Dr. Paul Conti: How to Understand & Assess Your Mental Health | Huberman Lab Guest Series
Transcription for the video titled "Dr. Paul Conti: How to Understand & Assess Your Mental Health | Huberman Lab Guest Series".
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Introduction: Guest Speaker
Dr. Paul Conti (00:00)
Welcome to the Huberman Lab Guest Series, where I and an expert guest discuss science and science-based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today's episode marks the first in a four-episode series all about mental health. The expert guest for this series is Dr. Paul Conti. Dr. Paul Conti is a medical doctor and psychiatrist who completed his medical training at Stanford University School of Medicine and then went on to become chief resident of psychiatry at Harvard Medical School. He then went on to found the Pacific Premier Group, which is a collection of psychiatrists and therapists who are expert in treating all types of psychiatric disorders and life stressors. Across the four episodes of this series on mental health, Dr. Conti teaches us about the structure of our own minds and how to think about our own minds as a way to enhance our mental health. He explains how our subconscious mind and our conscious mind interact to drive our emotions, our decision-making, and our behavior. And while any series about mental health requires that from time to time, we discuss personality disorders and psychiatric challenges, the main discussion in today's episode, and in fact, all four episodes in this series, are about what it means to be mentally healthy and how to build one's mental health through specific practices, either done alone or with a therapist. Today's episode addresses several key questions as well as provides protocols for you to address questions about your own mental health. For instance, you will learn what constitutes the most mentally healthy version of yourself. You will learn to assess and indeed, you will learn protocols for addressing levels of anxiety, levels of your confidence, how to think about your beliefs and internal narratives, how to think about your self-talk and restructure your self-talk. We discuss common challenges such as overthinking, we talk about the role of defense mechanisms and other aspects of the conscious and unconscious mind interactions that can lead us toward or away from the healthiest versions of ourselves. You'll notice that during the first five minutes or so of today's discussion, Dr. Conti describes a framework of what he refers to as the structure of self and the function of self, and he describes several pillars for understanding what those are. I'd like to highlight that while that short portion of our discussion does bring up a number of terms that are likely to be novel to you, they certainly were novel to me, that as our conversation proceeds, you will really come to appreciate just how simple and yet powerful that framework is. It will help you understand, for instance, the relationship between your conscious mind and your subconscious mind in ways that you can really apply toward enhancing your mental health. In addition to that, Dr. Conti has generously provided a few PDFs which illustrate that framework for you and that are available completely zero cost by going to the links in the show note captions. So you have the option to download those PDFs and to look them over either prior to or during or perhaps after you listen to these four podcast episodes. As a final note before beginning today's discussion, just want to emphasize my sentiment, which I'm confident will soon be your sentiment as well, which is that Dr. Paul Conti shares with us immensely powerful tools for enhancing mental health that at least in my knowledge have never been shared publicly before. In fact, as somebody who has done more than three decades of therapy, I've never before been exposed to a conversation about the structure of the mind and the subconscious mind as well as tools and protocols for enhancing mental health as powerful as these. For me, the information was absolutely transformative in terms of reshaping my thought patterns, my emotional patterns, and indeed several of my behavioral patterns. And I'm confident that the information that you'll glean from today's episode and throughout the series will be positively transformative for you as well. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.
Understanding Self And Mental Health
Sponsors: BetterHelp & Waking Up (03:46)
It is, however, part of my desire and effort to bring zero costs to consumer information about science and science related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is BetterHelp. BetterHelp offers professional therapy with a licensed therapist carried out online. I personally have been doing weekly therapy for more than 30 years. And while that weekly therapy was initiated, not by my own request, it was in fact a requirement for me to remain in high school. Over time, I really came to appreciate just how valuable doing quality therapy is. In fact, I look at doing quality therapy much in the same way that I look at going to the gym or doing cardiovascular training such as running as ways to enhance my physical health. I see therapy as a vital way to enhance one's mental health. The beauty of BetterHelp is that they make it very easy to find an excellent therapist. An excellent therapist can be defined as somebody who is going to be very supportive of you in an objective way with whom you have excellent rapport with and who can help you arrive at key insights that you wouldn't have otherwise been able to find. And because BetterHelp therapy is conducted entirely online, it's extremely convenient and easy to incorporate into the rest of your life. So if you're interested in BetterHelp, go to betterhelp.com/huberman to get 10% off your first month. That's BetterHelp spelled H-E-L-P dot com slash Huberman. Today's episode is also brought to us by WakingUp. WakingUp is a meditation app that offers dozens of guided meditation sessions, mindfulness trainings, yoga need recessions, and more. By now, there's an abundance of data showing that even short daily meditations can greatly improve our mood, reduce anxiety, improve our ability to focus, and can improve our memory. And while there are many different forms of meditation, most people find it difficult to find and stick to a meditation practice in a way that is most beneficial for them. The WakingUp app makes it extremely easy to learn how to meditate and to carry out your daily meditation practice in a way that's going to be most effective and efficient for you. It includes a variety of different types of meditations of different duration, as well as things like yoga nidra, which place the brain and body into a sort of pseudo sleep that allows you to emerge feeling incredibly mentally refreshed. In fact, the science around yoga nidra is really impressive showing that after a yoga nidra session, levels of dopamine in certain areas of the brain are enhanced by up to 60%, which places the brain and body into a state of enhanced readiness for mental work and for physical work. Another thing I really like about the WakingUp app is that it provides a 30-day introduction course, so for those of you that have not meditated before or getting back to a meditation practice, that's fantastic. Or if you're somebody who's already a skilled and regular meditator, WakingUp has more advanced meditations in yoga nidra sessions for you as well. If you'd like to try the WakingUp app, you can go to wakingup.com/huberman and access a free 30-day trial. Again, that's wakingup.com/huberman. And now for my discussion about how to understand and assess your level of mental health with Dr. Paul Conti. Dr. Paul Conti, welcome.
What is a Healthy Self? (06:55)
Thank you. I'm very excited for today's episode and for this series because I, like so many other people out there, have a lot of questions about myself and themselves. And not just about ourselves, but how the different personality types out there, the healthy types, the narcissists, all the things that we hear about these days, gaslighting, all these sorts of things. Not all of that really is. Perhaps we can dispel some of the myths that exist during the course of this series. I'm sure we will, sure you will. And also, raise certain important questions that we should all ask ourselves in terms of trying to understand who we are and how we can be the best versions of ourselves, how we can experience the most happiness, also the most richness in life. Because of course, life isn't just all about being happy. So to start off this question, I want to raise a parallel with something I think for most people is more concrete, which is physical health. While there isn't an ideal physical self that's been defined by the medical community, we know, for instance, that there is a range of blood pressures that are considered healthy. There's a range of body mass index that's considered healthy. That's a little controversial because it depends on how much muscle, how lean people are, et cetera. I think it's reasonable to say that the healthy individual is not going to get exhausted walking up a flight of stairs. They could bend down and lift an object without hurting themselves. They might even have some additional strength or endurance, et cetera. Within the physical health domain, all of that is fairly well scripted. There are protocols that people can follow to improve their physical health. We've covered many of them on this podcast before. When it comes to mental health and it comes to concepts of the self, things become much more abstract for people. In fact, I think most people, including myself, are kind of wandering around in the dark, wondering whether or not we are the best versions of ourselves, whether or not we're thinking about ourselves and the world around us in the best ways. So to start things off, do you tell us what is the healthy version of self? What should we all be aspiring to? You've worked with people who presumably are healthy and people who have severe pathologies of different psychiatric types, bipolar, narcissistic, sociopathic, and everything in between. So for me and for the listeners, what is a healthy self? What should we be striving for? What a healthy self approaches life through the lens of agency and gratitude. If you look at happy people, people who like their lives, no matter what stage of life they're at, no matter what their socioeconomic status is, race, religion, there's so many things that we think matters. And they matter to a lot of things. Do they matter to, is someone happy or not? They are not factors. The factors that tell us, is this person enjoying life? Are they going to take care of themselves? Are they happy they're here? Are they engaged productively in the world? Is agency and gratitude? If we have those two things, then it's interesting you almost never see someone go wrong. And even if they're difficulties, even if there are, if things happen in life that can make some unhappiness, right? It doesn't take away the person's engagement in life, the person's enthusiasm for life. And I think if you look at even traditions of understanding, how are people happy, whether it's in psychiatry or it's through literature or through religious lens, it is always people who approach life through the lens of agency and gratitude. Could we go a little bit deeper on agency and gratitude?
Agency & Gratitude; Empowerment & Humility (10:41)
When I hear the words agency and gratitude, I think agency and ability to affect the world around me in the ways that I want. And I think gratitude being thankful. And we did an entire episode all about gratitude practices, some of the neuroscience and neuroimaging and neurochemical changes that occur in the brain and body when people exert a gratitude practice. But I have a feeling that when you talk about agency and gratitude, you might be talking about something slightly or maybe even quite a bit different than the way that I'm defining it. Yeah. I would say agency and gratitude are these amazing rewards, right, that sit on top of the highly complex brain function inside of us and the highly complex psychology in all of us. So if we think about a self, that I identify a self, I'm an eye, right, if I'm going to approach the world with agency and gratitude, that's sitting on top of a lot of healthy things, right? And the idea that, okay, there are ways in which we can be mentally unhealthy, right? But to start with like, what is going on inside of us, right? And what does it look like when we're healthy? So there's a structure of the self, right? There's function of the self. And if we look at the structure and the function and the parts, the components of structure and function, we can come to understand, okay, what is going on in us? What might we change for the better? How do we build empowerment, right? Empowerment is the ability to navigate the world around us and to bring myself to bear in ways that are effective and from empowerment arises the sense of agency, right? I have agency because I am empowered, right? And also from a healthy structure of self and function of self, we end up with humility, right? We come through that with the sense of our place in the world and our power in the world to navigate as we choose, but also a sense of the world around us that's far more complicated, right, than just we are, extends beyond us to other people, to the climate around us, to the health of the whole planet, right? We feel a sense of humility that I'm here and I can do good things. I'm fortunate to be here and I'm part of this bigger ecosystem, right, all the way up to the scale of the ecosystem of Earth, right? And if we feel that humility, then we approach the world through the lens of gratitude. So the idea that a healthy structure of self and a healthy function of self leads to empowerment and humility, and then upon that, we are sort of imbued with agency and gratitude and that leads us forth to happy lives. Okay, so it's clear to me why having agency and gratitude would be wonderful, perhaps even the goal state that we should all be seeking to achieve. And it also makes sense to me as to why empowerment and humility are important components that feed into our ability to have agency and gratitude, right? Because all of that, at least to my mind, sums to a very clear statement about having agency and gratitude is the best way to approach life. That all makes perfect sense to me and yet I've never really thought about it that way and I think most people haven't ever been told this, right? I mean, what should we be seeking, agency and gratitude? Yes. So we've heard endless number of podcasts, including this podcast, about physical health and we've been told by physicians and everybody else that we should seek to have a relatively low blood pressure, we should seek to have a relatively low heart rate that our cholesterol should be at a certain level, et cetera. So within the physical health domain, there are strong, clear messages about what we should all be striving toward. And in a similar way to how we're discussing the self and psychology, I don't think anyone seeks to have low blood pressure or low heart rate because that's what they want per se. They want those things along with some capacity for endurance, the ability to lift an object or some strength, et cetera, because of the way that those metrics of health allow them to move through the world in the best possible way. In other words, having some degree of endurance allows you to walk down the block maybe a lot further or to walk up several flights of stairs or to have some strength allows you to pick up objects and effectively move through life. You're telling us that having a sense of agency and gratitude and that agency and gratitude are undergirded by empowerment and humility. And that's the best way to move through life, the most effective, happiest, if you will, way to move through life. Well then I think we have to ask ourselves the same thing we would ask about physical fitness, which is what goes into creating a sense of agency and gratitude, empowerment and humility. What are the action steps? Because if I want more endurance, I know to get on an exercise bike or a treadmill or go out for a run a few times a week or more. If I want to get stronger, I'm going to lift objects that are difficult to lift until they're easier to lift. I mean it's all pretty straightforward in the physical domain, but in the mental health domain, in the psychological domain, it does become a bit more abstract. I think in part because no one's ever told us, certainly no one's ever told me what you really need is agency and gratitude in order to have the best possible life. So I very much appreciate that you're telling us this. And I'd love for you to tell us what are the action steps that go into creating these things that we're calling agency, gratitude, empowerment and humility.
Physical Health & Mental Health Parallels (16:13)
There's actually quite a strong parallel between the physical health dimension and the mental health dimension. So as you're saying, why do you put in the time, the energy, the learning, to be physically healthy? There's a lot of effort and we put so much of ourselves towards it if we decide that we value that. Why do we do it? Because as you said, it's the best way to approach life. There may be something that I want to do. I want to run a race or I want to climb a mountain. But ultimately we take care of ourselves physically because we don't know what's coming next in life and we want to be prepared for it good, bad and otherwise. And the same thing is true of mental health. So I can feel grateful for something. I can feel grateful that I'm still breathing right now. I can exercise agency. I can pick up that cup and take a drink. But that doesn't mean that I'm living life through the lens of agency and gratitude, which is consistent with every opinion. If you look psychologically through the lens of literature, through the lens of sociology and psychology, agency and gratitude make happiness. There are ways of approaching life and just like physical health is undergirded by cardiovascular health, heart health, muscle strength, right? There's an undergirding of agency and gratitude and empowerment and humility are ways of describing, okay, what arises from understanding ourselves, taking care of ourselves, that then gives us the agency and gratitude. So we have empowerment and we have humility, but where does it all come from, right? So just like we have to understand the physical body and what to do to it in order to be healthy, we also have to understand the mind, right? The self that wants to be healthier. And that comes through understanding the structure of the self and we have enough science through the lens of neurobiology and psychiatry to understand the structure of self and then the function of self, right? How we work, right? How we interface with the world. So it's actually not more complicated than physical health. It's just that we don't spell it out that way, right? We come at it through the lens of pathology of what's wrong and who has some diagnosis and you know, we're looking for the problematic instead of saying like, what do we look like when we're happy, right? And then going and digging down into the mechanics of it all, right? And if we're not in that state, right, to go and look at that and to make changes just as if you were very, very physically healthy, right? But you know, your heart rate couldn't go up that much without you feeling very, very fatigued. We'd say, well, look, you're doing a lot of the right things, right? But let's work more on your heart, right? We would go look at the specifics of it because that's how we understand it. And we just don't apply the same science, logic, common sense to mental health as we do to physical health. But it's time for that to change because we have the knowledge and ability to do just that. When we had Dr. Andy Galpin on this podcast to do a series on physical health and fitness, essentially, he said something that really stuck with me, which was that the number of different workouts that people can do out there, body weight workouts, work with weights, with machines, you can run far, you can run shorter distances more quickly, you can do planks, you know, sit up, so many variations on exercise routines. But what he very clearly stated was that there are only a few core adaptations that the body can undergo that lead to these byproducts that we call lower blood pressure, enhanced endurance, improved strength, improved neuromuscular function, improved brain function for that matter. It sounds to me like there are a lot of parallels in creating the healthy psychological self. So what are the core components that I and others should think about in terms of understanding he described them as the structure of the self and the functions of the self?
Structure of Self; Unconscious vs. Conscious Mind; “Iceberg” (20:21)
Again, just to draw a parallel, if we were talking about physical health, we'd say, "Okay, there's connections between nerves and muscle that allows us to move our limbs." If you apply a certain amount of resistance, you get a certain adaptation, which is the neuromuscular connection gets stronger, the muscle might get bigger or just stronger, etc. Flexibility, you know, you just push your range of motion just a little bit into discomfort. You do that. It so happens to be the case that you do that for just a couple of minutes each day over the course of about a week or so. You get a significant increase in flexibility. Okay, so it's all very clear in the physical domain. In the psychological domain, I hear you telling us that the action steps that we all should be taking in order to be the happiest version of ourselves by achieving agency and gratitude is to explore the structure of self and the function of self. So if you could tell us about what is the structure of self, like what goes into Andrew being Andrew and Paul being Paul and whoever the listener is into being who they are. What is that? And what is the function of self? How does a psychiatrist think about that? How should we think about that? Okay, if I could start maybe to set the stage for that, by pointing out that as we go up the hierarchy of health, everything should get simpler, not more complicated. If you think about physical health, there's so much complexity on the initial levels. So we think about your physical health status versus mine. It's going to be different. We're going to have different cardiac function and muscle function and pulmonary function. But if we're going to be healthy, we could do a lot of different things. There might be a whole set of choices that would work well for you, different choices that would work for me and we can gauge intensity, timing, frequency. It's very complicated when we're on the lower levels of the hierarchy. As we get higher up, let's say you and I both do the right things, then what happens? We both have endurance. We both have some strength. We're both robust. Those are getting simpler because we're approaching the unique idiosyncrasies in all of us. We have to look at that and look at that in a very specific way. But what we're trying to get to is something that's common for all of us. Stamina, for example, in physical health and endurance and agency and gratitude in mental health. So then if we go and we look and we look at the structure of the self and the function of self, we find that there's more complexity but that it is also understandable. There's tremendous complexity in the body just as there's tremendous complexity in the mind and we can understand what is the structure of self, what is the function of self, and we can look at that and assess that in the same way we would physical health parameters so that we arrive at the place we want to be, be it endurance or agency or gratitude. So structure of self. We all have an unconscious mind and we pay so little attention to this part of us that really is the biological supercomputer. So millions of things are going on all the time. In every split second, so for example, I can say these words. You can listen to the words. You can say things back and I can listen. There are millions and millions of things going on under the surface, much of which comes from either biological predispositions or habits over time, thought processes, patterns. So this unconscious mind, this supercomputer is doing all of these things. At the speed of light, there are electrical and chemical signals and multiple pathways as complicated as superhighway systems that then consolidate and communicate with others. And then what comes up from all of that is the conscious mind. So imagine an iceberg and it's a really, really big iceberg and we see the part above the surface. That's the conscious mind. But there's a huge part of this iceberg. Maybe 95% of it is underneath the water. There's this hulking mass that we don't see. That's the unconscious mind and it's feeding up to the conscious mind which is a much smaller part of our brain function. But it's the part that we're aware of. It's sitting on top of all the unconscious things which are extremely important. But then we become aware so that we can engage in the real world. In order for us to have this conversation, the millions of things per second have to be going on underneath the surface so that you and I, as conscious eyes, as conscious selves, can ride along on top of it. So that's the part of the iceberg that's above the water. It's the conscious self. And imagine that the conscious self is girded by a set of long tendrils that come out from under the water. Their defense mechanisms that are unconscious to us that sort of gird the conscious mind. So do we rationalize automatically? Do we avoid automatically? Do we act out automatically? Are these things in us in ways that we can observe and change but that are there to try and protect the conscious mind from the slings and arrows of the world around us? So if you imagine there's the big part of the iceberg under the water, the unconscious mind. The conscious mind is riding on top of it but the conscious mind that part sticking out of the water is vulnerable. So imagine that there's a defensive structure that arises from the part of the iceberg that's underwater that is there to defend and protect the conscious mind. So when you say to defend and protect, when you say that the conscious mind is vulnerable, what do you mean?
