04 Why Seeing Fast is Important - a podcast by The InBound Podcasting Network

What the heck is a magnocellular neuron you say? Douglas W. Stephey, O.D., M.S. will tell us why is it important to attention, movement, reading, and understanding where we are in space. Furthermore, the magnocellular visual pathway also plays a role in staying out of being in a perpetual state of fight or flight. This visual pathway will be explained in easy to understand detail and will be differentiated from the parvocellular or what visual pathway.

Douglas W. Stephey, O.D., M.S.

208 West Badillo St.  Covina, CA 91723

Phone: 626-332-4510

Website: http://bit.ly/DouglasWStepheyWebsite

Videos: http://bit.ly/DrStepheyOptometryVideos

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Transcription Below:

Tim Edwards: The Move Look & Listen Podcast with Dr. Doug Stephey is brought to you by audible. Get a free audio book download and a 30 day free trial audible membership at audibletrial.com/inbound. You'll find over 180,000 titles to choose from, including several books mentioned here in the podcast. Support the Move Look & Listen Podcast by visiting audibletrial.com/inbound. 

Dr. Stephey: If our two eyes are not working together well as a fast synchronized team, our internal mapquest continues to be off. It's consistently inconsistent with our ability to judge time and space. Those that don't feel well-grounded, those that have some measure of anxiety, oftentimes it starts in the visual system. If you can't move, look and listen in a fast, accurate, effortless, sustainable, age appropriate, meaningful way, you're in a world of hurt. There's a whole world in vision and how it affects brain function that no one's ever shared with you. 20/20 is perceived as a holy grail of going to the eye doctor. Well, I'm here to change that paradigm. 

Tim Edwards: This is the Move Look & Listen podcast with Dr. Doug Stephey. I'm Tim Edwards, the founder of the Inbound Podcasting Network, and a patient of Dr. Doug Stephey. He located in Covina, California. Episode four today, Dr. Stephey. We're talking about seeing fast. Never heard that phrase ever. And I've said that a lot in the last few episodes. I've never heard that before. Going to visit various optometrists throughout the last 25 years or so when I first started wearing glasses. It seems like everything that you bring up, every time we get together, there's something new and enlightening regarding our vision and our brain and how our eyes work together. Seeing fast. Tell us what that means. 

Dr. Stephey: Yeah. What the heck? Seeing fast. What's that all about? Well, certainly come into the optometrist. 20/20 is perceived as the holy grail of going to the eye doctor, right? If you could walk out seeing 20/20, it's all good. 

Dr. Stephey: Well, I'm here to change that paradigm. Fundamentally, the world generally is made up of prey, animals and predators. And prey animals have eyes on either side of their head, like horses and rabbits and predators have eyes closely spaced on their face. 

Tim Edwards: Like us. 

Dr. Stephey: Like us. And the reason that's true when you really stop and think about it. Is prey animals have to have almost a 360 degree field of view because they want to know when a predator is coming to eat them and they need to be able to see fast themselves in order to give them enough time..

Dr. Stephey: To flee the scene. Right? Because prey animals generally don't have great fighting skills. Their abilities to survive another day is that they have camouflage and they're fast, short term sprinters, and then there's lack of movement. Like the proverbial deer in headlights. 

Tim Edwards: So they can either hide or escape quickly. 

Dr. Stephey: That's it. 

Tim Edwards: To survive. 

Dr. Stephey: So predators have eyes closely spaced on our face because we need to be able to see in 3D. Now inherently to that we have to use our two eyes together as a well integrated team. And we also have to be able to see fast. And we have to see a large volume of space. Because if you and I were out walking down a wooded trail and we're looking at something straight ahead of us at 12:00 and the deer that hurt us, or saw us coming was off at 10:00 and it's now holding still because it doesn't want to enter our visual radar. So you and I are looking at 12:00..

Dr. Stephey: There's a movement in our periphery. If we're able to see fast, one, we should be able to perceive the movement and two, we should be able to localize a general area space of where that movement is coming from. So that when we turn and look and use eye focusing, eye tracking, eye taming skills to localize where we think we perceive that movement well then we should kick in our pattern detecting abilities so we can break their camouflage. I'm pretty convinced that's why we like playing where's Waldo and word search puzzles and hidden picture things in the highlights magazines at the dentist office. Because it feeds into our skills. We're good pattern detectors. It's innate, it's innate. It's inherent in how we see that we should be able to see fast and use our two eyes together as a well integrated team to localize a target of interest in space. And that in its essence is predator versus prey. 

