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Is your relationship running on autopilot, derailed by misunderstandings, stress, or simply the exhaustion of daily life? Too often, we fail to recognize how the health of our brains—our most vital organ—directly shapes the way we connect, love, and even argue with those closest to us. What if the difference between disconnection and deep intimacy has to do with our brain health?

In this episode, listeners will discover how brain health impacts everything from emotional regulation to sexual intimacy, and why tending to your mind’s well-being is foundational for thriving relationships. The conversation explores how stress, fatigue, trauma, and even everyday routines influence the way we interact with our partners, sharing practical neuroscience-backed strategies to build resilience, practice self-awareness, and foster genuine connection. Dive in to learn why caring for your brain might just be the ultimate relationship hack.

Dr. Majid Fotuhi, MD, PhD, is a world-renowned neurologist and adjunct professor at Johns Hopkins. In his new book, The Invincible Brain: The Clinically Proven Plan to Age-Proof Your Brain and Stay Sharp for Life (March 3, 2026 // Harper Wave), Dr. Fotuhi reveals that in just 12 weeks, it’s possible to prevent and even reverse cognitive decline – at any age – in over 80% of patients.

Episode Highlights

03:30 The brain as the source of emotions and relationship reactions.

09:33 Personal awareness and communicating emotional states in partnerships.

11:30 Taking pauses: Self-check and sharing needs during stress.

13:43 The nervous system’s role in stress, intimacy, and brain health.

19:33 Trauma, memory, and the brain’s ability to rewire through experience.

23:15 Challenging old narratives and the power of cognitive behavioral change.

26:07 Metacognition: Understanding and questioning our perceptions.

28:43 Belief systems, relationship interpretations, and subjective reality.

33:36 Emotional vs. logical brain circuits and habits of thought.

36:45 Healing from trauma: Neuroplasticity and creating new life patterns.

40:47 Sexual intimacy: The brain’s role in arousal, connection, and desire.

43:42 Stages of sexual arousal and gender differences in orgasm.

45:36 Building a healthy brain: The five pillars and empowerment strategies.

Your Checklist of Actions to Take

• Pause and Check In: Before reacting in a relationship, take a moment to pause and ask yourself if your brain is in a healthy, rested state.
• Communicate Your State: Let your partner know when you are feeling tired, stressed, or grumpy, and request space or support as needed.
• Practice Metacognition: Develop insight into your own thoughts and reactions, recognizing that your perceptions are shaped by past experiences.
• Use Calming Techniques: Implement short breathing exercises, such as the 6-3-6 breath technique, to reset your nervous system and reduce stress in moments of conflict.
• Be Mindful of Sympathetic Overdrive: Identify if you are constantly in stress mode (rushing, feeling late, overbooked) and intentionally schedule downtime to invite the parasympathetic (“rest and digest”) system.
• Engage in Brain-Healthy Habits: Prioritize exercise, optimal sleep, Mediterranean nutrition, stress reduction, and brain training for overall brain health and relationship functioning.
• Slow Down Intimacy: Extend foreplay and create a relaxed, affectionate environment before sexual activity to foster better physical and emotional connection.
• Challenge Old Narratives: Work with a therapist or on your own to identify and question limiting beliefs from your past, and consciously reinforce positive new pathways in your brain.

Mentioned

The Invincible Brain (*Amazon Affiliate link) (book)

The Invincible Brain Masterclass (free online course)

The Invincible Brain App (Apple App Store link) (app)

The Invincible Brain App (Google Play Store link) (app)

Relational Health Assessment

Connect with Dr. Majid Fotuhi

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TikTok: tiktok.com/@dr.fotuhi

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Episode Transcript

Doctor Majid Fotuhi, it's a pleasure and an honor to have you on the show. 

It's my pleasure to be on your show. Thanks for inviting me. 

Yes. And you're a neurologist, you're an associate professor at Johns Hopkins University, and you do a lot to help people understand the importance of brain health and how it applies to many different aspects of living. And we're going to focus a little bit more on intimate relationships. So as we begin our topic here, many people, when they think of brain health, they're thinking of cognition, memory, these types of things. But it also has a huge impact on secure functioning and relationships. Intimate bonding, feeling connected. Can you give people a bit of understanding around that? 

