The Power of Self Brain Surgery

Warwick Fairfax:

Welcome to Beyond The Crucible. I’m Warwick Fairfax, the founder of Beyond The Crucible.

Dr. Lee Warren:

I was doubly-wounded from the war and the loss of the first marriage and then the sudden loss of my son without any answers. I was really wrecked and didn’t know what the future would hold for me.

Gary Schneeberger:

What the future would hold for this week’s guest, brain surgeon, Dr. Lee Warren, was a breakthrough medical understanding that he’s dubbed self-brain surgery. The neuroscience-backed prescription he discusses with us this week boosts performance, connects science and faith and rewires your brain to overcome anything and flourish.

Warwick Fairfax:

Well, Lee, it’s so great to have you. Lee is Dr. Warren. Dr. Warren is an award-winning author, a neurosurgeon, Iraq war veteran, and he also writes and teaches and serves prescriptions for connecting neuroscience to faith for radical life transformation. He teaches the Art and Science of Human Flourishing on his podcast, the Dr. Lee Warren podcast, which is heard in 150 countries around the world. He’s got a number of books, including the one we will cover here, The Life Changing Art of Brain Surgery. He’s got some prior books, Hope is the First Dose. I’ve seen The End of You and No Place To Hide. This will be a fascinating discussion with Dr. Warren and just everything that he has got through and the wisdom that he has.

Gary Schneeberger:

And I just have to say at the outset work and Lee, I’m experiencing a crucible right now because I’m the least accomplished person in this room. It’s good. A little humility is always good for me.

Warwick Fairfax:

Not at all. Not at all. Lee, before we get to your book, you’ve had your share of crucibles and that has really, I think, informed everything you write about, everything you practice. Nobody wants to get learning this way, you’d like to read in a book or observe others practicing. It’s no fun to get learning this way, but in a way, you’ve got learning that is probably invaluable, not just to yourself, but to your patients and friends and family, hard run wisdom. Just talk about some of the crucibles with being in Iraq, as well as with your son. I have a feeling there’s an origin story behind the book that we’re going to discuss today.

Dr. Lee Warren:

Yeah, thank you. It’s an honor to be with you both today. I grew up in Oklahoma and always wanted to be a doctor. I was raised in a Christian family and had this, I would call it fundamentalist, legalist sort of theology, where control and good behavior were supposed to equate to a good life. And so if you did everything right and worked hard, God was supposed to take care of you and I believe that. And then, I went to medical school on scholarship from the United States Air Force and married very young at 19 and went off to med school and then residency. Long story short, my marriage didn’t survive all those years of training and education and hard work and all the things. By the time I deployed to the Iraq war, I was basically at the end of a 16-year marriage that was going very badly. I was at war when I found out I was getting a divorce. And then, I got home from the war after having done 200 brain surgeries in a tent hospital and surviving 120-some odd mortar and rocket attacks and found myself six weeks later out of the Air Force and divorced and moving from Texas to Alabama to try to reconnect with my children. And basically, didn’t have time to deal with the trauma that I experienced in the war, because I needed to go and start a practice and figure out how I was going to earn a living and take care of my kids. I really just stuffed all that trauma from the war down and put it in the trunk in my garage with all my uniforms and all of that and never dealt with it. And then fast forward a couple of years, I managed to reconnect with my children and had a good relationship with them and started a practice that was successful and ended up meeting and marrying Lisa, who I’ve now been married to for 20 years, and we blended our families, and it felt like things were going to be okay. Kind of got back on my feet and felt like God loved me again and all the theology that I had that was kind of skewed towards behavior that had taken such a big hit. I was finally figuring out who God was and how my family was going to be able to be all right and managed to navigate through the PTSD that came out of all of that and the war coming back. In 2013, on August 20th, my son, Mitchell, who was 19 at the time, was stabbed to death. It was just at the moment when I thought I was going to be okay that the worst thing that I could ever imagine as a parent happened. To make that worse, he and his best friend were both killed in the same house that night and the police never figured out what really happened. They sort of decided what they thought happened, but they never really solved it. We, basically, were given this devastating loss without any answers as to what happened. And so, I was sort of talking about a crucible, losing a child is hard enough, but to not really understand what happened or have any ability to say, “Okay, this guy did that, and now at least I understand sort of the answers.” We just weren’t ever going to get any because the police told us that the crime scene had been cleaned, there was no more answers coming. This was the end of it. There would never be any … unless somebody came and confessed, they weren’t going to figure out what happened. We were given this situation that me, as a control freak neurosurgeon, who wants to be in control of everything, literally couldn’t do anything about the fact that my son was dead and I would never know what happened. And so that sort of blew me up. It made me question God. It made me question whether I thought he was real or whether he loved me or … I just didn’t know what my life was about anymore for a little while. I was doubly-wounded from the war and the loss of the first marriage and then the sudden loss of my son without any answers. I was really wrecked and didn’t know what the future would hold for me. As it turns out, that began the process of me starting to understand how science and faith worked together, because I had a long history of scientific training that your brain was stuck and fixed the way it was made. I think most of us think that, that you are the product of how your brain works and that if you go through something really hard and it messes your brain up, that that’s just how you’re going to be, that there’s not a lot of hope beyond that. And then, I had this faith that you were supposed to be able to get stronger through hardship and find hope through all of it and all of that. And I didn’t know how to put those two things together, so for a while after that, I was searching for how to put it together. I think that’s where this story really starts.

