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[music] [music] >> We have a lot of resources and we want fast results.
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And then we confuse what these resources and these scientific advancements can get us.
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So we do very, very well with complicated acute problems, complex surgeries, intensive care unit levels of care.
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And that requires intensive resources and knowledge and scientific understanding.
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But we then think more is always better and more intense and more resources is better where what we lose is the basics of human resource, right?
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To say, "Hey, we human beings are resources to one another."
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And so for example, to really train good therapists who are looking for understanding and then to apply the those therapists to people takes that costs time and money invested in humans, right?
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And it also requires patience.
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We have to invest in the humans and we have to sometimes give ourselves the news we don't want, which is that issue you might want solved in 2 weeks won't be solved in 2 weeks.
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Maybe we can really get at that in 4 months.
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But it requires 4 months of work from you, not just 2 weeks.
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And we we want things so quickly and I see a lot of people who give up on themselves or they're oh, I'm I'm hopeless. Right?
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I need And you ask, "Well, what what have they done?"
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And they've applied themselves for a month to something that clearly is takes a year to really get their arms around, but there's no standards to tell us that.
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To say, "Hey, a process of understanding is valid."
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Like let's go through and do that and it's going to require time and effort and patience, but here's the good news.
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You can actually understand yourself better, right?
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And instead of saying, "Well, I want to feel better now.
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Let's beat that symptom back with me medicines."
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And then sometimes medicines will be have their time and place, but we overuse them to beat back symptoms, whether it's symptoms of poor physical health, symptoms of poor mental health, and then what we don't do is then go to understanding and say, "Well, maybe if we understood this, we got to the root of why is it that this person is feeling depressed and and they feel hopeless in the world.
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Where did that come from? When did that start?
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And then what's the manifestation?
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How's it changing behaviors?" Let's look at that.
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I bet we can understand something about it.
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Maybe even understand its root, and then we can change all of that.
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You know, if we're just going to polish the hood when when there's a problem in the engine, why do we expect we're going to get somewhere? You know?
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>> If you had a magic wand and could change the system, what would be the first thing you would do?
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>> We would have concerted leadership that would say, look, here's the first point to tell everyone.
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>> [snorts] >> There are ways you can understand yourself and make your life better. Right?
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No matter how afraid you may be to look at yourself or how many bad negative things you may have inside.
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Like there is absolutely a way of doing that.
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And we're going to tell you we're going to tell you we're going to help you do that.
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So, you can do a lot of this at home yourself or maybe you can do it with friends, trusted others, or a therapist.
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There's a lot that you can do, but we're going to help you understand, right, the the the path forward so that you don't have to be afraid and intimidated by it.
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If we knew nothing about our bodies, how they function, we didn't even know we had a heart or we didn't even know that it made sense to have weight in a certain range to be healthy, then we would be very very unhealthy, right?
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And we wouldn't want to look at how we're unhealthy cuz we'd have no hope of understanding and changing it.
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So, physical health is not a good job, right, of of helping us understand. Our heart's important. Why is it important? How is it important?
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How do we keep it healthy?
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We need to do the same thing for mental health and the field it needs to bring that message.
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And I am trying to some extent to bring that message with the book of saying, "Let's pull together what we know."
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And you can look at this.
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It's not something that's meta and more complicated.
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What we're doing actually is I'm trying to bring a grounding to simple goodness of yes, we're very complicated as humans, but there are pretty straightforward ways we can understand ourselves and look at ourselves and bring change so we don't have to be afraid and we don't have to view our mental health and our physical health as so different.
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One we can feel empowered to change and the other we're afraid of.
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>> Is this something that AI could help with?
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>> I think AI can possibly help if AI is drawing together resources, right?
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And and it's it's an information tool.
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I think when we start thinking of AI the way that we think of a human, I think that is very then that's very very different. Right?
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Then we lose sight of something very powerful that can be a tool to help us.
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Same thing is with the psychedelic medicines.
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AI is very powerful and it can be a tool to help us, but unless we are thoughtful about that, unless we are careful about that, the odds are that the power will get out of control and we will harm ourselves.
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I mean, human history shows us this that many many times over.
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So I think we have a lot that's powerful that we didn't have before.
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Psychedelics and AI being two of them.
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But we have to be respectful and judicious and bring together thoughts and ideas from different fields of human endeavor, from different cultures and different backgrounds.
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How do we want to do this?
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Otherwise, we will run far ahead of ourselves and we surely will harm ourselves.
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>> Do you remember your first encounter with having therapy? >> Sure. Yes. Yes.
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>> So my youngest brother died by suicide when he was 20 and I was in my mid-20s at the time.
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I was 25 and had had no mental health care.
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I mean, where I grew up and >> Took you totally by surprise? >> It did. It did.
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Now in retrospect, you could see but we I didn't know anything at the time.
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So yes, it took me completely by surprise and I just had no knowledge or understanding of mental health.
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I mean, in the environment I grew up in, mental health was for crazy people.
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And what crazy meant was something very, very undesirable.
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So, it was something to be feared, right?
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And then to see that something wasn't going the way I wanted it to be, to say, "I am not feeling You're not healthy."
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And I could see that my brother hadn't been healthy either, but like no one had really looked at that and thoughts had gone through my head like he'd had a very bad medical illness and like how much was that thought about?
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And he was kind of different afterwards and No, there was so much about it that led mental health to just be swept under the rug.
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And then to see, to know that I had that had that had had a factor in his death.
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I mean, it was clear as day.
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And then to see that my own mental health was going in a negative direction, less healthy relationships, drinking too much, and angry and frustrated, and to see like, this cannot be going anywhere good.
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And I need to get some help.
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And I said this before, I remember calling the mental health number on the back of my insurance card in a way that I felt very embarrassed.
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You know, I was going to call this number.
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Like, absolutely felt ashamed of it. And it was great.
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You know, put me in front of a therapist who my guess is that if she were to be asked now, it was so long ago, would say would agree that all she did was basic guidance to me.
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Like, "Whoa, it's okay that you don't that you feel bad after this happened and it's okay that you're confused and that you're angry."
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Like, all of this is natural and and well, look how it's leading to some change in you.
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Like, you know, you're angry and you're you you know, you're directing that in ways that that aren't good for you or anybody else.
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It's not making your anger less and you're more angry.
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And actually, who are you angry at?
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You're mad at yourself, you're mad at God, you're mad at the world.
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And and she just gave me permission to to like open my eyes, basically.
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And it was very, very helpful.
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And I'm sure she was quite skilled and could have done really like depth work with me, but but that wasn't what was called for.
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It was just a very basic that helped this person understand what's going on, and it made a huge difference in me.
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And I And I had much less fear of like, what's wrong with me?
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You know, I'm going crazy.
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I'm not going to make it. And say, "Whoa.
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I mean, look at what happened here.
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Let's just take a step back."
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And that was just immensely helpful to me.
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>> So, wouldn't you say it was almost like as simple as a mirror?
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She allowed you to see yourself in a way that you couldn't see yourself before.
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>> Well, if it was a mirror, let's say I already had a mirror.
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Like, I have a mirror at home, right?
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But But I wasn't looking at it because my eyes were closed, right?
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Because I was I was angry and I was afraid of the changes.
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So, I wasn't stopping and looking and saying, "Oh, like, here's just an obvious fact, right?
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You're less healthy in the world.
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You're choosing less healthy people, friendships, relationships.
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You're not taking care of yourself very well. Like, very clear. Like, look at that.
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It's like You can look at that and say, "I'd like to understand it."
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But you can't understand it until you look at it.
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And if you're too afraid to look at it, then it doesn't matter how many mirrors are around because your eyes are closed.
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>> From that experience, is that when you fell in love with the craft?
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>> I think maybe more than I knew at the time.
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You know, I had always thought about being a physician.
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And even when I was very young, you know, there were many older people in my family who were Italian immigrants, and they didn't have education, and they they spoke broken English, and and they didn't get good help when they got older and got sick.
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And there were physicians involved in hospitals and different places, but we never understood what they were saying.
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And there was a that that kind of communication with people who who needed and deserved extra help for communication.
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And so, that had always been with me.
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And even then, I was 25, so I thought I was too old to go back to medical school.
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I hadn't studied any pre-med classes.
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And even very, very bad things can have silver linings.
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And that's not a Pollyanna concept.
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We have to make the silver lining.
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And one silver lining of my brother's death was I realized, wait, I'm you know, I'm in my mid-20s and I'm alive and healthy.
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Like, I can go do something, right?
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Just cuz it might take me an extra year or two. So what?
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I'm I'm here and I can do this.
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And that's what led me to think, I want to learn about people.
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I want to learn about medicine.
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I went back to college, did a fifth year of college and took pre-med classes and in a post baccalaureate program and eventually got into medical school and and it brought me back around.
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Then all of a sudden it made sense.
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I studied political science, but I was really interested about the people who are the causing the action in the political scene.
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So that I under I realized and my interest in literature and philosophy is all about people and what they're doing and why they're doing it.
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So then kind of all the arrows started pointing towards psychiatry once I was along the path.
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>> How difficult was it once you decided to start practicing to have patients? How does that work?
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>> Because we get more independence, you know, in the last couple of years, you start to get sort of used to taking some responsibility for people.
