain perspective, more so than the physical pain because the pain is there. But then what makes it a lot harder on top of it is all these thoughts that we have, like it’s going to get worse, the medication is not going to work and so forth. And those projections of the future then make it really hard just to be compassionate with ourselves and deal with the moment and what’s right in front of us. One of the things that I learned is that can I begin to bring an attitude of non-resistance to what’s occurring? So a thought like this shouldn’t be happening. Sounds very logical, sounds very like makes sense, especially when you’re in a lot of pain. But a thought like that, if held on to too tightly, which is a form of should’s so our minds can do should’s and shouldn’ts, you know this shouldn’t be happening or they should this or they should that. That form of resistance moves us away from what’s actually occurring in reality, and then it creates an internal environment inside of us that amplifies either anger or fear or sadness or depression and so forth. And so one of the things that we want to support ourselves through with some kind of meditative practice is to begin to allow things to be as they are, meaning not going to add resistance. Because the more and more I argue with reality, the more and more I lose. That mind’s argument with what’s occurring creates a stressful emotional response, which just then makes it even harder to deal with the actual physical pain that we’re dealing with. It’s already hard enough to deal with the physical pain that we all go through with autoimmunity, but then the mind can add it and make it even heavier.

Clint – Yeah. And it’s tough, what you’re talking about is tough. Like, I can speak from experience and say, if I woke up in the morning and there was a finger that’s a little inflamed, it’s like the world has caved in, right? What does this mean? What did I do yesterday? What am I doing wrong? What’s my microbiome doing? Did I sleep on it? Are there other joints going to be okay? And yeah, you go into sudden like hit the biggest red panic button there is. So what would be a better approach to that example practically.

Nishant – Well what I found to be helpful, which is a skill that you know, we can develop and learn, is to learn how to question your thoughts. And so it’s kind of partly educational where you got to learn a little bit about the nature of the mind around that. And so there’s a process that I learned a meditative tool called the Work of Byron Katie. Byron Katie is a woman and she’s 80 now, I believe. And for over the past 30 years, she shares this modality. And I’ve had the good fortune in my 20s to staff her events with 250 people from around the world, literally. And from morning to night, one of the things that we do is we begin to give our emotions a right to life and begin to question the thoughts that we’re believing. And one of the things that we learn is that when we question the thoughts that we’re believing, a lot of them are not necessarily true and that we can begin to take power back from the mind. So in that process, just to give you a bit of a shortened version, a little bit of education of how the mind can make it a little bit heavier is once you’ve kind of identified a particular stressful thought, like let’s say I’m afraid, right? Let’s say I’m in chronic pain and came out of nowhere again and I’m laying in bed and I remember having this happen to me. I had this thought, it’s going to get worse, right? And so there’s the emotion, there’s the fear. The fear would be the emotion behind the fear is the interpretation that we’re talking about. It’s going to get worse as an interpretation. Right? And so that’s the assumption, that’s the belief that my mind hands me. And so in the process called inquiry, what we do is we bring it to these four meditative questions in something called the turnaround. And so the four meditative questions are, Is it true? Can I absolutely know that it’s true? How do I react, what happens when I believe that thought? And the fourth question, kind of funky at first, but it’s a meditative question is, who would I be without that thought in that same situation? And the last part, the turnaround is we take the original thought and we bring it to the opposite side to open up the mind to different possible perspectives. It couldn’t see because we were so attached to the original thought.

Nishant – So, for example, even though my mind is predicting and it certainly did for me, it’s going to get worse. I’m laying in bed and I’m in chronic pain, a lot of inflammation in my body. That ability to go can I absolutely know that it’s true that it’s going to get worse. Help me to shift my relationship to that thought. It doesn’t get rid of the thought. It’s about shifting our relationship to it. And that’s what really meditation is about, it’s a shift of relationship to our emotions as well as the thoughts and assumptions our minds make. And a lot more than that, too but just for now, we’ll just kind of mention it in that way. And so when I’m able to go like, Well, I can’t know that just right now that it’s going to get worse. It kind of loosens the grip of that thought on me. Now, in that third question, how do I react when I believe that thought? This is one of the most powerful things I learned on my journey, whether it’s autoimmunity, dealing with relationships, dealing with career or any aspect of our lives, is that whenever we believe a stressful thought, the mind is kind of like a lawyer and it gives us proof and evidence that that thought is true, even though it might not be. And the way that it does that, and this is true for most people that I encounter with even my clinical work, it’s not always the case for everyone because I’ve met individuals that don’t really get images. We can get images of a past or images of a of a future. So if I believe a thought like it’s going to get worse, my mind might show me images of past of things that happened a year ago, two years ago, five years ago, and use that as proof as to why it’s going to get worse. Right? Or it can show me made up images of a future of me looking worse than I actually am in the present moment, or me being in the hospital or something like that. And that influences my emotional state. And a lot of those images happen on their own. They’re kind of called automatic and spontaneous thoughts.