Defense Mechanisms; Character Structure “Nest”, Sense of Self (26:15)
Do you mean that it's vulnerable to physical attack or that it's vulnerable to us realizing that we're just a bunch of neurons that are clicking away underneath? Like in other words, where does the vulnerability of the conscious mind really reside? Not physically, where does it reside? But what am I so worried about in terms of my safety? I mean, right now we're in a room, I feel pretty safe. I don't think you're going to attack me verbally or physically. I suppose it's possible that could happen but it seems like a very distant possibility. So when you say that these defenses are there to protect us from some sort of awareness, what awareness are we trying to avoid? So the vulnerability of the conscious mind is to fear, confusion, despair. There's so many things that we can fear. Some people are afraid of snakes or spiders, some people are afraid of death, some people are afraid of health issues that could come to them or to people they love. We can get confused and not know what decisions to make and how to navigate the world and how to be who we want to be to ourselves and to others. We can feel tremendously vulnerable and despairing if we lose others or we start to see things happening in the world around us that we don't like. We start to feel like what will happen to the planet we live on? Will there be war where I live? Will my children be safe? There's so much that we need to protect ourselves again. So that vulnerable part of us, the part of the iceberg sticking out above the water needs a defensive structure around it to protect it against the vulnerability of fear, confusion, despair. Because the conscious mind is sticking out of the water with a defensive structure around it, it is the raw material from which we create our character structure. So the character structure is all of that, the part under the water, the part above the water, the defensive structure. So imagine a nest around all of that and that's the character structure that we utilize to interface with the world. So the character structure is the thing that I'm using. If you're driving somewhere in a car, the car is the thing that you're using to go there. The character structure is the thing that we're using to interface with the world. So for example, how trusting am I versus suspicious? How readily do I come to make friends with people? How much do I act out if I'm frustrated? How much do I exclaim something negative as opposed to holding it inside of me? How much do I rationalize if something isn't going well? Do I want to look at it and maybe see that it is so that I don't have to face it? How much do I avoid problems in the world around me? How much do I exercise altruism? These are all the ways in which we're engaging with the world around us and this determines the self, imagine that the self then grows out of this nest from the character structure that we use to interface with the world and the decisions that we make. So if our character structure is the thing through which we engage with the world, then we're enacting what is inside of us, what we've determined through our unconscious mind, our conscious mind, our defense mechanism, there's a certain us that that comes at the world in a certain way and if we're more or less trusting, more or less avoidant, we rationalize more or less, these are the factors that determine where do our lives go? Because on top of all of this, imagine that the nest of the character structure around all of this grows from it the self, the product of the feelings inside, the things that we know about ourselves and don't know about ourselves, the decisions that all of it leads to. So I may choose to be, for example, more trusting and that may bring an opportunity to me that I wouldn't have otherwise had, right? I may choose to be more trusting and it may bring risk to me that I wouldn't otherwise have had. So we want to be as healthy as we can, as knowledgeable of ourselves in the world around us so that it's safe for us to have a healthy character structure through which we can engage in the world around us with a sense of prudence, right? Taking reasonable risks, right? Not too little so that we shut ourselves down and maybe end up despairing, not so much that scary things can happen to us and we end up fearful, right? But the idea that if we know ourselves well, the character structure is healthy, right? Because it's built upon a structure of self and a function of self that are healthy and out of it is coming empowerment, right? And empowerment and humility, right? That then leads us to agency and gratitude, right? The idea here is that this is the character structure that we create that can then interface with the world in a way that's good for us and good for the world around us that leads us to be able to live in much more harmony inside of ourselves and outside of ourselves. So if I understand correctly, defense mechanisms that grow up out of this portion of the iceberg that we're calling the unconscious mind, they protect our conscious self in ways that can be adaptive or that can be maladaptive.
Predispositions & Character Structure (31:27)
In other words, defenses can be healthier, they can be unhealthy. And perhaps in a few minutes, we can get into what a healthy versus an unhealthy defense looks like. But the way you describe character structure sounds to me like an array of contextual dispositions. I don't want to add a necessarily complex language, but it sounds to me like a bunch of dispositions. Like, if I'm walking into the office where I know everybody and I see familiar faces, there's no reason for me to be on guard if I trust those people. But if I'm walking down a street at night that I'm not familiar with and I'm starting to get the sense that, you know, this neighborhood might not be the best, it makes sense for me to be on relatively high alert. So different dispositions depending on different conditions. I can't help but mention my Bulldog Costello who had basically three dispositions. It was a sleep, but in all seriousness, the second one was kind of bored, the Bulldog faces kind of bored, or if something was given to him that he liked or if we were doing something he liked delight, he basically had three dispositions as far as I could tell. I think one of the reasons we like dogs so much or that many of us like dogs so much is that their decisions are very predictable. Take him to the park, he's happy, unless he happened to be ill that day, which was rare. You know, feed him, he's happy, right? There wasn't a lot of, I don't like this particular meal or I don't like this particular park or this Bijon Frise does and smells so good to me. You know, it was so simple and yet people are very complex, right? I can look at myself and say, okay, what is my character structure? Character structure is certain things I like, certain things I dislike, certain things really irritate me, certain environments and people I just delight in. Okay, so is the definition of a healthy character structure, one in which the dispositions match the context perfectly? I mean, I don't know how any of us could be like that, but is that sort of the ideal much in the same way that, you know, we could probably arrive at an ideal degree of stamina that one could have. I mean, some people want, run ultramarathons, you know, 100 miles or more, some people want to run a marathon, some people like me don't really desire to run a marathon, but I want to be able to run a mile if I need to without being completely exhausted and injured. So, you know, when we, when we ask ourselves about character structure, are we asking ourselves about context driven dispositions? And, you know, how do we start to evaluate that for ourselves? I think because we're more complicated, I think it's not dispositions as much as it's predispositions, right? So, so in the example that you gave, right, you have a certain predisposition to be either trusting or wary, right? And, and you're, and that's healthy in you, right? So when you come into a setting where there's not a good reason to feel mistrustful, to feel anxious, to feel vulnerable, right, then you feel at ease, right? So you walk into the work setting, there are people you know, there are people you like, everything is okay, right? You have a different predisposition when the context is different, right? So if the context could bring a lack of safety, then you respond accordingly with the lack of safety, right? But, but it's possible, certainly those predispositions can be in unhealthy places, right? So, for example, you might have been traumatized in a certain way or you might approach the world in a certain way because of prior experience that you may not register as trauma, but it may be that within you is a predisposition to be mistrustful. So you could walk into a room of people that you know, of people who've never met you any harm and still feel unsafe, right? Now this happens most often after trauma, but there are other ways people can get to that where the predisposition isn't so healthy. The converse is true too, right? There are people who can have too much of what's called an omnipotence defense and then they don't recognize danger when danger is around them. So the idea, the character structure, that nest, right, that's built around the defensive structure and the conscious mind that's sitting on top of the part of the iceberg, the unconscious mind underwater, right? It's that nest that is interfacing with the world through a whole set of predispositions. I'd like to take a brief break and acknowledge one of our sponsors, AG1.
Sponsor: AG1 (36:01)
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Character Structure & Action States; Physical Health Parallels (37:27)
At least for most of us, we do that with no professional training or authority. That person is great. They're super nice. The person's a jerk. They're weird, etc. I think very few of us are familiar with assessing our own character structure. I have to presume that some of what happens when somebody comes to you as a psychiatrist or to a psychologist is that certain questions are asked and certain narratives are told that start to reveal to the clinician the character structure. Perhaps from there, some of the possible defense mechanisms and structure of the person's unconscious mind and conscious mind that obviously are unaware to them but would be clear to the clinician. Much in the same way that if somebody goes into the doctor and says, "I don't feel well," they're going to start probing with questions or they're going to listen to their breathing, their heart. I think you can help the stephoscope and figure it out. These are the pros, whereas the psychiatrist or psychologist uses words and language to probe. What are the sorts of aspects of character structure that we can be aware of in ourselves? In other words, should we be asking what type of character do I have depending on one circumstance or another? Should we ask ourselves what sorts of defenses we have? Maybe this would be a good opportunity to address this issue of what are healthy versus unhealthy defenses. Because it sounds to me, if I understand correctly, that the defense mechanisms are a very strong component in determining what our character structure is. Because the defense mechanisms are unconscious. The character structure that nest around the defenses in the conscious mind through which we interface with the world is very, very complicated. There are many character structures as there are human beings. It's very, very complicated. But there are factors that are consistently relevant across people and get identified as such. One example would be isolation versus affiliation. Does a person tend to group with others? Or does the person tend to avoid grouping and go about thoughts, tasks, approaches to life in a more singular manner? It's just one element. I'm making value judgment about it because it can be good or bad on either end of the spectrum. We're just saying, what are the factors? Am I more affiliative or do I tend to isolate and be more singular? That's just one example. Another example could be things like, for example, use of humor. Does a person use humor and in what way? Does a person use humor to deflect discomfort in negative situations? Does a person use humor in order to be little others or to be little themselves? Or does a person not use humor? These aspects of character structure and so much research has been done on this over the years to determine what is most salient in this thing that we use in order to interface with the world around us, out of which grows ourself. That makes good sense. It makes me want to revise a little bit what I asked about before, which is I said that when it comes to an exam of physical health, we measure blood pressure, measure breathing, etc. Maybe even a blood test, look at some biomarkers. But what you're describing is a little bit more analogous to the physician addressing a patient who's having some physical discomfort or malaise and saying, tell me about your day. What do you do when you get up in the morning if the person says, well, I drink a quarter pint of vodka. It's a very different answer than I'd go outside and get sunlight in my eyes, drink a glass of water, and maybe have a cup of coffee. Or if somebody says, I have six espresso. If I understand correctly, the character structure is better revealed by exploring the action states that somebody engages in. Isolation versus engagement, as opposed to a read of one specific biomarker. It's character structure brought to life. Immediately I'm thinking about movies and books where we learn so much about somebody through observing the way that they interact with people in very potent ways. For instance, I can think of countless movies where you learn a ton about somebody in the first scene simply because of the way they react to somebody who cuts them off in traffic. They just explode. Then we think of that person as reactive from that point on, unless there's a significant amount of material to revise that. But it's in the action of getting explosive, incursing, etc. As opposed to if they just laugh it off or laugh at themselves, or blame someone within their own vehicle or something like that. Are those the sorts of things that a clinician like yourself is listening for when somebody says, "You know, I don't feel well." And he said, "Well, tell me about what's going on lately." And they start describing what's going on in their life. Are you listening for those places where the defense mechanisms are starting to reveal themselves? The character structure starts to reveal itself through these action steps that the person seems to be taking. Maybe one way of looking at character structure is that it's potentialities and predispositions. That there's so much that's latent that then interfaces with events, like a person stuck in traffic. How does that person respond? If that person weren't stuck in traffic, there wouldn't be a response to it. So there are potentialities, there are predispositions, and then we live through enacting them as we're moving them through life. And the attempts to understand, so using the physical health parallel, if you came in and you said, "I don't feel well." We might run a lot of tests. We might get an MRI or a CAT scan or even put in the stethoscope and listening to us inside of you. Those, we could say, are unconscious things. You're not aware of what the imaging may show or the blood test may show or how your lungs may sound when someone puts a stethoscope on them. So a clinician, if you're trying to understand and help someone, then you do want to look for those things. You want to look for the things that are underneath the surface, but that can be very, very important. You also want to look at everything that's on the surface. So if you're engaging with someone, you're engaging with the self, the self that grows out of the character structure nest. So by engaging with and doing one's best to understand the self, then you learn about what is underneath of it. So I may then learn, well, how do you respond in certain situations? Just like I could ask you questions, "Well, when do you not feel well?" So you're asking a person questions because the idea is to understand elements of the character structure. So how do you respond in certain situations? What's going on inside of you? What do you understand about yourself and what do you not understand about yourself? How do you bring yourself to bear in the world around you? So there's a similar process going on, but here we're trying to understand the self and the understanding of the self can help us understand the components underneath of the self because that's where we're going to go to make things better. The idea is there shouldn't have to be mystery or certainly not mystery any more than there is in physical health. I mean, rarely someone comes in and they're really not feeling well and a whole set of everything that should be done is done, right? Labs, physical examination, history, imaging, right? And you still just don't know, right? I mean, sometimes that can happen, but it's very rare. And the same should apply here that if we're examining a self, right, and we're looking for the components out of which that self comes, right? Then we should be able to understand well enough to go back to the components of self and to make change so that the self is in a better place, right? And that self can then be empowered, can feel humility, right? Can then come at life through the altruism and gratitude that we seek because again, you show me someone who's coming at life through altruism and gratitude and is not happy with their life. And you'll be showing me something I've never seen before, something entirely new. So if we want to get there, we want to know how to get there. And there are ways as there should be that parallel physical health that aren't mysterious that we can come at to make understanding and change. I'm wondering about the role of anxiety in all of this. The reason I ask about anxiety is that you said that so much of character structure is determined by a set of predispositions and potentialities.
Anxiety; Understanding Excessive Anxiety (46:20)
And earlier we were talking about example of either being afraid or unafraid in particular environments or feeling like we can walk into a classroom and learn or whether or not we're overly concerned about what people think about us or both, right? It could be a mix. Whether or not we can embrace novel environments in safe and adaptive ways, whether or not we can grow from them as opposed to whether or not we can be overtaken by them or perhaps even injured, harmed psychologically, physically or both. Anxiety to me is a very basic function. I think about it in terms of the autonomic nervous system and degrees of excitability and etc. And ability to sleep at night and ability to wake up feeling reasonably good but not have a panic attack. But anxiety to me does seem like a key node in all of this. Meaning, most people, including myself, I don't walk around thinking about my character structure. I don't walk around thinking about how I'm going to behave in a bunch of hypothetical environments. I think about the fact that most mornings I wake up and I feel pretty good, to be quite honest, not as good as I would like to feel. And then I certainly because anything's wrong, but because I think I'm wired to be a little bit more on the anxious side and to predict what's going to happen next and what needs to be done. And so until I'm actually engaging in certain behaviors, that anxiety hums a little bit high for me. The gears turn a little bit faster perhaps than I would like when I wake up in the morning. But once I engage, I feel like the speed of that gear turning matches the demands of life pretty well. I feel agency. So if you don't mind, could we explore this feeling of anxiety or lack of anxiety that I think people are pretty familiar with within themselves at different times of day and under different conditions? Because to me, it seems like an interesting lens to explore this notion of character structure and defenses. Is anxiety a healthy defense or an unhealthy defense, or does it simply depend on the circumstances? Well, we all have some degree of anxiety in us. We all have some awareness that we're navigating the world and not everything is perfect. This is not Nirvana. So there's some anxiety within us. And the thought is that that anxiety can keep us vigilant about the things we should be vigilant about, health and safety, but that too much anxiety then becomes counterproductive. And we can look at this in a very regimented way. So some anxiety makes sense. It keeps us being careful. It keeps you being careful as you're pulling out of a driveway, for example. So it can be absolutely fine. But let's say you bring something to clinical attention that isn't absolutely fine. Let's say I didn't know you and you come in, we have the example that you used before, where you walk into work and there's a group of people you know well and like. Let's say you told me, when I walk in there, I feel very anxious. I don't feel like things are okay. So then we would go through it. We said, that's not good. Maybe it's impacting a professional life, things are not going well. You really want this to change because it's impacting your life in a negative way. We say, okay, let's look at that from the perspective of structure of self. So first, unconscious. Is it that just genetically are you built with just higher levels of anxiety? So we could learn, okay, have you always been anxious like this? Is this always been in your life since you were a little kid no matter what? So we're looking for biological nature, so to speak, variables. We might also look for things that have happened to you that are lodged in your unconscious mind. Is there trauma that you haven't processed? That now is underneath the surface but is spinning off more anxiety? Let's say you tell me, oh, it wasn't that long ago you started being anxious. Did something happen? Did you walk into a group of people and I don't know, you tripped and you felt bad about something, then you get more anxious? So are there things going on underneath the surface that are impacting? You're like, let's look into that, right? Because that's the biggest part of the iceberg, right? Then your conscious mind, we could start thinking about, okay, what's going on? What are you actively thinking about? So this is where sometimes cognitive behavioral techniques can come into mind. Like, are you thinking, like, oh no, I'm scared. It isn't going to go well. We're having thoughts on the thoughts and making you more anxious, right? What's going on in your conscious mind? I would also be very interested in the defenses around you. So for example, do you tend to avoid, right? Has this been getting worse for three months, but you just, your mind wouldn't acknowledge it, right? And by the time you have to acknowledge it, now it's really bad, right? Or do you not avoid, and like this started, just started happening and you wouldn't end up it in the bud, right? So I would be interested in the defense mechanisms, right, that are girding your conscious self, and I would be interested in the character structure. What decisions are you then making? Like, are you going anyway, right? Are you having trouble? So sometimes you avoid. Are you then making decisions that make you late? And that causes problems. How does it impact you once you're there? Are you engaging differently with people doing your work differently? So I want to understand the character structure. And ultimately, you understand all of this by probing the self that's writing along on top of it. And then what is the experience of that self? Like, do you see that, okay, this is a problem and I want to address it, but like, look, I know that I'm good at what I do. And, you know, I mean, this isn't some like awful thing about me. I just have to deal with it, right? Or is yourself impacted where you started thinking, maybe I can't do this anymore. I'm not good enough or, you know, we want to understand what's the experience of the self, right? And if we do all of that, how is it that we don't get to a place where we can understand that anxiety, right? And we can make things better. So just like in physical health, okay, maybe we can't. But that is a dramatic outlier. If we bring ourselves to bear, we would say, you should not have to have this in you, right? Because it is something negative. It is making unhappiness for you. It is taking away from empowerment, right? And it's also taking away from humility, right? Because if someone's beating up on themselves, you're beating up on yourself about it, then that's not humility, right? Then that's being sort of falsely persecutory, right? This is not an honest humility to that. It leads us away from health. So it's like we don't want it to be this way, right? Because that is working against agency and gratitude. So we can understand it and we can go after it and make it better. One of the most common questions I get on the internet, and I get a lot of questions, is what can be done to improve confidence?