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And then residency for psychiatry is 4 years and you and you're taking more you're learning more and more and you're taking more responsibility.
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So so some of that you can you get your arms around over time.
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The difference was was really being the end point.
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I mean, so okay, I'm I'm now responsible, right?
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I could consult with other people, but I'm responsible for a group of people who are really relying on me.
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And I think what that brings to the fore in in in good doctors, and maybe I don't think I was aware of it at the time, is we start looking for patterns.
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All right, I have to figure some things out on my own.
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Like, what what can I see and learn from now doing this?
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And I remember one of the best mentors I ever had, who was the chair of the department at Harvard, who was still seeing patients every chance she got, cuz she that she just keep learning.
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The more you learn, the more you will know.
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And it's not quantitative, right?
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This is qualitative shift in understanding and it's it's that way that I came to realize I'm just treating trauma day in and day out.
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The manifestation may be different and it may look like 10 different problems on the the list of the next 10 patients I'm going to see, but one 10 problems right?
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So, we're not defining ourselves by what's going right.
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We're defining ourselves by and identifying with what's going wrong.
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Then it all looks very different, but there has to be common roots and I could see the root of trauma and then ultimately that we all have a structure of self.
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We all have a function of self.
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We have we have drives and that oh, just like you know, human bodies are birth rated.
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We can understand our physical health through that through understanding the human body.
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The same is true for our minds and it just came through lots of experience and seeing lots of people and lots of frustration and wanting to help people more and even wanting to help myself more.
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I've you know, I've had my own problems you know, going forward and and being able to to seek help and to know okay, try to understand what's going on inside of me as I'm trying to get help.
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It was all a lot of motivation.
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>> When you're talking to people dealing with problems all day, every day, can you let go of that burden when you come home to your family or on weekends? Can you not be working?
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>> I do think that's hard to do because a lot of people in any helping profession, you know, they the way that they're built to enter it in the first place, they're built to carry home with them the the the problems that they're finding and also to blame themselves have an attribution of self like if
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someone's not doing well, I you know, what am I not doing right or I have to do better and that can become very very limiting and it can weigh on us and that's why doctors have you know, more mental health problems is than the average person in the doctor demographic. >> Shorter lifespan as well, I believe.
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>> Shorter lifespan as well, I believe. >> Right. Right.
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Lower you know, higher degrees of of substance abuse, higher degrees of mental illness and of suicide.
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So, yes, there is a lot of that, but I think that it doesn't have to be that way.
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You You the is also quite uplifting.
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You know, sometimes people will think that what I do for a living must be really miserable cuz like everyone's sick and miserable, no one's getting better.
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And I'm like, well, who said that, right?
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You know, that is not that is not true.
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And I And I think if we work hard on ourselves and we know that we're good, we're bringing a good self that's that's self-educating and is conscientious and present, and we know we're doing a good job, and we can we can see when people are getting better, right?
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And even see if people aren't getting better, just the value of being with someone, right, who's really suffering, then I think we can feel very good about the discipline.
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I feel very good and optimistic and and the sense of a sense of happiness in me about what I do for a living.
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It does it bring some difficult things that are hard to then not think about or not have in your mind.
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Yes, but all the more reason to pay attention to you know, our own mental health.
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>> What would you say after trauma would be the next biggest category?
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>> It's a tough question because I think a lot of the things in the next biggest category bring trauma.
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So, so all these things that divide us, you know, with the prejudice in one form or another.
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We're looking for divisiveness.
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If you think of how similar we all are and how our needs are similar, right? We want to survive.
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We want our families to be healthy, right?
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If we have children, we want them to be healthy.
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We want all children to be healthy.
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We want the world to be safe and clean around us.
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There's so much similarity between us, but more and more we trend towards how can we look at what's different and seize on what's different between us with the idea somehow that's going to make us safe, right? And it doesn't.
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It's just more divisive and it brings more misunderstanding and confusion and conflict and vulnerability.
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So, I think yes, that does lead to trauma.
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But if we're going to separate out that there's the the coping skills overwhelmed brain changes of trauma, and then we lose track of who we are and in this guilt and shame, you know, we we we forget and we think that we think worse of ourselves than has always been true of us, right?
15:18
I think if that's one the major area, I think, the area of needless devicesness, I would put second, although that then does fuel trauma.
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>> Tell me about the stories we tell ourselves.
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>> The stories we tell ourselves are so important, and we often have not even stopped to think about like what is that story.
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And so many times a person will tell me story of themselves, and they're telling me something and I know it appears no resemblance to that person. Right? Like I know that. I know that.
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I've known them across time, and they're telling me nothing's ever been successful, and they're weak, and you know, no one likes them.
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And I think, "Oh my gosh, this person has been, you know, persevered and resilient through so many things."
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But what they're looking at is is the things that they haven't, they feel they haven't done well enough, they haven't been able to overcome, and they're making a story of self that's negative, and and we can just internalize that without thinking twice about it.
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And it is remarkable sometimes to to see the shock in a person to to kind of bring to them like, "Wow, that bears no resemblance to the person I know."
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You know, that's not something you would >> How do people react if you say that?
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>> Well, in the right circumstance, with the right relationship, like people can be really struck by that in a good in a good way.
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Like, "What did I just say to myself?" Right?
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Or if they're telling the story and we're in a reflective place, you know, we're in a therapy circumstance, and then you can see sometimes even as they're telling it, they know it's not true. >> Yeah. >> Right?
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Even if they told themselves that for years and years, just, "What am I saying?"
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They They start hearing their own voice.
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Because when things are just knocking around in our minds, right?
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We are not bringing these error-checking mechanisms to bear.
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That's why we say, "Oh, I've I've been thinking about it for hours, and I I can't make any progress."
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That's a sign you haven't been thinking about it.
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It's just been bouncing around in your mind, right?
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But when we we do apply different mechanisms of the brain, like saying something aloud, or I know now I'm saying it and I know that I'm listening, and I know that you're listening, too, then different parts of the brain come online, and our brain starts error checking like, wait, is that what am I saying?
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We start hearing ourselves, right?
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I can This is really true of a person saying something to telling me something completely false and and wrong and persecutory and mean and then saying, I've never really heard myself say that.
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That's very, very powerful.
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>> Can writing also work? >> Mhm, yes.
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Anything that gets it out of us.
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So, even making words, you know, we could we say it in a place where no one else is, we're making words, some error checking mechanisms come online.
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When we're writing words down or we're talking to another person, then there more of those mechanisms and we're just checking ourselves more, especially if we're interested.
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I'm not just saying something that I say all the time when I talk about myself, but I'm actually stopping and thinking, what is true and it is shocking some of the things that people have been through who have told me in earlier phases that they've never done anything difficult.
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A person who left South Vietnam on a raft and arrived in the Philippines, who it took a long time for me to learn that.
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And and during that time he was telling me he didn't have strength in him and he's wasn't good enough and then you think, oh my >> [snorts] >> you know, wow, right?
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What this person survived, but to to not see that so much so that it was out of his system and he had a story of weakness when that was a story of strength.
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>> How do you think it works that the stories that we tell ourselves don't match our realities?
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>> I think little by little we get further and further away from the truth and and a lot of this comes because there's a bias in us for the negative to be more salient.
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Well, it makes sense for survival.
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If we were hunter-gatherers and we, you know, found five kinds of new berry that was nutritious and tasty, that'd that would good to remember.
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But if we find one that makes us very, very sick, we really had better remember remember that.
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So, so that's a a survival bias in us, but the problem is it gets misapplied. Right?
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Then we start making the the story of self about the negative, and we we do that in part because of that bias, and in part because we we do often want to be better.
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We don't see that the way to help ourselves be better is not to get down on ourselves.
19:36
You know, I I I see these signs in shops sometimes that say, "The beatings will not stop until morale improves." Right?
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And it's designed to be funny, but if you think, "Why is that a thing?"
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Like, why would we make signs like that that are designed to be funny in shops?
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Because that's what we often are doing to ourselves. Right?
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We want to get better, so it's like, "Damn it, what's wrong with me?"
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Or, "I can't believe I'm an idiot."
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Or, this we say these things ourselves, and we think that's going to help us be be better, but it's it's a response to not feeling good about something, or sometimes someone has put that in our in our minds, and and we want to be different, but we can't get around how powerful the negative is.
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And then you could see how that moves forward to, "Well, I can't do anything.
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Now I feel hopeless, and I feel so down on myself, and I forget what the good qualities I I have in the first place."
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So, part of it is that bias, and then the story just accumulates negative and negative, and we don't go through and look at it and say, "Hey, is this unfair?"
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Now, so we don't look at it as it drifts further and further away from ourselves.
20:40
The vast majority of people who have an an inaccurate narrative of self, which is most of us, the vast majority, that is not because it's we're thinking too highly of ourselves.
20:48
That's a different set of problems that we're not they're talking about.
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We're talking about regular humans now.
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Like, the vast majority of us, our narrative is still good, and it's still good against ourselves.
21:01
>> How similar are insecurity and overcompensation with big ego. >> Mhm.
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>> So, they two sides of the same coin? >> They can be.
21:12
So, so we can react to insecurity or vulnerability in a lot of different ways.
