 Thank you, Ashkahn. What we're going to try to do is have a discussion and address maybe some of the complexities of the issues that have been talked about at the conference and maybe haven't been talked about at the conference. So I want to start with you, Peter. What would you consider to be the most important research question? What would you consider to be the most important research question that you addressed or your lab addressed when you were doing flotation research? Okay, well, before I answer that question, I want to make a comment about Ashkahn's introduction of the panel. In case you're wondering, I'm the ghost of research past. And Arita is the ghost of research past and present. And Justin is the ghost of research future. I don't know what, Tom. Yeah, what does that make me? Now, to answer your question, I think that evaluating the importance of research is left to long-term examiners to see what turned out to be the most important. Because when you're doing the research, you don't really know what's going to have the most influence or the greatest effect in coming years. But I can tell you what was the most fun. The things that I enjoyed doing the most when I was doing flotation research was first of all the studies on creativity, especially the first one that we did, which involved my recruiting colleagues from my own psychology department to float and see if that affected their creativity. And if you think you have problems recruiting the general public to float, you should try a bunch of academic psychologists. That was a feat. But you were chair of the department then, weren't you? You supported them. I was head of the department, but that's not the kind of thing you can order people to do. And the ones I recruited were mostly full professors. And if you know full professors, there's no way of controlling them anyway. You know, birding cats is not in it. And the second one that I really enjoyed was the research on athletic performance, improvement of athletic performance. I met people who had sports-related activities and hobbies that were somewhat off-peak. Members of a dark team, for example. And so we had to measure by the millimeter how close they came to the 50-point target and stuff like that, and they were fun. And it was also interesting because I could try, and to some extent succeeded, in teasing out what kind of sports were susceptible to improvement by having people float and what sports did not seem to be improved by that. And so we got some theoretical ideas out of it. The ones where it worked were the ones where accuracy was involved. Basketball free throws, dart throwing, rifle marksmanship, things like that. When it was just pure muscle power, there was no effect. So we tried with weight lifters, and they floated and they were very good about it and so on, didn't improve their performance one bit. So we were starting to make some distinction, I talked about yesterday about what are the limits of flotation, what doesn't it do? So we were starting to get a handle on at least this aspect of what it didn't do. Then I became dean and I had to stop doing research. Can you tell us a little bit about the creativity research, what that showed? Okay, the first creativity study that I did, which is the one that I just talked about, we got members of my department to float for an hour and then go to their offices and record the ideas that they had had while they were in the tank that were related to their work, either research or theory or both. And the control condition was the same people sat in their office for an hour and the ideas that they had. We counter-balanced the order, so everybody did either flotation first or the office first, so it was our half and half. And what we found was that months later we asked them, we typed up their log that they wrote down about their ideas, I think they dictated into microphone and then we transcribed it. And then months later we gave them the list all randomized and we said, just rate these ideas as to how useful they've been in your research or your theorizing and how creative you think they are. And the ideas that were generated after the float were rated significantly more creative than the ones that were generated sitting in the office. It was important to randomize the order, otherwise we didn't want them to think, oh yeah, I remember that, that came to me while I was in the tank, so it probably was more creative. I want to make the department feel good, so I say it was more creative. Not that anybody in that department ever wanted to make me feel good, but if it's randomized you don't, and they didn't necessarily remember which was which, we asked them which was which and they were all over the place. So it was a very promising study and you know they liked it too, they enjoyed floating and it's a nice handy piece of advice to give to junior faculty in their field that they're not being very creative go-float. Then the most recent study that we did had to do with jazz improvisation. I've had a number of students who are jazz musicians on the side, or maybe they're students on the side of the other. And so one of them had this idea that he wanted to test the effect of floatation on music performance. And he recruited a group of music majors who were specialized in jazz and did before and after with floats and then had their professors in the music school rate of their performance. And the ones that they did after floating were rated by the professors as being more creative. They were doing whatever they felt like doing and not a set piece of music. And so it's the thing that they came up spontaneously with after the float were rated by the professors as more creative than the control group that did that without a float. Okay, Arid, can you tell