Improving Confidence: State Dependence & Phenomenology; Narcissism (53:12)
And I've thought a lot about that question and what is confidence. In the context of what we're talking about now is one reasonable definition of confidence, our ability to trust our predispositions and our potentialities enough that we're to encounter scenarios A through Z, we feel pretty good that we would respond the right way in a way that wouldn't threaten our conscious mind at a core level, right? You know, that we wouldn't, I used to use the term and joke a lot in my laboratory with the phrase, you know, dissolve into a puddle of our own tears, right? It's kind of this like hyperbolic explanation of what I think many people fear. Like they're going to be called upon to answer a question publicly or give us each or they're going to be at a critical moment in a relationship or something and just everything is just going to go so badly wrong that it's just going to dissolve them as a person. It's impossible, right? Dissolve in a puddle of our own tears is impossible, but I think that's a fear that a lot of people live with because we can get into this a little bit later and we will. I'm sure, you know, this notion of like protecting one's ego seems really vital to being a human being at some level. Like we don't want to dissolve until puddle of our own tears. So is confidence the ability to trust ourselves in a bunch of different contexts? And at the same time, I do have to raise the this notion of narcissism. I think, you know, this word gets thrown around a lot lately, but it seems to me that any truly psychologically healthy person would also not want to be the idiot that thinks that they're better than they actually are. What are your thoughts on this? Well, I agree with the things that you said about confidence, except I would add two factors that I think are like really big factors, right? One being state dependence and the other being phenomenology, right? So think about the state dependence first, right? We're talking about confidence. It's not uniform, right? Or it's not automatically uniform, right? So if you were to tell me, oh, I lack confidence, right? Then I want to understand, is that across the board? Is that a way that you feel about yourself? I'm not good enough at anything, for example, right? Or do you lack confidence in a specific area? Right? And this is often the case, right? And it's a huge difference, right? It says, that person has the machinery of confidence, so to speak, right? They have the potentialities in the predispositions for confidence, right? When that character structure that's self-built upon it is engaging with the world, right? But they're not able to bring it to bear in a certain special situation, so to speak. So for some people, for example, the way we most often see this is like the carve-out of romance, right? Where because it's so emotionally laden, right? And like rejection can feel so bad, right? That we can see people who are very confident in many, many aspects of life, but they are very different about romance. And they'll say, "Definitely." It never works out for me, or no one will ever like me, right? And you say, like, that's not how that person actually feels, right? About themselves as a whole human being, right? Which is, then we are coming at how to make that better in a way that's very robust, right? We might say something like, "Hey, here's the good news," is you have the tools in the machinery that you need, right? You're confident in so many ways, right? In fact, maybe in all ways, accept this one. So let's go take a look at like, why is that special, right? And then, and where are we? We're back to, is it something in the unconscious mind? Is it something in the conscious mind about how that person is engaging, right? So we have to understand what the state is, and if the lack of confidence is state dependent, if the person is not confident across the board, then again, we go back to the same, we always go back to the same places to look, right? But then you might more think, okay, is there an impact of childhood trauma or early life trauma that took away from that person, you know, their ability to gain confidence, right? Because if you have no confidence across the board, there's a deeper problem, right? Because there would be something anyone can be good about and feel confident in, right? So the state dependence is very important, as is phenomenology. So what is your experience of being confident? If you tell me, well, I'm, let's say, in a different version of this example, you say, you know, actually, I'm quite, I feel quite confident when I, when I walk into a room of, of people, say, okay, I want to understand more about that too, right? Because if I ask questions about that, and you say, well, I feel confident because, you know, look, I'm a pretty smart person, I can think on my feet, I can, I can deal well with, with people, if something doesn't go right, I can recover from it. Like, I have got, you know, that's why I have feel confident, you know, and say, okay, that sounds pretty good. If you say, well, I feel confident because I know that I'm better than everybody, right? Now we have a problem, right? Right? Like, that's not going to go well in other, you know, in other aspects of life and engagement, like there's, you know, it's not going to lead to humility and gratitude. And so, so where's that coming from? And again, maybe there's a deeper problem, right? There's narcissism, right? Which can be a reaction, right? Which is a reaction to vulnerability, right? So then there's, was got a reaction formation. And now the person is actually deeply diffident, right? But presents is very, very confident and with a sense of superiority. And that's not a recipe for happiness, right? So, so in the, in approaching it, we do want to understand all the things that you said, what are the factors, and the, the set of predispositions and the set of potentialities? But then what's the real world experience of that across situations? And what is the person's experience of that inside, which is why if we're going to understand and help people, like that's the understand part, right? You know, it's why the conveyor belt medicine, you know, it doesn't work, right? In situations where we're dealing with human beings, like mental health, right? We have to understand something about people to understand whatever they're telling us means. Otherwise, you have no context. So you have no knowledge. Another very common set of questions that I get that I believe is very directly related to this is about beliefs and internal narratives.
Changing Beliefs & Internal Narratives (59:44)
You know, people ask me all the time, how can I change what I believe about myself? And they also ask, how can I change the script in my head? How do I typically, it's, how do I shut down a particular narrative in my head? It seems to fit very well in thinking about structure of self, because as you pointed out, you know, the, the self or the structure of self includes the unconscious mind, you know, what's going on below the surface of the water in this iceberg model, what's going on in the conscious mind that the conscious mind is protected by these defense mechanisms that grow up from the unconscious mind from that character structure, and then this thing that we call the self, right? But when it comes to beliefs and internal narratives, those seem to me, things that people are pretty well aware of. In fact, the very example that people are asking me this all the time, how to change beliefs and internal narratives means they are aware of them. It also suggests that for many people out there, their beliefs about themselves and their internal narratives are not healthy, or at least they don't feel are serving them well, or that they are intrusive. I don't know how open people are about their beliefs and internal narratives when they come to you in their, in your clinical practice. But you could tell us a little bit about beliefs and internal narratives and whether or not they are important to rewire and reset. This part is extremely important, right? So imagine, for example, that I'm saying to myself over and over again that I'm a loser, right? Or I'm not good enough, right? I mean, imagine trying to go through life and someone else were saying that to you all the time, right? I mean, it's worse when it's inside your own head, right? So what's going on inside of us, our internal dialogue, our internal narratives, are extremely important. And here's where we run into a very big problem, is that we live in an era and in a culture that is very attuned to rapid gratification, right? And all of this that we're talking about can change, but it does not change quickly. And it's amazing to me when, you know, you'll see under insurance paradigms often, right? No matter what's going on with someone, they have 10 sessions of cognitive behavioral treatment, right? If there's something like we're trying to change beliefs, it's a guarantee of failure, right? Because beliefs don't change that fast, right? So imagine, for example, that we, you and I chose a word, a random word, and we decided to say it 500 times, right? We'd each be saying it tonight, right? Like it's not going to be out of our minds by tonight, but because we what took a random word and said it 500 times, right? So imagine that there's something that's highly emotionally laden, and we've said it thousands and thousands and thousands of times, right? That's not going to go away quickly, right? But it can go away, and during the process of it atrophying, right, our lives can get better, right? This is the opposite of hopeless, right? It's actually very, very encouraging, but in a world that's rapid gratification, right? Like how do we fix this? How do we fix this now that doesn't acknowledge this? We hear all the time that a person has failed therapy, right? Like this is said all the time, that person failed. It was failed therapy, mean, right? I mean, I think therapy failed that person, right? But we label like, oh, a person isn't better, right? But there are things going on inside of us that could take months and months or years to make better. Now, again, that's okay if we're aware of what's going on, just the very fact that we understand and we're making change, right? It helps us feel better about ourselves and more confident, right? That we can change all of this, but we have to approach it in the right way. So let's say that I'm telling myself over and over again, you're not going to get there, right? And let's say a place I want to go professionally, right? Or no one's ever going to really want you, right? If I'm looking for a romantic partner, right? So imagine these things are going on and they're going on over and over again. And you can imagine now that it's intruded into the unconscious mind, it's going on in my conscious mind, my defensive structure is shifting in negative ways and becoming more avoidant. Like, nothing about this is good and I want it to change. And I wanted to change to something that says, like, you can do it, right? Or you're lovable, right? Or you can be a good partner to someone. So I want to change it, right? So imagine now, when I start to make that change, I'm blazing a path, right? And I'm blazing a path where there wasn't a path before, right? And I can blaze a path and I can go through that path, but that path is going to be nothing like maybe the four-lane highway, right? Adjacent to me where the thing that I've been telling myself for years and years and years, born of trauma, right, is going back and forth, right? I mean, it's got a four-lane highway. I'm cutting a path, right? But over time, you cut that path more and more, you tread that path more and more, you take energy towards that path, it becomes better. Now, let's imagine, like, the path is well-lit and it's 12 feet wide and maybe we can pave the path so more traffic, so to speak, goes down it and we're taking energy away from that four-lane highway and maybe it starts to be overgrown a little bit and there are cracks in the road. Like, we can change all of that, but we have to understand what's going on and identify it. Like, what is going on inside of me? What do I make of it, right? How do I understand the process of change? How do I increase my empowerment during the process of change? If we come at it the right way, all of this can be changed. It's not hardwired in us. It's just very, very strongly reinforced. The same way our brains are built this way, so we don't forget our own names, right? We don't forget where we live back when we were hunting and gathering. We don't forget where the good fruits are, right? I mean, this goes on in human life now. We have to remember things. It's very, very important if something has high emotional valence and we've thought it a lot that we don't forget it, but that mechanism gets hijacked by things that are not good for us and we can take it back, but not if we don't understand. What are the tools or the questions that you give or ask of patients in order to help them along that pathway?
Looking Into Defense Mechanisms And Function Of Self
Individuality & Addressing Mental Health Challenges (01:06:04)
Because I totally agree that changing beliefs and internal narratives is very, very hard. Just one quick example that meshes with the physical health realm. I have a friend and colleague. He's a very accomplished scientist who was very overweight for a long period of time. He finally made some behavioral changes that allowed him to lose. I think it was in upwards of 80 pounds. A significant amount of weight felt much better, looked much better. He just delighted in his ability to do that, but then started to reveal to me that he was deathly afraid that he was going to lose control and start eating the way he was before and stop exercising in a way that would return him to his previous weight and feelings of malaise. I said, "Well, all the things you're doing are in the direction of health. None of what you're doing speaks to the possibility of this all crumbling. This was the dissolve into a puddle of my own tears kind of narrative, but at this point coming from him." He just said, "I know, but despite doing all the right things, I'm still incredibly afraid that it's going to happen." It was as if the beliefs and the internal narratives hadn't changed despite the fact that he was engaging in the world differently and more positively. I haven't checked in with him recently to find out where he's at with us now several years later. He has kept off most of the weight. Not all of it gained a little bit back, but he's still far healthier than he ever was. Hopefully, he's experienced some relief. What do you tell a patient who is saying, "I've got this loop in my head that tells me I'm not good enough," or that even when things are going well, they're going to return to that state that I fear so much once again. This lack of agency, just lack of agency, lack of agency, lack of empowerment. What sorts of practical tools can one give themselves or that you would provide to somebody? No matter what is behind what's going on in that person's mind, it's addressable. But you don't know what it is and how to address it until we ask the question of what's going on inside. If he's afraid that he's going to gain all that weight back, and he has a history that if significant negative things happen, he throws self-care to the wind. Then we'd come at it through that pattern because he would have a good reason to be worried because this pattern of something bad happens and I don't take care of myself for six months and maybe someone, I'm just making this up, and maybe someone in his life is ill or he's fearing a death. If you choose something that would say, "That's a very legitimate fear to have, let's talk about that. Let's look at where that comes from. What got that person into that pattern in the first place by understanding the pattern and by working together? Can we stave that off?" It could be different. The person might say, "I'm having a lot of food cravings." What does that mean? Where's that coming from? Or maybe he's depressed and when he's getting depressed and when he's depressed, he can't stop eating more. You would look or it might just be plain old fear. This is so good that I'm worried it will go away. Then we might want to reinforce, "Okay, you're a person who's able to use circumspection and perseverance and preserve goodness. You do that and you do that really well. Let's make sure we're doing that here." A lot of times a person is worried, but that worry is coming through the lens of health. They're healthy. Then we look at, "Can we sue that worry? Where's that coming from? We can come at it and reinforce the positive." But if there is something negative, there's a trauma-driven cycle, there's depression, there are cravings, we can understand that too. I come back to this idea that there's answers to just about everything. In a very regimented scientific way, it's not that hard to come to them, just like in physical medicine. We have the tools that we need to bring to bear, but you have to understand the person. Again, if you come in and say, "I'm not feeling good," and someone else comes in and says, "I'm not feeling good," the doctor better not do the same things. How are you not feeling good? Let me understand that and then let me map that also to you, whatever underlying state of health you may have or diagnoses you may have. The same is true in mental health. If we just apply that, then it's remarkable the good that we do, which I've seen very consistently across 20 years of doing this, not only in my own practice, but who are the people who do really, really well, trying to understand and take care of people, including sometimes not doing too much and realizing, "This person is okay. There's a state of health here, but this person is worried. How do we reassure them? How do we help someone living a good life, live a better life? If we're going to do all of this, we have to approach people as individuals." The science tells us that and common sense tells us that too, but if we do that, a person can get to the place they want to be. I'd like to address a different person as an example, a hypothetical person.
Mental Health Goals & Growth (01:11:21)
I'm certain there are many, many of these people out there. These are the sorts of people that think, "Okay, there's a self and a mind and a unconscious mind, etc." At some level, why not just do what needs to be done in life? The people that don't want to explore the self, because to me, it seems so absolutely clear that just as it's important to have a certain level of endurance, strength, flexibility so that one can extract the most joy and agency and gratitude and empowerment and humility from life, that it makes sense to explore the self, to ask, "Where am I internally strong? Where am I internally weak? Where might I perceive myself as strong as I'm actually weak?" These seem very important, if not crucial questions to ask, but I know that there are a certain number of people in the world that think all of that is just a waste of time. It's all about doing stuff. Why explore the self? I think the rest of us are looking at that person often and thinking, "Well, you're exactly the kind of person that needs to do this because of the way that you grate on other people," but not always. Sometimes these people just appear to be very effective. They're all about the outward expression of what they're doing. I certainly don't know how other people feel waking up in the morning and going to sleep at night and throughout the day, but to the person that feels like introspection and exploring, maybe even excavating for trauma that they haven't been in touch with or haven't dealt with yet, for the person that feels that all of that is not really worth the effort and that's all about action, what can we say to that person or those people? Put differently, does one need to change and need to believe in the power of these sorts of approaches in order for them to work? We often hear that. People don't change until they want to change. Could we also say perhaps that even for the people that feel like they're functioning extremely well in all domains of life? I know no such people, and I know some very high achieving people as you do too. I know no such people, the only people who seem to exist in that sphere are the clear narcissists that to them, just even like they're doing great, but everyone else can't stand them, by the way, narcissists. No one else can stand you. What do we say to those individuals? Because I think it's a big swath of humanity, and I think it accounts for a lot of suffering in the world, including their own suffering. I would make an appeal to common sense. Imagine you take someone who doesn't know anything about health. They don't know how to exercise, they don't know how to eat well, they just don't know, and they're very really, really unhealthy. They're overweight, they have low energy, they have sleep apnea, they don't need to have you. Why not just say to them, well, just go be different. In fact, be different now. Why aren't you different right now? Of course, we would never do that because it's absurd. By the way, it also would be cruel. It's absurd, and it's cruel, so we would never do that. Let's say we fast forward some period of months saves, make it up. We see that person, and wow, they are much healthier. They have much more energy. They've lost way. They're physically fit. A lot will have gone on in between those two snapshots of that person. That person has to learn a lot. How does one take care of oneself? More specifically, how do I take care of myself? What healthy foods will I like? What healthy foods will I eat? How will I put that on the table? What kind of exercises can work for me? How will they work for me? How do I strengthen muscle? How do I strengthen the heart? How do I increase lung capacity? There's learning, there's diligence, there's stick to itiveness, there's resilience. That's how the person gets there. It is no different. It's mental health. If we say, "Well, you feel different into cross the board," or "You feel superior across the board," or whatever it is, life isn't going well, and you don't have things you want. The self-talk is negative, and we say, "Well, look, it'll just be different right now." It's remarkable that people will say that at times, not just in a way that's denigrating and awful for others, but to themselves too. I hear people say this most often to themselves, "Why am I not just different? I want to be different," or, "What's wrong with me that I'm not?" It's like, "Yeah, it's like everything else. You have to apply understanding and work and effort." The good news is you can get to whatever change you want. A person can get to whatever reasonable change that person wants. I'm 54 years old, I'm not going to climb Mount Everest. I'm not a mountain climber. If I want to learn to climb some mountains, I want to get out there and do some things, I can go do that. The same thing is true with our mental health goals, but not at the snap of a finger, not by magic. It's through applying the same science and common sense, combination of science and common sense that we apply to other things. That's why we go through this procedure of unconscious mind, conscious mind, the structure and function of the self, because that's how it's done. That's how the after snapshot looks different than before from the mental health perspective as well. That's very helpful. I think it's going to be very helpful to a lot of people in thinking about what to think about, what sorts of questions to address, maybe even whether or not to get therapy, and hopefully we'll remap their notions of therapy. Of course, this critically relies on the therapist being good to excellent. I think in the previous sit-down we had in the episode on trauma, specifically, you mapped out a number of the features of quality therapy. We can refer people to that if they're thinking about it's time stamped in that episode, what to look for in a therapist, how to assess whether or not it's going well or not, whether or not to move on or stay put with that therapist and so on. You've been telling us a lot about the structure of the self, unconscious mind, conscious mind, defense mechanisms, character structure, self.
Function of Self (01:17:32)
We haven't talked so much about the function of self. I realize it's been woven in here or there. Could you tell us about the function of self? The functions of self, verb actions, I mean, are these things that we are all doing right now that reflect our character structure? Are these things that we can change more readily than trying to snap our fingers and say, okay, I'm now going to be a more altruistic person because I can decide that right now, but then ultimately I have to engage in some altruistic behaviors to lend support to that. Again, staying with the parallel that I can't just snap my fingers and say lower blood pressure. I have to do some meditative practice, some cardiovascular training and things of that sort. What is this function of self thing? What goes into the functions of self? Just stepping back to the framing, right? There are these two pillars upon which we build our lives, the structure of self and the function of self. We've been talking, as you said, more about the structure, which is more than nouns of it, like there is an unconscious. What is in that unconscious, for example, there are defense mechanisms, how are we using them? It's not all nouns, but it's more what are those things? And then we start talking about how we put them into practice. The function of self is much more the verbs. If the structure is more nouns, the function is more the verbs, the actual engagement. So that would start with an awareness of I. So a function of self has to start with an awareness that there is a person, there is a me that is separate from others. I have responsibility for this I. It is me, no one else is guiding it. It's me. I know there's a me. Then on top of that, we start seeing defense mechanisms in action. We're thinking about function. We're aware that there's an I. But the first thing that starts happening to that I are unconscious things. So the defense mechanisms, because we're not choosing them, they start doing things automatically. So if, for example, I have a defense of avoidance, then I'm not thinking, if I'd like to meet a new person, but I automatically am shying away, then it's not good. It's a factor. But it's a factor I'm not aware of until I start this process of introspecting. So the defense mechanisms are then determining the lay of the land. So in that example, I'm sorry to interrupt, but in that example, the turning away you describe as reflexive. So you're talking about someone, perhaps we would like to have a romantic partner or meet somebody, have a companion, and they go to the grocery store and somebody says something as they're reaching for the milk. And there's that moment of opportunity where they could say something back, but instead they just go, thanks, and then they kind of way. And then the narrative in their head might be, oh gosh, that was silly. But they don't really think about the alternate possibility. Or there might be no narrative. But they just they head off to the produce section. Yeah. And then they go home and and sometimes they say, oh, anything happened at the grocery store? Meaning once the grocery store, no, right? Because it's all unconscious. Right. Right. Now again, can we explore that and change that? Yes. But it's important to understand that whatever that nest of defense mechanisms is like, that's what I've got right now, right? And I'm living through that right now, right? That it's performing a function, right? Just because it's an unconscious function doesn't mean it's not a very, very important function. I can see in that example how it protects the conscious mind from risk, because there's always a possibility of rejection. There's a possibility of over-interpretation of what the other person is talking to them for, right? Like, is the person interested in them, or whether or not this is just, you know, friendly banter, the sort that anyone would have next to anybody that is not special to them. So I can see how the unconscious turning away is protective against all the negative possibilities. And in some sense is pretty rational because the probability that that one interaction could ratchet up to a life of companionship and romance with somebody is exceedingly small, really. Although you could imagine a set of data points where you string together, you know, like five second clips, you know, all, like the time something like that has happened, right? So maybe this is a person that, you know, intermittently, like people are interested in them, or saying, "Hey, you're saying hello, or showing interest, you could string all those together." And the person hasn't noticed one of them, right? And then could have a very negative see. Nobody, no one wants me, no one's interested in me, or whatever the person is saying. But, like, it's different if you see from the outside, like it's objectively different, but that person doesn't know. And that's why after an awareness, there is an eye. The next thing that I think of in the function of self is the defense mechanisms in action. What are some other examples of defense mechanisms in action? Because I think there's immense interest in this.