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So, some people may react to that by avoiding.
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You know, they think very little of themselves, so they avoid and they don't interact with others.
21:24
It's just one possibility.
21:24
Um another possibility on the other end of the spectrum is people can respond with an overinflated sense of self, but that's covering something.
21:35
You know, people who who say aren't doing something well and decide that they're the best ever at it.
21:40
There's a disconnect from logical processes there, right?
21:41
It's it's serving a purpose.
21:42
For example, there's someone who might not know or think, I can't really make myself better, right?
21:48
And then the unconscious mind, you know, which has so much flying around in it then feels angry, frustrated, I can't make anything better, so we just jump to something that feels good in the in the moment.
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If we have a way of understanding ourselves, what is it that I'm not happy about?
22:02
Can I understand enough to bring change?
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Then we don't need the compensatory mechanism either of avoiding, right, or of approaching the world through a falsely inflated ego. >> Mhm.
22:14
What are the other versions of falsely inflated egos that are not rooted in a vulnerability?
22:21
>> Well, falsely inflated egos, the vast majority of times, are a reaction to something and they're a reaction to some insecurity. Right?
22:30
Otherwise, we wouldn't need to falsely inflate our ego.
22:36
So, if I'm pretty good at something, but that's it, you know, for me to think, well, I need to make you think I'm really good at it, right?
22:43
Um there's something inside of me that makes me not feel good enough about myself that it's not okay that I'm just kind of good at that or maybe I'm not good at it at all, right?
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But I don't want to feel that way because I think it means more than it does.
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If I say, look, I'm I'm a person who tries to bring his best self and and tries to do the best I can at the things in life and there's some things I'm pretty good at and there's some things I'm not so good at and you know that's okay.
23:07
I'm trying to make myself better and some things I can make improvement in some things maybe I'll never get anywhere with but you know what?
23:12
It's all okay because I'm okay.
23:14
There's not a need for that inflated ego to cover up something, right?
23:19
So we were always looking for why why a compensatory mechanism?
23:23
What's not what's not where we would hope it to be in that person's understanding of themselves and ability to to bring a good competent self to bear in good ways and feel good enough about that.
23:35
>> What percentage of people would you say don't feel good about themselves?
23:40
>> If we think about people who just don't feel good about themselves all the time, that's a minority of people.
23:44
It's not vanishingly small but it it it shows if you don't feel good about yourself almost all the time or all the time, then we we really want to get help for that, right?
23:58
There's something going on that is maybe clinical depression and there's a place for treatment of clinical depression including with medicines for as an example, right?
24:04
Or there may be something going on that's very bad.
24:07
Person's in an abusive situation say all the time.
24:09
So that's a marker of something for us to take very seriously.
24:13
Most of us don't feel good about ourselves a lot of the time.
24:15
I would put it you know I would put it that way and sometimes there are reasons not to feel good about ourselves.
24:21
I mean I could have done something better or I could have been a little bit more thoughtful but when it's that we want to bring a solution to that.
24:27
If I make a misstep and I make someone feel bad, right?
24:30
I could really get down on myself for for a while about it and I could start some negative self-talk but it's not helping me be any better.
24:40
If I say, "Look, that's not how I want to be, right?"
24:41
Instead of hiding from myself or they did something to make me say that or say, "Look, I I I didn't handle that the best I could.
24:46
I don't feel good about that." Why? Why am I that a bit?
24:50
And maybe it's something so simple as well I was hungry or I didn't sleep enough. Maybe it's that, right?
24:55
Maybe there's something weighing on me that I'm not acknowledging or something I'm worried about.
24:58
Now, we can figure it out, right?
25:00
Or am I holding a grudge against that person, right?
25:02
Or am I holding a grudge against somebody else and it's easier to take it out on this person, right?
25:06
Now, we we can come to some understanding because we're approaching ourselves with this compassionate curiosity, which doesn't mean we're letting ourselves off the hook.
25:15
It's quite the opposite of saying, "I want to look at what I don't what I might not like about myself or somebody's choices that I've made."
25:19
And if I do that, it's it's not a condemnation of my self.
25:23
In fact, it's coming from a place of me seeing that a lot more is going right than wrong and I can feel safe to look at what's not the way I want it to be and to bring a fix.
25:33
So, maybe the fix is, "Hey, before those meetings when I tend to snap at people, you know, I really should just have a snack in the morning or something."
25:38
It could be something that simple or it could be saying, "I really do I'm I'm mad at that person and I got to acknowledge that.
25:46
Do I Is that something I should go talk to the person about?
25:48
Is there something in me?"
25:50
You know, now we can bring a solution, but we have to look at ourselves in order to do it. Not hide from ourselves.
25:57
>> Is communication always the way forward? >> In some sense, yes.
26:03
And communication is of inestimable value, right?
26:06
And it's so hard to understand ourselves even with language, right?
26:12
Even when we have the same language and a good command of the language, it's so easy to misunderstand.
26:19
And we can misunderstand ourselves with the language we're using towards ourselves.
26:22
So, so to be aware of that and how careful we have to be, you know, that we see more than just words.
26:27
There's body language and all the ways we can telegraph to other people.
26:29
And if we're going to avoid misunderstandings, just check in with someone.
26:33
Like, "Hey, I think I really heard you say this or what I was trying to get across."
26:36
Like, let there be time back and forth so that we really understand one another.
26:41
It's sort of our best tool though to avoid distress between people.
26:46
So, on the one hand, we might say communication is always good.
26:50
Sometimes the communication though could be for there to be no more communication, right?
26:55
So for example in abusive situations and and say the situations are understood and the person doesn't want to change and to say well the communication is that I have to end this relationship or I have to end this friendship.
27:07
So so it's not always communicate cuz that can seem like we're always supposed to keep talking about it or and there's a time often to say no, you know, I've had enough of this and I'm I'm done with it.
27:18
>> In the book you suggest starting with the subconscious when looking at a problem. >> Yes.
27:25
So the the structure of self is one of the two pillars inside of us, the structure of self and then the function of self and there are five parts of each and the unconscious mind is the most foundational of the structure of self.
27:37
It's where most of what's going on in our minds is going on.
27:40
So there are hundreds of thousands of things going on in both you and I right now.
27:46
>> And we're not aware of them. >> Right.
27:47
We're not aware of it because we're cuz we're orienting to each other with our conscious minds, right?
27:50
But in order to do this we're gating out thousands of stimuli for our attention both inside and out and we are now paying attention with our conscious minds, but our unconscious minds are very, very powerful so they can prime us.
28:03
If there's a lot of negativity and fear then we're much more likely to see things in a negative way.
28:07
We're much more likely to misunderstand a word or an expression.
28:11
So to be aware of what's going on in our unconscious minds is almost indispensable to leading really good lives because most of what's going on inside of us and setting the climate of us is going on in the unconscious mind.
28:25
>> And what are the best ways to tap into it?
28:28
>> To be aware of what am I saying to myself when I'm not paying attention?
28:32
You know, what am I saying to myself if the car pulls up at a red light or in the shower or in the elevator when when there's just stuff going on inside of us.
28:39
>> Like automatic behavior would you call it?
28:41
>> Yes, automatic thoughts. Right?
28:41
It may not be behaviors but it's it's it's our thoughts towards ourselves.
28:45
Am I saying am I getting down on myself every chance I get?
28:49
You know, am I telling myself why I'm doing everything wrong, right?
28:51
Am I telling myself I'm never going to get that thing I really want.
28:55
Am I telling myself I want something I really don't want because I don't want to commit to myself what I do want, right? Whatever it may be."
29:03
You know, we we can't say, "Well, mind, tell me what's unconscious, right?" But it will tell us.
29:07
All we have to do is be observant of it.
29:09
So, if we think about what is the narrative I tell myself?
29:11
How do I think of myself inside?
29:13
What do I say to myself in quiet moments?
29:15
How do I respond reflexively if I feel embarrassed or ashamed or frustrated?
29:23
Then then we get an insight because we're observing ourselves and what goes on inside of us.
29:27
That starts giving us a real line in to the unconscious mind. >> Tell me about dreams.
29:34
>> Dreams can tell us a lot.
29:34
They don't always tell us a lot and sometimes dream interpretation can be complicated and sometimes we just don't know or there's multiple interpretations.
29:43
to be careful, but boy, our unconscious minds will bring important material to the surface often in ways that astound us.
29:52
Just how good the unconscious mind is saying there's a really complex issue of self and will bring it into one dream and you know, that person who is see is very small and they're fighting a dragon and you know, they're armed with just a stick.
30:07
There's a what might that mean?
30:09
There could be a whole constellation of how they felt in their life and like feeling like an underdog and what are they facing and you might think, "Wow, that one dream about fighting the dragon has pulled together these themes across life."
30:19
And there there's so much to learn from careful from careful dream interpretation that's respectful that we can learn things through the traditions that we have and education, training, and experience of someone who's trained to do so and even our own [snorts] self-observation, but we have to be respectful of our own complexity and we don't always know the answer from dreams, but they can tell us a lot.
30:45
>> Do you deal with people who need help in their relationship? >> Sure. Sure.
30:48
We do individual work and couples work.
