Alice Sibelli, PhD: Gut-Brain Health, Digital Therapy & Living With Chronic Illness

Alice Sibelli, PhD (00:00) for the first time I was a patient. I wasn't the researcher. wasn't the psychologist developing program for people. I was actually experiencing those symptoms. I was actually dealing with the challenges that our health system, unfortunately, sometimes experiences because of the pressure. So my confidence took a big hit. I was being incredibly self-conscious during social situations. Annie Wenmiao Yu (00:24) who do you think will benefit the most from our conversation today? Alice Sibelli, PhD (00:28) people who have developed a health problem and that they're learning to cope with physical and mental symptoms that are impacting different aspects of their lives. Relationships, work, daily activities, and even their sense of self. Annie Wenmiao Yu (01:29) Today on Low to Grow, I am delighted to welcome Alice Sibelli, born in Italy, raised across South America, and has actually called the UK home since 2008. She is a psychological researcher with over 15 years of experience, and she is passionate about turning science into digital health solutions that can truly help people who are living with long-term conditions. Now, Alice's personal journey with Digestive Health. has deepened her empathy and connection to the patients that she now serves, making her work both professional and also profoundly personal. Currently, advises health tech companies, leads clinical research, and supports organizations of all sizes in creating user-friendly and impactful interventions. Alice, it's a pleasure to have you on the Low to Grow podcast. Alice Sibelli, PhD (02:17) Hi Annie, thank you so much for the invitation. I'm delighted to be here today. Annie Wenmiao Yu (02:21) Alice, who do you think will benefit the most from our conversation today? Alice Sibelli, PhD (02:27) I am thinking about people who have developed a health problem and that they're learning to cope with physical and mental symptoms that are impacting different aspects of their lives. Relationships, work, daily activities, and even their sense of self. And also I would say people who have loved ones going through this as well. Annie Wenmiao Yu (02:54) think you've mentioned your personal experiences with your digestive issues has a lot of impact on the work that you're doing now. Would you be able to share a bit more about your experiences? Alice Sibelli, PhD (03:04) approximately, I would say 10, 12 years ago, I woke up one night and I just started having quite unusual symptoms in my throat, in my stomach, I had already been working with people with these problems for years in my academic role. But when you experience that yourself, especially when there's very uncommon symptoms is, it's just completely different. I'm not going to lie to you. It was the start of a very long medical journey, but also that experience, especially in the beginning, I would say the first year or so completely threw me off, completely threw me off one because it wasn't a straightforward diagnosis. So there was. nothing necessarily wrong with my stomach or my esophagus. And when that happens, you just get discharged. You have so many unanswered questions and you really have to advocate for yourself until you find the right doctor that will look at the problem from a more integrative approach or more holistic way. Annie Wenmiao Yu (03:59) Hmm. Alice Sibelli, PhD (04:09) But the also the other point was that for the first time I was a patient. I wasn't the researcher. wasn't the psychologist developing program for people. I was actually experiencing those symptoms. I was actually dealing with the challenges that our health system, unfortunately, sometimes experiences because of the pressure. So my confidence took a big hit. I realized that I was being incredibly self-conscious during social situations. I was concerned about my noises, the throat noises, the stomach noises when I was talking to people, social situations around food as well became incredibly stressful work situations too. my job requires public speaking, requires talking to different types of healthcare professionals, participants in our studies and patients. was quite scared because I didn't know how I was coming across. I didn't want my credibility to be affected. first I tried to micromanage external situations to feel that I was in control and diet is the best example. I just didn't enjoy having food with other people anymore. So that was one way to control things. And then I realized, well, that's not probably the best way to approach it. I need to start applying all the strategies and skills that we teach in our programs. And maybe the last thing that I will say here is that Besides, you know, the anxiety and the stress when you're dealing with a new situation like this, especially when it affects your physical health and in turn also your emotional well-being, I was grieving old self. I was grieving the way my body used to function before I developed that problem. I had to start working on accepting the fact that something changed but that I could still be myself and I could really learn to cope with the symptoms. Annie Wenmiao Yu (06:13) Wow, that's quite a long-term it's actually made me that when you have a longer term condition with the symptoms, it's something that actually changes how you experience life. think I actually fully realized before that if you have a longer term digestive issue, then it can actually cause a lot of changes, which can be quite harmful for you in a way. for example, if you had