Yes. 

So when you feel loved, when you feel passionate, when you feel tired, when you feel grumpy, it all emanates from your brain. So anytime you seem to be in love with someone, or you're irritated, or you just find someone fascinating or someone boring, it all happens in your brain. And your brain is the source of all your feelings. “So it's important to keep in mind that when you interact with people, it's your brain that's interacting.” And your brain, at the same time, is an organ, just like your heart is an organ, your kidney is an organ, your liver is an organ, which means it has some basic needs. It needs sugar, it needs oxygen, it needs nutrients, it needs a certain low level of inflammation. 

But it's not a machine made up of hardware. It's made up of cells that are very delicate. “So I learned that to have good feelings and be in a good state of mind, whether it's relationships or your work or dealing with your kids, it's important to have a healthy brain.” 

And perhaps just in life, we're not necessarily giving a lot of credit or credence or value to the importance of our brain health. 

Exactly. People think that whatever they do is whatever they don't realize it's the brain that's making the decisions and gives rise to the emotions they have, and that the brain can be taken care of. So if, you know, 

“So if you're tired, if you're angry, if you're grumpy, it's your brain. And so before you get mad at other people, you need to hit the pause button and say, “Am I taking care of my brain?” Because the 

Just like you take care of your teeth, you take care of your skin, you take care of your heart. You need to make the brain on that list. 

And there are a few things you need to do to put the checkbox that says, yes, I'm taking care of my brain. So before you do things and you complain about the people or have issues with other people, you need to check yourself and do a brain health checkup. 

Absolutely. I want to talk about the nervous system in a moment, but I can just comment. In my relationship with my husband, it took me quite a while to recognize, oh, he's grumpy because he's tired. Like later in the day, like, I would start to take it personally if he would get a facial expression or nonverbal cue of some sort. And I'm like, oh, he's just tired. And it's just. 

Exactly. Yeah, it's an excellent example. “A man or a woman comes home tired and hungry, and then the kid makes a noise, and the person snaps. Now you feed that person, and half an hour later, the same person is not snapping at anyone anymore. And so if you're hungry and your brain is not getting adequate nutrition, you're behaving differently; you're not the same person. And so that's an excellent point. You need to keep in mind, if you want to be very clever, who the person you're dealing with is and what the state of their brain health is at the moment. And if somebody had a fight at work and just arrives home, you need to realize that they're still recovering, and you need to give them some space to get a hold of themselves and recoup to their baseline.” 

And that's an extremely important point in relationships. Let me give you a little story. I get grumpy sometimes. 

I think we all do. 

Yeah, I'm usually well-mannered, quiet, easygoing, but especially if I'm hungry, I get grumpy. And I've told my wife, honey, if I'm ever upset, don't talk to me. Just scratch my hair and don't argue. Just scratch my hair. That's amazing, even though I may be grumpy at her. So we have this deal: don't worry about space. You don't have to hug me; you don't have to argue with me. Just scratch my hair. And it's Amazing how that calms me down. I just- it's like water or a fire; I just melt, you know. 

It's very soothing. 

It's very soothing. And you can be upset if somebody is affecting you. But this is the whole point because sometimes people get into this cycle of arguing, and one person- I mean, a common thing is, women go through the menstrual cycle, and it's not their fault that they're grumpy before or after their period. And you don't argue with them; you're not dealing with their baseline person. Don't try to convince them that this and that; you're not dealing with your lovey-dovey partner at the moment. You should just set aside everything and realize they're going through a hungry period. And whatever they say, you say, okay, honey, you don't argue because you lose anyway. So. 

Well, I mean, I think we're talking about the receiving end and what we observe, and the other. And we might be able to offer some grace or just recognize that the system, or even the brain, isn't at full capacity or is feeling about having those needs. Right. Or having needs. And that perhaps you also, as you said, we can take a mental or just a brief pause to do a brain health check, and that we might be able to use that information to say, oh, I know that I'm PMSing (Premenstrual Syndrome) and I have a tendency to overreact or feel more charged, or I just got home; it was a really hard day, I would love to connect. 

I just need a minute to take a few breaths and maybe drink some water, and maybe after dinner I can feel a little bit more available. So the person can also have some awareness and convey that. Is that right? 