Defense Mechanisms: Projection, Displacement (01:23:00)
You know, the idea that we have unconscious processes in us that are reaching up out of the iceberg and preventing us from seeing our life and ourselves the way that it actually is occurring, and perhaps preventing us from achieving these ideals of agency and gratitude, empowerment, and humility. You know, I mean, you seem like very powerful and important forces. And I and I know many other people out there want to understand whether or not what we're doing and what we're feeling and experiencing, whether or not that is serving us well or not. So I think the place to start is to say that there's something very, very complicated going on. The part of the iceberg underneath the surface, that biological supercomputer that's running at a million thoughts and a million actions and a million internal processes a second is constantly shifting our defensive structure. So it's complicated, and you can almost imagine that one leaves and another comes in and they're shifting and there's a little bit of one in some of another. So it's a very complicated process, but we can look at it and understand. So an example of a defense mechanism that's very common and can cause us a lot of problems is projection. So I'll give two examples of projection. So one is the experience of sitting in a car, and being stuck in traffic, being a little bit late, and feeling beleaguered. I mean, this has happened to me more times than I can count, but at some point I started to my own therapy looking at like, what's going on in me? When I'm doing this. So think about the feeling beleaguered, as if, what does that mean? There's something called traffic that exists and has a mind and wants to thwart me? Is it individual cars? Is it the people in the cars? What's going on? I'm having a perception of hostility. I feel beleaguered, right? But it's anger and frustration inside of me, right? I'm the one feeling angry and frustrated. There's no one and nothing but me that's feeling anything about this, right? But I have this sense of the world around me being hostile because I'm projecting my anger outward, right? Now think this isn't good because instead of sitting in traffic and saying, look, maybe it totally makes sense that I'm stuck in traffic and that I'm not happy. Like maybe I should leave a little bit earlier and I wouldn't be late or if it's going, I'm going to work. Should I live closer to work? I could make a whole set of decisions that I'm not making, right? Or maybe I know I thought it was going to be a 15-minute drive and like there was an accident, right? And okay, there are things that I can't control. I'm not supposed to control everything, right? If you think about what can I control, being aware of that, and what can I not control, right? Then it can make the situation much better so this doesn't happen with this frequency and it also takes away the anger and the frustration, right? So I think that's a good example because it happens a lot. It's very, very common. But projection then also happens with people, right? So let's say you and I work together and we're going to do something collaborative together and I'm just not having a good day and something negative happened before I came to work and I'm not at my best and I'm a little bit irritable and frustrated, right? This happens all the time where then the person sits down with someone and then I'm being irritable and frustrated, which doesn't feel good to you, right? And you may become irritable and frustrated, right? And then I say, "Oh, look, he's irritable and frustrated," right? But even if you don't, the fact that I feel that way, right? That projection often would lead me to think that it's you who's that way. Here I come wanting to do this job and you're not at your best. It's me who's not at my best, right? But we do this all the time and then we make incorrect or inaccurate attributions, right? So projection is an example of a defense mechanism that can cause us a lot of trouble, right? A lot of trouble. Another can be displacement where if I'm feeling anger or frustration, say, in a certain realm, then the idea of feeling it at work and then kicking the dog, right? It's not good that we do that. We're not acknowledging what's going on inside of us at work, what we could change, what we could make better, and the dog doesn't want to be kicked, right? And the dog is often also the family, right? And it could be physical or it could be through words, right? But the idea that there's something negative being generated in us but inside we're perceiving that it's coming from somewhere else, right? I mean, the thought is all things to lead us astray, right? When they're negative defenses, right? They're going to be positive defenses too, such as altruism, right? That someone could do something negative to me, right? And instead of me passing that along, I could decide, no, I'm going to do something nice for the next person I have an opportunity to do something nice for, right? Like that's a defense and sometimes we could think of it and decide that way but there are people who react that way, like there's something negative that happens and they respond with something that's different from that. So defense mechanisms can work against us, they can work for us, they're complicated, they're combinations of them, but we can look inside and say, for example, if I'm using projection all the time, right, and I think everyone around me is kind of always angry and frustrated, right? Then there's always bad traffic, right? But then as we start to talk about it more it becomes apparent that there's a lot I'm angry about, right? But I'm not aware of it then reflection or therapy, right? Or a good friend we're talking to can help us see, right, that, hey, this is going on inside of me, right? And that can really help us, same with use of humor. Like if I'm using humor and I'm kind of decompressing uncomfortable situations or things that make me feel uncomfortable, maybe that greases the wheels of social progress, but maybe over time I come to use humor in a way that's self-denigrating, right? Well, that's not so good anymore, but I may not be aware of this shift just because I can maybe be funny in certain situations that I'm now not using that for myself anymore, I'm using it against myself. And by talking to people, by reflection, like we can be aware of the defensive structure that's going on inside of us and then there's not an automatic maticity to it. If you point out that I'm using projection a lot, I can start to be aware of that. Just like if someone, let's say you were with me at the grocery store, right, and someone says something nice and I shy away and you say, hey, you know, you didn't even even aware someone said hello to you. And then I said, I want to be more aware of that. Like, I don't want that thing to happen unconsciously. So maybe now I think, okay, anytime someone, I don't know, says something, I'm going to just stop and think like, what's going on here, right? Is that person being friendly to me? Are they just, you know, it's just person exchanging money to cash raise? So like, what's going on? So we take what's unconscious and we make it conscious so that we can change it. Sounds to me like exploring and thinking about our reflexes is what's really key here.
Projection, Displacement, Projective Identification (01:30:14)
The example of displacement that you gave, you know, kicking the dog, I couldn't help but smile, not because I think it's a good thing to do. I never once kicked my dog, by the way, folks. Terrible thing to do. Also, he was the size of a boulder. It would have injured me more than it would have injured him. But I never would do such a thing. However, in academia, there's this phenomenon that's very common that I refer to as trickle-down anxiety, where the person running the laboratory is inevitably under a tremendous amount of stress, grants and papers, et cetera. And graduate students and postdocs will immediately be familiar with what I'm describing. But for those of you that haven't gone to graduate school, this will be a little bit foreign, but you'll think of other examples where when the labhead is under stress, it's incredibly common for labheads to walk through the laboratory and start asking about experiments and telling people to do additional experiments and basically just assigning busy work to people or pressuring what simply cannot be moved along any faster. And when I was a graduate student, I worked for somebody who was the exact opposite of this phenotype. When I was a postdoc frankly, I worked with someone who was a little bit of that phenotype, although I still liked working for him very much. But I used to have a response that, at least for me, was adaptive, which was I would always say, "I'm working as fast as I carefully can," because no scientist ever wants somebody to cut corners, no good scientist anyway. But trickle-down anxiety is common in every occupation, I think. We see this sort of displacement all the time, where someone's anxious and so they go start creating anxiety for other people. I mean, you could just, as you're describing, I was just seeing how pathologic that is for everybody involved. So the academic, the trickle-down anxiety that you were just talking about is it's a related, but it's a different defense mechanism. It's projective identification, which is causing others to feel the way that you feel in order to get your needs met. Is this a form of projection? And actually, perhaps you could clarify the definition of projection versus displacement versus projective identification. So projection is when you don't own it. So it's not me who's mad, it's you. So I don't own that I'm mad at all. I just think that it's you, even though I'm the one who's mad. Displacement is what comes out of us or what our attribution can shift. This person who's making me angry, it's that person because that's a safer person to be angry at. Or if I'm then going to take out my anger, instead of metaphorically kicking a person who might respond to me in a way I don't want, maybe I kick the dog that's helpless to respond back. That's displacement. Projective identification, there's an expression of an emotional state inside of a person that then becomes contagious to other people, even though the person isn't trying to do that. The person says, "I'm going to make you anxious." That's not a defense mechanism anymore. So here's an example I think. I think this is the best example of projective identification. For a little bit of time at work, I would occasionally lose my keys. So now I'm trying to go and I can't find my keys. So I say, "Oh, I don't know where my keys are." I start expressing something. I'm anxious and I'm tense. Now people around me hear that. What do they start feeling? They start feeling anxious and tense the way that I do. Now they want to find my keys. They want to help me so that I stop spreading anxiety and tension into the whole environment around me. Then they help me find my keys. I say, "Thank you. My own emotional state comes down." And upon reflection, I think, "Look, I don't want to do that. I'm getting my needs met by making other people feel in a way that's not a good or comfortable way to feel. So here's a way around that. Put my keys in the same place every day." So then I can avoid that because it doesn't feel good to me. Then if I get out to my car, I find I'm breathing a little heavy. It doesn't feel good because I was just agitated. And I did that to other people too. So it's an example of how projective identification works. It's a simple example, but it shows it's happening all the time. All these things are happening all the time. But we can become aware of it. Then I don't lose my keys. I don't have to feel bad about all to activate myself for no reason. And I don't have to activate other people for no reason. So it's sort of thinking and reflecting like change that thing for the better, and it can do it with much bigger things too. Thank you for those clarifications. I'd like to touch on humor for a moment. Obviously, humor is a wonderful thing or can be a wonderful thing.
Humor, Sarcasm, Cynicism (01:34:50)
I've also seen a lot of examples of where very smart and/or accomplished people, because those are not always the same thing. Use sarcasm as a form of humor, and it can be very funny. But I have to imagine, based on everything I'm hearing from you today, that there's a form of sarcasm, which is an unhealthy defense. I'm thinking of the person that no matter what someone else says that's positive or no matter what someone does that could be viewed as positive, they find some way to diminish it through sarcastic humor. I see this a lot, and I think closely nested with sarcasm is cynicism. In fact, I have a family member. I won't name who they are to protect the not so innocent, who used to be very cynical. And I once asked, "What is the thing about cynicism?" And they said, "Well, I have had a particular genre of schooling growing up, a formal schooling where if anyone behaved too happy, expressed too much happiness rather, too much delight, they were viewed as stupid. As if to be happy is to be unaware of the sophistication and the importance of things in life." And I hope that this is unrelated to most people listening. But I do think that sarcasm is a double-edged blade in this sense, and that cynicism is perhaps double-edged blade as well, but that it might even be worse than sarcasm, because it's a way of really reflecting back what's, by definition, what's not good about life, what's not good about what's happening. And it does seem protective, right? It protects one from disappointment. If you're already disappointed, how could you be further disappointed? It also seems to me like a bit of a power move. It's like, "You're going to be happy? Well, I'm going to take that away from everybody, something that's like for myself." Is any of this actually hold in the inside of the clinical literature? Because again, I enjoy a good sarcastic joke. In fact, there's a collaboration around a sarcastic joke. It can be truly funny to everybody, but sarcasm and cynicism, I feel like are often used to cut down what would otherwise be benevolence or bonding experiences. Yeah, absolutely. Look, I grew up in central New Jersey. Humor is a weapon, right? Or it certainly can be, right? And people can be very aggressive through humor. So acting out, which is letting our aggression flow, right? That's a defense, right? So just being aggressive and pushing someone back, right? However, that means, like, if I don't feel good about myself, I want you to feel not so good about yourself, right? Is where we start getting into envy, right? And humor can be used that way. So that sort of biting sarcastic humor is a form of acting out. It's a form of aggression, right? It's not humor as a healthy defense, right? We can call it the same thing, but we could also call it different things. It's just a nuance of our language, right? If humor can be a defense, like, I trip and fall, I make a little joke, people are laughing with me instead of at me, right? Hey, humor is a good defense. I made myself feel better, made things flow more easily. But if I'm using sarcastic humor to assail someone, right, then that's not, it's not that thing anymore, right? And, you know, now it's a manifestation of aggression, right? And the idea that cynicism, you know, is more than just talking about a worldview, right? Like sarcasm is something that can be done now. Like, we can make a sarcastic joke, funny or not, then it's over, right? But cynicism is a way of coming at the world. There's a different kind of defense, right? The idea that, hey, it's like the fox and the sour grapes. Like, I don't think there's anything good to be had anyway, right? So you can't take anything away from me. You can't make me feel worse, right? I already feel very, very bad about the world and about everybody in it, and I'm protecting myself that way. Like, that's then an unhealthy defense, because what does that lead to? At least isolation, at least to mistrust. You know, we know that people are happy if they live through altruism and gratitude, and they're well connected with others. So the cynical point of view, which again, to some degree, being in the world builds some cynicism in us, right? Like, that's okay. That's part of awareness in some sense. But I think what you're talking about is a very pervasive cynicism that then is an unhealthy defense that is very harmful to others. The idea that I feel lousy about everything, and if you don't, I'm going to try and bring you down, right? Like too much happiness. We'll label that as something, right? We could label it as stupid, right? So now it's like, it's not okay to be happier than some sort of cynical baseline, right? And again, there's nothing about altruism and gratitude. That's not happy, right? I mean, who's happy in that situation? People who are overly cynical are not happy, and the people around them are not happy. Nobody's happy. Thanks for the clarification on New Jersey. A good portion of my biological family is from New Jersey. Come out well-armed. I adore them, but it's true. There was once a moment at a family gathering where somebody said, "Oh, let's hug or something." And the reaction was like, "Oh, we're going to hug now." It was like, it was entirely sarcastic and cynical, and like, and the hug that resulted from that was this like little like distant hat kind of thing. It was, "Now I'm laughing about it, and it's funny." And they're very loving people, but you're right. It's a different style of humor and discourse. So you've been talking about these two pillars of the self and who we are and how things play out in the world for us as the structure of self and the function of self.
Exploring Self Awareness And Inner Drives
Attention & Salience; Negative Internal Dialogue (01:40:41)
And in terms of the function of self, you describe self-awareness, this notion or this realization that there is an "I," there's a "me." And then we've been talking about defense mechanisms in action, how these play out in the real world, both positive and negative. It seems to me that a lot of what is happening here in terms of understanding the function of self has to do with what we pay attention to, where we place our efforts or choose to not place our attention and not place our efforts. Do I have that right? Right. Salience is a huge concept in human existence. I mean, there are thousands upon thousands of things that you or I could be paying attention to right now. But we're not paying attention to anything, except what we're doing right here. So we are gating out so many other thoughts, ideas, narratives inside. Now if something were to shift very quickly, if we heard a loud noise, our attention would shift. So our attention is focused. We're salient to one another, because this is what we've chosen. We're focusing our minds. And we are also somewhere inside of us aware that we could shift away from it if something more important, like something dangerous, like where to happen. So it lets us be here and be salient to one another and have this conversation. But in the course of life, what's salient to us is so complicated and determined by so many factors that it's absolutely worth a lot of attention to. So one example is so many people have a negative internal dialogue that's running in them over and over again, or they're running through images, events. They may be traumatic events or things that they're not happy with, images of themselves in negative ways, that these internal narratives or internal images can become so strong that there's no room for anything else. So an example would be a person who really, really loved music and could have, just in addition to enjoying music, had good thoughts while listening to music. You know what? I could go do this, and had a history of that really working out well, following his interests and really creating goodness in his life. Who now was going for long drives, longer than would be needed to go somewhere or get something, like why the extra time in the car, and I had had a presumption, "Okay, the person's listening to music and thinking, but it doesn't quite add up." And then I learned that the person is not listening to music, right? That they're using that time so that the internal narrative, which was a very, very negative, repeated internal negative. You're not going to get anywhere, you're not going to make anything of yourself. It could be there in his mind. It was a form of self-punishment, it was a form of taking the anger and frustration inside and enacting it towards himself. And that was so salient that this person could not see his way to any goodness. Nothing could change. Nothing could get any better. It felt very sure and very resolved about that. And the answer was, "Yeah, that's right. Nothing can get any better with this constant mantra running over and over again, but things can get better if that becomes less salient over time and your own thoughts and reflections become more salient." So at the other end of that shift, that narrative that was still there, but it was weakened because it takes time to really change things. So it was very much weakened. The person was listening to music again. Those thoughts had come back to the surface and they were being jumbled in ways that brought new and interesting thoughts coming from them. And the person was in an entirely different place and completely changed their life. I mean, this is true. It's a dramatic example, but dramatic examples inform us where the salience shifted and then the life shifted after that. What you're describing in terms of this specific example doesn't resonate with me in terms of my own experience, although as you point out, it's very striking. It's very dramatic. But it resonates with me from a different perspective.