us what you consider to be the most important research question that your lab addressed with floatation tank research? With the float system, again, the sports performance enhancement really was the most interesting. It was also one of the greatest risks to the entire lab. We were doing a study on improving basketball performance with our Washington State University basketball team on the University of Idaho. And the newspapers got wind of this in Seattle and phoned the student who was in charge of running most of the experiment, Jeff Wegeman. And he was so enthusiastic he did the one thing you never do. He divulged a person's name from the study and that turned out to be Brian Quinette before he was in the NBA. And he scored 60 points in two hours after floating in the tank in one single game all by himself. And WSU as known, if you guys from Portland here know, were known for grasping defeat out of the jaws of victory, we still lost the game. But we had a lot of volunteers, we had difficulty with the control group because we were trying to hold out controls and everybody wanted to float from both teams. So that was the most fun. I don't know if that was the most significant, but that was really interesting. Marksmanship turned out to be improved again. Our work was done often at the same time and we came up with the same results which says we do really good work, I guess, because we're using the same kind of controls versus controls. Marksmanship, we had no improvement in actual physical sports ability. We didn't do weight lifting, but we did some other things like that, hand grip, and we didn't get any changes there either. But with accuracy and calmness in the face of a lot of pressure, they did better with the floating experience. And that's pretty much across the board. I mean, these results you don't have to do a statistical analysis with because they're so obvious it really came out, which is one of the neat things about rest. The results come out whether you're using flotation rest or chamber rest, things really happen. And that's important to know the ones that really happen and not try to sell things to people if they don't happen, you know, stick with the research with it. Probably the most significant, Robbie, was our discovery purely accidentally that although we weren't able to enhance hypnotizability with flotation rest like we could with chamber rest, it did serve for people who are hypnotizable to take the place of a hypnotic induction. We did like Stanford scale scores at Stanford scale testing in the tank and basically we got the same results as if we'd done a formal hypnotic induction. So it served as a hypnotic induction. So that may be what happens for those people who have the ability to enter a state of hypnosis. So those are the more exciting ones. That was the pain study, Ryan. Pilot training study was really neat. You didn't mention that. I don't remember it. And one of the things... That is all the C is. I bet that's all the C is. When you deal with a ghost of research past, we deal with ghost memories and sometimes we forget what we've done. I read a very nice study on pilot trainees in a simulator and he had them float and then do the simulator stuff and they... Oh yes, that one. And then when we remind him, he remembers. That one. That one. Very good result. So Justin, what's the most important research question you're currently asking? For me, the question that I'm starting to sort of make the centerpiece of the lab is a clinical question, which is how to take a traumatized brain and heal it. I think that there's something very profound about floating and entering into what you might call a blank slate or tabula rosa. It brings you back before the trauma to a state of calm, quiescence, equanimity. And to give somebody who's been traumatized in life, whether it be early in life or later in life, a chance at that. Just a taste of what it's like to live without that trauma affecting every aspect of your being, I think could be an enormously huge finding. But right now there hasn't been a single study that I'm aware of looking at floating and PTSD or even early childhood trauma. And so the hope is over the next few years we're going to try to develop a proper randomized controlled trial to investigate this. And then if the results bear out what I think they will, you could get places like the VA hospital or even psychiatrists and psychologists using this as the prescribed treatment. So this sounds like a clinical question. That's a clinical question. Justin, that when a person begins to have glimmering recurrences of the trauma in the environment, which is reciprocally inhibiting of a traumatic type of flashback reaction that you're actually getting a reciprocal inhibition effect. My work with PTSD is hypnosis where we actually relive essentially the experience and help the person overcome it by becoming very, very physiologically and psychologically active with it. And we encourage them to actually go through it. And with the ego strength, the psychologist doing the hypnosis, we overcome the trauma, whatever is remembered. And it's important by the way, what is remembered is often has nothing to do with the actual truth, but that's not what counts in therapy. That's right. It's what is encoded that counts. Yeah. So whatever they come up with in an environment like that, that could have tremendous treatment effects. And I wish I thought of that. Glad you did. Right now what we know about trauma treatment is the most effective in terms of evidence based treatment involves what's called prolonged exposure, which a read in talking about hypnosis and having them relive the trauma, prolonged exposure without using hypnosis. Except if you're doing AMDR in a sense is getting them to relive the