I think it's also important for you to convey that to your partner. Yes, I sometimes do that. I say, “Rani, I'm grumpy, you know. 

And lay your head on her lap. 

Oh, no, I mean, I can't always request that. I mean, I can't just walk around. But I just say sometimes you get an email that may upset you, or you have something in mind that doesn't happen, or you're hungry, or you have back pain. See, sometimes a person may have knee pain or back pain, and they're walking around, and that pain is irritating them, or it may be a person at work that's irritating them, but they're irritable without realizing it. So it's important to just verbalize it. Just say, “Honey, I don't feel well. Right now, just give me some time. And that 

because it doesn't say it in your face. And there are times legitimate reasons to have disagreements, and it's not hungry. 

It's not because you had, “We've been sitting in traffic for two hours or something like that. It's just sometimes genuine issues that need to be resolved. But if you feel not at your peak, it's helpful to convey that in a calm voice and let the other person know, until further notice, I'm not available. And that period could be 15 minutes, could be an hour, but that gives the other person the signal. Okay, honey, I can give you some space. And that really saves a lot of arguments, because once you get an argument, the other one argues. And arguing with someone who's hungry or having PMS or has back pain, it's really. It doesn't end well. 

Well, and there's so much more opportunity for misattributions or misunderstandings or perceptions. So if we can send that clear signal, there's an ability to stabilize and organize around that, and for the partner to maybe have more compassion or empathy and want to help. And also, I imagine just with any high intensity. Right. They talk about in neuroscience, naming it to tame it. Right. So once we can even just name it, that it's part of what's happening here in the system, I can reduce the intensity and start to organize it and deal with it either individually or even as a couple. Is that right? That's correct, yeah. Okay. So I wanted to ask about the nervous system and psychology. There's a lot of talk about getting activated in the system. Polyvagal. Right. I don't know how familiar you are, but the. 

For people listening, just even the fight, flight, freeze, fawn response, and that we're less able to be creative, intimate, social when we're in an activated state. And so for brain health, can you talk about how the nervous system relates to brain health? 

Yes. So there's a central nervous system, which is your brain, and there's a peripheral nervous system, the nerves that go to your heart and your kidneys and your lungs and so forth. And the state of your mind, your central nervous system, sets the tone for your peripheral nervous system. And in the peripheral nervous system, you have this thing called the autonomic nervous system, which means there are parts of these nerves that are working automatically. And the nervous system on top just adjusts the level. But the actual nerve endings are doing their job on their own, and the brain sort of supervises. And then you have these two systems, sympathetic and parasympathetic, which are ready to get involved depending on the state of your mind. 

So if you're in the airport and your flight is in five minutes and you're not at the right gate, you run. And then your brain says, okay, we need the sympathetic nervous system to be activated. And your heart goes fast; your muscles are going to run faster. It's not time to be creative; it's not time to be loving and doving. It's time to run. And then let's say you catch a flight. You're sitting in your seat, you're happy, you're on your flight, you have some food, and you're relaxing; you're gonna take a nap. And so now you're in a parasympathetic mode where everything is good, and you relax. And so at any given moment, there's a balance of the sympathetic and parasympathetic, which is a great system, by the way. It's just very well designed. 

So during the parasympathetic tone, your heart beats slower, your GI tract is working, and your pelvic secretions are in the mode to happen if somebody is running or catching a flight. You're not going to fall in love with anyone while doing this. You're not going to be in the mood to engage in any intimacy because your body is dropped out. So it's a beautiful system of the sympathetic and parasympathetic autonomic nervous system, regulated in broad terms by the brain. And of course, these also feed back to the brain, where your sympathetic nervous system is activated. It also activates your brain to have a narrow focus and run. What happens is, for many people, the sympathetic nervous system is upregulated all the time. There are people who are always in a sense of emergency. 

They're always late, they're always behind, they're always nervous about missing an appointment, missing something. They're always driving fast. They're always trying to get things done so they can go to the next thing. And so their mind is in overdrive, which means their sympathetic nervous system is in overdrive. And that's not good in many ways. “For one thing, when you're stressed out and you're in fight-or-flight mode, cortisol levels are higher, and cortisol is poisonous to the memory part of the brain called the hippocampus.” So when you're stressed out and you're always running around, your sympathetic nervous system is in overdrive at the very base level. It's bad for your brain, but then your heart is also beating faster, your body's tenser, and you're at increased risk of heart attack and strokes. 