30:51
couples work. I work at Pacific Premier Group and we we brought together people who are just interested in the empowerment of of others using knowledge for the empowerment of others and we do individual work and we also do couples work including intensive ways where we're trying to help people not only
31:06
understand themselves but their relation between them and how we can raise our defenses between people and how two people who have the capacity to be very healthy who can want to be healthy can be stuck in ways of interacting with one another keeps them both from health and often times that's rooted in our insecurities or often in our habits. If
31:25
If we stop and think, what is it that we're saying to ourselves?
31:29
What are we communicating to the other?
31:30
What do we really feel about the other person?
31:32
How is that consistent with what we're communicating? How do words land?
31:36
You know, I might see a word one way, you might see it another way.
31:40
So, I say it in a benign way, but you're hearing something very different each time.
31:43
So, it does come back to communication being a part of it and then also honoring this idea that arose after Viktor Frankl's work after the Second World War of of really understanding how humans make meaning within ourselves and amongst ourselves that that we are different when we're in groups.
32:02
So, so we can say that person can understand like everything or not everything.
32:05
You know a lot about you and a lot about me, right?
32:09
But understand nothing about the two of us together, right?
32:11
And you see this so much in relationships.
32:13
You have to honor that that diet that those people together.
32:18
There's one person, another person, and then there's two of them together, which is often a very different reality and it often offers different opportunities, more opportunities for understanding and change.
32:31
We have to be respectful of that and a lot of times what what ends up happening is we're bringing two different selves that are each trying to get their needs met and they're kind of putting something out and then the other person takes it in and processes it and puts something out and and that also is how we were classically thought of, but that doesn't do justice to us any more than him or all assertion and pleasure seeking, right?
32:50
That there is a different entity.
32:52
We are different selves when we're in union with another self and and that goes for even can be casual relationships or friendships, you know, through to family relationships and and deep romantic relationships.
33:04
>> How does that couple therapy begin if you come in with your loved one, what happens?
33:11
>> Well, kind of the first thing is any as a clinician, right?
33:13
A a therapist would try and understand like where are the the people at, right?
33:17
Because sometimes people are in very unhealthy places where you know, one person may be in the throws of depression or in the throws of addiction and we say, "Okay, there practical things, there things that we have to get at to try and help each individual person be in a healthy enough place that to engage as a couple."
33:31
And that's why a lot of times people will come in for couples work and what gets done is couples work.
33:36
But sometimes and a lot of the time what we we want people to do individual work so that they can bring the healthiest self to the couples work and then the individual work can feed the couples work.
33:46
So, gosh, I you know, I I noticed in my individual work I learned that I can I can get this very very defensive and I have been like that since I was a kid and I'm bringing that to our relationship, right?
33:57
And the other person may have noticed something different.
34:00
So, we learn about ourselves and we bring that to the couples work being respectful that there are two individual people, but but also there is a diet that we can't define by either individual person.
34:15
>> Tell me the role of spirituality in mental health.
34:19
>> I think spirituality has a great role in mental health and and that may or may not be anchored to religion.
34:24
I think that as modern science has learned more and more our scientific disciplines, neuroscience, quantum physics, chemistry, just to give three examples among many we could cite, tells us that there is so much more than we understand.
34:40
This idea that the science is going to tell us all the answers is just not true.
34:44
I mean, science is a great tool for understanding and what it tells us about is that there's so much complexity around us and so much mystery and I find that to be very heartening.
34:57
I think that tells us that spirituality is real and true.
35:03
There are mysteries around us and we don't understand everything and we're not going to take a tool of inquiry, which is science, and then make that the answer. Right?
35:12
If we if we use science with respect and look at what it teaches us, it tells us that yes, there is there's more to it to than meets the eye and spirituality has its place and it also tells us it also tells us something very hopeful. Right?
35:31
It tells us that um you know, these things that we feel inside of us.
35:37
Like who can explain what it's like to feel love, you know, whether it's for a person or a garden one is growing or someone who's never even seen.
35:43
Who can tell us what this is and and and what it means.
35:46
You know, there's there's so much that we experience, you know, phenomenology to the philosophic.
35:51
How do we experience life and and existence and things that we experience across people that that seem uncanny till we see that we're experiencing it across people, the sense of meaning beyond ourselves.
36:02
And some of this we don't need psychological medicines to come to this, you know, the reflection, meditation, peace has allowed people to feel this inside of themselves.
36:11
So, the science tells us what we've been feeling for a long time, which is that there are these hopeful mysteries around us and yes, I I think we don't need to know everything to feel a healthy sense of control.
36:23
And if If think we need to know everything or that we do know everything, we will never have a healthy sense of control.
36:28
If we have the humility to see there's a big universe out there and there are things we understand and a lot that we don't, then I think again we're in a great place to be fair, honest, real, true about ourselves. >> Tell me about belief.
36:46
>> I think we can tend to believe more than we actually know to be true, and that can get us into trouble.
36:51
You know, if we believe in the cause and effect of our own actions and choices, that you know, I I believe that I can be impactful in the world, right?
37:04
And and that could be with the next person I run across.
37:06
I can be at the checkout line and someone can drop something and I can scowl at them or I can help them pick it up, right?
37:11
That like I I matter and I have that belief because I see my mattering.
37:14
I see that if I scowl at that person, that's a different response in them than if I smile and I help them pick something up.
37:23
A very simple example of how we matter.
37:26
And if I believe that I matter, right?
37:29
But I'm not so sure about all the things I've been told, you know, about Tao.
37:33
And I want to bring to myself that beliefs that I can matter and then just kind of look at my life cuz it may be that the way that I matter is I have to keep working and working cuz I have to support more people. Just an example.
37:44
That may be a false belief that the way that the way that person matters more in the world is to, for example, have more of their time and energy for people around them.
37:51
It's just one example to challenge what our automatic beliefs are, right?
37:57
And then anchor to the belief that we can understand ourselves and the world around us enough to be healthy people who live through the generative drive and make the world around us better, and that includes our own lives.
38:10
>> Tell me more about the generative drive.
38:12
>> So, the generative drive is the governing drive inside of us.
38:14
It's saying, yes, we have assertion, what was called the aggression.
38:18
And yes, we have pleasure seeking, and that makes sense.
38:22
But it can't possibly be the whole story if our human birthright is a generative drive that we all have a drive to look at things in wonderment, right?
38:32
A drive to see someone else smiling instead of crying.
38:37
A drive to see if I just rearrange those flowers over there look a little bit better. Whatever it may be.
38:43
That there's something in us to make the world better, and it drives us to great things.
38:46
It drives people to get up in the morning when, you know, they're so daunted by the day, and they're going to just work and work, and they're going to Maybe they'll be going out for work, or they're taking care of a family, or it's all this quiet courage in people that we often don't give ourselves credit for to say, "This is generative.
39:02
This is me being in the world and making the world a better place."
39:05
And if we're anchoring to that, and that that's in all of us, that's how we take better care of ourselves.
39:12
That's when we might say, "You know, I do have to work very hard in a way that mostly doesn't bring enough thanks to me, and I and I feel very down about that, but what is there in me that can make this day better?
39:24
Like, how can I have a better day? Who do I want to see?
39:25
Who do I want to be nice to?
39:27
How Who wants to be nice back to me, right?
39:29
Do I have to live in this way where I'm I feel stressed every moment, or can I even value myself for that?"
39:35
Look, I get up in the morning, and I do what there is to do until I go to sleep at night, even though I'm daunted by the next day. Boy, that's generative.
39:42
generative. There may not be glory in it, and there may not be a lot of thrill in it, but but like a lot of people are living life that way, and and I've lived a fair amount of our lives that way without being able to step back and appreciate it and say there are a lot of
39:55
ways we can make the world a better place, [snorts] and that's how we take what's in ourselves, our talents, our inclinations, our abilities, our perseverance, and we live our own lives, and we live in a way that's interdependent with other people. If we're doing that, we're honoring this
40:10
If we're doing that, we're honoring this generative drive that's in us.
40:13
It animates us as a species and as individuals, and then we're not trying to then give it second shrift because I have to see myself as just doing, doing, doing, and I'm trying to find some pleasure that's eluding me.
40:26
>> What don't we see about each other?
40:26
How do we misjudge each other?
40:31
>> We misjudge each other because we often see each other through the lens of our fears.
40:35
So, you see this in in political disagreements where it's so easy for there to be a reflex if someone has a different opinion.
40:42
And and then there's a cascade, well, that's a bad person.
40:46
They don't know what they're talking about.
40:46
And you know, we just have this whole cascade, but it's coming from our own fear. Right?
40:50
It's coming from our own fear, and we're not approaching with that compassionate curiosity of hey, if I'm getting to know you and we're talking about things, we're probably going to disagree on some things.
40:59
You know, that's like, why is that not okay?
41:02
And and can we make it okay?
41:02
Can we learn from one another even if we still disagree?
41:07
Do we have to be destructive to one another? Right?
41:10
It it it's that that we most often miss, the well-meaningness in the other.
41:14
And of course, not everyone is well-meaning, but we're we're much more likely to see the people who really are not well-meaning, who mean us harm, if we're not mistaking that for everyone who has a different opinion.