to stick with a very restrictive food diet, that could have led to a lot of other diet related challenges as well for the individual. And I think what's so great about you sharing just now is you sharing your experiences, will resonate with a lot of people and making it a case that, it's not something that's shameful to talk about, but it's a normal part of life. And I think it's really great that you have opened the floor to that conversation. Alice Sibelli, PhD (07:01) And yes, thank you so much. You're absolutely right. It's particularly about the point you're making about around stigma you. Thank you for saying that. Annie Wenmiao Yu (07:09) Alice, could you give a short background on how mature is fulfilled that connects together physical health and mental health? Alice Sibelli, PhD (07:18) nowadays, particularly in countries like the United Kingdom, the United States, many other countries as well, but it seems that more and more people, more doctors, particularly specialists in the medical field, are talking about this connection between mind and body. there's still a lot of work that we need to do. even if in, for example, the 80s, where the biomedical model was the center of medicine, so our body and our mind were perceived as completely separate, then things started shifting during those years. For example, with model of health, which pretty much tells us that the health is the result of an interaction of biological, psychological, and environmental factors. So it's a combination of all of these factors that are incredibly linked. still it has taken years and years and years really for doctors and even some psychologists to acknowledge this deep connection. So I would say we're making incredible progress in this area. I am specialized particularly in digestive conditions and I'm very proud of all the work that we're doing in this field, but I would say still after years and years of research and clinical practice, we still need to do more work to create awareness, to raise awareness around this deep connection between mind and body. Annie Wenmiao Yu (08:53) I think it's you mentioned that our health is affected by physical health, mental health, and also environmental factors. earlier you also mentioned that it took a while for physicians and some other actors to really come around to this idea. I'm curious to understand what were the factors behind that initial actually accept and mental interactions and also the Contribution of environmental factors towards mental health. Alice Sibelli, PhD (09:20) the biomedical model, so again, very dualistic model that divides the mind and the body has a very, very long history in how medical doctors work, how medical doctors used to understand health and illness. we used to understand. physical problems were related to the body and psychological problems and symptoms, emotional problems were completely separate. What started happening is that research in different areas, but I'm going to try to talk a little bit more about, the digestive world, which is where I'm What happened is that Many patients would go to the doctor. They would have real physical symptoms. We're talking about abdominal pain, diarrhea, constipation, vomit. And the doctors would just start doing the tests, medical tests, imaging, blood tests. And they would realize there is absolutely nothing wrong so no organic cause. And what happened is that we had to start looking for more answers. because these patients actually had real symptoms. They were real symptoms, and there were no organic causes or at least no obvious causes, right? This is, as I was saying, it's a very, very complex topic. There are biopsychosocial variables, so I don't want to be oversimplistic in any way. But that's where, for example, a field like the one I work, They started realizing these are functional problems in the sense that this is how the body is not working as it's supposed to be. But there is nothing organic or structural that is wrong. So there must be different factors that are actually contributing to this physical symptoms. And in our field, the brain gut access is element that really, really clearly connects that mind and body. are biological pathways that could connect the brain and the gut. We know that the nervous system connects both of them, hormones, immune cells. So once you have those biological pathways that are showing researchers and clinicians that there is a connection between the brain and the gut. That's when you can also start understanding that there are physical symptoms that can happen in the absence of structural problems in our body. that's why biopsychosocial model now is becoming more popular and is helping us to understand health and illness and how to of course help people with their mental and physical problems. Annie Wenmiao Yu (12:10) I think I definitely remember some of my friends who were also doing PhDs in a similar field mentioning the gut brain microbiome. And I think that's what you were describing there as well. in the UK there's actually a lot of pop science about how stress, anxiety, maybe depression can trigger some digestive issues. But what I found, as someone who suffers from a lot of stress, either during work or during studying for I actually found that the symptoms that I had, was actually common to a lot of other like experiences. not necessarily just caused by stress. for example, indigestion could also come from me consuming something that I'm slightly allergic to. And it just seems it's difficult to actually appoint symptoms what particular cause that comes from. And