Dr. Stephey: So when you think about the anatomy of our sensory systems, vision, auditory, taste, touch and smell, there's about 3 million sensory neurons in those five systems. And of that 3 million neurons, there's about 30,000 auditory neurons per ear. There's roughly estimated to be 1.2 million optic neurons per eye. 

Tim Edwards: A big difference. 

Dr. Stephey: It's huge. So almost two and a half of the 3 million sensory inputs are tied up in vision. And of those senses, vision, auditory, taste, touch and smell, the two senses that are our primary threat detectors, are vision and auditory. Because both of those sensory systems allow you to perceive a threat at distance in preparation for fight or flight. So that's the reality of how our sensory systems are put together. If you have to wait to feel something before you consider it to be a threat, it is way too late. 

Tim Edwards: Too late. That's right. You're dinner. 

Dr. Stephey: You're dinner, dinner, and your gene pool didn't make it. So you were weeded out generations ago. If we inherently had poor binocular vision and we couldn't catch an animal source of protein, we probably would have all ended up vegetarians because we never would've been able to catch an animal source of food. Because to be able to do that, you've got to be able to see in 3D because you've got to localize where that prey animal is in space and you have to be able to predict the future. You didn't know you had a visual system that look into the future. Did you? 

Tim Edwards: No, I didn't. I can't wait to hear about this. Fight of the lottery numbers are for tomorrow. 

Dr. Stephey: So typically does a prey animal runaway in a straight line? 

Tim Edwards: No. 

Dr. Stephey: No. They zigzag, because it's hardwired into their system that if they zig and zag, it is harder for us to predict where they're going to be in the future. If I'm going to throw a spear at escaping animal or shootable it. Or an arrow or a slingshot, whatever my mode is. If I can't predict where they're going to be in the next instant in time, if I shoot to where they were, I'm going to always end up shooting behind them. So we've got to be able to predict the future by being able to analyze where we think that animal is going to be at the next instant in time. And all of that is dictated by how fast we see and how accurate we use our two eyes together as a well integrated team. Because at that juncture the escaping prey animal is the apex of the triangle and our two eyes roughly 60 to 70 millimeters apart in our face is essentially the base of that triangle and we've got to be able to localize where that pretty animal is in space, but we can't do that if the base of our triangle isn't stable. 

Dr. Stephey: If our two eyes are not working together well. As a fast synchronized team, our internal mapquest continues to be off. It's consistently inconsistent with our ability to judge time and space. So in that context, a lot of patients that I see and certainly a lot of folks walking around every day, those that don't feel well-grounded, those that have some measure of anxiety, oftentimes it starts in the visual system. Because they truly don't feel well-ground because their internal mapquest is off and there's a significant visual component contributing to their sense of where they are in space. 

Tim Edwards: So there is the need to see fast in today's society and not just back to the caveman days, right? You talk about anxiety issues because I would think that if somebody is not seeing fast based upon your examples, that they are in a constant state of fight or flight. 

Dr. Stephey: I think that's a reasonable statement. And related to that is something called the polyvagal theory of affect, emotion, self regulation and communication. 

Tim Edwards: That's a mouthful. 

Dr. Stephey: It is. And it's been written about for the past 30 or 40 years primarily by a fellow by the name of Stephen Porges. He wrote a book called a pocket guide to the polyvagal theory. That's the more readable of his books. So if you're going to read a book that's the one to read. It's really user friendly and it's interesting too because fundamentally we want to feel safe. There's not much more that we can do in life if you can't feel safe. So when we roll out of bed in the morning and we look around our environment and throughout every waking, second of the day, our subconscious mind is asking yourself the question, do I feel safe? And we're primarily answering that question through auditory and primarily vision. Just because of the anatomy of two and a half, almost two and a half to 3 million neurons feeding information to the brain is tied up in vision. 

Dr. Stephey: So when we look around and ask that question, do I feel safe? Well, a great part of that is your ability to see fast. So if you're able to see fast enough to just glance around your environment, subconsciously answered that question, why yes, I do feel safe. Then you go about your day and that question never bubbles up to your conscious awareness. It doesn't need to because your subconscious mind has already answered the question for you. But the problem is, in part, if you can't see fast or use your two wires together as a well integrated team and your subconscious mind asks itself that question again, do I feel safe and it can't answer that question below the level of conscious awareness, your brain goes into defcon one and the subconscious mind asks your conscious mind, well, do we feel safe? And the conscious mind says, you know what, I'm not really sure I appreciate you asking me for a second opinion so you know what I'm going to start to pay attention to whether or not I actually feel safe. 

Tim Edwards: And there's a level of anxiety boosted a little bit right there. 