Stress is one of the main causes of many diseases, not to mention anxiety disorders. So when it comes to relationships and intimacy, you know, to be in the mood, you need to be in a parasympathetic mode to relax and enjoy intimacy. And so if you find yourself that you're running around all the time, it's a good time for you to pause and say, what are the important things in my life that are worth my sympathetic overdrive? Because you can't be in overdrive all the time. That wears out your brain, wears out your systems. 

Thank you for pausing to give a bit more context to the fuller system. And oftentimes, when people have experienced some version of injury or trauma in the past, activation in intimate relationships, like seeing signs of threat or interpreting signs of threat. So can you talk about the bidirectional nature? Because I do understand that intimacy can be activating if someone has had injury and therefore has fears or attachment wounds. And then also intimacy can be incredibly supportive for brain health when we can have genuine, authentic connection, feeling bonded, not isolated, not in a place of disconnection. Right. That can be really helpful for our brain health and our overall health. So is it bidirectional? 

Yes. So the question is: if somebody has had some experiences in the past where intimacy can trigger anxiety or trigger nervousness about what may happen next, that's something that needs to be handled gingerly, tenderly, carefully. You can't just tell someone like that, “Come on now, enjoy it. You can't do that. 

And inside the brain, it's like there are highways and roads. And when you use the same road over and over again, it becomes a highway. So when you have these thoughts- whether, let's say, God forbid, when somebody was raped, and that thought of what happened keeps recurring in their brain- that thought erodes and creates these pathways. 

Because it's been repeated millions of times now, it has become a highway. Now, you don't want that. You want this to just go away. But it's not going to go away by telling them, well, don't do that. It's like somebody who's stressed out and anxious all the time; just tell them Hey, you have a beautiful life. Just enjoy it. You can't do that. You need Cognitive Behavioral Therapy (CBT). Because it takes several conversations, several sessions of therapy, to first appreciate what you're doing. When people have those things, they just experience the experience, but they don't have the insight into how those experiences are happening and where those experiences are coming from. So, in talking with someone who's an experienced psychologist or therapist, you can then pause and have a conversation to go and realize, I see what's going on. 

I'm repeating these thoughts, which then are reinforcing them. And then the more I think about it, the more it's gonna consolidate in my brain; the more difficult it would be to make it go away. 

Yeah. 

So there's no easy “do this, and you'll be fine tomorrow, 

See, I've seen many patients, and people always have a narrative in their mind, and I'm sure you're an expert in this. People have a narrative of their life story. And for example, a person may have a narrative that, “My mother was too controlling with me when I was a child; therefore, I can't do this and this. And anytime those situations come up, the narrative returns that says, “My mother was very controlling, and I can't do this, so I can't do that. They don't realize it's just a narrative. It's what has happened in the past. It was an event 20 years ago. It's far gone. And it's absolutely wrong to think that. 

That your brain cannot function otherwise. So 

And just like negative thoughts can consolidate, positive thoughts can also consolidate the more you repeat them. So, this is not something that can happen in one session. 

No. 

You first need to sit down and talk about what your narrative is. Tell me, and then let the other person give it back to you. So you're saying that 20 years ago your mom was abusive or controlling; therefore, you can't do things now? Is that what you're saying? Sometimes just bouncing it back to the person may make the person appreciate it. That doesn't sound right, and so gradually. So, in response to the question of what if something that's supposed to be intimate causes anxiety? This is something that really helps with CBT; usually it takes six sessions, 10 sessions. It's not like for years and years, but you need to start with the belief that it will change because you want to have optimal life experiences, and you deserve to have a good life. 

And you can allow the experiences in the past to totally ruin your future. The bidirectionality is this: when your body is revved up, when your sympathetic nervous system is revved up, it really affects your brain. And so, at the time that you're running around and you're just trying to do four things at the same time, and you had a bad interaction with your boss, and then now you have an argument with your spouse, now your sympathetic nervous system is in overdrive. And as a result of that, now your brain is affected because it's bidirectional. And so it helps to sit down and have a two-minute slow breathing exercise. It's very simple. We can do it together. You wanna do this? 