trauma over and over again. So how do you think introducing people to the tank with the expectation that they are going to experience that trauma? How do you think that would best be done in a research design? For a read of. For you. We'll start with you and then. So I mean, part of what has to happen is, and I think this is important for float center owners to realize as well, when you're dealing with a traumatized brain, you don't want to push them too hard. It's fragile. And I'm personally averse to the idea of sort of just throwing them into the void with no grounding skills, no preparation and having them sort of face their deepest and darkest fears and memories. So I think a lot of grounding techniques prior to even getting into the tank, teaching them basic skills like focused awareness on the breath relaxation techniques body awareness. And then slowly getting them into the full immersive float experience. I've always viewed it as kind of a hierarchical approach. You don't want to start right away and do the full flooding, but more sort of baby steps along the way. It could really run the risk. I don't like prolonged exposure for that. I mean, we do reliving of the experience. They're short and very intense in the psychological and physiological exhaustion. And I agree entirely with what you're saying. I mean, if we create an expectation, the person gets into that you can run the risk of retraumatizing. A lot of these repeated exposure things just retraumatize the patient because there's no resource. There's no what we call restructuring, rebuilding after to put the person back together. And you darn well better have people who are good with ab reactions around at the time. That's exactly right. But it's unlikely to happen if it's done, if it happens spontaneously because when a person recalls something, they recall it because they want to recall it. They're ready to recall it. It's not like a flashback where a sound of a backfiring car reminds them of being shot at or watching their buddy get killed or something like that. So we have some questions that were submitted. And I thought I would put them to the panel and let the panel sort of run with how they want to answer these questions. The first one deals with the number of floats and the timing of floats. Is that an important thing in terms of achieving the desired effect? So from our research experience, do the number of floats per week, does that make a difference? The length of the float make a difference? I mean right now we're seeing many centers using 90 minute floats. From the standpoint of our research, how long, I think that most of our research we use 45 to 50 minute floats. We even shortened it to 35 minutes in some studies. How long were the floats in your studies, Peter? Well, as I said yesterday, that question, both parts of that question are in the category of things we know we don't know. Right. We don't know what the optimal time period is in the tank and we don't know what the optimal number of floats in any given period of time is either. We used an hour, randomly more or less, because that's what a lot of people were using. But I don't know whether that's the optimal period or not. It may be a little too short. Maybe we'd get better effects a little longer. Maybe we could get the same effect a little shorter. Somebody needs to do the parametric research. How long were the, when you tried to achieve hypnotizability in the flotation tank, Arid, how long did people stay in? Those are just one hour floats. Okay. Again, we don't, I don't know. So you described. Research is that it's not exciting. Well, I understand that. That's why nobody's doing it. But I thought we could at least address this question a little bit. Arid, yesterday, today, when you said that flotation does not increase hypnotizability, but the dry tank, yeah, right, but the dry tank did. That was a six-hour study, right? So we really don't have data that tells us what would happen with a four-hour study or a five-hour study of people floating. We only have data with a one-hour study. And so in future research, somebody could, if they wanted to, try these longer studies to see if it had an effect on hypnotizability. Well, this is like a similar issue to some of Peter's work with smoking cessation, right? So with chamber rescue, very clear results after 24 hours. Yes, we did do parametric research on that and we tried 6, 12, 18, 24, and 30. Yeah. The result that we would get at all, we got with 30, we already got with 24, and we did not get with the shorter periods. So 24 was apparently the best period for chamber rescue, for that particular application. And that's exactly what we did with the problem foods category. Yeah. It's some effect at 12, optimal at 24, nothing at 3, nothing at 6. The other thing with, in terms of getting the optimal float times, as the psychophysiological instrumentation has improved a lot in terms of that, we should be able to get some real data like we can get in chamber. We have that data for the chamber that's a lot easier to keep electrodes on when you're not floating in salt water and so forth, you know? So you'll be able to do that. Yeah. I mean, one of the things that's really interesting, we've already started beta testing. We have a number of different units that are wireless, that are waterproof, salt-proof, non-invasive. And we could look at the relaxation response. So you could take blood pressure, for example. It's clear that for a lot of people, blood pressure is just going down within the first 20 to 30 minutes of a float. And you could kind of see the drop-off over time. And you could try to find the point in time where blood pressure starts coming back up again. And maybe that would be a good cut-off for where you might say that's