41:26
If we say, I want to try and approach people with seeing the good in them and giving them a chance to to, you know, in in slow incremental ways of showing them me who they are, and I'm showing them, and this is how we build all sorts of relationships, personal and professional.
41:40
And if we're doing that and we're open and we're not reacting to our own fears, our own prejudices, right?
41:46
Then we're going to be much more successful.
41:48
And when someone does come at us who really means us ill, we'll be able to see that. >> Yeah.
41:53
What's the state of psychology today?
41:58
>> I don't think it's good.
41:58
I think that there are there's a lot of understanding and insight in the field, but it's not it's not woven together.
42:04
So, I think the state of psychology, which I see psychiatry as then actually like psychology, I think encompasses psychiatry, right? it is.
42:13
>> Yeah, it's I think it's just very it's very very poor.
42:15
I mean the therapy part and how how people are trying to apply psychology to like old tired tropes, you know, or or staring they don't really make any sense or people come and okay, well, gosh, if you're doing this you should think differently and you'll do that or here's what this means or and it's like it doesn't well, it makes no sense.
42:33
I mean it doesn't honor that that people are different.
42:36
Have an inquiry process instead of this kind of one size fits all when really when CBT became a big thing. >> Mhm.
42:45
>> And then it fits with the insurance paradigm.
42:47
>> CBT is cognitive behavioral therapy. >> Yeah. Yeah, and it's a tool.
42:49
Like it's a you say it's an arrow in the quiver.
42:51
And but the whole story got made around CBT because it packages well for insurance purposes, which of course has nothing to do with efficacy, right?
43:00
And it and it led us further away from understanding.
43:06
They said, "Why would you want to understand?
43:06
Just change how you think and you'll feel better."
43:08
You know, that that it it deprioritized understanding.
43:11
And of course if you're going to try to give people like five sessions of CBT whether they stubbed their toe or their whole family got killed or you know, you're not going to get anywhere if you're looking for depth.
43:21
And and I think the field has kind of given up on that.
43:26
>> Can you tell me the history of the field? When did it start?
43:30
>> You know, the Greeks were thinking about it, the Romans were thinking about it, but really it just kind of came and went and we had we had almost no understanding let's say at the beginning of the 20th century, right?
43:39
I think we had no understanding other than what we had gained through our literature and philosophy and play like Shakespeare and Dostoevsky and Rilke.
43:46
So all the psychology was coming through there.
43:51
And then like you know, Dostoevsky started he's writing novels, but he was like really writing about humans.
43:56
He's like he's the first like real psychologist, you know?
43:59
And then when Freud came along you know, he was a neurologist, right?
44:03
So there was a thought of like, "Hey, this is all going on in the brain."
44:06
Like, there's a bunch of stuff going on in the brain."
44:08
>> Yeah, he saw and it's interesting these diagrams he he like sketched out of like a neuron A has too much tension and it flows into neuron B, but you could discharge you see it's so simplistic compared to what modern neuroscience tells us, but there's also like a real accuracy to that that you know, we develop this tension and it doesn't have any outlet.
44:26
Like he was right because ultimately it's all neurological.
44:29
But right in the sense of having something to contribute.
44:32
>> Was he the first one to see it as a mechanical function like that?
44:37
>> I think so at least the first to come to the fore that way.
44:38
Yeah, I think I think so and that had a lot of power when you know, we wanted we were learning new science, right?
44:44
And we wanted to see it as scientific and and he was also saying really interesting things.
44:49
People were coming to go before you know, sexual drives and you know, we repeated patterns.
44:55
We were like, "Whoa, this is interesting and medical you know, and neurological."
44:59
And and I think there's great insights to be gained, but I do actually think this is crazy.
45:03
See that that like Freud taught us having two drives, you know, that we have aggression assertion with aggression and pleasure. Which makes no sense.
45:12
Like what it doesn't explain art at all.
45:13
It doesn't explain art, altruism, love, right?
45:15
But what we made a story about that and then that became orthodoxy.
45:21
I think if I said what >> Still now?
45:25
>> Yeah, I think if I said what I said what I'm saying now 30 40 years ago they would just like throw you right out.
45:28
I'd be I'd be exposed because I'm saying this doesn't make any sense.
45:32
There's another drive in all of us as is obvious, right?
45:36
It's like painfully obvious. We wouldn't be here. >> Yeah.
45:39
>> And most of what we do of any value wouldn't exist.
45:41
So so we have to look at that, but no one ever did, right?
45:43
It was just that was the orthodoxy.
45:46
You couldn't step away from it just like you couldn't like not sit behind the patient, right?
45:50
There's a way to do it and it became overly structured and rigid and then like no one ever looked at it again. Like, "Oh."
45:56
And then like new ideas and thoughts came in, like really a hodgepodge.
46:01
Like, kind of like taking like 10 great meals up and then you take a little bit from each and put it all together.
46:07
Like, well, it's not good and you can feel the little pieces in there, but it doesn't make any sense.
46:14
>> Tell me about Jung breaking off from Freud.
46:16
What was the difference in the way they saw things?
46:19
>> How I see that is he just thought much more expansively.
46:25
You know, I mean, it it's simplifying a little bit.
46:27
He's like, "We're not going to figure this out in a bunch of a neuronal diagram, right?"
46:30
He's again, there there are these archetypes, right?
46:33
That we come down to us as an inheritance.
46:35
You know, in many ways like parallel to Chomsky saying like, "Language doesn't come out of nowhere.
46:41
Like, this is, you know, millions of years evolution puts us where ready for this."
46:45
And and Jung was saying, "We're ready for all these human things."
46:48
You know, what does mother mean?
46:50
What is, you know, we we we have these thoughts.
46:54
What's mother earth or it's this There's these concepts inside of us, and I think he was honoring there's so much more to us, and there's a spirituality to us, and and I think he saw the depths of humans as opposed to it.
47:05
And Freud was trying to simplify it into some neurological paradigm.
47:11
>> And then, what were the next kind of breakthroughs in the field?
47:14
>> What you see is and it was a combination [clears throat] of like steps up and steps back.
47:17
I mean, like at some point in time subsequent to that, we're like lobotomizing people for having like too many ideas, right?
47:24
So, we we took so many steps.
47:27
It was just then isolated insight, maybe it gets some traction somewhere, maybe not, you know?
47:34
And then there was the East-West divide.
47:36
You know, where there was so much orthodoxy, which is quite quite interesting that you know, there were these Yugoslav philosophers who were thinking about things like praxis as in like a human expression of self.
47:46
And and they were thinking about things as being generative.
47:49
Like, they were thinking about interesting things, but like, as far as I can see, no one cared, right?
47:54
Cuz the Eastern block was their orthodoxy, which was as as political weapon, right?
47:58
And in the West, it was all that Freudian lockstep.
48:01
So I So I thought there was a lot from those Yugoslav philosophers/psychologists that they got lost, right?
48:08
Like no one was really paying attention and and people were saying that a long time ago that well, there's like so much to us as humans and yes, with these mechanisms, but we're striving for something and existing for something and And so so people saw things, but that doesn't mean they gained any traction.
48:25
So I think there are a lot of steps up and a lot of steps back.
48:28
I think modern neuroscience has taught us a lot, but it's completely unintegrated.
48:33
You know, just like you see in regular physical medicine, you're like it makes no sense like add all these numbers up and say like that's your cholesterol.
48:43
What are all the subtypes?
48:43
But we still do it, right? We still do it.
48:44
And it's such a I don't know a better word.
48:47
It's such a disorganized hodgepodge and it has no messaging.
48:51
So it just makes people afraid.
48:55
>> Then in the '60s was the human potential movement, which seemed like many new modalities and >> Yeah, yeah.
49:00
They had a lot of new ideas.
49:03
Some of them really made sense and followed from other ideas and some didn't, but what got traction where I think was very very disorganized.
49:09
I just I think almost completely disorganized as far as I can see until like late '70s, '80s when that was like the Prozac era, right?
49:19
Then we became enamored, you know, we're going to fix We're just going to fix it all with medicines.
49:25
Everyone's going to be happy and >> Wasn't that really the beginning of psychopharmacology?
49:30
>> Uh you know what's amazing is I probably said this in the past too that the best psychopharmacology is often older than that.
49:36
You know, it's like chlordiazepoxide, Librium.
49:37
We used it for lots of things.
49:38
It's been around since like 1952 or something, right? And then chlorpromazine.
49:42
We started learning things of wow, these medicines hold real potential.
49:48
Like look at what you can do.
49:50
I think it was a dentist in Australia that discovered lithium, right?
49:52
Next thing you know, you have a way that people like literally don't go insane from bipolar disorder, right?
49:57
So, that happened, but then of course we built a story about that.
50:01
It's like the story of human hubris now.
50:02
Like now we're going to figure it all out with medicines and you know, now so much of what psychiatry is is just prescribing.
50:09
And we have literally 15-minute appointment with someone where what else are you going to do but take an inventory of symptoms and try to beat them back with medicines.
50:18
With no focus whatsoever on understanding.
50:21
So, I I think we let ourselves astray and then again you have the big pharmaceuticals and obviously there was like a lot of money in it and a lot of power and a lot of business.
50:27
And then I think it just got so regimented.