Nishant – So one of the things to know about the nature of the mind and this is what in meditation in general, the first thing you really realize, if you ask yourself to sit alone for five, ten minutes is the thing doesn’t shut up, it just doesn’t stop. And it’s not about making it stop, but about shifting your relation to it. And so when it comes to the image making mind, if I say to you or anyone else, if I say, Hey, whatever you do, your life depends on it, your actual life depends on it. Don’t think of a lemon, don’t think of a nice round, juicy lemon. A lot of times what happens is there’s the lemon in our head that just automatically pops up, even I said, don’t think. And if I say don’t think of biting into a nice round juicy lemon, you actually might salivate because the physiological relationship between thought and body and there’s no lemon in reality. And so one of the things that I learned in my own journey through that process is how those images of the future, it’s kind of like being in a horror movie, essentially. We can learn to help ourselves come back to the present, realize how lawyer minds taking us into the past in the future. And compassionately question that and then go like, well I’m in pain right now, who would I be without the belief it’s going to get worse? Let’s say, as an example. Well, I would still be with my chronic pain, but maybe feel a little bit lighter. Maybe I’d be a little bit more at peace and then maybe I would have the energy that that scary future is creating to then go, what’s my next step here? Go to the exercise, go to the doctor, take the medicine, just lay there and just rest compassionately. And then all these different other options open up.

Nishant – Then in the last part, with the turnarounds as an example, it’s like it’s going to get worse. Well, the opposite of that, it’s not going to get worse. And we’re just inviting the mind to go, could that be a possibility? I know you’re really believing this side, but could that be a genuine possibility? And then how could that be? And then it’s like when you begin to see like, well, I’ve been through this before and it kind of got better. It just took a little time and it’s like, okay, the mind opens up to that possibility. And you can find more genuine examples to open it up. That’s one of the primary meditative tools that I eventually share, even with my clinical clients that aren’t dealing with autoimmunity. But what I certainly found beneficial was noticing how the meaning making machine of the mind just made it super hard to deal with just the difficulty of dealing with chronic pain and that resistance that those thoughts create. There’s something we could do about it just to guide us and support us and help us out.

Clint – When I was listening to that, I was trying to think of the layman’s term or description or metaphor of that for my own benefit, because I haven’t heard this description before. But I do know that the mind tends to always go into protective mode. And a protective mode can be a fear producing mode because it doesn’t want us ultimately to die. And so it presents us with worst case scenarios.

Nishant – Yes.

Clint – Now what you’ve shared is and now this is my sort of metaphor here, it’s almost like the mind receives some information that it’s interpreted as bad, which might be inflammation in the finger. Okay. Yeah. And then if that were a Rubik’s cube, it goes from a pristine state of six sides of perfectly aligned colors to move move, move, move, and suddenly it’s almost contorted into what is no longer a beautifully aligned position. And what you’ve described is almost chiropractic moves to reverse those out so that it can get back into with 4 or 5 nice little steps back into the nice Rubik’s Cube balance that it was before. Because the only reason it got misaligned and entangled and contorted is because the brain reacting to a stimulus that it considered to potentially kill us if it were to go on to an extreme example. And so you’ve reversed out the brain’s contortion.

Nishant – Yeah. Love what you said there with like, you know, the mind is trying to protect us. It just doesn’t do a great job, you know, like like even with it’s going to get worse. Like, I was just showing how as an example, we can question that. But it kind of seemed logical, like it’s trying to help us out here, right? Like, watch out, it’s going to get worse. Like do something right. But what you really realize is the effect of it is just kind of makes you sad and depressed and then kind of takes you into images of a future, images of the past. And then that actually kind of paradoxically makes it a lot harder to do the efficient thing, which whatever it looks like, situation by situation, right? Get to the exercise by, go to the doctor, take the pill, just rest in bed, whatever the situation dictates.