the float effect. You want to stop once it reaches the bottom and then starts coming back up. Okay, you're ready to come out. And so you could use physiological equipment to kind of dictate what would be the ideal float to say maximize the relaxation response. So would you say that's a direction that future research should be going? I think so. One of the questions I get asked by every colleague of mine is what's the dose of floating? And it's a strange question because, you know, this is not a drug. But nevertheless, the western medical model is all about dose. And so to be able to give people a precise answer to that I think would be beneficial. Are there any physical disorders that would be automatically essentially excluders from floating? So one question was CHF, which is coronary heart failure, chronic. Are those things excluders? Do we know that or how do we decide what should be excluded or not? I remember in our early research, one thing we decided that we were going to exclude was anyone with epilepsy. And we were partly concerned that if a person began to enter into a low, a theta state, that it might trigger an epileptic seizure. But does the panel have any thoughts on this? What you excluded from your research, are you excluding anything right now from your research? Psychiatrically, I mean, I think there's a lot of things we need to be wary of until we have more data. Two things that I just don't know about and maybe people in the audience could illuminate us. If you have somebody who's extremely depressed, maybe suicidally depressed, and is a chronic ruminator, it's not clear to me whether or not the tank would exacerbate that. And so that is one of my concerns. Then also, if you have somebody who's actively psychotic, is the tank going to exacerbate, say, their delusions or their hallucinations? And I don't know if there's any data to speak to that. So for me, I think it's less about exclusion and more about treading cautiously until we have more data. Well, we excluded from both the chamber and the float, people who are deeply depressed, because we had the experience with a few of them that they spent in the chamber. They spent the 24 hours reflecting on how bad their life was, and that's not helpful. And of course, with the tank, we included people who had a rash that would be made painful by the solution. And we also excluded pregnant women, which mostly because we were afraid that if something went wrong, we'd be sued. We didn't think anything would go wrong, but it didn't have to go wrong during that hour if it had gone wrong any time. That's right. We could have been held liable. Although, as I said yesterday, there are some studies that show that the physical discomfort of pregnancy is likened by floating. But A, we didn't know that at the time. And B, we still wouldn't want to take the chance. You bring up a really important point, I think, with running subjects or running participants who just want to experience it. A lot of the cautions are simply because if something coincidentally happens in the environment, you're held to blame, whether it has anything to do with there's any causality at all. In the environment or afterwards. Or afterwards, exactly. What did you experience today? Well, yes. We have to err on the side of caution, I think. Of course, the person doesn't tell you when you're running a tank center. That's a different situation. But you might want to have some kind of disclosure statement. Are any of you aware of any research that's been done on traumatic brain injury or concussions using flotation? There was a researcher at LIBER who studied this, not with flotation, but he studied traumatic brain injury and he studied post-concussive syndrome. And what he told me essentially was the most commonly prescribed treatment for somebody after concussion is reduce your stimulation, rest. And boy, wouldn't this be a great environment to do that in. So as far as I know, I don't know of any studies that have been done, but theoretically it makes sense that if somebody just had a concussion, having them in a float tank could actually be very beneficial. Peter, I know that you did some work post-ECT using chamber rest. Not that ECT is a concussion, it's not. But could you talk a little bit about that? Because I think most people are not familiar with that research. Okay. We were working in collaboration with the psychiatry department at the university. And they referred to us, some patients who were getting ECT mostly because they were depressed. And what we were really interested in was to look at the competing hypotheses that we had found with chamber rest that it improved memory. But there was this general set of reports and anecdotal reports and so on that ECT was a memory destroyer. And so we wondered if we put people in rest after ECT with that balance out the effects of the ECT. And what we did was when they came for the rest session we would put them in the chamber and then when they were finished we would give them a variety of memory tests for things that they had learned prior. And what we found was that there was no effect. Because there was no forgetting of the material that they had learned prior to ECT. Their test scores on the memory tests were just as good as before the ECT. This was basically a demonstration project. It wasn't a full-blown experiment, we didn't do controls. There is so much of the self-reports that memory had deteriorated after ECT that the tentative conclusion that I came to was that we were using the wrong tests. That some kinds of memory are impaired and other kinds are not which is a step in the right direction because previously it was believed that all kinds of memory were negatively affected. I think we at least tentatively demonstrated that it's