Mm. 

So what you're gonna do is you take a slow breath for the count of six, you hold for the count of three, and you breathe out for a count of six. Look up like that, and you do it for two minutes. This is like a break that sort of puts the pause on the whole vicious bidirectional pathway that's happening. Your brain drives up your sympathetic nervous system. Your sympathetic nervous system makes your brain make poor decisions and go back and forth. You take a two-minute break, and you do it religiously. You set a timer, and for two minutes you don't allow the thoughts to come and go. You just breathe in, breathe out. And you pay attention to the sound of air in your nostrils. Like. 

Pay attention to the air going into your nostrils because that's where you're putting the attention to now. You're not talking about the boss, the spouse, the kids, the traffic. And two minutes is something that everybody can afford. And so I think relationships can really benefit from being mindful of your state of mind and how your brain is functioning, and having metacognition. 

See, a lot of people just do what they do, and they never question whether what they do is correct. They just see what they see. Not realizing that what they're seeing is really their perception of the world. Somebody is saying something that could be very benign or could be really mean. 

But whatever you interpret is your interpretation of the sound waves that reach your ears. It's not the reality. And so it's really helpful to have that metacognition, to realize that your thoughts, your behaviors are you and that they could be right, they could be wrong, they could be optimal, they could be suboptimal. It gives you humility in dealing with people, and it really helps you because when you realize that the world you see is because of your prior experiences of how you interpret things. 

Informed by your life and what messages, what experiences, and learning. 

I know, let me give you some examples. So, like, I was. I've traveled a lot. I mean, I've been to 46 countries, and I was in Jerusalem many years ago. And there's a religious part of Jerusalem where the Orthodox Jews pray. And they put these things around their arm, and they do these repetitive movements. And then you look at them and say, wow, it's so interesting that they so intensely believe in what they do. And it's possible what they believe in is true. I can't say it's not true. And then you go on the other side of the wall in the Muslim part, and you go to their temple, and they're all doing their prayers, and they're going down and up and down and up. And so they intensely believe what they believe in. 

And there's a rock there, and they think that rock is where Muhammad landed. And it just so be convenient that it happened where Ibrahim had been there, just a mile from each other. And you just realize that these people have such intense beliefs that when you go to the Western Wall, it's just one wall that separates these two worlds. Obviously it's the same world we all live in. But their experiences and their beliefs are so intense, and they're so far from each other. And so I think it's helpful for them and for all people around the world to have some humility and to have some metacognition that the way I see the world is the way I see the world. And as you said, it's been created by the environment I lived in. 

If you take one of those Jewish boys at the age of two, put them in the Muslim order, and if you take one of the Muslim boys and put them in the Orthodox Jewish area, they will turn out to be completely different people. And so those are kind of things that are humbling to realize that 

And maybe the alternative ways, maybe they're all wrong, or maybe there are alternative ways anyway. And in relationships, same goes. 

That's why I'm giggling. It's like, not only is our report often inaccurate just based on our memory when we're emotional, but also, to your point, two partners in a couple will have vastly different interpretations and associations with walking away in an argument. Right. Like, it could mean one thing to another and mean something different entirely to the other. And a lot of couples spend an enormous amount of time trying to recreate reality when that's, to your point, what it could be. Could be none. I don't know. Okay, so to be humble and to maybe have inquiry around: can we both look at, oh, what associations do I have about this? What am I aware of, how I'm experiencing this, and what are my thoughts? And also, can I hold space for my partner and what they might be experiencing, thinking, and feeling? 

And that could give a little bit more opportunity for understanding and then opportunity for new learning and repair. So just to kind of go back on just what I heard you say, when you talk about belief, there's in the brain neurochemicals that are responding to a belief and a thought, like the emotional tone of a thought or a belief. And then when you talk about trauma, I also think that EMDR (Eye Movement Desensitization and Reprocessing) and IFS (Internal Family Systems) have value, and that oftentimes, with CBT, there's an opportunity to metabolize what maybe didn't get processed. An opportunity to be processed in trauma because it was so intense, so overwhelming. So to have the space to process that. But also, sometimes when trauma happens at an early age, we're at a developmental age, and how we experience that, we will continue to be imprinted, so to speak. 