Dr. Stephey: Absolutely, because now your conscious mind has to be on high alert status, which means now that you're more sensitive to movement in your periphery, right? Because that's where predators are going to come from out of your peripheral vision. 

Tim Edwards: But a predator could also be a dresser in your bedroom. When you're getting up in the morning, you can't really see, a little dark and you nip your toe on it or something. Right? I mean, I'm being serious. Is that, that's not necessarily a predator, but like that's part of being able to see quickly or in the dark perhaps? 

Dr. Stephey: Well, it is because I suppose at that juncture, any object in your peripheral vision, whatever that object is, can be perceived as a threat which goes along with that whole expression about perception is reality. 

Tim Edwards: Yeah. 

Dr. Stephey: Well, if your perception is off and in most cases when we talk about perception is reality, we are talking about visual perception. But it doesn't usually get elaborated on to that degree. But it's not just objects in your periphery anymore. 

Dr. Stephey: Now your auditory hypersensitivity is elevated. Your touch sensitivity is elevated. Your tastes and smell sensitivities are elevated because now your brain is perceiving the environment as potentially one giant eminent threat and it better be on high alert status in preparation for anything that it needs to flee or fight from. Is that why individuals who are completely blind always seem to at least we're told, have this hypersensitive sense of, of, of smell and taste and sound. I think. I think arguably the answer to that is yes. If you. If you're losing out on that much visual input, but your brain still has to perceive your environment, it has to be tuned into other senses. The other interesting thing about blind folks is that when they use a white cane, for example, to maneuver around a room, their visual cortex lights up so they see the room in their visual cortex, but they're doing it through, feel, not through their eyeballs. 

Tim Edwards: It's amazing.

Dr. Stephey: From what I remember reading, when they read Braille, again, their visual cortex lights up at the same areas that relate to the written word in a sighted person. The same areas of the brain light up, but you're just doing that on your fingertips. You're looking through your fingertips. And I find that common in the patients that I see in my practice, typically more pediatric related. But when I see a kid in my practice who has a difficult time sitting in my exam chair when I'm talking with the parents, they want a slide out of my chair and they want to walk around my exam room because I got a lot of cool stuff to look at. 

Tim Edwards: You do.  

Dr. Stephey: So they feel compelled to go pick up everything and feel it. And most of the time I'm really tolerant to that because I understand the reason why. But I also understand what that kid is really telling me through their behavior, through their motor overflow, if you will, or what typically gets described as their ADHD behavior. 

Dr. Stephey: I know in most cases that's just a vision problem and they're looking around, but they have to do it through their fingertips. 

Tim Edwards: But the general public would say they're not paying attention. They're misbehaving and therefore they should be in trouble or suffer some type of consequences. 

Dr. Stephey: Yes, absolutely. 

Tim Edwards: Wow. 

Dr. Stephey: And related to that, are the kids that do have a difficult time sitting still and it is true that if we looked at an ADHD or an ADD checklist of behaviors, a lot of the kids' behaviors will fit those checklists, but they're just checklists of behaviors. There hasn't been any actual testing that has gone on. There's not a blood test to determine if you're ADHD and my experience over the years that I've been in practice and everything that I've read inside my field of optometry and all the stuff that I read outside my discipline really says ADHD ought to be a diagnosis of exclusion. And what I mean by that is that you should have ruled out everything else. 

Dr. Stephey: Things that ought to be measured and can be measured and can be trained, should be measured and assessed and treated. For example, there's something called retained primitive reflexes. There's nutritional aspects to behavior. There's seeing fast or magnocellular vision. There's eye tamng, eye focusing, eye tracking and working memory and executive function skills. All these things are tangibly measurable skills and they all could be trainable. We should do that rather than look at a checklist of behaviors and reach a conclusion that that kid's got ADHD and that we should put them on meds. That to me is malpractice. I'll give you a practical example. Picture yourself at the movie theater and they start the film and the video and the audio tracks are slightly out of sync. Maybe 20, 30 milliseconds. How's that gonna make you feel? 

Tim Edwards: I hate it. 

Tim Edwards: I've been to a few movie theaters where they're out of sync and I'm the guy that gets up and goes and complains in the back they fix it. No, it's aggravating. 

Dr. Stephey: It is. And I think those frustrating, aggravating, discombobulating, annoying. Those are the kinds of adjectives that describe what it's like to do that. 

Tim Edwards: Wow. So these people are living with their "films" out of sync all the time? 

Dr. Stephey: Well, I think so because fundamentally I think what that represents, it means that vision and auditory aren't in sync together and that's very disturbing. Now, if I sat in the back of that theater with a clipboard and a checklist of ADHD behaviors, about five minutes after starting a film like that, pretty much the entire audience, is going to start manifesting ADDness and ADHDness. 