Warwick Fairfax:

Losing a son has got to be up there with the worst possible thing that can happen. But the fact that there was uncertainty about what happened, I think you’ve written elsewhere that your son was somebody that was very sensitive, and he was with a buddy of his and somehow they were both stabbed and the police said, “Oh, nothing to see here. It’s just a mutual murder suicide or whatever.” And you’re thinking, “That’s not Mitch, that’s not possible.” So you’ve got to deal with the twin tragedies of losing a son and the sense that there’s something that we don’t know and that we’ll never know. How in the world did you get over the fact of not just losing your son, but sensing, “There’s something that’s not right here, there’s something unexplained that makes no sense, but yet there’s nothing I can do?”

Dr. Lee Warren:

Yeah. We had this moment, Lisa and I had, I had a friend who was a police chief in California and I called him and told him the whole story and laid everything out. And he said, “Lee, if that happened in California, we would’ve had the FBI there. We would’ve had the State Bureau of Investigation. We would’ve kept that crime scene active until we followed every lead.” They didn’t even dust for fingerprints. They just cleaned this place up. There were three bloody knives and both boys had multiple stab wounds and it was just a crazy thing. They just walked in and they looked at the scene and said, “Oh, this guy must have killed that guy and then killed himself and that’s it,” and they took the bodies out, cleaned the crime scene, it was over. My friend said, “You need to subpoena the police report and the records and you need to file a police malpractice or give me all this stuff.” Lisa and I talked about all that and we realized that this is going to go one of two ways. We’re going to go down this path in this small town in Alabama of demonizing the police work that was done and demanding answers and we’re not going to get any because we already know that unless somebody confesses to this crime, nobody’s ever going to know the truth, like those two boys are gone. We’re going to become these people that stand outside with picket signs and yelling and protesting and demanding answers, and it’s not going to bring Mitch back and it is not going to help us heal and it’s going to destroy our family. We could just see that really clearly. Or we had to trust that God’s plan included enough power and grace to satisfy our inability to know more than that. And we just had to step out in faith that that was the path we were going to take as a family, that we were going to decide we couldn’t know more than we know, and we were going to decide that we were going to have to be okay with that. Those two decisions, I think, really put us on the path of then searching for how we could heal in spite of not knowing what happened.

Gary Schneeberger:

It’s interesting, Lee, that in the two stories that you’ve told, one, you had to open the locker that you had put away to fight healing. And in this one, you had to not open the case, if you will, that was going on. I imagine they were both difficult to go through. What was perhaps the most difficult or what did you learn from those experiences? Has it taught you anything about sometimes you have to be quiet and just let it be what it is and sometimes you have to fight?