50:31
And you know, in many ways I hope now we can talk about how much we might so I don't want to say I'm an expert, you know, expert but enough to say that hey, the psychedelics and what we're learning is I think the greatest new knowledge and certainly my time on Earth. >> Wow.
50:48
>> You told me what these medicines do now and what we can see, I would have thought like aliens came down and gave it to us.
50:54
We we've learned I think more about >> Maybe they did, right?
50:56
But I would have thought they came down like right like it happened in 1997.
50:59
They came down, you know, I would have thought that of yes, maybe they left it for us, right?
51:03
But it's so science fiction that it really actually happens where it takes us out of this like doing part of our brain and it puts us into what's real in this insular area of the brain where we have connection with the greater than us and then like whoa, it is telling us something metaphysical and ontological all these things we have kind of known and understood in some ways but haven't gotten any attention.
51:28
Like we don't mean ourselves any harm.
51:30
No one ever wants to harm themselves when they're in that place.
51:34
It's just like trying to find solutions to things and then now the solution is to hate oneself or hurt, you know, that's all this which isn't really where our aliveness is.
51:44
>> When And first psychedelic revolution happened in the '60s.
51:47
For some reason, the powers that be tried to erase it. Do we know why?
51:54
>> I think that there were people who saw great human potential in it and they thought, "Well, this this can do so much for the world."
52:00
But then they became a little messianic about it.
52:04
So, Timothy Leary, for example, he says, "We're going to bring this to everyone without honoring There's a lot of power to this and and you know, we should be respectful about it, how we're trying to understand it, how we're trying to move this movement forward, and how we're trying to bring it to people.
52:19
And because it wasn't that, I think it allowed very reactionary powers, like the Nixon administration for example, to say, "Hey, this is all drugs. This is bad.
52:29
Anything that's altering your to state of consciousness is bad."
52:31
And it took a long, long time to revisit that and to say, "Hey, there's there's real science here.
52:40
You know, there's real human experience, right?
52:42
That that we understand a lot of what we know about ourselves in the world through phenomenology of being Well, like, what is it that I'm experiencing?
52:49
What is it that you're experiencing? Is there a sharedness? What might that tell us?
52:53
It's I think it's opened us up to much more realness about the human condition than maybe the rigidity that we've tried to place upon it.
53:04
>> Do you think the success of Silicon Valley is instrumental in why psychedelics are coming back? >> I don't know.
53:12
I It It certainly seems that psychedelics were instrumental in the success of Silicon Valley. >> Yeah. >> Right?
53:19
That that seems to be clear.
53:20
>> And it feels like it's always been an undercurrent. >> Mhm. >> Since '60s. >> Right.
53:24
But it never really went away >> Yeah. >> entirely.
53:28
So, the association with creativity and with new ideas, you know, with with letting yourself explore more of your own mind, I don't think went away there.
53:39
And having spent gosh, I spent 7 years in that environment in Silicon Valley, and I think saw that yeah, that ethic of self-exploration hasn't gone away.
53:52
So, then the psychedelics hadn't been pathologized as they were elsewhere.
53:56
Whether they're bringing it back to the fore again, I don't know, but it certainly ran through that culture as that culture ran through the culture.
54:04
>> Yeah, I think there's something happening.
54:06
And I think it's arising from our frustration with hey, like this isn't going okay. Right?
54:12
Like it can't be that we're driving towards more aloneness, more isolation, um just more fear of each other, more let's look for the for the differences, right?
54:20
Let's look for what's wrong.
54:20
I'm going to keep myself safe by seeing what's wrong with everyone else.
54:23
And and you know, I don't think we want to be like that.
54:27
I I think a lot of the dynamics around us, including political dynamics, have pushed us to a place where an aggressive defensiveness seems consistent with safety.
54:35
And and like we know that can't do anything good.
54:38
We know that it's so much easier to destroy than it is to build.
54:43
You know, whether it's a physical structure or it's a human relationship or it's someone's sense of confidence.
54:48
It's it's so much easier to destroy that it tells us we we can't keep moving in this direction.
54:53
And there's so much beckoning us other places.
54:58
The simple goodness of like kindness and altruism and artistic creativity and love has not gone away.
55:04
So, we know that it's there.
55:04
And I think the fact that these medicines are drawing the people into places where they feel a sense of truth, the opposite of intoxication, right?
55:14
Where someone uses a substance and then they have some perception of reality or ideas like, you know, having a bunch of drinks and thinking there's going to be some great ideas and people are going to write a novel or this or that.
55:24
Like it's kind of a a joke that people will think that with alcohol on board and the next day they know it's not.
55:29
They're not intoxicated anymore, right?
55:30
And here it's the opposite that people are finding truths that are very, very clear and explanatory within themselves, and then they are carrying that back to what we might call the intoxicated state, which is when we're just living in regular life and we're living with all the fears and insecurities.
55:46
So, I think we are learning a lot about what we really are, you know, what we really are as humans and how far we can move away from that when we're just lost in survival and frustrations and fears, and then our our perspective just gets more and more narrow, and then we really at that point are can be isolated.
56:09
>> Is it often the case that people who experiment with psychedelics can bring what's learned there back into their regular lives? >> Mhm. Yes. >> That's great. >> Yes.
56:17
Wisdom is one way of putting it, but insight of self, you know, someone who may have been just beating up on themselves terribly and just think, "I'm a bad person or I'm not worth enough. I'm not good enough."
56:27
over and over again, can just see how that's not true, and they can feel a sense of compassion for whatever who they are and what they've been through, and it doesn't then lead people to to become complacent, right?
56:39
That's what what's remarkable is you can judge it by its outcome, right?
56:43
How many people take that knowledge and make their lives better, and I think that's why this movement is moving forward because people are seeing if we treat this with respect and it is very powerful and it deserves our respect, and if we treat it that way, [clears throat] look at the good it's doing for us, and and we can see that so clearly in individual lives.
57:05
>> And it seems like PTSD is a great example of it.
57:09
>> I see PTSD as a way of trying to codify a post-trauma syndrome, right?
57:14
And it's not that I don't think PTSD is true and real.
57:18
I just think it's very rigid.
57:18
So, for example, you can't have these symptoms and problems if the trauma was vicarious, right?
57:25
So, if I if I listen to an harrowing experience that you tell me and I'm very deeply affected or I listen across months or years, that doesn't count because it was secondary which we doesn't make any sense.
57:37
I mean my brain doesn't know that, right?
57:38
You know, if we define trauma and post trauma problems, they happen when our coping skills are overwhelmed and then there are changes in our brains, right?
57:49
And so it's not a soft concept.
57:49
It's our brain function is different going forward and we tend to age faster in real life than the calendar.
57:55
You know, for example, we get more autoimmune diseases.
57:59
When you when we look at this we see, "Oh, this is so clearly true."
58:04
We we can be more afraid of neutral faces, right?
58:06
Where we just perceive more threat where threat isn't present.
58:11
There's a lot of examples we can give.
58:13
That's real and in the brain and the brain doesn't care if it came in an acute trauma, a chronic trauma, vicarious trauma.
58:19
So if we stop trying to service a book, you know, the DSM which is thick enough for how many diagnoses for all of us, like it it doesn't have any explanatory mechanism.
58:30
It's not looking to understand, but if we step away from that then there is so much that we can understand about ourselves and we can use that understanding to bring real change including about the traumas that have affected us.
58:45
>> Besides psychedelics, what are the other things that lead to insights?
58:50
>> I think first I put on that list is just slowing down, right?
58:52
Because for so many of us we're moving so fast all the time and I I I imagine like running as fast as I can and then someone faster, you know, has their hand in the small of my back and they're just pushing me forward and you know, for so long.
59:08
I mean I'm trying to live in a way that's that's slower than that or better than that for me and the people around me, but realizing that for so long I was living like that and I'm still moving faster than I want to and I see so much of this happening around us and because life is is so complicated and it comes at us so quickly, we don't have time to stop and even think, "What do I think about me?" Right?
59:30
We don't even have the time to do that.
59:33
And then, we just move forward trying to keep ourselves safe, which will often mean we have more blinders and more barriers and we become more rigid and and, you know, we we lose sight of the simple goodness of being human.
59:44
All those things that are in the generative drive, you know, the real humanness that is at the core of all of us.
59:50
>> Where would you say we are now in the arc of understanding psychology?
59:57
>> You know, I don't know that we're in an arc because I don't think we've used the increased information we have to bring more understanding.
1:00:05
So, if you if you're asking about knowledge, right, we have so much.
1:00:09
We have a a very strongly upward arc of knowledge.
1:00:11
While our understanding has stutter-stepped, you know, often taking steps forward and taking steps back.
1:00:18
But, what we have now is an opportunity.
1:00:20
We have an opportunity to say, "Hey, let's put this knowledge together."
1:00:24
Like, we have enough understanding to do much, much better.
1:00:29
And that's not a small thing.
1:00:31
That's going to be impactful on an individual person's experience of life today.
1:00:35
Does someone who wakes up facing a, you know, a difficult life with a lot of stressors go to bed tonight feeling no better than when they woke up, even though they braved the whole day and, you know, and had perseverance and resilience?
1:00:46
Or or does that person get to get to have a better understanding of self and what we're all up against and how we can think well of ourselves for good reason?