Tim Edwards: Absolutely. 

Dr. Stephey: So if all I did was look at the behavior and not the underlying skills related to moving, looking, and listening. I'm going to think everybody's got ADHD. Or they're inattentive and I would have missed the whole representation of what was really happening. Well and the reason I want to talk about those kinds of things because I'm going to circle back to a more fundamental component of how we see fast and what it represents in terms of us asking and ultimately answering that question about whether or not we feel safe and tied to that is the idea of autonomic state. 

Dr. Stephey: Autonomic state relates to the idea that are we in a perpetual state of fight or flight? Or can we be calm and mindful and in the moment. And it's really intriguing because the brain has 12 cranial nerves. Or 12 branches that are nerves directly off of the brain itself. And roughly two-thirds to three quarters of those are directly tied up in the visual system and a few others tie vision and the inner ear and the auditory systems together. And the 10th cranial nerve. It's called the vagus nerve. Vagus means to wander. So the vagal nerve or the vagus nerve wanders throughout our organ systems. And and it ties into our ability to self regulate and the really fascinating thing to me is the patients that I might see and they could be an adult patient, what I'm going to describe as a neuro typical patient could be a kid who's been diagnosed with ADD or ADHD, could be a student, has been diagnosed with dyslexia or reading disorder, could be a kid on the spectrum, could be any child who has some sort of a medical syndrome that has challenged their abilities to move, look and listen. 

Dr. Stephey: So there they do not find it easy to self regulate their behavior. And this is what's so fascinating about the work that I get to do every day. As an example, one of the assessments that I might do is to stand 10 feet across the room from somebody and I say, we're going to make eye contact with each other. I'm going to slowly walk towards you and you tell me when it feels like I've invaded your personal space bubble. I don't care how you measure it. Your heart skips a beat, you catch your breath, your palms get sweaty, you feel like you've got to step away. Or you feel like you want to run away from me coming across the room, you use your own benchmark. But I'm describing what we're going to do. 

Tim Edwards: Basically when they don't like it. 

Dr. Stephey: When they don't like it. 

Tim Edwards: It hits a point when they're uncomfortable in any way, shape or form. 

Tim Edwards: Interesting. 

Dr. Stephey: Yes. Doug, you're too close. So I start 10, 11 feet away. We make eye contact with each other. I slowly started to walk across the room and I can't tell you how common it is that I might be six, seven, eight feet away. And people telling me you're too close. 

Tim Edwards: Wow. Really? 

Dr. Stephey: It's phenomenal. And one of the things that I do straight away in that measure is I'll usually give them colored lenses to look through or some kind of prism lenses to look through and then we'll do the same thing again. It's astonishing in many cases how close I can get. I did that with. I did that with one adult gal and I was so close to her with the glasses on. I couldn't. I couldn't have asked for her to do a better response because she said I was so close. She said, oh, I feel like we're going to kiss and I'm okay with that. 

Dr. Stephey: Now mind you, this is the same. This is the same woman. That one I did at the first time without the glasses and I may be seven feet away and I describe this sympathetic overflow or this elevation of fight or flight, and she says, I felt like my arm pits are sweaty, and then she had this aha moment and she said, "do you think this is why I'm armpits get sweaty when I get in the crowd of people?" I'm like, yes, of course it is. Because the crowd milling around your periphery is triggering off this, this vagal response, your 10th cranial nerve is disregulating your behavior and it's wanting to push you into fight or flight. 

Tim Edwards: Think about the children in classrooms that don't even know why they're uncomfortable because there's one child right in front of them in one to their left and one to the right and one behind them in a teacher, maybe six to 10 to 15 feet away and all of that. I mean, if you can alleviate that anxiety that a child is feeling in classroom alone, think about how much better they're going to do in school. 

Dr. Stephey: Well, Tim, that's really well said. Because whenever I interact with school districts and the perception is, well the kids just not paying attention. When I say, well, it sounds to me like you've just rendered an opinion and that you act like they're willfully not paying attention. I'm here to humbly suggest that they are paying attention, but at survival based behavior. And survival based behaviors are going trump learning about reading and math every single time. So they are paying attention just not to the things that you want them to and that's not willful, that is reflexive behavior that's based in survival. It sounds a lot like what we're going to be talking about in our next episode. Actually that's true. We're gonna. We are gonna. Continue. The next episode was talking about the educational system and special education rights and how kids are being assessed and how they're not being assessed. 