So it's really important, to your point, to be able to address this, perhaps give new learning, new patterning around it. Otherwise we might be just perpetuating something that isn't entirely. Yeah. 

Yes. So our brain, in my book, The Invincible Brain, I do talk about these circuits. There's a circuit that is very important for the emotional system and the reward system. And in parallel to that, there is a system for logical thinking and reasoning. And these systems work in parallel to each other. And so at any given time, there's a push and pull. You're losing weight, you're trying to lose weight, and you see a tiramisu. Your reward system says, well, let's enjoy the tiramisu now. We worry about the extra pound later. And the logical part of our brain says, hey, you know, it's not eating this tiramisu and avoiding sugar for a few weeks that's gonna help me lose weight. And so at any given moment, you have this push-pull of these two neural systems. 

And depending on how strong one is versus the other, then one wins. So, for example, let's say you're getting married. You have to lose weight; you have to fit in that wedding dress. And so you say no to tiramisu. You say, I can't afford it. I am at 10 pounds, and this is not going to help. And whereas you've been wanting to lose five pounds for 20 years and you haven't lost it, and you say, I just have the tiramisu now, and I promise to go to the gym later today or tomorrow. So at any given time, these two systems are analyzing the world and experiences and our perception of what's gonna happen in the future to help you make decisions. Now, what happens is that these neural pathways are not fixed; they are malleable. 

So, for example, when you eat something over and over again, like sweets, and then the reward system of the brain enjoys that so much that next time you see the food, the reward system- this emotional system is in overdrive, and it just says, you logical, just. You just be quiet, and you just even allow the conversation to happen. You don't even let that thought come into the picture in the first place. And you just eat it. And you don't even think about the gym; maybe after you think about the gym, after you finish eating it. And whereas now somebody says you have diabetes, you just had a heart attack. If you have that, you're going to have another heart attack. And then common sense wins so much. There's not even a question of touching that term. You just don't. But here's the thing. 

And that's the beauty of the brain: it can always think. Now, when people have had PTSD or have had emotional trauma, they are repeating those thoughts, which strengthens those thought pathways, which can affect how they think and how they feel because they have become so reinforced. Remember, I've talked to you about how small roads become highways. 

Yes. 

And it's repetition of the thoughts that gets you there. However, if you tell yourself, what, there is scientific evidence, and apparently this guy knows something about these things. I mean, he's teaching at Hopkins, and he has written four books. And maybe he knows something. Thirty years of teaching at Johns Hopkins and Harvard, maybe. I know some things. So it is possible that these pathways can change. Let's give it a shot. Let's begin by doing it myself. Ideally, find a therapist and try to change the strength of these thoughts and emotions. So the next time the thought comes in that I was abused, another thought can come in and say, “That was 20 years ago, 15 years ago. It did affect me, but I have the whole future ahead of me. 

And maybe it's not a good idea for me to ruin the rest of my life for what happened in the past. And maybe I go for a walk; maybe I go play tennis instead of having these repetitive negative thoughts. I'm going to go fishing, I'm going to go crochet, I'm going to go pick a ball. I'm not going to sit and repeat these negative thoughts. And then, of course, don't expect it to happen tomorrow. And then it's all gone. So 

We know that for a fact. You get twins, and you take a twin at any age and take them from one place and put them in the other one, and they become a totally new person. 

You know, my daughters go to school, and their parents went and they to Africa. And they brought a young girl, age 12, from Africa. And now she is, I think, 17 years old. You would never know. This kid was walking barefoot in a small village in Africa. Now she lives in a very luxurious family. They have a private jet. And this girl is not the same girl who was back then. Her thoughts are different; if you go to their village, her way of life, her thinking, her criteria for happiness. Everything has changed. There's nothing solid about our thoughts, which is just amazing because our brain is the organ that makes us who we are and what we do, how we experience life, joys, tears. And yet that very organ can change. Yes. And that's such a beautiful, amazing thing. 

And once you have insight into that, you can take advantage of that knowledge then to carve out a beautiful future for yourself. Having those thoughts helps a lot. 