not necessarily all kinds of memory but we didn't rule out some kinds of memory. If you were starting a research program today, Arid, what would you study with flotation? Well actually I think Justin's got a good handle on what has to be done. We have a lot of things we need to know about duration, we need to know about physiological effects and you're set up to really do that properly. I think there's a lot to be learned and then we'll have data in terms of what's good for this, what's good for that, what's the duration, for this kind of a need whether it's a sports performance thing, what's the duration for somebody just wanting to calm down, how often it should be so we have something to offer the public which is based on science rather than based on sensation seeking which I think is a great way to get people started in it but they might continue if they're getting optimal results from it and that's the kind of data we need. It would be a lot of this, a lot of the research is not so exciting because we need to know things like duration, we need to know the optimal for different things. When you think of TMI, traumatic brain injury, the number of people with PTSD having had combat stress syndrome for example, this is a large number here at TMI, this could be a great opportunity to try to deal with that as well. But again, we don't know, that's the exciting part. I think the first step would be to get ahold of Justin's apparatus. Are you talking what's under his cranium or are you talking about the physical facility? So Justin, where do you see your research going in the next year, year and a half? What projects are you going to do above what we saw yesterday? Well, I think at least for the next year we're still trying to answer some very basic questions that are waiting to be answered and to be honest, I was surprised that they hadn't already been answered. So one of the things I discussed yesterday is, we need to know if magnesium is being absorbed through this high concentration salt bath. And so that's one of the things we're going to know probably within the next year whether that is actually happening. We need to understand more about what's happening in the brain and in healthy people, because eventually my research program is going to be really clinical based. And until we have some sort of understanding what's happening in the healthy, normal brain, we really can't make any sort of conclusions as to what's going on in the non-healthy brain. So I think for at least the next year it's going to be answering very basic questions about what's happening in the body, in the brain, in healthy flows. And then very quickly, probably in the next two to three years, shifting into clinical issues like post-traumatic stress disorder, anorexia and so forth. When you say what's happening in the brain of healthy people in the next year and a half, the study that you showed yesterday really looked at an fMRI right after they floated. What do you have on the drawing board for trying to get a feel for if somebody is floating regularly, what happens to their brain, but we're not going to look at it right after they floated? Well, what's really neat about this magnesium study is it's a longitudinal study. We're going to take people before they've ever floated, we're going to scan their brains, and we're going to let them float twice a week for five to six weeks, an hour and a half each time. So by the end of about a month or so, they've had 15 to 20 hours of float exposure. And then we're going to scan their brain again afterwards, then a month afterwards. And one of the neat things that we've developed is you could do automated algorithms to look at the physical structure of the brain. So we could look at things like cortical thickness. And what you might find is with floating, the physical structure of the brain could be altered. And our prediction would be the areas of the brain that map the internal world of our body might start flourishing. And you might actually see physical changes and expansion in those body maps that are happening in the brain. So I think one of the studies that we're going to be doing over the next year is actually trying to look at physical structural brain changes induced by the floating experience. Is there any evidence from other types of practices, mindfulness meditation, yoga, etc., that that kind of change actually can occur with regular practice of something? There's a lot of studies that use what's called the between-subject design. So you'll take a group of people who've been meditating their whole life and have 20,000 hours of meditation practice. And then you take a group of people who haven't, and you find major changes between these groups. But, you know, the study that I'm talking about is really a within-subject study. You take the same individual, you look at changes within their own brain. And that's pretty rare. Even in the meditation literature, you rarely see somebody tracking that individual over time and looking for changes within them. So the truth is this will be a really exciting finding if we find any... Do you have any speculation what parts of our brain would change with regular floating? You know, the area that we think is going to change the most is what Dr. Simmons presented yesterday. It's an area of the brain called the insular cortex, but in particular there's a part of the insular cortex that receives all the input from our internal world of the body and the vagus nerve in particular. And it's called the dorsal mid-insular. And this is pretty much the first area of cortex that receives input about things like what's happening in your heart, what's happening in your gut. And what we would expect is this is the area that would actually see the most changes. And so you'd