Dr. Stephey: But let's continue on with this idea about the vagal nerve because fight or flight is something that people commonly relate to and that's true. But there's other components to the vagal nerve as well. And in the wild, there are some animals that survive based on their ability to play dead. And classically, what does it mean to play possum? Right? And, and there's something about predators that don't like prey animals when they're dead. And you can see that with domesticated cats, right? If you have a domesticated cat and they happen to find a mouse in the house. 

Tim Edwards: They're not interested. If it's dead. 

Dr. Stephey: Well they're interested in it while they're slapping it around, but when the mouse is so overwhelmed by fear and their vagal response pushes them to basically pass out, the cats like, oh, oh, you're not going to try to run away from me anymore?

Tim Edwards: I'm bored. 

Dr. Stephey: I'm bored, I'm off to do something else. And then the animals got to wake itself back up because in that moment they've depressed their heart rate. They've depressed their respiratory rate. They literally are on the verge of death and you see that happen in humans. Oftentimes with trauma survivors or even if you've got a really dysregulated vagal nerve, some people just easily pass out on something that seems innocuous to, I don't know, 95 percent of the population. Those that have a really highly dysregulated vagal nerve will pass out at the craziest things. I don't think I've ever had anybody do this personally in my office, but I know of optometrist that have where they go to put a contact lens on somebody's eye and they pass out in the exam chair. That is a vagal response. 

Tim Edwards: Sure. 

Dr. Stephey: And it's beyond voluntary control. So the interesting thing about the vagal nerve is that it, it sets people up for fight or flight and Dr. Porges refers to that as mobilization with fear. So it is, I'm getting the heck out of town, I'm going to run away because I've had the pants scared off of me. Mobilization with fear. There's two branches to the vagal nerve, a relatively newer one from an evolutionary perspective and a much older ancient one. And the much older ancient one is where people pass out or some trauma survivors disassociate from reality in the middle of the trauma as a means of surviving. So one part of the vagus nerve that induces fight or flight, Dr. porges refers to that as mobilization or movement with fear. Another response of the vagal nerve, if fear is so overwhelming that you're frozen in time, you are that deer in headlights, that is immobilization. You are paralyzed. You cannot move a muscle because you're so scared. That's immobilization with fear. And then there's a third response which is really interesting. He refers to the third response as immobilization without fear and this is where it gets really interesting. Because the vagal tone of the 10th cranial nerve also ties in their idea of having a gut feeling right when we talk about having a gut feeling that's a vagal nerve response. Really interesting stuff. And play.. 

Tim Edwards: And let me hold on. So when we have that gut feeling, I think the gut feeling we have usually leans towards something negative or fearful. I don't know that I have too many gut feelings except for when I'm at a ball game and I think this guy might hit a home run and he does in my life to claim it that it was mom the reason for that. But no. Is that true? I mean, is that or is that just my perception? Do you think that gut feeling might normally be like something's a little off, something's wrong or can it go both ways? Well you're talking about fear here. 

Dr. Stephey: Well, but that's where the third part comes into play. Because the third part, when I talked about immobilization without fear, that actually facilitates our social adjustment skills. And our social adaptive skills and our abilities to engage with other humans in a playful, productive, emotionally connected way. So it's still a vagal response, but in a good vagal response. So you're probably right. Maybe most gut feelings tend to associate with fear, but I don't think that's true all the time. And you know, when you meet somebody new, it's really interesting because in many cases you can have an immediate connection to that person. Absolutely. And, and you can't even explain why. And others, you're like, no way, I don't want to be in this room with you. That's a vagal response that is happening. That is a perceptive response below the level of conscious awareness happening through vision and auditory and then activating that 10th cranial nerve through that response and making it so that you feel really comfortable with that person. 

Dr. Stephey: And if somebody you can welcome into your personal bubble and there's a lot of emotion and connectedness to being able to do that. The idea of being touched and a lot of cases, it's a pullback response like I don't like being touched or is it a touch that's really we would perceive as a caress and something that's inviting and something that we want more of. Ultimately that's a vagal response. Either that we invite more of the same response or you want to pull away from it. But it's a vagal response nonetheless and I find his body of work so fascinating because it ties in to the vision stuff that I do and he's looked at, Dr. Porges has looked at regulating vagal tone more through the auditory system and I'm looking at regulating vagal tone through the visual and the auditory system to the degree that I can. 