Yes. And I'm also thinking an intimate relationship, or even in life in general, if we can give some room to have a different experience or see what else is true, it can give an opportunity for something that feels really corrective or feels reparative, especially when we talk about intimate connection. And so it's almost suspending the loop to be able to explore or reprocess so we can help metabolize and maybe integrate and have a different understanding about the trauma, and also then be able to see what else is true and explore. So I know you are doing so much to help people understand the neuroplasticity and resilience of brain health. 

And before we turn towards what interventions you might want to recommend here for us today, when you were talking about the reward system and the dynamics, like the logic and the interplay there, I was thinking about sexual intimacy. I know we've been talking more about relationship functioning, but in an intimate relationship, there's usually the beginning phase where we have the neurochemicals that support bonding but are very intense and very exciting. Lots of dopamine and novelty. Or even the couple that I mentioned before: we started, like, going to a new place or learning something new. They get the infusion of dopamine and the excitement that can help with arousal and desire. And also, in long-term intimacy, the attachment system and perhaps the habits or routine that a couple might get into. And what about the reward system? 

If someone hasn't been orgasming or they haven't felt they're having good sex, they're not anticipating getting a lot of pleasure. So that might impact their motivation. Can you talk a little bit about the neural systems that relate to sexual intimacy? Because you talk about it very much as a brain process and how this can look in a long-term relationship. 

Yeah. 

All those thoughts play a role in the joy that you experience with someone. “So I think sex is best when there's someone with whom we have a good connection in the first place. Like if you think this person is a jerk and this person really is a horrible person to begin with, then it's hard to really get intimate with them because you don't value them as a person. You can have intercourse, but intercourse is not a loving sexual experience.” 

Now, sometimes you're in a relationship; it is what it is, and you want to have sex anyways, even though you think the other person is. Has a lot of room for improvement. One of the things to focus on is to extend the period of pre-play, where, especially for women, they have a lot of erotic zones, so you don't always have to touch someone's breasts or pelvic areas, like the areas behind the neck, around behind the ear, along the lower back, even on the knees, around the thighs. And I think this is more men who need to learn than women because I think a lot of men- it applies to them too- but to them is sort of, they just jump into having intercourse. 

So, in order to sort of get into that parasympathetic zone and calm down is to not rush the early stages. Don't just take all your clothes off and jump in, and you just sit down, you have a glass of wine, you have a little kissing, you play with someone's hair, you touch behind the ear, you tease the other person, you say nice things, and then maybe touch the back of the neck, and then touch the thigh, and don't go further; you don't rush it, 15 minutes, 30 minutes. And you play. And I think men reach orgasm a lot of times faster than women do. And the problem is that the men just rush it. The men need to learn that women need to come first, and they need to come afterwards. They just need to learn that. 

And again, orgasm is complicated because it has to do with what your perception of this person is and what your perception of what's going on is. You can have horrible sex with one person, and the next day you can have amazing sex with another person. When they say sexual dysfunction, it's so mind-related. And it's not always, I want to have sex with someone who's younger and has a much more beautiful body and this and that. It's really a perception of who this person is. And so the mind is engaged in sex, and the body follows. And it's not a below-the-neck issue; it's an above-the-neck issue. So anyway, in order to have the opportunity to reach orgasm is for the men need to really slow it down and enjoy the whole intimacy experience. 

And research has shown that the phase of arousal could start when you're painting a room together or maybe like you're walking together, or you're just talking, and it's not even in bed that arousal begins. And then when it comes to reaching a point where you get involved in sexual activity, where you actually start touching each other and genitals, that's the next phase where now your body is primed, and you're ready for the next step, which is the orgasm. Now here's the interesting thing is that for men and women they the arousal lines are parallel when they get to the reach of orgasm. Men have one orgasm, and they're done with it. They're like, not available for further until further notice. But for women, first of all, they reach that stage, so they're not. Nothing has happened. 

They have had a lot of joy already. And then while they're up there, the orgasm is one little spike on top of already being up there. You understand what I'm saying? 

Yes, I do. 

So they both rise. 

Yes. 

