THE SCIENCE OF TRUST

THE SCIENCE OF TRUST
Inside the Relationship that Makes Medicine Work
Exclusive Interview with Dr. Rob Pace
Featured in 'Innerviews'
Hosted by Allié McGuire

​Trust is not abstract. It lives in the brain, shapes our nervous system, and quietly determines how safe we feel placing our lives in another person’s hands. In this conversation, neurologist Dr. Rob Pace explores the science behind trust, the personal path that drew him to the mysteries of the mind, and the profound responsibility carried in the patient-physician relationship. As both interviewer and patient, I share a simple truth that anchors this dialogue: I trust my treatment because I trust him.

ALLIÉ: Before we talk science, I want to talk human. When someone says, “I trust you,” and they mean it, what is actually happening in the brain and in the body at that moment?

ROB: Well, there’s a lot of things that are happening, but you can break it all down to one word, which is resonance. Our mind, our brain, our entire body works on essentially frequencies. Energies that are accessible, readable, and measurable. And when we align with people, it’s not that we see something in them that we then agree to be trusting toward, like they make the cut of someone who is now able to earn our trust. It’s that what we see is something that resonates with us in them. So it’s more of something that we feel. We feel that they resonate with us in a way that allows us to say, okay, this person is moving in a direction with whatever we’re talking about that I am aligned with.

​ALLIÉ: Okay, so it’s all about alignment then. That you find alignment with someone on these frequencies.

ROB: That’s correct. Your brain works on synchrony. The best way I’ve always thought about it is like a symphony. You’ve got parts of your brain that are active at different times. It’s not that you only use 10 percent of your brain, that’s not accurate, but you’re not using your entire brain at the same time, in the same way that every single instrument in a symphony is not playing every single moment of the piece.

You’ve got different parts taking on different roles, sending information to other parts, synchronizing in a way that allows whatever needs to be done to be done. Whether you’re planning something, feeling something, or processing something. That happens within your brain, but it also happens between people.

So the same thing happens when you’re having a conversation. The networks your brain is creating, and the instrument it uses to send out the signal, namely your body, are lining up with another person. In the same way that a double bass and a cello line up to create harmony, tension, or something that works together within a piece of music.

ALLIÉ: That’s fascinating. I mean, this is what I expect of you. There are always these mind blowing moments, and that was certainly one of them.

Let’s go back to the beginning. Where did your fascination with the mind first start? And what was it about the brain that wouldn’t let you look away?

ROB: When I was a little kid, I remember being in a car. I have no idea how old I was, but I remember thinking, “Wait a minute. I have all these things going on inside my mind. All these storylines, these hopes, these thoughts. It’s this vast universe, and I’m just one person. And other people must also have vast universes inside them.”

That was probably the first time I remember thinking about thinking.

I was always like that. And like anyone who thinks too much, I struggled with things like depression, anxiety, and feeling uncomfortable in my own skin. That led me to try to figure out how to navigate my own head just to stay sane.

The way I deal with anything is to learn as much as I possibly can about it. So when something becomes a problem, I want to understand it down to its smallest parts. It was natural for me to move toward neuroscience in college.

I liked talking to people. I liked therapy type conversations, getting beneath the surface. For a while, I thought I would go into psychology. Then I took neuroscience classes, and the first time I did, I was hooked. The idea that an electrical signal could travel from somewhere in my brain through some mechanism and make this body do something functional was it for me.

I thought, okay, this is what’s going to consume my mind for the rest of my life.

The short answer is, that’s just how I’m wired. It’s who I am. I gravitate toward it. In the same way people gravitate toward each other when they resonate and trust one another. It’s that feeling of fit with signal.

ALLIÉ: A feeling of fit with signal. Yeah.

In neurology, uncertainty is part of the terrain. From your perspective, what builds trust fastest in the exam room, especially when a patient is scared or overwhelmed and trying to make sense of a new reality?

ROB: I can probably answer that better by saying what does not build trust. One of the biggest things is hierarchy. This idea that one person is here to tell you how things are and the other is here to receive it. A parent child dynamic.

In medicine, that’s an epidemic. It’s reinforced by the system and by society. The doctor knows, the patient listens. That’s not how humans are wired. When I slip into telling someone what to do or how things are, it immediately creates distance. It puts people in a place of either not wanting to be there or not trusting you. ​What builds trust is acknowledging that what someone is experiencing is part of being human, and being human is hard. Letting them know they’re not alone. That loneliness is what drives people toward despair more than anything else.

I want people to know I’m on their team. Not in the sense that I tell them what to do, but in the sense that I’ll help them figure out the best path forward. When people feel that, it doesn’t trigger alarm bells. It feels aligned.
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​ALLIÉ: So we’re back to alignment again. That feeling of fit.

You and I have been fit for over five years now, since my first diagnosis and your walk with me on my MS journey. I want to say something out loud that I think many patients feel but don’t always say. I trust my treatment because I trust you.

What do you think patients are really trusting when they say that? And what responsibility does that place on you?

ROB: I take that very seriously. If someone is going to trust me, I need to earn it. I need to bring something real to the table.

Understanding the brain is what I do, and that’s what I offer. Even if I’m wrong, the recommendations I make are grounded in depth and authenticity. They’re not based on a quick answer, a checklist, or a framework pulled from a book. They’re based on how I truly think and feel about a situation.

Being authentic in that role is everything.

ALLIÉ: You do a good job at it. You have a growing fan club.

If trust is the bridge patients have to cross before treatment, what are the small, concrete things physicians can do to keep that bridge strong over time, especially with long term diagnoses like MS?

ROB: It comes back to listening. I can tell you where I’ve failed. Sometimes you connect well at the beginning, and then you coast. You start checking boxes, ordering tests, moving through visits without really listening.

At some point, people realize you’re no longer paying attention.

Even if you’ve had a good relationship, it can change. You have to keep listening. Honestly, it makes my job easier. When I get caught up in guidelines and checklists, I lose the moment. But when I ask, “What’s going on in your life right now?” everything becomes clearer.

​ALLIÉ: I love that approach. You’re not treating a symptom. You’re treating a person.

One last question. When the science is said and done, is trust a form of medicine in itself?

ROB: It’s the form of medicine. Belief is the most powerful predictor of health outcomes. If someone believes what they’re doing will help them, they’re far more likely to get there.

That’s why placebo exists. The mind plays a massive role. If someone doesn’t believe something will work, it won’t. Trust and understanding create belief, and belief makes treatment effective.

Western medicine often gets this backward. We focus on instructions instead of understanding. If medicine were just about facts, technology could replace us. But it’s not. It’s about helping people understand so they can believe.

ALLIÉ: So trust is the conduit for hope.

ROB: Correct.

ALLIÉ: Because without hope…

ROB: It’s a necessary ingredient. A necessary state to be in. A state of trust. ∎

Find & follow Dr. Pace on TikTok:
​www.tiktok.com/@rjpacer