Dr. Stephey: There was some research recently out of Duke University that's so new that people don't even know what to do with it yet. And it reveals the connectedness of the visual system and the auditory and the vestibular or inner ear system so that when we look in right gaze, both eardrums, move to the left and when we look in the left gaze, both eardrums move to the right. But I find it fascinating to know to look at the connectedness even further between vision and auditory. And I also want to make a comment about vagal nerve tone because regulation of the vagal nerve also ties into the seventh cranial nerve or the facial nerve. And this is what is so interesting about Dr. Porges' work to the how it connects to what I do. Because the facial nerve ties into our own ability to regulate our own facial expression. 

Dr. Stephey: And I was just reading this morning about how exuberance and happiness is manifested by the facial nerve regulation of the orbicularis oculi muscles. Or the muscles that really circle around our face and eyes. So when you refer to somebody as having a twinkle in their eye, it's probably the facial nerve response in that orbicularis oculi muscle. And the flip side of that, if you've got poor vagal tone, it affects really more the lower jaw. And when we talk about somebody gritting their teeth or they set their jaw in a certain way. So if you have to fight your way out of survival or you have to bite your way out of survival, that's lower jaw. That's a different connection with the facial nerve. So how we express emotion ourselves happens to the facial nerve which is connected to vagal tone. The facial nerve connects to vocal cords, so how we intonate and the rhythm and the melody of our own voice is tied up in the facial nerve and those things are really interesting because they're also connected to our ability to perceive emotion in others and our ability to read their body language, which that's all vision, right? 

Dr. Stephey: When we talk about when social psychologist talk about how 80 percent of our communicative language is through body language, reading body language is a visual language. And so the vagal nerve and how it sets that tone throughout the body, particularly in the facial nerve. If you're vagal nerve is poorly regulated, you likely are going to default to being more fearful. So you're going to misread somebody's facial expressions. You're going to misread the intent and their voice because now if you've got poor vagal tone, you're predisposed to be fearful. Because it's better to be safe than sorry, and it's also really interesting because the facial nerve also connects to tiny muscles in the auditory system that connect the middle ear to the inner ear and to the auditory system. Those three tiny little bones that regulate tension on the eardrum also connected to the facial nerve also connected the vagal tone. And it's really interesting because if you're in a perpetual state of fear or your vagal nerve is dysregulated, the tension that's placed on your eardrums predisposes you to hear low frequency sound. 

Dr. Stephey: That tends to be more predatory based. So if we dial the clock back a number of generations, whether it was eat or be eaten, if you're in a fearful environment, predators are more likely going to make low frequency noise. So when your vagal nerve is disrupted, you're more attuned now. Your auditory frequencies are predisposed to low frequency sound and the human voice is more in mid frequency ranges. So if you lose the ability to hear human voice when your vagal nerve is disrupted, it's the whole thing is fascinating. One of the questions that typically arises in this discussion is, well, Doug it's really fascinating, really interesting that this is happening, but what the heck do we do about it? 

Tim Edwards: We fix it. 

Dr. Stephey: Because I don't want you to just tell me I got a problem that I can't make better. Yeah, and I don't like that either. 

Tim Edwards: Well, that's the point of this podcast actually. 

Dr. Stephey: Well, that's right. People need information so that they can then act upon the things that they learn and then know where to seek answers for because most eye doctors are not going to talk about this stuff. 

Tim Edwards: Well, I think one of the reasons this particular topic, Dr. Stephey when I was in your chair was so fascinating to me because you really broke it down to a very simple example of why one might feel a sense of anxiety. Or why and how it relates to our vision. So therefore, it seems like it could be a simple little tweak or a simple fix to alleviate all of these problems and I'm focusing mostly on maybe children in school. So that they can be more at ease and learn or if they don't see fast, how they can see fast so therefore they can move forward through life without that anxiety or at least having it minimized.

Dr. Stephey: Well so let's break it down into several different categories. The treatments ultimately are the same, but I do think it's important that the listening audience appreciate the breadth and the depth of how this applies across the spectrum. So if we talked about school age, kids that have an IEP for dyslexia or a reading disorder, well, lenses and prisms or vision therapy or sound therapy is designed to help regulate that vagal tone and ultimately shift them out of survival attention into learning attention. But it's fascinating stuff because I can really change somebody's quality of life frequently by color in prism in a prescribed pair of glasses. Sometimes they need vision therapy, sometimes color in prism is good enough. Sometimes they need sound therapy to access vagal tone in a different way and there are a number of optometrists that I believe I'm one of them and I think there are a number of others that incorporate sound therapy into the model of how they practice. And for me it's such an easy transition because the visual system and the vestibular or the inner ear are so intimately intertwined and because so much of our brain function, two thirds or three quarters of it is tied up in visual processing. 