And then the man has an orgasm and is done with. But women are having fun. Even though they may not hit that orgasm spot, they're already having a great time. And then for some women, it's the one orgasm or two orgasms or three orgasms they can have. Multiple orgasms can happen. And then, they both go through the refractory period where they're not available for another sexual activity. The point is this. Men need to know that women need more time; they need to be more comfortable, and they need to be teased a lot, primed to get there. And for women to know that, it's great to obviously hit the orgasm. “Orgasm is one brain activity where almost all brain areas become active. No other human experience.” 

“Interesting.” 

“Can activate so many brain areas at once. The only exception, maybe now I've got some parachuting where I jump off the plane. I think at that point, all my brain areas are active. But other than that, I think there's no other human experience. That literally blows up the whole brain. All brain areas glow up. And people have done that.” If you take a couple inside an MRI (Magnetic Resonance Imaging) machine and let them have sex, it's a tight space, but they get comfortable; they learn to do it. And you can image their brain at the point of orgasm, and you see the whole brain lighting up. Wow. And so no other human experience gets everything involved. But when you. That zone where you're just having a great time, you're feeling great, you're in the zone, you're just experiencing so much joy. 

The orgasm is like another 10, 15% up. So it's not a wasted experience. No, no. Yeah. And so I think you can, like I said, really, men. Oh. The other mistake that men make is that they realize that intercourse is really not involving the clitoris as much as the clitoris. That's the ultimate source of pleasure. 

Yeah. 

Clitoris has the highest density of nerve endings compared to anywhere else in the body, is a clitoris. That's the important point. 

Yeah. 

And the vagina obviously is very important. And there are three areas that can cause orgasm. Actually, for women, it's multiple areas, but three Main areas are the clitoris, the vagina, and the cervix. But women can experience orgasm even by touching their back or behind the ear. None of the sexual areas can bring a woman to orgasm, but those three areas are the main areas, with the clitoris being number one. “So a man who really wants her woman to reach orgasm really needs to tease them and then focus on the clitoris, make them come first, and then do their part for themselves to reach orgasm.” 

Yeah. Thank you. I appreciate all the science and research that you're bringing to us, and I know we're winding down. So is there, as you talk about brain health and in our conversation today, I know you've written a book, several books, and you're really promoting, again, the recognition that we have so much agency in helping improve our brain health, and you give a lot of interventions. I'm very excited about your work. I keep telling people about it and want people to read it because I think sometimes we think biologically we have genetics and we're predisposed and therefore maybe don't have as much power over our functioning. But you really are giving so much evidence that, in fact, we do. Do you want to comment on that? 

And then is there any suggestion or intervention that you would recommend, based on our conversation today, that might be too much? So I might. We might just pause here. 

No, no, I'll give you a summary. 

Okay. 

I think

 You really build your brain. You have some core parts of the brain that are, like, unchangeable. Like the parts for breathing, the parts for controlling your heart rate- those are fixed. They don't change. But the whole part of the brain for behavior modifications, for the experience of life, has been talked about as having a high degree of malleability. And they can change, just like your muscles can change depending on whether you exercise or not. And 

that functions well and enables you to perform well at home and at work. Now, I have actually created a free app called The Invincible Brain. 

And I have a free online course masterclass, also with the name of The Invincible Brain Masterclass. And of course, I have my book, The Invincible Brain. And I have a whole lot of details about how these interventions can have a profound effect on your brain. In the app invincible.drfotuhi.com that I have, people can do these questionnaires that sort of help them identify the areas that they need to focus on. And my website is drfotuhi.com

I will make sure to have the link to your app, to your course, to your book, as well as all your other website, all the things, and people can get in touch with you and get your book. Thank you so much for your time and everything you've shared here today. 

One more thing. I do have Instagram, Dr.Fotuhi, and LinkedIn. So if you're interested, you can also follow me; I post things three or four times a week. 

I love. 

Thank you very much, Jessica. I appreciate you inviting me and asking all those questions. 

Thank you. I'm imagining you got somebody to. So you got a call for something that you need to wrap up? Is that what that was? 

No, no, I'm good. 

Okay, awesome. Well, I so appreciate everything here today, and I'll make sure to have all of those links, everything you've mentioned, in today's show notes, and it's a pleasure to meet you. 

My pleasure. 

Okay. Take good care. Have a good rest of your afternoon. 

You too.

Bye.