Dr. Lee Warren:

Yeah, I think so. I think, in the first case, it was wounds that had not been examined and explored. And because of that, they never had an opportunity to heal. And so, until I was willing to say, “Hey, I had been wounded.” Because I was the hard charging neurosurgeon control freak and it wasn’t in my worldview that having gone there and undergone all that and taken care of all those people could have been an emotional wound to me. I didn’t ever say, “Oh, I’m damaged in some way. I’m hurt in some way.” I just stuck the stuff in the corner and got back to work, and so I never really processed any of it. I think there was this necessity of, and now we understand from trauma literature really well, that it is important to name the thing, you can’t really know it if you can’t name it, name the thing that hurt you, and then explore it and be willing to share it and bring it into the light with other people before it can become able to be disinfected and healed. I think that was a release of control and of my own sort of idol of self-sufficiency that I had to say, “I’m going to allow other people into this wound with me.” And then the other case, it was this sort of letting go of the control of being able to get to the bottom of something, because as a surgeon, if something’s wrong with you, I’m going to get to the bottom of it. It’s my purview to know everything I can know and take command of it and master it and fix it, and that’s just how I work. That’s what I’m supposed to do. And you want your neurosurgeon to be that guy. You don’t want me to go, “Oh, that’s good enough. Close enough. We got your brain almost all the way back in there.” But you don’t want that from your neurosurgeon. But in this case, it was crystal clear. There was no possibility that I was going to be able to engineer that situation in a way that would resolve it. And so therefore, I was either going to be spending the rest of my life on a pursuit that was already impossible and that would have destroyed my marriage. It would have hurt my children. It would have continued to wreck my reliance on God and it was going to be about me trying to find something I wasn’t going to be able to find. I think they’re both the same in the sense that they required a laying down of control and they’re different in the sense that one required openness and one required a willingness to close the future on a situation and just be okay with it.

Warwick Fairfax:

I want to get to some of the themes in the book because it’s so fascinating. Again, the book is The Life Changing Art of Self-Brain Surgery: Connecting Neuroscience and Faith to Radically Transform Your Life. It’s sort of this idea that we have a lot more control over our circumstances than we think. One of the things that starts with, you talk about modern brain imaging and neuroscience and how, depending on how your thoughts work, you can actually see changes in the structure of your brain. That seems to me a game-changer and elsewhere you talk about, again, I’m not a scientist or a neurosurgeon, so you’ll have to help us with this, you talk about the concept of epigenetics. There was a school decades ago in which, “Okay, your genes are determinative. You are what your genes are. I can’t help it, because my mom or dad or my grandpa or whatever,” whereas you write here that that’s a factor, but a vastly smaller factor then, so we have a lot more agency. Talk about some of those early concepts about imaging and what we now understand about the brain that’s so different than accepted science from decades ago.

Dr. Lee Warren:

That’s right. Most of us have believed this idea really since 1953, when Watson and Crick gave us DNA, like you just referenced, gave us the understanding of what DNA is, that it’s become really popular in culture of this thing called genetic determinism, which basically is how the genes you inherit and the parents you have determine most of the things that are true about you and your capabilities and your possibilities for you and all those things. And also, simultaneously, since Isaac Newton was alive 300 years ago, the idea that you could understand something by breaking it down to the parts from which it is made and then putting them back together, you could reverse engineer what something’s capable of. And then they applied that same idea of this materialism, we called it, of if you understand the parts, you can understand the whole, they applied that to people. Basically, your genes and your family and the stuff you go through create who you are and the cells in your brain make you feel and think and believe and do the things that you do. And so, you are pretty much just your brain, and if you happen to be born with a good brain, then good for you. If you happen to be born with one that’s autistic or has ADHD or has a weird enneagram or you go through the wrong kinds of traumas, then you’re just host and you can’t be different than you are because that’s who you are. It’s your brain. Most of us believe that to one extent or another. And I would say, I would challenge the listeners who are Christians, even Christians believe this to some degree. But if you stop and think about it for a second, you already believe that you’re not just your brain because you believe that when you die, some part of you still lives, that there’s some soul or something about you that is going to be eternal. And so, that means that the things that you think about as yourself, your personality, your memories, all those things, if you believe that those things are going to be permanent in heaven, then they’re not coming from your brain, so there is a difference in your theology between your mind and your brain. What’s interesting is, although science has taught us that since 1953 and since Isaac Newton in two different ways, that we are the parts from which were made pretty much. In 2001 or so, they invented a technology called functional magnetic resonance imaging. MRI, everybody knows what an MRI is, if you hurt your knee, we go put your knee in a scanner, we take a picture of your knee and we can see what it looks like. We can see what the thing looks like. But functional imaging is where we can put a brain or a heart in an MRI scanner and we can see what the thing is doing. We can actually see the electrical and chemical activity that’s happening inside an organ, and that’s why they call it functional. It’s what is this thing’s function and how does it work? We can put you in an MRI scanner in the early 2000s, and for the very first time, when you move or think, we can see what your brain is doing in response to that. That started to make some people question, maybe the brain and the mind are not the same thing, which again, Christians, if you really ever thought about it, you would have already thought that, right? What happened with us, I think it’s a grace of God too. I think God puts all of us in situations, where the way he has built us with our interests and our proclivities are sometimes the way he approaches us when he wants to teach us something or give us a gift in some way. Thinking about that, we lost our son and my wife, Lisa and I worked together, she ran our practice at the time. We were practicing in Auburn, Alabama on the third floor of a building on the university campus at Auburn University and that building was dedicated to functional MRI research. They had, at the time, this most powerful functional MRI scanner in the world. There were only three of them and one of them was there in that building. We lost Mitch and we didn’t go to work for about a month and we’re trying to grieve and recover, and the last thing I wanted to do was operate on somebody and take care of somebody. But at some point, reality hits and you’ve got to go back to work, you got to pay your employees and you got to keep your business going and all that. We went back to work, and in the same week that we went back to work, we were invited to go down to the research facility and watch some of these functional scans happen in a research environment. What they did was they put this woman in the scanner, she had some earbuds in so they could communicate with her. They turned the machine on and you could see what her brain was doing when she wasn’t thinking about anything in particular. They would say like, “Okay, move your right hand.” And she would move her right hand and you would see the brain light up and the hand move and you would see what happened. When she decided to do something, her brain would do something and then her body would respond and do something. And then they said, “Okay, Mrs. Johnson, think about the worst thing you’ve ever been through. Just picture in your mind the worst thing you’ve ever felt.” You would see her furrow her brow and think about something. Her brain wasn’t doing anything. She was thinking about something. And then the parts of her brain related to memory and fear and anxiety and pain began to light up on the screen, which meant that genes were being transcribed and neurotransmitters were being released and neuronal networks were getting activated. Shortly after that, we saw her vital signs, which were being monitored start to change. Her blood pressure would go up, her heart rate would go up and her vitals and her respiratory rate would go up. We saw her think about something that led to her brain doing something that led to her body responding in a negative way. And then they said, “Okay, stop thinking about that hard moment and think about the best day of your life, the happiest you’ve ever felt. Think about that.” Pretty quickly, the amygdala part of the fear part of her brain started to calm down and the frontal lobes came online, the bigger parts of her brain that are involved in thinking and processing reason and rational decision making and all those things. And then her blood pressure started to drop and her heart rate came down and her physiology improved in response to her changed thinking. We were watching that happen and my wife said, “That reminds me of Philippians 4, where it says, “Don’t be anxious, be grateful, and the peace of God will guard your heart.” These people are changing what they think about and it’s affecting their bodies in a positive way. I had this … I’m not a charismatic guy at work, Gary. I’m not the guy that goes around saying, “God spoke to me and told me this stuff.” I know he does that, but he doesn’t ever talk to me in an audible voice. But in that moment, something became crystal clear to me that I know was from God and it was, “Lee, when you go to surgery and you intentionally cut into somebody’s brain, what you’re doing is you’re on purpose, you’re making structural changes in their brain for the purpose of improving their life in some way.” That’s surgery. And when somebody thinks one thought and not another thought, when they intentionally change what they think about, what’s happening is they are changing the structure of their brain on purpose for the purpose of improving their life in some way, and that is also surgery. Just in that moment where we were standing in the scanner, I saw that when you think better thoughts, as the Bible said, you structurally change your brain under your own command of your mind, and that means you are choosing to perform surgery. You’re performing self-brain surgery, I’ll call it. That’s the day I was born, was this idea that I didn’t have to necessarily feel everything I was feeling about Mitch for the rest of my life, that I could learn how to harness the power of this ability to change what my brain was doing and learn how to navigate grief in a more empowered way. That began this now 12-year long process of trying to understand how science and faith work together to help us navigate these things in an empowered way rather than thinking our brains get to tell us what we’re going to feel and think all the time.