1:00:53
When we might be inclined that automaticity might lead us to do otherwise.
1:00:57
I think it goes all the way from there, from individual people to how we're treating our societies and how we're treating each other.
1:01:03
And when we're driving ourselves towards really spinning apart or to some catastrophe, which isn't an outlying sentiment to worry about all of that.
1:01:11
It is so much easier to hate than it is to repair bridges, you know, to hate than it is to love and to destroy than it is to be constructive.
1:01:20
But, the state of our lives when we're happy and healthy and thriving and safe is a state that comes through the generative drive in all of us.
1:01:30
It comes through being constructive.
1:01:31
It comes through an understanding of ourselves that's right there at our fingertips because we have all this information we're not using and pulling together and that's part of what I'm trying to do in the book.
1:01:40
I like to think I'm thinking of a few new things throughout the book, but most of it is drawing together what we already know and saying, "Look at this.
1:01:48
We can use this in a way that that can be of help to all of us."
1:01:53
>> What are the human drives?
1:01:55
>> So, the standard conception has been assertion, often called aggression, and pleasure with the idea that we are all sort of fundamentally isolated.
1:02:03
And And what I want to do is I want to be able to assert myself in the world.
1:02:07
I want to be able to do something and see some impact of it around me and I'm seeking pleasure.
1:02:13
And you pleasure is not just hedonistic, you know, it could be food, sex, leisure, all of that, but it can also be safety, you know, roof over our head, enough food.
1:02:21
And this idea that we are implicitly animals, right, that are And yes, we are, but there's a broader conception that we can use for or against ourselves, right?
1:02:32
That assertion or aggression and pleasure doesn't describe why we're still here.
1:02:37
It doesn't describe why we do things that are good that no one else might see.
1:02:41
Why we help someone when no one's looking one way or another.
1:02:45
Why we create art that no one else might see.
1:02:47
Why we're kind to people or why people risk their lives, you know, for for other people.
1:02:52
So, if you look at the hypothesis, right, that says that we're just assertion and pleasure, it just makes no sense.
1:03:00
There's no way we would still be here.
1:03:02
There's a third drive and it's so clear that this third drive sits over us and that's a generative drive to make the world better in the next moment than it is in this moment.
1:03:13
To add something of myself to the world.
1:03:15
To to care more broadly about the world around me and about people around me.
1:03:20
And we almost start to see this as as like a some poly added concept.
1:03:24
It means so pervasive has cynicism become in this idea that well, you have to think about yourself.
1:03:29
You're supposed to think about yourself.
1:03:30
Like otherwise there's no way things are going to be okay.
1:03:33
And what we do is find more reasons for divisiveness, more reasons to divide, and less adherence to what has always allowed us to survive and thrive.
1:03:44
It's people working together on common problems, whether it's a small group trying to find shelter or to to have enough food.
1:03:51
And those same small groups were not just interested, okay, we've we've eaten, we can go into the cave.
1:03:56
Everyone wants to go to sleep.
1:03:58
Like people wanted to make music and art on the walls of the cave and you know, and to do good things for other people.
1:04:04
And this is still how we are.
1:04:04
And the field has not had the leadership to say, hey, there's a there's a way that we can understand ourselves both in the depth the depth that's in us that's a sort of human birthright of this generative drive.
1:04:17
And then also pulling together knowledge and information, so there's a way of going about it. Right?
1:04:22
We don't have to be afraid to look at our mental health because here's a way of going about it.
1:04:25
We have a structure of self.
1:04:26
We have a function of self.
1:04:28
The qualities that sit on top of that. We have drives.
1:04:30
And we want to achieve happiness. What does that mean?
1:04:33
For most people it's peace, contentment, and the ability to find delight that it's all there before us.
1:04:38
Just as this heuristic is there for physical health.
1:04:43
You know, we don't think we're going to find the problems of our body outside somewhere else.
1:04:46
You know, we know that there's a way of bringing understanding, so we don't have to be afraid and we can feel hopeful about making healthy change.
1:04:54
>> How many patients have you seen over the course of your career? >> I don't know.
1:04:59
I mean, it must be thousands.
1:05:01
I've been doing it for 25 years.
1:05:03
So, I mean, I haven't thought of a number, but it's got to be high. >> Mhm.
1:05:06
And would you say that there are themes that you see over and over in people or is everyone completely different?
1:05:12
>> No, there absolutely are themes that we see over and over again.
1:05:16
>> What are the most obvious ones that seem to come often? >> Mhm.
1:05:20
So, one is related to trauma, which is why the first book that I wrote was about trauma.
1:05:25
When I you started to realize that gosh, 80% or more of everything I was doing was related to trauma.
1:05:32
It It's what made that person's depression worse, what's driven addiction, um >> Do you have any examples of trauma?
1:05:39
>> So, [snorts] a trauma is anything that overwhelms our coping skills and leaves us different afterwards.
1:05:43
So, we tend to think of acute trauma.
1:05:46
The study of trauma came about through the military.
1:05:50
So, the people went off to war, bad things happened, they came home, was called the shell shock during the the first World War.
1:05:55
And we started looking at trauma then.
1:05:58
[snorts] So, we think of acute trauma as a car accident, a a death, an assault.
1:06:02
But, chronic traumas can make the same brain change in us.
1:06:06
It's someone who's seen as less than across time.
1:06:08
You know, a prejudice that leads a person to be viewed by the society around them in a negative way.
1:06:14
And they keep having stimuli coming in to them.
1:06:16
So, it's just an example or or having someone in one's life or living with someone who's constantly critical and undermining.
1:06:22
Those chronic traumas can also overwhelm our coping skills.
1:06:27
Just as vicarious trauma can.
1:06:27
I mean, there are people who have been so attached to the news and they and they mean it in a good way.
1:06:33
They feel for the suffering of other people and they're following along with like everything that's happened in the the developments in the war in the Ukraine.
1:06:40
And you see, comes from a good place inside of them, but it makes real change in them.
1:06:45
Now, that person's having trouble sleeping. >> Real negative change.
1:06:50
They're having trouble sleeping.
1:06:51
They don't feel that anyone's safe.
1:06:52
They're worried about their kids.
1:06:53
They're waiting to get on the highway.
1:06:54
They're having panic attacks.
1:06:56
And you know, it can happen vicariously where we're overwhelmed and we change.
1:07:01
And the worst part about that is it comes with a reflexive guilt and shame and it leads us to then hide it away.
1:07:08
So, people often have a different conception of self.
1:07:10
Oh, I was never good at anything, or I was never popular, whatever it may be, and they don't know that that's not even that that's not at all true.
1:07:19
So, you know, our memories, our understanding of our past is is far from immutable.
1:07:23
It changes a lot, and we have to be very careful.
1:07:25
Is that what I've always thought about myself?
1:07:26
Is that what everyone else thinks about me?
1:07:28
Did I change at some point in time?
1:07:30
Have I lost the thread of my own story?
1:07:31
Did trauma in childhood lead me to take lessons forward that are not true? Right?
1:07:38
I'm never good enough, and I just have to make everybody happy. Right?
1:07:40
I mean, for many people they've taken that from childhood as an absolute truth. Doesn't mean it's true.
1:07:45
The person internalized it through trauma, and we can go back and address it, but unless we look at ourselves, we don't even stop and think, hey, is this very basic thing, for example, that I think about myself, even true?
1:07:58
And it is trauma that will lead us it leads us away, and then we can be so lost in a false story, a false narrative. Right?
1:08:06
I'm very big on make a life narrative. Like, who are you? Where did you come from?
1:08:09
What have you been through? What have you achieved?
1:08:11
Does it match what you think in a reflexive way?
1:08:15
Are you the architect of that, or has that story been put in your head, or one negative thing automatically leads to another, and now you've got a story you don't even believe about yourself?
1:08:22
So, bringing compassionate curiosity and looking at what we tell ourselves in our silent talk, or in our narratives, is how we start to get curious, and well, so how we start to to use that curiosity to bring understanding.
1:08:36
But, we have to not feel afraid.
1:08:38
We have to feel like, okay, I can bring compassionate curiosity to myself.
1:08:41
I can think about myself.
1:08:43
I don't have to look away cuz I'm afraid of what I'm going to find, or I'm going to see that I'm I'm in such a bad place, and there's nothing to do about it.
1:08:50
We worry about this, and it keeps us from doing exactly what we need to do, which is just to shine the light around inside of ourselves.
1:08:56
Start with what's going right, cuz there's way more going right than wrong in every one of us, or we wouldn't be here, let alone listening to something that's designed to be helpful, right?
1:09:04
So, there's way more going right than wrong, okay?
1:09:06
From there, let's look at how we can bring change.
1:09:10
>> Has the 24-hour news cycle and social media amplified this? >> I think so.
1:09:15
I mean, the 24-hour news cycle just gives us more opportunity to inadvertently harm ourselves.
1:09:20
You know, I'm in my mid-50s, but I remember when you know, I grew up in New Jersey, and something that happened in Ohio was far away.
1:09:29
We had to wait for that news, let alone, you know, sports scores on the West Coast, and you know, we we had a conception that there was a world around us, but that the things that were of immediate potential distress to us were much more localized.