Clint – Okay. So meditation has two benefits. One, we know that meditation has benefits towards actually oxidative stress, also overall emotional stress. And I think we could go into the literature and you could probably share it and know it all off the top of your head. But so many different benefits that are proven in those aspects. But what you’re saying is it also helps us to then make calmer and probably better decisions immediately after the meditation. So we then actually are better action takers?

Nishant – Yes, that’s my experience. So this process I was sharing with you the work of Byron Katie also called inquiry is a meditative tool. There’s so many different meditative tools out there and I literally talk to you for hours around it, but it’s one of the most powerful ones that came across into my life. And I use it in different aspects because I didn’t know about lawyer mind and how the mind can do that. It just, you know, how images influence us and how the mind can project all those fears, and then that makes it harder to be efficient. And once I kind of realized when I begin to question my thoughts and take power back from it, the assumptions that I make, it actually was really compassionate and kind to me as I’m dealing with the pain, as I’m dealing with just functioning in life and so forth. And even just to add a little had mentioned it earlier about it’s our mind’s resistance to reality, it’s an argument with reality that adds a lot of our stress. So like another thought is kind of come from should’s are supposed to right? Like I’m supposed to be productive. Because I certainly had a strong desire to be very productive in my life. I took like pride in doing that and being independent and productive, and then I’m in pain. And so it’s like, not today. Nishant You know, and you don’t don’t get a vote kind of thing, but I can have that thought I’m supposed to be productive and when I question and ask a question like is it true? We’re inviting ourselves to align with reality and go like that thought’s not true. How do I know that? I’m laying there in bed in pain and that’s what’s supposed to be happening. It’s not that I condone or like it. It’s not like bring me a pain any day of the week, I’m happy for that. Right? But that thought creates a resistance and a metaphor I like to use. It’s like arguing with reality is like banging your head on a brick wall, waiting for the brick wall to change in order to be okay. So like a thought, like I’m supposed to be, let’s say productive or this shouldn’t be happening is literally me banging my head against the brick wall, creating my psychological pain in that moment, which then just makes it harder for me to navigate the difficulty of being in pain and so forth. So when I’m not banging my head on the wall and I’m able to stand up straight just using it as a metaphor, options open up. It’s like, do I go up? Do I go down? Do I go left? Do I go right? Do I just stand here? I see the wall for what it is. Maybe not today, I’m not supposed to be productive. And then how can I compassionately support myself as I’m there?

Clint – Do you actively avoid the word should?

Nishant – Through meditative practice, I watch when it shows up. It was a skill I developed. It wasn’t like I avoided it, it’s just I noticed the effect. That’s the third question, how do you react when you believe that thought? So I learned when I attached to a particular should. Oh, look, anger shows up now and fear shows up or disappointment shows up. And that movement away from reality created such distress inside of me. And once I saw that, that’s what the beliefs created inside of me, I was able to then move away from should’s and shouldn’ts and things like that. And still certainly a work in progress in different contexts and scenario. But it’s one of the ways that we can take power back from our minds and be more in alignment with reality. That’s also a part of the essence of meditation in general is being in harmony with reality. It’s not a condoning or liking, but it’s about being in harmony with it. And the more in harmony with we are with it, the more effective we tend to be, at least certainly in my experience.

Clint – And my mind just went to Oh, but that sounds like we’re accepting a situation that we don’t like.

Nishant – No, not my experience. There’s a subtlety. I don’t actually like the word. I’m a psychotherapist and I actually don’t like the word acceptance, I’m probably the one in the world. But for me, acceptance, if I were to define it another way, is non-resistance. So resistance would be going back to the metaphor, banging my head against the wall. This shouldn’t be this way. I should be productive. And so that’s banging my head against the wall. So I’m definitely not accepting, first of all, in the traditional definition of acceptance, but I’m resisting reality, I’m not in harmony with it. But when I’m in a place of non-resistance and in alignment like this should be happening, how do I know it? It is I don’t get a vote here and not that I condone or like it, but then that actually gives me energy back to then go, okay, I’m not wasting on banging my head against the wall. I have availability now to go. Do I go left? Do I go right? Do I go up? Do I go down? Do I move forward? Do I move back? Like those kind of options open up situation by situation.