I wonder if you could share a bit about latest research in how you can actually better diagnose what the, mental health illness that a person is suffering from and how that can be traced to the set of symptoms that they're experiencing. Alice Sibelli, PhD (13:09) a great question, Annie, and you're absolutely right. Particularly when it comes to gastrointestinal symptoms, many people can present with similar symptoms and the root cause can be different. the first point is always a thorough assessment that is conducted by, of course, a gastroenterologist where they will start with tests, as I was saying, from the typical blood test to more specific blood tests, like for example, know, celiac disease. But the idea here is that they will conduct some important tests and to rule out physical causes or to understand whether there are actually some physical causes. the first step. If there elements those tests that actually provide information and confirm a diagnosis, for example, it could be an acute esophagitis, an acute gastroenteritis, but also we can talk about more chronic conditions like Crohn's disease or ulcerative colitis, that actually are organic diseases, the next step in terms of the treatment approach very important for the multidisciplinary team, not only the gastroenterologist to discuss and share the treatment, approach with the patient. What happens in other cases is you go through all those tests from the blood test, imaging and there is absolutely nothing wrong with the person. And that's when you start involving, for example, a dietitian, and you can start working with the dietitian to understand if there are foods that are triggering the symptoms. And of course, there are different approaches. specialized dietitians that they could start with a low FODMAP diet, but here, of course, it will depend a lot on the type of You could think about as well what happens with health psychologists or clinical psychologists who are specialized in digestive conditions, where are they actually coming in and helping patients? And how do we present also that to patients? Because let's remember that people come with physical problem and they talk to a gastroenterologist and then ruling organic problems, someone mentions randomly, well, there is a psychologist who could help you. that's a very important point because we need to be incredibly careful how we frame that help and why we're bringing a psychologist within the multidisciplinary team to support the patient summarize that there are different steps that the doctor and the multidisciplinary team will be taking to ensure that the right diagnosis is made and to make sure that if it's not an allergy or if it's not an organic problem like celiac disease, then it will be referred to the right psychologist with the right background to help the person. Annie Wenmiao Yu (16:09) Hmm, that sounds like quite a long process to go through. And I guess, you know, if, you're someone living in the UK with access to NHS or public health care, then that's probably a process that can take quite a few months. And it just seems like the person can suffer for quite a while whilst they're going through that process of getting there companies building tools to help streamline that diagnosis process? Alice Sibelli, PhD (16:35) Yes. Firstly, you are absolutely right. think that's an excellent point and many people with digestive conditions and particularly here talking again about functional problems. What we should be talking about nowadays disorders of the gut brain connection, which are the ones that do not have an organic or structural root cause. There are people. who can spend years in the system going back and forth to GPs problems and digestive symptoms. just because there is nothing serious, quote unquote, and the person will not die from it, let's say it, then they just are discharged and people are left with... unanswered questions and with ongoing symptoms. in many cases, we're talking about years, not even and I know this talking to too many people who have used our programs. to your question. There are, companies nowadays that they realized that digital health and in this case particularly digital therapy can actually help people access solutions that can actually improve both their physical symptoms but also their psychomotional well-being. And of course, there are different companies. It depends on the digestive problem. It depends on the approach that the company is embracing. But we are talking about digital solutions, for example, such as gut-directed cognitive behavioral therapy or gut-directed hypnotherapy. And there are startups in the US, UK, Europe, that have created these solutions that they have to be evidence-based. So there is a lot of clinical and regulatory work that goes into them to ensure that they're actually safe and effective. And of course, what these solutions offer people is faster access to something that can help them. I personally think that they are an excellent solution in the context of a stepped care approach. And by that, mean that if, for example, on a waiting list, because you have to wait for at least a year to see a specialized gastroenterologist, then you could have access to one of these digital programs that will help you start developing some key skills to manage your symptoms. And that means that by the time you get to the gastroenterologist, you may have already found some things that help you. Another option is, well, I could use this digital solution in combination with the support of a psychologist or a therapist, because