1:09:40
You know, now we often lose the the difference between bad things that happen close to home and farther from home, and then it makes us feel like bad things are happening everywhere, or we're not safe, and right, everywhere all the time, and we're not safe.
1:09:53
we're not safe. So, we we haven't put a understanding framework about it, and and absolutely, I've seen the overall mental health of us as a population has declined during the time that I've been a physician and a psychiatrist, and
1:10:09
it doesn't have to be that way, but clearly it has been that way, and the statistics bear that out, and part of that's just more anxiety, more distress, more sense of hopelessness, and more defensive aggression, and all the bad things it can bring. >> Are there different trends in therapy in
1:10:22
>> Are there different trends in therapy in other parts of the world that we don't see here? >> I think so.
1:10:28
I'm not an expert on how the therapy is is done in sort of regional places.
1:10:33
I think what happens sometimes is things either good or fads or trends can can come to the surface in different regions.
1:10:41
I mean, there is a lot of orthodoxy just because information is spread wide, and and and some of for example, our academic leadership in the United States um has a big impact on the rest of the world.
1:10:54
So, I I there are local and regional shifts from baseline.
1:10:56
There's also a lot of orthodoxy.
1:10:59
Now, the difference there might be therapy that's not say thought of as therapy, right?
1:11:05
Where where you know, you may have religious traditions where the religious entity is just is just being good to people who've had a trauma in their life or just has a hey, let's be around people when they when they need it.
1:11:17
Let's do good things for people.
1:11:17
So, you know, things you can say, well, there's a therapy tradition going on there, too, which is hey, we need help and and we don't want to feel alone when difficult things happen.
1:11:26
A lot of times the healthiest therapeutic traditions are not the ones that are being enacted on what we might see as higher levels of academia and training that's that doesn't necessarily mean we're on the right path.
1:11:39
>> What are the different styles of therapy being practiced today?
1:11:43
>> It's an interesting question because there are different styles of therapy.
1:11:45
I think they're based upon taking an arrow in the quiver and making the story around it.
1:11:51
So, for example, CBT, cognitive behavioral therapy, it has its place and and there are aspects of mental health about which it can be very helpful.
1:12:00
But, what happens is then a whole philosophy can get made around >> end-all.
1:12:07
>> Right, it's an arrow in the quiver, right? And >> the other arrows?
1:12:10
>> So, DBT, for example, dialectical behavioral therapy, >> What is that one?
1:12:15
>> It's similar to CBT, but there's a focus on the dialectic of we need to accept ourselves as who we are and we need to accept the need for change.
1:12:23
And DBT does a lot of great work around making effective decisions in the context of negative emotions.
1:12:30
So, you could see other places that can really come in handy, right?
1:12:34
Same thing with like IFS, internal family systems, that sometimes it's helpful for a person to think, oh, like the the firemen in me that are trying to put out fires, maybe, but maybe they see fires where there aren't and they're soaking everything and and that's causing problems.
1:12:48
Like, so you just see how that's applicable or psychodynamic inquiry, looking at what's on in our unconscious mind. But these are all great. They're arrows.
1:12:55
But but we need a way to draw that together.
1:12:57
We need a way of understanding ourselves so we can say, "Well, which arrow might we want to get from that quiver?"
1:13:04
And there are many more arrows and therapy styles, medications, psychosocial things that can be done, people getting linked to their community, spiritual things.
1:13:12
So from medicine, therapy, community, spirituality, there's so much that we can do.
1:13:19
But you know, we have to be able to stand back enough to look at ourselves and say, "Okay, what's going to be helpful for this person in this situation?"
1:13:29
Instead of relying upon some orthodoxy where we're going to get at everything with CBT for example, which absolutely makes no sense.
1:13:36
I mean, it would be like saying, "Let's take away every tool we have except the hammer."
1:13:41
Now, a hammer is very important where it's called for, but there are a lot more tools in the toolbox.
1:13:47
>> It also seems most therapists specialize in one of those modalities. >> Right.
1:13:53
>> So that's the one that they use when people come to them. >> Right.
1:13:56
I think there are times and circumstances where that can be helpful.
1:14:00
So for example, >> If you find the right one.
1:14:03
>> Or if you know what you need.
1:14:03
So there are people where it's pretty clear in the system.
1:14:06
That there's enough data out there in the world and studies and research saying that person will really benefit from DBT.
1:14:11
So we could send them then to a person who's trained in DBT.
1:14:16
But unfortunately, most of the time a person [snorts] is seeing if they have one lens, you know, like the CBT lens, they're going to see the person's issues through the CBT lens.
1:14:27
And then like you you cannot see a person, you know, if all you're seeing is an arrow in the quiver.
1:14:35
>> What's the best way to find a great therapist?
1:14:39
>> Well, best way is word of mouth.
1:14:39
And if you ask around and and people have had good experiences and they can and they can tell you why.
1:14:44
That's often that can be very helpful or you know, people who either when you're reading about them and learning about them or if you're going in and seeing them are really engaging with you.
1:14:55
Like they're making eye contact, they're interested in you.
1:14:59
They have a thought that we're going to do something collaborative because I think that's the only way it works, right?
1:15:04
it works, right? It has to be a collaborative endeavor where both the therapist and the patient are trying to figure things out and both feel like we've got a lot of resources, you know, that you know, each person's
1:15:14
intelligence and thoughts and memories and the therapist hopefully knows a lot and has techniques and thoughts and the patient knows their life and we're going to bring this together and and even the person may know their life and not know they know their life. Let's bring all
1:15:24
Let's bring all this to the to the surface and if we do that, we're going to make things better.
1:15:30
If someone's interested in doing that with you and and has flexibility of thought and and isn't telling you, okay, here's how we're going to understand you and you know, people can often tell if you're trying to be forced into a box, right?
1:15:41
Or if you feel like a square peg being hammered into the round hole.
1:15:43
Like we can know that that that's not about intellectual curiosity, right?
1:15:47
It's it's not about mutuality, it's not about a collaborative search for understanding.
1:15:54
>> Do you think when people don't connect with a therapist, it's often because of the modality they're using or is it just also people thing?
1:16:05
>> I mean, it certainly can be.
1:16:05
It can be that the the therapist is deploying a modality and that is not what that person needs.
1:16:11
It could be that people just don't hit it off.
1:16:14
You know, we always say in our line of work, no harm, no foul.
1:16:17
Like anyone can say, hey, I just don't feel like you're the right person for me or not.
1:16:21
Don't feel great about it.
1:16:23
I don't feel we're clicking. That's okay.
1:16:25
We all have to be aware of that because that will happen at times, right?
1:16:28
And if it does, then we just want to learn from it and maybe we we figure who else might be a match for that person, but but if you find people who bring that openness.
1:16:37
Like they a therapist who knows a lot and brings an openness then it's much easier to connect with people.
1:16:45
You know, it's not that people need a certain demographic or this or that, sometimes, right?
1:16:48
But more what people need is just an open inviting person who says, "Yeah, I'm going to meet you with with well regard and you know, let's figure something out, make things better."
1:16:58
>> Do people need to hit rock bottom to change? >> No.
1:17:04
We say that because we have examples, we have salient examples where a person hits what we see as rock bottom and you say, "Wow, that's really bad cuz they hit rock bottom and then they changed."
1:17:17
But there's a selection bias, right?
1:17:17
I mean, the often people hit rock bottom and then their lives are over. Right?
1:17:23
That's what rock bottom is, right?
1:17:23
But we think they've hit rock bottom or they think they've hit rock bottom, but there could be more to come.
1:17:29
I mean, I think the idea that we don't want more misery and unhappiness, right?
1:17:34
Let's let's look at that for real and look at how we could change that and not beat up on ourselves while we're trying to do it and not think it needs to be completely different overnight, right?
1:17:45
But try and bring to ourselves understanding because we want things to be better because they're not in a good place.
1:17:49
It's a much better way of framing it than rock bottom because I think sometimes it can let us let ourselves or others get to the point where there is an end to life.
1:18:00
The rock bottom was worse than we thought and now it's over, right?
1:18:02
Or there's needless suffering along the way.
1:18:05
And why let's try and not to have suffering in us.
1:18:08
We can't take all of it away, but let's try.
1:18:10
Whether you're in a good place, but there's some suffering or you feel that you're in a very bad place, let's bring that same ethic to it.
1:18:17
>> Would you say certain types of people are open to getting therapy and others are not? >> I think so.
1:18:25
I think a lot of that is falsely put into people by the social systems they come from.
1:18:31
So, you know, I came from a social system that found therapy to be shameful and unacceptable, right?
1:18:36
And and I know many, many people who came from social systems that were very different from mine that thought exactly the same thing.
1:18:44
So, the stigma of mental health, unfortunately, is a lot of them well, and we need that to change.
1:18:48
So, there aren't societal mechanisms telling people not to get help.
1:18:53
After that, that there are people who are more reflective, right?
1:18:59
Who who tend to be more curious about themselves and others.
1:19:03
There people who come to therapy easier than others.
1:19:05
But even people who we tend to think of sometimes as more concrete thinkers or have reflective capacity in them.
1:19:13
So, yes, like many, many things and we're [music] built for some things and not as much for others, but it doesn't mean we can't do those things and benefit from them anyway. >> [music]