Warwick Fairfax:

That’s incredible. I want to get here in a moment to the 10 commandments of self-brain surgery, because that is amazing stuff. But before there, you’ve got these four approaches to life, and you start with the bottom in a sense, nothing can help me. Basically, give up, there is no hope, doom and gloom, that’s an approach. And as you said, even not making decision decision, then you go up to, I can be somewhat happy, maybe 10% happy, maybe science can help me, maybe God can help me. Just briefly, just talk about those four approaches to life and what you were getting at in saying you’ve got four different approaches.

Dr. Lee Warren:

Yeah. The first piece of that is that most of us feel that we are the way we are and that there’s not much we can do about it. So going back to that idea that you just are the product of your brain, that we’re just, this is how I am. And in today’s culture, that’s especially prominent because people are claiming identity out of diagnoses and labels that they’ve received, sometimes not even from professionals. You hear people say things like, “I’m ADHD or I’m neurodivergent or I’m enneagram six or whatever.” And they put that in their Instagram profile and that’s to tell other people how they expect to be treated so as not to be harmed or triggered in some way, because you’re not honoring their identity. We were grabbing onto these things that we think identifies as who we are. But what the science is showing is that your brain is constantly changing and it changes mostly in response to what you think about. If you are thinking constantly about being anxious, you’re going to become more anxious. Your brain is going to become more that way. When I wrote that, what I was trying to get at is as a surgeon, we use what we call approaches, which is a combination of philosophical and technical things that we look at how a particular operation or a particular problem, like a brain tumor, for example, how are the different ways that I could approach that, how would I need to position this patient on the table and where would I need to make the incision and what types of techniques would I need to use to get that job done? What happens to some surgeons is we get trained in a certain place by a really strong-willed professor and we get taught that there’s only one way to do a certain thing. And if we get in the middle of that operation and it’s not working, then we have two choices. We can either quit or we can press on and hurt the patient even though it’s not working. We can keep doing what we’ve been doing and try to make it work when it doesn’t work. But a wise surgeon learns four or five or six different ways to get every particular thing done. And if you’re in the middle of an operation and it’s not working, then you change the position of the patient or you switch to a different angle or you change approaches so that you can accomplish the goal of getting your patient through the operation safely. It seems like a lot of surgeons stick there because it’s almost an admission of not being wise or smart if they have to change the approach that they chose, like “I made the wrong decision and I’m using the wrong approach and I don’t want to admit that.” But it’s actually the best surgeons who are willing to pivot from one approach to another to get the job done for their patient. What I wrote in the book was that most people go through their lives just doing what they’ve always been doing and then wondering why nothing ever changes when we know that the science says that when you think a different thing, you get a different result, but we keep doing the same stuff in our lives and then feeling stuck and not knowing what to do about it. That first approach is just that people say, “Nothing can help me. I am the way that I am. This is just how things are for me. I’m just this guy. This is the way my dad was. It’s the way I am.” If you feel that, if you think nothing can help you, then guess what? Nothing can help you. That’s what’s going to turn out to be true for you. The second approach is that maybe something can help me. This came out of a … there’s a guy named Dan Harris, who was an ABC Nightline host, nightly news guy, and he had a panic attack on air in front of three million people one night on the ABC News and just went crazy. He treated that anxiety with drug use, which didn’t work very well, and he almost wrecked his whole life. And then, he found out about meditation, Eastern meditation. He wasn’t a believer, he’s an agnostic or atheist guy, but he decided that he looked at the research and saw that people who did this Eastern meditation got a little bit happier and seemed to be able to manage their lives a little bit better. He just took that and stripped all the spiritual stuff out of it and developed a meditation practice that produced what he called being about 10% happier in this life. He wrote a book that became a runaway New York Times bestseller called 10% happier. His idea was all you need is to just calm your brain down a little bit and you can be a little happier, and for most people, that’s enough. And for him, that was enough. But I tried to make the approach, the point in the book that if you have anxiety, then 10% happier might be enough. But if your son is stabbed to death or your wife has an aneurysm and dies in her sleep while you’re next to her, 10% happier is probably not enough because you’re going to be more than 10% sadder than you were before that. This idea that maybe something can help me if you’re a little hopeful and you press in, you’re going to find that there are some things that can help you and you’ll find some traction and for a lot of situations in life, that might be enough for you. But then, there’s other people that it’s not enough and they need more, and so they turn to science and they say, “Well, by learning how the brain works and by understanding the way we think and that our thoughts improve our lives, I can actually get significantly better in my life and I can develop a sense of purpose again after I’ve gone through something hard.” That’s all true. The research really shows it, that if you understand how the brain works and how the mind works, you can really make your life better, even if you don’t believe in God and even if you don’t ever take it to the next level. But I think, if you follow that approach, that maybe science can help me approach, I think you’re going to get to a place where you’ll find that there are some questions and some issues in your life that science doesn’t have an answer for. Certainly, for me, that was the case. I couldn’t science my way out of losing my son or understanding how to live again after I lost him. At some point, I got to a place where the answers I needed were not available to me using science. That’s where I said, “If you follow the scientific method, it’s not supposed to have ever been that we decide what we believe and then we reject any evidence that contradicts that. And that’s what happens to a lot of people, evolutionary biologists, a lot of materialists, neuroscientists, they decide upfront what they believe. There’s no God or this is how this works. And then, even if evidence seems to suggest something else, they just ignore that evidence and pivot and say, “We’ll figure it out later. This is still what we know to be true.” But if in your life you start bumping into things over and over that aren’t working and you do all the things and you learn all the science and you practice all this stuff and you just aren’t getting there, then it starts to be reasonable to say, “Maybe science can’t actually fix this and maybe I need something past the limit of what science can answer,” and that’s when it’s reasonable to start looking at another approach where maybe philosophy, maybe theology, maybe God, maybe something else can help me. What I believe with all my heart is if you’re a smart person, work and you’re willing to let the scientific method lead you, the scientific method is actually that you’re supposed to develop a hypothesis and test it, and when it doesn’t test out, you change your hypothesis until you find something that is verifiable. I believe if you follow that kind of rational frontal lobe approach to your life, you get to a place where science can’t solve it and you just let God tell you some things that he says are true and you test those things out and they turn out to work, that maybe they work because they’re true. And then, it becomes reasonable for a smart person to say, “Maybe this is true and maybe I should investigate it further.” And that’s what I wrote about in the maybe God can help me approach. I don’t think it’s a whimsical or a moronic approach to say that maybe God is a reasonable thing, a place to turn when I’m hurting. It’s actually a valid, rational, scientifically grounded approach, where I just let the evidence lead me and let the process of how to answer questions appropriately take me to this place where I understand that science hasn’t gotten me there and maybe God is actually real.