again, this has to be personalized and tailored to the needs and the preferences of the person. So again, you can be on a waiting list, for example, of a talking therapy center in the UK that they also offer support for people with long-term condition, such as irritable bowel syndrome. And then... while I wait, could have access to just this digital solution, or I could have access right away, but with the support of a therapist that is going to guide me through the process, because perhaps my mental health symptoms are also quite severe, and it's not only about my digestive problems. at the end of the day, I keep saying this when I talk to people, I think it's incredibly important to embrace a personalized approach. And I think the digital solutions can really help with that. It's not about replacing necessarily doctors or psychologists, dietitians, but it is about increasing access to solutions that can truly help people that need it fast and safely. Annie Wenmiao Yu (20:34) That makes so much sense because even with getting access to NHS therapy services or counseling services that can be a couple months waiting and you know that all depends on how severe you have been deemed by the questionnaire that they have. So it seems like this digital health solutions they are tools that can be used alongside other treatments so maybe therapy sessions with a psychotherapist or a counselor or having hypnotherapy and having that package and as you said that personalized approach for each individual's circumstance. if one of our listeners, say they're a young professional working quite a stressful job in the city, they have been feeling very gassy and also feeling very bloated on a daily basis. And they're still having the same diet as before. And they really want to do something that can really alleviate that. How should they go about trying to find the best solution for them? Because it seems like there's a whole variety of digital mental health solutions out there. do they have to do research themselves or do they go to the GP first and be almost hand-led and listen to what type of solution that the GP recommends? Alice Sibelli, PhD (21:45) the GP is certainly a good starting point. Now, we know that GPs deal with many different types of problems, there is so much pressure on them. that it can be incredibly useful to go with the GP with already a very, thoughtful list of symptoms that you're experiencing the potential solutions that you would like to explore. So let's say that, for example, you've seen that there is a talking therapy center that can offer support to people with digestive conditions, then you can mention that and some of them actually self-refer. So use self-referrals system so you can actually do that. But I think here one of the most important points is that Going to the GP for me is incredibly important because digestive symptoms can be so different and can again have different causes that sometimes it's very easy online to find information and to immediately think that you already have a chronic condition or that you have something incredibly serious, but maybe you know, that might not be the case. So going to the GP is what I think that's why I'm going to a medical doctor is what we're allowed to start thinking about. Okay. How do we move forward from here? Is it this an acute problem? Is this a potentially long-term problem? What are the tests that we need to start doing to rule out or to confirm potential diagnosis? That for me is certainly the best way. would also say are lots of solutions in the app store. And I might think that I have irritable bowel syndrome and I want to download a great hypnotherapy app. And that's fantastic because again, hypnotherapy, cognitive behavioral therapy that are specifically tailored to digestive problems are incredibly effective. We know that even better than some medications, but let's just be sure. that we go to the right doctors and specialists to ensure that we get the diagnosis and then we find those digital solutions that can help our problem. I hope that that makes sense because I want to make sure that that's a point that comes across as well to our audience. Annie Wenmiao Yu (24:10) think that's really clear and I think what you said about getting the right diagnosis first so that then either you or your GP or health provider so that you're all looking for the right solutions to the right problem. I think that will make sure that the patient gets the most appropriate the right time. Alice, I want to ask you a bit about your experiences at Mahana were there for about five years and most recently as the head of medical and clinical. And I'd love to hear a bit more about your experiences working in that company. Alice Sibelli, PhD (24:41) my experience at Mahana was absolutely fantastic. It was my first experience in the industry. So I started working at Mahana over six years ago and I have an academic background. So I had been working at different universities, such as University College London, King's College London, and always As I said in the beginning, I was incredibly passionate about developing and evaluating rigorously digital solutions for people with long-term conditions. And what happened is that one of the programs that I developed senior researchers and clinicians was actually licensed by a US-based which was Mahana I helped with the licensing process and then I started working for Mahana full time. you know, in startups, you wear very different hats and there is a very fast pace. You have to be incredibly committed to the mission of the startup and