Repetition Compulsion & Defense Mechanism, Trauma (01:45:02)
I'm not seeking a free clinical session here, but to give meat to the example I'm about to ask you for insight on. I've never allowed myself to stay in a bad professional situation for very long. When things didn't feel right or when I sensed someone I was working with or for wasn't the right situation, I got out despite if I were to really think about it, that could have been pretty severe long-term consequences. Fortunately, it all worked out. In fact, so much so that I would say I pay attention to whether or not people I work with and for are of the sort that I want to be working with. And if I sense a particular type of danger, I'll look at that and I'm 100% so far, knock on wood, but 100% so far on recognizing later that it was a great decision to move on. And on the flip side of it, I've made, I believe, excellent decisions in terms of who to work with in terms of my podcasting, in terms of my academic career, etc. But I've had to move away from people that just weren't right for me. I don't think they were truly bad actors, but thank goodness I moved away. And thank goodness I found these other wonderful people to work with. However, there are circumstances that have been repetitive in my life where I've just be honest, repeatedly made not good decisions about who to be involved with over fairly long periods of time. And there can even be an awareness, or I should say there has been an awareness, like this isn't a good situation. And yet I'm persisting in seeking out this and similar types of situations. So I consider myself at least partially rational, being with some degree of introspection. You know, when I look at this and I think, okay, this is a choice to focus on placing myself in, I have to assume it, placing myself in the situations that are challenging for me in a way that I know is preventing me from living in certain ways that I want and from being "happy" in certain ways that I want. When you hear a scenario like that, like I can do it over here, but I can't seem to do it over here. In fact, I see myself doing it the wrong way here, right? A little bit different than the example you gave a moment ago because the guy was driving to work, not listening to music, but wasn't putting two and two together about what was going on. But when somebody can see what's going on, I think this might even be called the repetition compulsion or sometimes. What is that about? Are people trying to work out something specific, or are they deliberately creating some friction to accomplish something else? I mean, I realize this could be infinitely complex. And again, I'm not trying to extract the clinical insight for my own sake. I started on the clock on that. Thank you. But I think a lot of people do this. They do what they know they shouldn't be doing. They know they shouldn't be doing it. DAW. I just said that two ways. But they do it like it must serve them in some way. You think about when you get a dog and you talk to a dog trainer, they say, "A dog's do what works." They get a reward for doing something and continue doing it. You apply that to the same sort of thing I'm describing for myself and that I've observed in other people. And you must say, "It must work for them." You hear this in kind of pop psychology. Like, "It must work for them." Like, "You must be solving something." Why the hell do I do this? Why do people do this? Is it real pathology or is it a roundabout way to get to something else that's actually pretty adaptive? DAW. I mean, instead of defining it as pathology, I would not define it as pathology. I would define it as humanness. If humanness is not in and of itself pathological, then all you're doing there is describing something that is common widespread across human beings. Now, it doesn't mean we can't understand it and make it healthier. I work in a discipline that wants to put a number on everything, label it as something, and then do something about it that's more often than not ineffective because we're not looking at things in a top-down way of what is human experience, what are the natural aspects of human experience that are less than ideal that we can then understand and make better. If we come at it that way, then we see, "Ah, this is a great example because here's where structure meets function." On the structure side, we said, "Okay, there's defense mechanisms," and we imagine the branches that are coming up from the unconscious mind. Here it meets function, defense mechanisms in action on the function side, then determining salience. So what I would imagine in your example, my image is that your defensive structure when you're doing the thing that's effective, the professional decisions, it looks elegant. There's harmony to where those branches are, the consciousness is sitting in between it. You can see the elegance to it. That I can just imagine shifting when you're not doing the thing effectively because now you're using an entirely different defensive structure, which is going to function differently and create different salience. I imagine that it's convoluted and that it's piecemeal, that it's not something elegant. You say, "Okay, what does that actually mean? Let's translate it into what are the actual defenses." Think about what you're not doing when you're making good decisions in the professional realm. You are not using denial or avoidance or rationalization or projection or projective identification or acting out. There are all these things that you are not doing that are the unhealthy defenses beckoning to us. "Oh, wouldn't it be easier to kick the can down the road? Wouldn't it be easier to just say, "No, no, everything's okay. Everything's going to work out. Wouldn't it be easier instead of being angry at one person who is really intrinsic to the environment if you know it's actually somebody else or you're displacing and projecting?" That's how people, that's how we get ourselves into trouble. If that's going on, then that set of defense mechanisms in action creates something that obscures the ability to make good judgment. With none of those things going on, then what are you doing? What you're applying your intelligence, you're applying your discernment, you're applying your desire to make things better, you're able to look at it, you're able to bring diligence, perseverance, you're able to bring healthy aspects of self to the question and decide like, "Oh, I don't want this and it should be different." There again, what's going on? There's a complexity under the surface, but now we're coming up towards simplicity. We're coming up towards the things that are healthier, that are simplistic. If we look then, "Okay, what's going on if you're making the same mistakes over and over again?" Well, we would dive under the hood and really look and say, "What are you doing there?" But it has to be an array of unhealthy defenses. There's no other thing it could be. So we would say, "Okay, are you using avoidance? Maybe a little, maybe a lot? What about denial? What about rationalization? What about projection? You go through the unhealthy defenses and you see, what is it that you're bringing to bear that is leading you astray? And then, of course, the goal is to use the role modeling and you role model for yourself how to be healthy. So let's take that role modeling and apply it to the thing you're carving out and treating differently. That's a reason when people talk about repetition compulsions. It's not a formal term because what we're really talking about is repetition. We're interested. Why do we repeat things? Now, that's one reason because we bring an unhealthy set of defenses and then, at the end of the day, things come out the same because we're bringing an unhealthy set of defenses. There can be other motivations that are related to all of that and there's complexity to it. But the compulsion part can be that we can re-enter situations that didn't go well with the idea that we're going to fix what happened in the past. We're going to make ourselves feel better. We're going to take away the mark of trauma. Because remember, trauma doesn't care about the clock or the calendar. That's why you'll see someone who has had, say, five abusive relationships that looked very much the same and is about to enter the sixth. It's not because, hopefully, in most cases, not because that person wants to be hurt. Sometimes it's a different problem. There can be a drive inside of us to try and fix something. If I can make it work this time, I won't have to feel so bad about the other five. An attempt to change the past through one's current actions. Right. Which is rooted in the limbic system and how trauma affects us and how, again, it's outside the clock and the calendar. That kind of magic, so to speak, can happen so the brain can seek that magic. But again, there are unhealthy defenses coming into play. There has to be denial. Otherwise, the person would map if the same thing happened five times and this looks the same, it's probably going to happen now. Anytime you think a person, most often it's us, is smart enough or worldly enough to like, no better, which happens all the time. Then look for the answer. Say, well, shouldn't that person know better than to get into the sixth abusive relationship? The answer is like, yes. Because it's not that hard, if you saw a set of circumstances five times, to map that the sixth is going to have the same outcome. The person would do that in other scenarios. So then you say, right, that is true. So now, let's look for why the person doesn't recognize that. And again, we go down into the structure of self and the function of self, defense mechanisms and actions, salience, the things that we're talking about now. Does that fit? Yeah, it makes sense in what comes to mind is the idea of getting into a car that you know is going to get into an accident over and over and over again, but being quite cognizant of safety and its importance in every other domain of life. Not even jaywalking, but if certain ubers arrived with a little flashing light that said, this ride is going to have an accident, it's like getting into that vehicle. And I see this in others as well. And it raises all sorts of questions like, is the person actually unconsciously afraid of the vehicle arriving where they want to go? Because then, like, are people actually afraid of things working out? I mean, this gets to something that- I'm so sorry, can I say? Yeah. That's why you have to know the person, right? Like, who is that person? Right? Why do they not want to get in that car? Right? Are they afraid they're not going to get somewhere? Are they going to get somewhere? Right? But ultimately, we're looking for unhealthy defenses. And I, I still want to emphasize that that, you know, I will often think that the aspect of my education that's most helpful in me doing my job when I'm in the job as a practicing psychiatrist is actually my mathematics minor, right? Because there's a lot more math to this, right? People tend to think, oh, mental health, it's all esoteric and you can sort of say anything, you know, anything you want and there's no way of proving or disreading. It's not like that at all, right? There's a mathematical aspect to it. So if you do the correct, logical, common sense thing, right, in all aspects of your life, accept one and you're like 100 times more intelligent than you need to be to figure it all out, right? Then if there's a carve out, we say, look, that's of huge interest, right? I mean, the probability that we're going to find something interesting, there's 100%, right? Because we know that you know better, we know that you do better, but why here? So like, that's so interesting, right? Like, that's where the x marks the spot, like, let's go dig there, right? So then when we go and dig there, like, we're going to find something, right? And we'll say, what is that? Like, do we find that like, oh, it's an array of really unhealthy defense mechanisms. Maybe we find that. Do we find that there's a deep unconscious motivation, right? Like, we might find that too, right? There, we might find a lot of things, right? But we're going to find them. If we go back to what is the structure of self, what is the function of self? If we go and look like that x marks the spot means there's pay dirt there, right? And then when we figure that out, then we go through and we can make things change. So if it's a deep-seated trauma-driven, unconscious motivation that is resulting in an unhealthy array of defense mechanisms, well, let's go look at that, right? Let's look at the trauma. Let's take the thing that's unconscious and bring it to consciousness, right? Then we can make that better. And that array of unhealthy defenses, again, we're not going to change it overnight. But can we change it very, very significantly, pretty rapidly? Probably yes. And we can almost entirely change it across time. So there's a mathematical aspect of this that I think is so important to point out because, you know, mental health, even as a field, right? We all want to be mentally healthy. Like, there's a rhyme and reason to it that yes, it follows science and yes, it also follows common sense. And if we apply those things, we get to answers. It's very reassuring. Thank you.
Mirror Meditation & Self Awareness; Structure & Function of Self, “Cupboards” (01:58:55)
Thinking about the functions of self and, again, just to remind myself and other people, starts with self-awareness, involves defense mechanisms in action, then there's the salience piece, but paying attention to what's inside of us as well as what's external. And then you're now describing a lot of choices, choice making and behavior and action in the world. I have to assume that for the person trying to improve themselves and get to agency and gratitude, that paying attention to all of these is important. But of course, if a defense mechanism is unconscious, we can't simply decide, OK, I'm going to see the unconscious defense mechanism. Does that mean that we should ask ourselves about what is most salient to us? Or should we be focusing on our behavioral choices? In the example, I just gave up, I'm aware of my behavioral choices, making certain decisions to engage with certain people and not with others. But should I be asking, for instance, what's salient? What are the thoughts leading up to that decision? In other words, how does salience of internal and external cues and processes relate to behavior? And which of these should we be paying attention to if our goal is to eventually change our behavior? So think about what we're starting, we're sort of starting at the bottom. So we're starting with, OK, there is an eye. And that's just not just an apprehension. There's a lot to that. So for example, I know someone who is doing some mirror meditation, staring into the mirror, right, looking back itself with a desire to be aware, like, there is a me, like this me is in the world. This is the first I've ever heard of such a practice, except when I was in elementary school, maybe it was the ninth grade, I had a teacher who talked about, gave us an assignment to look in the mirror and ask ourselves questions. But if I understand correctly, you think there's utility to people spending a few minutes or more looking in the mirror and thinking about oneself in the eye as a way to build up this self-awareness. Do I have that right? If you want to take the best care of yourself that you can, right, you want to understand yourself the best you can, and you want to make your life the best it can be, right, then if there are answers, right, and let's say the answers are in five or ten different cupboards, right, look in all of them, right? I mean, that's the idea, right, that if we want to know something, look everywhere for it, and also realize what we are building, what we are creating, maybe a recipe, there may be things from different cupboards that overlap. So the way to translate that practically is to say, to find the answers to what is either ailing us, why we're repeating things we don't want to repeat, or even if things are going okay, but we want them to be going better because we don't quite feel the peace and contentment we want to feel, then look everywhere. So in the function of self, in the function of self, start with the eye, right? There are ways of increasing self-awareness, you know, they can range from contemplation of self to meditation to looking in the mirror, right? There are things that we can do to more strongly emphasize to our self that there is an eye and this eye is going through life, right? Then we know that there are defense mechanisms and that they're present, that they're acting in us, right? We can't just see them because they're unconscious, but if we start thinking about them, we can learn about them, right? And that's where salience comes into play. Salience kind of points both ways, right? Salience can point us towards the unconscious mind, right? I realize I'm doing this over and over again, or I'm saying this thing to myself over and over again. Where's that coming from? We start becoming curious about ourselves and we look to the unconscious mind and then we also look to the conscious mind. That's why after salience is behavior, like, what am I doing, right? And a lot of times we don't know, just say examples of we don't know why we're doing things, right? Someone who wants to lose weight, but always goes to the grocery store and comes home and is like, has some sense of surprise that there are things there that they don't want to eat, right? Like, why am I behaving in a certain way? Why do certain things bother me when other things don't? Am I really touchy about one thing and not another? Why might there be things that bother others and not me or vice versa, right? So, so, you know, we're looking at what's going on inside of us and then how we respond, right? Because how, what may be upsetting me or what's going on inside of me, both conscious and unconscious, right, is then determining how I'm acting, how I'm behaving in the world around me. If I want a better job, but I never take an interview for another job, I'm not going to get another job. If I want a romantic partner, but I automatically turn away from anyone who smiles at me, I'm not going to have a romantic partner, right? If I want life to be better and there's a certain thing I repeat and I don't want to repeat that, I want to understand myself better so I can change the behavior. And that's why the function of self ends with strivings, right? The strivings are into the future. I know there is an eye. I know there's a network and web of defense mechanisms in action. I know that there's salience going on inside of me and I'm only going to pay attention to a few things from the thousands I could pay attention to. I want to be aware of that and have more control over that. Then I'm enacting behaviors. I'm engaging in the world around me and ultimately I want things, right? I want life to be better. I want to have that feeling that you can get to. I want to be in the state of agency and gratitude. So again, these two pillars structure of self, function of self, that's where all the answers are. So there are all the cupboards, right? There are these five cupboards in the structure of self and five in the function of self. And I know there'll be a, we'll have it out there in a PDF, right? Because you can go back there. And that's where the vast majority of answers are to both understanding and routes to change. What you just described is incredibly helpful. It's absolutely apparent to me why looking in all the cupboards is so key.
Pillars of the Mind, Agency & Gratitude, Happiness (02:04:57)
It's also apparent that many different aspects of psychology and psychiatry, at least as I understand them, might probe, for instance, just at the level of behavior. I think this is the just do it mantra. Well, just do the right thing, right? You're not finding a romantic partner. Like schedule three dinners with friends and ask them to invite over people who are looking for part. It sounds really simple, right? But much as with the example of my friend who lost all this weight through behavioral change, the fear still lives within him very, very strongly. And so clearly, there's some stuff happening underneath there. Now, fortunately, he did lose the weight and he's kept most of it off. But it's clear to me that until he addresses some of these other issues of salience and defense mechanism, self-awareness, etc. that the fear he's still experiencing makes total sense because the foundation of that change is not nearly as strong as it could be. Maybe, right? Or maybe it isn't apt to have the fear, but he's not going to learn either one without the exploration. So he won't, if there is risk, he won't be able to avert the risk. And if there's not risk, he's then sort of laboring through life, which is difficult enough without being worried about something you don't have to be worried about, right? So the process of inquiry will always make that better. It's clear to me that his fear of regaining weight is absolutely sapping his enjoyment and his productivity and other domains of life. So warrants attention, right? Because we're deciding in that sort of mathematical way, like it doesn't have to be that way. It doesn't mean it can change overnight, but it can be understood and it can be changed. Well, it's for that reason and many other reasons that I'm very grateful that you explained these two pillars structure of self and function of self and how these flow up to empowerment and humility and how those flow up to agency and gratitude. You've given us a set of ideals and a road map of how to get there and one that we're going to continue with in a moment here. I did want to reiterate what you said, which is that there is a PDF version of this structure, this road map of ideals and how to get there. That's been provided as a link in the show note captions so people can refer to them there in visual form if they like. If you're interested in understanding yourself and in having goodness in your life as much as you possibly can, then you're interested in the structure of the mind. And this means that you're interested in the unconscious mind in all the things that go on and million things a second that we don't know or understand one by one, but that we can explore and understand better in total. We're also interested in the conscious mind in being self aware. We're interested in the array of defense mechanisms and whether or not they're elegant and light passes clearly through them or whether they're distorting light and creating misperception. If you're interested in the structure of the mind, then you're also interested in the character structure. Like what is your character structure? What is the nest around all of it? How do you interface with the world? And then you're interested in the self that you grow from that phenomenologically, meaning what is your experience of self? How does it feel to you? These are all important parts of this pillar of health and happiness. The other pillar is the function of the mind. And of course, there's overlap. There are different covers, but the cupboards all contain different ingredients that together make the recipe. Right? So if we're interested in the function of the mind, then we want to pay attention that there's an eye. We want to be self aware and we want to cultivate self awareness. We're also interested in how those defense mechanisms work when they're in action. Right? What's salient inside of us and outside of us? What are we paying attention to? How are we behaving? What are our strivings? Do we feel hopeful about ourselves and the world around us? And if we're interested in all of these things, we can't help but be respectful of just how complicated this is. Like life is difficult and understanding ourselves is difficult. You know, wonderful joy can come of living life, but it is hard and it's hard day by day and trying to understand ourselves going to these places, these pillars that hold the answers. Right? They can't but make in us a respect for all of it. Right? And the respect for ourselves, for others brings with it humility. Right? When we come to this point of looking at ourselves and exploring, then yes, we become empowered, right? Because we've gained a lot of knowledge, right? We're digging where the pay dirt is and we're figuring things out. And along with that empowerment comes humility, a respectfulness for how difficult all of this is, how complicated we are, how we can make happiness in our lives, but how it certainly isn't easy. And we take with us the empowerment and the humility and we express them. And if we're expressing empowerment and humility, we come to living through agency and gratitude. So here, both are active words. So agency, it's easier to see it. It's an active word where I'm aware of my ability to project myself into the world around me. I know that I can't control everything, right? But I'm really trying to understand what can I control, right? How can I control it? What do my decisions now lead to in the future? So agency is very, very active, right? Gratitude is active too, right? Because we're bringing an active sense of gratitude, a sense of the amazingness that we're here and pride in ourselves and others for being here and trying to move forward as best we can. And then we bring that to our interactions. We're much more likely to have a kind gesture towards others instead of being angry. We're much more likely to have something compassionate to say, including to ourselves than we are to have something angry to say. That gratitude accompanies agency, their active words and their active together. And if we're living life through agency and gratitude, I mean, there's a lot of wisdom about this. There's a lot that's been written and researched about this. And if you look at what is it telling us, right? Remember, things are getting simpler, right? As we're getting higher up the levels here, right? The unconscious mind is most complicated. Now we're at, hey, can we live our lives with agency and gratitude at the forefront? And what does it bring for us? And I think it brings what we are seeking, that we might say, okay, we're seeking happiness. And that can mean a lot of things, you know, a lot of different things. It can be a very active thing. Am I happy in the moment? And we can use happiness sometimes to distract ourselves. Like happiness is important. But words, when people really think, like, what is it that they want or what is it that they have, right? If they're overjoyed to be alive, they're finding a sense of peace. They're finding contentment. They're finding delight, the ability to be delighted. This is what people want. Our human history and our searchings tell us this and our own experiences tell us this. And now it could lead a person to think, well, okay, what's going on? I mean, is this someone who's, you know, levitating at the top of a mountain? Like, is this just a state? Is this a state that people are in? And the answer is, no, there'll be some times we could be in that state where we can feel peace. There's no tension inside of us, right? I can feel to have times when I don't feel tension inside of me. There's contentment. There's peace. I don't have to drive towards anything, right? But it's not the passive experience of it because we are living life. It's that that feeling goes hand in hand with a drive within us, that when we're in this healthy place, we are living life, the decisions that we're making, what is putting the rubber to the road? It is a generative drive within us. There is a drive to make things better, to understand, to explore. And it's that drive that we access and cultivate. And synonymous with happiness is it's not just the state when people want to be happy in that very, very general way. Yes, contentment, peace, delight, right? But they're happening as we're living life, right? As we're enacting a generative drive where we're looking at ourselves in the world around us and we're interested in understanding, we're interested in making things better. And that's the place that we're trying to get to. I believe that with all my heart and my and my brain, my education, training, experience, and also experience living life. And for 20 years doing this work with people tells me this is what we're seeking. And it's an active way of experiencing ourselves and our place in life. I love that because it merges both the nouns and the adjectives and the verbs.