expect thickening, which would imply increase in neurons. Exactly. So the idea, as I told you yesterday, even a single 2mm voxel has about 100,000 neurons. So if we see even a 10 or 20% change, who knows how many new neurons that actually equates to. And why do new neurons appear? Well, this is the exciting times we're in. I mean, 20 years ago when you would teach neuroscience to somebody, it was like, alright, you're born with your brain and your neurons, and once you reach a certain age, it's over. Those neurons will start disappearing as you become demented and life is over. And so what really happened that I think changed the whole field of neuroscience about a decade or so ago is this idea of neuroplasticity. The idea that we're growing new neurons all the time and it happens throughout our life. And so to tap into this concept of neuroplasticity and to use floating as sort of a tool to actually enhance it, I think that's a fascinating way to go. Arit, I know a lot of your recent work has been with hypnosis. Is there any evidence of this with hypnosis? Not that I know of. We know what happens when we enter the hepatic state. Well, we have the anterior cingulate. We did the changes with being able to be... We know that the pain effects have nothing to do with releasing endorphins. Very similar to what happens with... Tell us a little bit more about that because that applies to your study and I think everybody would like to understand that a little bit more deeply. Well, it depends which little bit you want because that's about all I talk about for the last 30 years. But while the exciting thing, people often thought that the hypnotic effects on pain control, this, by the way, is nothing new. Ernest Hillgaard, Jack Hillgaard at Stanford, it produced 20 years of research, gave himself his own building. Jork Nahali had to become Dean of Arts and Sciences to do that for doing hypnosis research and he's the one who established reliable measurement of hypnosis. But the pain control aspects were studied and it was thought for a while. Well, hypnosis is releasing endorphins and they did some studies by injecting folks with naloxone and it turned out that they were able to attenuate, reduce, or eliminate pain completely with hypnosis anyway. So it appears to be an association effect. I've had some personal experience with that. I'm only average hypnotizable. I went through surgery with that as an effect. I was surprised at work, frankly, so it's not expectations that some people think it is. But expectation effect to things I think we have to think about in breast research. But one of the things that really struck me, which has pertained to hypnosis research for many decades, is that initially with between-group designs, many good findings were missed because it was obliterated in the fog of the differences in subjects. But within subjects' designs, it was able to give us clues as to what's really happening and changes that happened. For example, you find if you're going to do a, say, hypnotize somebody and you tell them that there's a cardboard box blocking the computer screen in front of them, we have a flashing image to do like a nod-ball paradigm for doing evoked potentials. And what will happen is they will have a reduction at the P300 evoked potential. It doesn't disappear. They actually have to receive the signal to make it go away because it's happening at the executive level. And there's a lot of things like that in breast we haven't touched looking at. And maybe the epic model that Kyle was talking about yesterday becomes a global model to sort of understand that. Well, this has been very, very interesting. And we actually have one more minute. So Peter, I want you to wrap up with basically what you would like to see in the future of breast research. Wow. I would like to see universally accepted. Yeah, I think, first of all, you know, I wasn't kidding about the apparatus. I think that having equipment that can do what Justin's equipment can do is a tremendous step forward in flotation research. The only thing I would wish for in addition was scanning devices, PET scan and MRI that can do it while you're in the tank. Wouldn't that be amazing? I expect you're on the way. Well, you know, I think there's one alternative to that. And that is if we can build a tank that'll fit into an MRI. So that may be the first engineering feat. We just have to get our tank designers and the MRI designers together. Well, actually, you know, the dry float tank is easier for that purpose, right? Because you don't have to worry about the corrosion from the solder and all that stuff. And then I think we do, you know, we kept talking about doing parametric studies and we need to know what the optimal length of flotation is. And I would guess there'd be different optimal lengths for different purposes. And we haven't looked at that at all. And how long the after effect lasts? We don't really know that. You get people who reduce their blood pressure. Well, how long does that last? And then again, how many floats per what amount of time? And then we've identified lots and lots of important problems and important questions that should be addressed by looking at flotation as an investigative tool. And as I said yesterday, there are also a lot out there that we haven't even thought of, but presumably that will come to us as we go along and as more people come into the field. Well, so maybe we can challenge the community of flotation to be active in a way that will get either the government who funds us through NIH or NIMH to realize that we need these studies done or we come up with our crowdfunding mechanism, get our own energy together to be able to generate the funds necessary for this type of research. Thank you very much. This is very...