Dr. Stephey: That if I can affect one of the other systems, motor or auditory, I know there's going to have a salient or an improvement in the visual side of things. I think we're just remiss if we don't pay attention to global aspects of things. There were several optometrists and a pediatrician at Yale back in the 40s and 50s who studied vision development. From infants, I think up until 10 or 12 years of age and they wrote a book about that and a number of articles. One of the things that stuck with me from that perspective and that study that was done was an expression that went like this. If you want to understand the whole child, you have to understand their visual system. And if you want to understand their visual system, you have to understand the whole child. So we can't parse out vision from everything else and that's why when I talk about move, look and listen, I really mean that in its totality. 

Dr. Stephey: So other than school age kids, who else? Well, some of the most highly dysregulated of the population are kids on the autistic spectrum disorder. They spend a tremendous amount of their time in fight or flight as a survival mechanism to not be overwhelmed by being in fight or flight all the time. They tend to be inattentive or they tend to disassociate, I think from their environment because it's an adaptive survival response. They have to learn how not to pay attention just to get through the day. So that's the pediatric sort of student population side of things. But does that mean that this doesn't carry over into the adult population? No, not at all because there are a number of trauma survivors who have made their way into adult hood who still have significant behavioral or emotional outcomes. And again, this is typically based in behavioral outcomes. But we're talking about autonomic state and vagal tone and how vagal tone is affected by the auditory and the visual system. 

Dr. Stephey: And it's interesting because there are a number of psychotherapies that are designed to try to help trauma survivors let go of the emotional conflict that they experienced for years later. For example, there's something called EMDR. Eye movement desensitization and retraining. Well, think about that name, eye movement desensitization and retraining. So somebody who's doing EMDR, psychotherapist, who's doing EMDR, is typically using left or right, rhythmic eye movement in order for that trauma survivor to re-experience some component of that trauma, but do it in a more emotionally disconnected way so they can come to truly at the core of their being believe that what happened to them was not their fault and that they did the best they could in the circumstances that they found themselves in. And from the reading that I've done, if a trauma survivor can come to believe those two questions, it wasn't my fault and I did the best I could. They can let go of a lot of emotional problems that persist with that preexisting traumatic event. 

Tim Edwards: Wow.

Dr. Stephey: Eye movement, desensitization and retraining. 

Tim Edwards: I'm familiar with that. I did some, a series of videos for a psychotherapist who actually had that modality in their office and it looks like it's a relatively simple form of therapy. It looks like watching pong, number pong. 

Dr. Stephey: Yes, of course. 

Tim Edwards: For this, for those of you who are now playing fortnite and are young and have no clue what pong is it's one of the very first video games. And there's that movement of following this dot. 

Dr. Stephey: Well, you've heard of EMDR? Have you heard of brainspotting? 

Tim Edwards: No. 

Dr. Stephey: So brainspotting is a variation of EMDR. But rather than using the rhythmic movement from left to right, the psychologist who developed the brain spotting technique realize that he can have better outcomes and faster outcomes if he has patients look in certain positions of gaze. 

Tim Edwards: You mean just shifting your eyes to a different place? 

Dr. Stephey: Yes, so maybe up and right or maybe up and left or down and left. So still using eye movements to have this therapeutic outcome and I know I've had a number of patients over the years when we do some of the vision therapies that we do. They started remembering their dreams as an adult. There's one gal that was 67 I think when I did therapy with her and she hadn't been to the office for maybe six or seven visits. She came in one day and she said, hey, last time I left here on my way to the car, I started remembering stuff that I haven't thought about in 50 years. She's like, have you had people tell you that they're starting to have memories from long time ago? Well, it was her history that made me ask a handful of other patients back at that time. One adult who was for 47 years old when she did the therapy. She's the one that said, I haven't remembered a dream in 20 years, but I started remembering my dreams. The husband of my vision therapist at the time started the therapy and quit because he said, Doug, I've started having nightmares from when I was a kid growing up in World War II, Germany, and I've spent my whole life running away from that and now I'm having, I'm dreaming about that. 

Tim Edwards: Alright. So we're talking to some potential negative effects from EMDR. 

Dr. Stephey: Well, potentially negative effects for vision therapy and I won't, and I won't say negative effects from vision therapy, but the point I'm really making is that vision therapy is more than about learning how to see fast and using your two eyes together in a coordinated way. It is a, is a powerful tool of healing. 

Tim Edwards: Wow. I've never thought of it that way. And you know, and you and I have known each other for a couple of years and you've mentioned vision therapy and I always perceived that as just a way to maybe strengthen your eyes, you know, like lifting weights for your eyes or something. And, maybe you've said that, forgive me if I didn't absorb the information correctly, but, but what you just said is pretty poignant. Please repeat that for our audience. 