Generative Drive, Aggressive & Pleasure Drives (02:13:53)
And this notion of a generative drive to me is so compelling because I have the sense, and I hope I'm right, that we all have some sort of generative drive within us starting at an early stage. Maybe even starts as visual foraging or touching things with our hands as an infant and an exploration of the world, right? It is what brings about the changes in the neural circuitry that allow us to engage even more and in progressively on the one hand, narrower ways, but also with more richness and more detail. Could you tell us more about generative drive and how this shows up in different types of people? Is it always positive? Can there be too much of it? I certainly know a number of people who are addicted to work. Those of you listening, I'm raising my hand. But I would say nowadays I'm not as addicted to work as I once was in the sense that I derive far more satisfaction from less work now provided that the work is really in-depth. I think that there were years in graduate school where I wanted to publish a bunch of papers and then quickly realized through the not so gentle persuasion of my mentors that let's just do the best possible work we can do. And there's so much more richness and experience and things to be gained from that. So I'm familiar with generative drive as I understand it, but maybe if you would, if you could flush out a bit of what generative drive is, and does it arrive in parallel with or before we are able to access piece contentment and delight, can it even be separated out from that? What is this generative drive? So drives are built into us. So there's synonymous with our existence. If we exist, then we have the drive. I mean, that's how the drive is defined. And we understand going far back to psychodynamic and psychoanalytic roots. And when people were really thinking hard about human beings and what's going on inside of us that we've sort of identified and then validated over the period of time since that we have aggressive drives within us and we have drives towards pleasure. Now, this often gets misunderstood that so aggression can be active violent aggression, for example, but aggression can also be a sense of agency, the inaction of agency. Like, I want to do things. I want to change things. I want to make the world a different place, right? That all of that comes under this drive. So an aggressive drive is not a bad thing. If we had no aggressive drives, the thought is we'd just lie down and nothing else would happen and then we'd all be gone, right? So there's a way in which this drive within us moves us forward, right? And of course, extremely complicated, the ways we can manifest too much of it or too little of it or how our defense mechanisms can intertwine with the drive, but the drive is there. It's like it's fuel within us that comes with our existence and then how that fuel moves us forward, how much of it there is. Now, that is determined by the meshing of the drive with how we're living life, right? And the same would be true of pleasure. You know, the pleasure drive doesn't just mean like we all want to be heatiness, right, inside. It means that we want things that are gratifying, right? We want to feel good, right? This isn't just, you know, the drive towards physical pleasure, like a sex drive or eating food or having comfort. Like all of that can be part of it, but it's a drive for relief, right? The idea that we don't want to be white knuckling life, right? Searching for pleasure. So it's having aggression within us as we white knuckle life and we search for some pleasure and relief, right? These drives within us can be healthy. They can be unhealthy. You know, they can be anything, right? They're well springs within us that then fuel us forward. And there's controversy to the idea of is there a generative drive? And there's certainly parts of the field that do not think so, right? But there have been strong thinkers in the field that have thought we do have a generative drive that it is within us to look around us to be curious, to be amazed, right? To think like how can I engage with this and make this better or happier to think outside of ourselves, right? To think if I feel good and you're in pain, can I make you feel better, right? Having nothing to do with me, right? The idea of altruism coming to the fore and having industriousness within us, right? And the idea that there is a generative drive, it's strengthened when you look at how humans behave when, you know, we're not struggling, right? That people are interested in learning. You know, you think about how much of people give of themselves to learning, right? Or to serving others. Like there's so much of this goodness in the world around us. Now, if we shut people away, right, they have no, you know, imagine, you know, God forbid someone is in a solitary confinement from when the moment they're born, you know, then there's not an opportunity for the generative drive to thrive, right? And we see so many, so many situations where it doesn't thrive enough, right? You know, violence in people's surroundings, lack of opportunities, right? That we can squelch a generative drive, anyone's generative drive. But if we give ourselves opportunities, if, you know, if we're healthy, that we're not weighed down by trauma and illness and misperceptions of self, and we can live life in a way that brings us to agency and gratitude, now we're allying with the generative drive that I absolutely believe is within us. I think just look at life, look at human beings. We observe that we have this drive within us. And if that drive is at the forefront and that drive then naturally, of course, allies with agency and gratitude, then I think we're at the place that is the place we ultimately seek, right? And that we can find it for brief periods of time. So, by really pursuing this and like really strongly in my own therapy and reflection and attempts to understand, I can have periods of time where I can feel that way. I can feel outward growth and interest in the world. And I feel good. I'm not trying to answer some question of like, why am I alive? Or like, I'm doing things that I feel good about. And I feel good about doing those things and about being in the world. And I think this is not uncommon. It may be far more common in societies that are allegedly less advanced, right? That is, have less distractions or maybe less knowledge of all the awful things in the world that can happen to us that are constantly fed to us. Like there's a whole bunch of other questions and topics about it. But this, this absolute belief that there's this generative drive in us that wants to ally with agency and gratitude and that we all have it within us to bring those to the forefront and to find that thing that we seek, whether someone's person says it's Nirvana, the other person says it's joy or happiness or peace or numbing. Whatever it is, there's something to it where we're not feeling the tension within us. We're not feeling the anxiety, the pressures, but we're feeling a sense of goodness. The way you're describing it makes perfect sense why peace, contentment and delight be so closely linked to this generative drive.
Peace, Contentment & Delight, Generative Drive; Amplification (02:21:33)
Yeah, the word peace as you alluded to is often brings to mind the idea of passivity, but generative drive and the inclusion of things like aggression and a drive for pleasure or anything but passive. So I think that's important for me and for everyone to understand that peace, contentment and delight can really be action terms. Again, moving them from from the more typical conception of them to verb states. So peace, contentment and delight are not passive states. There can be periods of time where we can be just very peaceful and very much at rest, but those words are not synonymous with inaction. In fact, they're synonymous with action a lot of the time. If we are suffused with peace, contentment, the ability to delight, then what we're doing is we're raising up the generative drive. We're making conditions that are permissive for the generative drive to come to the forefront, to be paramount over the aggressive and the pleasure drives. And remember, we're not trying to get rid of those drives. We just want the generative drive in us to be at the forefront. Then we'll be able to harness the aggressive drive through, for example, a strong sense of agency fueling the sense of agency forward as opposed to destructive aggression. The search for pleasure, which sure can include physical pleasures in ways that are good and reasonable and healthy for us, but also the pleasure of learning, the pleasure that altruism brings, that we can take the aggressive drive that we know is in us and the pleasure drive that we know is in us and we can dial them to the right places. Like this gets very complicated and it's easy to dial that too far up and it's easy to dial it too far down. But if both are serving the generative drive because we lift up the generative drive and we bring it to primacy by being able to handle our lives, to understand ourselves, to go back to those pillars and to build upon it the agency and the gratitude that then leads us to peace, contentment and delight, we can put all of this together and like we're really and truly living in an active way in the world that's good for us, good for the world around us and doesn't leave us with a sense of yearning or sense of tension within us. Do you think it's also the case that generative drive has kind of a self amplification feature to it?
Overcoming Mental Challenges And Understanding Drives
Generative Drive, Amplification & Overcoming (02:24:18)
What comes to mind is you're describing generative drive and its relationship to peace, contentment and delight is that approximately a half hour after I wake up I start to feel more physically energized. I'm not somebody who just pops out of bed and is ready to go exercise or do mental work. But about 30 minutes or so after waking my mind starts to wake up and I've noticed that if I read a scientific paper or if I read a chapter in a book or if I do something that feels a little bit difficult, cognitively difficult in particular that the sense of satisfaction that I get from that is immense. And it's not necessarily the case that I have to learn something that I'm going to use that day but for me learning and often learning and sharing what I learn with the world whether or not they want to hear it or not is part of my pleasure loop. And I've learned that if I don't capture some new knowledge in a way that's challenging in the morning time, I feel like the gears are still turning but I start to lose energy whereas if I find something interesting in particular and write it down and I feel like I own it, that's what I enjoy so much about learning. It's like it's in there, maybe it'll be useful at some point, maybe it won't. But it's like an animal finding a tool that it can maybe use to forage more effectively later in life. I get such a sense of satisfaction that then I find that I have immense energy to do whatever is next, whether or not that's exercise or learn more or prepare a podcast or write a grant or work on a paper. And this feature of my mental life has so prominent that I almost set to force myself to do it each day. And there are so many distractions in the world nowadays that I've come to a place where I almost have to force myself to do what I know works for me. But when I do, it feels like a almost like a chemical rocket fuel. And it doesn't make me manic or crazy. I don't need to pick up the phone and call somebody or tell everybody about or post on social media. It's more of a deep sense of satisfaction and I get energy from it. Is that the generative drive? Well, it's great that that works for you. What you're saying is that for you, you can prime your generative drive that way. And then you prime it, you prime the palm, it gets revved up. And then it's really manifesting itself inside of you. There are many different manifestations of the generative drive as there are people. So something's going to work for some person, other things are going to work for a different person. But you're saying that, hey, I know this thing works for me. And even though sometimes it's not easy to do, I do it. And then look what it gets for me. And that's really healthy. It's like knowing that this thing works for you. And then you become committed to it because your generative drive is really strongly supported by it. And then you have this sense of good feeling. So then you have the peace and you have just the overall sense of goodness, right? The peace and contentment and delight. You're getting that and learning and in teaching. So you're figuring out, like, hey, this works for me. And again, you don't have to figure it out through this lens. It's if we find parts that aren't working, then we go back and we figure them out. Maybe a good example, maybe is-- so let's say you take someone who really enjoys gardening and gets something out of gardening, right? So there are as many generative drives in how they're measured out as there are humans, but there can be common outcomes of them, right? So the enjoyment of fostering plants, growing a garden, it's like that's not uncommon in humans, right? So imagine someone who hasn't been doing that, right? They really want to. They have a drive to do it. There's a pot of land in the back that they used to cultivate, right? So if they're not doing it, there are any number of reasons. Maybe they were depressed and they needed mental health treatment. Maybe they just got away from the path that they were on. Maybe their defenses shifted a little bit. Whatever the case may be, they go back to the pillars and they figure it out, right? And now they're in accord with themselves, right? And they're living through agency and gratitude. And they feel like, right, I can go back out there and I can till that land, I can get the whole out, I can make the plots, I'm going to put the seeds in, I'm going to nurture, I can go do that. And I can do it even what? Even though I was depressed, even though somebody assaulted me five months ago, even though I lost my job, even though, even though, even though, they overcome the even those, right? And the sense of agency tells them, right, I can go do that, right? And the sense of gratitude, no one who's miserable and now is in such an awful position about life because they were attacked or lost their job or something bad happened whatever it may be or they're lost in cynicism. There's no gratitude there, right? It's a gratitude for being in life or having the capability of going back and planting seeds in that garden. That's the alliance between agency and gratitude and then the person goes and does that, right? So think of what's going on there. They do this thing. They feel good about this thing. They can have, they can look out at the garden, feel some peace, right? Feel some contentment to them, be delighted by what they did. Remember how much they loved it before, how much it means to them. So yes, that goodness comes, that goodness suffuses us and it raises up the generative drive. That says, right, it's good. We breathe some life into it, right? Enough to get that garden done. Now the generative drive is further fostered forward by the goodness the person feels. So the example, the difference between the person who's like wants a garden feels terrible about themselves and they're not doing it and it feels lousy every time they look out the window and there they are looking out the window, right? The difference between that and having made a garden looking out the window at it is a night and day difference and the person who's looking out the window at the garden that they build overcoming whatever was inside of them because they went and addressed it and proved to themselves that they could, that's what we're after in life, right? We all know this. It doesn't look like somebody levitating at the top of a mountain, right? That's what it looks like. The person looking out the window at the garden and thinking about what they overcame to create the garden and seeing the goodness of it all. Yeah. Glad you said the word creating because it seems it's about creating things. It's real tangible things, but that the process to get there is every bit as important as what's created. When you create knowledge, that's tangible, right? Like you create knowledge. Maybe that person looks down the row of beautiful flowers and has the same sense of goodness inside of them that you do when you're well, right? I just went and learned something. As you described that, I'm thinking I certainly hope so because for me it's an incredible sense of satisfaction. One that I enjoy so much that I almost don't want to look at it too much because to me it sits in this rare domain of perfect. It just feels so good and that I can get back there is very comforting to me. Right. That's all of this. That it feels so good. That's what all this is. It's the generative drive. It's the gratitude. It's the contentment. It's like all that coming together. It's interesting. We could contrast that to when you talked about a repeated cycle that's negative, right? Then you're not feeling that, right? So think about the learning that can come from it. You can achieve this and feel this and be in this state in one aspect of your life. What can you learn from that to bring to the other place? And more, yes, that's important. It's often starting with what's going on in the place that's not doing well, right? Like is it why the repetition, right? So this is how we can have what we're seeking in parts of our lives even if we don't in others. But if we can have it in parts of our lives, we can have it in others too and we can become role models for ourselves. We can learn from ourselves. We can learn from what brings the good to how to raise up the things that about us in our lives and aren't there yet. I often get the question from the general public, how can I stop overthinking?
Over-Thinking, Procrastination, Choices (02:33:00)
I have to imagine based on the fact that I get that question so often that there are a great number of people who sense their own generative drive. What are your thoughts on that? Thinking can be wonderful if we're using thinking to learn, right, to figure things out. So when thinking is doing that, thinking is great. But a lot of thinking is just in the service of something else, right? And a lot of thinking works against us. So imagine the person making the garden, look at the person has to think about it. If you think about what seats to make, they have to think about where the tools are. They have to think about what they're doing, when they're planting, when they're watering. There's a lot to do, but the beauty of it isn't in the thinking, right? The thinking is in the service of what is generative. So that's a different kind. It's just thinking in the service of something. But a lot of our thinking is that. It's planning, it's projecting. We tend to glorify the planning and the projecting. And it can be great when we're learning, when we're figuring things out. But a lot of that is there so that we can do the things that are good for us to do, right? The planning and the projecting around making the garden where the point of it is the garden. It's not the thinking part, right? We can also use thinking against us. So much thinking is repetitive and not just unproductive but harmful, right? That person who's looking out the window at the garden may be thinking. I mean, sometimes they're just pauses in our thinking. But a lot of times a person must be thinking. And what often goes on there is just repetitive, negative thinking. It's, gosh, I used to have a garden. I remember when that was beautiful or remember before such and such a person passed away and then we stopped making the garden or I'll never be able to make a garden again or, gosh, it's too much. It's just something that's negative and unproductive. I mean, what else is there to think? If the person's actually looking out the window at the garden and they're in this sort of stuck state, they're not in a generative state, then the thinking becomes repetitive and it furthers all the negative, right? It's just the more we further the negative, the more we take it, the more we take it. There's a four-lane highway that we want to atrophy. Let's not make it into a six-lane highway, you know. But we do that when we have this repetitive thinking which then can evolve into the narratives, the things that we say to ourselves, right? So your thinking is wonderful. It's wonderful, but it can also just observe something else and it can also be used against us. So what we're talking about here doesn't glorify thinking. I mean, it does if it's in the service of the generative drive, but it doesn't in and of itself. I think many people set a time, say, you know, 9.30 a.m. or 10 a.m. when they are going to begin doing something that they want to do or know they should do, that's a little bit challenging. It could be exercised, could be cognitively demanding work. And then 10 o'clock rolls around, they say, okay, 10.15. And they're distracted by often social media texting. These days, I think those are the main culprits, really. I don't know too many people that get distracted by exercise and reading books. Some do and doing complex puzzles or math, but social media is a little bit like mental chewing gum, except that I would add to that, that's the kind of chewing gum that really does say the appetite in a way that prevents you from eating nutritious food, unless used correctly. And then people feel bad about themselves because the whole morning went by, now it's noon, then they require some food like any typical person. They eat, then they might kneel a little nap for the gross perandale dip in energy. And then the afternoon, and then it goes on and on. I mean, I hear this all the time. I've experienced this before, so I'm not immune to this myself. That's why I try and capture that early wave of energy, whatever it might be, adrenaline nor adrenaline, some combination. The way you describe thinking and its potential relationship to generative drive, it seems to me it's so important that we capture those moments of potential creation. However small the action might be to remind ourselves that we are capable of moving things from point A to point B. Because in the description I just gave of the person that lets the morning escape, there's really no external barrier except these distractions. Put differently, all the tools exist within most all of us to be able to create what we want to create or at least to create something. And yet many, many people just don't fulfill that right that we've all been given. So think about what's going on there. The person that I'm going to exercise at 10 o'clock, and push it back to 10.15, and they do something on social media, they push it back to 10.30, it'll be okay, I'll get it all in. What they're doing is they're engaging in unhealthy defense mechanisms. So if we go back to the pillars, the structure of self, the function of self, there may be other reasons for it, but let's just identify the unhealthy defenses of avoidance and rationalization. And then there's no thinking going on about that. They're just unconscious processes and you kick it down the clock 15 minutes. They're not thinking about it. Thinking then is observing something different. The thinking is observing the avoidance. If I'm going to go look on something, read a couple of things, reply, I'm thinking, I'm planning, maybe I got to get the phone out, I got to tap my code into it, I got to go to a certain website. People were doing something that we're thinking about, I think about what I'm going to write back. But the thinking is all in the service of the unhealthy defenses. So then by understanding ourselves better, we can bring that to a healthier place. Wow. By actually using thinking for what helps us. So let's think of what's going, let's say if you're doing that, what's going on when you're doing that? So you really want to exercise, but it's not easy to exercise. And sometimes maybe just problem solving. Are you doing a thing you like? Maybe something you like more, there's lower barrier, etc. But let's say we're just working within the psychological, then you can come at that a couple of ways. Like, I don't want to do that thing. That thing's hard. I think that about things in my life sometimes and it always makes me weighty and unhappy. I may as well put 20 pound weights on either side of me. I can look at it that way. Or there's a different way of looking at that actually fits much better, which is like, I'm not daunted by doing difficult things. And I can get out there and apply myself. And when I feel good about that, when I do difficult things, it's like part of my identity, it's like part of how I see myself. So, right, I'm going to go do this thing. And I'm going to feel good about it. And isn't it amazing that I get to do it? Like, look, here I am. I'm alive. I'm healthy. I can go do this thing. My health is good, but I want to make it better by working out or I'm at least alive. And if I lose a little bit of weight, I'll feel healthier. Like, come on, this is good. And then I'll feel different about that. And truth is one or the other. It's like, oh, both can be true. Now, what will be true is what you choose. And if you choose the negative, then yes, the unhealthy defense is perpetuated. And even if you get yourself to do it today, it's harder to do it tomorrow. That's why sometimes I'll say to a person, just take a look at it and decide if you want to do it or not. If you don't want to exercise, just decide you don't. And then, okay, there's a trade-off for everything. Maybe you're okay with the trade-off, right? But what am I trying to do there, right? Is bringing to consciousness that that person is making a choice, right? Do you want to do it? If you want to do it, it's great to just do it, right? And if you don't, it's great to not do it. At least you're being honest and clear with yourself and you're not wasting all that time when you keep kicking it 15 minutes down the clock until it's too late. Does that make sense? That's I think how the structure here really does. It works because it's pulling together what we know from the biology to the psychology of how to understand ourselves and how to understand when things aren't the way we want them to be so that we can make them the way we want them to be. It's not magic. It's following the mathematical aspects of going to the factors, assessing them, making changes. And then, of course, we see the outcome we want to see. The way you describe it does make sense. And I appreciate it because I think ultimately it seems to ratchet back to actions, to verbs, to bring us to these feeling states that I think are what people are seeking, peace, contentment, delight through agency, gratitude as active terms. Right. I mean, there's yes. I think these are universal desires. And again, you're providing this wonderful roadmap for people to arrive there. Thank you. I do have a question about some of the underpinnings of generative drive. In particular, this notion of aggressive drive.