you have to be willing to be flexible and adapt to ensure that you're supporting what the business needs to make it. I would say one of the highlights at Mahana for me, and I'm sure for other colleagues, was when the program that we developed for irritable bowel syndrome was cleared by the FDA. This was the first digital therapeutic for irritable bowel syndrome cleared in the US by the FDA. it was, Annie Wenmiao Yu (26:06) FDA. To give a sense of scale to the audience who might not be familiar with that process, how long does it normally take to get a product cleared by the FDA? And also, what significance does it have for Mahana Solution to be the first one to have had that accreditation? Alice Sibelli, PhD (26:22) I'm trying to remember approximately the timeline, but I can tell you that it was a very lengthy process. It was approximately a year. this is because we already had... run a very large and rigorous randomized controlled trial in the UK, King's College London and University of Southampton to actually evaluate the clinical and cost effectiveness of this therapy for irritable bowel syndrome. So cognitive behavioral therapy tailored to irritable bowel syndrome. not even counting the years of research that actually led to to ensure that if the product was safe and effective. But then after that, of course, you have to ensure that you complete a de novo submission to the FDA. In our case, we had to do the de novo. So that pretty much means that you are not claiming equivalence with any other product that the FDA has already cleared. obviously the regulatory and clinical work that goes into that process is incredibly rigorous and detailed. So it's a great partnership between regulatory the clinical team, also the product team, because we had to redevelop the program with a more sophisticated platform. And also at Mahana, we enhance the user interface, we enhance the product, and also that takes time. But that process of applying and... having a back and forth with the FDA, all the questions that they had to ensure that they were actually convinced that the product was safe and effective, it was around a year. Annie Wenmiao Yu (28:05) that must have been so rewarding to have gone through that process and worked with such an interdisciplinary team across the company to then bring that to fruition. similarly, I remember in our company, we build hardware and we also have to get a special type of ESV certification. And that's also a very, lengthy process. you know, as a company, if you're able to get these type of certifications, not just a stamp but it's also a mark of credibility for your customers and your end users as well. So I can definitely appreciate and also emphasize with you having gone through that process. I did want to pick up on something before joining Mahana, you were in academia. How did you find that transition from academia? Alice Sibelli, PhD (28:37) Yes. Annie Wenmiao Yu (28:49) to in a startup. Alice Sibelli, PhD (28:51) a very exciting transition, but of course not always easy just because academia and the private sector work very differently. I was incredibly lucky because I joined a company that truly cared about the scientific evidence and evidence generation process of digital therapies. And that's very important because coming from a an academic background, what I learned was not only to develop the clinical protocols and the clinical content of these interventions, but to also conduct different types of research following. qualitative and quantitative methodologies to ensure that you are rigorously evaluating those interventions. So there was a continuity in that sense that I knew my academic background was appreciated and it was needed particularly when you want to develop. regulated products. But nowadays we know that even for wellness products, it's always good to have people with a clinical science background, were many differences, but I want to focus on one that I think for me was quite key. I realized that in a startup, you do not have five years necessarily to conduct a large trial. And you need to really, really adapt all the research and clinical skills that you bring to a fast-paced environment that is working in the real world. So of course, sometimes you do need to have clinical trials running on the side. I'm not saying that I know many startups do that and Mahana was doing that as well. But also there is this wealth of data and this great possibilities in the real world that you have that you're taking the product to the hands of people. And you can actually use the data and the information you're gathering to understand how the product is working in the real world to understand who is responding better to the product, what parts of the product are contributing to those changes that are meaningful to people. that was an important shift for me. First, I need to start thinking about research design in a different way in the real world. And you need to find the right balance between being rigorous and conducting systematic research, but also ensuring that you're doing it in a way that is safe in the real world and that is quicker than what I used to do. also had to work with product experts. commercial leaders, because in a startup, you work very closely with the leads of the other teams to ensure that all the voices are heard, including clinical, you do have to make sure that that voice is heard, because of course, commercial goals are incredibly important in the private sector, rightly so. So how does a person with a clinical background talk to commercial leaders and