Dr. Gabor Maté and Dr. BJ Miller — The Tim Ferriss Show

Dr. Maté defines trauma not as what happens to you (e.g., abuse, loss), but rather what happens inside you as a result of those events. This includes disconnection from emotions and body, negative self-perception, and a defensive view of others, often stemming from childhood experiences.

Trauma of omission occurs when positive experiences that should have happened in childhood, such as sufficient attention and attuned connection from parents, did not. This can lead to self-disconnection, even if parents acted out of their own issues rather than lack of love.

Dr. Maté recommends various therapies, including Somatic Experiencing (Peter Levine), EMDR, Emotional Freedom Tapping, motor sensory integration, and intentional yoga. He emphasizes the importance of professional help for many, as self-healing is difficult.

Dr. Maté began working with psychedelics after his book on addiction sparked questions about ayahuasca. His first ayahuasca experience deeply connected him with profound love and revealed how he had closed off his heart due to childhood abandonment.

Dr. B.J. Miller is a hospice and palliative care specialist. He works at the Zen Hospice Project and UCSF, advocating for better end-of-life care and promoting societal attention to inevitable life truths.

Palliative care focuses on improving the quality of life for anyone suffering from a serious illness, regardless of prognosis, and can span many years. Hospice care is a specific type of palliative care focused on end-of-life, with an insurance designation that typically requires stopping curative treatments.

At Zen Hospice, death is typically peaceful, with staff and volunteers creating a warm, familiar environment and providing emotional support for families, culminating in rituals like a flower ceremony. Hospital deaths are often sterile, mechanistic, and lack the space for grief or personalization.

Witnessing many deaths has taught Dr. Miller the importance of living without regret, being kind to oneself and others, and valuing the preciousness of time. It has made him more aware of finitude and less likely to squander moments, emphasizing forgiveness and reconciliation.

After his accident, Dr. Miller switched his major to art history, finding that art helped him develop perspective and redefine his humanity. He appreciates art not just for its aesthetic value, but for its ability to help in creativity with reality and understanding the human condition.

Dr. Miller advocates for prizing purposelessness, delighting in things for their own sake without needing them to serve a grander meaning. This approach helps patients beyond a life of 'purpose' find joy in simple sensory experiences, such as smelling a cookie or feeling snow.

Dr. Miller is thrilled about the potential of compounds like psilocybin and MDMA to address 'existential distress' in end-of-life patients. He sees them as a way to foster meaning-making moments and a sense of belonging, an area where traditional medicine currently lacks chemical interventions.

He rides a special Aprilia Mana model with an automatic transmission (clutchless) and all controls (throttle, brakes, turn signals) customized to his right hand. A prosthetic component attaches his arm to the handlebar, and he uses his prosthetic feet to balance.

He would advise himself to let go more, not believe everything he thinks, and embrace playfulness and purposelessness with seriousness. He spent his 20s in an experimental phase and struggled with guilt, and his 30s included the death of his sister, making it a heavy time.