Aggressive, Pleasure & Generative Drives, Envy (02:42:20)
I've known people that seem to have a lot of this. I just have a lot of get up and go or a lot of drive to create in the world or to figure things out. They often do create great lives for themselves in work and relationship, etc. I've also observed that these people often don't have the best relationship to themselves or that they run up against barriers or, frankly, sometimes straight into brick walls in certain domains of their life, perhaps as a consequence of having too much of this generative or aggressive drive. And at the same time, I know that there are people in the world many that have what seems to be a low generative drive. I don't know if that's the case or not, but that they seem to have a hard time engaging in doing things. And often, you get the impression that they somewhat are completely given up. Life is just too hard. Or sometimes it's even more subtle. I know someone who they like their job, but they've come to the place that it's just work. It's a paycheck. And that might be enough. But they're always talking about it. So I have to assume that it's not enough. They aren't able to slot their work into one domain and just focus on the other aspects of their life that are going well. It doesn't compensate for them to think about the other aspects of their life that is. So is there a continuum of generative drives that exist in us? Are these intrinsic? I realize there are a near infinite number of conditions that could give rise to one or the other. The hardwired could be nature, could be nurture. But what is the relationship between arousal or potential for arousal and aggressive drive and these things that we're seeking? Yeah. So if it's okay, I'd like to start like the first principles of the drives. So the theory of drives came about when people were observing very closely like human beings and human behavior, individuals, societies, cultures, and identifying that you can boil a lot of things down to a drive that we call aggressive. There's something to impose myself out there on the world around me. It explains a lot of what people do. And then the other identified drive was pleasure, was enjoyment, even relief of unpleasantness. There are those. You can describe a lot of human behavior and that to understand what's going on inside of us, that means that we're here. You see that through the lens of aggressive and pleasure drives and that's the answer to it, to how we survive. But I think that is not the answer to it, that if it were just aggressive drives and pleasure drives, there's not a value system around that. Somebody who's very industrious can build or destroy. And we see this in historical figures, like being very intelligent and very industrious and it says nothing to do with whether you're building or destroying. So if it were just an aggressive drive and a pleasure drive, then we wouldn't be having this conversation because the species would not have survived. So if you believe that and I believe that, then you look for something else. You see, maybe we looked and we found two things and there are more things. And then we start thinking about learning for learning sake, altruism, things that are not explained unless there's a self-referential. We feel good doing something for someone else. So therefore, it's selfish. There's a lot of gyrations around that. If you really observe humans, you do see altruism. You see learning for learning sake. You see people being benign when everything about a situation would say that they could, would or should under society's rules, not be benign. And then we start to see that there is another drive. That how do you explain that we're here? Yeah, aggression, pleasure, and generativeness or generative drive. The drive to make things better. That's why we build more than we destroy. We destroy a lot, right? But we build more than we destroy. Otherwise, we wouldn't have clothes on our backs, let alone have the technology to sit here and to be able to do this. So it's the generative drive that is most realized in the healthy person, right? And the healthy person has this strong generative drive. Now, as you said, there are other factors. And this is sort of what you were asking about. They're probably, they're natural levels of aggression or pleasure-seeking or generativeness that differ across people, right? Because we're a product of the complexity of our genetics and all the complexities of nature and nurture. So we're going to get to a place where some of us have more, some of us have less, right? The conclusion though is for all of us, the generative drive being at the helm is what leads us to live good lives, right? To live to the things that we aspire to the peace and contentment, right? So we want the generative drive to rule the day, right? Whether a person is studying neuroscience or growing gardens, right? The importance is about being generative. Then aggression and pleasure can subserve the generative drive, right? And then the question you're asking, I think, which is, well, what if there's too much aggression, too little aggression, right? Or too much pleasure-seeking, too little pleasure-seeking. That's when we can see problems, right? And the problems then lead us back to the pillars to figure out the problems. So too much aggression ultimately becomes envy, right? Too much aggression means. I want, I want to impose myself on the world around me more than I can, more than is reasonable, more than I can do without impinging upon others, right? That what you end up doing is taking from others, right? Too much aggression becomes destructive, right? Maybe a person destroys, tear something down, right? Takes from others, says that the nasty comment when it wasn't necessary and now everyone feels bad, right? There's that too much aggression, it becomes envy, right? And envy is destructive, right? The same thing with too much pleasure-seeking. If I say, okay, I want, you know, I want my fair share of pleasure and, you know, relief of distress and all that, but if I rely on that too much, right, we're now instead of aggression eclipsing the generative drive, now it's pleasure eclipsing the generative drive. Then I want more pleasure and more pleasure and more pleasure and how long before I want your pleasure, right? So then it's not healthy, right? What it becomes is envious, right? It becomes destructive because now then I become covetous of your pleasure or if I can't get it but I could bring you down, then I'll feel better about myself. That's envy, right? So too much aggression eclipsing the generative drive, too much of the, of pleasure-seeking, pleasure drive eclipsing the generative drive and we end up in places of envy and envy is destructive and now we're in trouble. I've never thought before about the relationship between aggression, pleasure and envy, but as you're describing it, it comes to mind the movie American Psycho, where Christian Bale plays this basically an 80s yuppy in, you know, working in finance in New York and for anyone that's seen it, it's that can only be described as a violent parody of 80s yuppy culture and it's meant to be- It's dark a comedy as there's going to be here.
Envy, Destruction, Mass Shootings (02:49:46)
Yeah, it's as dark a comedy as it could be and don't let your young children watch it because it's very gruesome and like very sexual and but the the aggressive features within the character that Bale plays are immediately apparent in the movie like, you know, violent aggression, sexual aggression, seeking money, seeking wealth all the time, a narcissism to an obsession with like everything from his skincare routine to his eight pack abs and like it's ridiculous, but but also an interesting window into some milder forms of those features that still exist in many people today, right? But the envy component starts to reveal itself a little bit later into the movie where the scene I recall is one around where someone hands him a business card and then you hear the narrative in his own mind about how much nicer that guy's business card is than his and how he hates him so much. He ends up killing the guy in very violent and sadistic fashion. That's aggression over generative. That's right. Right. And so and the whole movie is about this one aspect of culture at that time's ability to impose their will on everyone at their whim, you know, basically, Bale just does whatever the hell he wants at any point, goes returns videotapes in between and you know, and there's so much woven into it and that is relevant and so much that's woven into it. That's just purely for people's kind of sick entertainment. But that I believe is Brent, Brent Easton Ellis that wrote that and you know, is tapping into the the aggression component, the pleasure component, but the envy component is really what resonates as you come to the end of the movie is like there's no satisfying this guy. He could kill or sleep with as many people as he wants in the movie and he can have as much wealth as he wants. He can have entire buildings. In fact, I think he's living in an entire building at some point. He takes over people's apartments after he kills them. It's it's wild and disgusting. But it really speaks to the extent to which envy is woven into absolutely aggression and pleasure seeking. And it's not something that had really sunk in for me until you describe it now. Because I think for most people, they imagine, okay, when somebody has X number of millions or billions of dollars that they'll reach this place of peace contentment and delight, right? They'll have enough. And in the movie Wall Street, there's that one scene where someone says, you know, what's your number? Like at what point is it enough? And the guy says more. That says all sorts of things about the dopaminergic system of reward systems in the brain, et cetera. But I think it says a lot more about envy and just what and what a pit of despair envy is for everybody involved. Right. Right. Look, envy may not be the root of all evil, but envy plus natural disasters may be so much evil and destruction arises from envy. And it may be that it's at the root of all of it. And we so underappreciate that, right? We so underappreciate why people are destructive, right? Which is why the roots aren't always in trauma, but a significant aspect of where envy arises from can often be trauma, creating a sense of guilt and shame and vulnerability. But wherever a person may come by it, and it's a larger discussion of envy and where it may come from is it drives destruction. And if the aggressive drive is greater than the generative drive or if the pleasure drive is greater than the generative drive or if both are greater than the generative drive, it will drive destruction. And that destruction, the vast majority of times, if you look deep enough, you find at its roots envy, that envy may arise from guilt and shame within the person. But as soon as it becomes about another, right, I feel guilt and shame and inadequacy inside of me. But then I feel envy of those around me, it drives the vast majority of destruction. Do you think that's what's happening when we see these sadly ever more frequent examples of active shooters and school shootings, things of that sort? Yes. There are other people who have life, and that person doesn't feel that they do. So they want to go and take it away from them. That's why, as long as we have human tribulation and a lot of guns, it's going to happen. It's a logical conclusion of enough people being in places of despair and how envy can be cultivated within us. And then ultimately how it blinds people, it creates such a desire for destruction that then people will take life away from others. And often enough to people will sometimes take their own life, which I think really brings to the forefront, that that person doesn't feel that they have a life, certainly not a life worth preserving. So they're then going to take the lives of others. And I think we're seeing that is as stark a portrait of where envy can lead, I think as we can find on a one person basis, we can look at wars and their destruction on a societal basis. But I think that's the ultimate in understanding where envy can drive a person. What about the other end of the spectrum when aggression and pleasure seeking are too low?
Demoralization, Isolation, Low Aggressive Drive (02:55:38)
The other side of the spectrum is demoralization. So imagine very, very low aggression, so low self-assertion, low agency, there comes a place where the person is not then imposing themselves or believing that they can in much of any way on the outside world. And that creates a sense of isolation, understandably, a sense of powerlessness and vulnerability and isolation. And that then becomes demoralizing, which is not the same as depression. We know depression is a, there's a neurochemical imbalance, right? Whether that imbalance came purely biologically or came psychologically or because of external events, there's a neurochemical imbalance. Here, we're not talking about an illness state as identified by modern psychiatry. There's not a number in the book of diagnoses that goes along with being demoralized. Why? Because it's a state that humans can be in and too low of an aggressive drive and all the things that come of that, it's isolating and it's demoralizing. The same with too low of a pleasure drive. So an example that may be relatable is to some people is knowing someone who has had a couple of really bad breakups and then says, "Oh, I'm done with that. There's no more romance. I'm going to be single way." And you know, that person has a drive in them. They're an interconnected person. They want romance. These are things that are important to them, but they make a decision. I'm not going to have that in my life. What would be called in some psychodynamic sense is inviting death into life, a little bit of death by swearing off something that the person has a drive towards, the pleasure drive of companionship and of romance. Right? That then becomes demoralizing as well. So sure, those things, demoralization can predispose to depression, but demoralization is a thing in and of itself where then there's a sense of hopelessness. There's a sense of the goodness then is inaccessible anymore. And that's the other side of envy. Can low levels of aggression and the resulting demoralization be coupled with high levels of pleasure seeking. So I'm thinking about the person that is very overweight, clearly headed for health issues if they don't already have them. And perhaps would like to remove that weight, would like to feel more vigorous, doesn't want type 2 diabetes and an early death, but at some level, they've given up. But because the pleasure of eating is something they really enjoy. They really love it. And yet it has a component to it in their life where they either self-soothe with it or they're just trying to hit baseline levels of satisfaction with it. They allow themselves to effectively be sedentary. And then the other sorts of troubles start to show up, sleep apnea from carrying excessive weight, and then they're feeling tired during the day. And then who can exercise when they're too tired when you got to work and maintain other life demands. And you can kind of see where this could rise and makes perfect sense. You can also see where if there were just a little bit more aggression, it could all be turned around, but they don't have it. So is the scenario described something that you've seen clinically? I certainly observe it in my non-clinical stance out there in the world a lot. Well, I think the most important thing you're pointing out is that aggression and pleasure on the high end, we know can trump the generative drive, but that this can also happen on the low end. So you're describing a situation. This is a great example, because it's not uncommon in the world around us. So the aggression, meaning the fuel to put oneself out there in the world, to utilize the sense of agency. So this is going to be a person who's low agency. The aggressive drive has little fuel then to give the sense of agency. It's further squelched by negative sense of self and negative self-talk. Now you find where the aggressive drive is too low and too low can also trump the generative drive, because then that person can't take care of themselves. A generative drive would say, "There's a lot of life to live in. There can be great things in life and take better care of yourself." And by the way, they're like people that you love and people that love you or if not, there's an animal regarding you love. So the generative drive is saying that, but it's not winning the day because the aggression is one word we could put to that drive. You could call it an assertion drive. We call it an agency drive, but we're using agency in a different way, but that thing is too low. So it wins out over the generative drive, and then in the example you gave, it's not surprising that the pleasure drive goes the other way. Maybe there's a predisposition to that genetically. Maybe it's just reinforced because a person in that place could say, "Well, think of what the self-conception would be. I'm in this terrible place. I'm a terrible person. I can't make myself better or I'm not good enough to get better. No one cares about me. I can't make anything right." So therefore, I don't matter. There's no reason to take care of myself. So why would I not do if I eat that one thing that I enjoy and it gives me pleasure, even gives me pleasure for two minutes, then I'll eat another one. In a sense, so what? Because I don't feel that I'm worth preserving or that I can preserve myself. There's a nihilism to it that then makes sense to over-indulge the pleasure drive, whether it's biologically predisposed or one is just arriving there. But the reason all that is bad is because the aggressive drive is too low, and in fact it's low enough that it's outweighing the generative drive. Then the pleasure drive is going to come into one place or another. If it's also really low, the person does not much of anything and wastes away, which tragically happens a lot in our society. Or if the pleasure drive is high, maybe that person over-indulges and things that provide short-term gratification, and then that causes a different set of problems. But what's deterministic there is whether aggression or assertion, again, we can put different words to that drive, but what we've been calling the aggressive drive and the pleasure drive is one or the other or both high enough to trump the generative drive or low enough to trump the generative drive. And I think all problems that we see, like everything fits into this model because it honors what we know. It honors what we know about human behavior and insights into human behavior over hundreds of years, over thousands of years, like the wisdom that we bring forward, and it honors the science. And that's why it fits together because I think it honors who we are as what are species, is what we are, and what life is like as we try and engage with it. Yeah, I've seen cases of demoralized people where they simply disappear. They hide, they isolate, they slow down, they take terrible care of their health.
Demoralization, Affiliate Defense (03:02:50)
And, you know, sadly, I've known several people like this in my lifetime, one of whom killed himself, the other just has an immense number of health problems related to overeating and inactivity and knows it and talks about it, but nothing seems to change despite multiple interventions from a caring standpoint from friends, et cetera. I've also seen examples of people who are demoralized to seem to band with other demoralized people, sort of try to recalibrate the standard that they feel oppresses them, you know, that they, and this isn't necessarily just in the realm of physical fitness. This is also in the realm of like school demands. I went to a very demanding high school, as I've talked about before on a couple of podcasts, I barely finished high school. I was not an attentive student. I was my aggressive and pleasure drives went into non academic endeavors, and I regret that. You know, I had so much making up of learning to do by the time I, you know, fortunately got to college, eventually caught up. But my experience of high school was that there were these, you know, kids scoring perfectly on the SAT and the early admission to Harvard and early admission to Yale and all these places. And then there was, you know, a distribution in the middle. And then there was a collection of kids who were not doing well, knew they weren't doing well, and kind of banded together around the idea of not doing well. I didn't consider myself part of that group because I frankly wasn't there that often. And I was focused on other things, as I mentioned, but what came of that group was actually quite tragic, not just for them, but for a lot of other people. They eventually engaged it. It wasn't a school shooting type scenario, but they eventually, you know, set off explosives on the school campus. This was after they'd graduated. I don't know where they are nowadays, but things did not go well for them. And they exerted a lot of destruction to other people around them. But before they did that, there was this kind of banding together around there, the fact that they didn't fit in that they weren't bullied, as I recall, that I could be wrong about this. But I've seen this in other forms too. Like, you know, if you can't meet the standard, band up with other people and change the standard, and then you don't feel as demoralized perhaps. I can understand I can rationalize why this would be a reasonable approach. But I'm seeing this more and more. I'm also seeing, by the way, you know, the other end of the spectrum, people are overly aggressive and pleasure-seeking and things that sort. But for the moment, I'd like your thoughts on, you know, how demoralization can split off into different expressions, depending on how people feel and who else they're relating to. Yeah. Yeah. Well, I think the place I would start is to say, our society rushes headlong forward in a way that causes our society to trample people who are vulnerable. And vulnerable people are demoralized people. Demoralized people are vulnerable people. And our society often tramples them. And then they're not here with us any longer. And that is tragic. But at times, they don't get trampled. They get cast aside, right? They're injured, right? And cast aside. And from that place, tragic things happen, right? People then stay isolated. You know, I think it's a tragedy that we don't all band together and go door to door, right? To like seek people who aren't coming out of doors, right? You know, in the sense of like, we let people be so isolated and oftentimes, that's the tragic end of someone's story, right? But sometimes people do engage, right? Either demoralized, but they can engage in ways that involve an affiliative defense. So sometimes people who are demoralized can affiliate. They can band together in ways, as I think you were eluding to, that can make things better. So if people are demoralized because, say, they're a group in society that is chronically very mistreated, right? Then it can be very powerful to band together, both because there's what's called an affiliative defense. That if I feel bad about myself about something and I'm alone, it's highly likely I'm going to continue feeling bad about myself about that thing, right? But if you feel bad about yourself about the same thing and then work together, right? We help each other feel better. We don't feel so lonely. We don't alone. We don't feel so isolated. We don't feel so ashamed, right? So an affiliative defense can help people to say, wait a second, like, I'm not. There's nothing wrong with me and I'm not going to take this lying down or something, right? And then to make assertions that create better rights in the world around us. So very good things can happen from affiliation in the context of demoralization. But very bad things can happen too, right? Because people can also affiliate around things that are very destructive. I mean, if I am hateful of society and I would like to be destructive and I'm alone, okay, I could do destructive things alone. But if I band together with a couple other people who feel that way, now I'm empowered to feel that way, right? Instead of maybe I feel that way or there's racism or prejudice and I don't feel like I can say that, right? But then when it's permissive, right? Because other people are in the same place, then people can accentuate the hatred within them. So affiliation is very, very powerful. And part of society rushing so headlong forward and either trampling or marginalizing people is that we then don't pay attention or not enough attention to what happens with the affiliative groups, right? How do you guide people towards being able to affiliate in ways that are productive? How do you give them routes of being productive, right? How do you try and protect against the ways that affiliation can lead to destructive behaviors? So I think a lot of this is that these are the natural things that happen within us. But a lot of what we're talking about now gets impacted a lot by society and societal standards, which we of course altogether determine, right? And arise from us, but they start to sort of transcend because it's now people interacting with a whole social system. Going back to the other end of the spectrum, excess aggression in particular was in a conversation with somebody recently.