Warwick Fairfax:

I want to move to the 10 commandments of brain surgery are really fascinating. I’m going to read them briefly and then just give us a high-level overview of these, because this is probably the core of the book. I love this first one. This is profound. The first commandment is, I must relentlessly refuse to participate in my own demise. Sometimes we wonder who the enemy is. We look at the mirror and the enemy is us. Sometimes that’s the case. Second one, I must believe that feelings are not facts, they’re chemical events in my brain. How often do we … You write a lot about this. We have these feelings, but they’re not necessarily facts. The world is against me. Well, sometimes they are, but maybe sometimes they’re not to some people. Number three, I must believe that most of my automatic thoughts are untrue. You can easily go into autopilot with unhelpful thoughts. Number four, I must believe that my mind is in charge of my brain. Number five, I must believe that self-brain surgery is not a metaphor. It’s the mechanism of transforming my life. Number six, I must love tomorrow more than I hate how I feel right now. Number seven, I must stop making an operation out of everything. You’re talking about operations versus procedures, which if a doctor ever says to me, “I’ve got a big operation,” I’ll be worried versus a procedure, but anyway. Number eight, I must not perpetuate to start half a generational thought or behavioral issues in my family. Number nine, I must believe I’m getting better at what I’m doing. And number 10, I must understand that thoughts become things. This is profound stuff. What’s the best way to approach these 10 commandments? Because these are, obviously, very well thought out. What’s your overview of these commandments?

Dr. Lee Warren:

These came from, as I said, Lisa and I and our family trying to navigate the 12 years since we lost Mitch and me understanding that God had given me this insight to see this process of self-brain surgery as something that was already happening, and if you don’t take command of it happens in a default way that generally leads to more chaos in your life or staying stuck. And then, realizing that neuroscience and scripture have said a lot of things about how humans are best to flourish.