communicates, by the way, as a clinical person, I can help you with the business goals. can let me contribute to that, but also let me contribute to the credibility of the startup to ensure that we're also doing things the right way. And of course, you have regulatory team that will also help with that. It's not only clinical. that's the first thing that comes to mind. difficulty, but challenge that I faced and I had to overcome coming from the academic world. Annie Wenmiao Yu (32:26) That's a real wealth of experience, Alice. your experience of pace at which products need to be developed. compared to your previous experience in academia, I think that's a common challenge faced by a lot of academic employees who leave academia to join startups or even to work in larger organizations. If you could go back. and speak to the evening just before you join Mahana, what advice would you give to that person who has just left academia and are about to start on their career in industry? Alice Sibelli, PhD (32:58) I love that question, Breathe. Because shut down several months ago, but those five, over five, six years that I worked with them. were an amazing roller coaster, so there were no regrets. But one of the things is, when I say "breath", what I mean, of course, is not only that, not literally necessarily only that, because deep breathing is incredibly important, but it is about, grounding yourself and looking at priorities. it actually took me quite a while to understand during my transition. When you are working in such a fast paced environment, you realize that you cannot focus on hundreds of priorities. You do need to be very good at understanding. What are my top three priorities even today of the week, of the month, of the quarter? And you know that also that's going to change sometimes depending on what other teams needs, priorities of the company. So what I would say is prioritizing and focusing more The last thing I could say that is related to that, that is more personal, is let go of some perfectionistic tendencies or thoughts. Sometimes, especially in a startup environment, and when it comes to some clinical task and some clinical work, it has to be good enough. It doesn't have to be absolutely perfect because maybe the commercial team needs something. Maybe the marketing team needs an educational resource and it has to be good enough. And then you can iterate and work and improve. And I think that again, coming from an academic background, that was quite hard for me because I just wanted to get it right. And if it takes a week, it takes a week. so those are quite a few things that I would tell myself, just some tips I would say, would have probably helped a little bit, particularly during the first year Annie Wenmiao Yu (34:59) Thank you for sharing that, Alice. I especially loved what you said about not being a perfectionist or learning to let go of the need to have everything perfect. a lesson that I've had to learn as well. I, when I speak to other founders in the industry, that's also what they say as well. In the end, I think almost it's just reframing that view are the priorities for this organization? And in a startup, the priority is actually getting a usable, credible product in the hands of customers, getting feedback and then iterating on that. So it's just almost accepting that you will never have a perfect product and that the product is always going to be evolving and improving. And that's just a natural part of the amazing world of trying to build a business and trying to create a new market. Really, really loved how you were able to share your experience of moving from academia into the startup world. And now Alice, what are some of your key focus areas? Alice Sibelli, PhD (35:51) We have talked about Mahana and I mentioned that the startup shut down several months ago and what happened there. I was at a crossroads really because I found myself having to make a decision. Do I actually move forward and I accept another full-time role? But there weren't necessarily options that I was fully convinced. And also I think I was still processing that. loss in a way that was quite important for me and everyone working at a mission-driven company such as Mahana Annie Wenmiao Yu (36:28) are you able to share why Mahana ended up shutting down? Alice Sibelli, PhD (36:33) I can share about that process is that digital at the moment, particularly in a market like the US are still not reimbursed. system is incredibly robust and it works really well when it comes to medications. But we still need to do more work for digital therapies to be reimbursed, of course, there is a lot of progress that many people are doing, but I think we needed more time as a startup to be able as well to change some things of the system. I think that unfortunately, as you know, many digital therapeutics companies have shut down in the past few years, not all of system is evolving and I am incredibly optimistic, but that I would a very important reason on the commercial side. Yes. Annie Wenmiao Yu (37:26) Understood. What an experience to have gone through. Alice Sibelli, PhD (37:30) Absolutely. all that experience, not only the academia, but also what I learned in the startup and what I have been living for years in terms of my also own struggles with some digestive problems. So life literally imitated research for me. All of those factors contributed to my decision to actually create my own consultancy business. I don't think I would have been able to do it without the professional experience, but also the personal experience as a