Dr. Stephey: Vision therapy is a powerful tool for healing. 

Tim Edwards: For healing.

Dr. Stephey: Emotional, mental, cognitive, physical. We keep a lot of memories stored in our body. One of the books that I have is called the body keeps the score. Well, people don't really realize that the visual system has a tremendous effect on balance and gait and posture. And for those of you listening audience out, quick way to demonstrate how much vision affects balance would be to have you stand with your arms crossed, eyes open, and then balance on one leg and then focus on how stable you are and then immediately see what happens when you close your eyes. You'll find your ankle wobbling and you probably won't be able to stand on one leg with your eyes closed for any length of time. People don't really realize how much vision affects everything. There's something called the Mcgurk effect. 

Dr. Stephey: And the McGurk effect is when we use the visual perception of lip movements to prime the auditory cortex. So watching lip movements can actually change what you hear. That's fascinating. 

Tim Edwards: You mean, you mean lip reading? 

Dr. Stephey: No, not just lip reading. Because lip reading would be perceiving speech without the vocalization of speech. Well, let's go back to the movie analogy. When the audio track is slightly out of sync with the video track and it makes your brain hurt trying to put the two things together. That's that asynchrony between vision and auditory. So what I'm saying is that even when somebody's speaking, you hear better when you watch their lips move. Because vision happens so much faster than auditory, right? 

Tim Edwards: The speed of sound as opposed to the speed of light, right? 

Dr. Stephey: The speed of sound is about 1100 feet per second. The speed of light is 186,000 miles per second. And think about if you've got disrupted vagal tone and you don't see, lip movements fast. You don't read facial expressions fast and your default setting is to be pushed. And the fear to be rather safe than sorry. You can't socially engaged with others in a way that you should be able to. And if no one figures this out about you, you go through your whole lives and really become more and more isolated because you can't put yourself out in that social environment because your vagal nerve disrupts your ability to self regulate your behavior. And the whole thing just starts to snowball. 

Tim Edwards: And you're labeled as socially inept and maybe a lot of this can be fixed, diminished and completely eliminated through various forms of healing therapies. 

Dr. Stephey: You've got to be able to move, look and listen. You got to be able to see fast. You've got to have nutritional foundations. That's going to be one of our upcoming episodes. We're going to talk about the nutritional side of not only the visions discussion, but how it ties into memory and attention and reading and learning and cognition in general, so hopefully you'll tune in and the near future when we talk about the nutritional episode because I think you'll appreciate what I'm going to say about that topic as well. 

Tim Edwards: Well, Dr. Stephie, I think there may be a lot of people and I'm sure parents that are listening to this that are elated at this information because you're offering some solutions that they've never heard of before that seemed quite simple, that don't involve medication. Well, that's true. You know, medication has a place. I'm not, I'm not anti medication. It does have a place, but again, I think generally it should be a diagnosis of exclusion and we've got to measure the things that we can measure. We've gotto  address all of these pieces. They're all trainable. I don't care if you're an infant. I don't care if you're 90-years-old. All these things can be measured and all of it can be trained. 

Tim Edwards: Thank you for listening to the Move Look & Listen Podcast with Dr. Doug Stephey brought to you by audible. Get a free audio book download and a 30 day free trial of audible membership at audibletrial.com/inbound. You'll find over 180,000 titles to choose from, including books mentioned here in the Move Look & Listen podcasts. You can listen to these books through your iphone, your android, your kindle, your computer, or even an MP3 player. And if for any reason and at any time you choose to cancel your membership, you keep all of your audio book, downloads. Give it a shot for 30 days. You got nothing to lose. Support the Move Look & Listen podcast by visiting audibletrial.com/inbound. We will include a link for your convenience, in the show notes of this and every episode of the podcast. And of course if you like some more information regarding Dr. Stephey's practice or to make an appointment, we will include links in the show notes to Dr. Stephey's website and his youtube channel. 

Tim Edwards: Dr. Stephey's website is stepheyoptometry.com. That's s t e p h e y optometry.com. You can also call the office at 626-332-4510. Again, all of Dr. Stephey's contact information will be included in the show notes of each and every episode. One last request before we let you go on to the next episode, please subscribe to the podcast from whichever platform you might be listening in. Of course, it is free to subscribe and it ensures that every time we post a new episode, you'll find it right there waiting for you to listen in your podcast app of choice. We really do appreciate your listening and until next time for Dr. Stephey of the Move Look & Listen podcast. I'm Tim Edwards with the Inbound Podcasting Network.

 

 

 

 

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