Clint – Right. Okay, good. So can you tell us how much this has helped you with your own dealing with your health? And also, have you got an example for us or to where it’s helped 1 or 2 of your clients?

Nishant – It’s paramount, it made the biggest difference in my whole life of dealing with autoimmunity in particular, but also just, you know, every other aspect of my life, like career and relationships and so forth, because the common denominator is our minds relationship to that. So all this, even though I’m dealing with autoimmunity, is dealing with our interpretation of events, our interpretation of dealing with people and so forth, and learning how to begin to discover that who we are without those beliefs and without those thoughts is actually a kinder, more peaceful, compassionate, efficient person. And that’s a discovery that you make on the process. And we didn’t get into it, but just a quick snippet of it. I had mentioned the thing about being 17 and then, you know, think I’m a gargoyle and things like that with the way I looked. One of the beautiful things about meditation, which we don’t have to go into, is that you can also discover through other practices a sense of self that is not dependent on the body. Where your body is a vehicle, of course, that we use, the five senses we use thinking, we use feeling to navigate the world. But it’s not necessarily me. What you are is more than this. If you want to get sciencey the word consciousness, if you want to get theological, you can use the word spirit. Other traditions use like awareness, and we touch into this kind of grander sense of self that’s whole. But certainly you don’t feel whole when you’re dealing with autoimmunity, your mind will give you a boatload of reasons why you’re not whole. And so that’s also one of the beauties that I gained and still continue to discover in different ways a sense of wholeness that is not contingent upon the body having to show up a certain way.

Clint – I love it. You can give us an example of a client in a second. But do you feel that having a scheduled meditation practice each day is best or, and also meditating when we’re in a crisis moment where we feel that the inflammation has risen?

Nishant – I think a daily practice is beneficial. There’s so many different daily practices, like I share a bunch of different inquiries, a type of meditation. It’s really, like I said, a shift of relationship. So when you begin to see that a primary source of our emotional distress, whether it’s autoimmunity or other areas of our life, is coming from what we’re believing in thinking, as you said, the interpretation of events, that’s a skill. It’s not like we came out of the womb knowing how to do that and I had to learn it. My clients are learning it, other people, have taught it to me and shared it with me in their own language and in different ways. So having a consistent meditative practice is really about shifting your relationship to your mind, to your emotions without trying to get rid of your emotions. It’s actually giving it a right to life, but in a very compassionate, constructive way.

Clint – Mhm. Okay, good. Yeah, What I always laugh at is I laugh at how I have to convince my conscious mind to go and meditate when it’s the conscious mind that benefits the least from the meditation. So you almost have to just bypass the thought of is it a good time? Or is this going to be good for me? Because you’re asking the questions of the one particular aspect of your existence that will say no.

Nishant – Exactly. That’s so true. And so that’s why when my clients ask me, like, when should I meditate? I’m like, whenever you can fit it in the day, I don’t care if it’s morning, afternoon, night, just get it in. Put an alarm clock somewhere. Let it remind you to do it and go for it. Yeah.

Clint – I love it. And then would you like to share about a client that you’ve been able to help with a with a condition similar to ours?

Nishant – Well, in terms of, you know, what actually sparked this conversation between you and I was literally I was working with a client last week and it’s not necessarily autoimmune, but she suffers from the I guess you would label it a disorder of migraines. Um, so she dealt with migraines a lot and she did eliminate gluten. And she told me that was supportive in her life journey. So just a side, just a side note for migraine sufferers, maybe that might be supportive. But when we were working together, I realized that a lot of these thoughts, the same ones that I dealt with when dealing with my autoimmune condition, are talking to other people, doing things like it’s going to get worse. You know, I’m supposed to be productive, Um, you know, this is never going to get better. The medications aren’t going to work. And then, you know, certainly fears around taking medications and side effects and the thoughts around that. And so she certainly benefited. And I’ve been working with her for many years now for different reasons, but she certainly benefited from being able to question the thought. And she even said herself like, thank you for helping to meet the need of the moment because her mind was certainly taking to into the future and creating so much fear. And you could see the kind of the tears coming up. And by questioning her mind, she was able to go, here’s what I can do now. Here’s my next step. It’s who we are without this belief, without this thought, it allows us to realign into the present moment and just do our next step.