patient. because I just built more resilience, I built more trust and confidence. I realized that I wanted to really start living a life more aligned with my values. And of course, this is always a work in progress. But the fact that I could actually offer what I know to different companies, startups, pharma companies, universities to actually support projects that I feel excited about because I think they're impactful. For me, that was incredibly important when I decided to step back from a full-time role with only one company and just work as a consultant for different companies. Obviously, this is a fairly new journey for me. I'm learning a lot, but I just wanted to mention that because I think that what I'm doing now has really been defined by the experiences that I have been through professionally and personally. There are three main buckets that I'm quite passionate about. One is product development, as we have been talking. So digital solutions for people with long-term conditions, but also medication adherence help people with long-term conditions take their medications and optimize the benefits of the medications. The other bucket is really evidence generation. So how do we use research to help companies gather the right data, particularly for their digital solutions? And I would say, finally, I also do secondary research to support companies to build credibility. to work towards their goals. So many, many more people nowadays are thinking about clinical science and how do I include that as well into the business and how I go out and talk to also investors and clinicians and other stakeholders and how I think data and clinical science should be at the center of this. Annie Wenmiao Yu (40:01) love that. Alice, what do you hope to see in the world health and mental health in three years time? Alice Sibelli, PhD (40:03) I've worked you Ooh, I love that question too. one wish I have, also based on the conversation we've had today, is to be able to see digital therapies that are evidence-based, that are safe, engaging and personalized, available to people. everywhere, we talk about the UK, for example, what I think it would be incredibly important, and I think the 10 year NHS health plan will help us is let's have, you know, a centralised platform where clinicians and patients can actually find evidence based digital solutions. that are already regulated and approved by the NHS and that would really, really, I think, streamline the whole process. Hopefully three years from now, that process will be refined and will be available. And again, I know that there are some great digital solutions and apps available to people in the UK for different health, both physical health problems and environmental health as well. But there is no centralized system that can really help. clinicians and patients to access that. would say that's definitely one of my biggest wishes at the moment. Annie Wenmiao Yu (41:31) That's a very worthy goal and a wish to have because whilst you were talking, I was thinking, you know, if I was a clinician, I can only really recommend digital therapeutic apps if I know about them. And if I don't have a such resource where I can go to search, then it will be based on what I know to date. what I am able to find by looking online and I guess for patients when they are doing research just before starting a digital process. it would make information finding for them a lot easier as well. Alice, I've really enjoyed speaking to you. Let me end by asking you our podcast staple, which is what is one thing that you believe will allow more people to have better mental health? Alice Sibelli, PhD (42:12) personally think that there are different factors that contribute to the to our mental health and they're unique to each person. Having said that, very important for us to learn how to regulate our emotions. This is something that I have also conducted some research on this topic. It's a very complex topic. what I would like to highlight now is the importance of identifying and recognizing our emotions with no judgment, coming from a very compassionate place. because we know that bottling up emotions, so ignoring our emotions, not talking about our emotions, not being able to express the emotions in any way, not even writing or journaling, that process of bottling up has a negative impact on both mental and physical outcomes. So if we can identifying our emotions correctly, labeling them, so using the right vocabulary as well. I am feeling anxiety, am feeling sadness, am feeling anger, frustration, guilt, shame. That's a really important first step in emotional management. Again, this is a very complex process, so I do not want to oversimplify it, but I think it's worth mentioning. And it's something that we can start doing. And of course, there are therapists and psychologists and specialized mental health professionals that will help with that. But this is something we can also start doing as well on our own. be kinder to when it comes to feeling the emotions that we feel. Annie Wenmiao Yu (43:51) I completely echo what you said and I think what you said really, really resounded with me about reacting from a place of compassion and also being kinder to ourselves and allowing ourselves to feel the emotions so that we don't repress them and for them to then fester and build up and spill out in a later date. Alice, it's been such a pleasure to have you on the Low to Grow podcast. Alice Sibelli, PhD (44:13) Thank you so much, Annie. I really enjoyed our conversation and I'm really grateful for this opportunity.