An Analysis Of Aggressive Drives And Current Mental Healthcare
Strong Aggressive Drive, Competition, Generative Drive Reframing (03:09:32)
It was very successful, like beyond most people's comprehension of successful, financially successful. And seems to just set you know, checked off their goals one box at a time, you know, from from go. But who described his underlying psychology and emotional state as one in which much of what he does on a day-to-day basis is driven by aggression. In fact, he volunteered in anecdote about the fact that he hates early morning meetings on zoom, but he shows up to them as sort of like an FU towards somebody that might not even be on the meeting. And so there's a friction point for him that allows him to engage in a way that he wouldn't otherwise be able to engage. And he channels that towards productivity and clearly it's worked for him. You know, I don't know if he's done the sort of introspective deep dive, I imagine, know through the structure of self and function of self. But you know, what are we to make of that sort of example? I mean, I like the idea that if someone has a strong, aggressive drive that they would channel it toward good, I mean, I have no reason to think this person is doing anything but good in the world for themselves and others. They're certainly not harming anyone, at least not to my knowledge. But that seems like a rough place to live. For me, it seems like a rough place to live. And at the same time, I'll offer a very brief anecdote that, you know, at one point in my career, namely when I was a postdoc, I was in a position by virtue of having left a laboratory in the nature of the field at the time where the work I wanted to do was directly pitted against the work of another very powerful laboratory, except that I was alone postdoc working in a laboratory, essentially on my own on this problem. And I remember going to my postdoc advisor, the late Ben Barris and saying, you know, I think it might just move to a different problem because I don't really want to go up against this goliath. And he said, you know, this is the best day, you know, I can capture Ben's voice. He said, they're absolutely not, like there's no way you love this stuff. You have to do it because you love it. And he kept telling me how much I love it. And he reminded me that indeed, I did love the questions. And once I was able to tap back into the love for and the curiosity around the questions, I was able to push aside the concerns enough that we did well in publishing certain papers. They did well, but those five years, frankly, were a lot less pleasurable than they could have been, I think, because much of the script in my head was that I was in friction with this, like, you know, at least in my mind, this oppressive force. It was it was purely competitive. And I truly believe that we can't be in our most creative state when we are competing with someone else by definition, because then you're you're creating against a standard as opposed to raw creation. So in both cases, a lot of aggressive drive, frankly, I have some of that and I had that. But a desire for revenge, a component of friction mixed in, you know, or integrated with this aggressive drive, like this picture, like even as I describe it is, you know, causing the release of a little bit of adrenaline. It's not a comfortable state. It can't be a state of happiness, right? So as you said, people can do good in the world. They can do not good in the world. Like, we're not making value judgment about what the person is doing, because that's not what the question is about, right? Like, how are they feeling? How are they doing? Right? What's going on inside of them? Right? And that can't be happy, right? That can't be happy because if you're built to be pretty good at competition, right? So you can size up what are the factors, you know, you can strategize, right? So if person is built to be really good at competition, then, you know, it sounds pretty good to make everything a competition, right? Because you have the highest winning percentage, right? And that's good to achieve some end, right? That doesn't have any feeling intrinsically associated with it, right? And if all you're doing is a series of competitions, then what you're doing then is winning, right? And like, winning is something like, you know, winning is like, I won, I beat you, whatever that is, like, that can be part of happiness, but it doesn't have to be, right? That's not happiness, right? So, so yes, that kind of, I'm really built to compete well, and I'm going to just see a series of competitions in front of me. That's for expedient forward progress, right? That's very effective, but again, expedient forward progress is nothing to do with peace, contentment, delight, like, it's not, you know, it doesn't have anything to do with that in order to have anything to do with doing good or bad, right? And I think the example you gave in your own, in your career is like, it's such a good example, right? Because, you know, if you think about it, when the way that you were sort of framing it inside is like, there's a question I'm asking, there's a question they're asking, right? And there's a competition, right? And again, it has to be too, too, to compete, right? So, so there's almost an automaticity, right? That like, they're studying the same thing, maybe, you know, they feel competitive or certain people there too. They were, were in our definitely competitive, they know who they are, they're extremely competitive and very successful. Okay, so then, so then, you're like, okay, I'm in a competition. Now again, but you never decided to be in a competition, right? But, but automatically, right? I mean, it's interesting, right, to understand you're acting as if you're in a competition, you're just, I don't want this competition, right? Because like, they're bigger than me, it's gonna be unpleasant, it's gonna take you away from really thinking about what you want to do, right? It's gonna make it harder to do a good, to do the job you want to do, right? Because now you're embroiled in, you know, something that's, you know, that has aggression behind it, right? So, so you choose, no, I don't, I choose not to do that, right? And then Ben Barris reframes it to the truth and says, this, this is not a competition, because you're not choosing to compete, right? Because Ben pointed out what was important to you was the questions, right? So it's like, almost as if Ben reminded you, no, no, no, no, no, this is not through the aggressive drive, look at it through the generative drive, that's what wins out in you, right? And then you go and apply yourself to it. Yeah, and bless him for doing it, because from that point forward, I've made it my firm mission to always do things from a place of what I always think about as delight, you know, curiosity, delight, the things that give me energy and that give me more energy from doing them. It wasn't a coincidence, I believe that in those five years when I was operating from a mix of generative drive and the competition would then resurface and you know, I couldn't hold it constant that I was absolutely exhausted by the end of that phase. I just in a way that sucked a lot of the pleasure out of it, I still drive some pleasure. But then as I mentioned, fortunately, I was able to pivot back to doing things out of love, you know, and getting back to peace, contentment, and especially delight, right now, right? And I absolutely make a value judgment about that, right? That what you did is better, right? So what if you did, what if you were different? So think about if we talk about it through this accurate lens, what if you were different at that time and the aggressive drive in you was greater than the generative drive in you, right? Which would be an unhealthy state to be in. But let's say you were in that unhealthy state, then you probably would have still done what you did, but you would have done it through the lens of aggression. Like, I'm going to get that right now, you're competitive with them. There's anger in you, there's, you know, there's aggression, right? That you're enacting in fantasy as you're, you know, you're thinking about them and how you're going to win, like all sorts of things go on inside of us. And I would say there's no way on earth you could have done the science as well as you did, right? It couldn't be because all that stuff is distracting, right? It's, you know, that kind of negative affect pool for energy and time from you. And also what seeds would you have planted in the microcosm that you operate in, right? More competition, right? More competitiveness, more badness, right? So let's look at what you did do, right? Because you're healthy or this particular question about this particular thing we know for sure, because your generative drive eclipses the aggressive drive, then you set yourself to the work in a way that's going to be more effective, right? Your brain isn't clouded, you're not wasting energy, you know, plotting some revenge, you're plotting what you're going to do if they come take something from your lab. I mean, whatever it is, you know, like, you're not living in any of that. So you're going to do a better job at what so important to you to do and what seeds are you sewing then, right? You're sewing seeds of collaboration, right? And even then, if someone could say, well, what does even that matter, right? Say, no, it doesn't matter because what you're doing then, we just follow for the math of it, right? Is contributing to understanding that's contributing to human health, right? And the better understanding we have of human health, the more people stay alive and the more people stay healthy, which could mean any one of us. Just like any one of us could be the vulnerable person that society tramples or casts aside. We all have it in us to be that or have been that at stages of our lives, right? We also all have it in us to be the opposite of that, right? We have it in us to be generative. We have it in us to make good. We have it in us to contribute to health, to survival, and that I place a value judgment upon. It's why doing good is better than doing bad, why creating is better than destroying and why ultimately is the generative drive that has to trump the other drives. And when it does, we're happy, we're healthy, we make the world a better place. We rely with and are suffused with the gratitude and agency in us are fully active and we're suffused with peace, contentment, delight, as you said, that's the place to be from that place. We get this thing that we want and we hope to make the world a better place, which helps us to keep the thing we want. It sounds so simple because as you pointed out, the manifestations of looking at the right things and doing the right things are so simple.
Cultivating a Generative Drive, Spirited Inquiry of the “Cupboards” (03:20:02)
It's a list, really. And again, we have a PDF that includes this list and the structure of the pillars and how they flow up to this list. But ultimately, it's peace, contentment, and delight, undergirded by agency and gratitude as active terms. I mean, very simple at some level. And yet for many people, including myself at certain times in life, the excess or lack of aggressive drive or excess or lack of pleasure drive can interfere with people's ability to access these simple but incredibly powerful being states. Because it's nature and nurture. So you might be built with a greater or lesser natural amount of one drive than I am. But then we've had life experience that creates a delta around that. So you say, "Okay, we're built with different amounts of all these drives." Yes, yes, we are. But we also have control through our decisions, through how we handle our lives to modulate them. So that makes sense because the thought can be, "Well, the drive is what the drive is." And it varies across people. No, there's a range the drive is in. And that range can be very broad. I mean, people can do all sorts of things to cultivate the better. We all can. So if we look at it as an unlimited upside, then what we see is, "I want to know where they at in me now. What's going on inside of me? What are all those other factors?" Because I want to cultivate the good. I want to cultivate that generative drive. And I want to make sure the aggression and the pleasure aren't out of balance one way or another. We can actively look at that and manage it. And I think that's so what we're striving for. Because there's nothing here that we don't have some control over. And the higher we get up, the simpler it gets, the more we have control over it. And for people who feel like the ideals that we're providing a roadmap toward are not accessible, for whatever reason, maybe feeling a little bit or a lot demoralized, overly aggressive and not ending up where they want to go or ending up where they want to go and not experiencing deep satisfaction, peace, contentment and delight, where should they look in this framework that includes these pillars at the deep levels of structure of self-function of self that give rise to empowerment, humility, agency, gratitude, peace, contentment, delight. If someone should find themselves unmotivated or stuck, metaphorically speaking, staring out the window into the garden that could be and that they want so very much, but that they're not creating. Again, that should translate to whatever domain of life you're seeking or not even in touch with what you really want. Infinitely confused about what to do in relationship, school, work, life, and thinking about all the oppressive forces in the world, like the political chasm and the pandemics and lockdowns and like and all the stuff and all the things that are weighing down on us. So what should that person, in other words, what should we all do at that moment, you know, stop and what? Each pillar has five cupboards, look in all five and follow the clues that you find there. That's the answer. So go back to structure of self-function of self, ask questions about and engage in practices that bring about more self-awareness, practices that draw our attention to what salient for us, ask ourselves, you know, what am I thinking about internally? What is my internal script? What am I focusing on externally? Am I spending all day on Twitter looking at accounts that I know I hate because it activates something in me, etc, etc. I might have revealed something about myself. I'm just kidding. That's not my behavior, but I see a lot of other people doing it. What are my behavioral choices, you know, what could bring about more hopefulness and strivings? You don't have that right? There's so much of this that say one could do on one's own, right? Because we can think about ourselves and we can learn things. We say, well, I don't really know that much about defense mechanisms. Okay, look, we could read about it, right? Like we can do a lot of this on our own and we can get so much from talking to other people, you know, people in our lives who are close to us, who love us, right? We can talk with them about what's going on inside of us, right? And that is such an amazing mechanism of learning and they're also professional resources. I mean, like the good therapy should encompass, like, this should be what it's doing, right? It might come out if you won lens or another lens and, you know, because everybody's different, we can bring different modalities. But ultimately, that's what good therapy is doing, right? It's looking in all 10 of those cupboards and it's seeing, where is the issue? Let's follow the clues. Like it's a spirited inquiry, right? Whether we're doing it on our own or we're doing it with other people in our personal lives or we're doing it with someone professionally, it's a spirited inquiry to follow the clues because if we follow the clues, there are answers, right? And if we have the answers, then we can bring things into better alignment and then we're in a better place. Those pills are more stable and we can build on top of them what we want to build on top of them and the drives come better into line that we can do that and it can be an iterative process of, you know, if we attain some better state of mind and like life is better and like we're happy. Like this happens to people. There's a lot of contentment and peace and if things are going well and now something isn't as much, go back and look again, right? It's a process we can use over and over because it works because it fits with the truths and the reality is as we have understood, learned them, you know, our education, the, you know, this is learning about humans across hundreds of years. Tells us this. It makes very good sense to me in the way that you have mapped it out for us.
Current Mental Health Care & Medications (03:26:06)
So much sense in fact that I'm just struck by how divergent it is from what I think most people think of when they think of therapy or that some of the risks of going to a psychiatrist which I think it's only fair to consider in particular the way that at least from my outside non-clinical understanding these sorts of situations of high levels of demoralization or excessive aggression or just people not being in the place or being able to exert their actions in the world the way they want or not get the results they want is they'll start asking questions like, you know, maybe have a chemical imbalance or maybe they'll go to a clinician, maybe a cognitive behavioral therapist or a psychiatrist and more often than not it seems they'll get, you know, prescription for x number of milligrams of some serotonergic agonist or dopaminergic agonist. And of course as a neurobiologist, I, you know, I applaud the exploration of underlying brain mechanisms and the involvement of neuromodulators like dopamine and serotonin. But what you're describing today is very different. I think then what most people can expect if they go to the typical psychiatrist or typical psychologist, which is part of the reason we're having this conversation. But I'd love your thoughts on that. And I don't want to make this about me. I only offer this anecdote as a way to round out a little bit of the earlier discussion. I'll never share this publicly. But when I was a postdoc and going through that very hard phase of competition that I didn't want and having a hard time staying in touch with that and there were some other developmental things starting to resurface just by virtue of moving back to the town I grew up in etcetera. I recall getting to the stairway of the building I was working in at the time, which is the same one where my laboratory exists now actually. And realizing I couldn't go up the stairway. I've always been reasonably fit and just being so exhausted and then driving home that day on 280 and thinking, you know, like, none of this matters. Like, what am I doing? Like, none of it matters. I could have been exhausted. I don't know what it was. But what that ultimately resulted in was me talking to a psychiatrist who gave me a low dose of a of a of a serotonergic antidepressant. I took that low dose of serotonergic antidepressant. I don't recall which one it was. Maybe it was the telepram. Would that make sense? And spent that evening staring at my plate of Thai noodles for about two hours. It hit me really hard. And and I hated that feeling and then just stopped taking the drug. Now, I'm not, this is no knock on the telepram or the use of serotonergic agents in the proper context. They've saved lives. So the problematic too. But I just, you know, that wasn't the route that eventually got me out of it. It was mainly talk therapy and and self-care. But I just offer that because I, you know, I even as a neurobiologist, I perhaps, especially as a neurobiologist, I thought, okay, here's the solution. Right? It's going to shift some internal modulatory system. And I'm going to feel okay about the situation I'm in. And thank goodness, it didn't work even for a short while because the while I didn't do all the things that you're describing here of exploring the function of self because no one has ever laid this out for me. I took the route of talk therapy, which I find immensely beneficial. It takes time, but immensely beneficial. So what are your thoughts on the current strategies for diagnosis? Where those succeed, where they fall short and the role of medication in navigating this, you know, simple and yet complex landscape. Right? We are so dramatically over reductionist, you know, it's almost to the point of unbelievable. I mean, think about getting a medicine, getting some say, sitalopram because of what happened, right? It can't possibly work. Right? Now maybe a judiciously chosen medicine could provide a little more distress tolerance and you could sort of think about it more and you could find your way through it. But clearly it was an issue of self, right? Like you're in a situation that was high stress and you're going to have to have this competition or not is it going to be good for you? And, you know, you don't want that, but can you avoid it? Like there's something going on that makes you not be able to walk up those stairs, right? So again, I'm not criticizing, I don't want the person, what kind of conversations you had about it with the person, but the idea that a pill will fix that is like that's insane, right? Now medicines can help smooth the way. So let's say you initially went in the first time you see someone and they said, okay, we have to talk about this, right? Like what's going on in your life? And you know, because normally you can walk upstairs and go to work, right? Why can't you now? Like we need to think about that when you talk about that. Let's say you start doing that and you're having a lot of trouble with it. We're just having really high levels of anxiety. We might say, like a medicine can kind of take the temperature down a little bit, you know, give you a little more distressed tolerance. And then, you know, we can, you can think about it better inside of you and we can talk about it better, but it's medicine in the service of understanding. Now, sometimes medicines are doing things like medicines that can help prevent bipolar episodes, right? Like they're doing something that is purely biological, but we use so many medicines for things that are not biological, they're psychological, but we're so over reductionist that we could actually over reduce the problem that you said, right? Like a clear, wow, that's fascinating, right? Like how many times have you gone up those stairs and now you can't? It's so interesting, the idea of like, let's just give you a pill. I mean, it really makes no sense, but if we're over reductionist enough, you could see how that's the logical endpoint of an illogical process, right? And I'll give you another example, and this is really, it's a true story of a woman who, young woman comes into the emergency room and she says, she can't sleep and, you know, she looks anxious and she feels very, very anxious, you know, by her description and that's why she can't sleep and she gets a sleeping medicine and she goes home and then she comes back, she comes back a couple of days later and she's very, very anxious and she can't sleep and she looks like she did before or like nothing that seems to be different and she hasn't gotten any sleep at all. So the doctor in charge gives her a higher dose of the sleeping medicine. Then she goes home and then she comes back yet again and nothing is any different. She's still not sleeping, she's still anxious and then the doctor concludes that she's drug seeking because she wants more and more of the sleeping medicine, okay? Was actually going on was she was getting hurt at home, she was terrified to go home. Of course she couldn't sleep, right? Like bad things were happening, right? But no one asked the question, right? They thought she cannot sleep, will give sleeping medicine, right? Instead of asking why, right? And then she gets home, she sent home and when the medicine doesn't work, well, now there's something wrong with her, right? And if you put that label on her, now she's drug seeking, right, then she's not going to get any help, right? So I'm not against medicines. I mean, I use psychopharmacology as part of my practice and I think from a biologically based perspective about many things. But we have to know what something is the answer for and what something is not the answer for. And in the overly reductionist world of throughput in healthcare systems, people are even being trained these days that don't know any different, right? And I don't try to be overly critical of practitioners because often practitioners are working in impossible situations where the goal is through throughput and that's more efficient in the short term, right? It's more efficient today, right? But it's of course not good in anything but the today term and it's interesting because it's never good for the person even today. It's like never good for the people in it, right? But often these decisions are being made based upon business and money. And I understand business and money. I'm a capitalist. I'm interested in these things. But the way that we have let things get, the business and money with a short-sighted, short-term perspective then bonds with the over reductionist ways that we approach medicine and then we have these bizarre things happen and these kind of bizarre things and lives, right? It changed the courses of lives. Like fortunately, you got what you needed and you figured things out. But if you hadn't, would you have the career you have? We don't know, right? Or if someone else hadn't realized, like, let's talk to that woman and see what's going on, they'll, would she have survived? I mean, we don't know. The point of that is lots of bad things happen, right? We're rolling the dice too many times with too many people and it doesn't have to be that way. And the way that we're doing it now is not only inefficient, financially, right? The thing that we seem to be caring about most, it leads to bad outcomes and it also makes no sense, right? We're looking at it through this sort of bizarre lens, then we may find within us the strength to change that and to change it in a way that actually fits the science and fits the common sense. I have to imagine that both for people who require medication in order to cope, in order to manage their way through these questions about function of self and how they are in the world, what they're paying attention to, etc.
Role of Medicine in Exploration (03:35:33)
And for people who don't require medication to do this exploration, that this very same exploration is the roadmap to feeling agency, gratitude, peace, contentment, and delight. Medicines may have a role. So if, for example, we go look at the pillars and things are not going so well and you see that whenever that person has a bipolar manic episode, while things get really, really damaged and it's very, very hard, they can't recover from that in the ways they want to, then we'd say, "We're going to use medicine to help this." Now, of course, there are other things too, use behavioral changes, for example. But there's a clear biological role just like we use medicine to stop seizures. But people also have to make sure they're not super sleep deprived. There's another part to it too. We can use medicine to prevent bipolar episodes, but there's another part of self care involved too. But it's a role of medicine. Just as if anxiety levels aren't coming down too much, say for the person to get at the trauma, they know there's a trauma, they've talked around it for 20 years, they know it's been impacting them, they're not sure how it's hard to go there. They're with a trusted therapist, but it's still hard to put words to it and now they're maybe having a panic attack. We can use medicines to take the temperature down, to sort of ease that person's way forward so that they can understand something, that then provides a resolution in that part of the pillar and then things are set in a better place. So the biological aspect, specifically here we're talking about medicines has its place, but the idea that medicines are a substitute for understanding, just makes no sense. Well, you've provided us an incredible framework. Thank you. This framework really speaks to all of us, right? The components that make us who we are, put it the structure of the self, everything from the unconscious mind, conscious mind, defense mechanisms, character structure, self. And the functions of self, these components of self awareness, defense mechanisms reaching up from that iceberg under the water, what we pay attention to our behaviors and hopefully our strivings and sense of hope, and how those two pillars flow up into empowerment, humility, agency and gratitude, again, as action terms, as active terms, and eventually to peace, contentment and delight in this notion of generative drive, as well as some of the pitfalls and challenges that can pull down on generative drive or occlude generative drive. And you very clearly pointed us to where we should all look in terms of understanding ourselves better and where we could do better and be better in the world. Because this is a series, we have the wonderful opportunity to have you tell us even more about how this structure plays out, both in terms of its healthy expression and in terms of its unhealthy expression, in different pathologic conditions that most of us are familiar with, at least in name. And I'm sure you're going to tell us more about what the real, both underpinnings and expressions of things like narcissism and extreme and mild form, anxiety and its extreme and mild forms, and also some of the names and diagnoses that we're more familiar with hearing about, such as bipolar disorder, obsessive compulsive things of that sort. But that all relate back to and really are nested in this structure and function of self and where it can all go. So, first of all, I want to say, and thank you, really an immense thank you for for defining this structure and making it so clear to me and to everybody else. And as you said, it has its complexity. There's in fact, immense complexity down there at the bottom, but that flows up from complex to very simple ideals and a roadmap to get there. And again, the PDF is available to people as a link in the show note captions. Should they want to see this in visual form? I also want to thank you for assembling this structure, not just as a tutorial, but because at least to my knowledge, no such structure or summary of these structures exists anywhere in the world. And certainly not in any form that the non-clinician and not highly trained psychiatrists could ever access or understand. So, this is both an immense resource and an immense gift to us all. Thank you so very much. You're so welcome and thank you for having me here, which is a gift. To be continued in the next episode. Thank you. Thank you for joining me for this first episode of our series on mental health with Dr. Paul Conti. And I encourage you to keep an eye out for the second episode in this series, which is going to be about how to improve your mental health. I'll just remind you that all episodes of the Huberman Lab podcast can be accessed completely zero cost and in all formats by going to HubermanLab.com.
Final Notes And Acknowledgements
Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Social Media, Momentous, Neural Network Newsletter (03:40:41)
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