Clint – And how are her migraines? Or is it too soon to tell?

Nishant – She deals with it on and off. And so, um, you know, too soon to tell and she’s done different things and she even decided gluten is certainly something that has been supported getting rid of that for her in particular. But one of the things that she benefited from was just she’s into meditation, into this work and that shift, the relationship to that fear creating mind has certainly been supportive in dealing with that.

Clint – As a sort of close up. Imagine you’re sitting next to someone on an aeroplane and you’re just walking off the aeroplane and they say, Nishant, you’ve got all this experience that you that I found from looking over your shoulder at your notes and stuff about psychotherapy and meditation. What would be just a couple of quick takeaways before we never see each other again as we’re walking off the plane, what would you say to that person?

Nishant – The most important relationship you’ll ever have in your life is not the one with your significant other, your children if you have any, or with your parents or your friends. It’s actually the one with your own mind, with your own thinking. Because at the end of the day, that’s the thing that influences your relationship with your parents, your significant other and your children, and so forth. So our relationship with our mind, which is a skill to understand what that even means and how thinking has limitations, and how we need to take power back from it is a skill that we can learn and develop. And what I would add on to there is that it can be a real support and benefit in experiencing more clarity, freedom, and inner peace in life. If we can begin to learn how to question our stressful thoughts. And begin to learn how to. Yeah, I’ll just say the kind of same way to take power back from the mind.

Clint – Love it. Now, could you please give us your website and tell us if you do telehealth or only local New York based clients? And tell us also a couple of resources that people could look into that you like or recommend, such as books or online programs.

Nishant – Yeah. So my website is www.therapywithnishant.com, that’s my therapy website. And so I only work with people locally in New York. I’m only licensed to work with people in the state of New York. So usually if you’re in New York and you’d like support, you’re more than welcome to reach out. Um, right now I do telehealth, but it’s with people that are in the state of New York. That’s where I can that’s where I’m licensed as of this point to, to work with individuals. And in terms of resources and books, you know, Loving What Is, is the first book of Byron Katie. That’s the original book that she created. She has many other books, but that’s, that’s the first book that she wrote to share about this practical inquiry. You can also go to our website. It’s called www.thework.com. She has a podcast where she works with people doing this actual meditative practice with people on different topics, it’s not just autoimmunity, but different topics. And so that could be good exposure to learning more about that process and skill that we’ve been talking about today and what served me in my own autoimmune journey.

Clint – Okay. All right. Thanks, Nishant. This has been really, really interesting and really appreciate your time and sharing with us. And you’re doing some amazing work with your clients. And it’s been great to also to learn your strategies and your journey so far with psoriasis and psoriatic arthritis. You look, as you said, that some people said to you in the past super healthy, handsome and well and no apparent appearance of anything other than health. So congratulations on how you’re living your life with this challenging condition. And thank you so much for sharing with us today. It’s been great.

Nishant – I would just like to add one quick thing, just a huge gratitude for you and the program that you created, and especially it’s a component that really helped me out throughout my journey, which was the community you built. And what I mean by that, hearing your podcast that you had with people and hearing about their journeys and um, was really inspirational, especially when I was kind of feeling down and depressed and thinking that I was having the same thoughts and it’s never going to end. And all the things I did, the meditative work to help me out. But the community that you built and the compassion that you’ve shown through your work and working with other people and hearing their stories was of immense benefit. So thank you for bringing that component to my life of the community, along with all your kind of dietary recommendations and things like that. But the community is amazing and it was kind of one of the reasons I wanted to come here is just to share and just support others too, and just the way you have with so many people too. So thank you for that. Appreciate you for your work.

Clint – Um, well, that’s very kind. I appreciate that. And now you’ve contributed to that community, just as you said. So I’m grateful in return. And thanks for all that you do. I’m going to wrap up now and say bye-bye and let you have a nice rest of your evening there in New York. And I much appreciate it. Bye for now. Thanks, Nishant.

Nishant – Bye. Thank you.